Attachment 1
AN AGREEMENT BY AND BETWEEN
THE NORWALK-LA MIRADA UNIFIED SCHOOL DISTRICT,
THE CITY OF NORWALK,
AND
CALIFORNIA STATE UNIVERSITY LONG BEACH
This Agreement ("Agreement") for operating the Health on Wheels Program (Program ) is entered into by and among the Norwalk-La Mirada Unified School District ("District"), a California school district; the City of Norwalk ("City"), a municipality; and Calitornia State University Long Beach ("University") public, nonprofit educational institution exempt under 501(c)(3) collectively the ("Parties") or known individually as (Party) on the following terms and conditions:
HEALTH ON WHEELS PROGRAM:
The Parties will work together to operate the Health on Wheels Program ("HOW"), which consists of providing primary health care services, i.e. physical exams, immunizations, diagnosis and treatment of minor illnesses as noted in Section III below to children attending District schools, and to other children residing within the City boundaries on a first come first serve basis and to the extent limited resources permit.
The Parties will meet not less than twice each year to discuss the needs of the Program.
Il. TERM:
This Agreement shall become effective as of July 1, 2025 and shall be in full force and effect until June 30, 2026 with two automatic renewal terms of one (1) year each thereafter, or until earlier terminated as provided in Section XII.
III. DESCRIPTION OF SERVICES:
District shall:
• Designate a pediatrician to conduct quarterly audits to ensure the quality of the services provided pursuant to this Agreement, and also to mentor and consult with nurse practitioners, either in person or by telephone, during clinic hours of operation. The pediatrician shall have and maintain a license to practice medicine in the State of California as well as meet all Employee Qualifications as identified in paragraph IV below; • Provide medical malpractice insurance for the pediatrician; • Provide Program School Nurse/Nurse Practitioner who shall provide the primary health care services, conduct physical assessments and give 1 Attachment 1
immunizations to preschool and school-aged children, with such qualifications as are described in Exhibit 1 attached hereto and incorporated herein by reference, maintain the appropriate State of California licensing, certification and skills to provide these services and meet and all Employee Qualifications as identified in paragraph IV below; Provide a part-time Medical Technician, with such qualifications as are described in Exhibit 2 attached hereto and incorporated herein by reference and all Employee Qualifications as identified in paragraph IV below;
Develop a Schedule for Services and Protocols reasonably acceptable to the other Parties and within the licensing, education, training and background of personnel provided by those Parties;
• Verify student participants are eligible to receive services outlined herein and that signors of informed consents are valid legal guardians entitled to give consent for treatment by the named participants; and • Keep and make available all Material Safety Data Sheets as is required of supplies that are utilized in the mobile unit.
Calibrate equipment as is recommended by manufacturer and maintain supplies/equipment inventory as needed.
Dispose of biohazard waste (sharps containers) in accordance with local, Federal and State laws and regulations.
• Provide a full-time administrator, reasonably acceptable to the other Parties, to oversee the program and meeting the Employee Qualifications set forth in Section IV.
City shall:
• Provide the Health on Wheels motor home to conduct primary health care services, insure it for automobile/garage liability, and provide a licensed and insured driver for school site visits. City shall ensure that the driver is appropriately licensed in the State of California, has passed a defensive driving program, is eligible to operate a Vehicle of the make and model of the motor home, and meets background clearance requirements as identified in the Employee Qualifications set forth in Section IV. (At a minimum, the background check shall include the following: verification of identity (social security trace); criminal background check in all counties of residence and employment for the last seven (7) years; motor vehicle records trace. Use of the motor home is limited to and from pre- designated sites or incidental stops and will exclude transportation of patients or third parties not an employee of any of the named parties herein to any other medical facility;
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• Provide janitorial supplies (e.g., soap dispensers, towels, cleaners and other sanitary supplies), clean-up and maintenance of the motor home in accordance with CALOSHA, and OSHA's Universal Precaution standards; • Repair and maintain the motor home as required by the manufacturer's schedule or as may be needed to maintain the vehicle in safe, operable mode;
Keep and make available all required Material Safety Data Sheets of the supplies; that are utilized for janitorial or maintenance; Fill the motor home with gas, when required;
• Store and safeguard the motor home;
Maintain a cellular phone within the motor home for use by Health on Wheels personnel while providing services under this Agreement; Designate and provide a representative to work with the other Parties to ensure the efficiency and continuity of the Health on Wheels overall program goals.
University Shall:
In conjunction with the School of Nursing, provide California State University, Long Beach ("University") students ("University Students"), when required and in accordance with State licensing and University accreditation requirements, to assist in the provision of such services; and Provide selective equipment and supplies for the nurse practitioners as- needed.
Designate and provide a representative to work with the other Parties to ensure the efficiency and continuity of the Health on Wheels overall program goals.
IV. EMPLOYEE QUALIFICATIONS
With the exception of janitorial service/maintenance and repair service personnel providing services on the motor home, each of the hiring Parties shall certify and confirm that all or their respective employees or agents have the minimum and necessary qualifications, licensing and credentialing as may be required by State or Federal regulatory agencies for them to provide services as may be required or incidental to those as set forth in this Agreement. For University Students, University shall be responsible to confirm that University Students meet these requirements as well.
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All Employees, University Students or Volunteers with direct access to patients, patient records, or financial information shall successfully complete a background check with satisfactory results to be provided to that employee's employer. At a minimum, the background check shall include the following: verification of identity (social security trace); criminal background check in all counties of residence and employment for the last seven (7) years; motor vehicle records trace; and Office of Inspector General ("OIG") sanction trace.
All Employees/University Students comply with immunizations required for healthcare personnel as recommended by the Centers for Disease Control and Prevention -Advisory Committee of Immunization Practices (ACIP), including but not limited to an annual health examination, annual TB screening (includes skin testing and symptom screening and chest x-ray, influenza immunization (required annually) or declination statement and must wear an approved mask during influenza season.
• Observe at all times policies and procedures regarding blood-borne pathogens including but not limited to universal precautions. • Receive training on standard precautions, infection control including TB, Fire, Hazardous materials, Body Mechanics, Patient Safety and Patient Rights.
• Sign a confidentiality form for services to be provided through HOW.
CONSENT FOR SERVICES
Prior to the commencement of any medical services or treatment to a minor, the District is responsible for and shall first obtain and retain the written consent of such minor's parent or guardian.
VI. PERSONNEL AND FINANCIAL REQUIREMENTS:
The Parties shall provide the personnel and resources described in Section III at such hours and to such extent as may be reasonably necessary to accomplish the purposes of this Agreement and in accordance with State and Federal law.
With the exception of University Students, each Party shall be fully responsible for all expenses incurred with respect to each individual provided by the Party pursuant to Section III, including without limitation salary, benefits, Social Security, professional liability, OSHA claims, civil fines, payroll taxes, workers compensation insurance, and any other related and reasonably necessary expense. University shall ensure that University Students are provided workers' compensation insurance through the University Program.
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VIl. FUNDING:
All Parties have been notified and are aware that securing funding to commence and maintain operations is a condition precedent to performing any contractual obligations outlined herein and funding may need to be confirmed prior to rendering any services per the terms and conditions of this Agreement. Any Party may notify the remaining Parties of an intention to terminate this Agreement due to failure to secure the necessary funding to complete its obligations or for loss of a substantial portion thereof as may be required to continue with its ongoing obligations including but not limited to employee wages, benefits and insurance, vehicle maintenance and upkeep, supplies necessary to conduct the operations as outlined herein, training needed to properly execute duties to provide reasonable care under the circumstances, and/or costs associated with medical records maintenance and security. In such cases, the remaining Parties may collectively elect either to assume the notifying party's responsibilities and document the reallocation of duties and liabilities in writing or to terminate services to be provided by the remaining Parties within thirty (30) days upon receipt of written notice. Upon early termination, the remaining Parties shall move to mitigate any losses, damages or outstanding obligations and will suspend any activities that may incur additional liabilities/costs to that Party or any other.
VIll. CONFIDENTIALITY OF RECORDS
The Parties recognize that records maintained by them relative to pupils or persons treated under this Program are confidential under Education Code Sections 49060 et seq. the Confidentiality of Medical Information Act, Civil Code Sections 56 et seq., and related provisions of federal and state law.
It is understood and agreed that any and all medical records, charts, and business records, other than student evaluation records and information or employee records of any of the Parties (collectively "Records"), shall be and remain the property of District. District agrees to hold, transmit and receive all individually identifiable patient health information (Protected Health Information" that may be shared, transferred, transmitted, or otherwise obtained under this Agreement strictly confidential, and provide all reasonable protections to prevent the unauthorized use or disclosure of such information, including, but not limited to the protection afforded by applicable federal, state and local laws and/or regulations regarding the security and the confidentiality of patient health care information.
District further agrees to comply with any regulations, standards, or rules promulgated pursuant to the authority of the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and the California Medical Information Act ("CMIA").
In performance of this Agreement, all Parties shall sign the attached Confidentiality and Record Keeping Agreement to ensure compliance and preserve rights as required therein. A copy of the Agreement is attached hereto as Exhibit 3. 5 Attachment 1
IX. RESTRICTIONS ON USE OF MOTOR HOME:
• Parties may not utilize the motor home for any other uses except with the prior approval of the Parties, except that the City may use the motor home to support the City's response and recovery services during a declared Emergency.
• The motor home cannot be used by any entity or person other than the Parties or their employees identified herein.
• The motor home cannot be driven by any employee of University or District.
X. INSURANCE:
Each Party shall provide general liability insurance with liability limits in the amount of One Million Dollars ($1,000,000) per occurrence and Five Million Dollars ($5,000,000) in the annual aggregate and name each other as additional named insured by separate endorsement. The City and District shall provide automobile liability insurance with liability limits in the amount of One Million Dollars ($1,000,000) per occurrence and Five Million Dollars ($5,000,000) in the annual aggregate and name each Party as additional named insured by separate endorsement. Each Party shall also obtain worker's compensation insurance meeting the statutory limits and employer liability limits of not less than One Million Dollars ($1,000,000) per accident. Such insurance shall be provided by a commercial insurer, a commercial insurance program (e.g., the California Joint Powers Insurance Authority's insured programs) or through a self-insurance program reasonably acceptable to each Party. Each Party may submit legally adequate evidence of a commercial insurance program or self-insurance program for any coverage required in this Section X.
The University will require that each University Student participating in this program carry professional liability insurance of at least $1,000,000 aggregate and, by written agreement with the University, have proof thereof prior to the commencement of any activities by University Students pursuant to this agreement. Each Party will provide the other Parties with Certificates of Insurance evidencing the above-required insurance or evidence of a legally adequate commercial insurance or self-insurance program evidencing the above-required insurance.
Each insurance policy required by this Section X and secured by District shall be endorsed as follows: (1) the insurer waives the right of subrogation against City and University and their respective board members, officials, officers, employees, agents and representatives; (2) except for workers' compensation policies, the policies are primary and non-contributing with any insurance that may be carried by City and University; and (3) the policies may not be canceled or materially changed except after thirty (30) days' prior written notice by insurer to City and University, unless canceled for non-payment, in which case the insurer shall give ten (10) days' written notice to City and University.
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Each insurance policy required by this Section X and secured by City shall be endorsed as follows: (1) the insurer waives the right of subrogation against District and University and their respective board members, officials, officers, employees, agents and representatives; (2) except for workers' compensation policies, the policies are primary and non-contributing with any insurance that may be carried by District and University; and (3) the policies may not be canceled or materially changed except after thirty (30) days' prior written notice by insurer to District and University, unless canceled for non-payment, in which case the insurer shall give ten (10) days' written notice to District and University.
Each insurance policy required by this Section X and secured by University shall be endorsed as follows: (1) the insurer waives the right of subrogation against District and City and their respective board members, officials, officers, employees, agents and representatives; (2) except for workers' compensation policies, the policies are primary and non-contributing with any insurance that may be carried by District and City; and (3) the policies may not be canceled or materially changed except after thirty (30) days' prior written notice by insurer to District and City, unless canceled for non-payment, in which case the insurer shall give ten (10) days' written notice to District and City.
The Parties shall not cancel, reduce or otherwise modify the insurance policies required by this Section X
XI. INDEMNIFICATION:
To the fullest extent permitted by law, each of the Parties (each, as appropriate, an "Indemnifying Party") shall save, indemnify, defend, and hold harmless each other Party (each, as appropriate, an "Indemnified Party") and their respective officers, directors, agents, and employees from any and all cost, expense, damage and liability (collectively, the "Damages") arising out of negligent or intentionally wrongful acts or omissions in the performance of this Agreement by the Indemnifying Party, except that no Indemnifying Party, however, shall be obligated to reimburse or indemnify another Party for such other Party's negligence or willful misconduct. Upon demand for indemnification by a Party hereunder, the Parties shall meet and confer to determine their respective percentage of fault and or liability, and the Indemnifying Party responsible for liability to the other will indemnify the other Parties to this Agreement for the percentage of liability determined within sixty (60) days following such meeting. If the Parties are unable to reach agreement upon their respective liability, the degree of liability for each party shall be determined in a final non-appealable judgment by a court of competent jurisdiction as being proportionate to each part liability.
For purposes of this clause, the University Students shall not be considered to be officers, agents or employees of any Party identified herein, and the any duty to indemnify, defend and hold harmless shall not extend to the actions or inactions of the University Students. The parties shall look to the insurance required of the University Students for coverage for any negligent and or failure to act by the University Students, 7 Attachment 1
This section shall survive termination or expiration of the Agreement and is in addition to any rights or remedies that the Indemnified Parties may have under the law.
XII. TERMINATION:
Any Party may, in its sole discretion, terminate this Agreement with or without cause by providing not less than thirty days prior written notice to the other Parties addressed to the persons and addresses listed on Exhibit 4 hereto.
ENTIRE AGREEMENT:
This Agreement is the entire agreement by and among the Parties concerning its subject matter, and supersedes and replaces any prior oral or written agreements by or among them with respect thereto. This Agreement may be amended or revised only by a writing duly executed by Parties.
[SIGNATURE PAGE TO FOLLOW]
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IN WITNESS WHEREOF, Parties have caused this Agreement to be executed:
Norwalk-La Mirada USD City of Norwalk
By: By:
Estuardo A. Santillan Date Jesus M. Gomez Date
Assistant Superintendent, Business City Manager
Services
Attest:
California State University
Long Beach
By:
Theresa Devoy, CMC Date
City Clerk
By:
Barbara E. Taylor, PhD Date
Interim Associate Vice President for
Research and Sponsored Programs
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Exhibit 1
NORWALK-LA MIRADA UNIFIED SCHOOL DISTRICT
Human Resources Division
SCHOOL NURSE:
HEALTH ON WHEELS
BRIEF DESCRIPTION OF POSITION:
Assists the Director of Attendance, Health and Welfare in all areas assigned.
DIRECTLY RESPONSIBLE TO:
The Director of Attendance, Health and Welfare
DUTIES AND RESPONSIBLITIES:
• This position is primarily concerned with the implementation of an innovative school-based health clinic with the basic responsibility to oversee the program to ensure its success. Candidate will be involved in assisting and guiding schools to ensure continuity of services, as well as provide physical examinations and treat minor illnesses.
• Interpret Federal and State health regulations.
• Provide Direct Medical Services according to protocols. • Serve as a liaison between District office, schools, and community partners. • Establish and maintain relationships with community health and social services. • Monitor and coordinate budget and financial status of program. • Maintain communication with all disciplines involved. • Monitor health care status within the community to ensure that program is responsive to changing needs. • Oversee ongoing evaluation of program results.
• Serve as resource to teachers of health education, as time permits. • Assist in promoting a healthful school environment.
• Assume responsibility for continuing education and professional development of self and contribute to the professional development of others.
MINIMUM EMPLOYMENT QUALIFICATIONS:
• Credential - Any valid California credential that authorizes services as a school nurse. • Education- A bachelor degree granted by an accredited institution. • Licensed as a Pediatric Nurse Practitioner; and certified with furnishing number, preferred. • Bilingual Spanish
A.D.A. REQUIREMENTS
Physical, Mental and Environmental Demands:
Physical:
Sitting, walking level surface, reaching, bending, use of both legs; wrist/arm motion, grasping/holding, use of both hands, regularly lift 1-15 Ibs., occasional lift 26-40 Ibs., regularly carry/push 1-15 lbs., occasionally carry/push 26-40 Ibs; color vision, near vision, use of both eyes, sense of smell, normal hearing, distinguish sounds in transmission, speaking.
Mental:
Occasional stress of emergencies, normal work standard stress, ability to work with interruption, reading interpreting policy, memorize and recall objects, people, analyze problems and generate alternatives, reconcile apparent ambiguities.
Working Conditions:
Occasional exposure to sun, occasional wetness, dust, occasional exposure to childhood disease.
An Equal Opportunity Employer
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Exhibit 2
NORWALK - LA MIRADA UNIFIED SCHOOL DISTRICT
JOB DESCRIPTION
BILINGUAL HEALTH ON WHEELS MEDICAL TECHNICIAN
I. GENERAL DESCRIPTION:
Il. ESSENTIAL DUTIES AND RESPONSIBILITIES:
A. Take children's height and weight, vital signs.
B. Perform screenings for vision and hearing
C. Collect specimens for approved laboratory test.
D. Administer childhood immunizations and skin tests.
E. Transport clinic computer/laptop and supplies to and from the District office to the scheduled school sites on a daily basis.
F. Setup and store equipment/supplies in the mobile unit for daily operation.
G. Accurately document in student's health record.
H. Utilize the immunization registry to update accordingly.
I. Assist in monitoring/storage/handling of vaccines.
J. Assist in making patient appointments and follow-ups.
K. Assist nurse practitioner whenever necessary.
L. Abide by all Health on Wheels Policy Procedures.
Il. QUALIFICATIONS:
A. License:
1. A valid California Driver's license is required.
B. Ability to:
1. Relate will with children.
2. Travel to various school sites in the Norwalk - La Mirada community.
3. Communicate in English and Spanish.
C. Skills:
1. Able to measure children's height and weight.
2. Able to take children's vital signs.
3. Perform snellen vision screening.
4. Perform puretone audiometric screening.
5. Collect specimens for approved laboratory tests.
6. Perform proper technique in administering intramuscular, subcutaneous, and intradermal injections.
7. Perform fingersticks.
8. Properly perform and document urine dipstick analysis.
9. Basic computer or data entry skills.
10. Pass the District Bilingual Test.
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Exhibit 2 cont.
IV. Knowledge:
1. Using of weight scale.
Taking child's blood pressure, temperature and respirations; screening
1. Performing fingersticks for capillary lab tests.
5. Knowledge of intramuscular, subcutaneous, and intradermal injectior V. Education:
1. Proof of High School Diploma or equivalency.
2. Certified as a medical assistant or equivalent.
Expe. Prior medical experience in working with children preferred.
VII. Medical Required:
Tuberculosis Test.
VIII. PHYSICAL, MENTAL and ENVIRONMENTAL DEMANDS:
A. Physical:
B. Mental:
Able to work under stress.
C. Environmental Demands:
Ability to work within the confines of a mobile unit.
IX. WORK YEAR:
As prescribed by CSEA Master Agreement between the Board of Education NLMUSD and CSEA.
x. SALARY RANGE:
As prescribed by CSEA Master Agreement between the Board of Education NLMUSD and CSEA.
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Exhibit 3
HEALTH ON WHEELS
A SCHOOL BASED CLINIC COLLABORATIVE PROGRAM AMONG CALIFORNIA STATE UNIVERSITY LONG BEACH, CITY OF NORWALK, AND NORWALK-LA MIRADA UNIFIED SCHOOL DISTRICT.
WORKFORCE
CONFIDENTIALITY AGREEMENT
I understand that Health On Wheels has a legal and ethical responsibility to maintain patient privacy, including bligations to protect the confidentiality of patient information and to safeguard the privacy of patient information In addition, I understand that during the course of my employment/assignment/affiliation at Health On Wheels, I may see or hear other Confidential Information such as financial data and operational information pertaining to the practice that Health On Wheels is obligated to maintain as confidential.
As a condition of my employment/assignment/affiliation with Health On Wheels, 1 understand that I must sign and comply with this agreement.
By signing this document I understand and agree that:
• I will disclose Patient Information and/or Confidential Information only if such disclosure complies with Health On Wheels policies, and is required for the performance of my job. • My personal access code(s), user ID(s), access keys) and password(s) used to access computer systems or other equipment are to be kept confidential at all times. • I will not access or view any information other than what is required to do my job. If I have any question about whether access to certain information is required for me to do my job, 1 will immediately ask my supervisor for clarification.
I will not discuss any information pertaining to the practice in an area where unauthorized individuals may hear such information (for example, in hallways, on elevators, in the cafeteria, on public transportation, at restaurants, and at social events). 1 understand that it is not acceptable to discuss any Practice information in public areas even if specifics such as a patient's name are not used.
I will not make inquiries about any practice information for any individual or party who does not have proper authorization to access such information.
• I will not make any unauthorized transmissions, copies, disclosures, inquiries, modifications, or purgings of Patient Information or Confidential Information. Such unauthorized transmissions include, but are not limited to, removing and/or transferring Patient Information or Confidential Information from Health On Wheels' computer system to unauthorized location (for instance, home).
Upon termination of my employment/assignment/affiliation with Health On Wheels, I will immediately return all property (e.g. keys, documents, ID badges, etc.) to Health On Wheels. I agree that my obligations under this agreement regarding Patient Information will continue after the termination of my employment/assignment/affiliation with Health On Wheels.
I understand that violation of this Agreement may result in disciplinary action, up to and including termination of my employment/assignment/affiliation with Health On Wheels and/or suspension, restriction or loss of privileges, in accordance with Health On Wheels' policies, as well as potential personal civil and criminal legal penalties.
• I understand that any Confidential Information or Patient Information that I access or view at Health On Wheels does not belong to me.
I have read the above agreement and agree to comply with all its terms as a condition of continuing employment.
Signature of employee/physician/student/volunteer Date
Print Your Name
Attachment 1
Exhibit 4
Estuardo A. Santillan, Assistant Superintendent
Norwalk-La Mirada Unified School District
12820 Pioneer Blvd.
Norwalk, California 90650
Jesus Gomez, City Manager
City of Norwalk
12700 Norwalk Blvd.
Norwalk, California 90650
Barbara Elan Taylor, Interim Associate
Vice President for Research and Sponsored Programs
California State University, Long Beach
1250 Bellflower Blvd
Long Beach, California 90840