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HomeMy WebLinkAboutCentral Washington Family Medicine Residency Program Letter of AgreementKittitas County Review Form Grants & Contract Agreement Today's Date Agenda Date 02/27/2018 Fund/Department 116 -Public Health -fk:yzs3-4- Contract/Grant Information Contract /Grant Agency: Central Washington Family Medicine Residency Program Letter of Agreement Period Begin Date: November 21, 2018 Period End Date: November 21, 2023 Total Grant/Contract Amount: $None_ Grant/Contract Number: Contract/Grant Summary: The Program Letter of Agreement is established to allow residents of the Central Washington Family Medicine Residency Program to rotate through the health department. The agreement establishes the responsibilities of the health department and supervising staff to provide a learning environment conducive to educating residents about public health. Recommendation for Board of Health and Board of Health Review on Department Head Signature: Administrator Date: Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: APPROVED A5 TO FORM: Signature of Prosecutor's Office Date Signature of Auditor's Office Signature of Board of Health member I Financial Information Date Date Total Amount $ State Funds $ Federal Funds $ Percentage County Funds Matching Funds $ CFDA# Grant/Contract Review Page 1 In-Kind $ Explain Is Equipment being purchased? Who owns equipment? New Personnel being hired? Contact HR hiring — reporting requirements Future impacts or liability to Kittitas County: Budget Information Budget Amendment Needed? Yes ❑ attach budget form No ❑ why not New Division Created? Revenue Code Date: Pass Through Information Agency to Pass Through Amount to Pass Through $ Sub -Contract Approved Date: Prosecutor Review Has the Prosecutor reviewed this agreement? Yes ❑ No ❑ County Departments Impacted Auditor Facilities Maintenance Information Services Human Resource Prosecutor Treasurer Submitted Signature: Date: Department: Assignment of Tracking Intormation Auditor's Office Human Resource Prosecutor's Office Who Signed the grant application Reviewer I Date Grant/Contract Review Page 2 Central Washington_ ager Family Medicine --s—FommunllyNeaRh Residency Program Of COARd WOSNngron Program Letter of Agreement between Central Washington Family Medicine Residency Program and Kittitas County Public Health Department This Letter of Agreement is entered into by and between the Central Washington Family Medicine Residency Program ("CWFMR") and Kittitas County Public Health Department ("Participating Site"). This Letter of Agreement is effective for five years beginning November 21, 2018, unless terminated by either CWFMR or Participating Site upon 18 months written notice, or upon mutual agreement. 1. Persons Responsible for Education and Supervision The below mentioned people are responsible for the education and supervision of the residents while rotating at Participating Site: a. For CWFMR: Russell G. Maier, MD b. For Participating Site: Mark W. Larson, MD Other volunteer faculty who will supervise residents include: Staff of Kittitas County Public Health Department 2. Responsibilities The faculty at Participating Site must provide appropriate supervision of residents in patient care activities and maintain a learning environment conducive to educating the residents in the Accreditation Council for Graduate Medical Education (ACGME) competency areas. The faculty must evaluate resident performance in a timely manner during each rotation or similar educational assignment and document this evaluation within four (4) weeks of the completion of the assignment. 1) CWFMR RESPONSIBILITIES a. Background checks shall be required for all residents before being place at Participating Site. Participating Site may refuse placement of a resident who does not provide the requested records or who has a record of prior criminal conduct. b. Residents will obtain and provide proof of any licensure requirements. 2. PARTICIPATING SITE'S RESPONSIBILITIES a. Participating Site will provide residents with an educational experience within the scope of Central Washington Family Medicine Residency Program Program Letter of Agreement Page 1 of 5 health care services provided by Participating Site. b. Participating Site retains full responsibility for the care of patients/clients. C. Participating Site will have the right to take immediate action to correct a situation where a resident's actions endanger patient's/client's care. Participating Site reserves the right to terminate the use of its facilities by a particular resident when it is necessary to maintain its operation free of disruption and to ensure quality of patient care and or unilaterally terminate a resident from the program when such action is in the best interest of the Participating Site and those it serves. d. The performance of all or part of this shall not operate to vest any employment rights whatsoever and shall not be deemed to guarantee any employment of the participating residents at the present time or in the future. Participating Site does not and will not assume any liability for students under any law relating to Worker's Compensation on account of this Agreement, but may choose to cover students as volunteers under RCW 51.12.035. Residents will not be entitled to any monetary or other remuneration for services performed by them at Participating Site, nor will Participating Site otherwise have any monetary obligation to CWFMR or its residents by virtue of this Agreement. 3. Content and Duration of the Educational Experiences The content of the educational experiences has been developed according to ACGME Residency Program Requirements, and include the following: a. Objectives: See Attached b. The duration(s) of the assignment(s) to Participating Site is (are): 4 weeks in duration. c. In cooperation with the CWFMR Program Director/Designated Official, Participating Site Director and the faculty at Participating Site are responsible for the day-to-day activities of the residents to ensure that the rotation goals and objectives are met during the course of the educational experiences at Participating Site. 4. Policies and Procedures that Govern Resident Education a. Residents are under the general direction of their CWFMR Program Director/DIO. Residents are expected to adhere to the policies and procedures applicable to graduate medical education, the Resident Contract, as well as applicable policies of Participating Site. b. Reimbursement & Compensation: CWFMR is solely responsible for the salaries and benefits of its residents and the Participating Site shall incur no costs associated with, or in connection with, the training of residents at the Participating Site. 5. Other Provisions a. Immunizations: CWFMR will ensure evaluation of residents' immune status with regard to current Centers for Disease Control and Prevention and OSHANVISHA standards for health care workers. CWFMR will also give residents initial and annual tuberculosis screenings according to current CDC and OSHA/WISHA guidelines. b. HIPAA: CWFMR voluntarily provides its residents with training on the requirements of the Health Insurance Portability and Accountability Act (HIPAA). Participating Site will provide additional training on its specific policies and procedures. Solely for HIPAA purposes, residents are defined as members of Participating Site's workforce for activities under this Agreement. Central Washington Family Medicine Residency Program Program Letter of Agreement Page 2 of 5 Indemnification & Insurance: CWFMR provides claims made type Professional Liability Insurance for all residents which covers professional activities within the scope of the approved educational program. LIABILITY COVERAGE PROVISIONS Each Party to this Agreement will be responsible for the negligent acts or omissions of its own employees, officers, or agents in the performance of this Agreement. Neither Party will be considered the agent of the other and neither Party assumes any responsibility to the other Party for the consequences of any act or omission of any person, firm, or corporation not a party to this Agreement. For purposes of liability and indemnification, residents participating in the program are considered agents of CWFMR. 4. TERMINATION a. The Participating Site may terminate the Agreement in whole or in part whenever the Participating Site determines, in its sole discretion that such termination is in the best interests of the Participating Site. ENTIRE AGREEMENT This Agreement and any amendment(s) attached hereto constitute the entire agreement between the Parties and supersede any and all prior oral or written agreements, commitments, or understandings concerning the matters provided for in this Agreement. 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. 6. MODIFICATION The Parties may modify this Agreement only by a subsequent written agreement executed by the Parties. Any modification shall be effective only if written, signed, and dated by the authorized representatives of each Party and attached to this Agreement. 7. GOVERNANCE This contract is entered into pursuant to and under the authority granted by the laws of the state of Washington. The Parties' rights or obligations under this Agreement shall be construed in accordance with those laws. The provisions of this agreement shall be construed to conform to those laws. 8. SURVIVAL CWFMR and Participation Site expressly intend and agree that the liability coverage provisions of this Agreement will survive the termination of this Agreement for any reason. 9. SEVERABILITY If any provision of this Agreement or any provision of any document incorporated by reference, or any other agreement document or writing pursuant to or in connection with this Agreement, shall be held wholly or partially invalid or unenforceable under applicable law, such invalidity shall not affect the other provisions of this Agreement which can be given effect without the invalid provision, if such remainder conforms to the requirements of applicable law and the fundamental purpose of this agreement, and to this end the provisions of this Agreement are declared to be severable. Central Washington Family Medicine Residency Program Program Letter of Agreement Page 3 of 5 10. WAIVER Waiver of any breach or condition of this Agreement shall not be deemed a waiver of any prior or subsequent breach. No terms or conditions of this Agreement shall be held to be waived, modified or deleted except by an instrument, in writing, signed by the parties hereto. 11. CONFIDENTIALITY CWFMR, its employees, and residents, shall maintain the confidentiality of all information provided by the Participating Site or acquired by CWFMR, its employees, or students, in performance of this Agreement, except upon the prior written consent of the Kittitas County Prosecuting Attorney or an order entered by a court after having acquired jurisdiction over the County. CWFMR shall immediately give to the County notice of any judicial proceedings seeking disclosure of such information. CWFMR, its employees, or students shall indemnify and hold harmless the County, its Additional Insured's, officials, agents or employees from all loss or expense, including, but not limited to settlements, judgments, setoffs, attorneys' fees and costs resulting from CWFMR, its employees, or students' breach of this provision 12. VENUE AND CHOICE OF LAW In the event that any litigation should arise concerning the construction or interpretation of any of the terms of this Agreement, the venue of such action of litigation shall be in the Superior Court of the State of Washington in and for the County of Kittitas. This Agreement shall be governed by the law of the State of Washington. 13. NON-DISCRIMINATION Each party certifies that it will not discriminate in the performance of this Agreement on the basis of race, color, national origin, gender, sexual orientation (to include gender identity), religion, veteran or military status, or the presence of any sensory, mental or physical disability. 14. NOTICES All notices, demands, requests, or other communications required to be given or sent by CWFMR or Participating Site, will be in writing and will be mailed by first-class mail, postage prepaid, or transmitted by hand delivery or facsimile, addressed as follows: For CWFMR: Central Washington Family Medicine Residency Program 1806 W. Lincoln Avenue. Yakima, WA 98902 For Participating Site: Kittitas County Public Health Department 507 N Nanum #102 Ellensburg, WA 98926 Each Party may designate a change of address by notice in writing. All notices, demands, requests or communications that are not hand delivered will be deemed received three (3) days after deposit in the U.S. mail, postage prepaid; or upon confirmation of successful facsimile transmission. Central Washington Family Medicine Residency Program Program Letter of Agreement Page 4 of 5 15. SIGNATURES The Parties executing this Agreement below hereby certify they have the authority to sign this Agreement on behalf of their respective Parties and that the Parties agree to the terms and conditions of this Agreement as shown by the signatures below. SIGNATURES: Russell G. Maier, MD Date Program Director/Designated Institution Official Central WA Family Medicine Residency Program 1806 West Lincoln Avenue, Yakima WA 98902 509-452-4946 Central Washington Family Medicine Residency Program Program Letter of Agreement Signature Date Printed Name Title Page 5 of 5 Camrnunify Health t71 !'���ifral Wo';hing Ambulatory Family Medicine (AFM) Curriculum: Ellensburg Rural Site DESCRIPTION OF EDUCATIONAL EXPERIENCE: This curriculum facilitates development of quality care skills in Ambulatory Family Medicine (AFM). Competency -based practice will focus on interpersonal and community-based health care delivery. To prepare residents for practicing family medicine, these rotations will provide community-based opportunities to learn specialized methods of evaluation, treatment and resources for referral. Residents will be exposed to a range of primary care practices, including: primary prevention, care of chronically ill, and assessments of special populations. Learning methodology will include: community-based health care activities, self -study and shadowing. STRUCTURE AND TIMING OF ROTATIONS: 1. R1 AFM: This is a one-month rotation. a. Open Door Clinic: 2 half days b. A -Team: 1 half day c. Kittitas County Health_ Department (KCHD) Project: 2 half days, as applicable d. Syringe Exchange: 1 half day e. Dental Clinic: 1 half day f. Central Washington University (CWU) Student Health: 2 half days g. WIC: 1 half day h. First Stepsl Bright Beginnings: 1 half day i. Bookmobile/Early Learning Coalition: 1 half day j. EMS ride alone: 2 half days k. Pharmacy: Diabetes Management, Coagulation: 1 half day I. Comprehensive Mental health with Jamie Walker: 1 half day 2. R3 AFM: This is a two-month rotation combined with Ambulatory Pediatrics, resulting in one-month of time dedicated AFM. a. Open Door Clinic: 4 half days b. A -Team: 1 half day c. Kittitas_County Health Department (KCHD}: 2 half days d. New Hope Clinic: 2 half days e. Hepatitis C Clinic: 2 half days f. 5uboxone_Clinic [MAF -E): 1 half day g. Central Washington University (CWU} Student Health: 4 half days FACULTY OVERSIGHT: 1. Faculty Lead: John Asriel, MD 2. Preceptors.: See schedule for specific personnel and contact information a. R3 AFM: AFM 1 introduces residents to systems providing medical services to the community and to aspects of healthcare requiring cooperative care. In addition to CHCW-E faculty members, residents will work with members of the Kittitas County Public Health Department, CWU Student Health Services, The Open Door Clinic (Ellensburg Free Clinic), and other allied health providers within the community, as listed above. This rotation also familiarizes residents with other CHCW services, such as dental, pharmacy, MAT -E clinic, WIC. These experiences will focus on health literacy concepts, patient health and safety, and diabetes/anticoagulation management. b. R3 AFM: AFM 3 provides an R3 year update to AFM 1. With the exception of CHCW-E faculty, faculty and preceptor oversight is varied, depending on needs of each resident and availability of resources. External experiences include those listed above and additionally include work with allied health professionals at CHCW-E. CURRICULUM GOALS: a. Develop understanding of medical systems for the delivery of preventative care to individuals and communities. b. Develop understanding of medical systems for care of patients acute and chronic conditions. c. Learn how to interact with the greater medical community to promote population -based healthcare. d. Gain cultural competency to treat diverse patient populations over the continuum of care. R1 -Specific Goals: Learn about systems of care in the community and the care of at risk populations. 1113-Spec€fir Goals: i, Develop independence in community resource utilization to prepare for future rural medical practice. i. Provide services for high risk and chronically ill patient populations. CURRICULUM OBJECTIVES: a. Longitudinal Objectives a. Develop knowledge of and participate in the systems for delivering healthcare services in a rural area. b. RI Objectives a. Learn about the delivery of care to an underserved population in a free clinic setting. (Open Door) b. Become familiar with the role of the Health Department in a rural area. (Health Department) c. Learn harm reduction methods for IV drug users. (Syringe Exchange) d. Learn about the delivery and importance of oral health to an underserved population in a rural setting. (Dental Clinic) e. Learn about the system of healthcare delivery to a college population. (CWU Student Health) f. Learn the components of maternal and pediatric nutrition. (WIC) g. Learn about pediatric development and care in a rural area. (First Steps/Bright Beginnings/ASQ Screening) h. Prepare for possible participation in the Medical Reserve Corps. (FEMA) i. Learn about the system for delivering on-site emergency medical care. (EMS Ride Along) j. Learn about organizational medicine at the county level and participate in community advocacy. (KCMS) k. Learning the pharmacy role in management of diabetes and anti -coagulation. (Pharmacy) I. Learn about the treatment of addiction at a counseling agency. (MERIT) m. Learn about the delivery of mental health services in a rural area. (Comprehensive) n. Participate in dissemination of healthcare information. (Newspaper Article/Senior Center Presentation) C. R3 Objectives a. Review R1 objectives by way of repeated activities. b. Learn about the delivery of HIV care. (New Hope Clinic) C. Learn about the delivery of Hepatitis C Care. (Hepatitis C Clinic) d. Learn about office based opioid treatment. (Connect Clinic) ASSIGNMENTS: Required Assignments: a. Newspaper article b. KCMS position statement c. Patient Safety (IHI) Modules d. FEMA IS -100 Module e. Complete evaluation of rotation SUPPLIMENTAL READINGS: 1. Free Clinic a. Free Clinic organization - http://www.nafccli n ics.org/sites/defa u It/files/NAFC%201 nfogra phic%20%26%20Report%20Feb%202%202015 %20small.pdf I. http://www.nafcclinics.org/ b. Latino care - https://www.aafp.org/afp/2013/0101/p48.htmi 2. WIC - http://www.nafcclinics.org/ 3. First Steps - https://www.hca.wa.gov/free-or-low-cost-health-care/apple-health-medicaid-coverage/first-steps- matern ity-a nd-infa nt-ca re 4. Warfarin management - UptoDate chapter "Warfain and other VKA: Dosing and Adverse Effects 5. Common dental conditions: https://www.aafp.org/afp/2008/0315/p797.htmi 6. CWU Student Health a. College student health - https://www.aafp.org/afp/2008/0315/p797.html b. STI/USPSTF - https://www.aafp.org/afp/2016/1201/p907.htmi 7. Early learning coalition - https://www.aafp.org/afp/2017/0701/p36.html 8. ASPEN a. Domestic violence - https://www.aafp.org/afp/2016/1015/p646.htmi b. Sexual assault - https://www.aafp.org/afp/2010/0215/p489.html 9. EMS Ride Along - https://www.kittitascountyems.org/home.htmi 10. HOPE clinic a. 2014 What's new - https://www.aafp.org/afp/2014/0215/p265.htmi b. Initial care - https://www.aafp.org/afp/2016/1101/p708.htmi c. Complications - https://www.aafp.org/afp/2017/0801/pl6l.htmi 11. Hepatitis C a. Primary Care - https://www.medscape.com/viewarticle/891213#vi)__2 Board Preparation: R3 Board Preparation: Graber and Wilbur's Family Medicine and Board Review (UW library) 1. Pediatrics Cases 13.2 and 13.12 2. Cardiology Case 2.3 3. HIV/AIDS chapter 4. Gastroenterology case 7.10 R3 Board Preparation: Graber and Wilbur's Family Medicine examination and Board Review (U W library) 1. Ethics chapter 2. Evidence -Based Medicine chapter 3. Patient -Centered Care chapter EVALUATION: 1. Assignment Completion: The following assignments must be com fp eyed in order to pass the rotation. R1 a. Diabetic for a weekkproiect b. Patient Safety Modules (IHj): QI 101, QI 102, QI 103, PS 101, PS 102, PS 103, PS 104, PFC 101, PFC 102, PFC 202 c. KCMS Project: as applicable d. KSA Self -Study- Modules: Health Behavior and Hypertension; Preventative Care e. Newsaaaer Article: Upload into NI R3 f. IHI Modules: QI 105, QI 201, PS 105, PS 201, PS 202, L 102, TA 101, TA 103, QI 104, QI 202 g. Dermatology Modules: Psoriasis, Adult Fungal Infections, HIV Dermatology. h. KSA Self -Study Modules: Heart Failure and Asthma i. Open Reffection: choose your own topic from the rotation to write a 250-500 word reflection, upload into NI and send to advisor j. Newspaper Article: Upload into NI 2. Preceptor Evaluation: Using a standardized form the following performance variables will include: a. Did the resident meet the objective for your area? b. Was the resident timely in their attendance and properly participate in activities?