(a) A hospital with a designated SAFE Program shall enter into a provider agreement with the department. Such agreement shall address at least the following:

1. (1) A description of the proposed SAFE Program model that is acceptable to the department, including adequate availability of appropriately trained and certified SAFE examiners.

2. (2) Participation by the program in an interdisciplinary/community task force, including:

   1. (i) hospital administration and emergency service representatives;
   2. (ii) the local rape crisis center;
   3. (iii) law enforcement entities; and
   4. (iv) a representative of the district attorney's office of the county or city in which the hospital is located, including the special sex crimes unit, where available.
3. (3) The program's organization, including administrative and clinical oversight, designed to provide care to survivors that is consistent with generally accepted standards of care.
4. (4) A listing of facilities/equipment required of the program, including a private, designated room for the performance of exams, access to a shower and access for individuals with disabilities.
5. (5) A listing of data required to be maintained by the program and provided to the department on a quarterly and/or annual basis.
6. (6) Other such terms and conditions that may be required by the department to ensure that the program will comply with relevant statutes, regulations, generally accepted standards of care and the goals of the SAFE Programs.