MOBERLY AREA COMMUNITY COLLEGE - MACC Resourcesresource.macc.edu/~board/agendas/2014dec.pdf ·...

MOBERLY AREA COMMUNITY COLLEGE

BOARD OF TRUSTEES

James M. Cooksey, President Brad Goessling, Member

John Cochran, Vice President David Weis, Member

Denise Caldarello, Secretary Lori Turk, Member

COLLEGE PRESIDENT

Jeffery C. Lashley

DECEMBER AGENDA

December 15, 2014

MISSION

Moberly Area Community College, a public institution of higher education, provides open admission to students and fosters excellence in learning through innovative educational programs and services that are geographically and financially accessible throughout our service region.

VI. REPORT OF THE PRESIDENT

A. Personnel (Please see Appendix C.)

I. Appointment

It is recommended to the Board of Trustees that the person listed in the attachment be formally approved for appointment as presented.

Notations:______________________________

Motion to:----------------------------

By:____________,Seconded by:____________

Action:_______________________________

2. Employment

It is recommended to the Board of Trustees that the persons listed in the enclosed attachment be formally approved for employment as presented.

It is also recommended to the Board ofTrustees that the adjunct faculty members be formally employed. Employment of part-time faculty members is contingent on class enrollment and all official records required being on file at Moberly Area Community College.

Notations:______________________________

Motion to:______________________________

By:____________,Seconded by:____________

Action:_______________________________

B. Occupational Therapy Assistant Student Affiliation Agreements (Please see Appendix D.)

It is recommended to the Board of Trustees that MACC formally approve the Occupational Therapy Assistant Student Affiliation Agreements with Children's Therapy and Early Education; Douglass Community Services; Hand to Hand Rehab, LLC; Missouri Valley Community Action Agency; UCP Child Development Center; Villa Marie; The Work Center, Inc.; Sylvia G. Thompson Residence Center, Inc.; Missouri Veterans Commission; Lewis County Nursing Home; and HealthSouth Corporation. These agreements allow MACC students direct clinical experiences while under the supervision of the facilities' occupational therapist or other assigned professionals.

Board ofTrustees' Agenda, December 15, 2014 4

Notations:_______________________________

Motion to:_______________________________

By:_____________Seconded by: ____________

Action:________________________________

C. Agreement with Elsevier Inc. (Please See Appendix E.)

It is recommended to tbe Board of Trustees that an agreement for Packages of Products with Elsevier Inc. be approved for renewal. This agreement provides a complete line of testing and remediation products and services for students preparing for the National Council of Licensure Examination (NCLEX). The AADN program wishes to use this service to complete Health Education Systems, Inc. (HESI) testing. These testing and remediation products will allow student nurses the opportunity to test their knowledge and prepare for taking the state board exams. The nursing students will bear the cost of the practice exams and ancillary testing materials.

Notations:_______________________________

Motion to: _______________________________

By:._____________Secondedby:._____________

Action:.________________________________

D. Audit Report 2013-2014

It is recommended to the Board of Trustees that the Board-appointed Audit Committee be authorized to accept the audit of Moberly Area Community College's financial statements for the year ended June 30,2014. The completed audit will be forwarded to the Board of Trustees as soon as it becomes available.

Notations:_______________________________

Motion to:,_______________________________

By:.______________Secondedby:.____________

Action:;________________________________


E. Proposed Pay Rate Schedule (Please see Appendix F.)

It is recommended to the Board of Trustees that the Proposed Pay Rate Schedule be adopted, effective January I, 2015. These revisions recognize changes to state minimum wage from $7.50 to $7.65 that become effective on that date. Additions are shown in bold, while deletions or shown by striking through the text.

Notations:_______________________________

Motion to:_______________________________

By:______________Seconded by:------------

Action:________________________________

F. Proposed MACC Website Upgrade

It is recommended to the Board of Trustees that approval be given to enter into a contract with Kansas City Web Design in Overland Park, Kansas in the amount of $6,000.00, to upgrade the current operating system of the college's website to Joomla 3.0. In part, this process will improve the site's performance on mobile and tablet devices and pave the way for future enhancements. Other bids received were from CorePHP, LLC, Battle Creek, MI ($8,925) and 4WEB, Inc., Keene, NH ($9,500).

Notations:_______________________________

Motion to:,_______________________________

By:_____________Seconded by:____________

Action:________________________________

G. General Information

I. Off-Campus Holiday Community Projects

The MACC-Columbia Higher Education Center faculty and staff adopted four elderly households through the Voluntary Action organization. Their generous contributions made it possible to fulfill everything on the wish lists of their adoptees.

Board of Trustees' Agenda, December 15, 2014 6

http:6,000.00

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The MACC-Hannibal Area Higher Education Center students, faculty and staff collected 436 jars of peanut butter for the Hannibal Public School Buddy Pack Program. They will also help stuff and prepare the Buddy Packs for distribution.

The MACC-Kirksville Higher Education Center students, faculty and staff are collecting new baby items to be auctioned off for the Adopt-A-Child program. They have also been decorating the Twin Pines Nursing Home with help from art instructor Nancy Herron.

The Advanced Technology Center, Mexico - PTK members, faculty, and staff are sponsoring a non-perishable food drive for the Help Center. The food items will be distributed throughout the Mexico community. They also participated in the campaign for the United Way of Audrain County. The ATC exceeded their goal by 62%.

Notations:

2. MACC Small Business Technology Development Center - Fiscal Year 2014 Year End Report

MACC's Small Business Technology Development Center (SBTDC) closed out its 20132014 fiscal year September 30, 2014. The SBTDC provided counseling for fifty-one clients this past year, assisted in starting seven new businesses, and also helped in the creation of sixty-six new jobs for the area.

Notations:______________________________

3. Athletic Banquet

Both the Greyhound and Lady Greyhound teams will be honored for their season accomplishments at the annual Athletic Banquet to be held in the MACC Auditorium on April!!, 2015. Hall of Fame inductees will be recognized at this year's banquet.

Notations:______________________________

4. Curriculum Committee (Please see Appendix G.)

The Curriculum Committee revised program and new course proposals are attached for your information. These proposals have been approved by the Curriculum Committee, the President's Council, and the MACC President.

Notations:______________________________


5. Executive Session (Closed Meeting, Closed Record, Closed Vote) Following Regular Board of Trustees' Meeting, December 15,2014

There is an executive session (closed meeting, closed record, closed vote) immediately following tonight's regular Board of Trustees' meeting to discuss personnel as per RSMo. Sec. 61 0.021.(3) "Hiring, firing, disciplining, or promoting of particular employees by a public governmental body ...."

Notations:______________________________

VII. OTHER BUSINESS

A. Other

Notations:______________________________

B. Forum- Open Discussion

Notations:______________________________

VIII. ADJOURN

Notations:________________________________

Motion to:.________________________________

By:______________Seconded by:------------

Action:_________________________________

Board of Trustees' Agenda, December 15,2014 8


BOARD OF TRUSTEES

December 15, 2014

VI. Report of the President

A. Personnel

1. Appointment

a. Data Reporting Specialist- Lisa Gentner

Lisa Gentner will fill the position Data Reporting Specialist, beginning January 5, 20 15. She previously held the position Records Specialist, and has been employed by MACC since July, 2011.

2. Employment

a. Coordinator of Practical Nursing Program, Advanced Technology Center, Mexico- Ryan House

Ryan House will be employed as Coordinator of Practical Nursing at the Advanced Technology Center, Mexico. Mr. House earned his master in science in nursing from the University of Texas at Tyler, and his bachelor of science in nursing from the University of Missouri-Columbia. He most recently was employed as a practical nursing instructor at Pike-Lincoln Technical Center in Clarksville, Missouri. Mr. House will be relocating to Mexico.

b. Director of Institutional Development and Alumni Services- Susan Arment

Susan Arment will be employed as Director of Institutional Development and Alumni Services. Ms. Arment earned her bachelor of science from the College of Home Economics, University of Missouri-Columbia with special emphasis in housing and interior design. She most recently was employed as an accounting clerk at Mack Hills, Inc., Moberly. Ms. Arment resides in Moberly.

c. Women's and Men's Resident Assistants for Spring 2015

Wesley Nosakahare will continue filling the position of Men's Dorm Resident Assistant for the spring 2015 semester. Mr. Nosakahare is a 2014 graduate of Grandview High School in Grandview, Missouri. He is seeking an associate of arts degree in general studies.

Additionally, Debrielle Starkey will continue as Women's Dorm Resident Assistant for the spring 2015 semester. Ms. Starkey is a 2013 graduate of Withrow University High School in Cincinnati, Ohio. She is seeking a degree in criminal justice.

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d. Part-time Event Staff

John Secora and Taylor Ginter will be employed as part-time event staff at the Activity Center. Their duties include but are not limited to the following: concessions, cleaning, selling and taking tickets, officiating, office work, security, and general labor.

e. Faculty

Anita Smith will be employed as a part-time clinical coordinator of the MLT program. Ms. Smith earned her bachelor of science in nursing from Reagents College in Albany, New York. Ms. Smith currently resides in Sturgeon.

Persons previously employed at MACC:

Main Campus

Adolph, Jesse Composition II Barner, Brenda Composition I, Introduction to Contemporary Literature, Public

Speaking Bennett, Marlena Computer Essentials, Web Design I Cella, Kathy Human Anatomy, Physiology Cooksey, Rebekah Children's Literature for the Elementary Teacher Ehrhardt, Virginia Fundamentals of Writing, Fundamentals of Critical Reading Ellersieck, Chris Life Sports Fowler, Terry World Geography II, American History to 1865 Grant, James Sociology Heckner, Renee Nutrition, Health, and Safety Hughes, Jill Fundamentals of Writing Jemes, Natalie CDA Seminar, Play as Learning Johnson, Julie Composition II Killinger, Chad Varsity Sports II; Intro to Physical Education; Varsity Sports IV Moore, Fergus Art Survey and Appreciation I, Ceramics I and II Rash, Joseph Industrial Safety and Health Ratliff, Jonean Private Voice I, II, III, and IV Riely, Pat College Orientation; Employment Seminar Riley, Frank Introduction to Correction/Probation/Parole Roads, Charles Fundamentals of Math, Fundamentals of Algebra Schulte, Joyce General Psychology Schurb, Ken Introduction to the Bible Smith, Pat Methods & Tech of Officiating I, Varsity Sports II, Varsity Sports IV Vossler, Barb College Algebra Woods, Donnie Life Sports

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MACC - Columbia Higher Education Center

Allen, Rebecca Baker, Cara

Baker, Christina Beck, Shari Binkley, Ginger Blazis, Vincent Briscoe, Andrew Brown, David Bryan, Joey Burns, Robert Callahan, William Casey, Bill Chitwood, Kimberly Craig, Ted Dacey, Evelyn Day, Rebecca Derboven, Deb Easter, Matt Echternach, Tim Facetti, Elisa Fennewald, Elizabeth Fish, Andrew Fine, Connie Fischer, Robert Freelin, Jeff Gaddy, John Glendening, Theresa Goodrich, Russell Green, Daniel Habermeyer, Ryan Hardwick, Samuel Harlan-Newberry, Mary Head, Betsy Heckner, Renee Hickman, David Jacobs, Ted Johnson,Parvaneh Johnson, Scott Jones, Cynthia Karl, Martin Kastman, Joshua Kerns, Amanda Krishna, Santosh Lamsal, J agat Lorio, Julio

General Psychology Fundamentals of Math, Fundamentals of Algebra, Computer Assisted Pre-Algebra I, II & III Functions & Policies of American Government General Psychology, Human Lifespan Development General Psychology, Human Lifespan Development General Chemistry I Functions & Policies of American Government Fundamentals of Algebra, College Algebra Advanced Word Processing using Microsoft Word Intermediate Algebra Public Speaking World Geography I Physiology Earth Science, Geology College Algebra Computer Essentials General Psychology General Psychology Fundamentals of Critical Reading, Public Speaking College Orientation Composition I Fundamentals of Math, Fundamentals of Algebra Theater Appreciation, Acting I & II, Public Speaking American History to 1865 Introduction to Ethics Foundations of Chemistry Sociology Western Civilization I, American History to 1865 Composition II, Introduction to Contemporary Literature Composition I, American Literature from 1870 Intermediate Algebra Medical Office Insurance Intermediate Algebra Nutrition, Health and Safety Elementary Accounting I & II Public Speaking Fundamentals of Algebra Biology Fundamentals of Critical Reading, Technology for Teachers Computer Essentials Atmospheric Science College Orientation Computer Essentials, Introduction to Information Technology General Astronomy Biology, Introduction to Conservation Biology

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Madison, Ahmed Marchbanks, Eli McCrady, Andrew McDermott, Maggie McFillen, Kevin McVicker, Maryellen

Mendez-Flores, Carlos Merrill, Pat Mertens, Laura Montgomery, Court Mummert, Jenny Najem, Lanya Palmer, Bill Parke, Catherine

Perkins, David Perkins, Marcus Polk, James Proctor, Michael Provorse, Chris Radtke, Glenn Rinehart, Janet Robbins, Wayne Roberts, Nicholas Roberts, Steven Ross, Eric Russell, Ramin Schlimpert, Sherrill Schrader,Jazmin Semler, Brandon Shanks, Patti Small, John Smith, Rose Snodgrass, Mike Spiess, Jennifer Stewart, Ernest Stahlman, Brian Sveum, Matt Tate, Brian Tennill, Don Walker, Lisa Wallace, Laurie Wemhoff, Faith Whalen, Nancy Zumsteg, Cathy

Fundamentals of Math Business Communication Calculus I, Computer Assisted Pre-Algebra I, II, & III Composition I, Composition II Theater Appreciation, Public Speaking Art Survey & Appreciation I, American History to 1865, Functions & Policies of American Government Elementary Spanish, Intermediate Spanish College Algebra, Trigonometry College Orientation Composition II, African-American Literature Fundamentals of Writing Intermediate Arabic Human Anatomy Fundamentals of Critical Reading, History & Development of the Short Story Sociology, Social Deviance Computer Essentials Sociology, Sociology of the Family Macroeconomics College Orientation Public Speaking Play as Learning Computer Essentials, Music Appreciation Composition I, English Literature from 1750 Introduction to Juvenile Justice System Intra to Business Fundamentals of Algebra Children's Literature for the Elementary Teacher College Orientation Public Speaking Color Theory General Psychology, Personality Adjustment Fundamentals of Critical Reading American History to 1865, American History from 1865 Introduction to Conservation Biology, Introductory Plant Biology Introduction to Business, Principles of Marketing Fundamentals of Writing Macroeconomics, Microeconomics Music Appreciation, Music of America Business Law II Human Anatomy Physiology, Zoology Introduction to Social Work and Social Welfare College Algebra Earth Science, Geology

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MACC - Hannibal Higher Area Education Center

Brummett, Kenneth Campbell, Melissa Dick, Jimmy

Gilliland, Helen Griffin, Mary Lebron, Peter Lomax, Janice

Mack, Jeanne McGowan, Cheryl Miskell, William Rothfuss, Helen Salter, Frank See, Amy Seward, Karen

Stupavsky, Christine Trullinger, Terry

Williams, William Woodside, Melissa

Introduction to Conservation Biology Sociology, Introduction to Juvenile Justice System World Geography I, American History to 1865, American On-Screen II Principles of Management, Computer Essentials Human Lifespan Development Elementary Spanish Teaching Profession with Field Experience, Fundamentals of Critical Reading Intermediate Algebra, College Algebra Computer Essentials Western Civilization I, American History to 1865 Music Appreciation, Music of America Foundations of Chemistry, Earth Science, General Astronomy College Orientation Foundations of Education, Technology for Teachers, Children's Literature for the Elementary Teacher General Psychology, Abnormal Psychology American History to 1865, Functions & Policies of American Government Introduction to Ethics, Bioethics Fundamentals of Math, Fundamentals of Algebra

MACC - Kirksville Higher Education Center

Bevill, Kim Bradshaw, Janelle Byers, Jeremy Casady, Jean Connor, Nichole Fowler, Artie Frushour, Ted Garth, David Hartman, Janice Herron, Buster Herron, Nancy Keene, Anthony King, Meghan Lee, Gary Magruder, Jack Marcus, Jenny Meyer, Jennifer Miller, Elizabeth Noah, Darla Nothdurf, Jennifer

Computer Essentials Introduction to Ethics American History to 1865 Theater Appreciation Teaching Profession with Field Experience, Technology for Teachers Fundamentals of Critical Reading Science Fiction Intermediate Algebra General Psychology, Human Lifespan Development Fundamentals of Math Art Survey & Appreciation II, Beginning Sculpture Human Relations in Management Foundations of Education College Algebra, Trigonometry Foundations of Chemistry Classical Mythology Educational Psychology General Psychology Elementary Accounting I, Computer Essentials Human Anatomy

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Pita, Laura Quist, Jim Rempe, Sandra Roberts, Julie Snider, Cynthia

VanDolah, Lynn

Music Appreciation Religions of the World Introduction to Juvenile Justice System College Orientation Composition II, Introduction to Contemporary Literature, Public Speaking Sociology

Macon Area Education Center

Dwiggins, Amy (Wilson) Johnson, Julie King, William Neubauer, Ann Stanley, Sherry

Intermediate Algebra Classical Mythology Principles of Marketing General Astronomy Introduction to Criminal Justice Systems

Advanced Technology Center - Mexico

Blakely, Coltier Burson, Barbara Eick, Christine Fennewald, Betty Fischer, Robert Fuemmeler, Cindy Groes, Candace Kemp, Cynthia Lierheimer, Vicki Lower, Elizabeth Mayson, Anna McClain, Mya Morman, Todd Mossman, Karen Nance, Julie Owens, Andrea Pasley, Lois Roberts, Steven Schuler, Mark Staley, Walter Wolf, Steven Yacovazzi, Cassie

Online

Allen, Rebecca Baumann, Joseph Beckers, Laura Blake, Betsy Brobst, Travis

Computer Essentials, College Orientation Fundamentals of Math, Fundamentals of Algebra General Psychology, Human Lifespan Development Composition I Public Speaking Computer Essentials Introduction to Business, Human Relations in Management Intermediate Algebra, College Algebra Elementary Accounting II Fundamentals of Writing, Fundamentals of Critical Reading Fundamentals of Writing, Fundamentals of Critical Reading Fundamentals of Math American History to 1865 Public Speaking Sociology General Psychology Immunohematology Sociology, Introduction to Criminal Justice System Clinical Microbiology Music Appreciation, Music of America Fundamentals of Algebra American History to 1865

General Psychology American Literature to 1870 Biology Fundamentals of Algebra, Intermediate Algebra Personal Finance

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Byers, Jeremy Chrisman, Carolyn Coleman, Rebecca Crandall, Katie Crist, Shannon David, Jessica De Vine, Linda Dennis, Laura Dittmer, LilliAnn Douglass, Misty Pacetti, Elisa Fast, Tonya Forte, Jus tin Fowler, Artie Gentile, Deana Gilliland, Helen Grindstaff, Jennifer Groves, Caroline Habermeyer, Ryan Hansen, John Hitchcock, Christina Jermyn, Deb Johns, Amy Killian, Tony Koffarnus, Patricia Laccone, Frank Lamb, Vanessa Lasley, Annetta Marek, Sandra McCall, Michele McClay, Rebecca Mendez, Sarah Mertens, Laura Mileski, Michael Miller, Wynter Morgenstern, Nicole Nichols, Francine Niklova, Teodora Patton, Catherine Perkins, Julie Phillips, Stephanie Read, Carl Ricar, Sondra Roberts, Julie Ross, Anne Ruhlander, Tanya Ruzihitskay, Lanika Schlosser, Annie

American History to 1865 American History to 1865 Composition II Atmospheric Science Health & Hygiene General Psychology Composition I History & Development of the Short Story, Classical Mythology Sociology General Psychology College Orientation College Orientation Computer Essentials Health & Hygiene Composition II, Children's Literature for the Elementary Teacher Introduction to Information Technology Composition I & II Human Relations in Management Classical Mythology Composition I Composition II, African-American Literature Medical Terminology Medical Terminology, Music Appreciation American History to 1865 Medical Terminology Introduction to Conservation Biology Composition I & II Composition I Elementary Accounting I Art Survey & Appreciation II Human Anatomy Biology College Orientation Physiology Introduction to Ethics Computer Essentials Introduction to Social Psychology, Abnormal Psychology Elementary French American History to 1865, American in Vietnam College Orientation Computer Essentials Computer Essentials American History to 1865 Introduction to Business Fundamentals of Algebra Functions & Policies of American Government General Astronomy Introduction to Conservation Biology, Human Anatomy

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See, Amy Shanks, Patti Stuart, Kelsey Stuart, Parker Suchland, John Terhune, Michael Townsend, Susan Warner, Shawna Weimer, Amy Wilson, Chad

Dual Credit Online

Coleman, Rebecca DeVine, Linda Douglass, Misty Lamb, Vanessa Mendez, Sarah Ricar, Sondra Townsend, Susan Wooldidge, Holly

Principles of Marketing Art Survey & Appreciation I Biology Biology Biology World Geography I & II Composition II, Science Fiction Public Speaking College Orientation General Psychology

Composition II Composition II General Psychology Composition II Biology World Geography I Science Fiction Elementary Spanish

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Presented to Board of Trustees December 15, 2014

AFFIUATION AGREEMENT


Au Member of

Mlsouri Health Professions Consortium

Occupational Therapy Assistant Program

WITNESSETH WHER~ The College, as a member of the Missouri Health Professiops Consortium

(r-1HPC), has a p gram In Occupational Therapy Assistant (OTA) and Is deslro~s of cooperating with th~ Agency fort e benefit of MHPC OTA students as well as the benefit of th~ Agency and,

W~EREAS, the ~ency Is desirous of establishing a clinical educational progra\11 and of obtaining the e ucational and ractlcal benefits to be derived from the carrying out of suchie program and desires to cooperate wit the college In this respect

N~WTHEREFOR~, In consideration of the mutual promises and for such otnet t'urther co slderatlons a hereinafter contained, the parties hereby agree on the follo!Ning terms and co ditlons as foil ws:

l M q. College II plan and Implement an educational program for Its stu den s and will determine

the adeq acy of the educational experience oflts students in theoretlqal training, basic skills in the pr lsion of health care, professional ethics, attitude, and beha"i'or. College will determln a student's final grade. College will notify the agency of stu1ent(s)' asslgnment(s), teaming jectlves related to the curriculum, and schedule(s), lncludln~ the dates and purpose affiliation, the name(s) of the student{s)and the level of ac.demlc preparation.

l.~ College w II provide a qualified, Fieldwork Coordinator, employed by tt\e MHPC, to oversee agency fl ldwork educator and student educational relationships durh~ clinical assignments.

d College w II advise students.asslgned to agency of their responsibllitlesjfor complying with the pollcl s, rules, and regulations ofthe agency.

1.41 Program ill inform student(s), as part of the conditions of admission, Of their responslb litfes to maintain and to provide upon request a current healfh record showing the student's hysical status, Including Hepatitis B. vaccination status and eyldenei! of the student's mmunlzation for mumps, measles, and rubella (MMll), TB te~tlng, training In Universal recautlons, and follow-up exposures.

1.5) The Colle e shall provide professional liability protection for Its studen1s assigned to the Facility. T ellmlts for professional liability shall be a minimum of $1,00!>,000 each occurrent and $3,000,000 Aggregate.

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1.~

l.if

2. 2.~

2.2

2.3

The Coil e agrees to, at the written request of agency, remove from J;he agency's program any stud nts who, In the discretion ofthe agency, have performed uni;atlsfattorlly or whose behavior r activities are inappropriate or detrimental to the agency's! provision of health care to I clients or which are contrary to the objectives of this Agreement. Requests for removal fa student must be provided In writing and should follow th~ following procedure: a. If the agency deems a student's performance to be detrimental to ~he agency's health

care sponslbllitles the agency will recommend to the college thai the student be temp rarlly suspended from the program. The College will follow ~ts written policies relat to program continuance and student behavior, Student will be notified In wrltl ; the MHPC OTA Program Academic Fieldwork Coordinator \viii be notified.

b. Agen y, MHPC OTAAcademlc Fieldwork Coordinator, an official oflthe college and Stud t will confer as soon as feasible following such temporary s~spenslon to discuss reaso s for the suspension and the possibility of student's contlnu~tlon In the program.

c. If the gency determines that the continuation of the student in th~ program would be detri ental to the agency's health care responsibilities, the MHPCioTA Program and Colle e will withdraw the student from the agency upon receiving Written reasons from the a ency for such determination. :

d. If age cy determines the student can continue In the program, the~ a plan will be devel pedjolntly by the MHPC (ITA Program Academic Fieldwork Educator, agency, and stu de t for the remainder of the affiliation. The agency will provldl! makeup time for the stu de t equal to the period the student was suspended.

College a rees to provide evaluating forms to agency to be utilized In rating student performa ce. Upon req est, the MHPC OTA Program will provide to Agency the studr,nt's background screening results from the Missouri family care Safety Registry {FCSR),

1the Office of

Inspector eneral {OIG), and the General Services Administration Excluded Parties List System {E LS), In addition, If the student has lived outside of Missouri Wthin the past 10 years, a n tionwlde criminal background screening will also be provide~.

The agen will appoint one of Its employees, with the concurrence of \he Program and the College, a a Fieldwork Educator for each student{s). The Fieldwork Ed~cator will be responslb e for the planning and supervision of all experiences of the S1udent taking part In the educa lonal program at the agency. The Fieldwork Educator will be available for meetings lth the Program Academic Fieldwork Coordinator concern in~ the planning, implemen atlon, and carrying out of the student educational program

agency a~cl the Fieldwork Educator has sole primary responsibility fa~ patient care and treatme~t.

3~ RESPON Bl I 0 BOTH ARTIES 3.)1 Both pa les acknowledge and agree to Instruct student(s) on the lmpprtance of

respect! g the confidential nature of all information, which may comE{ to them regarding agency p otected health Information while participating In the fieldw

AFFILIATION AGREEMENT

MOBERLY AREA COMMUNITY COLLEGE As a Member of

Missouri Health Professions Consortium


THIS COOPERATIVE AGREEMENT (hereinafter the "Agreement) Is made and entered Into this 1st dav of Januarv. 2015 by and between MOBERLY AREA COMMUNITY COLLEGE (hereinafter

the "College") and Douglass Community Services (hereinafter called "Agency").

WITNESSETH WHEREAS, The College, as a member of the Missouri Health Professions Consortium

(MHPC), has a program In Occupational Therapy Assistant (OTA) and Is desirous of cooperating with the Agency for the benefit of MHPC OTA students as well as the benefit of the Agency and,

WHEREAS, the Agency Is desirous of establishing a clinical educational program and of obtaining the educational and practical benefits to be derived from the carrying out of such a program and desires to cooperate with the college In this respect

NOW THEREFORE, In consideration of the mutual promises and for such other further considerations as hereinafter contained, the parties hereby agree on the following terms and conditions as follows:

1. RESPONSIBILITIES OF THE COLLEGE AS A MEMBER OF MHPC OTA PROGRAM 1.1 College will plan and Implement an educational program for Its students and will determine

the adequacy of the educational experience of its students in theoretical training, basic skills in the provision of health care, professional ethics, attitude, and behavior. College will determine a student's final grade. College will notify the agency of student(s)' asslgnment(s), learning objectives related to the curriculum, and schedule(s), Including the dates and purpose of affiliation, the name(s) of the student(s) and the level of academic preparation.

1.2 College will provide a qualified, Fieldwork Coordinator, employed by the MHPC, to oversee agency fieldwork educator and student educational relationships during clinical assignments.

1.3 College will advise students assigned to agency of their responslbllitles for complying with the policies, rules, and regulations of the agency.

1.4 Program will Inform student(s), as part of the conditions of admission, of their responsibilities to maintain and to provide upon request a current health record showing the student's physical status, Including Hepatitis B vaccination status and evidence of the student's immunization for mumps, measles, and rubella (MMR), TB testing, training In Universal Precautions, and follow-up exposures.

1.5 The College shall provide professional liability protection for Its students assigned to the Facility. The limits for professional liability shall be a minimum of $1,000,000 each occurrence and $3,000,000 Aggregate.

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1.6 The College agrees to, at the written request of agency, remove from the agency's program any students who, in the discretion of the agency, have performed unsatisfactorily or whose behavior or activities are Inappropriate or detrimental to the agency's provision of health care to Its clients or which are contrary to the objectives of this Agreement. Requests for removal of a student must be provided In writing and should follow the following procedure: a. If the agency deems a student's performance to be detrimental to the agency's health

care responsibilities the agency will recommend to the college that the student be temporarily suspended from the program. The College will follow Its written policies related to program continuance and student behavior. Student will be notified in writing; the MHPC OTA Program Academic Fieldwork Coordinator will be notified.

b. Agency, MHPC OTA Academic Fieldwork Coordinator, an official of the college and Student will confer as soon as feasible following such temporary suspension to discuss reasons for the suspension and the possibility of student's continuation In the program.

c. If the agency determines that the continuation of the student In the program would be detrimental to the agency's health care responsibilities, the MHPC OTA Program and College will withdraw the student from the agency upon receiving written reasons from the agency for such determination.

d. If agency determines the student can continue in the program, then a plan will be developed jointly by the MHPC OTA Program Academic Fieldwork Educator, agency, and student for the remainder of the affiliation. The agency will provide makeup time for the student equal to the period the student was suspended.

1.7 College agrees to provide evaluating forms to agency to be utilized In rating student performance.

1.8 Upon request, the MHPC OTA Program will provide to Agency the student's background screening results from the Missouri Family Care Safety Registry (FCSR), the Office of Inspector General (OIG), and the General Services Administration Excluded Parties list System (EPLS). In addition, If the student has lived outside of Missouri within the past 10 years, a nationwide criminal background screening will also be provided.

2. RESPONSIBILITIES OF THE AGENCY 2.1 The agency will appoint one of Its employees, with the concurrence of the Program and the

College, as a Fieldwork Educator for each student(s). The Fieldwork Educator will be responsible for the planning and supervision of all experiences of the Student taking part In the educational program at the agency. The Fieldwork Educator will be available for meetings with the Program Academic Fieldwork Coordinator concerning the planning, Implementation, and carrying out of the student educational program as necessary.

2.2 Agency will conduct a complete orientation for each student In respect to the policies of the agency, will provide each student with the necessary instructional materials to be utilized during the educational programs as well as provide a place for safekeeping of student belongings while participating In affiliation duties.

2.3 Agency understands that the student will participate In providing, but shall not be solely responsible for, patient services rendered at agency as part of the student's experiences, including that students will also have the opportunity to participate In conferences and programs of Interest which are related to their discipline. It Is understood, however, that

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agency and the Fieldwork Educator has sole primary responsibility for patient care and treatment.

3. RESPONSIBILITIES OF BOTH PARTIES 3.1 Both parties acknowledge and agree to Instruct student(s} on the Importance of

respecting the confidential nature of all information, which may come to them regarding agency protected health Information while participating In the fieldwork education at the agency.

3.2 College will not discriminate against any student in its assignments to this program because of race, color, religion, sex, or national origin. Agency will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin.

3.3 Both parties recognize that they are bound to comply with the Family Educational Rights and Privacy Act (FERPA or the Buckley Amendment} In the handling of educational records of students enrolled In their programs.

3.4 Both parties agree that any amendments to this Agreement will be effective only If in writing and signed by all parties.

4. TERM AND TERMINATION This Agreement Is valid beginning 1/1/2015 and will remain In effect until terminated by either party. This Agreement may be terminated by either party upon notifying the other In writing sixty (60) days prior to the intended termination date. Such termination shall not, however, take effect with regard to Students enrolled In the Program until such Students have completed their clinical experience. The College and agency shall review this Agreement every 5 years. Pursuant to such review, the College shall issue a statement to the Agency for appropriate signatures to Insure that this Agreement remains current and timely.

COLLEGE: Moberly Area Community College

(Signature of Authorized Agent)

President (Title)

(Date) (Date)

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Missouri Health Professions Consortium Occupational Therapy Assistant Program

THIS COOPERATIVE AGREEMENT (hereinafter the "Agreement") is made and entered into this 1'' day of January, 2015 by and between MOBERLY AREA COMMUNITY COLLEGE (hereinafter the "College") and HAND TO HAND REHAB. LLC (hereinafter the "Agency").


(MHPC), has a program in Occupational Therapy Assistant (OTA) and is desirous of cooperating with the Agency for the benefit of MHPC OTA students as well as the benefit of the Agency and,

WHEREAS, the Agency is desirous of establishing a clinical educational program and of obtaining the educational and practical benefits to be derived from the carrying out of such a program and desires to cooperate with the college in this respect

NOW THEREFORE, in consideration of the mutual promises and for such other further considerations as hereinafter contained, the parties hereby agree on the following terms and conditions as follows:

1. RESPONSIBILITIES OF THE COLLEGE AS A MEMBER OF MHPC OTA PROGRAM 1.1 College will plan and implement an educational program for its students and will determine

the adequacy of the educational experience of its students in theoretical training, basic skills in the provision of health care, professional ethics, attitude, and behavior. College will determine a student's final grade. College will notify the agency of student(s)' assignment(s), learning objectives related to the curriculum, and schedule(s), including the dates and purpose of affiliation, the name(s) ofthe student(s) and the level of academic preparation.


1.3 College will advise students assigned to agency of their responsibilities for complying with the policies, rules, and regulations of the agency.

1.4 Program will inform student(s), as part of the conditions of admission, of their responsibilities to maintain and to provide upon request a current health record showing the student's physical status, including Hepatitis B vaccination status and evidence of the student's immunization for mumps, measles, and rubella (MMR), TB testing, training in Universal Precautions, and follow-up exposures.

1.5 The College shall provide professional liability protection for its students assigned to the Facility. The limits for professional liability shall be a minimum of $1,000,000 each occurrence and $3,000,000 Aggregate.

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1.6 The College agrees to, at the written request of agency, remove from the agency's program any students who, in the discretion of the agency, have performed unsatisfactorily or whose behavior or activities are inappropriate or detrimental to the agency's provision of health care to its clients or which are contrary to the objectives of this Agreement. Requests for removal of a student must be provided in writing and should follow the following procedure: a. If the agency deems a student's performance to be detrimental to the agency's health

care responsibilities the agency will recommend to the college that the student be temporarily suspended from the program. The College will follow its written policies related to program continuance and student behavior. Student will be notified in writing; the MHPC OTA Program Academic Fieldwork Coordinator will be notified.

b. Agency, MHPC OTA Academic Fieldwork Coordinator, an official of the college and Student will confer as soon as feasible following such temporary suspension to discuss reasons for the suspension and the possibility of student's continuation in the program.

c. If the agency determines that the continuation of the student in the program would be detrimental to the agency's health care responsibilities, the MHPC OTA Program and College will withdraw the student from the agency upon receiving written reasons from the agency for such determination.


1.7 College agrees to provide evaluating forms to agency to be utilized in rating student performance.

1.8 Upon request, the MHPC OTA Program will provide to Agency the student's background screening results from the Missouri Family Care Safety Registry (FCSR), the Office of Inspector General (OIG), and the General Services Administration Excluded Parties List System (EPLS). In addition, If the student has lived outside of Missouri within the past 10 years, a nationwide criminal background screening will also be provided.

2. RESPONSIBILITIES OF THE AGENCY 2.1 The agency will appoint one of its employees, with the concurrence of the Program and the

College, as a Fieldwork Educator for each student(s). The Fieldwork Educator will be responsible for the planning and supervision of all experiences of the Student taking part in the educational program at the agency. The Fieldwork Educator will be available for meetings with the Program Academic Fieldwork Coordinator concerning the planning, implementation, and carrying out of the student educational program as necessary.

2.2 Agency will conduct a complete orientation for each student in respect to the policies of the agency, will provide each student with the necessary instructional materials to be utilized during the educational programs as well as provide a place for safekeeping of student belongings while participating in affiliation duties.

2.3 Agency understands that the student will participate in providing, but shall not be solely responsible for, patient services rendered at agency as part of the student's experiences, including that students will also have the opportunity to participate in conferences and programs of interest which are related to their discipline. It is understood, however, that

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3. RESPONSIBILITIES OF BOTH PARTIES 3.1 Both parties acknowledge and agree to instruct student(s) on the importance of

respecting the confidential nature of all information, which may come to them regarding agency protected health information while participating in the fieldwork education at the agency.

3.2 College will not discriminate against any student in Its assignments to this program because of race, color, religion, sex, or national origin. Agency will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin.

3.3 Both parties recognize that they are bound to comply with the Family Educational Rights and Privacy Act (FERPA or the Buckley Amendment) in the handling of educational records of students enrolled in their programs.

3.4 Both parties agree that any amendments to this Agreement will be effective only if in writing and signed by all parties.

4. TERM AND TERMINATION This Agreement is valid beginning January 1, 2015 and will remain in effect until terminated by either party. This Agreement may be terminated by either party upon notifying the other in writing sixty (60) days prior to the intended termination date. Such termination shall not, however, take effect with regard to Students enrolled in the Program until such Students have completed their clinical experience. The College and agency shall review this Agreement every 5 years. Pursuant to such review, the College shall issue a statement to the Agency for appropriate signatures to insure that this Agreement remains current and timely.



President QLJAw Hqnd 76 fk,'l J IG_I~ k '-1 J.:,J_ (Title) (Title)

lo-l:r- ~~ (Date) (Date)

3

D -9





THIS COOPERATIVE AGREEMENT (hereinafter the "Agreement") Is made and entered Into this 1'1 day of Januarv, 2015 by and between MOBERLY AREA COMMUNITY COLLEGE (hereinafter the "College") and MISSOURI VALLEY COMMUNITY ACTION AGENCY (hereinafter the "Agency").


(MHPC), has a program In Occupational Therapy Assistant (OTA) and is desirous of cooperating with the Agency for the benefit of MHPC OTA students as well as the benefit of the Agency and,

WHEREAS, the Agency is desirous of establishing a clinical educational program and of obtaining the educational and practical benefits to be derived from the carrying out ofsuch a program and desires to cooperate with the college In this respect

NOW THEREFORE, In consideration of the mutual promises and for such other further considerations as hereinafter contained, the parties hereby agree on the following terms and conditions as follows:

1. RESPONSIBILITIES OF THE COLLEGE AS A MEMBER OF MHPC OTA PROGRAM 1.1 College will plan and Implement an educatlonal program for Its students and will determine

the adequacy of the educational experience of its students in theoretical training, basic skills In the provision of health care, professional ethics, attitude, and behavior. College will determine a student's final grade. College will notify the agency of student(s)' asslgnment(s), learning objectives related to the curriculum, and schedule(s), Including the dates and purpose of affiliation, the name(s) ofthe student(s) and the level of academic preparation.



1.4 Program will Inform student(s), as part of tne conditions of admission, of their responsibilities to maintain and to provide upon request a current health record showing the student's physical status, Including Hepatitis B vaccination status and evidence of the student's Immunization for mumps, measles, and rubella (MMR), TB testing, training In Universal Precautions, and follow-up exposures.


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1.6 The College agrees to, at the written request of agency, remove from the agency's program any students who, In the discretion of the agency, have performed unsatisfactorily or whose behavior or activities are Inappropriate or detrimental to the agency's provision of health care to Its clients or which are contrary to the objectives of this Agreement. Requests for removal of a student must be provided In writing and should follow the following procedure: a. If the agency deems astudent's performance to be detrimental to the agency's health

care responsibilities the agency will recommend to the college that the student be temporarily suspended from the program. The College will follow its written policies related to program continuance and student behavior. Student will be notified In writing; the MHPC OTA Program Academic Fieldwork Coordinator will be notified.



d. If agency determines the student can continue In the program, then a plan will be developed jointly by the MHPC OTA Program Academic Fieldwork Educator, agency, and student for the remainder of the affiliation. The agency will provide makeup time for the student equal to the period the student was suspended.

1.7 College agrees to provide evaluating forms to agency to be utilized in rating student performance.

1.8 Upon request, the MHPC OTA Program will provide to Agency the student's background screening results from the Missouri Family Care Safety Registry (FCSR), the Office of Inspector General (OIG); and the General Services Administration Excluded Parties List System (EPLS). In addition, If the student has lived outside of Missouri within the past 10 years, a nationwide criminal background screening will also be provided.


College, as a Fieldwork Educator for each student(s). The Fieldwork Educator will be responsible for the planning and supervision of all experiences of the Student taking part In the educational program at the agency. The Fieldwork Educator will be available for meetings with the Program Academic Fieldwork Coqrdlnator concerning the planning, Implementation, and carrying out of the student educational program as necessary.

2.2 Agency will conduct a complete orientation for each student In respect to the policies of the agency; will provide each student with the necessary Instructional materials to be utilized during the educational programs as well as provide a place for safekeeping of student belongings while participating in affiliation duties.

2.3 Agency understands that the student will participate In providing, but shall not be solely responsible for, patient services rendered at agency as part of the student's experiences, Including that students will also have the opportunity to participate In conferences and programs of Interest which are related to their discipline. It Is understood, however, that

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3. RESPONSIBILITIES OF BOTH PARTIES 3.1 Both parties acknowledge and agree to Instruct student(s) on the Importance of

respecting the confidential nature of all Information, which may come to them regarding

agency protected health Information while participating In the fieldwork education at the

agency.

3.2 College will not discriminate against any student In its assignments to this program because of race, color, religion, sex, or national origin. Agency will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin.

3.3 Both parties recognize that they are bound to comply with the Family Educational Rights and Privacy Act (FERPA or the Buckley Amendment) In the handling of educational records of students enrolled In their programs.

3.4 Both parties agree that any amendments to this Agreement will be effective only If In writing and signed by all parties.

4. TERM AND TERMINATION This Agreement Is valid beginning January 1. 2015 and will remain in effect until terminated by either party. This Agreement may be terminated by either party upon notifying the other In writing sixty (60) days prior to the Intended termination date. Such termination shall not, however, take effect with regard to Students enrolled In the Program until such Students have completed their clinical experience .. The College and agency shall review this Agreement every 5 years. Pursuant to such review, the College shall issue a statement to the Agency for appropriate signatures to Insure that this Agreement remains current and timely.

COLLEGE: Moberly Area Community College AGENCY: Missouri Valley Community Action Agency

I

{Signature of Authorized Agent)

President Dt:ec~cof r:.t..:w-. Gzrn,f:s I>lzv. {Title) {Title)

9/ztr //If(Date) {Date)

3

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THIS COOPERATIVE AGREEMENT (hereinafter the "Agreement) is made and entered into this 1st dav of January, 201S by and between MOBERLY AREA COMMUNITY COllEGE (hereinafter

the "College") and UCP Child Development Center (hereinafter called "Agency").


(MHPC), has a program in OccupationaiTherapy Assistant (OTA) and is desirous of cooperating with the Agency for the benefit of MHPC OTA students as well as the benefit of the Agency and,

WHEREAS, the Agency is desirous of establishing a clinical educational program and of obtaining the educational and practical benefits to be derived from the carrying out of such a program and desires to cooperate with the college in this respect


1. RESPONSIBiliTIES OF THE COLLEGE AS A MEMBER OF MHPC OTA PROGRAM 1.1 College will plan and implement an educational program for its students and will determine

the adequacy of the educational experience of its students in theoretical training, basic skills In the provision of health care, professional ethics, attitude, and behavior. College will determine a student's final grade. College will notify the agency of student(s)' assignment(s), learning objectives related to the curriculum, and schedule(s), including the dates and purpose of affiliation, the name(s) of the student(s) and the level of academic preparation.

1.2 College will provide a qualified, fieldwork Coordinator, employed by the MHPC, to oversee agency fieldwork educator and student educational relationships during clinical assignments.


1.4 Program will inform student(s), as part of the conditions of admission, of their responsibilities to maintain and to provide upon request a current health record showing the student's physical status, including Hepatitis B vaccination status and evidence of the student's Immunization for mumps, measles, and rubella (MMR), TB testing, training in Universal Precautions, and follow-up exposures.


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1.6 The College agrees to, at the written request of agency, remove from the agency's program any students who, In the discretion of the agency, have performed unsatisfactorily or whose behavior or activities are inappropriate or detrimental to the agency's provision of health care to Its clients or which are contrary to the objectives of this Agreement. Requests for removal of a student must be provided in writing and should follow the following procedure: a. If the agency deems a student's performance to be detrimental to the agency's health

care responsibilities the agency will recommend to the college that the student be temporarily suspended from the program. The College will follow its written policies related to program continuance and student behavior. Student will be notified in writing; the MHPC OTA Program Academic Fieldwork Coordinator will be notified.


c. If the agency determines that the continuation of the student in the program would be detrimental to the agency's health care responsibilities, the MHPC OTA Program and College will withdraw the student from the agency upon receiving written reasons from the agency for such determination.


1.7 College agrees to provide evaluating forms to agency to be utilized in rating student

performance.

1.8 Upon request, the MHPC OTA Program will provide to Agency the student's background screening results from the Missouri Family Care Safety Registry (FCSR), the Office of Inspector General (OIG), and the General Services Administration Excluded Parties List System (EPLS). In addition, if the student has lived outside of Missouri within the past 10 years, a nationwide criminal background screening will also be provided.

2. RESPONSIBILITIES OF THE AGENCY 2.1 The agency will appoint one of its employees, with the concurrence of the Program and the

College, as a Fieldwork Educator for each student(s). The Fieldwork Educator will be responsible for the planning and supervision of all experiences of the Student taking part in the educational program at the agency. The Fieldwork Educator will be available for meetings with the Program Academic Fieldwork Coordinator concerning the planning, implementation, and carrying out of the student educational program as necessary.

2.2 Agency will conduct a complete orientation for each student in respect to the policies of the agency, will provide each student with the necessary instructional materials to be utilized during the educational programs as well as provide a place for safekeeping of student belongings while participating in affiliation duties.

2.3 Agency understands that the student will participate in providing, but shall not be solely responsible for, patient services rendered at agency as part of the student's experiences, including that students will also have the opportunity to participate in conferences and programs of interest which are related to their discipline. It is understood, however, that

2

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3. RESPONSIBILITIES OF BOTH PARTIES 3.1 Both parties acknowledge and agree to instruct student(s) on the importance of

respecting the confidential nature of all information, which may come to them regarding agency protected health Information while participating in the fieldwork education at the agency.

3.2 College will not discriminate against any student in its assignments to this program because of race, color, religion, sex, or national origin. Agency will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin.

3.3 Both parties recognize that they are bound to comply with the Family Educational Rights and Privacy Act (FERPA or the Buckley Amendment) in the handling of educational records of students enrolled in their programs.

3.4 Both parties agree that any amendments to this Agreement will be effective only If in writing and signed by all parties.

4. TERM AND TERMINATION This Agreement is valid beginning 1/1/2015 and will remain in effect until terminated by either party. This Agreement may be terminated by either party upon notifying the other in writing sixty (60) days prior to the intended termination date. Such termination shall not, however, take effect with regard to Students enrolled in the Program until such Students have completed their clinical experience. The College and agency shall review this Agreement every 5 years. Pursuant to such review, the College shall issue a statement to the Agency for appropriate signatures to insure that this Agreement remains current and timely.

COLLEGE: Moberly Area Community College AGENCY:


President

(Title) (Title)

0~11UVL (Date) (Date)

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THIS COOPERATIVE AGREEMENT (hereinafter the "Agreement") is made and entered into this 1" dav of Januarv. 2015 by and between MOBERLY AREA COMMUNITY COLLEGE (hereinafter the "College") and Villa Marie (hereinafter the "Agency").


(MHPC), has a program in Occupational Therapy Assistant (OTA) and Is desirous of cooperating with the Agency for the benefit of MHPC OTA students as well as the benefit of the Agency and,

WHEREAS, the Agency Is desirous of establishing a clinical educational program and of obtaining the educational and practical benefits to be derived from the carrying out of such a program and desires to cooperate with the college in this respect

NOW THEREFORE, In consideration of the mutual promises and for such other further

considerations as hereinafter contained, the parties hereby agree on the following terms and

conditions as follows:

1. RESPONSIBILITIES OF THE COLLEGE AS A MEMBER OF MHPC OTA PROGRAM 1.1 College will plan and Implement an educational program for its students and will determine

the adequacy of the educational experience of its students In theoretical training, basic skills In the provision of health care, professional ethics, attitude, and behavior. College wlll determine a student's final grade. College will notify the agency of student(s)' asslgnment(s), learning objectives related to the curriculum, and schedule(s), including the dates and purpose of affiliation, the name(s) of the student(s) and the level of academic preparation.


1.3 College will advise students assigned to agency of their responsibilities for complying with the policies, rules, and regulations ofthe agency.

1.4 Program will inform student(s), as part of the conditions of admission, of their responsibilities to maintain and to provide upon request a current health record showing the student's physical status, Including Hepatitis B vaccination status and evidence of the student's immunization for mumps, measles, and rubella (MMR), TB testing, training in Universal Precautions, and follow-up exposures.


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1.6 The College agrees to, at the written request of agency, remove from the agency's program any students who, In the discretion of the agency, have performed unsatisfactorily or whose behavior or activities are inappropriate or detrimental to the agency's provision of health care to its clients or which are contrary to the objectives of this Agreement. Requests for removal of a student must be provided In writing and should follow the following procedure: a. If the agency deems a student's performance to be detrimental to the agency's health

care responsibilities the agency will recommend to the college that the student be temporarily suspended from the program. The College will follow its written policies related to program continuance and student behavior. Student will be notified In writing; the MHPC OTA Program Academic Fieldwork Coordinator will be notified.





1.8 Upon request, the MHPC OTA Program will provide to Agency the student's background screening results from the Missouri Family Care Safety Registry (FCSR), the Office of Inspector General (OIG), and the General Services Administration Excluded Parties List System (EPLS). In addition, if the student has lived outside of Missouri within the past 10 years, a nationwide criminal background screening will also be provided.

2. RESPONSIBILITIES OF THE AGENCY 2.1 The agency will appoint one of Its employees, with the concurrence ofthe Program and the

College, as a Fieldwork Educator for each student(s). The Fieldwork Educator will be responsible for the planning and supervision of all experiences of the Student taking part In the educational program at the agency. The Fieldwork Educator will be available for meetings with the Program Academic Fieldwork Coordinator concerning the planning, implementation, and carrying out ofthe student educational program as necessary.

2.2 Agency will conduct a complete orientation for each student In respect to the policies of the agency, will provide each student with the necessary instructional materials to be utilized during the educational programs as well as provide a place for safekeeping of student belongings while participating in affiliation duties.

2.3 Agency understands that the student will participate in providing, but shall not be solely responsible for, patient services rendered at agency as part of the student's experiences, including that students will also have the opportunity to participate In conferences and programs of interest which are related to their discipline. It is understood, however, that

2

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3. RESPONSIBILITIES OF BOTH PARTIES 3.1 Both parties acknowledge and agree to instruct student{s) on the Importance of

respecting the confidential nature of all information, which may come to them regarding agency protected health information while participating in the fieldwork education at the agency.

3.2 College will not discriminate against any student In Its assignments to this program because of race, color, religion, sex, or national origin. Agency will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin.

3.3 Both parties recognize that they are bound to comply with the Family Educational Rights and Privacy Act {FERPA or the Buckley Amendment) in the handling of educational records of students enrolled in their programs.


4. TERM AND TERMINATION This Agreement is valid beginning January 1. 2015 and will remain in effect until terminated by either party. This Agreement may be terminated by either party upon notifying the other In writing sixty {60} days prior to the intended termination date. Such termination shall not, however, take effect with regard to Students enrolled in the Program until such Students have completed their clinical experience. The College and agency shall review this Agreement every 5 years. Pursuant to such review, the College shall Issue a statement to the Agency for appropr1ate signatures to insure that this Agreement remains current and timely.


{Signature of Authorized Agent)

President

{Title) (Title)

(Date) {Date) 1

3

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ADDENDUM NO. 1 (ADDITIONAL TERMS)

THIS ADDENDUM NO, 1 to the Affiliation Agreement dated January 1. 2015 (the "Agreement"), is made and entered Into by and between MoberlY Area Community College. as a member of the Missouri Health Professions Consortium ("College") and VIlla Marie ("Agency").

The parties agree to the following revlslon(s) to the Agreement:

1. The College agrees to defend, Indemnify and hold harmless the Agency, its officers, directors, employees, agents, assigns, from and against all claims, damages, losses and expenses, Including, but not limited to attorney's fees, which may be asserted by a student against the Agency, whether direct or indirect, foreseeable or unforeseeable, for any act, omission, arising out of, or from the performance of the Agreement, regardless of whether or not such claim, damage, loss or expense is caused In part by a party indemnified hereunder. Such obligation shall not be construed to negate, abridge or reduce other rights or obligations of Indemnity that would otherwise exist In the absence ofthls Agreement.

2. If any provision of this Agreement, or any section, paragraph, sentence, clause, phrase, term, word or the application thereof, In any circumstance, Is held void or invalid by a court of competent jurisdiction, then It shall be deemed to be excised and the invalidity thereof shall not affect any of the other provisions, sections, paragraphs, sentences, clauses, phrases, terms and words of this entire Settlement Agreement.

In all other respects the terms and conditions of the Agreement will remain unchanged. In case of a conflict between the terms of the Agreement and the terms of this Addendum, the terms of this Addendum No. 1 will control.

This Addendum No. 1 is effective as of the effective date of the Agreement.



President (lltle)

(Date) (Date)

D- 19





THIS COOPERATIVE AGREEMENT (hereinafter the "Agreement") is made and entered Into this 1'1 day of January, 2015 by and between MOBERLY AREA COMMUNITY COLLEGE (hereinafter the "College") and THE WORK CENTER. INC. (hereinafter the "Agency").


(MHPC), has a program In Occupational Therapy Assistant (OTA) and is desirous of cooperating with the Agency for the benefit of MHPC OTA students as well as the benefit of the Agency and,

WHEREAS, the Agency Is desirous of establishing a clinical educational program and of obtaining the educational and practical benefits to be derived from the carrying out of such a program and desires to cooperate with the college In this respect


1. RESPONSIBILITIES OF THE COLLEGE AS A MEMBER OF MHPC OTA PROGRAM 1.1 College will plan and implement an educational program for its students and will determine

the adequacy of the educational experience of its students in theoretical training, basic skills In the provision of health care, professional ethics, attitude, and behavior. College will determine a student's final grade. College will notify the agency of student(s)' asslgnment(s), learning objectives related to the curriculum, and schedule(s), Including the dates and purpose of affiliation, the name(s) of the student(s) and the level of academic preparation.



1.4 Program will inform student(s), as part of the conditions of admission, of their responsibilities to maintain and to provide upon request a current health record showing the student's physical status, including Hepatitis B vaccination status and evidence of the student's Immunization for mumps, measles, and rubella (MMR), TB testing, training In Universal Precautions, and follow-up exposures.


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1.6 The College agrees to, at the written request of agency, remove from the agency's program any students who, In the discretion of the agency, have performed unsatisfactorily or whose behavior or activities are Inappropriate or detrimental to the agency's provision of health care to Its clients or which are contrary to the objectives of this Agreement. Requests for removal of a student must be provided In writing and should follow the following procedure: a. If the agency deems a student's performance to be detrimental to the agency's health

care responsibilities the agency will recommend to the college that the student be temporarily suspended from the program. The College will follow Its written policies related to program continuance and student behavior. Student will be notified In writing; the MHPC OTA Program Academic Fieldwork Coordinator will be notified.



d. If agency determines the student can continue In the program, then a plan will be developed jointly by the MHPC OTA Program Academic Fieldwork Educator, agency, and student for the remainder of the affiliation. The agency will provide makeup time for the student equal to the period the student was suspended.


1.8 Upon request, the MHPC OTA Program will provide to Agency the student's background screening results from the Missouri Family care Safety Registry (FCSR), the Office of Inspector General (OIG), and the General Services Administration Excluded Parties List System (EPLSj. In addition, If the student has lived outside of Missouri within the past 10 years, a nationwide criminal background screening will also be provided.


College, as a Fieldwork Educator for each student(s). The Fieldwork Educator will be responsible for the planning and supervision of all experiences of the Student taking part in the educational program at the agency. The Fieldwork Educator will be available for meetings with the Program Academic Fieldwork Coordinator concerning the planning, Implementation, and carrying out of the student educational program as necessary.

2.2 Agency will conduct a complete orientation for each student in respect to the policies of the agency, will provide each student with the necessary Instructional materials to be utilized during the educational programs as well as provide a place for safekeeping of student belongings while participating In affiliation duties.

2.3 Agency understands that the student will participate In providing, but shall not be solely responsible for, patient services rendered at agency as part of the student's experiences, Including that students will also have the opportunity to participate in conferences and programs of Interest which are related to their discipline. It is understood, however, that

2

D- 21


3. RESPONSIBILITIES OF BOTH PARTIES 3.1 Both parties acknowledge and agree to instruct student(s) on the Importance of

respecting the confidential nature of all information, which may come to them regarding agency protected health Information while participating In the fieldwork education at the agency.

3.2 College will not discriminate against any student in Its assignments to this program because of race, color, religion, sex, or national origin. Agency will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin.

3.3 Both parties recognize that they are bound to comply with the Family Educational Rights and Privacy Act (FERPA or the Buckley Amendment) In the handling of educational records of students enrolled In their programs.


4. TERM AND TERMINATION This Agreement is valid beginning Januarv 1. 2015 and will remain In effect until terminated by either party. This Agreement may be terminated by either party upon notifying the other In writing sixty (60) days prior to the Intended termination date. Such termination shall not, however, take effect with regard to Students enrolled In the Program until such Students have completed their clinical experience. The College and agency shall review this Agreement every 5 years. Pursuant to such review, the College shall issue a statement to the Agency for appropriate signatures to Insure that this Agreement remains current and timely.

COLLEGE: Moberly Area Community College AGENCY: The Work Center. Inc.

(Signature of Authorl~ed Agent)

President (ntle)

Slgnat re of Authorized Agent)

(Date) (Date)

3

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MOBERLY AREA COMMUNITY COLLEGE NtMtmberof

Missouri He~tth Professions COnsortium Occupational Therapy Assistant Program

THIS COOPERATIVE AGREEMENT (hereinafter the "Agreement) Is made and entered Into this 1st day of Februarv, ZOl$ by and between MOBERLY AREA COMMUNITY COLLEGE

(hereinafter the "Collese"-) and Sylvia G. Thompson Residence center. Inc. (hereinafter called "Agency").

WITNESSETH WHEREAS, The College, as a member o.fthe Missouri Health Professions Consortium

(MHPC), has a program in Occupational Therapy Assistant (OTA) and Is desirous of cooperating with the Agency for the benefit of MHPC OTA st\ldents as \Yell as the. benefit of the Agency and,

WHEREAS, the Agency Is deslrqus of establlshlog a clinical education~! program and of obtaining the educational and practiCehavlor. College will detenmlne a student's final grade. College will notify the a~,:ency of student(s)' asslgnment(s), learning objectives reiatet(s), as part ofthe conditions of admission, ofthelr responsibilities to maintain and to provide upon request a current health record showing the student'S physical status, Including Hepatitis B vaccination status and evidence of the studen\'s lmmunl1atlon for mu_mps, measles, and rubella (MMR), TB testing, training In Universal Preeautlons, and follow-up exposures.

1

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1.5 The College shall provide professional liability protection for Its students asslgnedto the Facility, The limits for professional liability shall be ~ minimum of $1,000,000 each occurr~nce ~nd $3,000,000 Aggregate.

1.6 The College agrees to, at the written request of agency, remove from the agency's program ~nv students who, in the discretion ofthe.. agency, have performed unsatlsf~ctorliY, or whose behavior or activities are inappropriate ordetrimental to the agency's provision of he;~lth care to Its clients or whiP, are contrary to the objectives of this Agreement. Requests for removal of a stut!ent must be provided In writing and should follow the following procedure: a. If the agency .!l.eems a-student's performance to be detrimental to the agency's he

2.3 Agency understands that the student will participate In providing, but shall not be solely responsible for, patient serviCes rendere~ at agency as part of the student's expetiences, l'ncludlng that students will also have the' opportunity to participate In conferences and programs of Interest which are related to their discipline. It Is understood, hoWever, that agency and the Fieldwork Educator has sole primary responsibility for patient care and treatment.

3. RESPONSIBIUTIES OF BOTH PART(ES 3.1 Both parties acknowledge. and agree to Instruct student(s) on the importance of

respecting. the confidentlalnature of all Information, which may come to them regardi.ng agency protected health Information while participating In the fieldwork .education at the agency.

3.2 College will not dl$Crlmlnate ~galnst any student In Its assignments to this program because of race, color, religion, sex, or national origin. Agency will not discriminate against any employee or applicant foF employment because of race, color, religion, sex, or national origin.

3.3 ~oth parties recognize that they are bound to comply with the Family Educational Rights and Prl~acy Act (FERPA or the Buckley Amendment) in the handling of educational records of students enrolled In their programs.

3.4 Both parties agree that any amendments to this Agreement will be effective only If In writing and signed by all parties,

4. Jl;RM AND TERMINATION This Agreement Is valid beginning 2/1/2.015 and will remain In effect until terminated by either party. This Agreement may be terminated by either parw upon notifying the other In writing sixty (60) days prior to the Intended termination date. Such termination shall not, however,. take effect with regard to Students enrolled in the Program until such Students have completed )heir clinical experience: The College and a)!ency shall review this Agreement every 5 years. Pursuant to such review, the College shalllssue a statement to the Agency for appropriate slgnat~res to Insure that this Agreement remains current and timely.

COLLEGE; MoberlvArea Cgmmunltv Collese AGENCY; Sylvia G. Thomeson Residence Center,

!.n.

~~ju~ttJ(Signature of Authorl~ed Agent) (Signature of Authorized Agent)

President (Title)

(Date) (Date) v I

3

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http:regardi.ng


THIS AGREEMENT is made and entered into as ofthislst day of February 2015 by and between the MISSOURI VETERANS COMMISSION ("MVC"), a Missouri state agency organized and existing under Chapter 42 of the Revised Statutes of Missouri (RSMo) and MOBERLY AREA COMMUNITY COLLEGE a member of Missouri Health Professions Consortium organized and existing under the laws of the State of Missouri "AFFILIATE".

WHEREAS, the State of Missouri has established seven Missouri State Veterans Homes that are operated by the MVC, providing long-term care for Missouri's Veterans; and

WHEREAS, MVC's long-term health care facilities are approved by the United States Department of Veterans Affairs (VA) and are licensed by the MVC; and

WHEREAS, AFFILIATE is desirous of providing a clinical learning experience for Students Enrolled in their Occupational Therapy Assistant Program (OTA)

WHEREAS, in the interest of promoting the highest level of quality in the skilled nursing facility labor pool, MVC is willing to cooperate with AFFILIATE and make its facilities available to AFFILIATE and its Program Participants, subject to the terms and conditions set forth in this Agreement; and

WHEREAS, the parties are desirous of entering into an agreement to facilitate AFFILIATE's training of its Program Participants at the MVC's Missouri Veterans HomeMexico (MVH) while ensuring the highest practicable physical well-being and care of the residents,

NOW THEREFORE, in consideration of the premises and the mutual obligations set forth in this Agreement, the parties agree as follows:

I. Term of Agreement.

a. Initial Term. This Agreement shall be for an initial of (I) year, commencing on or about the!'' day of February 2015.

b. Renewal. The Agreement may be renewed by the MVC, with the acceptance of AFFILIATE, by providing thirty (30) days advance written notice to AFFILIATE of its intent to renew the Agreement for an additional one (I) year term, not to exceed a total of four (4) additional renewal periods.

c. Termination. Either party may terminate the Agreement without cause with the provision of thirty (30) days advance written notice to the other party of its intent to terminate the Agreement.

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2. Standard Terms and Conditions. This document includes Business Associate Provisions which are attached hereto as Exhibit A and incorporated herein by reference, as if fully set forth in this Agreement.

3. Consideration. The consideration for this Agreement shall be the mutual promises and obligations of the parties and shall not include monetary consideration, except as may otherwise be specifically provided.

4. Roles and Responsibilities.

a. Identification of Designated Representatives, Each party agrees to identify a Designated Representative to communicate with the other party. The contact information for the Designated Representative is listed in the attachment labeled as Exhibit "B," which is incorporated herein by reference.

b. Conditions of Participation. As a condition of participation in the Program, Program Participants and AFFILIATE staff assigned to MVH shall be informed by AFFILIATE, and shall agree in writing, that Program

MOBERLY AREA COMMUNITY COLLEGE - MACC Resourcesresource.macc.edu/~board/agendas/2014dec.pdf ·...

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