academic assets. The parties enter into this affiliation in a spirit of mutual benefit to be achieved through an
equitable contribution of resources. The affiliation agreement is crucial to the partnership because it forms the
philosophical and, in some cases, the legal basis for numerous specific agreements that may be executed between
components of the affiliate and VA.
In entering into any agreements, VA and the affiliate have a responsibility to comply with federal laws and
VA policies concerning conflicts of interest. The existence of an affiliation agreement does not guarantee that VA
and the affiliate will enter into additional agreements. However, some institutions may have other agreements
including contracts, memoranda of understanding, or other written agreements.
TERMS OF AGREEMENT
Ultimate responsibility for the control and operation of VA facilities and programs rests with VA. Ultimate
responsibility for academic education rests with school of dentistry and its affiliated institutions. Through this
affiliation agreement, a partnership is created to enable enhanced patient care, education, and research.
The partner institutions comply with Title VI of the Civil Rights Act of 1964, section 504 of the
Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, the Age Discrimination Act of 1975,
and all related regulations, and assures that they do not, and will not, discriminate against any person on the basis
of race, color, national origin, sex, disability, or age under any program or activity receiving federal financial
Nothing in this agreement is intended to be contrary to state or federal laws. In the event of conflict between
terms of this agreement and any applicable state or federal law, that state or federal law will supersede the terms
of this agreement. In the event of conflict between state and federal law, federal law will govern.
When providing professional services covered by this agreement, protection of faculty members (except those
providing services under a contract with VA) and trainees of the affiliated institution from personal liability while
at a VA health care facility will be that which is provided under the Federal Employees Liability Reform and Tort
Compensation Act 28 U.S.C.2679 (b)-(d).
Place a checkmark in the box that appropriately defines personal liability for participants in this VA
sponsored educational program:
Trainees of the VA sponsored educational program, and the VA-employed faculty members who
accompany them on their VA duty time, when at the non-VA health care facility or agency will have personal
liability protection provided by the provisions of the Federal Employees Liability Reform and Tort Compensation
Act, 28 U.S.C. 2679 (b)-(d) if all the following apply:
(1) the trainees and faculty members are providing professional services covered by this agreement;
(2) the non-VA facility is not providing them with compensation for these professional services; and
(3) the non-VA facility has declined to provide them with coverage under its insurance.
Faculty members and trainees of the VA sponsored educational program, when at the non-VA health care
facility or agency, and furnishing professional services covered by this agreement, will have personal liability
protection provided by the non-VA health care facility or agency.
VA FORM 10-0094e
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