Training Agreements
Master Affiliation Agreement
Program Letter of Agreement
Residency Training Agreement
Off-Site Training Agreement
Training Agreement Addendum
Visiting House Staff Agreement
Why?
• ACGME Requirement
o Between participating site and every location providing a required
rotation
• CMS (Centers for Medicare/Medicaid Services)
o Required for reimbursement to training institution
• University of Utah
o Funding commitments
o Legal verbiage regarding insurance and indemnification
When?
ACGME requirement
• Must be renewed every 5 years
o Our institution converted to a five year agreement in 2010 (July 1, 2010-June
30, 2015)
o For newly executed agreements use an end date of June 30, 2015
o Renewals July 1, 2015- June 30, 2020
• Agreements must be complete and on file before the
rotations begin
• Agreements must be in place for every location your
residents rotate, 365 days a year. Know where your
residents rotate!
Which?
• Master Affiliation Agreement
• Program Letter of Agreement
• Residency Training Agreement
• Off-Site Training Agreement
• Visiting House Staff Agreement
Master Affiliation
Agreement
• Used by GME only
• Between University of Utah and Affiliated Hospitals
Intermountain Health Services, Inc. (IMC, LDS, and other IHC locations)
Primary Children’s Medical Center (PCMC)
Shriner’s Hospital for Children
University Neuropsychiatric Institute (UNI)
University of Utah Hospitals & Clinics (ARUP, UOC, HCI, HCH, Community
Clinics)
o Veterans Administration Medical Center (VAMC)
o
o
o
o
o
• Include important information
o
o
o
o
Resident selection process
Administrative responsibilities
Malpractice insurance responsibilities
Indemnification
Program Letter of
Agreement
• Used when we have a Master Affiliation Agreement
in place
• Includes information not found in the Affiliation
Agreement
o List of teaching faculty
o Goals and objectives
o Funding
*PCMC and Shriner’s Hospital have their own Program Letter of Agreement
which has been approved by their legal council.
Residency Training
Agreement
• Used at non-affiliated sites
• Contains important information not found in the
Program Letter of Agreement because there is no
Master Affiliated Agreement in place
• Combined the Residency Training Agreement, Rural
Agreement and Private Practice Agreement into
one agreement going forward.
Off-Site Training
Agreement
• Used at non-affiliated sites that are
irregularly used
o Electives
o Occasional “interesting cases”
o When there is no specific understanding with the site, or no
expectation on the part of the site for a certain amount of
coverage
Note: We do not cover liability insurance for out of state rotations!
Training Agreement
Addendum
• Used to make changes to a current
agreement
o Faculty changes – need this annually to attach to current
agreement, no signatures required
o Responsibilities for teaching, supervision, and formal
evaluation changes
o Duration and content of educational experience changes
o Funding changes
Notes…
• Always use our GME templates to renew
agreements, contains the latest revisions
Indemnification. Training Institution shall indemnify and hold harmless University and the School of Medicine, and the respective directors,
officers, agents, and employees thereof, and any Resident participating in the Training Program, from all claims and liabilities arising from or
incurred in connection with any negligent act or omission of Training Institution, Teaching Staff, or any Resident while participating in the
Training Program. The University shall indemnify and hold harmless the Training Institution, in performance of its obligations under this
agreement, from all claims and liabilities to the extent caused by the negligence of University, the School of Medicine, and their respective
directors, officers, agents, and employees thereof; provided, however, that University shall not indemnify and hold harmless Training
Institution for the negligent acts or omissions of any Resident or Teaching Staff participating in the Training Program. Nothing in this
agreement shall be construed as a waiver of any rights or defenses applicable to University under the Utah Governmental Immunity Act,
Section 63G-7-101 et seq., Utah Code Ann. as amended, including without limitation, the provisions of Section 63G-7-604 regarding limitation of
judgments.
INSERT IF THE TRAINING INSTITUTION WILL NOT PROVIDE LIABILITY INSURANCE:
Indemnification. Training Institution shall indemnify and hold harmless University and the School of Medicine, and the respective directors,
officers, agents, and employees thereof, from all claims and liabilities arising from or incurred in connection with any negligent act or omission
of Training Institution or any member of the Teaching Staff. The University shall assume responsibility for any and all claims and liabilities to
the extent caused by the negligence of University, the School of Medicine, and their respective directors, officers, agents, employees and any
Resident participating in the Training Program. Nothing in this agreement shall be construed as a waiver of any rights or defenses applicable to
University under the Utah Governmental Immunity Act, Section 63G-7-101 et seq., Utah Code Ann. as amended, including without limitation,
the provisions of Section 63G-7-604 regarding limitation of judgments.
Notes…
• Find templates on our GME web site at
http://medicine.utah.edu/gme/
o Program Directors and Coordinator information
tab
o Forms & Templates link
o Templates section
• Follow the red typeface for instructions.
Contact GME with questions.
• Know what is in your agreement!
Notes…
• List of templates
o Off-Site Training Agreement
o Program Letter of Agreement (Uhosp &
IHC/IMC)
o Program Letter of Agreement (PCMC)
o Program Letter of Agreement (Shriner’s
Hospital)
o Program Letter of Agreement Addendum
o Residency Training Agreement
o Residency Training Agreement Addendum
And More Notes
• Current agreements are scanned and found in
E-Value www.e-value.net
o
o
o
o
o
Program Tools
Documents
Search
Document Collections
GME Office Documents
• Training agreement flow chart…
TRAINING AGREEMENT FLOW CHART
COORDINATOR
COORDINATOR
COORDINATOR
Gets template from
GME website, and
creates agreement.
NO
Finalizes
agreement.
PROGRAM
COORDINATOR
COORDINATOR
Forwards final.
Signs
Different than
template or funding
changes?
GME MANAGER
(Sharee)
YES
NO
SHAREE
Reviews agreement.
SHAREE
Reviews, initials
and adds info to
ALLHOSPS file.
SHAREE
Are there legal
questions?
YES
OTHER
EDUCATION
COORD. (Ronnie)
RONNIE
Reviews
against
checklist,
attaches
approval signoff
sheet.
SCOTT SMITH
Reviews, makes
changes, or
approves.
TRAINING
LOCATION
Signs
RONNIE
RONNIE
ALAN SMITH
Signs
Scan to H drive,
copy to e-value, log
in tracking
spreadsheet, put
hard copy in binder,
email coordinator.
TRAINING
LOCATION
Visiting House Staff Training
Agreement
This agreement is used when a resident from another
ACGME accredited program is requesting a rotation
with a program here at the U. These agreements should
be on our template but the template is often altered
and has to be checked by the GME office.
These agreements establish:
• An understanding of the obligations of the University of
Utah program
• An understanding of the obligations of the affiliate
• The insurance and indemnification between the parties
involved
• Security and privacy standards as related to HIIPA
Visiting Housestaff LEAN Process / Procedure
2012 RAK
Ronnie
Receives VHS Packet
and reviews
Request Uid…
Receive Uid
Receive
provider
number
Alan Smith
Input visitor
information in
E*Value under
Visiting Resident
Program
Scan to H
Drive
Dr Smith signs to approve
UUHC Coordinator
Receives packet for completion
Send scan
to
Outside Coordinator
Send scan
to
Receives packet for
completion
Human Resources
Hospital I T Dept
Request Drug
Screening and
Background
check if needed
Request Non-Emp ID Number
mikelle.hatcher@hsc.utah.edu
request provider
number from HSC I IT
https://cmsworkflow1.
med.utah.edu/provider
request
= Steps that may need to take
place several times to
finalize information needed
Request; Internet,
Email, EPIC,
Powerchart from
https://sawf1.ad.u
tah.edu/AccountR
equester
File in
GME
office
Do we know what you are
doing?
• ONLY Residents cleared through the GME and this process
can visit / rotate at the U
• GME 7.1 Visiting House Staff
• GME 7.2 Clinical Observers
• Please note: the University does NOT provide liability
insurance for any visiting house staff.
• Do you know what your Program Director and other Faculty
are doing?
Contact in GME
• Ronnie Koon
801-213-2734
• Sharee Bracken
801-213-2735