Affiliation Agreements 2017-06-28T17:01:35+00:00

Affiliation Agreements & Program Letters of Agreement (PLA)

An Affiliation Agreement is a contract between Los Angeles County and an outside institution. A Program Letter of Agreement is the educational curriculum agreement between a department at Harbor and a department at an outside institution.

Affiliation Agreement and PLA must be in place before a Harbor resident can rotate to an outside institution and/or before an outside resident can rotate at Harbor for a rotation.

Affiliation Agreement

Affiliation Agreements should be completed with the support of the Graduate Medical Education Office. First contact should be made by the Harbor department to initiate the process via MedHub. Institutions must provide the Affiliation Agreement Application to department.

Affiliation Agreement Template

Payment Exemption Amendment to the Affiliation Agreement

As written, the Affiliation Agreement requires institutions accepting our residents as rotators to pay Los Angeles County a certain dollar amount. The Payment Exemption Amendment to the Affiliation Agreement does away with the billing and payment section of the agreement. Therefore, institutions willing to sign the Affiliation Agreement but refusing to pay will need to request payment exemption. Below please find the County’s Payment Exemption Policy and the Request for Payment Exemption form. Harbor departments wishing to affiliate with other institutions that are requesting payment exemption should complete the Request for Payment Exemption form and submit it to the Graduate Medical Education Office.

Payment Exemption Policy
Payment Exemption Request Form
Payment Exemption Amendment

Program Letters of Agreement – for Harbor residents rotating to outside (Affiliate) institution

Each department can complete Program Letters of Agreements by using the template below. All departmental signatures must be in place before submission to the GME Office. Once all Harbor signatures are in place the PLA will be returned to the department to mail to the Affiliate department for signatures. Once all signatures are obtained from Harbor and the Affiliate, a copy of the PLA must be sent to the GME Office.

Program Letter of Agreement Template

Program Letters of Agreement – for outside residents rotating to Harbor

The sending institution should complete a PLA using their institution’s template. The sending institution must sign their PLA before sending it to the Harbor Department they wish to form an agreement with. The Harbor department should sign the PLA and then submit to the GME Office for the Designated Institution Official and Hospital CEO’s signature. The GME office will keep a copy of the PLA and return the original to the requesting Harbor department.

NOTE: Housestaff will not be provided information regarding affiliation or PLA process.

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