HomeMy WebLinkAboutTouro University, California-Educational and Training Experience and Observational Opportunities_A-20-080.pdfMEMORAMDUM OF UNDERSTANDING
COUNTY OF FRESNO
AND
TOURO UNIVERSITY CALIFORNIA
AFFILIATION AGREEMENT
This Affiliation Agreement ("Agreement") is made on ________ , 2020 betv.recn the
County of Fresno, a political subdivision of the State of California ("County" or "Institution" herein
after, referred to as County) for the exclusive benefit of its Department of Public Health, whose
address is 1221 Fulton St Fresno, CA 93721 and Touro University, a California nonprofit public
corporation (''TUC"), whose address is 1310 Club Drive, Vallejo , CA 94592. County and TUC are
referred to herein. collectively, as "Parties", or "Party" individually.
Recitals
A. County operates at the following office (Facility or Facilities): located at 1221 Fulton
Slreet, Fresno, CA 93 721
B. TUC operates the College of Education and Health Sciences (CEHS), the College of
Osteopathic Medicine (COM), and the College of Phannacy (COP) in Vallejo,
California and operates a branch campus in Henderson. Nevada with Colleges of
Osteopathic Medicine and Health and Human Services. TUC desires that its students
obtain practical educational and training experiences and observational opportunities
at the Facilities through participation in an affiliation program ("Program").
C. County deems it beneficial to participate in the Program by providing educational
and training experiences and observational opporrunities at its Facilities for TIJC
students punuant to the terms and conditions of this Agreement.
In consideration of the foregoing objectives and in further consideration of the covenants and
promises hereinafter set forth, the Parties agree as follows:
I. PROGRAMPARAMETERS
1.01 The period of tirru: for each student's educational and training experience and
observational opportunity shall be agreed llpon by the Parties before the student begins
his or her Program training.
1.02 The maximum number of students to receive training mall be agreed upon by the
Parties at least sixty (60) days prior to the beginning of Program training based on the
availability of space and personnel at the school district and other considerations.
1.03 The TUC Program Coordinator and the County's Designee shall be responsible for
arriving at an agreement on behalf of their respective Parties regarding the duration of the
Program training and the number of TUC students to receive Program training at the
Facilities.
1.04 The Program and the maintenance of the standards of instruction shall be the sole
responsibility of TUC. TUC shall only refer for participation in U1e Program students
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February 25
Agreement No. 20-080
who are in good a.Qademic standing and TUC shall at the reque11t ofCwnty provide the
County with verification of such good standing.
1.05 All students panicipating in the Program shall meet all applicable health standards
established by TUC and any applicable governmental authority and implemented by
County for each Health Care and Office Facility. County shall have the right to terminate
from the Program any student when the health status of such student is detrimental to the
health and/or safely of County patients or staff as determined by County.
Il. TliC'S RESPONSIBILITIES
2.01 Student Con tact Information. TUC shall complete and send to County contact
infonnation for each student emolled in the Program which shall include the student's
name, address and telephone number prior to the beginning date of the planned
educational and training experience and observational opportunity. County shall only use
the student contact information to fulfill its obligations under this Agreement and agrees
not to release any information in the student profile to any third party.
2.02 Schedule of Assignments. TUC shall notify the "County Designee" (as defined in
Section 3 .02), designated by the ColU1ty from time to time, ofTUC's planned schedule of
student assignments, including the name of each student, and the student's level of
acodemic preparation and length and dates of the educational and training experience and
observational opportunity.
2.03 TUC Program Coordinator. TUC shall designate a faculty member as TUC
Program Coordinator, who shall coordinate with CoWlty Designcc in planning the
Program.
2.04 Records. TUC shall maintain all personnel and academic records of TUC students
participating in the Program.
2.05 Rules and Regulations. TUC shall enforce rules and regulations governing the
students that are mutually agreed upon by TUC and County. TUC shall instruct its
students on the general requirements of The Joint Commission ("TJC"), Centers for
Medicare and Medicaid Services ("CMS") and the Health Insurance Portability and
Accountability Act ("filPAA"). TUC shall require that its students comply with all
applicable Health Care and Office Facility policies and Federal and St11te regulatory
requirements including, but not limited to T JC, CMS and HIPAA.
2.06 Student Responsibilities. TUC shall notify the students who are to participate in
the Program at the County that they are responsible for:
(a) Following the clinical and administrative policies, procedures, rules and
regulations of County.
(b) Arranging for their transportation and living arrangements when not
provided by TUC.
(c) Arranging for and assuming the cost of their he.a.Ith insurance.
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(d) Assuming responsibility for treatment of any illness or injury the student
may have while participating in the Program, obtaining necessary
immunizations and a tuberculin test, and having an annual health examination.
(e) k; required by a specific Program. maintaining current certification of:
proof of immunization or immunity agairut rubella and measles, and PPD test or
chest x-ray showing no active tuberculosis. Maintain proof of immunimtion or
immunity against Hepatitis B, or proof of declination of the Hepatitis B
vaccination in conformity with Occupational Safety and Health
Administration (OSHA) standards. As per CDC guidelines, maintain proof
of immunity or immunization against mumps and varicella, and document
vaccination against tetanus and pertussis.
(f) Keeping all patient infonnation confidential. No student shall have access to
or have the right to receive any medical record. except when necessary in the
regular course of the practical experie11ce. The discussion, transmission or
narration in any form by students of any patient infonnation of a personal
nature, medical or otherwise, obtained in the regular course of the Program is
forbidden except as a necessary part of the practical experience.
(g) Following the dress code ofthc Health Care and Office Facility and wearing
name badges identifying themselves as students.
(h) Attending an orientation of the Health Care and Office Facilities.
(i) Complying with the rules and regulations that have been developed by TUC to
govern student activities during assignment to a training at County facility, a
copy of which is attached to this Agreement as Exhibit A.
2.07 Payroll Taxes and Withholdings. TUC shall be solely responsible for any payroll
taxes, withholdings, workers' compensation and any other insurance or benefits of any kind
for employees and agents of TUC providing services under this Agreement. TUC shall
defend, indemnify and hold County harmless against all claims against County by
employees or agents of TUC with respect to payroll taxes, withholdings, workers'
compensation and other insurance benefits.
2.08 Student Insurance. TUC shall provide County with a certificate of insurance or
other written confirmation that ea.ch student participating in tbe Program carries health
insurance.
UI. COUNTY'S RESPONSIBLITIES
3.01 Educational and training experience and observational om,ortunity. County
shall accept from TUC the inucually agreed upon number of students enrolled in the
Program and shall provide said students with supervised practical experience.
3.02 County Desjgnee. County shall designate a member of County's Program
Staff to participate with the TUC Program Coordinator in planning, implementing
and coordinating the Program.
3.03 Access to Facilities. County shall pennit students enrolled in the Program
access to the Health Care and/or Office Facilities as appropriate and necessary for the
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Program, provided that the presence of the students shall not interfere with the activities
of County.
3.04 County Rules & Regulations. County shall instruct the students on Cowity rules
and regulations, as well as the application ofTJC, CMS and HIPAA requirements specific
to the County. County hereby accepts Exhibit A, which incorporates by reference the
applicable rules and regulations of the County. as the rules and regulations that shall
govern TUC students during their training assignment e.t the County.
3.05 Withdrawal of Students. Co1D1ty may request TUC to withdraw from the
Program any student who County determines is not performing satisfactorily, or who
refuses to follow County's administrative policies, procedures, rules and regulations. Such
request must be in writing and must include a statement as to the reason or reasons why
County desires to have the student withdrawn TUC shall comply with such request within
five (5) days of receipt of thc written request by TUC.
3 .06 Emergency Health Care F irst Aid. County shall, on any day when students are
receiving training at the Facilities, provide the students necessary emergency health care
or first aid for accidents occurring in the Facilities. Except for such emergency
assistance, County shall have no obligation to furnish medical or surgical care to any
student.
3.07 Maintenance of Patient Services. County shall he responsible for developing,
maintaining and providing services to all its patients and County will at all times provide
an adequate, competent staff to be responsible for the development , maintenance and
provision of these services to County patients.
3 .08 Evaluation. Company shall evaluate the pcrfonnance of the student on a regular
basis using the evaluation form supplied by TUC. The completed final evaluation shall
be forwarded to TUC within ten (10) business days following the conclusion of the
student's educational and training experience and observational opportunity.
3.09 Compensation/Invoicing. TUC Student Program conducted pursuant to tenns
and conditions of this Agreemcnl shall be performed without the payment of any
monetary consideration between TUC and County, from one party to the other.
IV.NON-DISCRIMINATION
The Parties agree that all students receiving an educational and training experience and
observational opportunity pursuant to this Agreement shall be selected without
discrimination on account of rdCe, color, religion creed, color, national origin, ancestry,
physical disability, mental disability, medical condition, genetic infonnation, marital
status, sex, gender, gender identity, gender expression, sexual orientation, age, military
status or veteran status pursuant to all applicable State of California and Federal statutes
and regulation.
V. STATUS OF TUC AND COUNTY
5.01 It is expressly agreed and understood by TUC and County that students
participating in the Program are in attendance for educational purposes, end such students
are not considered employees of County or TUC for any purpose, including but not limited
to compensation for services. provision of employee welfare and pension
benefits, or provision of workers' compensation insurance.
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5.02 County assumes and maintains primary responsibility for services rendered to all of
its patients and assumes and maintains complete control and supervision over all its
employees and no County employees shall be deemed to be the employees or agents of
TUC. TUC shall not be liable for any salaries, and employees of County shall not have
the right or claim to any benefit or privilege as an employee or agent of TUC. County will
asswne sole and complete liability for all acts and omissions of its employees and shall
indemnify and hold TUC harmless from any and all liability arising out of or connected
with the acts or omissions of its employees.
VI. INDEMNlFICA TION
6.01 TUC agrees to indenmify, defend and hold harmless, County and its affiliates, its
directors, trustees, officers, agents, and employees against all claims, demands, damages,
costs, expenses of whatever nature, including court costs and attorney fees, arising out of or
resulting from the negligence or willful misconduct of TUC or its students in the
performance of this Agreement.
6.02 County agrees to indenmify, defend and hold harmless, TUC and its affiliates, iis
directors, trustees, officen., agents, and employees against any and all claims, demands,
damages, costs, expenses of whatever narure, including court costs and attorney fees,
arising out of or resulting from the negligence or willful misconduct of County in the
perfonnance of this Agreement.
VIJ. INSURANCE
7 .01 TUC shall procure and maintain in force during the term of this Agreement, at its
sole cost and expense, insurance in amounts that are reasonably necessary to protect TUC
and County from and against liability arising from or incident to the use of the Facilities by
TUC students participating in the Program. TUC, at its sole expense, shall maintain in full
force and effect, the following insurance policies or a program of self-insurance, including
but not limited to, an insurance pooling arrangement or Joint Powers Agreement (JPA)
through the tenn oftbe Agreement.
TUC shall provide County with a certificate of insurance evidencing the insurance coverage
required under this Article VII. All policies shall be issued by admitted insurers licensed
to do business in the State of California, and such insurance shall be purchased from
companies possessing a current A.M. Best, Inc. rating of A FSC VII or better. TUC shall
further ensure that not less than thirty (30) days notice s hall be provided to County of the
cancellation of such insurance. TUC shall promptly notify County of any cancellation,
reduction, or other material change in the amount or scope of any coverage required
hereunder.
(a) Professional Liability
IfTiiC employs licensed professional staff, (e.g., Ph.D., R.N., L.C.S.W.,
M.F.C.C.) in providing services, Professional Liability Insurance with limits
of not less than One Million Dollars ($1,000,000.00) per occurrence, Three
Million Dollars ($3,000,000.00) anDual aggregate.
(b) Commercial General Liability.
Commercial General Liability Insurance with limits ofnot less than Two
Million Dollars ($2,000,000.00) per occurrence and an annual aggregate
of Four Million Dollars ($4,000,000.00). This policy shall be issued on a
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per occurrence basis. COUNTY may require specific coverages including
completed operations, products liability, contractual liability, Explosion-
Collapse-Underground, fire legal liability or any oilier liability insurance
deeme d necessary because of the nature of this contract.
(c) Automobile Liability.
Comprehensive Automobile Liability Insurance with limits of not less than
One Million Dollars ($1,000,000.00) per accident for bodily injury and for
pro perty damages. Coverage should include any auto used in connection
wi1h this Agreement.
(d) Worker's Compensation.
A policy of Worker's Compensation insurance as may be required by the
California Labor Code.
(e) Molestation.
Sexual abuse/molestation liability insurance with limits of not less than
One Million Dollars ($1,000,000.00) per occurrence. Two Million Dollars
($2,000,000.00) annual aggregate. This policy shall be issued on a per
occurrence basis.
(f) Cyber Liability
Cyber Liability Insurance, wi1h limits not less than $2,000,000 per
occurrence or claim, $2,000,000 aggregate. Coverage shall be sufficiently
broad to respond to the duties and obligat ions as is undertaken by
CONTRACTOR in lhis agreement and shall include, but not be limited to,
claims involving infringement of intellectual property, including but not
limited to infringement of copyright, trademark, trade dress, invasion of
privacy violations, information theft, damage to or destruction of
electronic information, release o f private information, alteration of
electronic infonnation, extortion and network security. The policy shall
provide coverage for breach response costs as well as regulatory fines and
penalties as well as credit monitoring expenses with limits sufficient to
respond to these obligations.
Additional Regpirements Relating to Insurance
TUC shall obtain endorsements to the Commercial General Liability insurance naming
the County ofFrcsno, its officers, agents, and employees, individually .and collectively,
as additional insured, but only insofar as the operations under this Agreement ere
concerned. Such coverage for additional insured shall apply as primary insurance and
any other insurance, or self-insurance, maintained by County, its officers, agents and
employees shall be excess only and not contributing with insurance provided under
TUC's policies herein. This insurance shall not be cancelled or changed without a
minimwn of thirty (30) days advance written notice given to County.
VIll. TERM AND TERMINATION
8.01 Ie!m. This Agreement shall be effective as of the date specified above and shall
remain in effect for an initial tenn of one (I) year. This Agreement may be extended for
two (2) additional twelve (12) month periods upon written approval of both parties no
later than thirty (30) days prior to the first day of the twelve (12) month extension period
unless either Party elects not to renew this Agreement by giving the other written notice
at least thirty (30) days advance written notice. The County Director of Public Health or
his or her designee is authoriz.ed to execute such written approval on behalf of County
Page 6 of lti
based on TUS's satisfactory perfonna!lce.
8 .02 Termination.
(a) Mutual Agreement.
This Agreement may be tenninated at any time upon the mutual written
agreement of the Parties.
(b) WitboutCause.
This Agreement may be terminated without cause upon thirty (30 ) days prior
written notice by either Party. Such termination shall not take effect,
however, with regard to students already enrolled in the Program until such
time as those students have completed their training for the TUC semester
during which such termination notice is given.
IX. GENERAL PROVISIONS
9.01 Amendrrumts. This Agreement may be amended at any time by mu tual agreement
of the Parties without additional consideration, provided that before any amendment s hall
become effective, it shall be reduced to writing and signed by the Parties. Notwithstanding
the foregoing, should any provision of this Agreement be in conflict
with the law of the State in which the Facilities are located or Federal law, it shall be
deemed amended to eliminate the conflict.
9.02 Assignment. Neither Party shall assign or otherwise transfer this Agreement
without the other Party's prior written co.nsent. Any purported assignment in violation of
this Section shall be null and void.
9.03 Captions. Any captions to or headings of the articles, sections, subsections,
paragraphs, or subparagraphs of this Agreement are solely for the convenience of the
Parties, are not a part of this Agreement, and shall not be used for interpretation or
determination of validity of this Agreement or any of its provisions.
9.04 Counterparts. This Agreement may be executed in any number of counterparts,
each ofwbich shall be deemed an original, but all such counterparts together shall
constitute one and the same instrument.
9 .05 Entire Agreement. This Agreement, together with all attachments, is the entire
agreement between the Parties and no other agreements, oral or written, have been
entered into with respect to its subject matter.
9.06 Force Majeure. Neither Party shall be liable nor deemed to be in default for any
delay or failure in perfonnance under I.his Agreement or other interruption of service or
employment resulting, directly or indirectly, from acts of God, ci\il or military authority,
a c ts of public enemy, war, ac cidents, fires, explosions, earthquakes, floods, failure of
transportation, machinery or supplies, vandalism. strikes or o ther work interruptions
beyond the reasonable control of either Party.
9.07 Governing Law. The validity, interpretation and perfonnance of this Agreement
shall be governed by and construed in accordance with the laws of the State of California.
Subject to Section 9.10 below, any and all disputes arising out of or relating to this
Agreement s hall be settled through expedited binding arbitration before a single arbitrator
(who shall be an attomey knowledgeable about matters relating to health care) and shall
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be conducted at and by the American Arbitration Association ("AAA") or its successor in
accordance with its rules and procedures in the offices of County. The arbitrator shall
be vested with determining all matters surrounding this Agreement. The costs of such
arbitration shall be home equally by the parties with each party bearing its own attorneys'
fees and any costs associated with presenting its proof. Judgment upon the award shall
be final and binding on the parties and may be entered in any court of competent
jurisdiction.
9 .08 Notices. Notices required under this Agreement sball be sent to the Parties by
certified or registered mail, return receipt requc:sted, postage prepaid, to the address for
the Party set forth below:
To TUC:
To Cffilllty:
Touro University California
Public Health Program
College of Education and Health Sciences
1310 Club Drive
Vallejo, California 94592
Altcntion: Dr. Lisa Norton, Dean
Director, County of Fresno
Department of Public Health
P.O. Box 11867
Fresno, CA 93775
9.09 Remedies. The various rights, options, elections, powers, and remedies oflhe
respective Parties hereto contained in, granted, or reserved by this Agreement, are in
addition to any others that said Parties may be entitled to by law , shall be coru1lrued as
cumulative, and no one of them is exclusive of any of the others, or of any right or
priority allowed by law.
9 .10 Severability. The provis ions of this Agreement shall be deemed severable and if
any portion shall be held invalid, illegal or unenforceable for any reason, the remainder of
this Agreement shall be effective and binding upon the Parties.
9 .11 Waiver. Any waiver of any tenns and conditions hereof must be in writing and
signed by the Parties hereto. A waiver of any term or condition hereof shall not be
construed as a future waiver of the same or of any other tenn or condition hereof.
9 .12 Non-Exclusive Agreement. This Agreement is not exclusive. Accordingly, either
Party shall have the right to enter into one or more agreements relating to the same or
similar matters as are covered by this Agreement.
9 .13 Patient Care. County shall retain ulti mate responsibility for patient care, even if
such care is provided by students, IUld for ensuring that health care services provided or
activities performed pursuant to this Agreement comply with all applicable provisions of
federal , state and local laws, rules and regulations.
9 .14 Student Records. All records kept by County relating to students in the Program,
including evaluations and grades, shall be made available t o the student but not to other
persons as required by the Famly Educational Rights and Privacy Act of 1974, as
amended (FERPA). Pursuant to FERPA, County must obtain a student's written
pennission before releasing such records or any personally identifiable infonnation to
anyone other than the student. 1f County receives a request for access for s uch records or
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infonna.tion, County shall promptly notify TUC so that TUC can take prompt legal action to
protect its interests.
9.15 Each party shall pay its own costs associated with the Program. County shall not
charge TUC with a "clinical rotation fee" or any other fee related to TUC's participation in
the Program.
X. HEALTH INSURANCE PORTABJLIJY AND ACCOUNTABil..lJY ACT
10.01 Toe parties to this Agreement shall be in strict conformance with all applicable
Federal and State of California laws and regulations, including but not limited to Sections
5328, 10850, and 14100.2 et seq. of the Welfare and Institutions Code, Sections 2.1 and
431.300 et seq. of Title 42, Code of Federal Regulations (CFR), Section 56 et seq. of the
California Civil Code and the Health Insurance Portability and Accountability Act
(HIPAA), including but not limited to Section 1320 D et seq. of Title 42, United States
Code (USC) and its implementing regulations, including, but not limited to Title 45, CFR,
Sections 142, 160, 162, and 164, The Health Information Technology for Economic and
Clinical Health Act (HITECH) regarding the confidentiality and security of patient
infonnation, and the Genetic Information Nondiscrimination Act (GINA) of2008
regarding the confidentiality of genetic information.
Except as otherwise provided in this Agreement, TUC, as a Business Associate of
COUNTY, may use or disclose Protected Health Information (PHI) lo perform functions,
activities or services for or on behalf of COUNTY, as specified in this Agreement,
provided that such use or disclosure shall not violate the Health Insurance Portability and
Accountability Act (HIPAA), USC 1320d et seq. Toe uses and disclosures of PID may not
be more expansive than those applicable to COUNTY, as the "Covered Entity" under the
HIP AA Privacy Rule (45 CFR 164.500 et seq.), except as authorized for management,
administrative or legal responsibilities of the Business Associate.
l 0,02 TUC, including its subcontractors and employees, shall protect, from wiauthorized
access, use, or disclosure of names and other identifying information, including genetic
information, concerning persons receiving services pursuant lo this Agreement, except
where permitted in order to carry out data aggregation purposes for health care operations
(45 CFR Sections 164.504 (e)(2)(i), 164.504 (3)(2)(ii)(A), and 164 .504 (e}(4}(i)] This
pertains lo any and all persons receiving services pursuant to a COUNTY funded program.
This requirement applies to electronic PHI, TUC sha\1 not use such identifying
information or genetic infonnation for any purpose other than carrying out TUC's
obligations under this Agreement.
10.03 TUC, inc\uding its subcontractors and employees, shall not disclose any such
identifying information or genetic information to any person or entity, except as otherwise
specifically permitted by this Agreement, authorized by Subpart E of 45 CFR Part 164 or
other law, required by the Secretary, or authorized by the client/patient in writing. In using
or disclosing PHI that is permitted by this Agreement or authorized by law, TUC shall
make reasonable efforts to limit Pffi to the minimum necessary to accomplish intended
purpose of use, disclosure or request.
10.4 For purposes of the above sections, identifying infonnation shall inelude, but not
be limited to name, identifying number, symbol, or other identifying particular assigned. to
the individual, such as finger or voice print, or photograph.
10.5 For purposes of the above sections, genetic information shall include genetic tests
of family members of an individual or individual, manifestation of disease or disorder of
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family members of an individual, or any request for or receipt of, genetic services by
individual or family members. Family member means a dependent or any person who is
first, second, third, or fourth degree relative.
10.6 TUC shall provide access, at the request of COUNTY, and in the time and manner
designated by COlTNTY, to PHI in a designated record set (as defined in 45 CFR Section
164.50 I), to an individual or to COljNTY in order to meet the requirements of 45 CFR
Section 164.524 regarding access by individuals to their PHI. With respect to individual
requests, access shall be provided within thirty (30) days from request. Access may be
extended if TUC cannot provide access and provides individual with the rewmns for the
delay and the date when access may be granted . PHI shall be provided in the form and
format requested by the individual or COUNTY.
TUC shall make any amendment(s) to PHI in a designated record set at the request of
COUNTY or individual, and in the time and manner designated by COUNTY in
accordance with 45 CFR Section 164,526.
TUC shall provide to COUNfY or to an individual, in a time and manner designated by
COUNTY, information collected in accordance with 45 CFR Section 164.528, to permit
COUNTY to respond to a request by the individual for an accounting of disclosures of PHI
in accordance with 45 CFR Section 164.528.
10.7 TUC shall report to COUNTY, in writing, any knowledge or reasonable belief
that there has been unauthorized access, viewing, use, disclosure, security incident, or
breach of unsecured PHI not pennitted by this Agreement of which it becomes aware,
immediately and without reasonable delay and in no case later than two (2) business days
of discovery. Immediate notification shall be made to COUNTY's Infonnation Security
Officer and Privacy Officer and COUNTY's DPH HIPAA Representative, within two (2)
business days of discovery. The notification shall include, to the extent possible, the
identification of each individual whose unsecured PHI has been, or is reasonably believed
to have been, accessed, acquired, used, disclosed, or breached. TUC shall take prompt
corrective action to cure any deficiencies and any action pertaining to si1ch unauthorized
disclosure required by applicable Federal and State Laws and regulations. TUC shall
investigate such breach and is responsible for all notifications required by law and
regulation or deemed necessary by COUNTY and shall provide a written report of the
investiga.tion and reporting required to COUNTY's Tnformation Security Officer and
Privacy Officer and COUNTY's DPH HIP AA Representative. This written investigation
and description of any reporting necessary shall be postmarked within the thirty (30)
working days of the discovery of the breach to the addresses below:
County of Fresno
Dept. of Public Health
HIP AA Representative
(559) 600•6439
P.O. Box 11867
Fresno, CA 93775
County of Fresno
Dept. of Public Health
Privacy Officer
(559) 600.6405
P.O. Box I 1867
Fresno, CA 93775
County of Fresno
Information Tectmology
Information Security Officer
(559} 600-5800
333 W. Pontiac Way
Clovis, CA 93612
l 0.8 TUC shall make its internal practices, books, and records relating to the use and
disclosure of PHI received from COUNTY, or created or received by TUC on behalf of
COUNTY , in compliance with .HIPAA's Privacy Rule, including, but not limited to the
requirements set forth in Title 45, CFR, Sections 160 and 164. TUC shall make its internal
practices, books, and records relating to the use and disclosure of PHI received from
COUNTY, or created or received by TUC on behalf of COUNTY, available to the United
States Department of Health and Human Services (Secretary) upon demand.
Page 10 of 16
TUC shell cooperate with the compliance and investigatio.n reviews conducted by
the Secretary. PHI access to the Secretary must be provided during TUC's normal
business hours, however, upon exigent circumstances access at any time must be granted.
Upon the Secretary's compliance or investigation review, if Pill is unavailable to TUC and
in possession of a Subcontractor, it must certify efforts to obtain the information to the
Secretary,
10.9 Safeguards. Tt:C shall implement administrative, physical, and technical
safeguards as requir ed by the HIP AA Security Rule, Subpart C of 45 CFR 164, that
reasonably and appropriately protect tbe confidentiality, integrity, and availability of PHI,
including electronic Plll, that it creates, receives, maintains or transmits on behalf of
COUNTY and to prevent unauthorized access, viewing, use, disclosure, or breach of PHI
other than as provided for by this Agreement. TUC shall conduct an accwate and thorough
assessment of the potentiel risks and vulnerabilities to the confidential, integrity and
availability of electronic PHI. TUC shall develop and maintain a written information
privacy and security program that includes administrative, technical and physical
safeguards appropriate to the size and complexity ofTUC's operations and the nature and
scope of its activities. Upon COUNTY's request, TUC shall provide COUNTY with
infonnation concerning such safeguards.
TUC shall implement strong access controls and other security safeguards and
precautions in order to restrict logical and physical access to confidential, personal (e.g.,
PHI) or sensitive data to authorized users only. Said safeguards and precautions shall
include the following administrative and technical password controls for all systems used
to process or store confidential, personal, or sensitive data:
(a) Passwords must not be:
1. Shared or written down where they arc accessible or recogni7.able by
anyone else; such as taped to computer screens, stored under
keyboards, or visible in a work area;
2 . A dictionary word; or
3. Stored in clear text
(b) Passwords must be:
1. Eight (8) characters or more in length;
2. Changed every ninety (90) days;
3. Changed immediately if revealed or compromised; and
4. Composed of characters from at least three (3} of the following four
(4) groups from the standard keyboard:
A. Upper case letters (A-Z);
B. Lowercase letters (a-z);
C. Arabic numerals (0 through 9); and
D. Non-alphanumeric characters (punctuation symbols).
TUC shall implement the following security controls on each workstation or
portable computing device ( e.g., laptop computer) containing confidential,
personal, or sensitive data:
(a) Network-based firewall and/or personal firewall;
(b) Continuously updated anti-virus software; and
Page 11 of 16
( c) Patch management process including installation of all operating
system/software vendor security patches.
TUC shall utilize a commercial encryption solution that has received FIPS 140-2
validation to encrypt all confidential, personal, or sensitive data stored on portable
electronic media (including, but not limited to, compact disks and thumb drives) and on
portable computing devices (including, but not limited to, laptop and n otebook computers).
TUC shall not transmit confidential, personal, or sensitive data via e-mail or other
internet transport protocol unless the data is encrypted by a solution that has been validated
by the National Institute of Standards and Technology (NIST) as conforming to the
Advanced Encryption Standard (AES) Algorithm. TUC must apply appropriate sanctions
against its employees who fail to comply with these safeguards. TUC must adopt
procedures for tenninating access to PHI when employment of employee ends.
l 0.1 0 Mitigation of Hannful Effects. TUC shall mi ti gate, to the extent practicable, any
harmful effect that is suspected or known to TUC of an unauthorized access, viewing, use,
disclosure, or breach of PHI by TUC or its subcontractors in v iolation of the requirements
of these provisions. TUC must document suspected or known harmful effects and the
outcome.
10.11 TUC's Subcontractors. TUC shall ensure that any of its contractors, including
subcontractors, if applicable, to whom TUC provides PHI received from or created or
received by TUC on beha!f of COUNTY, agree to the same restrictions, safeguards, and
conditions that apply to TUC with respect to sueh PHI and to incorporate, when applicable,
the relevant provisions of these provisions into each subcontract or s ub-award to such
agents or subcontractors.
10.12 Employee Training and Discipline. T UC shall train and use reasonable measures
to ensure compliam,;e with the requirements of these provisions by employees who assist in
the performance of functions or activities on behalf of COUNTY under this Agreement
and use or disclose PHI and discipline such employees who intentionally violate any
provisions of these provisions, including termination of employment.
10.13 Tennination for Cause. Upon COUNTY' s knowledge of a material breach of
these provisions by TUC, COUNTY shall either:
(a) Provide an opportunity for TUC to cure the breach or end the violation and
terminate this Agreement if TUC does not cure the breach or end the violation
within the time specified by COU~TY; or
(b) Immediately terminate this Agreement if TUC has breached a material tenn of
these provisions and ewe is not possible.
(c) If neither cure nor termination is feasible, the COUNTY's Privacy Officer shall
report the violation to the Secretary of the U.S. Department of Health and
Human Services.
10.14 Judicial or Administrative Proceediags. COUNTY may terminate this Agreement
in accordance with the terms and conditions of this Agreement ru written hereinabove, if:
( 1) rue is found guilty in a criminal proceeding for a violation of the HIP AA Privacy or
Security Laws or the HITECH Act; or (2) a finding or stipulation that rue has violated a
Page 12 of 16
privacy or security standard or requirement of the HITE CH Act, HIP AA or other security
or privacy laws in WI administrative or civil proceeding in which the TUC is a party.
10.15 Effect ofTennination. Upon termination or expiration of this Agreement for any
reason, rue shall return or destroy all PHI received from COUNTY (or created or
received by TUC on behalf of COl.JNTY) that TUC still maintains in any form, and shall
retain no copies of such PHI. If return or destruction of PHI is not feasible. it shall
continue to extend the protections of these provisions to such information, and limit further
use of such PHI to those purposes that make the return or destruction of such PHl
infeasible. This provision sha11 apply to PHI that is in the possession of subcontractors or
agents, if applicable, of TUC . If rue destroys the Plll data, a certification of date and
time of destruction shall be provided to the COUNTY by TUC.
l 0.16 Disclaimer. COUNTY makes no warranty or representation that compliance by
TUC with these prov:i sions, the HITECH Act, HIP AA or the HIP AA regulations will be
adequate or satisfactory for TUC's own purposes or that any information in TUC's
possession or control, or transmitted or received by 11.JC, is or will be secure from
unnuthorized access, viewing, use, disclosure, or breach. TUC is solely responsible for all
decisions made by TUC regarding the safeguarding of Pffi.
10.17 Amendment. The parties acknowledge that Federal and State laws relating to
electronic data security and privacy are rapidly evolving and that amendment of these
provisions may be required to provide for procedures to ensure compliance with such
developments. The parties specifically agree to take such action as is necessary to amend
this agreement in order to implement the standards and requirements ofHlPAA, the
HIP AA regulations, the IDTECH Act and other applies ble laws relating to the security or
privacy of PHI. COUNTY may terminate this Agreement upon thirty (30) days written
notice in the event that TUC does not enter into an amendment providing assurances
regarding the safeguarding of PHJ that COUNTY in its sole discretion, deems sufficient to
satisfy the standards and requirements of HIP AA, the HIP AA regulations and the HlTECH
Act.
10.18 No Third.Party Beneficiaries. Nothing express or implied in the terms and
conditions of these provisions is intended to confer, nor shall anything herein confer, upon
any person other than COUNTY or TUC and their respective successors or assignees, any
rights, remedies, obligations or liabilities whatsoever.
10.19 Interpretation. The tenns and conditions in these provL'lions shall be interpreted as
broadly as necessary to implement and comply witb HIP AA, the HIP AA regulations and
applicable State laws . The parties agree that any ambiguity in the terms and conditions of
these provisions shall be resolved in favor of a meaning that complies and is consistent
with HIP AA and the HIP AA regulations.
10.20 Regulatory References. reference in the tcnns and conditions of these provisions
to a section in the HIPAA regulations means the section as in effect or as amended.
I 0.21 Survival. The respective rights and ob ligations of TUC as stated in tbis Section
sh.all survive the termination or expiration of this Agreement.
10.22 No Waiver of Obligations. No change, waiver or discharge of any liability or
obligation hereunder on any one or more occasions shall be deemed a waiver of
performance of any continuing or other obligation, or shall prohibit enforcement of any
obligation on any other occasion.
Page 13 of 16
XI. DATA Sll':CURITY
For the purpose of preventing the potential loss, misappropriation or inadvertent access,
viewing, use Cilr disclosure of County data including sensitive or personal client
infonnation; abuse of County resources; and/or disruption to County operations,
individuals and/or agencies that enter into a contractual relationship witb the County for
the purpose of providing services under this Agreement must employ adequate data
security measures to protect the confidential information provided to TUC by the County,
including but not limited to the following:
l 1.01 TUC-Owned Mobile, Wireless, or Handheld Devices
TCC may not connect to County networks via personally-owned mobile, wireless or
handheld devices, unless the following conditions arc met:
(a) TUC bas received authorization by County for telecommuting purposes;
(b) Current virus protection software is in place;
(c) Mobile device has the remote wipe feature enabled; and
(d) A secure connection is used.
11.02 TUC-Owned Computers or Computer Peripherals
TUC may not bring TUC-owned computers or computer peripherals into the County for
use without prior authorization from the County's Chief Infonnation Officer, and/or
designee(s), including but not limited to mobile storage devices, If data is approved to be
transferred, data must be stored on a secnre server approved by the County and transferred
by means of a Virtual Private Network (VPN) connection, or another type of secure
connection. Said data must be encrypted.
11.03 County-Owned Computer Equipment
TUC or anyone having an employment relationship with the County, may not use County
computers or computer peripherals on non-County premises without prior authorization
from the County's Chiefinformation Officer, end/or designee(s).
11.04 TUC may not store County's private, confidential or sensitive data on any hard-
disk drive, portable storage device, or remote storage installation unless encrypted.
11.05 TUC shall be responsible to employ strict controls to ensure the integrity and
security of County's confidential information and to prevent unauthorized access,
viewing, use or disclosure of data maintained in computer files, program documentation,
data processing systems, data files and data processing equipment which stores or
processes County data internally and externally.
11.06 Confidential client information transmitted to one party by the other by means of
electronic transmissions must be encrypted according to Advanced Encryption Standards
(AES) of 128 BIT or higher. Additionally, a password or pass phrase must be utilized.
11.07 TUC is responsible to immediately notify County of any violations, breaches or
potential breaches of security related to County's confidential information, data
maintained in computer files, program documentation, data processing systems, data files
end data processing equipment which stores or processes County data internally or
externally.
Page 14 of 16
11.08 County shall provide oversight to TUC's response to all incidents arising from a
possible breach of security related to County's confidential client information provided to
TUC. TUC will be responsible to issue any notification to affected individuals as required
by law or as deemed necessary by County in its sole discretion. TUC will be responsible
for all costs incurred as a result of providing the required notification.
XU. NO EMPLOYMENT GUARA.:.'"ffEES
TUC and County acknowledge and agree that although County may employ Tntem at
some future date, neither TUC nor County has made any statement, representation or offer
to Intern guaranteeing Intern employment with County based upon Intern's participation
in, or completion of, the Internship Program, Tbe Internship Program is not a recruiting
mechanism for County and the Internship Program is not intended to screen potential
applicants for future employment opportunities with the County. After the internship
period has expired, County may consider qualified Interns for future employment
opponunities.
XJIL DISCLOSURE OF SELF-DEALING TRANSACTIONS
This provision is only applicable if the TUC is operating as a corporation (a for-profit or
non-profit corporation) or if dwing the term of this agreement, TUC changes its status to
operate as a corporation. Members ofTUC 's Board of Directors shall disclose any self-
dealing transacti ons that they are a party to while TUC is providing goods or performing
services under this agreement. A self-dealing transaction shall mean a transaction to which
TIJC is a party and in which one or more of its directors has a material financial interest.
Members of the Board of Directors shall disclose any self-dealing transactions that they
are a party to by completing and signing a Self-Dealing Transaction Disclosure Form,
attached hereto as Exhibit B and inc orporated herein by reference, and submitting it to the
County prior to commencing with the self-dealing transaction or immediately thereafter.
Page 15of 16
XIV. EXECUTION
IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed
by their duly authorized representatives.
COUN1Y OF FRESNO, a Political Subdivision of the State of Californi•
B£., .:t:-/.L , ~~Date : 6 \~S ~
Ernest Buddy Men~Cbairmao of the Board
of Supervisors of the County of Fresno
Attest:
Bernice E. Seidel
Clerk of the Boazd of Supervisors
County ofFresao, State of California
TOURO UNIVERSITY. a California nonprofit public benefit corporation
By:-~->=---:.~~-
Lisa Nanon, Ed.D .
Dean
Co1lege of Education and Health Sciences
Touro University California
By: __ )4~1i?H_. 1_ l/~:5/~~ Date: _...,_ ___ -+/-(-----
Sarah Sweitzer, Ph.D.
Provost and Chief Academic Officer
Office of the COO & Provost
Touro University California
Page 16 of 16
Exhibit A
~ w
TOURO UNIVERSITY
CALl~OIINIA
COLLEGE OF ED UCATI ON
AND HEALTH SCIENCES
PUBLIC I-IEALTI-I PROGRAM
2016-2017 Field Study
Preceptor l-landbook
Revised l=ebruary 2017
TABLE OF CONTENTS
Course Overview .............................................................................................................................. 2
Learning Objectives ......................................................................................................................... 3
Public Health Competencies ............................................................................................................ 4
COMMUNITY HEALTH FIELD STUDY 5
Course and Fieldwork Format for MPH Students ........................................................................... 6
Course and Fieldwork Format for Joint MSPAS/MPH Degree Students .......................................... 6
Course and Fieldwork Format for MPH Dual Degree Students ....................................................... 6
Student Field Study Work Schedules ............................................................................................... 7
Community Health Field Study Placement Sites ............................................................................. 8
Student On boarding Requirements ................................................................................................ 8
Exceptions & Waivers ...................................................................................................................... 8
The Matching Process .................................................................................................................... 13
Placement Policies ......................................................................................................................... 14
Community Health Field Study Placement Planning Timeline ...................................................... 15
During the Public Health Field Study ............................................................................................. 17
Means for Evaluating Student Performance: Public Health Field Study Course
Requirements & Student Deliverables .......................................................................................... 18
Field Study Evaluation & Grading .................................................................................................. 22
Field Study Responsibilities ........................................................................................................... 22
GLOBAL HEALTH FIELD STUDY 27
Course and Fieldwork Format for MPH Students ......................................................................... 28
Course and Fieldwork Format for MPH Dual Degree Students ..................................................... 28
Course and Fieldwork Format for Joint MSPAS/MPH Degree Students ........................................ 28
Student Field Study Work Schedules ............................................................................................. 28
Global Health Field Study Placement Sites .................................................................................... 29
Exceptions & Waivers .................................................................................................................... 30
The Matching Process .................................................................................................................... 33
Placement Policies ......................................................................................................................... 34
Global Health Field Study Placement Planning Timeline ............................................................... 35
During the Public Health Field Study Placement ........................................................................... 37
Means for Evaluating Student Performance: Public Health Field Study Course
Requirements & Student Deliverables .......................................................................................... 38
Field Study Evaluation & Grading .................................................................................................. 42
Field Study Responsibilities ........................................................................................................... 42
APPENDIX 47
1
o
o
o
Course Title:
Course No./CRN:
Faculty:
Office Phone:
Cell Phone:
Fax:
Office:
Public Health Field Study
PBHC 600-2 (2 Units)
PBHC 600-4 (4 Units)
PBHC 600-6 (6 Units)
PBHC 600A: (Continuation
Course (O Units)
Assistant Professor &
Field Study Coordinator,
Nemesia Kelly, MPH
707-638-5827
707-731-7436
707-638-5871
Wilderman Hall 403
COURSE OVERVIEW
Email: nemesia.kelly@tu.edu
Office Hours: Office Hours: Wednesdays: 12 -
2:30 p.m. & Thursdays: 12 -1:30 p.m.
Course Location: Affiliated Community & Global
Health Field Study Placement Sites
• The Public Health Field Study is required for all MPH students. As part of the Master of Public Health
(MPH) Culminating Experience, the Field Study is a structured and practical experience in a
professional public health setting which allows the student to apply and integrate the knowledge
and skills acquired during the didactic period into public health practice. The Field Study is an also
an opportunity for students to explore public health careers, cultivate their public health skills, and
to develop their professional goals and contacts for future employment through networking. It
allows them to apply their academic knowledge to "real world" situations, projects or tasks and
make meaningful contributions to a public health organization. Clinical experience involving
individual patient care or health facility administration is not considered relevant public health
experience.
• Course Prerequisites: To be eligible to begin the Public Health Field Study, students must have
completed all MPH core and track-required courses. In addition, all new students are required to
complete the on line courses listed below through Blackboard, effective Fall 2015, as part of the
Annual PH Program Orientation Blackboard Organization for New Students. Effective Fall 2016,
these online course prerequisites are required for all students (new and continuing). Students who
entered the Program prior to Summer or Fall 2015 must complete these prerequisites via the
following format:
Online Training Course on Professionalism for MPH Students provided by TRAIN.org
Cultural Diversity. Health Disparities. and PH Online Training provided by TRAIN.org
Unite for Sight's Cultural Competency Online Course -Global Health Track Students ONLY
• Students who are solely pursuing the MPH degree are required to enroll in PBHC 600-4 or 6: Public
Health Field Experience (4 or 6 units) and complete the Field Study over a 10 to 11-week period.
• Part-time MPH students enrolled in the Community Health Track may complete part-time field
study placements over the course of two field study terms (semesters or academic sessions -12 to
24 weeks). Students who receive approval to conduct part-time field studies are required to
2
(
complete a minimum of 20 field study hours per week.
• DO (Doctor of Osteopathic Medicine)/MPH ) and (PharmD (Doctor of Pharmacy)/MPH ) dual degree
and Joint Master of Science in Physician Assistant Studies (MSPAS/MPH) students must enroll in
PBHC 600-2 or 4 (2 or 4 units) and complete the Field Study over a 6-week period. Two (2) units
are transferred from the College of Osteopathic Medicine (COM). College of Pharmacy, (COP) and
PA Program curricula towards the Field Study for MPH dual and joint degree students.)
• As a working partnership between the Program and the public health practice organization, this
course provides a public health fieldwork experience for all MPH students. The students' work in the
field study projects should be valued by the organization and contribute to meeting the
organization's goals or mission. Field study projects must also address a public health issue and
student participation should contribute to strategic resolutions.
• Students enrolled in either the Community Health or Global Health tracks conduct their field
studies under the guidance and supervision of preceptors at affiliated public health field study
organizations that serve as field study placement sites. Community Health field study sites include,
but are not limited to: county health departments, state and federal health agencies, community
health organizations, hospitals, clinics, managed care organizations, academic institutions, California
correctional facilities, philanthropic and voluntary health agencies, and non-profit organizations.
Global Health Track students conduct their field studies at sites in Bolivia, Cambodia, and Ethiopia
under the guidance of course coordinators and preceptors at public health institutions, universities,
ministries of health, non-governmental organizations, and United Nations agencies.
• The practical skills and the knowledge gained in field work at public health practice
agencies/organization are essential to students' academic and professional growth, preparing them
for a professional career in the field of public health. Students are encouraged to maximize and take
full advantage of the field study experience as it can help place them on the path to obtaining jobs
and building careers in the field of Public Health.
LEARNING OBJECTIVES
Through the field study, students MPH students will be able to:
1. Integrate public health theory, knowledge and skills in a practice setting;
2. Complete a defined project(s) in an area of public health practice including core public health
functions such as a needs assessment, program plan, program evaluation, policy development,
educational campaign, applied research project;
3. Exhibit proficiency in at least one of the following areas: program planning, needs assessment and
data gathering, program implementation, applied research, program evaluation, policy analysis, or
data analysis under the guidance of an experienced preceptor;
4. Demonstrate competence in a public health practice setting; and
5. Demonstrate leadership, teamwork, communication skills, and creativity in the development of a
public health practice activity.
3
The Public Health Field Study will involve:
a) Participation in "project-oriented" work in a public health setting. Examples of appropriate tasks
may include the following, but are not limited to involvement in:
• Developing, implementing and or evaluating health promotion programs for specific
population(s); • Conducting research on a public health issue of interest (e.g., study and assessment
instrument design, data collection, data entry, analysis, and assessment of findings; • Conducting policy analysis or advocacy related to a public health issue; • Conducting a community needs assessment; • Coalition building and coordination of resources; • Developing, pre-testing and evaluation of curriculum and or health education materials; • Contributing to the development of grant proposals; • Communicating health education needs and information to policy makers and the public
b) Development of a Scope of Work to implement the selected project;
c) Presentation of project findings in a field study summary report that addresses a health issue of the
community and contributes in resolving practical health problems.
PUBLIC HEALTH COMPETENCIES
For their field study projects, students are required to identify at least three to five (3-5) corresponding
core public health competencies (one from each core area-Biostatistics, Epidemiology, Environmental
Health Science, Health Policy and Management, and Social and Behavioral Sciences, one (1) cross-cutting
competency, and three (3) corresponding Community Health Track or Global Health Track competencies.
Competencies should be identified as a collaborative process between students and preceptors by
identifying and selecting the competencies that will be addressed through the field study and objectives of
the Scope of Work as indicated on the Competency Inventory Form. See Appendix or visit
http:ljcehs.tu.edu/publichealth/curriculum/competencies.html for a full listing of the Program's
competencies.
4
COMMUNITY I-IEAL Tl-I
FIELD STUDY
5
COURSE AND FIELDWORK FORMAT FOR MPH STUDENTS
Full-time Field Study Option: MPH students who seek full-time community health field study placements
are expected to complete 30-40 field study hours per week over an 11-week period (equivalent to 400+
hours) from mid-May to the last week of July during the summer academic session of Year 1. Placements
must be conducted at an appropriate public health field study placement site under the guidance and
supervision of a field study preceptor. (Clinical experience involving individual patient care or health
facility administration is not considered relevant public health experience.)
Part-time Field Study Option: This option is available to MPH students enrolled in the Community Health
Track who need to maintain employment while enrolled in the Field Study course, and who are unable to
complete a more than 20 field study hours per week. Part-time field study student interns may extend a
field study to be completed over the course of two (2) field study terms (semesters or academic sessions)
(20-24 weeks -equivalent to 400+ hours), in which they are expected to complete a minimum of 20 field
study hours per week. After initial enrollment in the Public Health Field Study and partially their completing
field study hours, part-time MPH student interns will receive a grade of INC (Incomplete) and will be
required to register for the 0-Unit PBHC 600A Field Study Continuation course in the following semester in
order to continue the Public Health Field Study. By enrolling in this zero-credit course, students will
maintain "active MPH student status" while completing their field study. If a student does not complete the
remainder of field study hours within their first semester of PBHC 600A, they will be required to register for
PBHC 600A for a second time for the following semester. Once the student's field study has been
successfully completed, the student's grade of INC will be changed to P (Pass).
COURSE AND FIELDWORK FORMAT FOR JOINT MSPAS/MPH STUDENTS
Joint MSPAS/MPH students enrolled in the Community Health Track are expected to complete 30-40 field
study hours per week over a 6-week period during the spring semester of Year 3 in the PA Program. Joint
students must conduct the Field Study at an appropriate public health field study placement site under
the guidance and supervision of a field study preceptor. (Clinical experience involving individual patient
care or health facility administration is not considered relevant public health experience.)
COURSE AND FIELDWORK FORMAT FOR MPH DUAL DEGREE STUDENTS
MPH Dual Degree (DO/MPH & PharmD/MPH) students enrolled in the Community Health Track are
expected to complete 30-40 field study hours per week over a 6-week period during a semester or
academic session at an appropriate public health field study placement site under the guidance and
supervision of a field study preceptor. (Clinical experience involving individual patient care or health
facility administration is not considered relevant public health experience.)
DO/MPH Dual Degree students: These students have a unique opportunity to utilize the field experience to
satisfy two different courses in the two colleges in which they are concurrently enrolled: the TUC CEHS
Public Health Field Study and College of Osteopathic Medicine (COM) DO Program Research Elective
Rotation. Students who pursue this opportunity are required to submit a Research Elective Rotation
6
application and proposal, including the CV and/or resume of their assigned Public Health Field Study
preceptor, as supporting documentation to the COM Clinical Education Department. Upon obtaining
acceptance for field study placements, DO/MPH students routinely request CV and/or resumes from their
assigned field study preceptors. If you agree to mentor a dual degree student as a field study intern, please
provide your CV and/or resume as supporting documentation for their Research Elective Rotation
application/proposal.
Part-time Field Study Option: MPH Dual degree students enrolled in the Community Health Track may
extend a field study to be completed over the course of two (2) successive field study terms (semesters
or academic sessions -12 weeks), in which they are expected to complete a minimum of 20 hours per
week. After initial enrollment in the Public Health Field Study and partially their completing field study
hours, students will receive a grade of INC (Incomplete) and are required to register for the PBHC 600A
Field Study Continuation 0-Unit course in the following semester in order to continue the Public Health
Field Study. By enrolling in this zero-credit course, students will maintain "active MPH student status" while
completing their field study placement.
STUDENT FIELD STUDY WORK SCHEDULES
Typically, students are allowed to work up to a maximum of 8 hours per day in their field study placements.
However, if a field study placement site utilizes a 10/40 work schedule, students may work up to a
maximum of 10-hour days per week during their field study placements (three (3) days for MPH dual/joint
degree students, and 4 days for MPH students).
All field study work must be conducted on-site under the supervision of the field study preceptor. Students
are not allowed to telecommute or work from home during the Field Study as working from home is not
an acceptable form of professional conduct for the MPH field experience. Students may only work
outside their placement site when attending off-site meetings, trainings, or events sponsored by or
affiliated with the placement site. Specific work schedules are negotiated between the preceptor and the
student.
All affiliated field study placement sites typically operate during normal business hours between Monday
through Friday (8 a.m. to 5 p.m.); however, on occasion, students are requested by their preceptors to
participate in special weekend (Saturdays and Sundays) events (e.g., meetings, or trainings sponsored
by/affiliated with the placement site) as part of their field study projects. Students must receive approval
from their preceptors in order to complete field work hours on weekends at such events. Moreover,
students are not permitted to complete field study hours on weekends by telecommuting or conducting
field work from home. If there is field work that cannot be completed on site during a nationally
observed holiday, that field work must resume on site on the next available work day during normal
business hours.
7
COMMUNITY HEALTH FIELD STUDY PLACEMENTS SITES
TUC and the Public Health Program have successfully developed a network of placement sites via
collaborations with local organizations engaged in public health activities that provide its Community
Health track students many placement sites from which to gain field experience. Students conduct their
field studies under the guidance of site preceptors and course coordinators at affiliated public health
organizations, including but not limited to: county health departments, state and federal health agencies,
community health organizations, hospitals, clinics, managed care organizations, academic institutions,
California correctional facilities, philanthropic and voluntary health agencies, and non-profit
organizations. To view the TUC Network of Community Health Field Study Placement Sites, please visit
http:ljcehs.tu.edu/publichealth/culminatingexperience/chfieldstudysites.html or see Appendix.
STUDENT INTERN ONBOARDING REQUIREMENTS: The Program ensures that all student interns fulfill
certain agency clearance or onboarding requirements prior to beginning their field study placements, which
may include completion of forms/paperwork, health and immunization documentation/screening, security
scans/background checks, and drug testing/toxicology screenings.
TUC processes background checks for its students. In addition, all dual and joint students are required to
satisfy requirements (health and immunization documentation/screening, security scans/background
checks, and drug testing/toxicology screenings) routinely prior to beginning rotations for their clinical
programs.
EXCEPTIONS & WAIVERS
Application for Placements at Unaffiliated Community Health Field Study Sites: This application is for
students who wish to independently develop their own field study placements at sites outside the TUC
Network of Community Health Field Study Placement Sites. Motivated students may receive approval for
exceptions to conduct field study placements at unaffiliated field study sites (alternative public health
agencies or organizations outside the existing TUC Network). Requests for these exceptions must be
submitted through an application process which evaluates and determines whether unaffiliated sites and
their field study project proposals qualify for approval. Applications are considered on an individual basis
and reviewed by the Program Director and Field Study Coordinator. Students may contact unaffiliated sites
to inquire about potential field study placement opportunities.
Approval Criteria: The prospective site must meet the Program's criteria in order to be approved as a field
study site. Further, TUC and the Public Health Program must also meet the criteria of the proposed site
required for affiliation, partnership, and/or collaboration.
Field Study Site Eligibility Criteria:
1. The proposed field study placement and/or site must be within appropriate public health practice
agencies or organizations that:
• Provide public health related planning, research and/or services;
8
• Have one or more staff on site with a graduate credential in public health or equivalent
professional experience and education who will serve as a designated preceptor;
• Offer opportunities for students to be exposed to a variety of organizational
departments and individuals, functions and or tasks; • Offer responsibilities to students that are relevant and appropriate to the their individual field
study learning goals and professional development;
• Provide necessary access to data and program materials for students to conduct their projects;
• Have adequate organizational support for students to successfully complete field study
activities;
• Provide direct and regular supervision for students throughout the placement;
• Permit MPH students to complete 30-40 field study hours per week over a minimum of 10
weeks and MPH dual or joint students to complete 30-40 field study hours per week over a 6-
week period
• Preceptors must submit an Online Registration for New MPH Field Study Placement Sites at
https:ljwww.surveymonkey.com/s/TUCPHFieldStudySiteRegistration
by specified deadlines.
Student Requirements:
2. Students who identify potential public health practice entities as prospective Community Health
field study sites are advised to review the following sections which can be found at the Field Study
webpage or in the Student and Preceptor Field Study Handbooks (available online at
http:ljcehs.tu.edu/publichealth/culminatingexperience/phfieldstudy.html):
a. Course Overview
b. Learning Objectives
c. Public Health Competencies
d. Public Health Field Study Site Responsibilities
3. Students are required to provide the following important web links to their proposed
preceptors/sites which can be found at on line at
http:ljcehs.tu.edu/publichealth/culminatingexperience/forpreceptors sites.html :
a. Public Health Program Brochure and our invitation to Prospective Field Study Sites to develop
a partnership with TUC to provide essential program information
b. Guidelines for Public Health Field Study Sites & Preceptors, Field Study Overview & Placement
Planning Timeline, and Field Study Preceptor Handbook to ensure that proposed sites and
preceptors are aware of the required course learning objectives the Program's approval criteria
9
for Community Health field study placement sites and preceptors, the placement planning
timeline, and the field study responsibilities for students, preceptors, sites, and the Program
c. The web link for Online Registration for New MPH Field Study Placement Sites for proposed
sites and preceptors to post their site/preceptor information, proposed field study placement
projects, available course learning objectives, research opportunities, and student and
onboarding requirements
4. Students are required to review the Approval Criteria for Placement at Unaffiliated Community
Health Field Study Sites and submit an Application for Placement at Unaffiliated Community
Health Field Study Sites by specified deadlines posted on line at
http:ljcehs.tu.edu/publichealth/culminatingexperience/chfieldstudy.html. Application approval
criteria the Application, are available online at
http:ljcehs.tu.edu/publichealth/culminatingexperience/exceptions waivers.html and in the
Appendix.
5. Students who plan to independently seek and establish their own field study placements at sites
outside the TUC Network of Community Health Field Study Placement Sites must also complete the
Field Study Planning Form, submit a C.V./resume to the Field Study Coordinator, and complete the
course prerequisites.
Student-Initiated Placements at Affiliated Community Health Field Study Sites: This application is for
students who wish to independently develop their own field study placements at sites within the TUC
Network of Community Health Field Study Placement Sites. Motivated students may receive approval for
exceptions to conduct field study placements in new departments, divisions, or offices at existing affiliated
Community Health field study placement sites under the supervision of new first-time preceptors.
Applications are considered on an individual basis and reviewed by the Program Director and Field Study
Coordinator. Students may contact unaffiliated sites to inquire about potential field study placement
opportunities. Application approval criteria the Application are available online at
http:ljcehs.tu.edu/publichealth/culminatingexperience/exceptions waivers.html and in the Appendix.
Formal Requests to Apply Current Professional Public Health Employment to the Community Health Field
Study: Independent MPH students who are currently employed at local public health practice agencies and
organizations (for less than three continuous years) while enrolled in the Public Health Program may be
permitted to apply their current professional public health employment towards the Public Health Field
Study. The agency/organization must approved by the Public Health Program as an appropriate field
study site and the projects to which the student employee is assigned must provide a Scope of Work that
meets the criteria of the Public Health Program. (To view the qualifications required by
agencies/organizations to become approved field study sites, please see the Guidelines for Public Health
Field Study Sites and Preceptors online at
http://cehs.tu.edu/publichealth/culminatingexperience/forpreceptors sites.html .) Students are required
to submit a formal request to the Field Study Coordinator for approval to apply their current professional
public health employment towards the Public Health Field Study. All requests are subject to review by
committee and must be approved by the Program Director and Field Study Coordinator. Application
approval criteria the Application are available online at
http:ljcehs.tu.edu/publichealth/culminatingexperience/exceptions waivers.html and in the Appendix.
10
Paid Internships: The Public Health Program does not manage paid internships. Our network of field study
placements sites currently offers non-paid field work experience for MPH students. Students who are
interested in paid internships are strongly encouraged to seek out paid internships at public health practice
agencies/organizations independently. Seeking paid internship is similar to searching for jobs or positions at
public health practice entities. Frequently, the Public Health Program receives information regarding paid
internships which it disseminates via students listserves and posts online at its Jobs, Training Fellowship and
Scholarship webpage (http://cehs.tu.edu/publichealth/careers/internshipsfellowships.htm l).
Students who wish to apply a paid internship to the Public Health Field Study for academic credit, must
have completed all core and track-required courses prior to beginning their paid internship. Requests for
paid internships to satisfy the Field Study must be approved by the Program. In addition, paid internships
selected for the field study course must permit MPH students to complete 30-40 field study hours per week
over a minimum of 10-11 weeks and MPH dual or joint students to complete 30-40 field study hours per
week over a 6-week period.
Students who wish to apply a paid internship to the Public Health Field Study for academic credit must
submit a formal request to the Public Health Program at least one month prior to the planned field
study/internship start date. Application approval criteria the Application are available online at
http://cehs.tu.edu/publichealth/culminatingexperience/exceptions waivers.html and in the Appendix.
The Field Study Waiver (Criterion I}: MPH students who can verify previous public health employment of
three years of continuous, paid, public health employment prior to enrollment in the MPH program may be
eligible for a waiver that would allow them to complete 30-40 field study hours per week over the course of
6 weeks reduced from 11 weeks. (Clinical experience involving individual patient care or health facility
administration is not considered relevant public health experience.)
Relevant public health experience must include involvement in at least one of the following activities:
• Assessing, monitoring, or conducting surveillance of health conditions or delivery of services in a
population;
• Establishing public health objectives and priorities;
• Conducting basic or applied research on population-based health problems including the behavioral,
biological or environmental risk factors; or
• Designing, implementing and/or evaluating policies and/or intervention strategies/programs.
To apply for this waiver, students are required to submit a separate 2-3 page (single-spaced) narrative
describing relevant public health work experience, including:
• Description of specific duties performed;
• Discussion ofthe impact or relevance of the experience to public health, highlighting
knowledge, theories and concepts covered in MPH coursework;
11
• List of skills/competencies gained in the experience (see MPH general and track specific
competencies specified in the MPH Learning Outcome Inventory; and
• Reference/contact person (preferably someone who supervised you) so that
employment/involvement with the agency can be verified.
In addition, students are required to submit an Application for the Field Study Waiver (Criterion I}.
Application approval criteria the Application are available online at
http:ljcehs.tu.edu/publichealth/culminatingexperience/exceptions waivers.html and in the Appendix.
Applications are due at least 4 weeks prior to registration in the Public Health Field Study. Applications are
subject to review by committee and all waivers must be approved by the Program Director and Field Study
Coordinator. Students will be contacted by the Field Study Coordinator within two to three weeks with a
decision. Decisions of the Committee are final.
Upon approval of this waiver, students will register for the Field Study for 4 or 6 units and will be approved
for a 6-week waiver for the Field Study. If students who receive this waiver elect to complete a longer field
study placement between 7-12 weeks, they are expected to dedicate a minimum of 20 hours per week
over the course of one semester or academic session.
The Field Study Waiver (Criterion II): The Field Study Waiver (Criterion II): Independent MPH students
who have completed all MPH core and track-required courses and who can verify enrollment in any non-
TUC (outside of TUC) accredited four-year medical or pharmacy school, or Master of Science in Physician
Assistant Studies program via official transcripts, may be eligible for a field study 6-week field study waiver.
Students who receive approved waivers are required to complete 30-40 field study hours per week over the
course of 6 weeks.
To apply for this waiver, students shall provide an official copy of their transcripts verifying enrollment in a
non-TUC accredited four-year medical or pharmacy school, or Master of Science in Physician Assistant
Studies program to the Public Health Program. In addition, students are required to submit an Application
for the Field Study Waiver (Criterion II}. Application approval criteria the Application are available online at
http:ljcehs.tu.edu/publichealth/culminatingexperience/exceptions waivers.html and in the Appendix.
Applications are due at least 4 weeks prior to registration in the Public Health Field Study. All applications
are subject to review by committee. All waivers must be approved by the Program Director and Field Study
Coordinator. Students will be contacted by the Field Study Coordinator within two to three weeks with a
decision. Decisions of the review committee are final.
Upon approval of this waiver, students will register for the Field Study for 4 or 6 units and will be approved
for a 6-week waiver for the Field Study. MPH students who receive this waiver and elect to devote 30-40
field study hours per week toward their field study placements are required to complete the Field Study
within a minimum of 6 consecutive weeks. If students who receive this waiver elect to complete a longer
field study placement between 7-12 weeks, they are expected to dedicate a minimum of 20 hours per
week over the course of one semester or academic session.
12
THE MATCHING PROCESS
Step 1.The Field Study Coordinator will work to facilitate the placement process by matching the student's
skills, qualifications, public health interests, and geographic location preference (within the TUC Network)
with the requirements of existing affiliated placement sites. Student curriculum vitae (C.V.) or resumes are
an essential part of this process. Field study preceptors require student C.V.s and/or resumes to consider
evaluate students who are recommended for available placement opportunities within their respective
agencies or organizations. Preceptors review students' experience, skills, qualifications, public health
interests relevant to available field study projects.
Another important factor in the matching process is field study placement and site availability at our
partnering organizations. Program or project funding cycles, appropriate number of staff, time of year, and
availability of physical space to accommodate student interns, all determine whether or not a placement
site will have available field study opportunities for students. Due to these factors, placement sites are
limited and students may not be assigned to their top-ranked sites. TUC is unable to guarantee field study
placements. Additionally, it is important to remember that field study projects evolve continuously over
time as public health campaigns, interventions, research studies, programs, projects and funding cycles
begin and end, and as site administrative or staffing priorities change over time. Students typically will
know the subject area of a field study project based on a placement site's mission and goals, but do not
usually find out what their specific field study projects entail until they meet with their prospective
preceptors or site administrators.
Step 2. Once a match has been made, an official field study placement recommendation letter is emailed to
the student and preceptor based on the student's skills, qualifications, public health interests. The official
placement recommendation letter and email communication to the student will clearly state that it is the
responsibility of the student to contact the site preceptor or coordinator to confirm, secure, and finalize
their placement. (The Field Study Coordinator will ensure that the student has completed a Signed Student
Code of Conduct before the student is instructed to contact their potential preceptor.)
It is important to note that a placement recommendation from the Field Study Coordinator does not
necessarily guarantee a placement. In most cases, students are required to interview with the site
preceptor or coordinator to secure their field study placements and preceptors make final decisions to
accept a student for a placement post interview. The Program recommends that student utilize the Helpful
Tips for Interviews with Potential Public Health Field Study Preceptors (see Appendix).
In addition, the email correspondence will emphasize that the placement site may require agency clearance
or student onboarding requirements, such as security scans or drug testing and direct students to ensure
that all preliminary requirements are satisfied one (1) to two (2) months prior to the field study start date.
Placement recommendation letters provide details on the course and fieldwork format and includes
information and instructions for completing the field study deliverables, as well as a placement
confirmation form to be completed and submitted by the student.
Step 3. Once the student field study placement has been confirmed by the preceptor/site, a contractual
agreement or memorandum of understanding (MOU) or a Short Affiliation Letter of Agreement with TUC
13
will be prepared by the Field Study Coordinator to be signed by the two parties: The program/university
and the placement site agency/organization. In some cases, a third party signature is required of the
student as part of the public health field study agreement.
Step 4. Once the student field study placement has been confirmed by the preceptor/site, students and
preceptors must sign the Emergency Protocol Statement of Understanding prior to the start of the field
study placement. The Community Health Field Study Emergency Protocol has been designed to prepare for
and facilitate rapid response to emergencies which may arise during the Field Study. Although no single
plan or protocol can address all contingencies, Touro University California (TUC) recognizes the importance
of establishing, in advance, policies and procedures to safeguard the welfare of students during their field
study placements at affiliated community health field study sites.
The procedures set forth are to be followed by the all students in community health field study placements
sponsored by TUC. It is the responsibility of the Field Study Coordinator to follow the procedures outlined
below and educate all field study students, preceptors, and site coordinators or administrators about these
procedures through preceptor orientation. Please see Appendix/or the Emergency Protocol and Incident
Report Form.
PLACEMENT POLICIES
1) Students are required to notify the Field Study Coordinator immediately if they become aware of any
changes, issues, or problems that may delay or interrupt their field study placement. If for some reason a
student is not accepted for a recommended field study placement or is unable to begin a recommended
placement or continue a confirmed placement due to events or circumstances beyond their control, the
Field Study Coordinator will assist the student in finding an alternative placement based on site availability,
the student's experience/qualifications, and location preference.
2) If a student declines to accept a recommended field study placement well before the placement start
date due to changes in their public health interests or preference in placement site or geographical
location, the Field Study Coordinator will assist the student in securing up to a maximum of one (1)
additional field study placement.
3) If a student fails to follow up on a second recommended placement, he/she will be responsible for
independently securing their own field study placement at another site by completing the application
process detailed in the EXECEPTIONS section of this handbook. Further, if there is any indication that the
student has committed a breach of professionalism resulting in a failed placement, the student may be
placed on academic probation and sent to the Academic Probation Committee.
4) Cancellation requests for any confirmed field study placement initiated either by the Field Study
Coordinator or the Student must be submitted to the Field Study Coordinator no later than 5 weeks prior
to the student's intended field study start date. There is no guarantee that requests to cancel confirmed
placements received after the 5-week cutoff will be approved. Students must be aware that cancellations
can be extremely disruptive to the field study placement process and to the existing partnerships
between the Public Health Program and field study placement sites and preceptors. Failure to comply
14
with designated deadlines may result in a delay in a student's graduation. Again, if there is any indication
that the student has committed a breach of professionalism resulting in a failed placement, the student
may be placed on academic probation and sent to the Academic Probation Committee.
5) If a student chooses not to begin his/her confirmed field study placement that has been initiated
either by the Field Study Coordinator or the Student, or ceases conducting his/her field study after
beginning a placement that has been initiated either by the Field Study Coordinator or the Student, and
his/her actions constitute a breach of professionalism, the student may not be eligible for a second
placement recommendation from the Field Study Coordinator during that same semester or in
subsequent semesters. Further, in such cases, students will be sent to the Academic Probation
Committee. This policy applies to placements that have been initiated and confirmed either by the Field
Study Coordinator or the Student.
6) With the exception of dual appointees at TUC and Solano County (e.g., Outpatient Clinic Instructor, Joy
Dugan, Dr. Jay Shubrook), TUC faculty cannot serve as field study preceptors.
Community Health Field Study Placement Planning Timeline
The following timeline describes the placement planning process.
15
Community Health Field Study Placement Planning Timeline MPH Students (10-11 Weeks) Summer (2017-2018 Academic Yr) Fall (2017-2018 Academic Yr) Spring (2016-2017 Academic Yr) Placement Terms/Start & End Dates May 15 -July 28 August 1/Sept. 11-December 8 January 9 -May 12 Field St1,.1dy Orientation February July November Students Submit February 15 May 1 October 1 Field Study Planning Forms, cover letters, C.V.s/Resumes To Field Study Coordinator New Field Study Site Registration February 15 Mayl October 1 (Requests for Placement @Unaffiliated Sites) Field Study Coordinator Reminds February May October Preceptors/Sites to Post Available Field Study Opportunities Matching Process Begins Feburary -March May October Field Study Coordinator Confirms 3-6 weeks prior to 3-6 weeks prior to 3-6 weeks prior to Field Study Placement Opportunities general field study start dates general field study start dates general field study start dates DO/MPH & PharmD/MPH Dual Degree Students (a minimum of 6 Weeks) Placement Terms/Start & End Dates May 15 -July 28** AVAILABLE FOR PHARMD[MPH January 9 -May 12 (Variable start/end dates) DUAL DEGREE STUDENTS ONLY* (Variable start/end dates) August 14/Sept. 11 -December 8 (Variable start/end dates) Field Study Orientation February July November Students Submit February 15 Mayl October 1 Field Study Planning Forms, cover letters, C.V.s/Resumes To Field Study Coordinator New Field Study Site Registration February 15 Mayl October 1 (Requests for Placement @Unaffiliated Sites) Field Study Coordinator Reminds February May October Preceptors/Sites to Post Available Field Study Opportunities 16
Community Health Field Study Placement Planning Timeline Matching Process Begins February -March May October Field Study Coordinator Confirms 3-6 weeks prior to 3-6 weeks prior to 3-6 weeks prior to Field Study Placement Opportunities field study start date field study start date field study start date Joint MSPAS/MPH Students (a minimum of 6 Weeks) Placement Terms/Start & End Dates February 20-March 31, 2017 (2016-2017 Academic Yr) Field Study Orientation August 16 Students Submit October 1 Field Study Planning Forms, cover letters, C.V.s/Resumes To Field Study Coordinator New Field Study Site Registration October 1 (Requests for Placement @Unaffiliated Sites) Field Study Coordinator Reminds October Preceptors/Sites to Post Available Field Study Opportunities Matching Process Begins October Field Study Coordinator Confirms 3-6 weeks prior to field study start date Field Study Placement Opportunities *The Field Study in the fall semesters is available to PharmD/MPH dual degree students ONLY. Registration for the Field Study course in the fall semesters is not permitted for DO/MPH dual degree students in Y3 or Y4. Third and fourth-year DO/MPH students may only register for the Field Study course in either the PH Program spring semesters or summer academic sessions. Start dates may vary for dual degree students. **Students enrolled in the summer academic sessions may not begin the Field Study prior to the placement term start date, nor may they extend the Field Study beyond the placement term end date. DURING THE PUBLIC HEALTH FIELD STUDY PLACEMENT The preceptor supervises the student's onsite performance. Communication is an important aspect of a successful placement. It is expected that both the student and preceptor will contact the Field Study Coordinator at any time when questions, changes, issues, or problems arise. The Field Study Coordinator will also conduct a site visit to evaluate the student's progress near the midpoint of the placement. 17
MEANS FOR EVALUATING STUDENT PERFORMANCE: PUBLIC HEALTH FIELD STUDY COURSE
REQUIREMENTS & STUDENT DELIVERABLES
All documents, forms, and instructions required for completing all field study deliverables listed below,
including the MPH Student Field Study Handbook, are available in the Appendix or on Blackboard. Students
are expected to complete the following required course deliverables. IMPORTANT: Group work is
unacceptable. Although, two or more students can be placed simultaneously at the same site and with the
same preceptor; each student is ultimately responsible for completing and submitting his/her own work.
1. Scope of Work:* The scope of work provides the framework for the field study, by ensuring that
the student and preceptor have a clear understanding of this planned experience. Students must
work with their preceptors to generate a Scope of Work that describes a set of measurable
objectives, activities, a timeline, and outcome indicators for each objective:
a. For instructions for completing the Scope of Work see Blackboard or Appendix.
b. Although, this is a collaborative process between student and preceptor, it is the ultimately
the responsibility of the student to compose the Scope of Work.
c. When submitting your scope of work via Blackboard as an attachment, please remember to
name the file appropriately with your first/last name (e.g., Jane_Smith_Scope of Work).
d. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
e. (Due one week after the placement start date via Blackboard}
2. Competency Inventory Form:* This form ensures the integration of didactic coursework with
public health practice. Students are required to identify at least three to five (3-5) corresponding
core public health competencies (one from each core area), one (1) corresponding cross-cutting
competency, and three (3) corresponding track competencies (Community Health or Global
health):
a. Competencies should be identified as a collaborative process between students and preceptors.
In order to complete this process, the preceptor and student identify and select the
competencies that will be addressed through the field study.
b. Although, this is a collaborative process between student and preceptor, it is the ultimately the
responsibility of the student to compose the Competency Inventory.
b. Students will be evaluated to determine their level of mastery of the selected competencies
upon the completion of the field study (see Appendix).
c. When submitting your competency inventory via Blackboard as an attachment, please
remember to name the file appropriately with your first/last name (e.g.,
Jane_Smith_Competency Inventory).
d. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
e. (Due one week after the placement start date via Blackboard}
3. Field Study Contract:* This contract must be signed by the preceptor and the student
acknowledging an agreement for the student to work and complete agreed upon objectives as
negotiated between the student and preceptor.
a. When submitting your field study contract via Blackboard as an attachment, please
18
remember to name the file appropriately with your first/last name (e.g., John_Smith_Field
Study Contract).
b. (Due one week after the placement start date via Blackboard}
c. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
4. Field Study Site Visit:* The site visit is an assessment occurring midway through the field study
placement, in which the Field Study Coordinator or another Public Health Program faculty member
visits the field study placement site to meet with the student and preceptor.
a. During the first week of the field study placement once the preceptor has signed the Field Study
Contract, the student is responsible for working with their preceptor to select 3-4 possible
dates/times that occur midway through their field study placement on which to schedule the
site visit.
b. A minimum of 30 minutes should be allocated for each site visit (15-minute separate meetings
are required with the student and the preceptor).
c. Site visits may be held in person, by phone, or by Skype.
d. Students are required to submit possible site visit dates/times to the Field Study Coordinator
using the Selected Dates for Field Study Site Visit form.
e. This form requires signatures of both student and preceptor.
f. When submitting the Selected Dates for Field Study Site Visit form via Blackboard as an
attachment, please remember to name the file appropriately with your first/last name (e.g.,
Jane_Smith_Selected Dates for Field Study Site Visit form).
f. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
g. Due one week after the placement end date via Blackboard}
5. Field Study Logs. The purpose of the weekly logs is to help students develop the discipline of
keeping track of significant activities and progress toward reaching the objectives that you have set
out to achieve in during the field study:
a. Students must submit two weeks of logs to the Field Study Coordinator via Blackboard every
two (2) weeks
b. Log submission begins two (2) weeks after the start date of the field study placement.)
c. See Appendix or Blackboard for Field Study Log Guidelines.
d. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
6. Field Study Summary Report: The purpose of this assignment is for the student to:
a. demonstrate application and integration of the skills and knowledge acquired through the
didactic and practical components ofthe MPH Program to public health practice
b. demonstrate mastery of and ability to integrate the core public health principles and
material learned in MPH program
c. demonstrate competency in all five core areas -biostatistics, epidemiology, health policy
and management, environmental health science, and the social and behavioral sciences--
and in areas relating to the Program's community health and global health concentrations.
19
d. determine aptitude for applying this knowledge to issues he or she may confront as a public
health professional
e. Three to Four (3-4) Field Study Photos. This minimum number of digital photographs are
required for Part I ofthe Field Study Summary Report and ePortfolio. The Program requires
students to obtain permission from their site/preceptor/site supervisor to document their
field work experiences. Please submit digital photos of your placement sites, field study
project activities, such as agency/site-sponsored events or meetings, preceptors,
administrative supervisory team members, agency staff, or the general appearance of the
site location (e.g., landscape, scenery, surroundings). We welcome photos featuring you as
smiling student interns, preceptors, agency staff or team members, but we are also
interested in photos that capture public health in action!
Important: If you prefer not to be featured in any of your field study photos, you may
decline to be photographed and instead submit approved photos of agency/site-sponsored
events or meetings, preceptors, administrative supervisory team members, agency staff,
or the general appearance of your site location (e.g., landscape, scenery, surroundings).
Part I ofthe Report will require the student to summarize the field experience and complete various
sections that include, but are not limited to: The executive summary, statement ofthe problem,
theoretical comparisons, results achieved, recommendations, and professionalism. The page limit
for this section is 10 pages including, photos and captions, and references. Supporting documents
can be submitted separately from the report.
Effective Spring 2016, Part II is required ONLY for those students who are not completing an MPH
capstone or who have not passed the 3-unit TUC PH Program in-house MPH Comprehensive
Exam.
Part II: This portion of the report will require students to refer to the main public health problem or
issue identified in their field study and to write a program evaluation proposal in response that
problem or issue. Students must demonstrate a sophisticated and thorough grasp of public health
concepts, appropriate public health interventions, program evaluation techniques, and their field
study site's policy environment for this assignment. The page limit for this section is 7 pages
including references and notes, charts, diagrams, or tables.
See Appendix or Blackboard for the Field Study Summary Report Guidelines.
f. When submitting the Field Study Summary Report via Blackboard as an attachment, please
remember to name the file appropriately with your first/last name (e.g., John_Smith_Field
Study Summary Report)
g. (Due one week after the placement end date via Blackboard)
h. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
7. Field Study ePortfolios are required ONLY for students who entered the Program in or after
Summer 2015. Login to myeFolio to create your myeFolio account. IMPORTANT: The TUC School
20
myeFolio "Sign Up Code" is available via Blackboard for students enrolled in the Field Study
course.
The Field Study ePortfolio is similar to Part I of the written Field Study Summary Report, but
instead utilizes digitized collections (e.g., textbased, graphics, archived multimedia elements, such
as approved field study photos, PPT slides, audio or voice recordings, websites, web links, and
other electronic media to provide a more virtual representation of your public health field work.
Please note that each section of the e-Portfolio Outline can serve as abbreviated versions of those
that are featured in the written Field Study Summary Report.
a. (The web link to your myeFolio webpaqe is due one week after the placement end date via
email to nemesia.kellv@tu.edu}.
For more information about ePortfolios, please visit the ePortfolio webpage .
8. Student Testimonials (Optional). Routinely, the Program features brief testimonial quotes from
students and alumni online and in its print media for promotional and recruitment purposes. The
testimonials reflect the enriching experience of alumni as a result of their course of study in the
MPH Program and how the MPH Culminating Experience (Field Study, Capstone) and MPH degree
have played a role in advancing their academic goals and professional careers. An example of a TUC
MPH Student/Alumni Testimonial is available at
http://cehs.tu.edu/publichealth/ resources/mphwebfiles/ArmandoBanner photo.jpg. If you
would like for the Program to publish your testimonial in its on line and print media, please add it to
your Field Study Summary Report and/or ePortfolio and upload a digital photo of yourself via
Blackboard in the Assignments section under "Student Testimonial Photo."
9. Preceptor Evaluation:* Student performance during the field study will be evaluated by the site
preceptors to document students' demonstration of public health competence in a public health
setting:
a. This information is collected via an online survey (SurveyMonkey); preceptors will receive
this survey link via email. Students are responsible meeting with their preceptors to ensure
that this evaluation is completed.
10. Student Field Study Site Evaluation: Students are required to submit an evaluation of the field
study site via an online survey (SurveyMonkey). This survey link is available on Blackboard. (Due
one week after the placement end date)
11. MPH Student Exit Survey: This survey is required ONLY for Independent MPH students who
entered the PH Program prior to Summer/Fall 2015 and for all dual and joint degree students.
This is an online assessment via SurveyMonkey:
a. The week prior to their field study end date, students are required to email the Field Study
Coordinator (nemesia.kelly@tu.edu) requesting to receive this SurveyMonkey link via email.
b. Due one week after the placement end date
*Preceptor Requirements: Preceptors are required to assist the student in developing the Scope of Work,
the identification of competencies that are addressed in the field study placement, and completion of the
21
Field Study Contract. In addition, the preceptor must evaluate student performance during the field study
to document students' demonstration of public health competence in a public health setting and also meet
with the Field Study Coordinator or another Public Health Program faculty during a site visit (see more
details on additional preceptor requirements in the Public Health Preceptor Responsibilities section in this
handbook.)
FIELD STUDY EVALUATION & GRADING
The Public Health Field Study is a Pass/Fail course. Evaluation and grading is based on the following
measures:
For students who entered the Program prior to For students who entered the Program in or after
Summer 2015. Summer 2015. •
FIELD STUDY GRADING SCALE FIELD STUDY GRADING SCALE
Deliverable
Percentage of
Grade
Deliverable
Percentage of
Grade
Field Study Scope of Work & Field Study Scope of Work &
Competency Inventory/ Competency Inventory/
Field Study Contract/Selected Field Study Contract/Selected
Dates for Site Visit/ 20% Dates for Site Visit/ 10%
Field Study Logs/Student Field Field Study Logs/Student Field
Study Evaluation/ Study Evaluation/
MPH Student Exit Survey MPH Student Exit Survey
Field Study Preceptor Evaluation 30% Field Study Preceptor Evaluation 30%
*Field Study ePortfolio 10%
Field Study Summary Report 50%
Field Study Summary Report 50%
Generally, final field study grades are submitted via TouroOne within 10 business days after the last day of
classes of each semester or academic session. If you planning to graduate at the end of the
semester/academic session during which you have conducted your field study, all field study deliverables
must be completed by the last day of the semester/academic session in order to be evaluated for your final
grade and to allow the course instructor sufficient time to post your final grade by the Registar's deadline
for the forthcoming degree conferral date.
FIELD STUDY RESPONSIBILITIES
Student Responsibilities
In return for the commitment of the organization, the student has a responsibility to the organization. The
PH Program expects students to behave professionally and develop a commitment to the organization and
to their life-long professional development through:
22
• Adhere to TU C's Student Code of Conduct Policy and maintain an acceptable standard of
professionalism at all times during the Field Study
• Communicate directly with the Field Study Coordinator immediately should any changes, issues, or
problems arise that may delay or interrupt their field study placement;
• Participating in setting goals for their own learning;
• Developing the scope of work and completes a competency inventory with assistance from the
preceptor and feedback from the Field Study Coordinator;
• Returning completed forms (scope of work, competency inventory and Field Study Contract);
• Performing assignments and activities identified in scope of work, seeking assistance from the
preceptor, other agency staff or the faculty advisor when needed;
• Maintaining contact with the advisor during placement;
• Maintaining a daily log;
• Assessing the extent to which the field experience has met his/her needs by preparing a written
Summary Report and completing other assignments required by the field experience;
• Completing an evaluation of Field Study via an on line survey within one week of the final field study
end date;
• Fulfilling the minimum requirement of an 11-week or 6-week public health field experience
depending on the student's degree option;
• Completing academic work and assigned papers relating to their internship;
• Behaving in an ethically and morally professional manner;
• Performing professional quality work; and
• Conducting themselves consistent with the values of the organization.
Public Health Field Study Site Responsibilities
• Provide public health related planning, research and/or services;
• Have one or more staff on site with a graduate credential in public health or equivalent
professional experience and education who will serve as a designated preceptor;
• Offer opportunities for students to be exposed to a variety of organizational departments and
individuals, functions and or tasks;
• Offer responsibilities to students that are relevant and appropriate to the their individual field study
learning goals and professional development;
• Provide necessary access to data and program materials for students to conduct their projects;
• Have adequate organizational support for students to successfully complete field study activities;
• Provide direct and regular supervision for students throughout the placement; and
• Provide a minimum of 11 weeks of public health field work experience for MPH students (30-40
field study hours per week) and a minimum of 6 weeks (30-40 field study hours per week) for MPH
dual and joint degree students
Public Health Field Study Preceptor Responsibilities
Our preceptors play a vital role in helping our students apply and integrate their academic knowledge to
"real world" situations, projects or tasks while making meaningful contributions to a public health
organization. Preceptors help to enrich the education of future practitioners in the public health field.
Overall, preceptors are expected to provide supervision for the student and to ensure that assigned tasks
meet not only the agency's needs, but provide opportunities for the student's personal and professional
23
growth. Preceptors must also serve as a liaison between field study site supervisors, project team members
or staff, and the Field Study Coordinator. Preceptors are strongly encouraged to contact the Field Study
Coordinator at any time if they have questions, and especially if any issues or problems should arise
concerning the student's field study placement. Specific duties related to the student fieldwork learning
objectives include:
a) A mutual agreement on a public health project and field study objectives for the student to pursue.
b) Assisting the student in developing the scope of work and identification of competencies.
c) Development of a work schedule based on mutually agreed upon objectives for the field experience.
d) Ensuring that a project in which the student can carve out ownership of the process and outcome is
provided.
i. Review of policies and procedures with which the student is expected to comply.
ii. Completion/signing of the Field Study Contract
iii. Maintain accessibility to the student through a commitment to meeting with the
student on a regular basis to discuss and critique the student's work and progress (at
least once per week).
iv. Encourage student to work independently while providing opportunities for data
gathering and sharing information.
v. Become involved with and foster the student's learning experience.
vi. Evaluate the student's performance during and after the field experience via a
scheduled site visit with the Field Study Coordinator or another Public Health Program
faculty member and by completing the performance evaluation.
Once a student has been recommended for a field study placement at their site, the preceptor must
confirm with or inform the Public Health Program Field Study Coordinator and student regarding his/her
agency's clearance/onboarding requirements.
Public Health Program Responsibilities
1. Preparation: The Program will adequately prepare the student for the public health field
experience both academically and administratively. In addition, the Program will ensure that all
students sign a professional code of conduct. Professional attributes are considered to be part of
the academic performance of MPH students, which include honesty and integrity, leadership,
excellence and continuous improvement, ethical practice and public accountability, life-long
learning and competency, respect for diverse individuals and organizations, the ability to work
effectively with others in a team environment, follow through on commitments, take and give
constructive feedback, follow directions, accept responsibility for own actions. Students are
expected to demonstrate the legal, moral and ethical standards required of a public health
professional and display behavior that is consistent with these qualities. Among the characteristics
included in this context are the knowledge, competence, demeanor, attitude, appearance,
mannerisms, integrity, and morals displayed by the students to faculty, staff, preceptors, peers,
members of the public, colleagues in public health and other settings. The Program expects nothing
short of respect and professional demeanor at all times.
24
• Beginning in Fall 2015, the Program will require all new students to complete an Online
Training Course on Professionalism for MPH Students provided by TRAIN.org. the premier
learning resource for professionals who protect the public's health. A free service of
the Public Health Foundation . www.train.org is part of the newly expanded TrainingFinder
Real-time Affiliate Integrated Network (TRAIN). More information on the course is available
through the Public Health Training Centers/US Department of Health and Human Services,
Health Resources and Services Administration . The course is sponsored by the Wisconsin
Center for Public Health Education and Training (WiCPHET). Effective Fall 2016, this on line
course will be required as course prerequisites for the Field Study.
• Beginning in Fall 2015, the Program will encourage new students to use ePortfolios
throughout their entire course of study in the PH Program to demonstrate key skills and
accomplishments and to organize, manage and display academic and career information and
to showcase professional-quality work for prospective preceptors and employees. In
addition, new students will be encouraged to open Linked In Accounts to develop
professional networks and showcase their work experience, abilities, and recommendations
from employers and work colleagues.
• The Program will also provide all students guidelines on resume/curriculum vitae and
interviewing with field study preceptors.
• The Program will also require students to complete the on line Cultural Diversity. Health
Disparities. and Public Health provided by TRAIN.org. This training provides public health
professionals with a broad overview of cultural diversity issues with a focus on
race/ethnicity and gender. Health disparities, a major public health problem of interest, is
discussed using cultural diversity as the conceptual framework for thinking about the role
of the public health community and health policy solutions for addressing these issues.
2. Assignment: The Program will be responsible for assigning students to sites that will provide a
quality learning experience.
3. Objectives: The Program will provide field study learning objectives. Students and preceptors will
be required to evaluate compliance with these learning objectives.
4. Affiliation Agreements: The Program will develop affiliation agreements with public health practice
sites.
5. Insurance: The Program will assure that all students have current liability Insurance as defined
below:
"TUC shall procure and maintain in force during the term of this Agreement, at its sole cost and
expense, insurance in amounts that are reasonably necessary to protect TUC and Institution from
and against liability arising from or incident to the use of the Facilities by TUC students participating
in the Program. Coverage under such insurance shall not be less than One Million Dollars
($1,000,000) for each occurrence and Three Million Dollars ($3,000,000) in the aggregate each for
professional liability insurance and comprehensive general liability insurance. TUC shall provide
25
Institution with a certificate of insurance evidencing the insurance coverage required under this
Article VII. TUC shall further ensure that not less than thirty (30) days notice shall be provided to
Institution of the cancellation of such insurance. TUC shall promptly notify Institution of any
cancellation, reduction, or other material change in the amount or scope of any coverage required
hereunder."
The Program will also assure that all students have current health insurance.
6. Student/Intern Onboarding Requirements: The Program will ensure that students take the
necessary steps to satisfy all required on boarding requirements (e.g., completion of
forms/paperwork, health and immunization documentation, security scans/background checks, and
drug testing/toxicology screenings) well before their field study start dates.
7. Grading: The Program will be responsible for assigning a final grade to each student.
8. Issues or problems: The Program will interact with preceptors and be available to address any
issues, problems, or concerns of the student or the preceptor. Should any problems arise at the
placement site and there are indications of breaches of professionalism by the student, the Field
Study Coordinator will immediately intervene to facilitate a resolution. If the student has
demonstrated unprofessionalism in their field study and a resolution is not possible allowing the
student to continue his/her placement, he/she may be placed on academic probation and sent to
the Academic Probation Committee. The Program retains the right to remove a student from a
rotation.
26
GLOBAL I-IEAL Tl-I
FIELD STUDY
27
COURSE AND FIELDWORK FORMAT FOR MPH STUDENTS
Full-time Field Study Option: MPH students who seek full-time global health field study placements are
expected to complete 40 field study hours per week over a 10-week period (equivalent to 400 hours)
from mid-May to the last week of July during the summer academic session of Year 1. Placements must
be conducted at an approved global health field study placement site under the guidance and supervision
of a field study preceptor. (Clinical experience involving individual patient care or health facility
administration is not considered relevant public health experience.).
COURSE AND FIELDWORK FORMAT FOR JOINT MSPAS/MPH STUDENTS
Joint MSPAS/MPH students enrolled in the Global Health Track are expected to complete 30-40 field
study hours per week over a 6-week period during the spring semester of Year 3 in the PA Program. Joint
students must conduct their field studies at approved global health field study placement sites under the
guidance and supervision of a field study preceptor. (Clinical experience involving individual patient care
or health facility administration is not considered relevant public health experience.)
COURSE AND FIELDWORK FORMAT FOR MPH DUAL DEGREE STUDENTS
MPH Dual Degree (DO/MPH & PharmD/MPH) students enrolled in the Global Health Track are expected
to complete 30-40 field study hours per week over a 6-week period during a semester or academic
session at approved global health field study placement sites under the guidance and supervision of a
field study preceptor. Six weeks is equivalent to a 210-hour field study placement. (Clinical experience
involving individual patient care or health facility administration is not considered relevant public health
experience.)
DO/MPH Dual Degree students: These students have a unique opportunity to utilize the field experience to
satisfy two different courses in the two colleges in which they are concurrently enrolled: the TUC CEHS
Public Health Field Study and College of Osteopathic Medicine (COM) DO Program Research Elective
Rotation. Students who pursue this opportunity are required to submit a Research Elective Rotation
application and proposal, including the CV and/or resume of their assigned Public Health Field Study
preceptor, as supporting documentation to the COM Clinical Education Department. Upon obtaining
acceptance for field study placements, DO/MPH students routinely request CV and/or resumes from their
assigned field study preceptors. If you agree to mentor a dual degree student as a field study intern, please
provide your CV and/or resume as supporting documentation for their Research Elective Rotation
application/proposal.
STUDENT FIELD STUDY WORK SCHEDULES
Students are not permitted to leave the country site that is designated for their global health field study
during the 6 or 10-week field study placement period. While space issues may occur at field study
placements, students must find ways to work from or near the office of their local global health field study
28
site preceptor and to check in with them daily. To obtain approval to take any time off during the Global
Health Field Study, students must first submit a request to the TUC Public Health Program Global Health
Field Study Country Site Coordinator before obtaining approval from their local global health field study
site preceptor. If local global health field study site preceptors request student presence during non-
traditional work hours for project-specific meetings or activities, this should take priority over sight-seeing
or other social plans.
GLOBAL HEALTH FIELD STUDY PLACEMENTS SITES
Global Health Track students conduct their field studies at sites in Bolivia, Cambodia, and Ethiopia under
the guidance of site preceptors and course coordinators at public health institutions, universities, ministries
of health, non-governmental organizations, and United Nations agencies. Detailed information regarding
the Global Health Field Study is available online at
http://cehs.tu.edu/publichealth/culminatingexperience/ghfieldstudy.htm l. Listed below are the Global
Health Field Study Coordinators assigned to the three (3) Global Health Field Study sites:
• Bolivia: Professor Sarah Sullivan (sarah.sullivan@tu.edu)
• Cambodia: Dr. Carinne Brody (carinne.brody@tu.edu)
• Ethiopia: Dr. Sahai Burrowes (sahai.burrowes@tu.edu )
GLOBAL HEALTH FIELD STUDY REQUIREMENTS:
• Students must attend the Global Health Field Study Orientation where each global health site will be
presented in detail.
• Prior to travel, all Global Health Track students are required to attend special pre-departure
sessions to obtain information on global health ethics and cultural preparation; field study topic
review; introductions to the global health field study site preceptors; vaccination and travel
medicine; logistics for travel and visas; and IRB submission for any proposed research activity.
• Students are required to attend a series of three to four pre-departure meetings with the global
health field study site coordinator of their country site to conduct communication with their
designated global health field study site preceptor and submit forms required for travel (waivers of
liability, health insurance, student information, and student participation agreement and code of
conduct).
• Students are required to complete Unite for Sight's Cultural Competency Online Course prerequisite
prior to traveling to global health field study sites. This training aims to underscore the
understanding that cultural competency training and cultural awareness is of paramount
importance for those working in any international setting.
• Students are required to pass a test demonstrating basic Spanish proficiency for the Bolivia Field
Study.
29
(
EXCEPTIONS & WAIVERS
Application for Placements at Unaffiliated Global Health Field Study Sites: This application is for students
who wish to independently develop their own field study placements at sites outside the TUC Network of
Global Health Field Study Placement Sites. Motivated students may receive approval for exceptions to
conduct field study placements at unaffiliated field study sites (alternative public health agencies or
organizations outside the existing TUC Network). Requests for these exceptions must be submitted through
an application process which evaluates and determines whether unaffiliated sites and their field study
project proposals qualify for approval. Applications are considered on an individual basis and reviewed by
the Global Health Track Chair and Program Director. Students may contact unaffiliated sites to request field
study placements.
Approval Criteria: The prospective site must meet the Program's criteria in order to be approved as a field
study site. Further, TUC and the Public Health Program must also meet the criteria of the proposed site
required for affiliation, partnership, and/or collaboration.
Eligibility Criteria:
1. Students must choose from any low and middle-income LMIC) countries designated by the World
Health Organization (WHO).
2. Students must have any necessary language proficiency specific to the country identified.
3. Students must submit a one-page essay demonstrating their rationale and level of interest in
selecting a country outside the current TUC Network of Global Health Field Study Placement Sites.
4. Students must identify names of potential qualified preceptors and a logistics/safety plan for the
country they select.
5. Preceptors/sites must submit an Online Registration for New MPH Field Study Placement Sites at
https://www.surveymonkey.com/s/TUCPHFieldStudySiteRegistration by deadlines specified by the
Global Health Track Chair.
6. Students must provide translations for online registration forms if necessary.
Student Requirements:
1. Students who identify potential public health practice entities as prospective Global Health field
study sites are advised to review the following sections which can be found at the Field Study
webpage or in the Student and Preceptor Field Study Handbooks (available online at
http://cehs.tu.edu/publichealth/culminatingexperience/phfieldstudy.html):
a) Course Overview
b) Learning Objectives
c) Public Health Competencies
30
d) Public Health Field Study Site Responsibilities
2. Students are required to provide the following important web links to their proposed
preceptors/sites which can be found at on line at
http:ljcehs.tu.edu/publichealth/culminatingexperience/forpreceptors sites.html :
a. Public Health Program Brochure and our invitation to Prospective Field Study Sites to
develop a partnership with TUC to provide essential program information
b. Guidelines for Public Health Field Study Sites & Preceptors, Field Study Overview &
Placement Planning Timeline, and Field Study Preceptor Handbook to ensure that proposed
sites and preceptors are aware of the required course learning objectives the Program's
approval criteria for Global Health field study placement sites and preceptors, the placement
planning timeline, and the field study responsibilities for students, preceptors, sites, and the
Program
c. The web link for Online Registration for New MPH Field Study Placement Sites for proposed
Sites and preceptors to post their site/preceptor information, proposed field study
placement projects, available course learning objectives, research opportunities, and
student and onboarding requirements
3. Students are required to review the Approval Criteria above and submit an Application for
Placement at Unaffiliated Global Health Field Study Sites by specified deadlines.
4. Students who plan to independently seek and establish their own field study placements at sites
outside the TUC Network of Global Health Field Study Placement Sites must also complete the
Field Study Planning Form, submit a C.V./resume to the Global Health Track Chair, and complete
the course prerequisites.
Paid Internships: The Public Health Program does not manage paid internships. Our network of field study
placements sites currently offers non-paid field work experience for MPH students. Students who are
interested in paid internships are strongly encouraged to seek out paid internships at public health practice
agencies/organizations independently. Seeking paid internship is similar to searching for jobs or positions at
public health practice entities. Frequently, the Public Health Program receives information regarding paid
internships which it disseminates via students listserves and posts on line at its Jobs, Training Fellowship
and Scholarship webpage (http:ljcehs.tu.edu/publichealth/careers/jobs.html).
Students who wish to apply a paid internship to the Public Health Field Study for academic credit, must
have completed all core and track-required courses prior to beginning their paid internship. Requests for
paid internships to satisfy the Field Study must be approved by the Program. In addition, paid internships
selected for the field study course must permit MPH students to complete 30-40 field study hours per week
over a minimum of 10 weeks and MPH dual or joint students to complete 30-40 field study hours per week
over a 6-week period.
Students who wish to apply a paid internship to the Public Health Field Study for academic credit must
submit a formal request to the Public Health Program at least one month prior to the planned field
31
study/internship start date. To review the Application, please visit
http://cehs.tu.edu/publichealth/culminatingexperience/exceptions waivers.html or see Appendix.
The Field Study Waiver (Criterion I): MPH students who can verify previous public health employment of
three years of continuous, paid, public health employment prior to enrollment in the MPH program may be
eligible for a waiver that would allow them to complete 30-40 field study hours per week over the course of
6 weeks reduced from 11 weeks. (Clinical experience involving individual patient care or health facility
administration is not considered relevant public health experience.)
Relevant public health experience must include involvement in at least one of the following activities:
• Assessing, monitoring, or conducting surveillance of health conditions or delivery of services in a
population;
• Establishing public health objectives and priorities;
• Conducting basic or applied research on population-based health problems including the behavioral,
biological or environmental risk factors; or
• Designing, implementing and/or evaluating policies and/or intervention strategies/programs.
To apply for this waiver, students are required to submit a separate 2-3 page (single-spaced) narrative
describing relevant public health work experience, including:
• Description of specific duties performed;
• Discussion of the impact or relevance of the experience to public health, highlighting
knowledge, theories and concepts covered in MPH coursework;
• List of skills/competencies gained in the experience (see MPH general and track specific
competencies specified in the MPH Learning Outcome Inventory; and
• Reference/contact person (preferably someone who supervised you) so that
employment/involvement with the agency can be verified.
In addition, students are required to submit an Application for the Field Study Waiver (Criterion I). To
review application approval criteria and to obtain the Application, please visit
http://cehs.tu.edu/publichealth/culminatingexperience/exceptions waivers.html or see Appendix.
Applications are due at least 4 weeks prior to registration in the Public Health Field Study. Applications are
subject to review by committee and all waivers must be approved by the Program Director and Field Study
Coordinator. Students will be contacted by the Program Director within two to three weeks with a decision.
Decisions of the panel are final.
Upon approval of this waiver, students will register for the Field Study for 4 or 6 units and will be approved
for a 6-week waiver for the Field Study. If students who receive this waiver elect to complete a longer field
study placement between 7-12 weeks, they are expected to dedicate a minimum of 20 hours per week
over the course of one semester/academic session.
32
The Field Study Waiver (Criterion II}: MPH students who can verify enrollment in any non-TUC (outside of
TUC) accredited four-year medical school, Doctor of Pharmacy program, or Master of Science in Physician
Assistant Studies program after completing all core and track-required courses and all or the majority of
course electives in the Public Health Program may be eligible for a waiver which would allow them to
complete 30-40 field study hours per week over the course of 6 weeks reduced from 11 weeks.
To apply for this waiver, students shall provide an official copy of their transcripts verifying enrollment in a
non-TUC accredited four-year medical school, Doctor of Pharmacy program, or Master of Science in
Physician Assistant Studies program to the Public Health Program. In addition, students are required to
submit an Application for the Field Study Waiver (Criterion II). To obtain the Application, please visit
http://cehs.tu.edu/publichealth/culminatingexperience/exceptions waivers.html or see Appendix.
Applications are due at least 4 weeks prior to registration in the Public Health Field Study. All applications
are subject to review by committee. All waivers must be approved by the Program Director and Field Study
Coordinator. Students will be contacted by the Program Director within two to three weeks with a decision.
Decisions of the review committee are final.
Upon approval of this waiver, students will register for the Field Study for 4 or 6 units and will be approved
for a 6-week waiver for the Field Study. MPH students who receive this waiver and elect to devote 30-40
field study hours per week toward their field study placements are required to complete the Field Study
within a minimum of 6 consecutive weeks. If students who receive this waiver elect to complete a longer
field study placement between 7-12 weeks, they are expected to dedicate a minimum of 20 hours per
week over the course of one semester/academic session.
THE MATCHING PROCESS
Step 1. The Global Health Field Study Coordinator will work to facilitate the placement process by matching
the student's skills, qualifications, public health interests, and country site preference with the
requirements of existing sites and projects within the TUC network of global health field study placement
sites. Student curriculum vitae (C.V.) or resumes are an essential part of this process. Student curriculum
vitae (C.V.) or resumes are an essential part of this process, which is why they are required upon
submission of the Field Study Planning Form. Field study preceptors require student C.V.s/resumes to
consider evaluate students who are recommended for available placement opportunities with their
respective organizations. Preceptors review students' experience, skills, qualifications, public health
interests relevant to available field study projects.
Another important factor in the matching process is field study placement and site availability at our
partnering organizations. Program or project funding cycles, appropriate number of staff, time of year, and
availability of physical space to accommodate student interns, all determine whether or not a placement
site will have available field study opportunities for students. Due to these factors, placement sites are
limited and students may not be assigned to their top-ranked sites. TUC is unable to guarantee field study
placements. Students are required to travel to Global Health Field Study sites where placements
opportunities are available.
33
Step 2. Once a match has been made, the Global Health Field Study Site coordinator will facilitate the
student's field study placement. The Field Study Coordinator will ensure that the student has completed a
Signed Student Code of Conduct before departing for their designated global health field study site.
Step 3. Once the student field study placement has been confirmed students and preceptors must sign the
Emergency Protocol Statement of Understanding prior to the start of the field study placement. The
Global Health Field Study Emergency Protocol has been designed to prepare for and facilitate rapid
response to emergencies which may arise during the Field Study. Although no single plan or protocol can
address all contingencies, Toure University California (TUC) recognizes the importance of establishing, in
advance, policies and procedures to safeguard the welfare of students during their field study placements
at affiliated community health field study sites.
The procedures set forth are to be followed by all students in global health field study placements
sponsored by TUC. It is the responsibility of the Field Study Coordinator to follow the procedures outlined
below and educate all field study students, preceptors, and site coordinators or administrators about these
procedures through preceptor orientation. Please see Appendix for the Emergency Protocol and Incident
Report Form.
PLACEMENT POLICIES
1) Students are required to notify their Global Health Field Study Coordinator immediately if they become
aware of any changes or issues that may delay or interrupt their field study placement. If for some reason a
student is not accepted or able to begin a placement due to events or circumstances beyond their control,
the Global Health Field Study Coordinator will facilitate an alternative placement based on site availability,
and the student's experience, skills, and qualifications.
2) If a student fails to follow up on a second confirmed placement, he/she will be responsible for
independently securing an appropriate field study placement at another location by completing the
application process detailed in the EXCEPTIONS section of this handbook. If there is any indication that
the student has committed a breach of professionalism resulting in a failed placement, the student may be
placed on academic probation and sent to the Academic Probation Committee.
3) Cancellation requests for any confirmed global health field study placement that has been formally
accepted by a student must be submitted to the Global Health Field Study Coordinator no later than 10
weeks prior to the student's intended field study start date. Requests to cancel confirmed placements
received after the 10-week cutoff will not be accepted. All students must be aware that cancellations can
be extremely disruptive to the Global Health Field Study Placement process and to the existing
partnerships between the Public Health Program and Global Health Field Study placement sites and
preceptors. Failure to comply with designated deadlines may result in a delay in a student's graduation.
Again, if there is any indication that the student has committed a breach of professionalism resulting in a
failed placement, the student may be placed on academic probation and sent to the Academic Probation
Committee.
4) If a student ceases conducting his/her field study after beginning a placement and his/her actions
constitute a breach of professionalism, the student may not be eligible for a second placement
34
recommendation from the Field Study Coordinator. Further, in such cases, students will be sent to the
Academic Probation Committee.
5) TUC faculty cannot serve as field study preceptors.
Global Health Field Study Placement Planning Timeline
Field study coordination timelines are scheduled by the Global Health Track faculty each semester prior to
departure dates.
35
Global Health Field Study Placement Planning Timeline MPH Students (10 Weeks) Summer (2017-2018 Academic Yr) Fall (2017-2018 Academic Yr) Sprring (2016-2017 Academic Yr) Placement Terms/Start & End Dates May 15 -July 28 August 1/Sept. 11-December 8 Bolivia: February 19 -May 12 Cambodia: January 8 -May 12 Ethiopia: TBA Field Study Orientation February July November Students Submit February 15 Mayl October 1 Field Study Planning Forms, cover letters, C.V.s/Resumes To Field Study Coordinator New Field Study Site Registration February 15 Mayl October 1 (Requests for Placement @Unaffiliated Sites) Matching Process Begins February -March May October Field Study Coordinator Confirms 8 weeks prior to 8 weeks prior to 8 weeks prior to Field Study Placement general field study start dates general field study start dates general field study start dates !Pre-departure Sessions See country site coordinator See country site coordinator See country site coordinator DO/MPH & PharmD/MPH Dual Degree Students (a minimum of 6 Weeks) Placement Terms/Start & End Dates May 15 -July 28** AVAILABLE FOR PHARMD[MPH Bolivia: February 19 -May 12 (Variable start/end dates) DUAL DEGREE STUDENTS ONLY* Cambodia: January 8 -May 12 August 14/Sept. 11 -December 8 Ethiopia: TBA (Variable start/end dates) Field Study Orientation February July October Students Submit February 15 Mayl October 1 Field Study Planning Forms, cover letters, C.V.s/Resumes To Field Study Coordinator New Field Study Site Registration February 15 Mayl October 1 (Requests for Placement @Unaffiliated Sites) Matching Process Begins February -March May October 36
Global Health Field Study Placement Planning Timeline Field Study Coordinator Confirms 8 weeks prior to 8 weeks prior to 8 weeks prior to Field Study Placement field study start date field study start date field study start date Pre-departure Sessions See country site coordinator See country site coordinator See country site coordinator Joint MSPAS/MPH Students (a minimum of 6 Weeks) Placement Terms/Start & End Dates February 20-March 31, 2017 (2016-2017 Academic Yr) Field Study Orientation August 16 Students Submit October 1 Field Study Planning Forms, cover letters, C.V.s/Resumes To Field Study Coordinator New Field Study Site Registration October 1 (Requests for Placement @Unaffiliated Sites) Matching Process Begins October Field Study Coordinator Confirms November Field Study Placement Pre-departure Sessions See country site coordinator *The Field Study in the fall semesters is available to PharmD/MPH dual degree students ONLY. Registration for the Field Study course in the fall semesters is not permitted for DO/MPH dual degree students in Y3 or Y4. Third and fourth-year DO/MPH students may only register for the Field Study course in either the PH Program spring semesters or summer academic sessions. Start dates may vary for dual degree students. **Students enrolled in the summer academic sessions may not begin the Field Study prior to the placement term start date, nor may they extend the Field Study beyond the placement term end date. DURING THE PUBLIC HEALTH FIELD STUDY PLACEMENT The preceptor supervises the student's onsite performance. Communication is an important aspect of a successful placement. It is expected that both the student and preceptor will contact the Field Study Coordinator at any time when questions, changes, issues, or problems arise. The Field Study Coordinator will also conduct a site visit to evaluate the student's progress near the midpoint of the placement. 37
MEANS FOR EVALUATING STUDENT PERFORMANCE: PUBLIC HEALTH FIELD STUDY COURSE
REQUIREMENTS & STUDENT DELIVERABLES
All documents, forms, and instructions required for completing all field study deliverables listed below,
including the MPH Student Field Study Handbook, are available in the Appendix or on Blackboard. Students
are expected to complete the following required course deliverables. IMPORTANT: Group work is
unacceptable. Although, two or more students can be placed simultaneously at the same site and with the
same preceptor; each student is ultimately responsible for completing and submitting his/her own work.
1Scope of Work:* The scope of work provides the framework for the field study, by ensuring that the
student and preceptor have a clear understanding of this planned experience. Students must work
with their preceptors to generate a Scope of Work that describes a set of measurable objectives,
activities, a timeline, and outcome indicators for each objective:
f. For instructions for completing the Scope of Work see Blackboard or Appendix.
g. Although, this is a collaborative process between student and preceptor, it is the ultimately
the responsibility of the student to compose the Scope of Work.
h. When submitting your scope of work via Blackboard as an attachment, please remember to
name the file appropriately with your first/last name (e.g., Jane_Smith_Scope of Work).
i. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
j. (Due one week after the placement start date via Blackboard}
2. Competency Inventory Form:* This form ensures the integration of didactic coursework with public
health practice. Students are required to identify at least three to five (3-5) corresponding core
public health competencies (one from each core area), one (1) corresponding cross-cutting
competency, and three (3) corresponding track competencies (Community Health or Global health):
a. Competencies should be identified as a collaborative process between students and preceptors.
In order to complete this process, the preceptor and student identify and select the
competencies that will be addressed through the field study.
b. Although, this is a collaborative process between student and preceptor, it is the ultimately the
responsibility of the student to compose the Competency Inventory.
h. Students will be evaluated to determine their level of mastery of the selected competencies
upon the completion of the field study (see Appendix).
i. When submitting your competency inventory via Blackboard as an attachment, please
remember to name the file appropriately with your first/last name (e.g.,
Jane_Smith_Competency Inventory).
j. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
k. (Due one week after the placement start date via Blackboard}
3. Field Study Contract:* This contract must be signed by the preceptor and the student
acknowledging an agreement for the student to work and complete agreed upon objectives as
negotiated between the student and preceptor.
a. When submitting your field study contract via Blackboard as an attachment, please
remember to name the file appropriately with your first/last name (e.g., John_Smith_Field
38
Study Contract).
b. (Due one week after the placement start date via Blackboard}
c. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
4. Field Study Site Visit:* The site visit is an assessment occurring midway through the field study
placement, in which the Field Study Coordinator or another Public Health Program faculty member
visits the field study placement site to meet with the student and preceptor.
a. During the first week of the field study placement once the preceptor has signed the Field Study
Contract, the student is responsible for working with their preceptor to select 3-4 possible
dates/times that occur midway through their field study placement on which to schedule the
site visit.
b. A minimum of 30 minutes should be allocated for each site visit (15-minute separate meetings
are required with the student and the preceptor).
c. Site visits may be held in person, by phone, or by Skype.
d. Students are required to submit possible site visit dates/times to the Field Study Coordinator
using the Selected Dates for Field Study Site Visit form.
e. This form requires signatures of both student and preceptor.
f. When submitting the Selected Dates for Field Study Site Visit form via Blackboard as an
attachment, please remember to name the file appropriately with your first/last name (e.g.,
Jane_Smith_Selected Dates for Field Study Site Visit form).
I. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
m. Due one week after the placement end date via Blackboard}
5. Field Study Logs. The purpose of the weekly logs is to help students develop the discipline of
keeping track of significant activities and progress toward reaching the objectives that you have set
out to achieve in during the field study:
a. Students must submit two weeks of logs to the Field Study Coordinator via Blackboard every
two (2) weeks
b. Log submission begins two (2) weeks after the start date of the field study placement.)
c. See Appendix or Blackboard for Field Study Log Guidelines.
d. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
6. Field Study Summary Report: The purpose of this assignment is for the student to:
a. demonstrate application and integration of the skills and knowledge acquired through the
didactic and practical components ofthe MPH Program to public health practice
b. demonstrate mastery of and ability to integrate the core public health principles and
material learned in MPH program
c. demonstrate competency in all five core areas -biostatistics, epidemiology, health policy
and management, environmental health science, and the social and behavioral sciences--
and in areas relating to the Program's community health and global health concentrations.
d. determine aptitude for applying this knowledge to issues he or she may confront as a public
health professional
39
e. Three to Four (3-4) Field Study Photos. This minimum number of digital photographs are
required for Part I of the Field Study Summary Report and ePortfolio. The Program requires
students to obtain permission from their site/preceptor/site supervisor to document their
field work experiences. Please submit digital photos of your placement sites, field study
project activities, such as agency/site-sponsored events or meetings, preceptors,
administrative supervisory team members, agency staff, or the general appearance of the
site location (e.g., landscape, scenery, surroundings). We welcome photos featuring you as
smiling student interns, preceptors, agency staff or team members, but we are also
interested in photos that capture public health in action!
Important: If you prefer not to be featured in any of your field study photos, you may
decline to be photographed and instead submit approved photos of agency/site-sponsored
events or meetings, preceptors, administrative supervisory team members, agency staff,
or the general appearance of your site location (e.g., landscape, scenery, surroundings).
Part I of the Report will require the student to summarize the field experience and complete various
sections that include, but are not limited to: The executive summary, statement of the problem,
theoretical comparisons, results achieved, recommendations, and professionalism. The page limit
for this section is 10 pages including, photos and captions, and references. Supporting documents
can be submitted separately from the report.
Effective Spring 2016, Part II is required ONLY for those students who are not completing an MPH
capstone or who have not passed the 3-unit TUC PH Program in-house MPH Comprehensive
Exam.
Part II: This portion of the report will require students to refer to the main public health problem or
issue identified in their field study and to write a program evaluation proposal in response that
problem or issue. Students must demonstrate a sophisticated and thorough grasp of public health
concepts, appropriate public health interventions, program evaluation techniques, and their field
study site's policy environment for this assignment. The page limit for this section is 7 pages
including references and notes, charts, diagrams, or tables.
See Appendix or Blackboard for the Field Study Summary Report Guidelines.
f. When submitting the Field Study Summary Report via Blackboard as an attachment, please
remember to name the file appropriately with your first/last name (e.g., John_Smith_Field
Study Summary Report)
g. (Due one week after the placement end date via Blackboard)
h. Please upload this attachment via Blackboard as a Word, PDF, or JPG document ONLY.
7. Field Study ePortfolios are required ONLY for students who entered the Program in or after
Summer 2015. Login to myeFolio to create your myeFolio account. IMPORTANT: The TUC School
myeFolio "Sign Up Code" is available via Blackboard for students enrolled in the Field Study
course.
40
The Field Study ePortfolio is similar to Part I of the written Field Study Summary Report, but
instead utilizes digitized collections (e.g., textbased, graphics, archived multimedia elements, such
as approved field study photos, PPT slides, audio or voice recordings, websites, web links, and
other electronic media to provide a more virtual representation of your public health field work.
Please note that each section of the e-Portfolio Outline can serve as abbreviated versions of those
that are featured in the written Field Study Summary Report.
a. (The web link to your myeFolio webpaqe is due one week after the placement end date via
email to nemesia.kelly@tu.edu}.
For more information about ePortfolios, please visit the ePortfolio webpage .
8. Student Testimonials (Optional). Routinely, the Program features brief testimonial quotes from
students and alumni online and in its print media for promotional and recruitment purposes. The
testimonials reflect the enriching experience of alumni as a result of their course of study in the
MPH Program and how the MPH Culminating Experience (Field Study, Capstone) and MPH degree
have played a role in advancing their academic goals and professional careers. An example of a TUC
MPH Student/Alumni Testimonial is available at
http://cehs.tu.edu/publichealth/ resources/mphwebfiles/ArmandoBanner photo.jpg. If you would
like for the Program to publish your testimonial in its on line and print media, please add it to your
Field Study Summary Report and/or ePortfolio and upload a digital photo of yourself via Blackboard
in the Assignments section under "Student Testimonial Photo."
9. Preceptor Evaluation:* Student performance during the field study will be evaluated by the site
preceptors to document students' demonstration of public health competence in a public health
setting:
b. This information is collected via an online survey (SurveyMonkey); preceptors will receive
this survey link via email. Students are responsible meeting with their preceptors to ensure
that this evaluation is completed.
10. Student Field Study Site Evaluation: Students are required to submit an evaluation of the field
study site via an on line survey (SurveyMonkey). This survey link is available on Blackboard. (Due one
week after the placement end date)
11. MPH Student Exit Survey: This survey is required ONLY/or Independent MPH students who
entered the PH Program prior to Summer/Fa/12015 and for all dual and joint degree students. This
is an online assessment via SurveyMonkey:
a. The week prior to their field study end date, students are required to email the Field Study
Coordinator (nemesia.kelly@tu.edu) requesting to receive this SurveyMonkey link via email.
b. Due one week after the placement end date
*Preceptor Requirements: Preceptors are required to assist the student in developing the Scope of Work,
the identification of competencies that are addressed in the field study placement, and completion of the
Field Study Contract. In addition, the preceptor must evaluate student performance during the field study
to document students' demonstration of public health competence in a public health setting and also meet
with the Field Study Coordinator or another Public Health Program faculty during a site visit (see more
41
details on additional preceptor requirements in the Public Health Preceptor Responsibilities section in this
handbook.)
FIELD STUDY EVALUATION & GRADING
The Public Health Field Study is a Pass/Fail course. Evaluation and grading is based on the following
measures:
For students who entered the Program prior to For students who entered the Program in or after
Summer 2015. Summer 2015. •
FIELD STUDY GRADING SCALE FIELD STUDY GRADING SCALE
Deliverable
Percentage of
Deliverable
Percentage of
Grade Grade
Field Study Scope of Work & Field Study Scope of Work &
Competency Inventory/ Competency Inventory/
Field Study Contract/Selected Field Study Contract/Selected
Dates for Site Visit/ 20% Dates for Site Visit/ 10%
Field Study Logs/Student Field Field Study Logs/Student Field
Study Evaluation/ Study Evaluation/
MPH Student Exit Survey MPH Student Exit Survey
Field Study Preceptor Evaluation 30% Field Study Preceptor Evaluation 30%
*Field Study ePortfolio 10%
Field Study Summary Report 50%
Field Study Summary Report 50%
Generally, final field study grades are submitted via TouroOne within 10 business days after the last day of
classes of each semester or academic session. If you planning to graduate at the end of the
semester/academic session during which you have conducted your field study, all field study deliverables
must be completed by the last day of the semester/academic session in order to be evaluated for your final
grade and to allow the course instructor sufficient time to post your final grade by the Registar's deadline
for the forthcoming degree conferral date.
FIELD STUDY RESPONSIBILITIES
Student Responsibilities
In return for the commitment of the organization, the student has a responsibility to the organization. The
PH Program expects students to behave professionally and develop a commitment to the organization and
to their life-long professional development through:
1. Adhere to TUC's Student Code of Conduct Policy and maintain an acceptable standard of
professionalism at all times during the Field Study
42
2. Communicate directly with the Field Study Coordinator immediately should any changes, issues, or
problems arise that may delay or interrupt their field study placement;
3. Participating in setting goals for their own learning;
4. Developing the scope of work and completes a competency inventory with assistance from the
preceptor and feedback from the Field Study Coordinator;
5. Returning completed forms (scope of work, competency inventory and Field Study Contract)
6. Performing assignments and activities identified in scope of work, seeking assistance from the
preceptor, other agency staff or the faculty advisor when needed;
7. Maintaining contact with the advisor during placement;
8. Maintaining a daily log;
9. Assessing the extent to which the field experience has met his/her needs by preparing a written
Summary Report and completing other assignments required by the field experience;
10. Completing an evaluation of Field Study via an on line survey within one week of the final field study
end date;
11. Fulfilling the minimum requirement of a 10-week or 6-week public health field experience
depending on the student's degree option;
12. Completing academic work and assigned papers relating to their internship;
13. Behaving in an ethically and morally professional manner;
14. Performing professional quality work; and
15. Conducting themselves consistent with the values of the organization.
Public Health Field Study Site Responsibilities
• Provide public health related planning, research and/or services;
• Have one or more staff on site with a graduate credential in public health or equivalent
professional experience and education who will serve as a designated preceptor;
• Offer opportunities for students to be exposed to a variety of organizational departments and
individuals, functions and or tasks;
• Offer responsibilities to students that are relevant and appropriate to the their individual field study
learning goals and professional development;
• Provide necessary access to data and program materials for students to conduct their projects;
• Have adequate organizational support for students to successfully complete field study activities;
• Provide direct and regular supervision for students throughout the placement; and
• Provide a minimum of 10 weeks of public health field work experience for MPH students (30-40
field study hours per week) and a minimum of 6 weeks (30-40 field study hours per week) for MPH
dual and joint degree students
Public Health Field Study Preceptor Responsibilities
Our preceptors play a vital role in helping our students apply and integrate their academic knowledge to
"real world" situations, projects or tasks while making meaningful contributions to a public health
organization. Preceptors help to enrich the education of future practitioners in the public health field.
Overall, preceptors are expected to provide supervision for the student and to ensure that assigned tasks
meet not only the agency's needs, but provide opportunities for the student's personal and professional
growth. Preceptors must also serve as a liaison between field study site supervisors, project team members
or staff, and the Field Study Coordinator. Preceptors are strongly encouraged to contact the Field Study
43
Coordinator at any time if they have questions, and especially if any issues or problems should arise
concerning the student's field study placement. Specific duties related to the student fieldwork learning
objectives include:
a. A mutual agreement on a public health project and field study objectives for the student to
pursue.
b. Assisting the student in developing the scope of work and identification of competencies.
c. Development of a work schedule based on mutually agreed upon objectives for the field
experience.
d. Ensuring that a project in which the student can carve out ownership of the process and
outcome is provided.
i. Review of policies and procedures with which the student is expected to comply.
ii. Completion/signing of the Field Study Contract
iii. Maintain accessibility to the student through a commitment to meeting with the
student on a regular basis to discuss and critique the student's work and progress (at
least once per week).
iv. Encourage student to work independently while providing opportunities for data
gathering and sharing information.
v. Become involved with and foster the student's learning experience.
vi. Evaluate the student's performance during and after the field experience via a
scheduled site visit with the Field Study Coordinator or another Public Health Program
faculty member and by completing the performance evaluation.
Once a student has been recommended for a field study placement at their site, the preceptor must
confirm with or inform the Public Health Program Field Study Coordinator and student regarding his/her
agency's clearance/onboarding requirements.
Public Health Program Responsibilities
1. Preparation: The Program will adequately prepare the student for the public health field
experience both academically and administratively. In addition, the Program will ensure that all
students sign a professional code of conduct. Professional attributes are considered to be part of
the academic performance of MPH students, which include honesty and integrity, leadership,
excellence and continuous improvement, ethical practice and public accountability, life-long
learning and competency, respect for diverse individuals and organizations, the ability to work
effectively with others in a team environment, follow through on commitments, take and give
constructive feedback, follow directions, accept responsibility for own actions. Students are
expected to demonstrate the legal, moral and ethical standards required of a public health
professional and display behavior that is consistent with these qualities. Among the characteristics
included in this context are the knowledge, competence, demeanor, attitude, appearance,
mannerisms, integrity, and morals displayed by the students to faculty, staff, preceptors, peers,
members of the public, colleagues in public health and other settings. The Program expects
nothing short of respect and professional demeanor at all times.
44
15.
• Beginning in Fall 2015, the Program will require all new students to complete an Online
Training Course on Professionalism for MPH Students provided by TRAIN.erg. the premier
learning resource for professionals who protect the public's health. A free service of
the Public Health Foundation . www.train.org is part of the newly expanded TrainingFinder
Real-time Affiliate Integrated Network (TRAIN). More information on the course is available
through the Public Health Training Centers/US Department of Health and Human Services,
Health Resources and Services Administration . The course is sponsored by the Wisconsin
Center for Public Health Education and Training (WiCPHET). Effective Fall 2016, this on line
course will be required as course prerequisites for the Field Study.
• Beginning in Fall 2015, the Program will encourage new students to use ePortfolios
throughout their entire course of study in the PH Program to demonstrate key skills and
accomplishments and to organize, manage and display academic and career information and
to showcase professional-quality work for prospective preceptors and employees. In
addition, new students will be encouraged to open Linked In Accounts to develop
professional networks and showcase their work experience, abilities, and recommendations
from employers and work colleagues.
• The Program will also provide all students guidelines on resume/curriculum vitae and
interviewing with field study preceptors.
• The Program will also require students to complete the on line Cultural Diversity. Health
Disparities. and Public Health provided by TRAIN.erg. This training provides public health
professionals with a broad overview of cultural diversity issues with a focus on
race/ethnicity and gender. Health disparities, a major public health problem of interest, is
discussed using cultural diversity as the conceptual framework for thinking about the role
of the public health community and health policy solutions for addressing these issues.
• Global Health Track students are required to complete Unite for Sight's Cultural Competency
Online Course prior to traveling to global health field study sites. This training aims to
underscore the understanding that cultural competency training and cultural awareness is of
paramount importance for those working in any international setting.
12. Assignment: The Program will be responsible for assigning students to sites that will provide a
quality learning experience.
13. Objectives: The Program will provide field study learning objectives. Students and preceptors will
be required to evaluate compliance with these learning objectives.
14. Affiliation Agreements: The Program will develop affiliation agreements with public health practice
sites.
Insurance: The Program will assure that all students have current liability Insurance as defined
below:
"TUC shall procure and maintain in force during the term of this Agreement, at its sole cost and
expense, insurance in amounts that are reasonably necessary to protect TUC and Institution from
45
and against liability arising from or incident to the use of the Facilities by TUC students participating
in the Program. Coverage under such insurance shall not be less than One Million Dollars
($1,000,000) for each occurrence and Three Million Dollars ($3,000,000) in the aggregate each for
professional liability insurance and comprehensive general liability insurance. TUC shall provide
Institution with a certificate of insurance evidencing the insurance coverage required under this
Article VII. TUC shall further ensure that not less than thirty (30) days notice shall be provided to
Institution of the cancellation of such insurance. TUC shall promptly notify Institution of any
cancellation, reduction, or other material change in the amount or scope of any coverage required
hereunder."
The Program will also assure that all students have current health insurance.
16. Student/Intern Onboarding Requirements: The Program will ensure that students take the
necessary steps to satisfy all required on boarding requirements (e.g., completion of
forms/paperwork, health and immunization documentation, security scans/background checks, and
drug testing/toxicology screenings) well before their field study start dates.
17. Grading: The Program will be responsible for assigning a final grade to each student.
18. Issues or problems: The Program will interact with preceptors and be available to address any
issues, problems, or concerns of the student or the preceptor. Should any problems arise at the
placement site and there are indications of breaches of professionalism by the student, the Field
Study Coordinator will immediately intervene to facilitate a resolution. If the student has
demonstrated unprofessionalism in their field study and a resolution is not possible allowing the
student to continue his/her placement, he/she may be placed on academic probation and sent to
the Academic Probation Committee. The Program retains the right to remove a student from a
rotation.
46
APPENDIX
47
TABLE OF CONTENTS
I-IELPFUL INFORMATION
• Public Health Field Study Calendar ...................................................................................... 49
• Community Health Field Study Time lines & Deadlines ........................................................ 50
• Global Health Field Study Timelines & Deadlines ................................................................ 51
• Student Codes of Conduct .................................................................................................... 52
• TUC Network of Community Health Field Study Placement Sites ........................................ 55
• Guidelines for Field Study Sites & Preceptors ...................................................................... 58
• Invitation to Develop a Field Study Partnership with TUC ................................................... 60
• Templates for MOU ............................................................................................................. 61
• Templates for Short Affiliation Field Study Letter of Agreement ......................................... 68
• Community Health Field Study Emergency Protocol ........................................................... 72
• Global Health Field Study Emergency Protocol. ................................................................... 79
• Field Study Incident Report form ......................................................................................... 88
DOCUMENTS AND FORMS FOR
FIELD STUDY DELIVERABLES
1. Instructions for Completing the Scope of Work ..................................................................... 91
2. Sample Scope of Work ............................................................................................................ 93
3. Scope of Work Form ............................................................................................................... 97
4. MPH Competencies ............................................................................................................... 101
5. Competency Inventory Form ................................................................................................ 104
6. Field Study Contract .............................................................................................................. 107
7. Selected Dates for Field Study Site Visit ............................................................................... 108
8. Media Release Forms ............................................................................................................ 109
48
~
TOU RO UN lVERS lTY
CA~IF0Pti41A
( 01 ,1 li(,E d f lillltCAT hn,
AN I> t·H :AI. IH SC'lr:Nl.ES
PUBLIC MlALT-M PROGRAM
Public Mealth , Field Study Calendar· ~-DI ,....._ DueDa.ta
Field S.tudy Letter of Agreement Signed and Submitted One week.aft,r tbe
& Emergency Protocol Statement by Preceptor Via email/mail platettter,J:start il..-i:e
of Understanding {If aoollcable}
Scope of Work & Compete!\CV ln,eollab_oratlon with Student; One week' tfter ttie
!nver,tory; Sisned Field Stud y 5i,tbmi_tted P-l•teiJ'ter,J ;start d$!
Contrast, and S.elected Dates ·tor by·St1,1dent via Blackboard
Field S.tudy Site Visit
Field Stl:!dy S~ Visit Atte11ded by Prec;eptor, Midway thro1,1gh
Studen~, ;1nd Site Visitor in placement
per~oh/Phone/Skype/lJJtsm
Prec;eptor Evalu-lori Subml tt,d on, week after
by Precept-OF, Tlie Field Study pla:~ment end date
Coottllilotor wlll ematlthe fink
to t hls SurveyMonlcey .survey
directly to the Pre~otor.
49
'
0 TOURO UNIVERSITY CALIFORNIA LULL!:C...I: UI 1:UULA I IUN AND H ALTH SCIENCE~ COMMUNITY MEAL TM FIELD STUDY TIMELINES AND DEADLINES 2016-2017 .Academic Vear PUBLIC MEAL Tl-I PROGRAM Field Study Objective Summer2016 Fall 2016 Spring2017 Summer2017 Field Study Orientations February 25 July 19• November&• February 23• Field Study Orientations (PA Class of 2017 ONLY) August 15• Students Submit Online Field Study Planning March 1 Mayl October 1 February 15 Form, Cover Letters, CVs/Resumes New Field Study Site Registration (for Requests March 1 Mayl October 1 February 15 for Placement at Unaffiliated Sites/Student-Initiated Placement) Field Study Start date•• May 2-June 1 Aug. 1 -Sep. 12 January 3 -16 May15 PA Class of 2017 Field Study Start date February 20-March 31 Dual Degree Field Study Start date Available every semester -Variable (minimu m 6 consecutive weeks) IMPORTANT: Third and /ourtlt-'Vfflr DO/MPH students ma, onl1, ,eglster /or tu Rehl Study t:Ollf'5e In eldiff rhe PH Program sprlnf 1emest:ms or SUfflfflflf' ocademlt: sessions. Registration for the Field Study cou,se in the foll semesters is not permitted for DO/MPH dual degree ,eudents in Y3 or Y4. Field Study Deliverables Field Study Scope of Work, Competency Due 1 week after placement start date Inventory, Field Study Contract, and Selected Field Study Site Visit Field Study Logs Mid placement Field Study Site Visit Due every 2 weeks (begin submitting 2 weeks after placement start date) Field Study Preceptor Evaluation Due one week after placement end date Field Study Student Site Evaluation Due one week after placement end date MPH Exit Survey Due one week after placement end date Field Study Summary Paper Due one week after placement end date *Tentative date: Exact dates, times and locations will be announced via email or pasted on the Public Health Program website where applicable. so
GD TOURO UNIVERSITY CALl~ORHIA COLLEGE or EDLICATION ANU HEALTH SCIENCES GLOBAL MEAL Tl-I FIELD STUDY TIMELINES AND DEADLINES 2016-2017 Academic Year PUBLIC MEAL TM PROGRAM Field Study Task Summer2.016 Fall 2.016 Spring 2.017 Summer 2.017 Field Study Orientations February 25 July 19* Octobers• February 23* Field Study Orientation (PA Class of 2017 ONLY) August 16• New Field Study Site Registration (for Requests for March 1 May1 September 30 (PA 2017s ONLY) February 15 Placement at Unaffiliated Sites) October 1 PA Class of 2017 Submits Online Field Study Planning September 30 Form, Cover letter, CVs/Resumes Non-PA Students Submit Online Field Study Planning Form, March 1 May1 October 1 February 15 Cover letter, CVs/Resumes Pre-departure sessions** See country site See country site See country site coordinator See country site coordinator coordinator coordinator Field Study Start Date••• May 2-June 1 Aug.1-mid-Bolivia: February 20 May15 September cambodia: January 2 -16 Ethiopia: January 23 PA aass of 2.017 Reid Study Start date February 2.0 -March 31 Dual Degree Field Study Start date Available every semester -Variable (minimum 6 consecutive weeks) IMPORTANT: Third ond /Ourth-year DO/MPH students moy on'1 tet&mr fOr th• Field Study cou,n in •ith•r thtl PH PIDfffltn spring •m•mn or 1umm•r academk HS51au. R..ii.stration fur the Field Study coune in the fr,11 nme•mn & not permitted fur DO/MPH dual det1rn nudents in YJ or Yif. Field Study Deliverables Field Study Scope of Work, Competency Inventory, Field Due 1 week after placement start date Study Contract, Selected Dates for Field Study Site Visit Field Study logs Due every 2 weeks (begin submitting 2 weeks after placement start date) Site Visit Mid placement Field Study Summary Paper Due one week after placement end date Field Study Preceptor Evaluation Due one week after placement end date Field Study Student Site Evaluation Due one week after placement end date MPH Exit Survey Due one week after placement end date *Tentative date: Exact dates, times and locations wlll be announced via email or posted on the Public Health Program website where applicable. Each coordinator will conduct orientations. pre-departure sessions and other meetings as necessary. The student is responsible for meeting with the Global Health Faculty coordinator for their field study site. 51
GD
TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF f:PUCATJON
ANlJ HEALTH SCIENCES
PUBLIC MEALTM PROGRAM
PROFESSIONAL CODE OF CONDUCT FOR
MASTER OF PUBLIC MEAL Tl-I (MPI-I) STUDENTS
Touro University California (TUC) is obliged to offer all faculty, staff, and students a safe working and
study environment. Part of this obligation requires that every enrolled in the Public Health Program
maintain an acceptable professional standard of conduct as outlined and as required by the TUC
College of Education and Health Sciences Public Health Program. This extends to an obligation
to comply with all lawful directives of TUC. Any failure to do so, or any willful breach of Public Health
Program policies or this Code of Conduct will be deemed non-academic misconduct in accordance
with TUC policies. Penalties, including dismissal may also apply.
Success in the public health field requires certain professional attributes in addition to content knowledge.
Professionalism is a Cross-Cutting Competency developed by the Associated Schools and Programs of Public
Health (ASPPH) as part of its MPH Core Competency Model. The ASPPH definition of Professionalism is "The
ability to demonstrate ethical choices, values and professional practices implicit in public health decisions;
to consider the effect of choices on community stewardship, equity, social justice and accountability; and
to commit to personal and institutional development." Along with this definition, the ASPPH includes 11
different modules of knowledge, skills, and abilities that comprise the Professionalism Competency.
Professional attributes are considered to be part of the academic performance of MPH students, which
include honesty and integrity, leadership, excellence and continuous improvement, ethical practice and
public accountability, life-long learning and competency, respect for diverse individuals and organizations,
the ability to work effectively with others in a team environment, follow through on commitments, take
and give constructive feedback, follow directions, accept responsibility for own actions.
Professionalism is as important as, and holds equal importance to academic progress. Students are
expected to demonstrate the legal, moral and ethical standards required of a public health professional
and display behavior that is consistent with these qualities. Professionalism and professional ethics are
terms that signify certain scholastic, interpersonal and behavioral expectations. Among the characteristics
included in this context are the knowledge, competence, demeanor, attitude, appearance, mannerisms,
integrity1 and morals displayed by the students to faculty, staff, preceptors, peers, members of the public,
colleagues in public health and other settings. The Program expects nothing short of respect and
professional demeanor at all times.
52
GENERAL CONDUCT
TUC expects every student to:
• Respect the rights of other students, faculty and staff, and members or the public, and not
engage in any conduct which may be perceived as harassment or interference with those
rights;
• To conduct themselves in a professional and productive manner being both diligent and
proactive;
• Apply basic principles of ethical analysis (e.g. the Public Health Code of Ethics, human rights
framework, other moral theories) to issues of public health practice and policy;
• Not behave in an unruly or disreputable manner to the discomfort of any other students, faculty
and staff, or members or the public;
• To exhibit the highest ethical and professional performance inside and outside of the classroom;
• Not knowingly engage in academic dishonesty defined as intentional cheating, fabrication or
plagiarism or facilitate another student's academic dishonesty, nor obstruct another student's
academic progress;
• Treat fellow students in an ethical manner, respecting the integrity of others and the right to pursue
educational goals without interference;
• Not exhibit misconduct, ethics violations, or violation of professional codes of behavior;
• Treat others with respect and consideration regardless of their status or position;
• Not physically or verbally abuse other students, faculty and staff, or members or the public;
• Be courteous when dealing with the public while in the field;
• Not tamper with, vandalize nor destroy private and public property;
• Behave in a way which protects the reputation and good name of the University; and
• Comply with all relevant laws nationally and internationally.
By signing this Code of Conduct, I, _________________ (print name and Student
ID Number), _________ verify that I have read and understand my obligations to uphold
and preserve the Professionalism Code of Conduct for MPH Students. I agree to be bound by and
acknowledge my obligations under the Code of Conduct. I further understand that penalties may be
imposed upon me should I willfully breach this Code of Conduct and that I may appeal against these
penalties using the University's appeal mechanisms.
Student Signature ________________ _ Date _________ _
53
@
TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
AND HEAL TH SCIENCES
PUBLIC MEAL Tl-I PROGRAM
GLOBAL I-IEAL Tl-I FIELD STUDY STUDENT CODE OF CONDUCT
Touro University California (TI.JC) is obliged to offer all staff members and students a safe working and study enmonment.
This includes ensuring that all field study activities are conducted in a responsible manner, having regard to the inherent
risks of fieldwork. 1."here is a complementary obligation on the part of every individual who partidpates in such
adivities, to take reasonable care to ensure their awn heal~ safety and welfare and that of other participants.
Part of this obligation requires that every student partidpa.ling in the field study practicum maintain an acceptable
standard of conduct as outlined and as required by the TUC College of Education and Health Sciences Public Health
Program. This extends to an obligation to comply with all lawful directives of TUC. Any failure to do so, or any willful
breach of the Public Health Program Field Study Guidelines or this Code of Conduct will be deemed non-academic
misconduct and studenl5 may be required to return home before the completion of the fieldwork activitie; at their own
cost Penalties, including dismissal may also apply.
GENERAL CONDUCT
TUC expecl5 every sb.J.dent to:
• Respect the rights of other students, staff members or the public, and not engage in any conduct which may be
perceived. 115 harassment or ild1:1:fe:tenre with those rightl!i;
• To conduct the field study in a professional and productive manner being both diligent and proactive;
• Not physically or verbally abuse other students, staff members or the public;
• Not behave in an unruly or disrepulable JIUlllnel', or to the discomfort of any other studenb!i, staff members or the
public;
• Be courtECJus when dealing with the public while in the field;
• Not tamper with, vandali7.e nor destroy privatE and public property;
• Behave in a way which protects the repulation and good name of the University; and
• Comply with all relevant laws.
• [Especially fm global travelel'II] A void unnece&BBI')' risks including travelling at night. unnecessarily travelling a.lane,
riding on a motorcycle, and excessively using electronics (i.e. laptops, cameras and iPods) in public, exces5:ive use of
alcohol, purchase of or use of any illegal substances, &0liciling of sex workers, use of firearms, extreme sports.
FIELD STUDY COORDINATOR
Each field study is conductEd under the supervision of a field study coordinator. All students are subject to the jurisdiction
of the Field Study Coordinator for the entire duration of the fieldwork excursion and must omerve all lawful directives and
instructions given by the Field Study Coordinator. Failure to do &0 will be deemed non-e.ca.d.em.ic misconduct in accordance
with TUC policies. Students also agree to accept and complete the field study placement as assigned.
I, _____________________ (print name and Student ID Number),
have read and undemtand my obligations under the atlached Code of Conduct I agree to be bound by and acknowledge my
obligations under the Code of Conduct. I further understand that penalties may be imposed upon me should I willfully
breach this Code of Conduct and that I may appeal against these penal.tie; using the Un±versity's appeal mechanisms. I
further acknowledge and agree that if I am :required by the Public Health Program to retum home before the completion of
the field study, I will do so promptly and be responsible for the cost5.
_________ __,.20
Signature Date
54
0
TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
AND HEALTH SCIENCES
PUBLIC MEAL TM PROGRAM
TUC Network of Community Mealth Field Study Plac.ment Sites
The TUC Public Health Program has established agreements and partnerships with the following agencies
and organizations to provide fleld study placement opportunities for TUC MPH students enrolled In the
Community Health Track. Note: This list is subject to change. It is recommended to always refer ta the
onllne llstln1 at http://cehs.tu.edu/publlchealth/culmlnatlrurexperlence/chfleldstudysltes.html for the
most updated information.
1. 4th Street Clinic, Wasatch Homeless Health Care, Inc., Salt Lake City, UT *
2. Alameda Health System. Ambulatory Care, Oakland, CA
3. Alameda Health System. Healthy Hearts Clinic, Highland Campus 0
4. Alameda Health System Women's Health Center, Highland Campus
5. Alameda County Department Public Health Developmental Disabilities Council and
California Children 1s Services, Oakland, CA
6. Alameda County Department Public Health Emergency Preparedness
7. Alameda County Public Health Department Office of AIDS
8. Alameda County Public Health Department-Women Infants and Children Program
(WIC)
9. Arizona Aids Education and Training Center, Tucson, AZ•
10. Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL),
Oakland, CA
11. Axion Health, Denver, CO*
12. California Department of Public Health
13. Cancer Prevention Institute of California (CPIC)
14. CAPS-UCSF, Center for AIDS Prevention Studies, Department of Medicine: Division
of Preventive Science•
15. Celiac Disease Foundation, Woodland Hills. CA
16. Chelan Douglas Health District, Wenatchee, WA•
17. Child Start. Incorporated, Napa. CA
18. Clinic by the Bay, San Francisco, CA
19. Clinica Sierra Vista, Bakersfield, CA•
20. CODAC Behavioral Health Services, Inc., Tucson, AZ.
21. Colusa County Public Health
22. Community Service Programs, Incorporated, Fullerton, CA
23. Contra Costa Health Services-Public Health AIDS Program, Martinez, CA
24. County of Marin Health and Human Services, Division of Public Health -Community Health and
Prevention Services
25. County of Marin Health and Human Services. Division of Public Health -Epidemiology
Program
26. County of Marin Health and Human Services. Division of Public Health -Prevention
Hub
55
27. County of Marin, Division of Public Health Prevention Wellness Program, Marin City,
CX3 Project
28. County of Marin Environmental Health Services
29. County of Placer Health and Human Services
30. County of San Diego HHSA Public Health Services
31. East & Central Harlem District Public Health Office. East Harlem Asthma Center of
Excellence. New York City Department of Health and Mental Hygiene*
32. FirstMed Health and Wellness Center, Las Vegas, NV*
33. Gila County Department of Public Health. Arizona*
34. Health Education Council, Sacramento, CA
35. Integrated Care Management Solutions Access Center. Mendocino. CA
36. Kaiser Permanente Health Education Department. Napa/Solano, Vacaville, CA
37. Kaiser Permanente Health Education Department. Sacramento Service Area
38. Kaiser Permanente Health Education Department. San Leandro. CA
39. Kaiser Permanente Health Education Department. San Rafael/Petaluma/Novato. CA
40. Kern County Public Health Services
41. La Habra Family Resource Center**
42. Lifelong Medical Care. Berkeley. CA
43. Lifelong Medical Care. San Pablo. CA
44. Lyon-Martin Health Services. San Francisco. CA*
45. Marin General Hospital. Center for Integrative Health and Wellness. Greenbrae. CA
46. Monterey County Health Department
47. Mount Sinai Adolescent Health Center, New York. NY
48. Napa County Health & Human Services Agency -Public Health Division
49. Orange County Health Care Agency, Tobacco Use Prevention. Santa Ana
SO. Partnership HealthPlan of California. Fairfield. CA
51. Planned Parenthood Northern California. Fairfield/Vallejo. CA
52. Planned Parenthood Pasadena and San Gabriel Valley
53. Preventive Care Pathways. Oakland. CA
54. Primary Care Office (PCO). Carson City. NV
55. Public Health Advocates. Sacramento. CA
56. Queen of the Valley Medical Center Community Outreach. Napa. CA
57. San Joaquin County Public Health Services*
58. San Luis Obispo County Public Health Department
59. San Mateo County Health System. Tobacco Prevention Program
60. San Quentin State Prison Health Care Services. San Quentin. Marin County
61. Santa Barbara County Public Health Department -Lompoc Health Center
62. Santa Clara County Public Health Department*
63. Second Harvest Food Bank. Santa Clara & San Mateo Counties
64. Shasta County Health & Human Services Public Health Branch*
65. Solano County Emergency Medical Services Bureau
66. Solano County Health and Human Services -Black Infant Health Program
67. Solano County Health and Human Services -Public Health
68. Solano County Maternal, Child and Adolescent Health Bureau
69. Sonoma County Public Health Department
70. Southern Nevada Health District*
56
71. Stanislaus County Health Services Agency -Public Health Division
72. St. Joseph Health, Santa Rosa Memorial Hospital. Community Benefit Department,
Circle of Sisters. Rohnert Park. CA
73. Texas Department of State Health Services*
74. The Environmental Justice Coalition for Water**
75. Touro University California/Solano County Family Health Services
76. UC Davis Center for Reducing Health Disparities*
77. University of California. San Francisco {UCSF) Department of Obstetrics. Gynecology
and Reproductive Sciences
78. UCSF Bixby Group for Global Reproductive Health. Philip R. Lee Institute for Health
Policy Studies
79. Vallejo City Unified School District
80. West County Health Centers
81. Yolo County Department of Health Service. Emergency Preparedness & Planning
*These sites are currently inactive and have not offered field study opportunities within the last three
years.
**Placement recommendations for this site must be also approved by specific Public Health Program
faculty in addition to the Field Study Coordinator.
57
TO SERVE, TO LEAD, TO TEACH
TOURO UNIVERSITY PUBLIC ~E:ALT~ PROGRAM
CALIFORNIA
MASTER OF PUBLIC HEAL TH PROGRAM
GUIDELINES FOR FIELD STUDY PLACEMENT SITES & PRECEPTORS
Does your organization seek the assistance
and contributions of bright, motivated Master of
Public Health (MPH) students who are eager to con-
tribute and bring fresh ideas and energy to your pro-
grams and projects? Our students have interperson-
al, leadership, and teamwork skills that enable them
to take initiative and make substantial contributions
to your programs and projects!
Overview
The Public Health Program al Touro UniversiLy California {TUC)
is couunilLPd Lo llw ongoint:: dPvelopnwnl of succPssful parlner-
ships with public heallh practice agencies and organizalions in
order Lo support Lhe education and public heallh training of its
MPH students. Th0 Public Health Field Study is r0quired of all
TUC MPH students and provides them with practical experience
iJ1 a pu.blic health setting. The Field Study provides invaluablt>
real-world, practirnl exposure, experience, and ml'ntorsh:ip to our
students. Students gain knowledge, skills, confidence, and rela-
lionsh:ips Lhat enhance ll1eir academic training, professional de-
velopnll'nt, and effectiveness. Read more al our websitl'.
The TUC Public He,tlth Program is well-represented by a student
populiilion with a diversity of experiencP through currenl enroll-
ment in ils MPH De&ree Proeram, ll1e Doctor of Osleopdlh:ic
Medicine (DO)/MPH and Doctor of Pharmacy (PharmD)/MPH
Dual Degree programs, ,md l11e Joinl Master of SciPnce in Physi-
cian Assistanl~ Studies/MPH Program. More information aboul
l11ese dual and joinl degrees is awilable al our Dual & Joint De-
grees wehpage.
Organizations find Lhat offering field sludy placemenls lo TUC
MPH students is well worth l11e investment of time ,md energy,
and Lhat the experience of providing mentorship to our students
is greatly beneficial.
Course Description
The Public Health Fieldwork Study Course is required of all
MPH studenl~ and is a structured and practical supervised pro-
fessional experience in an approwd public lwall11 SPllin/\ allow-
ing for llw applirnlion .md integration of ilie skills and
knowledge a,·qu:ired during llwir graduate didaclic coursework.
As a working parlnership beLWl'l'n sludenls and the public healllt
praclice organiwlion, lhis CDUTW provides a public lwallh field-
work expPrience for MPH studenl~ which can he rnnducted ei-
ther locolly or abroad.
The pmclical skill~ and Lhe knowledge r;ai.ned in field work at
public heallh prartice a11encies/ organization are essenlial Lo
students' academic and professional r;rowlh, preparing Lhem for
a professional career in Lhe field of public heal 111.
The sludenLq' work in Lhe firld study projrcts should be valu,,d
by ll1e orr;anizalion and conlribule Lo merlin!\ Lhe organizalion's
f\Oal~ or mission.
Field study projects musl address a rnuununiLy heallh issue and
sludenl participation should rnntribule Lil strategic resolulions.
Learning Objectives
T11rough the fidd study, students MPH students w;JJ be able to:
•
Integrate public health theory, k1,owledge and skills in a
practice setting;
Complete a defined project(s) in an areu of public health
practice including core public hcaltl, functions such as a
needs assessment, progrnm planning, progrnm ev,tluation,
policy development, educational campaign, applied re-
search project;
Exhibit proficiency in at least one of the following areas:
prognnn planning, needs assessment and data gathering,
program implementation, applied research, program evalu-
ation, policy analysis, or data analysis under the guidance of
an cxpC'Ticnced preceptor;
Demonstratc competence in a p11blic health practice setting;
and
Demonsb·ate leadership, teamwork, communicalion skills,
and creativity in the J.evell.lpme11t l.lf a public health practice
activity.
58
TO SERVE, TO LEAD, TO TEACH
TOURO UNIVERSITY PUBLIC I-IEALTI-I PROGRAM
CALl!=ORNIA
MASTER OF PUBLIC HEALTH PROGRAM
GUIDELINES FOR FIELD STUDY PLACEMENT SITES & PRECEPTORS
Public Health Competencies
The Public Health Field Study must addresses three to five (3-5)
of the core public h caltl, colllpctcn cics (Bios t,1tistics, Epidclll iol-
ogy, Environmental Health Scien ce, Health Policy and Manage-
ment, and Social and Behavioral Sdcnces); one (1) cross -cutting
competency, and three (3) track competencies (comm unity or
global health). These competencies can be found on.line at
http://cehs.tu .ed u/pu blicl1 ca Ith / curricu !um/
competencies.html.
To qualify as au approved field study site, the
agency/organization must
Provide public h ea lth related planning, research and/ or
services;
• Have one or more slali on site with a graduate cre dential in
public h ealth or equivalent professional expe ri en ce a.nd
edurntion wh o will serve as a designated preceptor;
Offer opportunities for sl11dents to be exposed to il vcJriety
of organizational depa.rtments and individuab, fw1Ctions
and or Lask~;
Offer responsibilities lo students that are relevant and ap-
propriate Lo Lhe Lheir individ ual field study learning goals
and professional development;
• Provide nec essary access to data and program mate.rials for
students to cond u ct tl,eir projects;
• Have adequate organization al support and capa bility for
students Lo s uccessfully complete field study activities
onsite;
Provide direct and regular supervision for stud ents
throur;houL the placement;
• Provide a minimum of 400 hours of public health field
work experience for Nil'H s tudents and 200 hours fo r dual
and joint degree students.
Placement Dates: ..
Fall (Augu s t -December)
Spring Oanuary-April)
Summer (May-July)
"Please note that dual m,d joint degree stu d ents conduct the
field study d ming precisely timed open blocks.
To register as a new field study site, please visit
https;//www.surveymonkey.com/s/
TUCPHFieldStudySite Registration
or contact:
Nemesia Kelly, MPH
lecturer/Field Sh1dy Coordinator
Public Heallh Program
Touro University California
Ph. 707/638-5827 • Cell: 707/731-7436
Fax. 707/638-5871
nemesia.kelly@tu.edu
publichealth.tu.edu
59
TO SERVE, TO LEAD, TO EACH
TOURO Uf\JIVERSITY PUBLIC I-IEALTl-l l~ROGRAM
CALIFO~!NIA
Public Health Field Study Preceptor & Solano County Maternal Child
Adolescent Health Senior Health Education Specialist,
Susan Whalen and TUC MPH Student Intern, Charla Brandon.
The Touro University California (TUC} Public Health
Program is committed to the ongoing development of
successful partnerships with local government and
community health agencies and organizations to support
the education and public health training of our Master of
Public Health (MPH) student through its Public Health Field
Study course. Organizations like yours are vital in provid-
ing invaluable field experience, real-world, practical
exposure, experience, and mentorsh ip to our students.
Through a field study placement partnership with TUC,
students have the opportunity to gain knowledge, skills,
confidence, and access to relationships that enhance their
academic training, professional development, and
effectiveness. In turn, organizations benefit from investing
in the training and mentorship of student interns, which
results in valuable assistance and SUIPport to their
programs. For the fie Id of public hea Ith, the return on this
investment is ultimately its expansion through an increase
in the number of public health professionals.
Our program trains many students from diverse
backgrounds with interpersonal, leadership, and team-
work skills that enable them to take initiative and operate
as motivated self-starters. We expect our students to
make significant contributions to thE! goals and missions
of our community partners.
60
DEVELOP A COMMUNITY
MEALTM l=IELD STUDY
PLACEMENT PARTNERSJ.•IIP
WITM TUC TODAY:
1-/ELP S1-/APE AND MENTOR
Tl-IE NEXT GENERJ.l TION 0~
PUBLIC 1-/EALTI-I PRO~ESSIONALS!
Please refer to the Guidelines for Public Health Field Study
Sites & Preceptors for details about:
•
•
•
•
The field study course overview and learning objectives
Criteria for Sites/Preceptors
Field study placement terms and dates
Registering as an new fie.Id study site
Please consider how our stude nts can make meaningful
contributions to YOUR organization's public health goals
and mission . If you have interest and capacity to host an
MPH student intern, or require more information or
consultation about developing field study/internship
opportunities at your organization, please contact :
Nemesia Kelly, MPH • Field Sltudy Coordinator
Touro University California Public Health Program
Ph. 707/638-5827 • Cell: 7'07/731-7436
TUC MPH Student Interns, Kevin Li & Joanne
Suarez at the Alameda Health System
Eastmont Wellness Center in Oakland, CA.
61
MEMORAMDUM OF UNDERSTANDING
COUNTY OF ____________
______________ AGENCY
AND TOURO UNIVERSITY CALIFORNIA
PUBLIC HEALTH PROGRAM PRECEPTORSHIP AGREEMENT
This Public Health Preceptorship Agreement (“Agreement”) is made on___________ between the County
of _________, a political subdivision of the State of California (“County”) for the exclusive benefit of its
Health Services Agency, whose address is _________________ and Touro University, a California
nonprofit public corporation (“TUC”), whose address is 1310 Club Drive, Vallejo, CA 94592, who agree
as follows:
A. County owns and operates the following health care clinics and public health offices (Facility
or Facilities): Health Services Agency located at_____________________.
B. TUC operates the College of Education and Health Sciences (CEHS), the College of Osteopathic
Medicine (COM), and the College of Pharmacy (COP) in Vallejo, California and operates a branch
campus in Henderson, Nevada with Colleges of Osteopathic Medicine and Health and Human
Services. CEHS is comprised of three programs: The Graduate School of Education (accredited by
the California Commission on Teacher Credentialing and the Western Association of Schools and
Colleges), the Joint Master of Science in Physician Assistant Studies Program (accredited by the
Accreditation Review Commission on Education for the Physician Assistant, Inc.), and the Public
Health Program (accredited by the Council on Education for Public Health). TUC desires that its
students (Master of Public Health students, Master of Science in Physician Assistant Studies/Master of
Public Health students, Doctor of Osteopathic Medicine/Master of Public Health students, and Doctor
of Pharmacy/Master of Public Health students, obtain practical public health experience at the Health
Care and Office Facilities through participation in a public health field preceptorship program
(“Program”).
C. County deems it beneficial to participate in the Program by providing practical public health
experience at its Public Health and Office Facilities for TUC students pursuant to the terms
and conditions of this Agreement.
In consideration of the foregoing objectives and in further consideration of the covenants and promises
hereinafter set forth, the Parties agree as follows:
I. PROGRAM PARAMETERS
1.01 The period of time for each student’s public health field experience shall be agreed upon by
the Parties before the student begins his or her Program training.
1.02 The maximum number of students to receive training shall be agreed upon by the Parties
at least sixty (60) days prior to the beginning of Program training based on the availability of
space and personnel at the school district and other considerations.
I. Recitals
62
1.03 The TUC Program Coordinator and the Institution’s Designee shall be responsible for
arriving at an agreement on behalf of their respective Parties regarding the duration of the
Program training and the number of TUC students to receive Program training at the Facilities.
1.04 The Program and the maintenance of the standards of instruction shall be the sole
responsibility of TUC. TUC shall only refer for participation in the Program students who are in
good academic standing and TUC shall at the request of Institution provide the Institution with
verification of such good standing.
1.05 All students participating in the Program shall meet all applicable health standards
established by TUC and any applicable governmental authority and implemented by Institution
for each Health Care and Office Facility. Institution shall have the right to terminate from the
Program any student when the health status of such student is detrimental to the health and/or
safety of Institution patients or staff as determined by Institution.
II. TUC’S RESPONSIBILITIES
2.01 Student Contact Information. TUC shall complete and send to Institution contact
information for each student enrolled in the Program which shall include the student’s name,
address and telephone number prior to the beginning date of the planned field experience.
Institution shall only use the student contact information to fulfill its obligations under this
Agreement and agrees not to release any information in the student profile to any third party.
2.02 Schedule of Assignments. TUC shall notify the “Institution Designee” (as defined in
Section 3.02), designated by the Institution from time to time, of TUC’s planned schedule of
student assignments, including the name of each student, and the student’s level of academic
preparation and length and dates of fieldwork experience.
2.03 TUC Program Coordinator. TUC shall designate a faculty member as TUC Program
Coordinator, who shall coordinate with Institution Designee in planning the Program.
2.04 Records. TUC shall maintain all personnel and academic records of TUC students
participating in the Program.
2.05 Rules and Regulations. TUC shall enforce rules and regulations governing the students that
are mutually agreed upon by TUC and Institution. TUC shall instruct its students on the general
requirements of the Joint Commission on Accreditation of Healthcare Organizations (“JCAHO”),
Centers for Medicare and Medicaid Services (“CMS”) and the Health Insurance Portability and
Accountability Act (“HIPAA”). TUC shall require that its students comply with all applicable
Health Care and Office Facility policies and Federal and State regulatory requirements including,
but not limited to JCAHO, CMS and HIPAA.
2.06 Student Responsibilities. TUC shall notify the students who are to participate in the
Program at the Institution that they are responsible for:
(a) Following the clinical and administrative policies, procedures, rules and regulations
of Institution.
(b) Arranging for their transportation and living arrangements when not provided by
TUC.
63
(c) Arranging for and assuming the cost of their health insurance.
(d) Assuming responsibility for treatment of any illness or injury the student may have
while participating in the Program, obtaining necessary immunizations and a tuberculin
test, and having an annual health examination.
(e) Keeping all patient information confidential. No student shall have access to or have
the right to receive any medical record, except when necessary in the regular course of
the public health experience. The discussion, transmission or narration in any form by
students of any patient information of a personal nature, medical or otherwise, obtained
in the regular course of the Program is forbidden except as a necessary part of the
practical experience.
(f) Following the dress code of the Health Care and Office Facility and wearing name
badges identifying themselves as students.
(g) Attending an orientation of the Health Care and Office Facilities.
(h) Complying with the rules and regulations that have been developed by TUC to
govern student activities during assignment to a training institution, a copy of which is
attached to this Agreement as Exhibit A.
2.07 Payroll Taxes and Withholdings. TUC shall be solely responsible for any payroll taxes,
withholdings, workers’ compensation and any other insurance or benefits of any kind for
employees and agents of TUC providing services under this Agreement. TUC shall defend,
indemnify and hold Institution harmless against all claims against Institution by employees or
agents of TUC with respect to payroll taxes, withholdings, workers’ compensation and other
insurance benefits.
2.08 Student Insurance. TUC shall provide Institution with a certificate of insurance or other
written confirmation that each student participating in the Program carries health insurance.
III. INSTITUTION’S RESPONSIBLITIES
3.01 Public Health Experience. Institution shall accept from TUC the mutually agreed upon
number of students enrolled in the Program and shall provide said students with supervised public
health experience.
3.02 Institution Designee. Institution shall designate a member of Institution’s Program
Coordinator to participate with the TUC Program Coordinator in planning, implementing and
coordinating the Program.
3.03 Access to Facilities. Institution shall permit students enrolled in the Program access to
the Health Care and/or Office Facilities as appropriate and necessary for the Program, provided
that the presence of the students shall not interfere with the activities of Institution.
3.04 Institution Rules & Regulations. Institution shall instruct the students on Institution rules
and regulations, as well as the application of JCAHO, CMS and HIPAA requirements specific to
the Institution. Institution hereby accepts Exhibit A, which incorporates by reference the
64
applicable rules and regulations of the Institution, as the rules and regulations that shall govern
TUC students during their training assignment at the Institution.
3.05 Withdrawal of Students. Institution may request TUC to withdraw from the Program any
student who Institution determines is not performing satisfactorily, or who refuses to follow
Institution’s administrative policies, procedures, rules and regulations. Such request must be in
writing and must include a statement as to the reason or reasons why Institution desires to have
the student withdrawn TUC shall comply with such request within five (5) days of receipt of the
written request by TUC.
3.06 Emergency Health Care First Aid. Institution shall, on any day when students are
receiving training at the Facilities, provide the students necessary emergency health care or first
aid for accidents occurring in the Facilities. Except for such emergency assistance, Institution
shall have no obligation to furnish medical or surgical care to any student.
3.07 Maintenance of Patient Services. Institution shall be responsible for developing,
maintaining and providing services to all its patients and Institution will at all times provide an
adequate, competent staff to be responsible for the development, maintenance and provision of
these services to Institution patients.
3.08 Evaluation. Company shall evaluate the performance of the student on a regular basis
using the evaluation form supplied by TUC. The completed final evaluation shall be forwarded
to TUC within ten (10) business days following the conclusion of the student’s public health field
experience.
IV. NON-DISCRIMINATION
The Parties agree that all students receiving public health experience pursuant to this Agreement shall be
selected without discrimination on account of race, color, religion, national origin, ancestry, disability,
marital status, gender, sexual orientation, age, or veteran status.
V. STATUS OF TUC AND INSTITUTION
5.01 It is expressly agreed and understood by TUC and Institution that students participating
in the Program are in attendance for educational purposes, and such students are not considered
employees of Institution or TUC for any purpose, including but not limited to compensation for
services, provision of employee welfare and pension benefits, or provision of workers’
compensation insurance.
5.02 Institution assumes and maintains primary responsibility for services rendered to all of its
patients and assumes and maintains complete control and supervision over all its employees and
no Institution employees shall be deemed to be the employees or agents of TUC. TUC shall not
be liable for any salaries, and employees of Institution shall not have the right or claim to any
benefit or privilege as an employee or agent of TUC. Institution will assume sole and complete
liability for all acts and omissions of its employees and shall indemnify and hold TUC harmless
from any and all liability arising out of or connected with the acts or omissions of its employees.
VI. INDEMNIFICATION
65
6.01 TUC agrees to indemnify, defend and hold harmless, Institution and its affiliates, its
directors, trustees, officers, agents, and employees against all claims, demands, damages, costs,
expenses of whatever nature, including court costs and attorney fees, arising out of or resulting
from the negligence or willful misconduct of TUC or its students in the performance of this
Agreement.
6.02 Institution agrees to indemnify, defend and hold harmless, TUC and its affiliates, its
directors, trustees, officers, agents, and employees against any and all claims, demands, damages,
costs, expenses of whatever nature, including court costs and attorney fees, arising out of or
resulting from the negligence or willful misconduct of Institution in the performance of this
Agreement.
VII. INSURANCE
TUC shall procure and maintain in force during the term of this Agreement, at its sole cost and expense,
insurance in amounts that are reasonably necessary to protect TUC and Institution from and against
liability arising from or incident to the use of the Facilities by TUC students participating in the Program.
Coverage under such insurance shall not be less than One Million Dollars ($1,000,000) for each
occurrence and Three Million Dollars ($3,000,000) in the aggregate each for professional liability
insurance and comprehensive general liability insurance. TUC shall provide Institution with a certificate
of insurance evidencing the insurance coverage required under this Article VII. TUC shall further ensure
that not less than thirty (30) days notice shall be provided to Institution of the cancellation of such
insurance. TUC shall promptly notify Institution of any cancellation, reduction, or other material change
in the amount or scope of any coverage required hereunder.
VIII. TERM AND TERMINATION
8.01 Term. This Agreement shall be effective as of the date specified above and shall remain in
effect for an initial term of one year and will be automatically renewed thereafter for consecutive
one-year terms (each a “Renewal Term”) unless either Party elects not to renew this Agreement
by giving the other written notice at least six (6) months prior to the expiration of the initial term
or any renewal term of its intention not to renew this Agreement.
8.02 Termination.
(a) Mutual Agreement. This Agreement may be terminated at any time upon the mutual
written agreement of the Parties.
(b) Without Cause. This Agreement may be terminated without cause upon 180 days
prior written notice by either Party. Such termination shall not take effect, however, with
regard to students already enrolled in the Program until such time as those students have
completed their training for the TUC semester during which such termination notice is
given.
X. GENERAL PROVISIONS
66
9.01 Amendments. This Agreement may be amended at any time by mutual agreement of the
Parties without additional consideration, provided that before any amendment shall become
effective, it shall be reduced to writing and signed by the Parties. Notwithstanding the foregoing,
should any provision of this Agreement be in conflict with the law of the State in which the
Facilities are located or Federal law, it shall be deemed amended to eliminate the conflict.
9.02 Assignment. Neither Party shall assign or otherwise transfer this Agreement without the
other Party’s prior written consent. Any purported assignment in violation of this Section shall be
null and void.
9.03 Captions. Any captions to or headings of the articles, sections, subsections, paragraphs, or
subparagraphs of this Agreement are solely for the convenience of the Parties, are not a part of
this Agreement, and shall not be used for interpretation or determination of validity of this
Agreement or any of its provisions..
9.04 Counterparts. This Agreement may be executed in any number of counterparts, each of
which shall be deemed an original, but all such counterparts together shall constitute one and the
same instrument.
9.05 Entire Agreement. This Agreement, together with all attachments, is the entire agreement
between the Parties and no other agreements, oral or written, have been entered into with respect
to its subject matter.
9.06 Force Majeure. Neither Party shall be liable nor deemed to be in default for any delay or
failure in performance under this Agreement or other interruption of service or employment
resulting, directly or indirectly, from acts of God, civil or military authority, acts of public enemy,
war, accidents, fires, explosions, earthquakes, floods, failure of transportation, machinery or
supplies, vandalism, strikes or other work interruptions beyond the reasonable control of either
Party.
9.07 Governing Law. The validity, interpretation and performance of this Agreement shall be
governed by and construed in accordance with the laws of the State of California.
9.08 Notices. Notices required under this Agreement shall be sent to the Parties by certified or
registered mail, return receipt requested, postage prepaid, to the address for the Party set forth
below:
To TUC: Touro University California
Public Health Program
College of Education and Health Sciences
1310 Club Drive
Vallejo, California 94592
Attention: Dr. Jim O’Connor, Dean
To Institution: _______ County Health Department
9.10 Remedies. The various rights, options, elections, powers, and remedies of the respective
Parties hereto contained in, granted, or reserved by this Agreement, are in addition to any others
that said Parties may be entitled to by law, shall be construed as cumulative, and no one of them
is exclusive of any of the others, or of any right or priority allowed by law.
67
9.11 Severability. The provisions of this Agreement shall be deemed severable and if any
portion shall be held invalid, illegal or unenforceable for any reason, the remainder of this
Agreement shall be effective and binding upon the Parties.
9.12 Waiver. Any waiver of any terms and conditions hereof must be in writing and signed by
the Parties hereto. A waiver of any term or condition hereof shall not be construed as a future
waiver of the same or of any other term or condition hereof.
9.13 Non-Exclusive Agreement. This Agreement is not exclusive. Accordingly, either Party
shall have the right to enter into one or more agreements relating to the same or similar matters as
are covered by this Agreement.
X. EXECUTION
IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed by their duly
authorized representatives.
COUNTY OF_____________
a Political Subdivision of the State of California
By: Date:
Name & Title
Health Services Agency
Title:
TOURO UNIVERSITY, a California nonprofit public benefit corporation
By: Date:
Dr. Jim O’Connor, Dean
APPROVED AS TO FORM:
By: Date:
County Counsel
68
PsyDc
ti
TOURO UNIVERSITY
C AL l ~OIINI A
LEITER OF AGREEMENT
Between
TOUio University c.alifornia
College of Education and Health Sciences (CEHS)
Public Health Program
And
Placement Site
This Letter of Agreement r Agreement'') is made between the TOUio University
California, Public Health Program, located at 1310 Oub Drive, Vallejo, CA 94592
("Touro" or "MPH"), and Placement Site, located at 123 S. Street, State, City, Zip for a
6 week/11 week field study experience for Stu.dent Name. Touro University California
and Placement Site shall jointly be referred to as the ''Parties.u
This Letter of Agreement is effective beginning February 20, 2017.
This Agreement sets forth important points, relating to public health education,
concerning the training programs at Touro and the Placement Site.
1. Responsible Persons
TOUio University California Gayle Cummings, ,MPH
College of Education and Health Sciences
Public Health Program Director
Entity Placement Site
As Public Health Program Director and Assistant Dean of the CEHS, Professor
Cummings is ultimately responsible lot the content and conduct of the educational
activities as they pertain to the :MPH students, (Title, if available), Preceptor Name
(''Prueptor'')will be directly responsible for the supervision, training, assessment and
evaluation. of the MPH student, and Placement Site shall retain ultimate responsibility
for ensuring that health care services provided or activities performed pursuant to this
Agreement comply with all applicable provisions of federal, state and local laws, rules
and regulations.
69
-
-
2. Educational Goals and Objectives
Please see attached MPH Field Study handbook that details the specific rotational
educational goals and objectives.
3. Assignment
This Touro student is required to complete a minimum of 6 weeks/11 weeks of
fieldwork experience. The purpose of the fieldwork experience is to apply the
knowledge and skills acquired in the classroom, in a public health setting congruent to
the MPH program's mission statement. Requirements for the fieldwork experience
include: program director approval of the fieldwork site as well as completion of the
core courses prior to the field study placement. Students are required to:
d) Conduct one of the following: a needs assessment, program plan, program
evaluation, policy plan/ analysis, educational campaign, or applied research
based upon the organization's needs, work, mission, and or data
access/ availability;
e) Develop a plan to implement one of the above;
f) Gather and analyze applicable data via:
primary data collection (questionnaire administration or interviews); or
secondary data/ existing data set(s)
d) Present project findings in field study summary that addresses a health issue of
the community and contributes in resolving practical health problems.
In addition to data collection and analysis, the students' work should be valued by the
organization and make a contribution to meeting the organization's goals or mission.
4. Financial Arrangements
Placement Site is under no obligation for the MPH student's salary, housing, food, or
other benefits.
5. Professional Liability Coverage
The MPH Student's professional liability insurance documentation will be provided at
no cost to Placement Site. The professional liability coverage is provided by Touro for
the MPH student while performing his/her responsibilities as further defined below
and in the Touro University California Public Health Field Study Preceptor Handbook.
70
"TUC shall procure and maintain in force during the term of this Agreement, at its sole cost and
expense, insurance in amounts that are reasonably necessary to protect TUC and Institution
from and against liability arising from or incident to the use of the Facilities by TUC students
participating in the Program. Coverage under such insurance shall not be less than One Million
Dollars ($1,000,000) for each occurrence and Three Million Dollars
($3,000,000) in the aggregate each for professional liability insurance and comprehensive
general liability insurance. TUC shall provide Institution with a certificate of insurance
evidencing the insurance coverage required under this Article VII. TUC shall further ensure
that not less than thirty (30) days notice shall be provided to Institution of the cancellation of
such insurance. TUC shall promptly notify Institution of any cancellation, reduction, or other
material change in the amount or scope of any coverage required hereunder."
6. Responsibility for Teaching, Supervision and Evaluation of the MPH Student
While at Placement Site, the MPH student will receive supervision and instruction
from active members of the Placement Site. The MPH student will be supervised in all
of his/her activities commensurate with the complexity of the project and the MPH
student's own abilities. The MPH student's evaluation will be both formal and
informal. At the conclusion of the rotations, a formal student evaluation will be
completed by the preceptor and submitted to Touro. The MPH student will in turn,
complete a site evaluation form at the conclusion of the field study and submit this to
Touro.
7. Policies and Procedures for Education
While at Placement Site, the MPH student will take an active role in educational
opportunities provided and directed by Placement Site. The responsibilities for
teaching, supervision, and formal evaluation of the student's performance while at
Placement Site are the duties of the assigned or designated Preceptor.
8. Miscellaneous Provisions
b) Each party will indemnify, defend and hold the other party, its employees,
officers, directors, associates, agents, and representatives harmless from and
against any and all loss, damage, liability or claims (including, without
limitation, reasonable costs and expense of litigation and reasonable attorneys'
fees) arising from its negligent acts or omissions, or the negligent acts or
omissions of its students, employees, agents, and representatives in connection
with this Agreement. Any and all disputes arising out of or relating to this
Agreement shall be settled through expedited binding arbitration before a single
arbitrator (who shall be an attorney knowledgeable about matters relating to
health care) and shall be conducted at and by the American Arbitration
Association(" AAA") or its successor in accordance with its rules and procedures
71
PsyDc
in the offices of Placement Site. The arbitrator shall be vested with determining
all matters surrounding this Agreement. The costs of such arbitration shall be
borne equally by the parties with each party bearing its own attorneys' fees and
any costs associated with presenting its proof. Judgment upon the award shall
be final and binding on the parties and may be entered in any court of competent
jurisdiction.
c) This Agreement constitutes the entire understanding between the parties with
regard to all matters referred to herein and supersedes all previous agreements,
whether written or oral. If any provision of this Agreement is, for any reason,
held to be invalid or unenforceable, the other provisions of this Agreement will
remain enforceable and the invalid or unenforceable provision will be deemed
modified so that it is valid and enforceable to the maximum extent permitted by
law.
The Parties acknowledge they have read this Agreement, understand the terms and
conditions, and agree to be bound by them.
Touro University California
College of Education and Health Sciences
Public Health Program
Gayle Cummings , MPH
Program Director & Assistant Dean
Placement Site
Site Preceptor
Date
Date
72
GD
TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
ANO Hl:::AL TH SCIENCES
PUBLIC MEAL TM PROGRAM
Community Mealth Field Study Emergency Protocol
The Community Health Field Study Emergency Protocol has been designed to prepare for and
facllltate rapid response to emersencles which may arise during the Field Study. Although no
single plan or protocol can address all contingencies, Touro University California (TUC)
recognizes the importance of establishing, in advance, policies and procedures to safeguard the
welfare of students during their field study placements at affiliated community health field
study sites.
The procedures set forth below are to be followed by the all students in community health field
study placements sponsored by TUC. It Is the responslblllty of the Field Study Coordinator to
follow the procedures outlined below and educate all field study students, preceptors, and site
coordinators or administrators about these procedures through preceptor orientation.
I. What should the TUC Field Study Coordinator do to prepare for
emergencies?
1. The Fie Id Study Coo rd lnator will obtain from each student, prior to the start date
a. emergency contact information for the Student;
b. the Student Code of Conduct acreement:
z. At a minimum, the following information should be provided to all community health
field study students during the placement preparation by the Field Study Coordinator.
a. Emergency contact numbers for the Field Study Coordinator, Program Director,
and Assistant Program Director, and Program Office Staff. This information will
be included in the Field Study Handbook and will be given to the students at
schedule fleld study overviews. This emergency contact Information wlll contain
the following names, numbers, and email addresses:
i. Field Study Coordinator
H. Program Director
Ill. Assistant Program Director
iv. Program Office Staff
b. Procedures for a medical emergency:
73
i. Students should be informed that they are required to notify the Preceptor about any
medical emergency, and that the Preceptor in turn is required to contact the Field Study
Coordinator.
ii. This information will be treated with the strictest confidentiality, and will be shared by
the Preceptor and the Field Study Coordinator on a "need to know" basis only.
111. If the crisis involving the Student is grave enough to seriously jeopardize his or her
safety or well-being, the emergency contact he/she has provided at the time of registration will
be informed.
3. Preceptors will be required to read the Field Study Preceptor Handbook, which will
provide an incident reporting form. Preceptors and Students will be asked to sign a Statement
of Understanding after the training session acknowledging that they
a. have received, reviewed, and understand this protocol,
b. have received and understand how and when to use the provided forms,
c. fully understand their duties and responsibilities as preceptors.
II. What is an emergency?
An emergency is any circumstance that poses a serious risk to, or that has already disturbed the
safety and/or wellbeing of field study students. Emergencies will include, though not be
confined to, the following types of events and incidents:
• Serious illness, physical or emotional trauma, injury or death
• Hospitalization for any reason
• Disappearance or kidnapping of a student
• Criminal assaults against program students
• Sexual assault or rape
• Arrest, incarceration, or deportation
• Automobile accidents involving program students
• Terrorist threat or attack
• Local political crisis disruptive of civil obedience
• Natural disaster
What to do in the case of an emergency: Preceptor
1. In an emergency, the Preceptor's first responsibility is to safeguard the immediate wellbeing
of field study students. The Preceptor should take appropriate steps to assure the
immediate safety and wellbeing of the students, including, as appropriate, obtaining
prompt and appropriate medical attention or protection by local law enforcement.
2. The Preceptor and, when possible, the student, should contact the Field Study
Coordinator immediately when an emergency event occurs or is imminent and brief them in
detail about the situation.
74
3. As necessary, the Field Study Coordinator should notify the Program and College
administration and the Office of Student Services about the emergency, and follow
whatever procedures they may suggest or require. If there is a continuing risk to the
immediate safety or welfare of the Student, the Field Study Coordinator should ask the
appropriate authorities to advise him/her on a regular basis about the evolution of the
crisis, and about how the field study program should respond.
4. When all has been done to assure the Student's immediate well-being, preceptors, with
the aid of the Student when possible, should gather all critical information, using the incident
reporting form as a guide. The incident report should be sent to the Field Study Coordinator
who will share copies with the:
a. Public Health Program Director and Assistant Director
b. Director of the PA Program regarding PA students and the deans of the colleges of
Osteopathic Medicine and Pharmacy regarding MPH dual degree students
c. Associate Dean of Student Services
d. Dean of the College an Education and Health Sciences
5. The Field Study Coordinator should be contacted first by phone, with
communication by e-mail and fax used as a last resort. Emergency contact
information for the Field Study Coordinator is available and should be obtained from
the Public Health Program. If the Field Study Coordinator is not available, the
Preceptor and the Student will send the incident report directly to the Program
Director who will then contact the other concerned TUC parties. Should the Field
Study Coordinator and PH Program Director not be available, the Preceptor and the
Student are encouraged to follow the PH Program emergency contact chain of (see
page 6.)
6. During an on-going crisis, the Preceptor should keep the Field Study Coordinator
updated on a regular basis. While there may not be time to complete the incident reporting
form initially, the Preceptor should use it as a guide and understand that it will need to be
completed and submitted to the Field Study Coordinator when possible to facilitate
management of the situation.
7. All field study students will be evacuated in the emergency scenarios outlined at the
beginning of section II. Evacuation for other incidents that might warrant concern and reporting
but that do not pose an immediate threat to student safety and/or wellbeing (such as robbery
or minor assault) will be decided jointly by the Field Study Coordinator and the Program
Director. In the case of widespread conflict or natural disaster, Field Study Coordinator will
reach out to local organizations to assist with ensuring the safety of the Student.
a. In an emergency, preceptors should urge students to contact family members or other
concerned parties as soon as possible to advise them of their personal situation. Wherever
necessary, the Preceptor should attempt to facilitate such contact. Methods of communication
may include email, phone calls, faxes, and posts to social networking websites.
75
b. In a medical emergency, the Preceptor or appropriate designee should accompany the
Student to an appropriate health care provider for medical attention. The Field Study
Coordinator should be contacted and made aware of the situation. No details of a student's
medical condition should be shared unless the Student grants permission. If a medical
emergency is critical and a student's family or other emergency contact should be informed,
the Preceptor should consult with the Field Study Coordinator to coordinate the contact with
the Student's emergency contact.
Upon receiving a call from the Preceptor or Student involving a serious injury, death, or
emergency, the manager will:
1. Start a log of all calls and activities.
2. Complete an Incident Report form, making sure to gather the following important
information:
a. Name of caller and of victim(s), if any
b. Brief description of accident, injuries, and/or emergency, the steps that have
been taken and the status.
c. Location of caller-street, city
d. Location of event, accident or emergency, proximity to student group
e. Phone, cell phone, fax, or beeper number where caller is
f. If any calls have been made to local law enforcement
g. If any information has been released to the media
h. If any specific plan of action is in place or anticipated
If a national/regional emergency-real or perceived -occurred, ask for answers to these
questions:
1. What impact, if any, did any emergency have on availability of food, water, and medical
supplies?
2. What was the nature of the emergency?
3. What is the intensity of the emergency?
4. Is there local law enforcement, military or emergency personnel at the site of the
emergency?
5. Is continuation of field study feasible?
6. What is the advice of the local law enforcement, military or emergency personnel?
For personal emergencies:
1. Has injured party been in contact with his/her family?
2. Do we have his/her permission to contact family or other concerned parties?
3. Has the injured party been hospitalized or received medical attention?
4. What is the contact information of the facility where the injured party is being kept?
5. Communicate with the necessary location personnel to develop a tailored response
plan. Communication will be ongoing until the situation is resolved
76
6. Do not make any statement directly to the media. Refer inquiries to the Program
Director or Associate Dean of Student Services and follow recommendations regarding a
consistent communication plan.
77PH Program Emergency Contact Information Field Study Coordinator Address Phone Email Fax Nemesia Kelly, MPH Touro University California Ofc: 707 /638-5827 nemesia.kell~@tu.edu 707 /638-5871 Assistant Professor Public Health Program Cell: 707/731-7436 Public Health Program 1310 Club Drive College of Education and Health Sciences Vallejo, CA 94592 Touro University California Program Director Address Phone Email Fax Gayle Cummings, MPH, PsyD (c) Touro University California Ofc: 707 /638-5831 ga~le.cummings@tu.edu 707 /638-5871 Associate Professor Public Health Program Cell: 707/373-4050 Public Health Program 1310 Club Drive College of Education and Health Sciences Vallejo, CA 94592 Touro University California Assistant !Program Director Address Phone Email Fax Elena 0. Lingas, DrPH, MPH Touro University California 707 /638-5830 elena.lingas@tu.edu 707 /638-5871 Associate Professor Public Health Program Public Health Program 1310 Club Drive College of Education and Health Sciences Vallejo, CA 94592 Touro University California PH Program Office Staff Address Phone Email Fax Alicia Ashorn, MPH Touro University California 707 /638-5839 alicia.ashorn@tu.edu 707 /638-5871 Research Assistant Public Health Program Public Health Program 1310 Club Drive College of Education and Health Sciences Vallejo, CA 94592 Touro University California Brigida Perez, MA (c) Touro University California 707 /638-5838 brigida.i;1erez@tu.edu 707 /638-5871 Administrative Assistant Public Health Program Public Health Program 1310 Club Drive College of Education and Health Sciences Vallejo, CA 94592 Touro University California
78
____________________
Statement of Understanding
Please sign below to indicate that you agree with the following statement:
"I certify that I have read and understood the above Community Health Field Study Emergency
Protocol. I understand that the Protocol is designed to improve the management of emergency
situations that arise during the Field Study and agree follow procedures as outlined within to
the best of my ability."
Signature: ______________ _ Date:
Print Name: ---------------
79
GD
TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
ANIJ HEALTH SCIENCES
PUBLIC MEAL TM PROGRAM
Global Mealth Field Study Emer1ency Protocol
The Global Health Field Study Emergency Protocol has been designed to prepare for and
facilitate rapid response to emergencies which may a rise during travel abroad. Although no
single plan or protocol can address all contingencies, Touro University California (TUC}
recosnlzes the Importance of establlshlng, In advance, pollcles and procedures to safeguard the
welfare of members of the community traveling internationally.
The procedures set forth below are to be followed by the all participants In global hea Ith fleld
placements sponsored by TUC. It is the responsibility of the Field Study Coordinator to follow
the procedures outlined below and educate all field study students, site coordinators, and
preceptors In their countries of responslblllty about these procedures during orientations and
site development visits.
I. What should the TUC Field Study Coordinator do to prepare for emergencies?
1, The Field Study Coordinator will obtain from each student, prior to departure:
a. Emeraency contact Information for the student;
b. ThE~ Student Code of Conduct A&reement;
c. Pra1of of enrollment in the Smart Traveler Enrollment Propam (STEP). STEP is a
free service provided by the U.S. Government to U.S. citizens who are traveling
to, or living in, a foreign country. STEP allows you to enter information about
your upcoming trip abroad so that the Department of State can better assist you
in an emergency. STEP also allows Americans residing abroad to get routine
Information from the nearest U.S. embassy or consulate.
2. At a minimum, the following infonnation should be provided to all global health field
study students during the pre-departure orientation by the Field Study Coordinator.
a. Information on where to obtain Travel Alerts Issued by the U.S. State Department for
the destination countries.
b. Field Study Coordinators are required to subscribe to the U.S. State Department
Travel Alert RSS feed and to monitor it for news on their representative country.
80
i. The public health program understands that not all country Travel Alerts are relevant to
field students (e.g., they may be about low level threats or affect an area of the country or
a specific population with which students are not expected to come into contact).
ii. In the event of a relevant and serious Travel Alerts, Field Study Coordinators will notify
Site Coordinators and all field-based students directly via email. Site Coordinators will then
notify students via phone as email access at global sites might be unreliable.
c. Emergency contact numbers for participants to provide to their families and
other concerned parties. This information will be included in the Field Study
Handbook and will be given to the students at orientation. This emergency
contact information will contain the following names, numbers, and email
addresses:
i. US Embassy at travel destination(s)
ii. Site Coordinator
iii. Field Study Coordinator
d. Information regarding safety and security issues specific to the country.
Participants should be advised to avoid travel to or through any location where
tensions exist and travel may be dangerous.
e. Procedures for a medical emergency:
i. Participants should be informed that they are required to notify the Site Coordinator
about any medical emergency, and that the Site Coordinator in turn is required to contact the
Field Study Coordinator.
ii. This information will be treated with the strictest confidentiality, and will be shared by
the Site Coordinator and the Field Study Coordinator on a "need to know" basis only.
111. If the crisis involving the participant is grave enough to seriously jeopardize his or her
safety or well-being, the emergency contact he/she has provided at the time of registration will
be informed.
3. In the case of programs or extracurricular field trips which entail overnight absence from
the home base, the student will leave a detailed written program itinerary with the Site
Coordinator with written instructions on how they can be contacted in an emergency. The
student will fill out a travel itinerary form and email copies to both the Field Study Coordinator
and the Site Coordinator
4. Site Coordinators will be required to attend an information session with Field Site
Coordinators during in-country site development visits, during which they will receive various
materials including an incident reporting and itinerary forms. Site Coordinators will be asked to
sign a Statement of Understanding after the training session acknowledging that they:
a. have received, reviewed, and understand this protocol,
b. have received and understand how and when to use the provided forms,
c. fully understand their duties and responsibilities as Site Coordinators.
81
II. What is an emergency?
An emergency is any circumstance that poses a serious risk to, or that has already disturbed the
safety and/or wellbeing of field study students. Emergencies will include, though not be
confined to, the following types of events and incidents:
• Serious illness, physical or emotional trauma, injury or death
• Hospitalization for any reason
• Disappearance or kidnapping of a participant
• Criminal assaults against program participants
• Sexual assault or rape
• Arrest, incarceration, or deportation
• Automobile accidents involving program participants
• Terrorist threat or attack
• Local political crisis disruptive of civil obedience
• Natural disaster
What to do in the case of an emergency: Site Coordinator
1. In an emergency, the Site Coordinator's first responsibility is to safeguard the immediate
wellbeing of program participants. The Site Coordinator should take appropriate steps to
assure the immediate safety and wellbeing ofthe participants, including, as appropriate,
obtaining prompt and appropriate medical attention, embassy intervention or police
protection.
2. The Site Coordinator and, when possible, the student, should contact the Field Study
Coordinator immediately when an emergency event occurs or is imminent and brief
them in detail about the situation.
3. As necessary, the Field Study Coordinator should notify the local U.S. Embassy or
Consulate about the emergency, and follow whatever procedures they may suggest or require.
If there is a continuing risk to the immediate safety or welfare of the participants (during a
terrorist threat, for example), the Field Study Coordinator should ask the appropriate embassy
or consular official to advise him/her on a regular basis about the evolution of the crisis, and
about how the field study program should respond.
4. When all has been done to assure the participant's immediate well-being, the Site
Coordinator, with the aid of the student when possible, should gather all critical information,
using the incident reporting form as a guide. The incident report should be sent to the Field
Study Coordinator who will share copies with the:
a. Global Health Track Chair
b. Public Health Program Director and Assistant Director
82
c. Director of the PA Program regarding PA students, the director of the College of
Osteopathic Medicine Global Health Program, and the deans of the colleges of
Osteopathic Medicine and Pharmacy regarding MPH dual degree students
d. Associate Dean of Student Services
e. Dean of the College an Education and Health Sciences
6. The Field Study Coordinator should be contacted first by phone, with
communication by e-mail and fax used as a last resort. Emergency contact
information for the Field Study Coordinator is available and should be obtained from
the Public Health Program. If the Field Study Coordinator is not available the Site
Coordinator and student will send the incident report directly to the Global Health
Track Chair and (Dr. Carinne Brody and/or the PH Program Director) who then will
contact the other concerned TUC parties. Should the Field Study Coordinator, Global
Health Track Chair, or PH Program Director not be available, the Preceptor and the
Student are encouraged to follow the PH Program emergency contact chain of (see
page 6.)
6. During an on-going crisis, the Site Coordinator should keep the Field Study Coordinator
updated on a regular basis. While there may not be time to complete the incident reporting
form initially, the Site Coordinator should use it as a guide and understand that it will need to
be filled out and submitted to the manager when possible to facilitate management of the
situation.
7. During a political crisis or some other emergency during which foreigners in general or
U.S. citizens in particular may be at risk, the Field Study Coordinator should advise the field
study students to keep a low profile and avoid demonstrations, confrontations or situations
where they could be in danger. The group should avoid locales where foreigners or Americans
are known to congregate and attempt to be as inconspicuous as possible. The participants
should be advised to follow the recommendations set forth in any Travel Alerts issued by the
U.S. State Department.
8. All field study students will be evacuated in the emergency scenarios outlined at the
beginning of section II. Evacuation for other incidents that might warrant concern and reporting
but that do not pose an immediate threat to student safety and/or wellbeing (such as robbery
or minor assault) will be decided jointly by the Field Study Coordinator, the Program Director.
In the case of widespread conflict or natural disaster, Field Study Coordinator will reach out to
local organizations to assist with ensuring the safety of local Site Coordinators.
a. In an emergency, Site Coordinators should urge participants to contact family members
or other concerned parties as soon as possible to advise them of their personal situation.
Wherever necessary, the Site Coordinator should attempt to facilitate such contact. Methods of
communication may include email, phone calls, faxes, and posts to social networking websites.
83
b. In a medical emergency, the Site Coordinator or appropriate designee should
accompany the participant to an appropriate health care provider for medical attention. The
Field Study Coordinator should be contacted and made aware of the situation. No details of a
participant's medical condition should be shared unless the participant grants permission. If a
medical emergency is critical and a participant's family or other emergency contact should be
informed, the Site Coordinator should consult with the Field Study Coordinator to coordinate
the contact with the participant's emergency contact.
Upon receiving a call from the Site Coordinator or student involving a serious injury, death, or
emergency, the manager will:
1. Start a log of all calls and activities.
2. Complete an Incident Report form . making sure to gather the following important
information:
a. Name of caller and of victim(s), if any
b. Brief description of accident, injuries, and/or emergency, the steps that have been taken
and the status.
c. Location of caller-street, city, country
d. Location of event, accident or emergency, proximity to student group
e. Phone, cell phone, fax, or beeper number where caller is
f. If any calls have been made to local law enforcement, U.S. Embassy or Consulate
g. If any information has been released to the media
h. If any specific plan of action is in place or anticipated
If a national/regional emergency-real or perceived -occurred, ask for answers to these
questions:
1. What impact, if any, did any emergency have on availability of food, water, and medical
supplies?
2. What was the target of unrest, if the event was political?
3. What is the intensity of the emergency or of the political unrest?
4. Are there military or emergency personnel at the site of the emergency?
5. Is the continuation of the travel program (and classes if involved) feasible?
6. How able are participants to travel in the country?
7. What is the advice ofthe nearest U.S. Embassy or Consulate?
For personal emergencies:
1. Has injured party been in contact with his/her family?
2. Do we have his/her permission to contact family or other concerned parties?
3. Has the injured party been hospitalized or received medical attention?
4. What is the contact information of the facility where the injured party is being kept?
5. Communicate with the necessary location personnel to develop a tailored response
plan. Communication will be ongoing until the situation is resolved
84
6. Do not make any statement directly to the media. Refer inquiries to the Program
Director or Dean of Student Affairs and follow recommendations regarding a consistent
communication plan.
7. If an emergency has occurred, call the U.S. Department of State Citizen Emergency
Center at 1-202-647-5225 for suggestions or assistance. For health emergencies, contact
the Center for Disease Control at 1-800-232-4636.
85Public Health Program Emergency Contact Information Field Study Coordinator Address Phone Email Fax Bolivia Touro University California Ofc: 707 /638-5832 sarah.sullivan@tu.edu 707 /638-5871 Sarah Sullivan, RN, MSN, PNP, MPH Public Health Program Associate Professor 1310 Club Drive Public Health Program Vallejo, CA 94592 College of Education and Health Sciences Touro University California Cambodia Touro University California Ofc: 707 /638-5833 carinne.brod~@tu.edu 707 /638-5871 Carinne Brody, DrPH, MPH Public Health Program Assistant Professor 1310 Club Drive Public Health Program Vallejo, CA 94592 College of Education and Health Sciences Touro University California Ethiopia Touro University California Ofc: 707 /638-5842 sahai.burrowes@tu.edu 707 /638-5871 Sahai Burrowes, PhD, MALD Public Health Program Assistant Professor 1310 Club Drive Public Health Program Vallejo, CA 94592 College of Education and Health Sciences Touro University California PH Program Field Study Coordinator Touro University California Ofc: 707 /638-5827 nemesia.kell~@tu.edu 707 /638-5871 Nemesia Kelly, MPH Public Health Program Cell: 707/731-7436 Assistant Professor 1310 Club Drive Public Health Program Vallejo, CA 94592 College of Education and Health Sciences Touro University California Program Director Address Phone Email Fax Gayle Cummings, MPH, PsyD (c) Touro University California Ofc: 707 /638-5831 ga~le.cummings@tu.edu 707 /638-5871 Associate Professor Public Health Program Cell: 707/373-4050 Public Health Program 1310 Club Drive College of Education and Health Sciences Vallejo, CA 94592 Touro University California
86Assistant Program Director Address Phone Email Fax Elena 0. Lingas, DrPH, MPH Toure University California 707 /638-5830 elena.lingas@tu.edu 707 /638-5871 Associate Professor Public Health Program Public Health Program 1310 Club Drive College of Education and Health Sciences Vallejo, CA 94592 Toure University California PH Program Office Staff Address Phone Email Fax Alicia Ashorn, MPH Toure University California 707 /638-5839 alicia.ashorn@tu.edu 707 /638-5871 Research Assistant Public Health Program Public Health Program 1310 Club Drive College of Education and Health Sciences Vallejo, CA 94592 Toure University California Brigida Perez, MA (c) Toure University California 707 /638-5838 brigida.~erez@tu.edu 707 /638-5871 Administrative Assistant Public Health Program Public Health Program 1310 Club Drive College of Education and Health Sciences Vallejo, CA 94592 Toure University California
87
______________________________
Statement of Understanding
Please sign below to indicate that you agree with the following statement:
"I certify that I have read and understood the above Global Health Field Study Emergency Protocol. I
understand that the Protocol is designed to improve the management of emergency situations that arise
during international travel and agree follow procedures as outlined within to the best of my ability."
Signature: ____________ _ Date:
Print Name: -------------
88
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TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
ANIJ HEAL TH SCIENCES
PUBLIC HEAL TH PROGRAM
Field Study Course Incident Report Form
Preceptors and students should complete this report Immediately after an Incident either using this form
or online at https://tuc.co1.qualtrics.com/ife/form/SV eal6Qo90ydReidT. All witnesses should submit
separate repons.
Today's Date: ___________ _
Name(s) of Student(s) Involved: ___________________ _
Student ID#: _________________________ _
Date and Tlme of Incident: _____________________ _
location of lnddent: _______________________ _
Name of Student Completln1 Report and Contact Information:
Name of Preceptor Completing Repon and Contact Information: .
Name of Field Study Placement Site: __________________ _
Names of Others Involved: ------------------------
COMPLETE THIS SECTION IF THERE WAS AN INJURY:
Please check the appropriate box to Indicate the nature of the Incident:
• Alcohol/Drugs • Theft • Assault of Student
• Injury/Illness • Arrest of Student • Other, please specify: ______________________ _
89
Please describe the incident. Be as specific as possible, including all details. Use additional sheets if
necessary.
Action(s) taken if any: ___________________________ _
Emergency medical treatment given? __ Yes __ No
To whom? _______________ By whom? __________ _
Describe procedure(s): ___________________________ _
Individuals (s) taken to hospital? __ Yes __ No
Name of individual(s) taken to hospital: ______________ _
Name and address of hospital:
Were police called to the scene? __ Yes __ No
Name of officer and police department: _____________________ _
COMPLETE THIS SECTION IF THERE WAS DAMAGE Property Damage (including damage to another's
vehicle):
90
Type of property: __________________________ _
Location of property: __________________ _
Name of Property Owner: ________________________ _
Street Address: -----------------------------
City: _______________ County: _____________ _
Provence/State: ____________ Country: ____________ _
Postal/Zip Code: ____________ Phone Number: __________ _
Email: ---------------
Nature and circumstances of damage:
Cost to repair: _______________________________ _
Witnesses names and addresses:
Signature of Reporting Preceptor/Student Date
Fax or email a copy of this report within 72 hours of incident to
the Field Study Coordinator and Program Director.
Fax: {707} 638-5871
Program Director Email: qayle.cumminqs@tu.edu
91
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TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
AND HEALTH SCIENCES
PUBLIC MEAL TM PROGRAM
ln1truction1 for Completing the
Field Study Scopa of Work
Each student Is required to complete a flnal scope of work durlns the first week of their fleld study. The
Scope of Work must be submitted via Blackboard one week after the placement start date. The Scope of
Work provides the framework for the field experience, by ensurin9 that:
1. The student and preceptor have a clear understanding of the field experience, specifically the role
and responsibilities of the student regarding the objectives, activities, timeline, and outcomes for
the field study project.
2. The experience is appropriate to earn academic credit toward the MPH degree.
Recommended time llne and steps for aeetln1 scope af work:
s. Meet with preceptor and or site coordinator to discuss and plan the fleld experience, project, and
the Scope of Work during the first week of the field study placement
6. Student writes draft of scope of work based on above discussion
7. Submit final scope af work to Nemesia Kelly via Blackboard along with a signed field study contract
one week after the placement start date. Nate: The Scape of Watt must be t,ped; handwritten
material Is not acceptable.
Provide a brief paragraph deKrlblns your field study project. See below for an example:
Alameda Health Sy.stem (AHS} Is dedicated to Improving cmt, quality, and acce.ss for their patient
population. Indicators of these gools hove been established by oversight agencies including the Agency for
Healthcare Research and Quality (AHRQ) and the Health and Human Services Notional Quality Measures
Oearinghouse. The California Association of Public Hospitals (CAPH), and the Safety Net Institute (SN/) have
cal/aboroted with UCSF to form The Public Healthcare system Evidence Network and Innovation exchange
(PHoENIX}. PHoENIX has created a "Big Alms CampalgnN which focuses on two measures of population
health: breast screening and control of cholesterol In people with diabetes. My field study project will focus
on assisting my preceptor to discover meaningful, evidence-based strategies for Implementation of Big Alms
goals at AHS. We will collect data on cu"ent system practices for both breast screening and LDL. Access to
care is influenced by provider capacity, known as provider panels. A partion of my worlc at AHS will focus on
the analysis of patient demand, provider performance issues, and clinical outcomes.
92
o
o
o
Suggestions for creating scope of work:
• Be clear in proposed general work
• Create objectives that are specific but not cluttered with language
• Scope of work should be as long as needed to adequately describe planned experience
• Be very specific in activities associated with objectives
• Estimate time for each activity, remember that deciding how much time something should take is
always an estimate
• Determine how you will evaluate yourself, think about:
How will you and your preceptor know that you completed an activity or objective?
How will you and your preceptor know how well you completed the activity or objective?
Some general evaluation guidelines:
• Weekly field study logs
• Final preceptor's evaluation
• Final student's evaluation
• Student's final summary report
Remember that, should it become necessary, it is possible (and sometimes expected) to change the scope
of work.
0 TOURO UNIVERSITY CA.LlfORl>IIA COi. LEGE or FDlll.ATIO~ AND HEALTH SCIENCES PUBLIC ~EAL T~ PROGRAM PUBLIC I-IEAL Tl-I FIELD STUDY SAMPLE SCOPE OF WORK FOR: Jane Smith J:ield Study Project Description (See Scope of Work Instructions. for an example): Alameda Health System (AHS) is dedicated to improving cost, quality, and access for their patient population. Indicators of these goals have been established by oversight agencies including the Agency for Healthcare Research and Quality (AHRQ) and the Health and Human Services National Quality Measures Clearinghouse. The California Association of Public Hospitals (CAPH), and the Safety Net Institute (SNI) han collaborated with UCSF to form The Public Healthcare system Evidence Network and Innovation eXchange (PHoENIX). PHoENIX has created a "Big Aims Campaign" which focuses on two measures of population health: breast screening and control of cholesterol in people with diabetes. My field ~tudy project will focus on assisting my preceptor to discover meaningful, evidence-based strategies for implementation of Big Aims goals at AHS. We will collect data on current system practices for both breast screening and LDL. Access to care is influenced by provider capacity, known as provider panels. A portion of my work at AHS will focus on the analysis of patient demand, provider performance issues, and clinical outcomes. 93
OBJECTIVES (S) ACTIVITIES TIMELINE INDICATORS OF OUTCOMES FOR EACH OBJECTIVE Improve mammography screening at AHS Research workflow. Collect and 9/6/14-Weekly logs, Preceptor (Goal of meeting or exceeding 9oth percentile analyze workflow surrounding breast 10/25/14 Evaluation of national benchmarks for breast cancer screening processes at AHS. screening in Medicaid population) Streamline, clarify and organize 9/6/14-Weekly logs, Creation of flow workflow processes using flow charts. 10/25/14 charts Rese·arch best practices for breast 9/6/14-Weekly logs, Preceptor screening at comparable health 10/25/14 Evaluation systems Creation of ambulatory care guidelines 9/6/14-Weekly logs, completion of 10/25/14 project Develop, produce, and disseminate 9/6/14-Weekly logs, completion of provider level reports 10/25/14 project, preceptor evaluation Deve•lop non-medical provider driven 9/6/14-Weekly logs, project outreach plan (workflows/clinical 10/25/14 completion protocols) Create process for sharing clinic level 9/6/14-Weekly logs, preceptor data and getting feedback from 10/25/14 evaluation 94
OBJECTIVES (S) ACTIVITIES TIMELINE INDICATORS OF OUTCOMES FOR EACH OBJECTIVE providers related to process/operations Rese·arch benchmark/national 9/6/14-Weekly logs, creation of report standard data 10/25/14 Analysis of patient data 9/6/14-Weekly logs, preceptor 10/25/14 evaluation Creation of Mammo Value Stream Map 9/6/14-Weekly logs, creation of VSM, framework 10/25/14 preceptor evaluation ***~•~•~******~*~***~****~*~******~•~·~·~·· 1'1:11"*******1'1:-Z:']l['fr*** ********~********~**********~*~**** r*************T***~*T******************T********~*T** * • Rese,arch workflow. Collect and 10/25/14-Improve LDL clinical outcomes analyze workflow surrounding LDL 11/30/14 Weekly logs, preceptor (Goal of meeting or exceeding 70th percentile practices at AHS. evaluation of national benchmarks for LDL in Medicaid population) Streamline, clarify and organize 10/25/14-workflow practices using flow charts. 11/30/14 Weekly logs, creation of flow charts Rese,arch best practices for LDL care 10/25/14-at comparable health systems 11/30/14 Weekly logs, preceptor evaluation Assist with creation of ambulatory care 10/25/14-guidelines 11/30/14 Weekly logs, project completion Assisi with the development and 10/25/14-dissemination of provider level reports 11/30/14 Weekly logs, preceptor evaluation Assisi with the development of non-10/25/14-medical provider driven outreach plan 11/30/14 Weekly logs, preceptor (workflows/clinical protocols) evaluation, project completion 95
OBJECTIVES (S) ACTIVITIES TIMELINE INDICATORS OF OUTCOMES FOR EACH OBJECTIVE ******************************************** ·**************** ***************************************************** * 9/15/14-*****************~***""************* * Collect and analyze data on AHS 9/18/14 * Assist with process for optimizing patient Freestanding Clinic Providers Weekly logs, preceptor experience by implementing panel size management framework ******"'Ir********"" evaluation, creation of Provider *****·**********·•·•***~•·············~·~•** 9/6/14-List ***************************************************** * 12/12/14 *7'r******ili:******ili;·***~***"***ili;*";*ill**** * Miscellaneous other tasks related to * Operations and process improvement projects Qualiity Improvement and Operations Weekly logs, Preceptor al AHS Eva I uatio n, Pro jecl Completion 96
______________________________________~ TOURO UNIVERSITY CALIFO~NIA COLLEGE OF EDUCATION AND HEALTH SCIENCES PUBLIC I-IEAL Tl-I PROGRAM PUBLIC MEAL TM FIELD STUDY SCOPE OF WORK FOR: Field Study Projed Description (See Scope of Work Instructions for an example): 97
OBJECTIVES (S) ACTIVITIES TIMELINE INDICATORS OF OUTCOMES FOR EACH OBJECTIVE 98
0
0
.-I
GD
TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
ANO HEAL TH SCIENCES
PUBLIC MEAL Tl-I PROGRAM
MPI-I COMPETENCIES
Discipline-Specific Competencies
AIN J.: Bloftatlstlt:s
• Describe the role of biostatistics in the discipline of public health
• Apply basic statistical techniques to describe, analyze and interpret public health data and research
Ana Z: Epidemiology
• Apply descriptive and experimental epidemiologic terms, methods and study designs to reveal
associations between the characteristics of a population and the features of an environment with
health
• Identify key sources of data for epidemiologic purposes, draw appropriate inferences from
epidemiologic studies and understand the limitations of a specific data source
Area J: Entflmnmental Health
• Describe major environmental risk factors, evaluate their impact on the health of populations,
describe and critique the risk assessment process, and review strategies for prevention and
remediation within the context of environ mental Justice
Ana 4: Health Policy ond Management
• Identify the main components and Issues of the Ol"lan lzatlon, financing and delivery of healthcare
services and public health systems in the US
• Describe medical care delivery and policy processes with an emphasis on systems thinking, basic
management concepts and quality of care implications
An:a 5: Sodal ond Behattlonll Sdem:u
• Identify the social and behavioral determinants that affect the health of individuals and
communities
• Understand and critique the application of theories, concepts and models used to Interpret
relationships between social determinants and health outcomes in research, interventions, policy
and practice
101
Cross-cutting Competencies
• Identify valid sources of public health information including peer-reviewed literature, government
records, and publically available datasets
• Understand and apply ethical practices and standards in public health
• Integrate principles of social justice into public health practice and promotion
Track-Specific Competencies
COMMUNITY HEALTH
1. Identify and assess community status and community health needs
2. Plan, develop, and implement community health programs using a variety of strategies to improve a
community's health
3. Advocate for better health and wellbeing through community mobilization efforts
4. Analyze and/or evaluate policies that impact a community's health
5. Demonstrate cultural sensitivity towards underserved populations
6. Manage fiscal and organizational resources to insure optimal program and service delivery
7. Evaluate the efficacy of health promotion/prevention programs
8. Demonstrate a commitment to social justice and health equity
9. Explain and interpret the roles and/or approaches of public health organizations
10. Synthesize and disseminate public health information
11. Apply conceptual framework s of health patterns, determinants and disparities in support of
community health policy, education, promotion or prevention
GLOBAL HEALTH
1. Define the global public health challenges ofthe developing world in terms of key parameters
including population, region, countries and magnitude.
2. Explain the political economy of global health issues.
3. Demonstrate the linkages between local and global health problems
4. Demonstrate the health disparities within the developing states and between the developed
and developing world.
5. Communicate effectively the mandates, roles and approaches of international public health
organizations.
6. Facilitate to build partnership with health institutions of higher learning, the NGO sector and
local community organizations.
7. Demonstrate an understanding of community's awareness of their own health problems and
their solutions.
8. Recognize the primacy of local solutions to global health issues and promote participatory
approaches to problem solving
102
9. Demonstrate a commitment to public health that values social justice and promotes health
equity globally.
10. Apply theoretical concepts related to global health patterns and social determinants in support
of global health policy, promotion or prevention
11. Engage in critical thinking about global health policy and health strategies, especially regarding
feasibility, cost effectiveness, sustainability and scalability of different approaches
12. Demonstrate an understanding of the importance of listening in an unbiased manner, respecting
diverse points of view, and observing humility in international situations
13. Develop skills to advocate for programs, resources and policies that advance global public health
103
GD
TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
ANO HEAL TH SCIENCES
PUBLIC MEAL TM PROGRAM
Public Me•lth Field Study Competency Inventory Form
Name: ________________ _
Publlc Health Prosram MPH Competendes: For their field study projects, students are required to identify
at least three to five (3-5) core public health competencies (one from each core area (Biostatistics,
Epidemiology, Environmental Health Science, Health Policy and Management, and Social and Behavioral
Sciences); 1 cross-cutting competency, and three (3) track competencies (Community Health or Global
Health) listed on the above pages (pp. 107-109). Competencies should be Identified as a collaborative
process between students and preceptors by Identifying and select Ins the competencies that will be
addressed through the fleld study. However, students are ultlmately responslble for completlnsthe
inventory. In addition, students may include detailed information explaining how each selected
competency specifically relates to their project. Please refer to the MPH Competencies listed above or on
Blackboard. The Competency Inventory must be typed as handwritten material is not aa:eptable.
Selection of 3-5 Core Public Health Competencies:
Competency Area
1.
2.
3.
4.
s.
104
Field Study Project Objectives Related to Core Public Health Competencies (OPTIONAL):
Students may include detailed information explaining how each selected competency specifically relates to
their field study project.
Example:
Project Objectives Related to Core Public Health Competencies Area
1. Analyze and interpret breast cancer data for CPIG Biostatistics
2. Apply epidemiological terms and knowledge to conduct research and Epidemiology
identify key data sources and gather appropriate information to
address the possible barriers faced by patients in utilizing group
therapy in the Appalachian region; Successfully understand the
strength and limitations of the found peer-reviewed articles and make
appropriate associations regarding cause and effect.
3. Describe major environmental risk factors, evaluate their impact on the Environmental Health
health of population of San Joaquin Valley and review strategies for Science
prevention for well contamination
4. Create MOU between WIC and South bay to improve quality of care Health Policy and
implications; Implement and monitor Breastpump Loan program Management
between WIC and Southbay Hospital.
5. Identify and disseminate social and behavior determinants that affect Social and Behavior Sciences
Type II diabetes among Latinos aged 4-18 in Logan County.
Project Objectives Related to Core Public Health Competencies Area
1.
2.
3.
4.
5.
105
Selection of One (1) Cross-Cutting Public Health Competency:
Competency
Selection of Three (3) Track Competencies (Community Health or Global Health):
Competency
1.
2.
3.
106
~
TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
ANO HEALTH SCIENCES
PUBLIC Ml:AL TM PROGRAM
1310 Club Drir,e •Vallejo• California• 94592 • 707-638-5838 (main ofc)
Public Mealth Field Study Contrad
The purpose of this agreement is to structure the field experience through results-oriented objectives and a wel I-
defined scope of work. This contract and related scope of wortc serves as the basis for the field study. Once the
student and preceptor have sisned the contract, any subsequent chanses will require the approval of the preceptor
and field study coordinator. The contract and scope of work must be submitted via Blackboard one week after the
start of the field study. Students must conduct all field study work on-site under the supervision of the field study
preceptor (students are not allowed to telecommute or work from home or off-site durins the field study
placement).
Student Name:
Student Phone Number:
Student Email address:
Preceptor Name
Preceptor Credentials (MPH, PhD, MD)
Preceptor Prefix (Mr., Ms. (if not •Dr.")I
Supervisor Name:
Site Name:
Preceptor Phone Number:
Preceptor Email address:
Site Address, Cty,
Site State/Province, Postal Code/Zip
Site Country
Preceptor Fax Number:
Field Study Placement Start Date:
Placement Length: 11 Weeks ___ 10 Weeks __ _
6 Weeb+ 12-24 Weeks (Part-time) __
I have read the scope of work attached to this document and by my signature approve the field study as
outlined.
Student Date
Preceptor Date
Please return a signed copy of this contract via Blackboard. If you experience difficulty in accessing Blackboard,
please email this Item as an attachment {JPG or PDF).
Nemesia Kelly, MPH
Assistant Professor & Field Study Coordinator
Touro University California Public Health Program
nemesia.kelly@tu.edu • 707.638.5827 (Office)• 707.731.7436 (Cell)
107
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TOURO UNIVERSITY
CALIFORNIA
COLLEGE OF EDUCATION
ANO HEALTH SCIENCES
PUBLIC MEAL TM PROGRAM
Selected Field Study Site Visit Dates
The site visit is an assessment that occurs midway throu1h the field study placement and conducted by the
Fleld Study Coordinator or another Public Health Program faculty member who visits the fleld study placement
site to meet with the student and preceptor. Durina the first week of the field study placement and after the
preceptor has s11ned the Fleld Study Contract,, the student Is responslble for working with their preceptor to
select M posslble dates/times on dates that occur midway throu1h their field study placement on which to
schedule the site visit. At least 30 minutes should be allocated for each site visit (1S-mlnute separate meetlnss
are required with the student and the preceptor). Student, are required to submit this form via Blackboard
(BB) lndlcatl111 selected dates/times for potential site visits (this form Is available on BB In the Assignment, &
Course Matl!rlals sections and In the MPH Student Fleld Study Handbook Appendix). The Field Study
Coordinator or another Public Health Program faculty member will contact the student and preceptor to
schedule a site visit based on those selected dates/times. Depending on the site location and availability of the
site visitor, site visits may be held in person, by phone, or by Skype. This form requires signatures of both the
student and preceptor. The grade percentase of the Field Study Site Visit ls worth 59' for the Public Health Field
Study course.
Student Name:
Name of Field Study Site:
Name of Preceptor:
Proposed Dates:
Preceptor Sl1nature Date
Student stanature Date
108
TOURO COLLEGE
GENERAL RELEASE FORM (INDIVIDUAL)
I hereby grant the right and permission, without reservation, to Touro College, and those authorized by Touro College,
to photograph and/or videotape me and further to display, use and/or otherwise utilize, in original or modified form,
my face, likeness, name, information, voice, and appearance forever and throughout the world, in all media, whether
now known or hereafter devised, throughout the universe in perpetuity (including, without limitation, in online
webcasts, television, motion pictures, films, newspapers, publications or use by third parties) and in all forms
including, without limitation, digitized images, whether for advertising, publicity, or promotional purposes, including,
without limitation, for the promotion, public education, and/or fundraising activities of Touro College, without
compensation, reservation or limitation. Touro College is, however, under no obligation to exercise any rights granted
herein.
I release Touro College, its officers, directors, agents, employees, independent contractors, licensees and assignees
from all claims that I now have or in the future may have, relating to the above.
I agree that Touro College, or its grantees or assignees, will be the sole owner of all tangible and intangible rights in
the abovementioned photographs and recordings, with full power of disposition.
Any controversy or claim arising out of or relating to this release or the breach, termination, or validity (including
enforceability and scope of this arbitration clause) thereof, shall be exclusively settled by expedited binding arbitration
in Touro College’s offices administered by the American Arbitration Association ("AAA") and conducted by a sole
arbitrator (who shall be an attorney) in accordance with the AAA's Rules ("Rules"). The costs of such arbitration shall
be borne equally by the parties, with each party also bearing its own attorneys' fees and any costs associated with
presenting its proof. Judgment upon the award rendered may be entered in any Court of competent jurisdiction. The
undersigned hereby waives trial by jury which waiver is independent of the agreement to arbitrate disputes.
I am over 18 years of age*
Date_______________________ Name (print)_____________________________
Date of Shoot/Session_________ Signature________________________________
Location____________________ Address _________________________________
Phone______________________ Program _________________________________
*(If a minor, the following should also be signed by the parent or guardian)
I am the parent or guardian of the minor named above, and I have consent to the foregoing on behalf of the
minor and myself.
Date______________________Address __________________________________
Name (print) ____________________________ Relationship ________________
Signature ______________________________ Phone ______________________
~
TOURO UNIVERSITY
CALIFORNIA
109
GD
TOURO UNIVERSITY
CALl~ORNIA
GENERAL PHOTO RELEASE
I hereby grant the right and permission, without reservation, to Touro College, and those authorized by Touro College, to photograph and/or videotape m e
and further to display, use and/or otherwise utilize, in original or modified form, my face, likeness, name, information, voice, and appearance forever and
throughout the world, in all media, whether now known or hereafter devised, throughout the universe in perpetuity (including, without limitation, in on line
webcasts, television, motion pictures, films, newsp.:1pers-, publications or use by third parties) and in all forms including, without limitation, digitized images,
whether for advertising, publlclty, or promotional purposeJ, Including, Without llmltatlon, for the promotion, public education, and/or fundralslng activities of
Toure College, without compensation, reservation or limitation. Toure College is, however, under no obligation to exercise any rights granted herein.
I release Touro College, Its officers, directors, agents, employees, Independent contractors, licensees and assignees from all claims that I now have or In the
future may have, relatlng to the above.
I agree that Touro College, or Its grantees or assignees, will be the sole owner of all tangible and Intangible rights In the abovementloned photographs and
recordings, with full power of disposition.
Any controversy or claim arising out of or relating to this release or the breach, termination, or validity (including enforceability and scope of this arbitration
clause) thereof, shall be exclusively settled by expedited binding arbitration in Touro College's offices administered by the American Arbitration Association
("AAA") and conducted by a sole arbitrator (who shall be an attorney) in accordance with the .AAA's Rules ("Rules"), The costs of such arbitration shall be
borne equally by the parties, with each party also bearing its own attorneys' fees and any costs associated Wlth presenting its proof. Judgment upon the
award rendered may be entered in any Court of competent jurisdiction. The undersigned hereby waives t rial by jury which waiver is independent of the
agreement to arbitrate disputes.
NOTES (If notai JU Student/EmpkWee
NAME (PRINT) SlGNATURE PROGRAM Include PhoneJ
..
' .
. '
110
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Exhibit B
Page 1 of 2
SELF-DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as “County”),
members of a contractor’s board of directors (hereinafter referred to as “County Contractor”), must
disclose any self-dealing transactions that they are a party to while providing goods, performing
services, or both for the County. A self-dealing transaction is defined below:
“A self-dealing transaction means a transaction to which the corporation is a party and in which one
or more of its directors has a material financial interest .”
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1) Enter board member’s name, job title (if applicable), and date this disclosure is being made.
(2) Enter the board member’s company/agency name and address.
(3) Describe in detail the nature of the self -dealing transaction that is being disclosed to the
County. At a minimum, include a description of the following:
a. The name of the agency/company with which the Corporation has the transaction;
and
b. The nature of the material financial interest in the Corporation’s transaction that the
board member has.
(4) Describe in detail why the self -dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5) Form must be signed by the board member that is involved in the self -dealing transaction
described in Sections (3) and (4).
Exhibit B
Page 2 of 2
(1) Company Board Member Information:
Name: Date:
Job Title:
(2) Company/Agency Name and Address:
(3) Disclosure (Please describe the nature of the self-dealing transaction you are a party to):
(4) Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233 (a):
(5) Authorized Signature
Signature: Date:
I I