St. Vincent Carmel Hosp/CFD
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APPROVED. AS TO
FORM 8Y:~
AGREEMENT FOR LIFE SUPPORT SERVICES
THIS AGREEMENT ("Agreement") is entered into by and between ST. VINCENT
CARMEL HOSPITAL, INC., an Indiana not-far-profit corporation (hereinafter "Hospital"), and
~:tITY OF CARMEL FIRE DEPARTMENT (hereinafter "Carmel").
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WHEREAS, Hospital desires to act as a Supervising Hospital, as defined by the State
Emergency Medical Services Commission (the "Commission"), in training, supervising and
evaluating EMS personnel and Paramedic Students in the furnishing of emergency mcdical
services; and
WHEREAS, this Agreement is intended to satisfy Hospital's obligation, as a Supervising
Hospital, to have a written contractual agreement with one or more emergency medical services
provider organizations that furnish Life Support services; and
WHEREAS, Hospital desires to provide Life Support Educational Experiences far its
Paramedic Students that would involve said Paramedic Students providing Life Support services
while aboard ambulances and in the Hospital; and
WHEREAS, Carmel has available to it ambulances in which a qualified Paramedic
Preceptor, employed by or affiliated with Hospital, could provide certain Educational Experiences
for the Paramedic Students; and
WHEREAS, Carmel is willing to allow the Paramedic Preceptors to provide Life Support
Educational Experiences for the Paramedic Students in such ambulances; and
WHEREAS, Carmel is a governmental entity which is certified by the Commission to
provide emergency medical services to the residents of Carmel, Ma,;o,1 County, Indiana; and
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WHEREAS, Carmel desires Hospital to provide training for its EMS personnel and
Paramedic Students and to be a Supervising Hospital for Carmel's Life Support services.
NOW, THEREFORE, in consideration of the mutual covenants contained herein, the
parties agree as follows:
I. DEFINITIONS
Unless otherwise clearly required by the context of this Agreement, the terms set forth
below shall have the following meanings. Other terms used herein shall have the meanings
ascribed thereto in the Act, as defined below.
1.1 "Life Support" shall mean basic Life Support and advanced Life Support as those
terms are defined in the Act.
1.2 "Educational Experiences" shall mean those experiences provided by the Paramedic
Preceptor pursuant to the terms of this Agrcemcnt.
1.3 "Act" shall mean the Emergency Medical Services Act, as outlined in Title 16,
Article 31, of the Indiana Code, and the regulations promulgated thereunder in Title
836 of the Indiana Administrative Code, Articles I through 4.
1.4 "Paramedic Student" or "Student" shall mean a Paramedic Student.
1.5 "Paramedic Preceptor" or "Preceptor" shall mean those certified individuals
employed by or affiliated with Hospital that are qualified to act as
Preceptor/Instructor for Paramedic Students.
1.6 "Policies of Hospital" shall mean and include the Bylaws and rules of Hospital, the
Bylaws and rules of the Medical Staff as approved by Hospital Board of Directors,
and other established policies, practices and procedures of Hospital.
1.7 "Medical Director" shall mean a physician or physician designate, appointed by
Hospital and authorized in writing by Hospital's rvedical staff, who shall act as the
Medical Director for Hospital in its role as Supervising Hospital for Carmel.
1.8 "Workforce Member" shall mean employees, volunteers, trainees, and other persons
whose conduct, in the performance of work for the Hospital, is under the direct
control of the Hospital, whether or not they are paid by the Hospital.
1.9 "EMS Personnel" shall mean those individuals who are employed by Carmel as
certified EMT's or Paramedics.
II. HOSPITAL SERVICES
2.1 Certification of Hospital. Hospital shall remain certified as a Supervising Hospital
throughout the term of this Agreement.
2.2 Services. Hospital agrees to provide medical supervision of Life Support services
performed by Carmel's Paramedics in accordance with the Act.
2.2-1 Continuing Education. Hospital shall provide continuing education and
instruction from time to time for Paramedics. Hospital agrees to provide
continuing education and instruction in accordance with applicable
regulations promulgated by the Commission and any other requirements
established by the Commission. Hospital may establish guidelines or
requirements which exceed those established by the Commission if such is
deemed advisable by Hospital in the interests of quality patient care. Carmel
agrees that it shall not employ nor permit a Paramedic to perform Life
Support services unless the Paramedic has successfully achieved the
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objectives of continuing education as determined by Hospital. Carmel agrees
to comply with any additional guidelines or requirements established by
Hospital.
2.2-2 Audit and Review. Hospital shall provide audit and review services from
time to time for the purpose of assessing the level of performance of Carmel's
individual Paramedics and the overall performance levels of Carmel in its
rendering of Life Support services. Hospital shall provide Carmel with data
relevant to the quality of care provided by its Paramedics and its general
performance of Life Support serviccs. Such audit and review services will
include, but are not limited to: routine audits of patient care based on review
of patient records; observance of field operations; inspections of equipment
and facilities; and critiques of radio communications.
Hospital shall also audit and review medical procedures performed by
Carmel's clinical personnel in order to ensure an appropriate level of
compliance with medical protocols, and an appropriate level of skill in the
performance of medical techniques by those personnel.
2.2-3 Medical Control and Direction.
(a) Protocols. Hospital shall utilize and make available to Carmel upon
request the Marion County EMS Protocols and any additional
policies, procedures and protocols Hospital deems appropriate for
medical control and/or standing orders to ensure the proper response
to all emergency situations by Paramedics.
(b) Location of Protocols. Copies of complete and current protocols are
to be kept in all Carmel certified emergency medical vehicles, the
Carmel dispatcher's office and in Hospital's emergency department.
A copy shall also be provided to the Commission. Carmel shall be
responsible for distributing a copy of the protocols to every EMT and
Paramedic and shall also distribute a copy of every written
termination or modification of a protocol to every EMT and
Paramedic. Hospital shall post copies of all written protocols and
copies of every written termination or revision of a protocol in
Hospital's emergency department and shall make them immediately
available upon request.
(c) Phvsicians' Orders. Direct communication of an instruction or order
from a physician in Hospital's Emergency Department shall take
precedence over all written protocols.
(d) Performance Standards. Hospital may establish standards regarding
overall performance of Paramedics which may exceed those
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established by the Commission as Hospital deems advisable in the
interest of quality patient care. Carmel agrees to comply with all such
performance standards within ninety (90) days after written notice of
such performance standards is provided to Carmel by Hospital. This
ninety (90) day notice requirement shall not apply if Hospital
determines that the performance standards must be implemented in a
shorter period of time or upon immediate notice for medical or patient
care reasons. If such a determination is made by Hospital and is
indicated in the written notice, then Carmel agrees to implement the
performance standards immediately upon receipt of said notice or as
otherwise directed in the notice.
2.2-4 Emergencv Medical Drugs and Suoolies. All drugs and supplies required for
the rendering of Life Support services shall be supplied to Carmel by
Hospital. Hospital shall provide Carmel with a new drug or supply item or its
equivalent when Carmel presents Hospital with a used drug or supply item or
documented proof that such drug or supply item has been used. Lost, stolen
or misused drugs or supplies shall only be provided when specifically ordered
in writing by Medical Director. Carmel agrees to comply with all
accountability and documentation requirements established by the Indiana
Board of Pharmacy and all policies and procedures of Hospital and its
pharmacy regarding such. Carmel shall reimburse Hospital for such drugs
and supplies pursuant to Section 5.1.
2.3 Emergcncy Medical Equioment. Hospital shall monitor the type and quality of
emergency medical equipment used by Carmel in the provision of Life Support
services. Hospital shall make recommendations to Carmel for the use of appropriate
emergency medical equipment. Carmel may purchase or lease certain emergency
medical equipment from Hospital. Hospital shall train Carmel personnel in the
proper use of such equipment. Hospital's bio-medical engineering service shall
repair Carmel's monitor defibrillator and other emergency medical equipment when
such is repairable in the opinion of the bio-medical engineering department.
Purchased, leased or repaired equipment under this Paragraph shall be limited to
equipment necessary and appropriate for Carmel to provide emergency medical
services. Carmel hereby agrees to use such equipment only for such limited
purposes. Carmel shall reimburse Hospital for such emergency medical equipment,
and repair thereof, pursuant to Section 5. r.
2.4 Medical Director. Hospital shall provide a physician or physician designate,
authorized in writing by Hospital's medical staff, who shall act as Medical Director
for Hospital in its role as Supervising Hospital for Carmel. Medical Director shall at
all times be immediately available to supervise the medical p'rocedures performed by
Carmel's clinical personnel via the voice communication system identified in Section
2.8. Medical Director, or his/her designee, shall be appointed by Hospital.
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2.5 Certification Contingencv. The provision of services as described in this Article II is
contingent upon Carmel remaining certified by the Commission as a Paramedic
organization for the rendering of Life Support services. Hospital shall be under no
obligation to provide the services described in this Agreement and shall not provide
said services until Carmel provides Hospital with documented proof that it is
currently certified by the Commission as a Paramedic organization for the rendering
of Life Support services.
2.6 Competencv Review. Hospital shall annually review the competency of the clinical
personnel of Carmel. Hospital shall annually send a letter to Carmel attesting to the
competency of such personnel.
2.7 Reporting Changes. Hospital shall report in writing to Carmel any material changes
to the parties relationship under this Agreement, including changes in key clinical
Hospital personnel. Such reports shall be made within thirty (30) days of such
material change.
2.8 Voice Communication Svstem. Carmel shall provide means of voice communication
to Hospital for medical control. The form of communication may be through the
Metropolitan Emergency Communication Agency 800 MHz tronked radio system;
the Indiana Hospital Emergency Radio Network; cellular telephones as owned and
operated by Carmel; or by standard telephone lines available for emergency crews to
utilize.
III. PARAMEDIC TRAINING SERVICES
3.1 Paramedic Training Services. Hospital agrees to provide a Preceptor and Paramedic
training services for Paramedic Students in accordance with the requirements and
standards for emergency Paramedic training set forth in the Act (hereinafter
"Training Program").
3.2 Initial Training of Paramedic Students. Hospital agrees to provide didactic and
clinical Life Support training for properly qualified individuals as part of the
Training Program. Carmel agrees that Hospital shall have the responsibility and
authority for evaluating Paramedic Students during the Training Program and for
determining whether the Paramedic Students have successfully achieved the
objectives of the Training Program.
Hospital's guidelines established for the Training Program shall comply with the
current guidelines and regulations established by the Commission. Hospital may
establish guidelines for the Training Program which exceed those promulgated by
the Commission. Carmel agrees to comply with any such requirements established
by Hospital.
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Paramedic Students shall be instructed by Paramedic Preceptors who are either
employed by Hospital or affiliated therewith, on-duty, and who are Hospital-
approved fire department Paramedics. The Paramedic Preceptor will observe the
Paramedic Student during the course of instruction and in the performance of his/her
duties. Students who are employees of Carmel may be precepted while on duty with
Carmel by a Preceptor upon mutual agreement of the parties.
Hospital shall dismiss any Paramedic Student from the Program if the Paramedic
Student is determined by Hospital to be unacceptable for reasons of health,
performance, or any other cause which could interfere with Hospital's operation or
quality of patient care.
3.3 Preceptors. Paramedic Preceptors who are either employed by Hospital or affiliated
therewith shall observe the Paramedics from time-to-time in the performance of their
duties and responsibilities. Paramedic Preceptors shall comply with the requirements
of the Act.
3.4 Qualifications of Paramedic Students and Paramedics. Paramedic students and
Paramedics must meet and maintain during the term of this Agreement all
requirements established by the Commission. Carmel is responsible for requiring its
Paramedic Students and Paramedics to meet such Commission requirements and
shall provide verification of such when requested by Hospital.
A Paramedic Student and a Paramedic shall not be permitted to perform any Life
Support skills unless said Paramedic Student or Paramedic has first been approved in
writing by Hospital and provided that such written approval has not been withdrawn
or modified by Hospital.
3.5 Health Screening of Students. Carmel shall assign only Students believed to be in
good health at the time of reporting for their Educational Experience. Prior to
admission to Hospital to perform clinical services and prior to participation in the
Field Internship Phase of the Educational Experience or Training Program, Carmel
shall ensure that each Student is in compliance with Hospital health and safety
screening requirements as set forth in Exhibit "A", attached hereto and incorporated
herein. Carmel shall attest in writing that each Student is in compliance with the
screening requirements in Exhibit "A". Carmel shall permit Hospital to audit its
records upon request to assure compliance with this Section.
IV. RESPONSIBILITIES OF CARMEL
4. I Regulatory and Hospital Standards. Carmel shall be solely responsible for
maintaining compliance with all federal, state and local emergency medical service
and Life Support laws and regulations with regard to its mobile intensive care
ambulances, its employees or independent contractors, its use of drugs, supplies, and
equipment and its general operation as a Paramedic organization. Carmel agrees to
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comply with OSHA requirements including blood-borne and airborne pathogens
during the Field Internship Phase of the Educational Experience or Training
Program.
Carmel further agrees to comply with all guidelines and standards established by
Hospital for training, continuing education and performance evaluation of Carmel
employees or independent contractors.
It is agreed that Hospital has no responsibility for verifying that Carmel and/or its
employees or independent contractors satisfy all federal, state and local requirements
as referenced above.
As directed by Carmel personnel, Hospital personnel and students shall also comply
with such OSHA requirements while aboard Carmel mobile intensive care
ambulances.
4.2 Primary Dutv of Paramedic to Contact Phvsician. Carmel understands and is
responsible for informing its employees and independent contractors that protocols
are not intended to encourage autonomous action by Paramedics. The purpose of
such protocols are to equip the Paramedic with a grasp of what is expected of him in
particular emergency situations to prevent the loss of valuable time. Carmel's
Paramedics shall establish radio or telephone contact with Hospital's emergency
department before intervening with Life Support care, except for providing
emergency first aid as allowed under the protocols established by Hospital.
4.3 Unsuccessful Attempts to Communicate. Unsuccessful attempts to establish radio
communication with Hospital emergency department by Paramedics neither absolves
Paramedics nor Carmel from responsibility to solicit direction from Hospital
emergency department's Physicians, nor does it constitute authority for the
Paramedic to perform any or all ofthe Life Support skills, except in those specific
instances as allowed in the protocols. Paramedics are responsible for continuing
attempts to contact Hospital emergency department by radio, telephone or any other
means that are available, both at the scene and while transporting the patient to
Hospital.
4.4 Dutv to Implement Standards. Carmel is responsible for implementing and
following all performance standards, protocols and requirements of Hospital and the
Commission, as such pertain to the rendering of emergency medical services and
Life Support services.
4.5 Confidential Information. Carmel shall instruct Students on their responsibility for
respecting the confidential and privileged nature of information which may come to
their attention in regard to patient medical records and other Hospital information.
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V. REIMBURSEMENT
5.1 Reimbursement. In consideration of this Agreement, Carmel agrees to reimburse
Hospital or its designee for the provision of drugs and supplies under Paragraph
2.2-4, the purchase, lease and repair of emergency medical equipment under
Paragraph 2.3, and the purchase of training book and supplies. Reimbursement shall
be reflective of the total cost for each item or service as incurred by Hospital or its
designee.
5.2 Billing. Hospital shall bill Carmel only for those items and/or services listed under
Paragraph 5.1. Hospital shall remit an itemized invoice to Carmel for such items
and/or services on a monthly basis. Complete payment on each invoice is due within
net thirty (30) days unless otherwise agreed in writing between the parties.
VI. INSURANCE
6.1 Worker's Compensation. Both parties agree to carry worker's compensation
insurance covering all of its employees and employer's liability insurance in an
amount not less than $1,000,000. Said worker's compensation policy shall contain
an endorsement waiving subrogation rights against Hospital.
6.2 Comprehensive and Propertv Damage Liabilitv. Both parties shall carry occurrence
form, primary commercial general liability insurance in minimum amounts of
$1,000,000 per occurrence, and $2,000,000 general aggregate, and combined single
limit on $1,000,000 bodily injury, $1,000,000 property damage and $2,000,000
general aggregate. Such policies shall also include contractual liability protection
insurance to satisfy both parties' indemnification obligations set out in Article VIII
below.
6.3 Professional Liabilitv. Both parties shall carry medical malpractice insurance with
those limits necessary to qualify themselves as providers under the Indiana Medical
Malpractice Act (I.C. 34-18 et ~ and to remain providers thereunder throughout
the term of this Agreement. Professional shall be covered under Hospital's medical
malpractice insurance policy.
6.4 Proof of Coverage. Each party, upon request, shall provide the other with
appropriate certificates evidencing the insurance covcrages set out in this Article VI.
VII. STATUS OF THE PARTIES
7.1 Status of the Parties. In performing the services as contemplated hereunder, Hospital
and Carmel agree that Carmel and Students are acting as independent contractors and
not as the agents or employees of Hospital. As appropriate, Carmel agrees to pay, as
they become due, all federal and state income taxes, as well as other taxes, including
self-employment taxes due and payable on the compensation paid to the Faculty by
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Carmel and to indemnify and hold Hospital harmless from any and all taxes,
penalties or interest which might arise by Carmel's failure to do so. This provision
shall survive the termination of this Agreement.
No Student in the Program will be deemed to be an employee of Hospital nor will
Hospital be liable for the payment of any wage, salary, or compensation of any kind
for service provided by the Students. Further, no Student will be covered under
Hospital's Worker's Compensation, Social Security, or Unemployment
Compensation programs.
VIII. INDEMNIFICATION
8.1 Carmel Indemnification. Carmel agrees that it will indemnify and hold harmless
Hospital, its officers, agents, and employees from any loss, cost, damage, expense,
attorney's fees, and liability by reason of bodily injury, property damage, or both of
whatsoever nature or kind, arising out of or as a result of the sole negligent act or
negligent failure to act of Carmel, its agents or employees.
8.2 Hospital Indemnification. Hospital agrees that it will indemnifY and hold harmless
Carmel, its officers, agents, and employees from any loss, cost, damage, expense,
attorney's fees, and liability by reason of personal injury or property damage of
whatsoever nature or kind, arising out of or as a result ofthe sole negligent act or
negligent failure to act of Hospital, its employees or agents.
IX. TERM AND TERMINATION
9.1 Term. The term of this Agreement shall be for one (I) year commencing on the 1st
day of August, 2006, and terminating on the 31 sl day of July, 2007.. Thereafter, the
Agreement is automatically renewable for successive one (1) year terms unless either
party gives notice of termination at least sixty (60) days prior to the end of the then
current term.
9.2 Termination. This Agreement may be terminated as follows: .
9.2-1 Termination bv Agreement. In the event Hospital and Carmel shall mutually
agree in writing, this Agreement may be terminated on terms and date
stipulated therein.
9.2-2 Earlv Termination. This Agreement may be terminated by either party with
or without cause by delivering a written notice of termination to the other
party at least thirty (30) days prior to such early termination. Such early
termination shall not prejudice the rights of the currently enrolled Paramedic
Students to complete the Training Program.
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9.2-3 Termination ofIndividual Paramedic. .Carmel shall terminate the services of
a Paramedic or a Paramedic Student in the performance of Life Support
skills, upon receipt of written notice from Hospital that such individual failed
to exhibit satisfactory performance during the Training Program, or at any
time subsequent to the completion of the Training Program. Hospital shall
not, though, have any affirmative duty or responsibility to notify Carmel to
terminate a specific Paramedic or Paramedic Student unless Hospital has
actual knowledge that said Paramedic or Paramedic Student is not performing
Life Support skills in a satisfactory manner or that he consistently or
repeatedly fails to perform Paramedic duties in accordance with the current
protocols.
X. ETHICAL AND RELIGIOUS DIRECTIVES
The parties acknowledge that Hospital conducts its operations in a manner consistent with
the Ethical and Religious Directives for Catholic Health Care Services as promulgated by
the United States Conference of Catholic Bishops, Washington, D.C., of the Roman Catholic
Church or its successor. Nothing in this Agreement shall be construed to require Hospital,
its employees or affiliates, to violate the Directives.
XI. REGULATORY AND CORPORATE COMPLIANCE
11.1 Regulatorv Compliance. The parties agree that this Agreement is intended to comply
with all applicable Hospital group purchasing contracts and state and federal laws,
rules, regulations and accreditation standards, including, but not limited to, the
Medicare and Medicaid Fraud and Abuse Statute and Regulations; Indiana
regulations for Supervising Hospitals; the Robinson-Patman Price Discrimination
Act; the Non-Profit Institutions Act; the Food and Drug Administration regulations;
the Indiana Pharmacy Board statutes; the JCAHO Accreditation Standards; and all
regulations governing use offacilities financed with tax exempt bonds ("Laws").
If, at any time, this Agreement is found to violate any applicable provision of these
Laws, or if any party has a reasonable belief that this Agreement creates a material
risk of violating any Laws, and after consultation with the other party, and after
thirty (30) days written notice to the other party, the parties shall renegotiate the
portion of this Agreement that creates the violation or risk of violation of the Laws.
If the parties fail to reach agreement, this Agreement shall automatically terminate
thirty (30) days after said written notice.
11.2 Corporate Compliance. Hospital has in place a Corporate Compliance Program (the
"Program") which has as its goal to ensure that Hospital complies with federal, state
and local laws and regulations. The Program focuses on risk management, the
promotion of good corporate citizenship, including the commitment to uphold a high
standard of ethical and legal business practices, and the prevention of misconduct.
Carmel acknowledges Hospital's commitment to the Program and agrees to conduct
all business transactions which occur pursuant to this Agreement in accordance with
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the underlying philosophy of the Program adopted by Hospital. Carmel further
agrees to disclose immediately any proposed or actual debarment, exclusion or other
event that makes Carmel ineligible to participate in Federal health care programs or
Federal procurement or non-procurement programs.
11.3 HIP AA Compliance. Hospital and Carmel agree that each party shall comply with
all federal and state regulations, rules and orders, including but not limited to
regulations promulgated under Section 264 of the Health Insurance Portability and
Accountability Act (Public Law 104-91 - "HIPAA"). Hospital and Carmel agree,
that for purposes of HIP AA only, Students shall be considered members of the
Hospital's Workforce, as that term is defined by HIPAA, and the Carmel agrees to
require Students to participate in any training required by Hospital for Workforce
members so that Hospital may comply with HIPAA. For all other purposes the
parties agree that each is acting as an independent contractor and not an agent or
employee of the other. Furthermore, the parties shall promptly amend the
Agreement to conform with any new or revised legislation, rules and regulations to
which Hospital is subject now or in the future including, without limitation, the
Standards for Privacy of Individually Identifiable Health Information or similar
legislation (collectively, "Laws") in order to ensure that Hospital is at all times in
conformance with all Laws. If, within thirty (30) days of either party first providing
notice to the other of the need to amend the Agreement to comply with Laws, the
parties, acting in good faith, are (i) unable to mutually agree upon and make
amendments or alterations to this Agreement to meet the requirements in question, or
(ii) alternatively, the parties determine in good faith that amendments or alterations
to the requirements are not feasible, then either party may terminate this Agreement
upon thirty (30) days prior written notice.
XII. GENERAL PROVISIONS
12.1 Amendments. This Agreement may be amended only by an instrument in writing
signed by the parties hereto.
12.2 Assif!:nment. Assignments of this Agreement or the rights or obligations hereunder
shall be invalid without the specific written consent of the other party herein, except.
that this Agreement may be assigned by Hospital without the written approval of
Carmel to any successor entity operating the facility now operated by Hospital or to
a related or affiliated organization.
12.3 Confidentiality. Hospital and Carmel agree that the terms and conditions of this
Agreement shall remain confidential. Neither Hospital nor Carmel shall distribute
this Agreement or any part thereof or reveal any of the terms of this Agreement to
parties other than their employees or agents.
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12.4 Entire Agreement. This Agreement supersedes all previous contracts or agreements
between the parties with respect to the same subject matter and does constitute the
entire Agreement between the parties hereto and Hospital and Carmel shall neither
be entitled to other benefits than those herein specifically enumerated.
12.5 Execution. This Agreement and ariy amendments thereto shall be executed in
duplicate copies on behalf of Hospital and Carmel by an official of each specifically
authorized to perform such executions. Each duplicate copy shall be deemed an .
original, but both duplicate originals together constitute one and the same instrument.
12.6 Governing Law. This Agreement shall be construed and governed by the laws of the
State ofIndiana.
12.7 Notices. Notices or communications herein required or permitted shall be given to
the respective parties by registered or certified mail (said notice being deemed given
as of the date of mailing) or by hand delivery at the following addresses unless either
party shall otherwise designate its new address by written notice:
CARMEL
City of Carmel
Fire Department
Carmel Board of Public
Works and Safety
One Civic Square
Carmel, IN 46032
HOSPITAL
St. Vincent Carmel Hospital, Inc.
Michael D. Chittenden, President
13500 N. Meridian Street
Carmel, IN 46032
Copies To:
St. Vincent Contract Management
8402 Harcourt Road, Suite 823
Indianapolis, IN 46260
City of Carmel Attorney
I Civic Square
Carmel, IN 46032
12.8 Severability. In the event that any provision hereof is found invalid or.unenforceable
pursuant to judicial decree or decision, the remainder of this Agreement shall remain
valid and enforceable according to its terms.
12.9 Waiver of Breach. The waiver by either party of a breach or violation of any
provision of this Agreement shall not operate as nor be construed to be, a waiver of
any subsequent breach hereof.
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IN WITNESS WHEREOF, the duly authorized officers and representatives of Hospital
and Carmel have executed this Agreement on the dates written below.
ST. VINCENT CARMEL HOSPITAL, INC.
By: ~~:Po C'ji6~~
ichael D. Chittenden: President
Date:
~ / /~/t') (..
I
CITY OF CARMEL, INDIANA
by and through its Board of Public
Works and Safety
By: /.-- ~_.--;~
I' James Brainard, Mayor
By:
By:
---v1A f ~
Lori Watson, Member
. By:
Diana Cordray, .Clei'
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, ...-...."'{'..".
JI~ rc
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,
Date:
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DOXBOX/212797 _3BAK
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EXHIBIT "A"
HEALTH AND SAFETY SCREENING REQUIREMENTS
Carmel shall provide documentation to Hospital attesting to the assigned Student's, medical
clearance. This documentation shall reflect Carmel's process for providing ongoing evaluation that:
1. The Student is free of communicable disease;
2. Carmel has documented evidence of Student's immunity to communicable disease;
3. Student is physically capable of performing job tasks (with or without reasonable
accommodation);
4. Student has awareness of actual and potential medical issues impacting safety in job
role as defined by Hospital; and
5. Student is compliant with Carmel's routine surveillance and incident reporting system.
The documentation shall reflect the Carmel's program of providing basic employee health
and safety information including:
1. Education consistent with Occupational Safety and Health Administration ("OSHA")
and Centers for Disease Control ("CDC") Directives (i.e. Blood Borne Pathogens,
Respiratory Protection, Tuberculosis Control, Infectious Disease, Safety Device Use);
2. Medical evaluation and screening in preplacement process;
3. Access to medical services for injury and illness assessment and care; and
4. An injury and illness reporting system that meets state, federal, and accreditation
standards (OSHA log, First Report of Injury, OSHA Sharps Injury Log, Medical
Records Custodianship for thirty (30) years).
Pre-Placement Medical Classification. Carmel shall provide or work with Hospital to
provide immunity screenings for (i) rubeola, (ii) rubella, (iii) varicella, and (iv) hepatitis B antibody
(if previously completed full series of Hepatitis B vaccination), as well as infectious disease
screening for (i) tuberculosis, (ii) Hepatitis B (for work assignments with Bloodborne Pathogen
Exposure risk), and (iii) Hepatitis C (for work assignments with Bloodborne Pathogen Exposure
risk). All such screenings shall be performed in a manner consistent with OSHA, CDC, and any
other regulatory requirements. In the event Carmel provides the screenings, Carmel hereby
warrants and represents to Hospital that the screenings are performed in a manner compliant with
such regulatory requirements.
Physical and Mental Capabilitv. Carmel shall provide documentation of or work with
Hospital to arrange for the following:
I. Evidence that a qualified medical professional has reviewed a thorough history,
performed a physical exam, and determined that the Student is able to perform the
required work associated with the Educational Experience; .
2. If required for the Educational Experience, evaluation of visual acuity and color
perception has determined the Student is capable of performing job tasks with or
without reasonable accommodation; and
3. Cognitive processing, communication abilities, and basic reasoning are appropriate for
Educational Experience requirements; and
4. Evidence of compliance with Hospital's Drug-Free Workplace Policies.
Upon reasonable request of Hospital, Carmel shall provide documentation related to, or
work with Hospital to arrange for, the following:
I. Medical Respiratory Health Screen;
2. Spirometry, as indicated;
3. Classification for use of type-specific respirator required to meet TB regulations and
standards established by OSHA and CDC.(i.e. N-95, PAPR with HEPA); and
4. Respirator Fit-Testing for appropriate respirator device used by Hospital or Carmel
provided P APR (Positive Air Purifying Respirator).
OSHA and JCAHO Compliance. Carmel shall work with Hospital to assure Student:
I. Possesses knowledge of duties in response to Hospital emergency and disaster codes;
2. Displays competency in response to Hospital fire response requirements;
3. Has or obtains training on Hospital Bloodbome Pathogens control plan, safety devices
and use of appropriate Personnel Protective Equipment; and
4. Has or obtains certification of training for all pertinent and applicable OSHA and
JCAHO required competencies.
5. Completes Hospital Non-associate Orientation Manual and submits acknowledgement
page prior to start of work duties.
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Injury and Illness Management. Carmel and Hospital shall work together to have in place
a procedure to be followed by Student in the event Student suffers an injury while providing
services pursuant to this Agreement. Such a procedure shall address the following:
I. Access to Medical Services including options surrounding urgent care, emergency
care and occupational health services; .
2. Injury and Illness Assessment and Care;
3. Infectious Disease Screening, Evaluation and Annual Testing;
4. Work Restriction;
5. Exposure Management addressing:
a. BBP (i.e. splash, stick, sharp cut, mucous membrane)
b. Respiratory Disease (i.e. pertussis, TB)
c. Chemical (i.e. Latex, solvents, inhalation, MSDS)
d. Physical (i.e. ergonomics, repetitive strain)
e. Radiation (i.e. x-ray, laser)
6. Food Borne Illness addressing:
a. Compliance with Indiana State Department of Health policies on Food Borne
Illness.
b. Identification of Educational Experience assignments with food borne illness
transmission risk.
c. Education of Student regarding food borne illness symptoms, reporting, and
work restriction for related illness.
d. Surveillance tracking for food borne illness among assigned Student in order
to identify outbreaks, clusters of Student absence and illness, and a trigger for
reporting Student with food borne illness to the Hospital.
7. Return-to-Work Clearance addressing:
a. Return-to-work following extended absence and suitability to continue
assigned work with or without restrictions;
b. Infectious Disease and potential for transmission - including food borne
illness;
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I,.
c. Impaired Immunity;
d. Temporary Physical Limitations;
e. Permanent Disability Accommodation; and
8. Incident Reporting addressing:
a. OSHA log
b. First Report oflnjury
c. Sharps Log
d. Incident Tracking and Post Incident Intervention
Additional Requirements. Carmel shall work with Hospital to ensure compliance with
. additional health and safety requirements that are enacted after the commencement of this
Agreement or that are mutually agreed to by the parties.
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