Agreements (PLAs & AIPAs)

Affiliation agreements protect the program's residents/fellows by ensuring an appropriate educational experience under adequate supervision.

This brief Affiliation Agreements presentation provides a high-level introduction to agreements.  The Institution and Program Level Agreement Overview provides a synopsis grid of all GME agreement types.

All programs (accredited and non-accredited) must maintain current agreements for all required rotations, and for elective rotations as outlined in the Affiliation Agreements Policy.  These agreements take one of three forms:

  • Program Letters of Agreement (PLA) attached to Master Affiliation Agreements (MAA): The University maintains Master Affiliation Agreements (MAA) with a number of major health systems.  Each MAA is an agreement between the University and the affiliate system, and includes a template for Program Letters of Agreement (PLA).  Each PLA is an agreement between an individual UMN program and an affiliate site location, documenting the terms both have agreed to for the educational experience(s) the program’s trainee(s) will have when rotating to the site.
  • Stand-Alone Program Letters of Agreement (PLA): When there is no Master Affiliation Agreement (MAA) between the University and affiliate health system, and the rotation is within the United States and does not have a financial component, the program executes a stand-alone PLA.
  • Agreements of Institution and Program Affiliation (AIPA): When there is no Master Affiliation Agreement (MAA) between the University and affiliate health system, and the rotation is outside of the United States or has a financial component, the program executes an Agreement of Institution and Program Affiliation (AIPA), which may also be referred to as an affiliation agreement.  Each AIPA is unique, and requires approval by the Dean of the Medical School and the Academic Health Center (AHC) Legal Office prior to the start of a rotation.  Because AIPAs are official legally-binding contracts, they must be critically examined by programs prior to their submission to GME for execution.

Internal sites: For sites internal to the sponsoring institution, the GME office recommends but does not require an agreement.  The site may have stricter requirements; it is the program's responsibility to verify this with the site when they are planning for the rotation.  The Stand-Alone PLA document is appropriate to document these experiences; the program may also use the site's preferred document.  Note UMPhysicians, Fairview Health Services, and M Health are separate entities from the sponsoring institution (University of Minnesota).  For rotations at UMP and Fairview sites, programs must execute the affiliate-specific PLA.

Affiliation Agreement Points of Contact

Each department has one or several designated affiliation agreement points of contact.  At UMN, affiliation agreements capture both legal and education-related information.  Because processing these agreements can be complex, the GME office works with a small number of people in each department who are experts on both central GME processes and department-specific processes.

For more information on the POC role, refer to the Affiliation Agreements Department Point of Contact (POC) Responsibilities document.

For an outline of responsibilities at the Department/Program, GME Office, and AHC Legal levels, refer to the Affiliation Agreements Responsibility Grid.

For assistance in determining which agreement type to request, refer to the Affiliation Agreements Decision Tree.


 

Entering into an agreement

Agreement of Institutional and Program Affiliation (AIPA)

Use this agreement type when there is no Master Affiliation Agreement (MAA) between the University and the affiliate, and the rotation is outside of the U.S. or has a financial component.  Work with your department point of contact (POC) for your AIPA request; each department has unique internal processes.

AIPA Request Form

AIPA Expiration date: 5 years from start date.

Process for developing and executing an AIPA

Process for developing a Financial Addendum to an AIPA

To share the AIPA language with an affiliate prior to requesting a program- and affiliate-specific draft from the GME office:
Access the latest AIPA Template (OGC-SC-201A) in the Contracts Library

 

Program Letter of Agreement (PLA)

Work with your department point of contact (POC) for your PLA request; each department has unique internal processes.

Use the Affiliation Agreements Decision Tree to determine whether or not you need an agreement, then which agreement type you need.  Then, use the appropriate form for your request:

Stand-Alone PLA Template

PLA Request Form: All major affiliates except HealthPartners

PLA Request Form: HealthPartners only

PLA Request Form: Other Health System from AHC Database

 

Memorandum of Understanding (MOU)

Note: The MOU Template has been retired.  For assignments at sites internal to the sponsoring institution (e.g. Boynton and CUHCC), the GME office recommends using the Stand-Alone PLA Template.

Modify as appropriate to document responsibilities and expectations related to the rotation.  The program obtains signatures and uploads the agreement to the Program Agreements module in RMS.

Note: UMPhysicians and Fairview Health Services are separate entities from the sponsoring institution (University of Minnesota).  For rotations at UMP and Fairview sites, programs must execute a PLA.


 

Updating an agreement

Updating an AIPA

AIPA Update Template

Use the AIPA Update template to document changes to an existing AIPA. Changes include a new program director or site supervisor, updating an affiliate’s legal business name, and/or major changes to the faculty supervisors, goals and objectives, and/or rotation periods documented in Attachments A-C.

Note AIPA amendments are extremely rare and must be facilitated via AHC Legal. If you have questions about whether or not your change warrants an AIPA amendment (vs an AIPA update), please contact gme@umn.edu prior to moving forward. If an amendment is required and requested by the affiliate’s legal office, notify the GME office.  We will liaise with AHC Legal and assist you with next steps.

GME will not accept any form/document that has reference to Amendment to, OGC, AHC Legal, Regents of the University of Minnesota that has not been generated directly by the AHC Legal office. Amending an AIPA without AHC Legal's involvement makes any change null and void (see Section 6.4 of AIPA template OCG-SC201a).

To use the update template, create/download a copy, complete the relevant information, and delete any sections that are not applicable. Submit the AIPA update by email to gme@umn.edu.

  1. In the subject line, please refer to the 4-digit number of the original AIPA.
  2. Create a separate update form for each AIPA, although all forms for the same change may be emailed together (i.e. three forms for three different affiliates, all with the same Program Director change, can be sent in one email).
  3. Please use the following naming convention when sending your files:
    1. #### - AIPA Update # - Program Name - Affiliate Name - Original AIPA dates
    2. Example: 4567 - AIPA Update 1 - Movement Disorders - Minnesota Head and Neck Pain Clinic, P.A. - 7.1.2014-6.30.2019
      1. If you cannot save the file name with commas, please omit them.

Once the AIPA update is received and reviewed for accuracy by GME, the Accreditation Specialist will:

  1. Upload the update(s) to RMS in the Agreements module;
  2. Email the program the complete update document(s).

Finally, the Accreditation Specialist will advise the program to:

  1. Notify their program-specific affiliate contacts (site supervisor, relevant faculty supervisors, site coordinator, etc) of the update(s);
  2. Email the affiliate an attachment of the completed update document(s).

Updating a PLA

PLA Update Template

Use the PLA Update template to document changes to an existing PLA.  Changes include a new program director or site supervisor, and/or major changes to the goals and objectives, faculty supervisors, and/or rotation periods documented in Attachments A-C.

To use the template, create/download a copy, complete the relevant information, and delete any sections that are not applicable.  After obtaining the current (new) program director's signature, submit the PLA update to the GME office by email to gme@umn.edu.  The GME office will then finalize the PLA update, upload a copy to RMS, and notify the program and lead affiliate administration.  The program is responsible for notifying their program-specific affiliate contacts (site supervisor, relevant faculty supervisors, site coordinator, etc) of the updates.


 

Best Practices

Site Director Appointment Letter

Each affiliate agreement specifies an overall site supervisor as well as a list of faculty supervisors at the site.  These individuals are responsible for teaching, supervising, and evaluating residents/fellows when they are assigned to the site.  It's very important for the UMN department/program to establish and maintain close relationships with faculty supervisors at each site, to ensure all parties understand their responsibilities, and the goals and objectives for the trainees during their rotation(s) to the site.

A signed site director appointment letter is an effective tool for documenting program-specific expectations of each site director.  This type of letter may vary between sites and/or supervisors within a single program/department.

Sample Site Director Appointment Letter (Surgery Residency Program)