HomeMy WebLinkAboutMINUTES - 07261994 - 1.39 TO: j Bb ARD OF SUPERVISORS � • 3�
FROM: Contra
Mark Finucane, Health Services Director
By: Elizabeth A. Spooner, Contracts Administrator Costa
Costa
DATE: County
July 12, 1994 00 `!
SUBJECT: Approval of Unpaid Student Training Agreement #26-204-1 with
Chabot - Las Positas Community College District
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee
(Frank Puglisi) to execute on behalf of the County, Unpaid Student
Training Agreement #26-204-1 with Chabot - Las Positas Community
College District (formerly: South County Community College District) ,
for the period from May 1, 1994 through April 30, 1997, to provide
field instruction and experience in medical records technology for
Chabot College students.
II. FINANCIAL IMPACT:
None
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On June 5, 1990, the Board approved Unpaid Student Training Agreement
#24-204 with Chabot - Las Positas Community College District
(formerly: South County Community College District) . The purpose of
this agreement is to provide medical records technology students with
the opportunity to integrate academic knowledge with application
skills and attitudes at progressively higher levels of performance
requirements and responsibility.
Approval of Unpaid Student Training Agreement #26-204-1 will allow
Chabot College students to receive field instruction and experience in
medical records technology, at Merrithew Memorial Hospital and
Clinics, through April 30, 1997.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMEND 10 OF BOARD C MMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON `^ - �-k> �g`1` APPROVED AS RECOMMENDED ✓ OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
Contact: Frank Puglisi, Jr. (370-5100) OF SUPERVISORS ON THE DATE SHOWN.
CC: Health Services (Contracts) ATTESTED v ';kO�
Risk Management Phi)Batchelor,Clerk of the Board of
Auditor-Controller Supervisors and County Administrator
Contractor
M382/7-88 BY 4.
, DEPUTY
Contra Cbsta County tandard Form
UNPAID STUDENT ::TRAINING AGREEMENT
Number 26-204-1
1. Contract Identification. DRA"r
e
County Department: Health Services (Hospital and Clinics Division)
Subject: Unpaid student training with Department, sponsored by
Contractor
2 . Parties. The County of Contra Costa, California (County) , for its
Department named above, and the following named Contractor mutually
agree and promise as follows:
Contractor: CHABOT - LAS POSITAS COMMUNITY COLLEGE DISTRICT
Capacity: State Educational Institution
Address: 5673 Gibraltar Drive, Pleasanton, California 94588
3 . Term. The effective date of this Agreement is May 1, 1994 and it
terminates April 30, 1997 unless sooner terminated as provided
herein.
4. Termination. This Agreement may be terminated by either party, at its
sole discretion, upon seven-day advance written notice thereof to the
other, or canceled immediately by written mutual consent, subject to
termination conditions (if any) set forth in the Program Plan attached
hereto and incorporated herein by reference.
5. Program. By this Agreement County agrees to . permit unpaid student
training by persons (participants) sponsored by Contractor under the
conditions set forth in Paragraph 1. (Volunteer Program) of the Program
Plan, attached hereto and incorporated herein by reference.
6. Independent Contractor Status. This Agreement is by and between two
independent contractors and is not intended to and shall not be
construed to create the relationship of agent, servant, employee,
partnership, joint venture, or association.
7. Indemnification. Except for those activities of participants covered by
the County's Volunteer policy, each party and its employees, agents and
officers shall be indemnified and held harmless against any and all
claims, demands, or causes of action allegedly arising out of any act or
omission arising as a result of the services provided in this agreement,
of any officer, agent, or employee of the other party, or resulting from
the conditions of any property owned or controlled by the other party.
8. Legal Authority. This Agreement is entered into under and subject to
the following legal authority: ,California Government Code Sec. 26227.
9. Signatures. These signatures attest the parties ' agreement hereto:
COUNTY OF CONTRA COSTA CALIF -BACONTRACTOR
By By
Des ' nee
Recommended by Department
(Designate official capacity)
By
Designee (Form approved by County Counsel)
PROGRAM PLAN
FOR
CLINICAL EXPERIENCE FOR MEDICAL RECORDS TECHNOLOGY
Number 26-204-1
1. Volunteer Program. By this Agreement, County agrees to permit
unpaid student training by persons (participants) sponsored by Contractor
under the following conditions:
a. Services provided under this Agreement are volunteer services,
and participants obtain no employment rights with, or employment benefits
from, the County, by virtue of this Agreement or service hereunder. County's
Unpaid Student Training Participant Agreement, attached hereto and
incorporated herein by reference, is required of every participant.
b. Upon approval by County's Board of Supervisors this Agreement
shall be an authorized volunteer program. The County's volunteer policy and
the County Administrator' s rules and procedures for authorized volunteer
programs, attached hereto, are applicable with respect to this Agreement, and
are incorporated herein by reference together with any amendments thereto,
subject nevertheless to the terms of this Agreement.
2 . Purpose of the Program. Chabot - Las Positas Community College
District conducts an educational course in medical records technology for its
students enrolled in the Health Information Technology Program. The
Contractor desires to have students, enrolled in this program, receive
clinical instruction from the County, and the County is willing to provide
such instruction under the terms and conditions hereinafter set forth.
Therefore, the parties will undertake a program whereby such instruction and
experience will be provided in accordance with a plan mutually agreed to by
the parties.
3 . Contractor's Obligations. In participating in this program,
Contractor shall:
a. Designate students for participation in the clinical
experience conducted pursuant to this Agreement.
b. Suggest dates for the clinical experience periods, and
cooperate with County's Department in establishing assignment schedules
consisting of specific dates for the placement of a specific number of
students with the County for training, which shall be established by mutual
agreement of the respective representatives of the County and the Contractor.
c. Assign for field instruction only those students who are
prepared to a degree ,considered adequate by mutual agreement of the parties
hereto;
d. Make all necessary arrangements so that each student will:
(1) Have completed all the necessary courses required by the
Contractor as preparation for said clinical experience;
Initials:
Contractor County Dept.
1
PROGRAM PLAN
FOR
CLINICAL EXPERIENCE FOR MEDICAL RECORDS TECHNOLOGY
Number 26-204-1
(2) Agree to execute the County's Unpaid Student Training
Participant Agreement upon referral to the training
program;
(3) Arrange for their own transportation to and from the
Health Services Department and for maintenance and
housing during field instruction;
(4) Channel educational problems to the Contractor;
(5) Promptly report illnesses and absence from duty; and
(6) Comply with regulations and standards of conduct
governing professional medical records personnel in the
County Health Services Department.
e. Furnish County with such evidence as County may require that
each student assigned for training hereunder is physically fit.
4 . County's Obligations. In participating in this program, County
shall:
a. Comply with all State statutes and regulations applicable to
the training of medical records technicians enrolled in the Contractor's
program;
b. Accept for clinical experience those students assigned by the
Contractor for such a period and in such numbers as may be mutually agreed;
C. Provide the student with learning experiences needed to meet
the objectives of the training program mutually agreed to by the parties in
accordance with the plan referenced in Paragraph 2. , above; and
d. Have the right to terminate the participation of any student
in the clinical experience for failure to follow the instructions of County,
or for any other reason deemed adequate by County. In the event of such
termination, County shall give prompt written notice to the Contractor.
5. Joint Obligations. County and Contractor shall jointly:
a. Plan a student training program including course content and
student assignment schedule so as to provide a sound and effective
educational program;
b. Review the program at the end of each training period in order
to evaluate progress and recommend changes for the next consecutive training
period; and
C. Plan for periodic review of this Agreement.
Initials:
Contractor County Dept.
2
' f
PROGRAM PLAN
FOR
CLINICAL -EXPERIENCE FOR MEDICAL RECORDS TECHNOLOGY
Number 26-204-1
6. Participants' Obligations. Participants shall:
a. Execute the County's Unpaid Student Training Participant
Agreement upon referral to the training program;
b. Abide by, County policies and regulations;
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C. Conduct themselves in an appropriate professional manner
consistent with responsibility;
d. Observe and respect patient's rights, privacy and dignity; and
e. Comply with applicable County, State and Federal regulations
respecting disclosure of patients ' health information and access to, and
removal of, medical records and/or information contained therein.
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7. Contractor,� County and Participant Agreement. Notwithstanding the
authorization for reimbursement for actual and necessary expenses (including
a flat mileage rate �' of $0. 15 per mile for use of personal vehicles) of
authorized volunteer ';services set forth in the final paragraph of attached
Contra Costa County ;Policy Statement on Volunteers, participant shall be
entitled to no reimbursement by County for said expenses while engaged in the
training program covered by this Agreement.
Initials:
Contractor County Dept.
3
Contra .Costa,County Standard Form
UNPAID STUDENT TRAINING PARTICIPANT AGREEMENT
The County of Contra Costa and the Participant named below agree as follows:
1. Participant will engage in training for a Contra Costa County Department pursuant
to a contract between the County and a contractor sponsoring the participant.
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2. Participant agrees that in connection with such training, participant is a
volunteer, subject to the! County's volunteer policy and regulations, and will obtain no
employment rights or employment benefits from the County and waives any claim to any
employment rights or bene°fits from Contra Costa County based upon participant's training
services, whether or not authorized under such contract.
3. Participant further agrees:
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"I have read the Contra Costa County Policy Statement on Volunteer Programs. In
return for the benefits provided by Contra Costa County in case of my illness, injury, death,
or third party liability while providing, or resulting from acts or occurrences within the
scope of my authorized '1rvolunteer services, and for my right to authorized expense
reimbursement, I waive anyuIclaim on my behalf and on behalf of my heirs, representatives, and
assigns against the County of Contra Costa or any of its agents, servants or employees for
illness, injury, debts or other harm arising from my volunteer services, whether or not
authorized. ,,
4. Participant has read and understands the Unpaid Student Training Agreement
(identified below) between the County and participant's sponsoring contractor and agrees to
and is bound by the terms j, of that contract.
5. County or participant may terminate this agreement upon three day's notice or
without prior notice, for' cause; or by mutual consent; otherwise this agreement terminates
upon termination of the agreement between the County and participant's sponsoring contractor.
6. This agreement is made in consideration of the County accepting participant for
training.
7. Neither the County nor any agent, officer, servant, or employee of the County
shall undertake or incuru any liability or other responsibility respecting the quantity,
quality, kind, or value of the training of participant and no warranty, express or implied
shall exist in that regard.
8. Entire Contract. This Agreement contains all the terms and conditions agreed
upon by the parties. Except as expressly provided herein, no other understandings, oral or
otherwise, regarding the subject matter of this Agreement shall be deemed to exist or to bind
any of the parties hereto.
9. Identification of Unpaid Student Training Agreement: Number 26-204-1
�a
Contractor Chabot - Las Positas Community College District (Chabot College)
County Department Health Services - Hospital and Clinics Division
CONTRA COSTA COUNTY PARTICIPANT
(Printed Name)
By
., (Designee) (Signature)
' pi
CONTRA COSTA COUNTY
POLICY STATEMENT ON VOLUNTEER PROGRAMS
The use of volunteers in performing specific services is a valuable resource
and provides an avenue for citizen participation in various County programs
which is recognized as being of public benefit. In recognition of the
benefits which may be 'derived from volunteer services, it is hereby declared
that it shall be County policy to encourage and promote volunteer programs
determined to be in the public interest.
e
It is County policy that volunteers will not replace County employees but
will provide servicesjto supplement or enrich regular County programs and
services.
This policy statement is designed to provide the framework for all County
volunteer programs and activities. The following guidelines are adopted for
volunteer programs:
VOLUNTEER PROGRAMS
A complete description of each volunteer program shall be submitted by the
department head to the County Administrator for review and presentation to
the Board of Supervisors with his recommendation.
Factors to be considered in evaluating programs are the need for and public
benefit to be derivedfrom the volunteer program, associated County cost and
staff effort required for such a program, the potential for injury to
volunteers, and the (possibility for injury to others including injuries
giving rise to possible liability claims.
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Regulations and procedures including, but not limited to, such matters as
eligibility, training,,, supervision and roster control, may be promulgated by
the County- Administrator for guidance of departments to assure proper
administration and control of volunteer services.
VOLUNTEERS
A volunteer is defined as a person who renders services gratuitously and has
been accepted in the volunteer program. The volunteer is not an employee of
the County.
In recognition of the„ benefit to the County derived from volunteer services,
authorized volunteers serving in programs approved by the Board of
Supervisors shall be �,provided the benefits indicated below.
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CONTRA COSTA COUNTY
POLICY STATEMENT ON VOLUNTEER PROGRAMS
1. Injury to Volunteer. Authorized volunteers are not under the
purview of the workers' compensation laws of California. In lieu thereof and
in return for the vollunteers waiver of any claim against the County for
illness, injury or other harm arising from acts or occurrences while
providing volunteer services, the County shall provide, in the case of
authorized volunteer services, through self-insurance, for reimbursement of
medical expenses and minimum permanent disability compensation equal to that
afforded under the workers' compensation laws of California, provided,
however, that no temporary disability compensation shall be paid and medical
expenses shall be limited to reimbursement for expenditures otherwise
qualified for reimbursement which are not covered by the volunteer' s health
plan, other available insurance coverage, or other third party (i.e. ,
Federal, State or other payment) .
2 . Public Liability. The County through its self-insurance program
shall defend and indemnify volunteers upon request against liability claims
initiated by third parties arising out of acts or omissions occurring within
the scope of authorized volunteer services, unless the volunteer acted or
failed to act because of actual malice, fraud, corruption or gross
negligence. Volunteers using personal automobiles in performing authorized
services must maintain liability insurance at limits which as a minimum
comply with the California Financial Responsibility law and must have a valid
driver's license. TY 'e protection afforded by the County shall be in excess
only of any other valid and collectible public liability or automobile
liability insurance ',' maintained by or which provides coverage for the
volunteer. Volunteers may be permitted to operate County vehicles in the
performance of authorized volunteer services.
x ense Reimbursement.sem
3 E p i r ent. Volunteers shall be reimbursed for actual
and necessary expense's in performance of authorized volunteer services at the
same rates and in accordance with regulations and procedures established for
County employees, except that a flat mileage rate of $0. 15 per mile for use
of personal vehicles will be allowed. No reimbursement will be made for any
child care expenses, mileage from the personal residence of the volunteer to
the County facility or service location or for damage to personal vehicles of
volunteers used when°performing authorized volunteer services.
2
i.
Administrative Bulletin Contra Number 321
Replaces
Office of the County Administrator Costa (Date 2-2 6-7 F�
County Section Porsn„nPl
SUBJECT: Rules and Procedures to be Followed
by County Departments for Authorized
Volunteer Programs
I . GENERAL
This bulle'�tin provides the rules and procedures to be
followed by Couty departments governing entrance, training, and
supervising of volunteers under County authorized volunteer
programs, including the policies and procedures for reimbursement
of expenses ; medical and permanent disability benefits ; and legal
defense and indemnification against liability claims initiated by
third parties . , These regulations and procedures are promulgated
in accordance with the policy adopted by the Board of Supervisors .
II . RULES AND PROCEDURES
County departments shall submit to the Office of the County
Administrator a'! description of each volunteer program, the number
of volunteers to be assigned, County staff requirements for
coordination and County expenditures and funding involved. Such
volunteer program definition, following review by the Office of
the County Administrator, shall be forwarded to the Board of
Supervisors for approval.
After Board approval, rules and procedures, as follows , shall
be adopted, and copies forwarded to the County Administrator:
A. County departments sponsoring volunteer
programs shall have a staff member assigned
as a volunteer coordinator, who will be respon-
sibile for the selection and acceptance of
volunteers . Personnel matters regarding the
volunteers will be referred to the volunteer
coordinator. Volunteers will work directly
with other staff members and will be under
their , supervision for each assignment. Each
County department will forward to the County
Administrator the name and telephone number
of the employee (s) assigned as the volunteer
coordinator. Volunteers will be provided
with initial orientation and training by the
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2 .
volunteer coordinator . Where appropriate,
confidentiality requirements shall be
explained, reading materials assigned and
discussion groups held on a regular basis with
the volunteers.
B. The volunteer coordinator will also be respon-
sible for requiring volunteers to 'Lill Out,
read and s'�ign the application form, and if
such volun^teer is accepted, the volunteer
coordinator will fill out the registration
form (just, below the application form) showing
acceptance,, of the volunteer, date services
commence and terminate , any remarks he may
wish to include with respect to the capability
of the volunteer and limitations as to tasks
to be performed, and lastly the service
authorized to be performed by the volunteer.
If the volunteer is a minor, the parental
consent form shall be completed and signed by
the parent' or legal guardian. Forms to be
used by departments are attached. Departments
may continue to use forms developed for
volunteer programs which include information
needed by the department in addition to that
indicated on the attachments . Any obvious or
suspected disabilities of a volunteer shall
be discusse' d with the. County Safety Officer.
If reimbursement of actual and necessary
expenses in performing volunteer services is
contemplated, volunteer must sign Oath of
Allegiance, form in accordance with established
department j procedures when registering to
perform authorized volunteer services with the
County.
The volunteer coordinator shall be responsible for mainte-
nance of a log listing pertinent information with respect to all
authorized volunteers , including date services commenced and
terminated. Recordsare. to be retained at least five years from
the date of the last volunteer service for subsequent reference
on claims which may be presented by either the volunteer or any
third party allegedly injured.
3.
If a volunteer is to use his personal vehicle in the course
of authorized volunteer services, he will be required to fill out
the "Volunteer 'i Auto Insurance Declaration" form. Volunteers must
check with their insurance agent or broker to make certain that
liability insurance is extended under their policy while their
vehicle is being used for volunteer activities . Auto insurance is
required for all volunteers who will use their personal automobile
while performing authorized volunteer services with at 'least the
following limits :
$15 , 000 for injury to or death to one person
$30, 000 for injury to or death to two or more
persons in one accident
$5 , 000 for property damage
The volunteer must furnish a valid California motor vehicle
operators license if he is to use a vehicle and the license number
together with insurance policy number duly noted on the Auto Insur-
ance Declaration (fora attached) . A Certificate of Insurance or
other evidence of insurance may be requested and placed on file .
III. PROCEDURE 'IN CASE OF ACCIDENT OR INJURY
When a volunteer is injured while performing authorized
volunteer services , the supervisor shall arrange for medical care
as necessary and appropriate in accordance with normal departmental
operating procedures . The volunteer' s supervisor shall immediately
thereafter complete the Supervisor' s Report of Occupational Injuries
or Illness (Form AK-30) . The supervisor sha11 _then forward the fora
to the volunteer cordinator who within 24 hours shall submit the
report through department channels to the Safety Division of the
Civil Service Office. The form shall indicate that the injured
party is a volunteer. A copy of the report must be .forwarded to
the Office of the County Administrator.
All medical bills received by the volunteer not otherwise
covered by health insurance, other insurance, or third party pay-
ment shall be forwarded to the Office of the County Administrator.
Such bills must be itemized and indicate the date of injury.
County payments': will be made jointly to the volunteer and to the
medical provider.
Any claims for permanent disability compensation shall be
referred to they' Office of the County Administrator for review and
adjustment. Prior to final settlement and payment of any such
claim, the volunteer shall execute an appropriate form releasing`
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the County fro ' any further liability and agreeing that such
compensation shall be the sole and exclusive remedy with respect
to the injury sustained.
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4.
When there is an accident resulting in third party personal
injury or property damage, the appropriate accident report form
shall be completed by the supervisor and forwarded to the volunteer
coordinator. The subsequent procedure to be followed shall be`
identical to that applicable as in accidents involving County
employees .
IV. LIABILITY
.The County under its self-insurance program upon request shall
defend and indemnify, the volunteer against liability claims initi-
ated by third parties arising from acts or omissions occuring
within the . scope of authorized services , unless the volunteer acted
or failed to act because of actual fraud, corruption, malice or
gross negligence .
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However, the County shall provide automotive liability insur-
ance protection as excess only of the limits under the volunteer' s
personal automotive liability policy. Such County insurance
protection does not cover an damages to the vehicle o t e volun-
teer, including any deaucti e provision wn1ch must be paid.
Maintenance of such records as determined necessary to assure
that adequate insurance protection is afforded shall be a respon-
sibility of the department' s volunteer coordinator.
V. REIMBURSEL`ENT O NF EXPENSES
Volunteers are 'eligible to receive reimbursement from the
County for certain actual and necessary expenses incurred in the
performance of authorized volunteer services . In order to claim
expenses , the Volunteer must have signed the Oath of Allegiance
before any County officer authorized to administer oaths and meet
previously described'" insurance requirements .
Volunteers are governed by general County reimbursement
policies established" for County employees with the exception of
mileage which will b e reimbursed at a flat rate of $0. 15 per mile .
The Count will not reimburse volunteers for child care expenses,
mileage ram t e vo inteer s residence to the County des gnated
facilityor service location or damage to the volunteer' s personal
vehicle , including any deductible provisions which are 2aid by the
volunteer. : The volunteer must provide intormation to the vo unteer
coordinator with respect to the automobile liability insurance
coverage maintained prior to use of the personal vehicle for
volunteer services and reimbursement of mileage claims . ,
5
Volunteers,,, are recognized as a valuable resource in perfo=-
ing services which are not provided by the County. The Board of
Supervisors has�I expressed its strong support of volunteer
programs. These policies and procedures have been developed for
the information.: and guidance of .Count7 staff and volunteers .
Acting County Administrator
CONTRA COSTA COUNTY
VOLUNTEER APPLICATION AND REGISTRATION FORM
Name Age Social Security No.
Home Address Home Phone
Business Address Business Phone
Driver ' s License No. , It Any
Service Preference
Acceptable Location
Do you have a health problem we should be aware of in an emergency?
Yes No (Describe - such as a history of back trouble ,
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heart, epilepsy, diabetes , fainting , etc. )
Is there a medication
ication you must take? Yes — No
Is there a medication to which you are allergic? Yes No
If yes, medication is :
Medical, Hospital or Other Insurance
Person to Cal1in Emergency Address ' Phone No.
Interviewed by .1 have been informed , against and accept
responsibility for any breach on my part
respecting confidential information. I
have read the Resolution adopted by the
Contra Costa County Board of Supervisors
Signature on volunteer programs . In return for the
benefits provided by Contra Costa County
in case of my illness, injury-, death, or
Date third party liability while providing, or •
resulting from acts or occurrences within
the scope of my authorized volunteer,
services, and for my right to authorized
expense reimbursement, I waive any claim
on my behalf and on behalf of my heirs,
representatives, and assigns against the
County of Contra Costa or any of its
agents, servants or employees for illness ,
injury, debts or other harm arising from
my volunteer services, • whether or not
authorized.
Signature
CONTRA COSTA COUNTY
VOLUNTEER SERVICES
AUTO INSUMICE DECLARATION
Date
This is to certify that 1, the undersigned, am in possession
of a valid California Driver' s License ,
(Number)
My car
(—Expiration Date) (Make).
ode I') (Year) f icense No . Y
is insured with
(Company)
(—Policy No .1 I (Expiration Date
) -
I further certify that I have minimum liability insurance coverage
as follows : $15 , 000 for injury to, or death of, one person ;
$30, 000 for injury to, or death of, two or more persons in one
accident; $5 , 000 for property damage .
Signature