S.A.F.E.R. Board of Directors
Regular MeetingWeston, WI · December 19, 2013
Agenda
OFFICIAL NOTICE & MEETING AGENDA
of a Board, Commission, Committee, Agency, Corporation, Quasi-Municipal Corporation, or Sub-unit thereof
Meeting: S.A.F.E.R. BOARD OF DIRECTORS
Members: A Opall {c} L White; B Ermeling; F Schaefer; K Langenhahn
Location: Rib Mountain Town Hall; 3700 North Mountain Rd, Wausau
Date/Time: Thursday, December 19th, 2013 @ 6:00 P.M.
AGENDA ITEMS FOR CONSIDERATION (All items listed may be action upon)
Notice is hereby given that a majority of the S.A.F.E.R. Fire Commission may be present at the
above noticed meeting due to the proximity of meeting time/location. This constitutes a meeting
of the S.A.F.E.R. Fire Commission pursuant to State ex rel. Badke v. Greendale Village Bd.,
173 Wis.2d 553,494 N.W.2d 408 (1993), and must be noticed as such, although the S.A.F.E.R.
Fire Commission will not take any action at this meeting.
1. Call to Order.
2. Comments from the public on issues related to the SAFER district – This period is an
opportunity for members of the community to come before the Directors and present to them
their comments related to the financial and administrative management of the SAFER
district. No action will be taken on comments received at this meeting.
3. Consent Items.
a) Approval of prior meeting minutes from Tuesday 12/10/2013.
4. Business Items.
a) Discussion and action on fleet replacement and capital equipment purchasing plan for the
SAFER district.
b) Discussion and action on clinical affiliation agreement between NCT and SAFER district.
5. Staff Reports.
a) Reports from Fire Chiefs.
b) Reports from Administrators.
6. Remarks from the Directors (No motions will be made, and no action will be taken related
to policy affecting the S.A.F.E.R. district as a result of this agenda item).
7. Set next meeting date and discuss items for next committee agenda.
8. Adjourn.
This notice was posted at the Municipal Centers and sent to the
Wausau Daily Herald newsroom on 12/17/2013 @ 5:00 p.m.
Please note that, upon reasonable notice, efforts will be made to accommodate the needs of disabled individuals through
appropriate aids and services. For additional information or to request this service, contact the Rib Mountain
Town Municipal Center at (715) 842-0983.
OFFICIAL MEETING MINUTES
SOUTH AREA FIRE & EMERGENCY RESPONSE DISTRICT
Board of Directors Regular Meeting
Tuesday, December 10, 2013 @ 6:00 P.M.
1. Call to Order
The regular meeting of the South Area Fire and Emergency Response District Board of Directors was
called to order at 6:00 PM by Village of Weston President, Loren White.
ALL MEMBERS PRESENT - Loren White, Village of Weston President; Barb Ermeling, Weston
Trustee; Fred Schaefer, Rib Mountain Supervisor; Steve Meilahn, Weston Fire Chief; Paul Wirth, Rib
Mountain Fire Chief; Village of Weston Finance Director, John Jacobs was also present. There was 1
audience member present at the meeting. Town of Rib Mountain Administrator; Gaylene Rhoden,
Village of Weston Administrator; Daniel Guild, SAFER Board Chairman; Allen Opall and Town of
Marathon Chairman; Keith Langenhahn were all absent and excused.
2. Comments from the public on issues related to the SAFER District.
There was no public comment or correspondence.
3. Consent Items
a) Approval of prior meeting minutes of Tuesday, November 26, 2013.
b) Acknowledge finalized contract for service with AccuMed to provide ambulance billing
services to the SAFER District.
Ermeling/Schaefer to approve consent items. Motion carried unanimously
4. Business Items
a) Discussion and action on Accident & Sickness Insurance proposal from VFIS.
Jacobs reviewed the summary of VFIS insurance plan options for accident and
sickness.
Schaefer/Ermeling to approve the 3 year insurance contract for the annual amount of
$4,244.00. Motion carried unanimously.
b) Discussion and action on the inventory of equipment from the Weston Fire Department
and the Rib Mountain Fire Department and transfer ownership from the member
communities and accept receipt of their property for the use and operation by the
SAFER District.
Schaefer/Ermeling to acknowledge receipt of the inventory lists and transfer ownership to
the SAFER District. Motion carried unanimously.
5. Staff Reports
a) Reports from Fire chiefs
Wirth reported on the status of state licenses. He also reported the hiring process is basically
done.
b) Reports from Administrators
Jacobs reminded board members to check their email from Administrator Guild.
6. Remarks from the Board of Directors (No motions will be made, and no action will be taken
related to policy affecting the SAFER District as a result of this agenda item).
7. Set next meeting date and discuss items for next committee agenda
Next meeting date set for Thursday, December 19, 2013. Trustee Ermeling stated she
will be absent.
8. Adjourn Meeting of SAFER Board of Directors
Motion by Ermeling Schaefer to adjourn the meeting at 6:25p.m. Motion carried unanimously.
Prepared by: Rhonda Christiansen on 12-13-2013
Presented for consideration to the Board of Directors on 12-19-2013
S.A.F.E.R.
Capital Equipment Replacement Schedule
2014
1 Ambulance Med 1 (Station 1) Replace 2003 Lifeline ambulance and cot $310,000.00 $5,000.00 $305,000.00
1 Turn out gear five (5) sets of turn out gear including boots helmet and gloves $9,200.00 $9,200.00
1 Fire Hose To maintain current hose level replacing old and or damaged hose $5,000.00 $5,000.00
Weston Tanker 2 Replace 1976 Fire Tanker ( no need to replace w/SAFER) $250,000.00 $250,000.00
2015
Med 3 (Station 2) Replace 1999 MedTec ambulance and cot $310,000.00 $3,000.00 $307,000.00
1 Turn out gear five (5) sets of turn out gear including boots helmet and gloves $9,500.00 $9,500.00
2 Fire Hose To maintain current hose level replacing old and or damaged hose $5,000.00 $5,000.00
2 Fire training props Props for tool safety, search and rescue drills, Haz mat training $5,000.00 $5,000.00
2 Computer/server upgrades up grade public safety server and computers to current technology $20,000.00 $20,000.00
3 Rescue 1 (Station 2) Replace 1995 Rescue Truck (upgrade to heavy duty chassis) includes $600,000.00 $6,000.00 $594,000.00
rescue equipment, hydraulic tools etc.
2 Car 1 (Station 2) Replace 2000 Chevy Tahoe 4X4 $40,000.00 $5,000.00 $35,000.00
2016
2 Station Two Study Feasibility study for need of second station on north side of Mtn. $20,000.00 $20,000.00
2 Training tower Completion of fire training/hose tower on Rib Mountain Station $100,000.00 $100,000.00
2 Lucas CPR Device Automated CPR Device, increased survival rates and lower injury rates $13,500.00 $13,500.00
1 Brush 1 (Station 2) Replace 1984 brush truck (slide in pump/tank also replaced) $60,00.00 $3,000.00 $60,000.00
1 Furniture/Fixtures/Equip Update furniture, fixtures and equipment for buildings as needed $25,000.00 $25,000.00
( printers, chairs, carpet, bed, mattresses etc.)
2 Tech/Water Rescue Equip, To continue to update and replace worn and or damaged equipment $6,000.00 $6,000.00
complete
1 Turn out gear five (5) sets of turn out gear including boots helmet and gloves $9,700.00 $9,700.00
1 Fire Hose To maintain current hose level replacing old and or damaged hose $5,000.00 $5,000.00
1 IV pumps upgrade Upgrade to current technology and replace old used pumps X 3 $15,000.00 $15,000.00
2 Tough book/tablet replace and up date to current technology for laptop/tablets for ems and fire $6,000.00 $6,000.00
2 Engine 2 (Station 2) Replace 1986 Seagrave pumper $375,000.00 $7,000.00 $368,000.00
S.A.F.E.R.
Capital Equipment Replacement Schedule
2017
2 Explorer (Car 1) (Station 1) Replace 2006 explorer $35,000.00 $5,000.00 $30,000.00
Weston 6-wheeler Replace 1996 Polaris six-wheeler $18,000.00 $4,000.00 $14,000.00
Training Storage Facility Facility capable of advanced and refresher fire/ems training $175,000.00 $175,000.00
1 Turn out gear five (5) sets of turn out gear including boots helmet and gloves $9,900.00 $9,900.00
2 Fire Hose To maintain current hose level replacing old and or damaged hose $5,000.00 $5,000.00
1 IV pumps upgrade Upgrade to current technology and replace old used pumps X 3 $15,000.00 $15,000.00
Tough book/tablet Purchase new laptop/tablets for EMS and fire (Station #2) $6,000.00 $6,000.00
Station #2 Paint Need to paint masonry (cost share with EMPD) $15,000.00 $15,000.00
2018
1 Station 3/4 Remote station location to be determined by SAFER $1,500,000.00 $1,500,000.00
1 Engine 1 (Station 1) Purchase new Engine, keep old unit until study of 3rd station is $375,000.00 $375,000.00
1 Furniture/Fixtures/Equip Update furniture, fixtures and equipment for buildings as needed $25,000.00 $25,000.00
( printers, chairs, carpet, bed, mattresses etc.)
Med 2 (Station 2) Replace 2006 McCoy Ambulance and Cot $310,000.00 $310,000.00
Station #2 Roof Repair/replace south side of Weston safety building roof $60,000.00 $60,000.00
Station #2 Parking Lot Replace parking lot (cost share with EMPD) $250,000.00 $250,000.00
1 Turn out gear five (5) sets of turn out gear including boots helmet and gloves $9,900.00 $9,900.00
2 Fire Hose To maintain current hose level replacing old and or damaged hose $5,000.00 $5,000.00
2019
Building maintenance Repairs and maintenance for public safety building $100,000.00 $100,000.00
(roof, doors, windows, etc.)
1 Med 3 (Station 1) Replace 2008 ambulance $280,000.00 $5,000.00 $275,000.00
SCBA (Station 2) Replace 20 2004 MSA SCBA + 40 Face Pieces $200,000.00 $200,000.00
SCBA Air Bottles Station 2 Replace 20 extra SCBA Air Bottles $10,000.00 $10,000.00
1 Turn out gear five (5) sets of turn out gear including boots helmet and gloves $10,100.00 $10,100.00
2 Fire Hose To maintain current hose level replacing old and or damaged hose $5,000.00 $5,000.00
S.A.F.E.R.
Capital Equipment Replacement Schedule
2020
SCBA (Station 1) Replace 20 2004 MSA SCBA + 40 Face Pieces $200,000.00 $200,000.00
SCBA Air Bottles Station 1 Replace 20 extra SCBA Air Bottles $10,000.00 $10,000.00
Rescue 1 Replace 2000 Engine/Rescue unit with new current unit 20 $400,000.00 $25,000.00 $375,000.00
Drains Station #2 Apparatus floor drains need replacement $30,000.00 $30,000.00
1 Turn out gear five (5) sets of turn out gear including boots helmet and gloves $10,100.00 $10,100.00
2 Fire Hose To maintain current hose level replacing old and or damaged hose $5,000.00 $5,000.00
2021
Ambulance Med 2 Replace 2010 Ambulance 11 $280,000.00 $5,000.00 $275,000.00
Weston Med 1 Replace 2011 Ambulance and Cot $310,000.00 $310,000.00
1 Furniture/Fixtures/Equip Update furniture, fixtures and equipment for buildings as needed $25,000.00 $25,000.00
( printers, chairs, carpet, bed, mattresses etc.)
1 Turn out gear five (5) sets of turn out gear including boots helmet and gloves $10,500.00 $10,500.00
2 Fire Hose To maintain current hose level replacing old and or damaged hose $5,000.00 $5,000.00
2022
Station #2 remodel Second floor remodel for more office space and a dormitory sleep area $150,000.00 $150,000.00
2023
Weston Tanker 1 Replace 1998 Fire Tanker $250,000.00 $250,000.00
2024
Ambulance Med 1 Replace 2014 Ambulance 10 $312,000.00 $5,000.00 $307,000.00
2025
Med 3 (Station 2) Replace 2015 Ambulance 10 $315,000.00 $5,000.00 $310,000.00
Car 1 (Station 2) Replace 2015 SUV 4x4 $60,000.00 $60,000.00
2026
Ambulance (Station 2) Replace 2016 Ambulance $315,000.00 $315,000.00
Weston Chief Car Replace 2006 SUV 4x4 $50,000.00 $50,000.00
2027
Car 1 Replace 2017 department vehicle 10 $45,000.00 $5,000.00 $40,000.00
$8,315,400.00
CLINICAL AFFILIATION AGREEMENT FOR
EMERGENCY MEDICAL SERVICES OCCUPATIONS
This Agreement is made effective this _________ day of _______, 2013, by and between
the Northcentral Technical College, a Wisconsin institution for technical education and training
(“NTC”), and South Area Fire and Emergency Response District, a Wisconsin clinical education
setting (“SAFER”).
WITNESSETH
WHEREAS, NTC administers educational curricula for various health occupations (each
a "Program" and collectively the "Programs"), and seeks to provide, as part of the Program
curricula, supervised clinical experiences for NTC students enrolled in the Programs
("Students"); and
WHEREAS, SAFER serves patients in the provision of emergency medical or non-
emergency services consistent with the one or more Programs, and is willing to assist in the
training of future Emergency Medical Services personnel by providing Students with supervised
clinical experiences at SAFER sites, consistent with the educational objectives of Students and
NTC; and
WHEREAS, NTC and SAFER have determined that each may best accomplish its
objectives by mutual assistance, and seek to describe their affiliation in this Agreement
combined with Emergency Medical Services Program Addenda attached to and made a part of
this Agreement;
NOW THEREFORE, in consideration for the mutual promises contained herein, NTC and
SAFER agree as follows:
AGREEMENT
1. NTC RIGHTS AND RESPONSIBILITIES. In addition to its rights and
responsibilities described elsewhere in this Agreement, NTC shall have the following rights and
responsibilities:
1.1 Preparation of Students for Clinical Placement. NTC shall ensure,
through qualified faculty that each Student assigned to SAFER is adequately prepared to benefit
from such assignment. A Student's preparedness shall be measured by: (A) academic
performance indicating an ability to understand what Student will observe and/or perform during
the clinical placement; and (B) appreciation of the nature and seriousness of the work Student
will observe and/or perform.
1.2 Assigning Students to SAFER. After receiving from SAFER the
number of placements available for Students, NTC shall select Students to be assigned to
SAFER. NTC shall notify SAFER of the Students assigned to SAFER, and each Student’s
availability for participation in clinical experiences.
1.3 Educational Coordinator. NTC shall appoint a faculty member to
serve as Educational Coordinator for the Program, and shall communicate his or her name, title
and telephone number to SAFER. The Educational Coordinator shall be responsible for overall
Affiliation Agreement-SAFER, 12/13/13 1
management of the Students' educational experience, and may be assigned as Educational
Coordinator for one or more Programs.
1.4 Professional Liability Insurance. NTC shall provide to each Student
assigned to SAFER professional and/or general liability insurance. This coverage shall be
provided at no cost to SAFER.
1.5 Accreditation and Licensure. NTC shall maintain, at all times during
the term of this Agreement: (A) accreditation as an educational institution; (B) all licensures and
approvals from the State of Wisconsin necessary to the applicable Program; and (C) full and
unrestricted accreditation of the Programs from the accrediting organization specified in the
applicable Program Addendum. NTC shall promptly notify SAFER of any change in its
accreditation or licensure status.
1.6 Background Investigative Disclosure. If required, responsibility for
background investigative disclosure, pursuant to the Wisconsin Caregiver Background Check
Law, shall be as described in the Program Addendum.
2. SAFER RIGHTS AND RESPONSIBILITIES. In addition to its rights and
responsibilities described elsewhere in this Agreement, SAFER shall have the following rights
and responsibilities:
2.1 Number of Placements. SAFER shall have sole discretion to determine
its capacity to accept Students for clinical placement under this Agreement, whether such
capacity is described in terms of the number of Students on-site at any one time, the number of
hours of clinical supervision that SAFER can provide over a period of time, or other such
description of capacity. SAFER shall communicate such capacity to NTC before Students may
be assigned to SAFER.
2.2 Site Coordinator. SAFER shall appoint an employee to serve as a
coordinator at the site for the Program (for purposes of this Agreement, the "Site Coordinator"
and as may be described in the Program Addendum), and shall communicate his or her name,
title and telephone number to NTC. The Site Coordinator shall be responsible for overall
management of the experience at SAFER, and may be assigned as Site Coordinator for one or
more Programs.
2.3 Orientation. SAFER shall provide NTC faculty and students with a
comprehensive orientation of SAFER, including all applicable policies and procedures and
expectations of SAFER, and a tour of the physical plant. Such orientation shall include a
comprehensive orientation of SAFER's emergency and safety protocols and policies and other
orientation activities as may be mutually agreed to by NTC and SAFER as set forth in any
Program Addendum attached hereto.
2.4 Qualified Supervision. SAFER will strive toward providing a
qualified preceptor to supervise each Student. A preceptor shall be qualified if he or she has
been designated by the NTC’s medical director and in accordance with Department of Health
Services (DHS) 110.51. The College will provide appropriate no-charge training to those
interested in becoming preceptors.
2.5 Student Access to SAFER and Patients. SAFER shall permit access
by Students to areas of SAFER as reasonably required to support Students' clinical development
Affiliation Agreement-SAFER, 12/13/13 2
and as permitted under applicable law. These areas shall include, with limitation, ambulances,
fire stations, and parking facilities.
2.6 Accreditation. Licensure and Eligibility. SAFER shall maintain, at all
times during the term of this Agreement, all qualifications necessary to provide services under
this Agreement, including: (A) full and unrestricted accreditation, as appropriate and as
described in the Program Addendum; (B) all necessary licensures, certifications and approvals
from the State of Wisconsin or other authority; and (C) if applicable, eligibility for participation
in the Medicare and Medicaid programs. SAFER shall immediately notify NTC of any change
in SAFER’s qualifications, accreditation, licensure, or eligibility status.
2.7 Clinical Component Requirements. The clinical component offered by
NTC shall in all respects be implemented and administered by SAFER in a manner that meets
the requirements of any agency that accredits licenses, certifies or otherwise oversees the
Program, other authorities identified by NTC, and all applicable laws.
2.8 Inspections. SAFER shall, upon reasonable request, permit inspection
of its premises by NTC.
2.9 Final Authority. SAFER retains final authority for all aspects of
operations at and management of SAFER.
2.10 Remuneration. Students may not receive remuneration for services
relating to the Program and performed for or on behalf of SAFER.
3. JOINT RIGHTS AND RESPONSIBILITIES. In addition to their rights and
responsibilities described elsewhere in this Agreement, NTC and SAFER shall have the
following rights and responsibilities.
3.1 Supervision and Evaluation of Students. NTC and SAFER shall, in
good faith, work cooperatively to assure adequate supervision and evaluation of Students while
Students are on-site at SAFER. Both parties shall reinforce with Students: (A) the seriousness of
the service being performed at SAFER, including the Students’ impact upon patients' wellbeing;
(B) the importance of abiding by SAFER rules and regulations; and (C) the confidentiality of
patient identities and health information. NTC shall, if SAFER so desires, assure prompt
feedback to SAFER regarding Students' evaluation of their clinical experience at SAFER.
SAFER shall assure prompt feedback to NTC regarding Students' performance at SAFER and
additional feedback as described in the Program Addendum, if any.
3.2 Review and Evaluation of Affiliation. NTC and SAFER agree to
review and evaluate any and all aspects of their affiliation at periodic intervals, and to work
cooperatively to establish and maintain clinical experiences that meet their respective objectives.
This Agreement may be amended or modified, pursuant to Section 6 below, to reflect changes in
the parties' relationship.
4. STUDENT RIGHTS AND RESPONSIBILITIES. NTC and SAFER shall
instruct Students regarding Students' rights and responsibilities while onsite at SAFER. These
rights and responsibilities shall include the following:
4.1 Conduct. Student shall, at all times while on SAFER premises,
conduct himself or herself in a professional manner and shall refrain from loud, boisterous,
Affiliation Agreement-SAFER, 12/13/13 3
offensive or otherwise inappropriate conduct. Student shall refrain from the improper use of
alcohol or other drugs, and shall not carry any firearms or other weapons while on SAFER
premises. Student shall abide by all policies, rules and regulations established by SAFER and
NTC. Failure to abide by these policies, rules and regulations may result in the student’s
removal from SAFER.
4.2 Timeliness. Student shall report to SAFER at the assigned place and
time. Student shall immediately inform SAFER and NTC of Student's inability to report to
SAFER as assigned.
4.3 Uniform and Identification. Student shall wear the uniform or other
clothing as directed by NTC. Student shall display proper identification as directed by SAFER.
Student's appearance shall be, at all times, neat and clean.
4.4 Personal Expenses. While at SAFER, Student’s shall be responsible
for their personal expenses such as meals, travel, medical care and incidentals.
4.5 Evaluation of Clinical Experience. Student shall, upon request of
NTC, or SAFER, provide a candid written evaluation of the clinical experience at SAFER
including, without limitation, preparation for the on-site experience, orientation to SAFER and
experience and supervision at SAFER.
5. STUDENT HEALTH POLICIES
5.1 Emergency Medical Services. If Student is injured or becomes ill
while at SAFER, SAFER shall provide emergent or urgent medical care, as appropriate,
consistent with SAFER's capability and policies. SAFER should promptly notify NTC that
Student has been injured or has become ill. Student shall bear full financial responsibility for
charges associated with said treatment.
5.2 Immunizations. NTC shall assure that Student has received, before
reporting to SAFER, appropriate immunizations and vaccines, or, in the alternative, has
completed the appropriate declination of immunization form, notice of which is provided to
SAFER.
5.3 OSHA Policies. NTC shall instruct Students regarding precautions
and other procedures to protect Students, patients and SAFER personnel and provide personal
protective equipment as needed. The three topic areas shall include: Bloodborne Pathogen,
Hazardous Materials Awareness level, and Highway Safety.
6. TERM AND TERMINATION
6.1 Initial and Renewal Term. Subject to Section 6.2 below, this
Agreement shall be effective as of the date set forth above and shall continue for an initial term
of one academic or Program year as set forth in the Program Addendum. Thereafter, this
Agreement shall automatically renew and continue in full force and effect for any and all periods
during which any Student in a Program is placed at and accepted by SAFER. Notwithstanding
the foregoing, either party may choose not to renew this Agreement at the end of the then-current
Program by providing the other with not less than thirty (30) days' advance written notice of its
intent not to renew prior to the end of then-current Program. In the event that either party's non-
renewal of this Agreement disrupts the clinical experience of any Student(s) in a Program, the
Affiliation Agreement-SAFER, 12/13/13 4
Agreement shall remain in full force and effect until such time as this Agreement may expire
without disruption of said Student(s)' clinical experience. Upon notice of non-renewal by either
party, no new Student may be placed at SAFER.
6.2 Termination. Notwithstanding Section 6.1 above, this Agreement may
be terminated as follows.
A. By Mutual Agreement. NTC and SAFER may terminate this
Agreement at any time, and on any terms, to which they agree in writing, though the parties shall
attempt, in good faith and using their best effort, to effectuate the termination to coincide with a
normal academic or Program break.
B. For Cause. In the event NTC or SAFER fails in any substantial
manner to perform as required herein, this Agreement may be terminated as described below:
(1) Either party may terminate this Agreement at any time,
upon material breach of any of its provisions by the other party; provided, however, if such
breach is curable, that not less than thirty (30) days prior to termination, written notice shall be
given by the non-breaching party to the breaching party that states the intention of the non-
breaching party to terminate this Agreement, the nature of the material breach giving rise to
termination, and shall permit the breaching party reasonable opportunity to cure such material
breach to the reasonable satisfaction of the non-breaching party during said thirty (30) day
period.
(2) If the material breach is not resolved to the reasonable
satisfaction of the non-breaching party during the thirty (30) day period as provided in B. (1)
above, the non-breaching party shall immediately give the breaching party written notice of
termination of the Agreement.
(3) In the event that termination of the Agreement by SAFER
pursuant to this Section 6.2 (B) disrupts the clinical experience of any Student(s) in a Program,
the parties shall attempt, in good faith and using reasonable efforts, to continue Students' clinical
experiences and this Agreement shall remain in full force and effect until such time as this
Agreement may expire without disruption of said Students' clinical experience. During any time
period in which notice of termination has been given and existing Students are completing the
Program, no new Student will be placed at SAFER.
C. Immediate Termination. NTC may immediately terminate this
Agreement and any and all Program Addenda if SAFER fails to maintain full and unrestricted
accreditation, licensure and, if applicable, eligibility as required under Section 2.6 of this
Agreement. SAFER may terminate this Agreement immediately upon written notice to NTC if
NTC fails to maintain full and unrestricted accreditation and licensure as required under Section
1.5 of this Agreement. In addition, SAFER may also terminate any Program Addenda if NTC
fails to maintain full and unrestricted accreditation with respect to said Program as required
under the applicable Program Addendum.
6.3 Effect of Termination. Upon termination of this Agreement, no party
shall have any further obligation hereunder except for obligations accruing under the terms of
this Agreement prior to the date of termination.
Affiliation Agreement-SAFER, 12/13/13 5
6.4 Amendments and Modifications. This Agreement may be changed at
any time with the written approval of the parties. Such amendments or modifications will be
written, signed by the parties and made a part of this Agreement.
7. INDEMNIFICATION AND LIABILITY
7.1 NTC. NTC shall indemnify, defend and hold harmless SAFER, its
governing board, officers, employees and agents from and against any and all liabilities, claims,
losses, lawsuits, judgments, and/or expenses including attorney fees, arising, either directly or
indirectly, from any act or failure to act by NTC or any of its employees. NTC shall indemnify
SAFER for any negligent acts or omissions by any Student that may arise during the course and
scope of the clinical experience as described in this Agreement and the attached Program
Addenda.
7.2 SAFER. SAFER shall indemnify, defend and hold harmless NTC, its
governing board, officers, faculty, employees and agents from and against any and all liabilities,
claims, losses, lawsuits, judgments, and/or expenses including attorney fees, arising, either
directly or indirectly, from any act or failure to act by SAFER or any of its employees, agents, or
staff that may occur during or that may arise out of this Agreement.
7.3 Costs. In the event each party is found to be at fault, then each shall
bear its own costs and attorney fees and its proportionate share of any judgment or settlement
based on its percentage of fault, as determined by a procedure established by the parties.
7.4 Survival. This Section 7 shall continue beyond the expiration,
non-renewal or termination of this Agreement.
8. INSURANCE.
8.1 NTC. NTC shall maintain, at no cost to SAFER, general and
professional liability insurance covering NTC as an entity and each of its employees and agents
against general and professional liability claims, in the minimum amount of one million dollars
($1,000,000) per occurrence. NTC agrees to list SAFER as an additional insured on all policies
required to be maintained under this Section 8.1 and to promptly provide SAFER with evidence
of such insurance upon request.
8.2 SAFER. SAFER shall maintain, at no cost to NTC, general and
professional liability insurance covering SAFER as an entity and each of its employees, officers,
and staff against professional liability claims, in the minimum amount of one million dollars
($1,000,000) per occurrence. SAFER agrees to list NTC as an additional insured on all policies
required to be maintained under this Section 8.2 and to promptly provide NTC with evidence of
such insurance upon request.
9. DISPUTE RESOLUTION. Any dispute arising under or in any way related to
this Agreement that is not resolved by agreement of NTC and SAFER may be submitted by
either party to binding arbitration pursuant to the Commercial Arbitration Rules of the American
Arbitration Association. The parties agree that such arbitration shall result in a final and binding
award in the State of Wisconsin, and may be judicially enforced. The losing party shall bear the
arbitration costs and expenses, unless otherwise determined by the arbitrator.
Affiliation Agreement-SAFER, 12/13/13 6
10. NOTICES AND COMMUNICATION.
10.1 Notices. All notices under this Agreement shall be given in writing and
shall be deemed to have been properly given when delivered:
If to Northcentral Technical College
1000 W. Campus Drive
Wausau, WI 54401
If to SAFER:
3700 North Mountain Road
Wausau, WI 54401
or at other such addresses as a party from time to time may designate by written notice to the
other party.
10.2 Other Communications. Communications, other than notices as
described in Section 10.1 above, whether written or oral, shall be directed to the appropriate
NTC Dean, Educational Coordinator or Site Coordinator as indicated in the applicable Program
Addendum.
11. NON-EXCLUSIVE. The parties agree that NTC shall be free to enter into similar
agreements with other facilities, and that SAFER shall be free to enter into similar agreements
with other educational institutions.
12. GOVERNING LAW. This Agreement shall be governed by and construed in
accordance with the Laws of the State of Wisconsin.
13. INVALID PROVISION. The invalidity or unenforceability of any particular
provision of this Agreement shall not affect the other provisions hereof, and this Agreement shall
be construed in all respects as if such invalid or unenforceable provision were omitted.
14. ASSIGNMENT. No assignment by a party of this Agreement or its rights and
responsibilities hereunder shall be valid without the specific written consent of the other party.
15. RELATIONSHIP OF PARTIES. NTC and SAFER, including their respective
agents and employees, shall be, at all times, independent contractors of the other. Nothing in this
Agreement is intended or shall be construed to create a joint venture relationship, a partnership, a
lease, or a landlord/tenant relationship. Should any governmental agency question or challenge
the independent contractor status of NTC, SAFER or their employees, both NTC and SAFER,
upon receipt by either of them of notice, shall promptly notify the other party and afford the
other party the opportunity to participate in any government agency discussion or negotiations,
irrespective of how such discussions are initiated.
Affiliation Agreement-SAFER, 12/13/13 7
16. CONFIDENTIALITY OF RECORDS
16.1 Student Records. NTC and SAFER acknowledge that many student
educational records are protected by the Family Educational Rights and Privacy Act ("FERPA")
and that, generally, student permission must be obtained before releasing specific student data to
anyone other than NTC. NTC agrees to provide SAFER with guidance with respect to
compliance with FERPA.
16.2 Patient Health Care Records. NTC and SAFER acknowledge that
patient health information is protected under Wisconsin law (e.g., Wis. Stat. §§ 146.82, 51.30
and 252.15) and the Health Insurance Portability and Accountability Act ("HIPAA") and its
accompanying regulations. SAFER agrees to provide Students and NTC with guidance with
respect to compliance with these statutes and regulations.
17. NON-DISCRIMINATION. NTC and SAFER shall not unlawfully discriminate
against any individual on the basis of race, creed, color, sex, religion, age, disability or national
origin, and shall comply with applicable anti-discriminatory laws and policies promulgated by
NTC.
18. ENTIRE AGREEMENT. This Agreement, together with one or more Program
Addenda attached (or that later may be attached) hereto, constitutes the entire agreement between
the parties and contains all the agreements between the parties with respect to the subject hereof.
This Agreement supersedes any and all other agreements, in writing or oral, between the parties
hereto with respect to the subject matter thereof.
THIS AGREEMENT PRESUMES THE EXECUTION OF ONE OR MORE PROGRAM
ADDENDA.
IN WITNESS WHEREOF, the parties have executed this Agreement as of the Effective Date.
Northcentral Technical College: South Area Fire and Emergency Response
District:
By: By:
Its: Its:
Date: Date:
Affiliation Agreement-SAFER, 12/13/13 8
CLINICAL AFFILIATION AGREEMENT FOR
EMERGENCY MEDICAL SERVICES OCCUPATIONS
This Program Addendum is made effective this _______ day of ________, 2013
(“Effective Date”) by and between NORTHCENTRAL TECHNICAL COLLEGE a Wisconsin
institution for technical education and training ("NTC”) and SOUTH AREA FIRE AND
EMERGENCY RESPONSE DISTRICT, a Wisconsin clinical education setting (“SAFER”).
WHEREAS, NTC and SAFER have executed a Clinical Affiliation Agreement for
Emergency Medical Services Occupations dated __________ ("Agreement") that describes their
relationship regarding educational and clinical experiences for Students enrolled in one or more
of NTC’s Emergency Medical Services programs; and
WHEREAS, the Agreement presumes the execution of a Program Addendum pertaining
to each Emergency Medical Services occupation program to which it applies and any capitalized
terms not defined in this Program Addendum shall have the meaning set forth in the Agreement;
and
WHEREAS, the parties desire to execute this Program Addendum to effectuate the
Agreement with regard to NTC’s Emergency Medical Services Program ("Program");
NOW, THEREFORE, with regard to the Program, the parties agree as follows:
1. Pursuant to Section 1.3 of the Agreement, NTC’s Educational Coordinator for the
Program shall be Martin Aubol.
2. Pursuant to Section 1.6 of the Agreement, all Students who are assigned to
SAFER shall have had a background check performed under the direction of NTC in accordance
with applicable Wisconsin Caregiver Background Check Law. The background check shall
include obtaining, as applicable, information from the Department of Justice, the Department of
License and Regulation, the Department of Health and Family Services and from out-of-state
agencies if the Student has lived outside of Wisconsin within the past three years. If the Student
has a criminal record, it will be evaluated by NTC to determine if the individual is barred from
performing duties at SAFER. Prior to placement of the Student, NTC will notify SAFER in
writing of any crime of which Student has been convicted so that SAFER may make a
determination as to whether the conviction(s) is substantially related to the duties the Student
would be performing. SAFER may refuse placement of any Student SAFER believes could put
its patients, employees and/or visitors at risk. NTC hereby agrees to notify SAFER when NTC
becomes aware that any Student on site at SAFER is charged with or convicted of any crime or is
investigated by any governmental agency. Both NTC and SAFER understand that the Student
has an ongoing duty to report to NTC should there be any change from the initial background
check.
3. Pursuant to Section 2.2 of the Agreement, SAFER's Site Coordinator shall be
determined at a later time.
4. Pursuant to Section 2.4, responsibility for qualified supervision shall be as
follows: Clinical Instructors (Preceptors) assigned to the Program will be responsible for
provision, coordination and supervision of the clinical instruction, and the experience to be
provided by SAFER to the Students enrolled in the Program. Clinical Instructors will be
licensed by the State of Wisconsin in good professional standing with at least two (2) years of
Affiliation Agreement-SAFER, 12/13/13 9
experience at or above the level precepting or such higher number of years' experience as
requested by accreditation agencies, and have such other qualifications and experience as agreed
to by NTC’s and SAFER, or as required for Program accreditation by accrediting agencies and
authorities. NTC will initiate and maintain communication with the Preceptors throughout the
student’s clinical experience.
5. Pursuant to Section 2.7 of the Agreement, the clinical component offered by
NTC shall in all respects be implemented and administered by SAFER in a manner that meets
the requirements of any accreditation agency that accredits the Program, including the
.
6. Pursuant to Section 3.1 of the Agreement, SAFER shall provide the following
additional feedback to the Program: Evaluation of clinical performance by enrolled Students at
SAFER will be the responsibility of the Clinical Instructors and SAFER. The Clinical
Instructors will participate in evaluation of the Student through written communication. It is the
responsibility of the Clinical Instructors to notify NTC of performance of a Student that is less
than satisfactory in a timely manner so that appropriate remediation may be initiated by SAFER,
and if necessary, other action taken with the assistance of NTC. NTC, following review of
written reports and input from SAFER concerning Student performance and coursework in the
Program, will assign the final Pass-Fail grade to the Student for each clinical internship.
7. Pursuant to Section 6.1, the Agreement may continue for an initial term of one
Program year ending on , 2014.
8. All other terms of the Agreement shall apply, as applicable, to the Program and
this Program Addendum.
9. This Program Addendum shall be effective as of the date first written above and
shall continue in full force and effect for so long as the Agreement remains in full force and
effect unless this Program Addendum is (a) terminated prior to termination of the Agreement
pursuant to Section 6.2 of the Agreement, or (b) superseded by the execution of an amended
and/or restated Program Addendum.
IN WITNESS WHEREOF, the parties have executed this Program Addendum to the Affiliation
Agreement for Health Occupations as of the Effective Date.
Northcentral Technical College: South Area Fire and Emergency
Response District:
By:
By:
Its:
Its:
Date: ___________________________
Date:
Affiliation Agreement-SAFER, 12/13/13 10
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