AND
«SigningAuthority»
(hereinafter called the "FACILITY")
1. Purpose
a) To provide clinical and fieldwork experience in terms of patient and related instruction for students of the UNIVERSITY; and
b) To increase contact between academic faculties and clinical personnel for fullest utilisation of available expertise.
2. Term and Termination
a) This Agreement shall be in effect commencing ______________ and shall thereafter continue from year to year, unless either Party gives written notice of termination or amendment at least four months in advance of the anniversary date of the Agreement. b) Where written notice of termination has been given pursuant to paragraph 2(a), such
termination shall not take effect during any clinical placement. 3. Indemnification
a) The Parties shall each indemnify and save harmless the other from and against all claims, losses, damages, judgments, costs, expenses, actions and other proceedings made, sustained, brought, prosecuted or threatened to be brought or prosecuted that are based upon, occasioned by or attributable to any bodily injury to or death of a person or damage to or loss of property caused by any negligent act or omission on the part of the
indemnifying party, its officers, employees, students, agents or volunteers arising out of this Agreement.
4. Insurance
a) The UNIVERSITY will maintain comprehensive third party liability insurance, including professional liability insurance, in the amount of not less than $5,000,000, covering claims brought against FACILITY and its employees for legal liability caused by any negligent act or omission of the UNIVERSITY, its officers, employees, students, agents or volunteers that occurs in connection with the UNIVERSITY’s obligations under this AGREEMENT. Such coverage shall not be cancelled or materially altered without thirty (30) days prior notice to FACILITY. The University shall provide FACILITY with a Certificate of Insurance naming FACILITY as an additional insured.
b) FACILITY will maintain comprehensive third party liability insurance, including professional liability insurance, in the amount of not less than $5,000,000, covering claims brought against the UNIVERSITY and its employees for legal liability caused by any negligent act or omission of FACILITY, its officers, employees, students, agents or volunteers that occurs in connection with FACILITY’s obligations under this
AGREEMENT. Such coverage shall not be cancelled or materially altered without thirty (30) days prior notice to the University. FACILITY shall provide the University with a Certificate of Insurance naming the University as an additional insured.
5. Responsibilities of the SCHOOL
a) The SCHOOL will designate a faculty member (“SCHOOL Coordinator”) responsible for the clinical fieldwork placements of its students.
b) The SCHOOL will direct students to abide by the policies and procedures of the FACILITY as they exist from time to time.
c) The SCHOOL will provide confirmation of the number of students, the beginning dates, the length and the type of fieldwork experience expected.
d) The SCHOOL will furnish the FACILITY with relevant background information regarding the level of the student, the academic curriculum, copies of the necessary student performance report forms and other documents, such as the SCHOOL’s Fieldwork Resource/Clinical Education Manual.
e) The SCHOOL will assume final responsibility for the educational program.
f) The SCHOOL will assign for instruction only those students who have met the admission requirements of the University and continue to meet the academic standards of the SCHOOL.
6. Responsibilities of the FACILITY
a) The FACILITY will accept for clinical and fieldwork experience students duly registered in a program at the SCHOOL. The number of students attending, the times of their attendance, the nature and objectives of their fieldwork or clinical experience and the physical and human resources to be provided at the FACILITY in support of the fieldwork and clinical experience will be negotiated and agreed on by representatives of the Program at the SCHOOL and the FACILITY and will be confirmed in a letter of introduction by the SCHOOL Coordinator to the FACILITY Coordinator prior to the commencement of the fieldwork experience.
b) With the agreement of the SCHOOL Coordinator, the FACILITY shall name a member of the senior staff as coordinator of the student fieldwork program at the FACILITY (“Facility Coordinator”). Such person shall be responsible for the coordination of the fieldwork program for students at the FACILITY and for the communication with the SCHOOL Coordinator in all matters related to (a) the academic clinical components of the fieldwork experience, and (b) the students while they are at the FACILITY.
c) The FACILITY will, at all times, be responsible for patient care and will ensure that, at all times, the students are under the supervision of the appropriate qualified health care professional.
d) The FACILITY will abide by the UNIVERSITY’s policies and procedures governing fieldwork education, as they exist from time to time.
e) The FACILITY will furnish facilities and supervision required for the student clinical or fieldwork experience.
f) The FACILITY will maintain records and reports on each student’s performance and provide an evaluation to the SCHOOL on forms provided by the SCHOOL.
g) The FACILITY will inform the SCHOOL of significant changes in the FACILITY policies or procedures that affect the student’s clinical program.
h) Should circumstances require the termination of a student placement, the FACILITY has the right to do so with prior notification to the School Coordinator, having followed procedures designed to resolve matters of concern in accordance with the SCHOOL’s Fieldwork Resource/Clinical Education Manual.
7. Workers’ Compensation Coverage
During the course of this agreement, the Student is considered to be a “Learner” engaged in an Unpaid Work Placement (unpaid placements include placements in which the student receive a token stipend or amount for living expenses but does not receive a wage for the work he/she is doing).
The Government of Ontario, through the Ministry of Colleges and Universities (MTCU),
provides Workplace Safety and Insurance Board (WSIB) coverage while the student is enrolled in an approved program at Queen’s University and participating in an Unpaid Work Placement with employers who are either compulsorily or have voluntarily applied to have WSIB coverage. For students that are in an approved Unpaid Work Placement outside of Ontario, or at an organization in Ontario that is exempt from having to have WSIB coverage, the government provides coverage through ACE-INA Insurers.
In the event of a workplace injury/illness all WSIB procedures must be followed. Therefore, the facility undertakes and warrants that it will, immediately report any workplace injury or illness involving a student on placement to the Department of Environmental Health and Safety of Queen’s University.
8. Entire Agreement
This AGREEMENT shall be the entire Agreement between the Parties; no amendments of this AGREEMENT shall be of any force and effect until they are reduced to writing and signed by the authorized persons.
The terms of this AGREEMENT are accepted and signed by the duly authorized signing officers of the Parties on this _____ day of ___________, _______.
QUEEN’S UNIVERSITY AT KINGSTON «SigningAuthority»
«Street1» «Street2»
«City», «Province»
«PostalCode»
________________________________ ________________________________
Alan Harrison Name
Provost and Vice-Principal (Academic)
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