2015 HCAM & MCAL Associate Partnership Program

Partnerships to Promote Quality Care in LTC

Associate Partnership PhilosophyThe Health Care Association of Michigan (HCAM) and the Michigan Center for Assisted Living (MCAL) is the leading professional association representing skilled nursing & rehabilitation centers and assisted living communities in the state. It is our mission to promote excellence in senior care by providing support, information and advocacy on behalf of the members we represent. We strive to be the most respected and influential voice on behalf of the profession.

Partnerships to Promote Quality Care in LTC

The Associate Partnership Program provides all vendors who share a genuine interest in furthering the quality of the profession the opportunity for a beneficial partnership. Associate Partners are dedicated to the success of the long-term care profession and are proud to support or provide programs, services and products that advance the profession and the association’s mission of promoting excellence.

By partnering with HCAM & MCAL, your organization will gain exposure, strengthen your market position and build powerful alliances with industry leaders.

Associate Partnership AgreementTo become an elite HCAM and MCAL associate partner, please thoroughly review the included associate partner benefits by tier, the associate partnership program benefit provisions and submit a completed Associate Partnership Agreement with payment to HCAM by one of three convenient methods:

Postal Service: Health Care Association of Michigan (HCAM) Attn: Lea Osborne 7413 Westshire Dr. Lansing, MI 48917

Fax: Attn: Lea Osborne (517) 627-3016

Email: LeaOsborne@hcam.org

Should you have questions or wish to discuss partnership further, please contact Lea Osborne or the association offices at (517) 627-1561.

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Associate Partnership ProgramBENEFIT PROVISIONS

I. The HCAM/MCAL Associate Partnership Program is available to companies/organizations that provide products and/or services to the long-term care and/or assisted living profession OR who partner directly with the long-term care and/or assisted living profession. a. HCAM/MCAL Associate Partnership Program excludes skilled nursing facilities and/or assisted living centers/communities and corporate facility/center/community management.II. HCAM/MCAL Associate Partnership is based on a company/organization NOT an individual unless agreed upon in writing by HCAM/MCAL.III. To receive benefits, your associate partnership dues/payment status must be in “good standing” with the association. This includes partnership dues, registrations, sponsorships, etc. Unpaid dues that are outstanding for more than 90 days will result in suspended benefits/partnership until payment is made current.IV. All associate partnership dues are nonrefundable. V. All associate partnership dues are based on the calendar year. a. Professional tier dues payment is required in full upon submission of the Associate Partnership Agreement & may not be pro-rated. b. Principal, Premier and Patron tier dues may be billed quarterly if commitment by way of the Associate Partnership Agreement is made prior to July 1st. On or after July 1st, payment for the remaining 2 quarters must be paid in full & benefit inclusions may be pro-rated depending on time of commitment.VI. All associate partnership benefits are nontransferable unless specified in writing by HCAM/MCAL. VII. All non-utilized benefits do not have cash or credit value.VIII. Principal, Premier and Patron tier associate partnership will automatically be renewed at the current tier each year unless HCAM/MCAL is contacted in writing stating otherwise (if applicable). a. Written notification will be sent by email and standard mail in December of each year informing associate partners of this automatic renewal policy for the upcoming new calendar year. b. Current associate partners will have until January 30 of the new calendar year to inform HCAM/MCAL in writing that they do not wish to automatically renew their partnership. IX. Professional tier associate partnership will NOT be automatically renewed by the association. Professional tier associate partnership must be renewed with HCAM/MCAL by January 30 of each year.

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Associate Partnership ProgramMEMBERSHIP BENEFITS & COST PER CALENDAR YEAR

2015

Mem

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2015 Membership Benefits by Tier

Principal Tier

$12,500

ProfessionalTier

$1,000

PremierTier

$5,000Patron

Tier

$2,500

Quarterly payment option available.

Associate Partnership ProgramINCLUDED BENEFITS FOR ALL TIERS• Exclusive member web site access & electronic association publications• Listing on website Annual Member Directory• Listing in hard copy Annual Member Directory• Hard copy of Annual Member Directory• Hard copy of Legislative Directory• Discounted member registration rates for all educational events & Annual Convention Expo Show• Priority consideration for educational presentation proposals• Opportunity to participate in regional meetings & networking events• Opportunity to secure exclusive sponsorship opportunities for board of directors, educational and networking events • Opportunity to partner by way of educational presentations, networking, sponsoships and expo with the Michigan

Chapter NADONA/LTC as HCAM is the exclusive event manager for the Michigan Chapter NADONA/LTC

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PrincipalTier|$12,500 PRINCIPAL Tier Exclusive BenefitsEducation & Networking• 2 full package registrations to the Spring Leadership Conference• 1 complimentary registration to the Happy Hour at the Spring

Leadership Conference • Opportunity to purchase additional registrations to the Spring

Leadership Conference • (20) Drink tickets at the Annual Convention & Expo• 1 booth of your choice at the Annual Convention & Expo• 1 team/4 people at the Annual Golf Outing• 4 full package registrations to the Annual Convention & Expo• 1 full package registration to the U.P. Education Conference Executive Priviledges• New! 1 lunch meeting 1x per year at Bordeaux in Lansing,

MI with HCAM/MCAL executive staff, 2 HCAM/MCAL board members & HCAM/MCAL director of education & partnerships

• Opportunity to serve on HCAM and/or MCAL committees• Opportunity for nomination to serve on HCAM and/or MCAL board

of directors • On-demand electronic attendee list for any educational program• New! On-demand electronic facility member spreadsheet in

Excel format • Communication to all members introducing company as a

Principal Tier Associate Partner• 1st opportunity to secure event sponsorships• 1st opportunity to secure expo booth • 1st opportunity to secure board of directors event sponsorships• New! Priority consideration of educational presentation proposals

Marketing & Advertising• Recognition as an event sponsor at the Annual Golf Outing• Company logo with hyperlink on association website• Biweekly, company recognition in the HCAM newsletter with

hyperlink to company website• New! Association will provide a 1-page piece of marketing

material of your choice to each attendee at all association educational events (3,000 copies due by Feb. 1, 2015)

• New! Association will provide 1-piece of “swag” of your choice to each attendee at all association educational events (3,000 pieces due by Feb. 1, 2015)

• 1 page black & white company ad in Annual Directory• Company listing in Annual Directory• 1 page color ad in the Annual Convention & Expo brochure • 1 page black & white ad in the Annual Convention & Expo

program book• 1 page color ad in the Spring Leadership Conference brochure • 1 page black & white ad in the Spring Leadership Conference

program book• 1 page color ad in the U.P. Education Conference brochure

(electronic)• 1 page black & white ad the U.P. Education Conference brochure

program bookAccounts Payable• Auto renewal option• Quarterly Payment for partnership dues

Associate Partnership ProgramINCLUDED BENEFITS FOR ALL TIERS• Exclusive member web site access & electronic association publications• Listing on website Annual Member Directory• Listing in hard copy Annual Member Directory• Hard copy of Annual Member Directory• Hard copy of Legislative Directory• Discounted member registration rates for all educational events & Annual Convention Expo Show• Priority consideration for educational presentation proposals• Opportunity to participate in regional meetings & networking events• Opportunity to secure exclusive sponsorship opportunities for board of directors, educational and networking events • Opportunity to partner by way of educational presentations, networking, sponsorships and expo with the Michigan

Chapter NADONA/LTC as HCAM is the exclusive event manager for the Michigan Chapter NADONA/LTC

PremierTier|$5,000 PREMIER Tier Exclusive Benefits

Education & Networking• 2 full package registrations to the Spring Leadership Conference• Opportunity to purchase additional registrations to the Spring

Leadership Conference • (15) Drink tickets at the Annual Convention & Expo• 1 booth of your choice at the Annual Convention & Expo• 2 people at the Annual Golf Outing• 2 full package registrations to the Annual Convention & Expo• 1 full package registration to the U.P. Education ConferenceExecutive Priviledges • Opportunity to serve on HCAM and/or MCAL committees• Opportunity for nomination to serve on HCAM and/or MCAL board

of directors • New! On-demand electronic facility member spreadsheet in

Excel format • On-demand electronic attendee list for any educational program• 2nd opportunity to secure event sponsorships• 2nd opportunity to secure expo booth • 2nd opportunity to secure board of directors event sponsorships• New! Priority consideration of educational presentation proposals

Marketing & Advertising • New! Association will provide a 1-page piece of marketing

material of your choice in the resouce center stands at all association educational events (2,000 copies due by Feb. 1, 2015)

• Recognition at the Annual Golf Outing as a hole sponsor• Half page black & white company ad in Annual Directory• Company listing in Annual Directory• Half page color ad in the Annual Convention & Expo brochure • Half page black & white ad in the Annual Convention & Expo

program book• Half page color ad in the Spring Leadership Conference brochure • Half page black & white ad in the Spring Leadership Conference

program book• Half page color ad in the U.P. Education Conference brochure

(electronic)• Half page black & white ad in the U.P. Education Conference

brochure program bookAccounts Payable • Auto renewal option• Quarterly Payment for partnership dues

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Partnerships to PromoteQuality Care in LTC

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PatronTier|$2,500

PATRON Tier Exclusive Benefits

Education & Networking

• (10) Drink tickets at the Annual Convention & Expo• 1 booth of your choice at the Annual Convention & Expo• 1 full package registration to the Annual Convention & Expo• 1 complimentary registration to Spring Leadership Happy

Hour OnlyExecutive Priviledges

• Opportunity to serve on HCAM and/or MCAL committees• Opportunity for nomination to serve on HCAM and/or MCAL

board of directors • New! 1x per year electronic facility member spreadsheet in

Excel format • 3rd opportunity to secure event sponsorships• 3rd opportunity to secure expo booth • 3rd opportunity to secure board of directors event

sponsorships• New! Priority consideration of educational presentation

proposals

Marketing & Advertising

• Company logo in the Annual Convention & Expo brochure • Company logo in the Annual Convention & Expo program

book• Quarter page black & white company ad in Annual Directory• Company listing in Annual Directory• Company logo in the Spring Leadership Conference

brochure • Company logo in the Spring Leadership Conference

program book• Company logo in the U.P. Education Conference brochure

(electronic)• Company logo the U.P. Education Conference brochure

program bookAccounts Payable

• Auto renewal option• Quarterly Payment for partnership dues

ProfessionalTier|$1,000 PROFESSIONAL Tier Exclusive Benefits

Executive Priviledges

• 4th opportunity to secure event sponsorships• 4th opportunity to secure expo booth • 4th opportunity to secure board of directors event sponsorships

Marketing & Advertising

• Company name in the Annual Convention & Expo brochure • Company name in the Annual Convention & Expo program book• Company listing in Annual Directory

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2015 HCAM & MCAL Associate Partnership Program

Associate Partnership Agreement

Associate Partnership Tier (select one)

________ Principal Tier ($12,500 per calendar year)

________ Premier Tier ($5,000 per calendar year)

________ Patron Tier ($2,500 per calendar year)

________ Professional Tier ($1,000 per calendar year)

Company InformationCompany Name:_____________________________________________________________________________________________________Mailing Address:_____________________________________________________________________________________________________City, State & Zip:_____________________________________________________________________________________________________County:________________________________ Phone:_________________________________ Fax: ________________________________Company Web Site:__________________________________________________________________________________________________Company Category (select the most applicable general category summarizing your company’s product/services):

___ Consultant ___ Home Health/Hospice ___ Pharmaceutical ___ Vision Services

___ Design/Building/Remodel ___ Housekeeping/Laundry/Linens ___ Physicians Services ___ Wound Care

___ Education/Training ___ Insurance/Risk Management ___ Portable Diagnostic Services ___ Other:

If other, please include 1-2 word company category description below:

________________________________

________________________________

___ Employment /Recruitment ___ Legal Services ___ Rehabilitation/Therapy

___ Environmental Supplies & Services ___ Marketing ___ Safety

___ Finance ___ Medical Supplies & Equipment ___ Security/Monitoring/Nurse Call

___ Food & Beverage/Service ___ Behavioral/Mental Health Care ___ Technology/Software

___ Furniture/Furnishings ___ Nutrition/Wellness ___ Transportation

___ Group Purchasing ___ Oral Health ___ Uniforms/Footwear

Credit Card Authorization ______ I authorize payment in full for my dues to be charged to the credit card listed below.______ I authorize my quarterly dues to be automatically charged to the credit card listed below.

Method of Payment______ Check made payable to “HCAM” ______ Visa ______ MasterCard ______ American Express ______ DiscoverCredit Card Number:________________________________________________________ Expiration Date:___________________________Three-digit security code on back of card:_______________________________________ Billing Zip Code for Card:____________________Cardholder’s Name (print):____________________________________________________________________________________________Cardholder’s Signature:______________________________________________________ Date:___________________________________

Associate Partnership Payment Preference (select one)

________ I have included payment for my annual dues in full for the associate partnership tier indicated above.

(Principal Tier: $12,500/Premier Tier: $5,000/Patron Tier: $2,500/Professional Tier: $1,000)

--Principal, Premier & Patron Tiers Only--

________ I have included my first quarterly dues payment at this time and would like to pay my remaining balance in quarterly payments for the associate partnership tier indicated above for agreements submitted prior to July 1. (Principal Tier: $3,125 per quarter/Premier Tier: $1,250 per quarter/Patron Tier: $625 per quarter) For agreements submitted after July 1, two quarters dues payment in full is required & benefits may be pro-rated.

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Signature of Approval

By signing below, I am acknowledging that I have reviewed and accept the benefits for the associate partnership tier that I have selected which are included with my 2015 HCAM & MCAL Associate Partnership.

By signing below, I am acknowledging that I have reviewed and accept the 2015 HCAM & MCAL Associate Partnership Benefit Provisions.

By signing below, I am acknowledging that I have reviewed and accept that my Principal, Premier or Patron tier associate partnership will be renewed automatically by HCAM/MCAL each calendar year and that I am responsible for payment until I contact HCAM/MCAL in writing to cancel and/or change my tier of partnership.

By signing below, I am acknowledging that I have reviewed and accept that my Professional tier associate partnership will NOT be renewed automatically by HCAM/MCAL each calendar year and that I am aware that I will need to renew my Professional tier partnership by January 30 of the new year (if applicable).

By signing below, I am stating that I am an authorized representative on behalf of my company with decision-making authority to sign this HCAM/MCAL Associate Partnership Program Agreement as this contract is a legally binding agreement between HCAM/MCAL and the company I represent.

_____________________________________________________________________

Signature of Authorized Representative

_____________________________________________________________________

Printed Name of Authorized Representative

_____________________________________________________________________

Title of Authorized Representative

____________________________Date

Company Billing Information (if different than Company & Company Representative Information)Please send all invoices/billing information to the attention of:Billing Personnel’s Name:_____________________________________________________________________________________________Billing Personnel’s Title:______________________________________________________________________________________________Billing Mailing Address:_______________________________________________________________________________________________City, State & Zip:_____________________________________________________________________________________________________Billing Personnel/Department Phone:_______________________________________ Fax: _________________________________________Billing Personnel’s Email Address:_______________________________________________________________________________________

Submit your completed HCAM & MCAL Associate Partnership

Agreement with payment to:

HCAM7413 Westshire Dr.Lansing, MI 48917

Or fax to (517) 627-3016

Company Representative Point of ContactAll correspondence from HCAM & MCAL will be sent directly to the attention of the indicated point of contact.Should you like to change the point of contact at any time, please notify HCAM in writing.

Contact Name:_____________________________________________________________________________________________________Title:_____________________________________________________________________________________________________________Phone (if different than above):_________________________________________ Cell Phone:_____________________________________Email Address:______________________________________________________________________________________________________Additional Email Addresses (secretary, administrative assistant, colleague, etc.) :_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Name of Direct Supervisor (if applicable):________________________________________________________________________________

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7413 Westshire Drive, Lansing, MI 48917 Phone (517) 627-1561 | Fax (517) 627-3016 | www.HCAM.org | www.MichCal.com

2015 HCAM & MCAL Associate Partnership Program

Partnerships to Promote Quality Care in LTC