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HomeMy WebLinkAbout8.3 FirstResponder ALSAGENDA STATEMENT CITY CLERK File# 0600-40 CITY COUNCIL MEETING DATE: February 15, 2000 SUBJECT: ATTACH3~NTS: RECOMMENDATION: First Responder Advanced Life Support (FRALS) Agreement with the County of Alameda Report_Prepared by: Christopher Z. Foss, Economic Development Director 1. Draft First Responder Advanced Life Support Agreement It is staff, s recommendation that the City Council authorize the Mayor'to execute the First Responder Advanced Life Support (FRALS) Agreement with the County of Alameda FINANCIAL STATEMENT: The City of Dublin will receive, net expenses, approximately $65,000 per year over the four-year life of the agreement. DESCRIPTION: The First Responder'Advanced Life Support Agreement with the County of Alameda rePresents a service entrancement to the citizens of Dublin and a new revenue source to the City of Dublin. BACKGROUND: ~ ' 'The County 'of Alameda is designated, by California Health and Safety Code DiviSi°n 2.5, Section 1797.94, as the' responsible agency for establishing policies and procedures for the approval and designation of paramedic service providers within its jurisdictions, including'the City of Dublin. TheCounty of Alameda established an Emergency Medical District and has entered into contracts with public and private providers to assure that emergency medical services are available wlthin the jurisdictions. The City of Dublin is provided fire protection services through a Fire Protection and Emergency Medical Services agreement with the Alameda County Fire District (ACFD), also known as the Alameda County Fire Department[ The contract calls for ACFD to provide, in 'addition to basic fire suppression and prevention, emergency first aid, Basic Life Support (BLS), and Advanced Life Support (ALS)-Paramedic services onits First ResPonder units to enhance the emergency medical services provided to the residents as well as to allow the private ambulahce provider: with the ability to meet certain response time requirements. The City of Dublin currently provides for a paramedic on each of the department's three units (2 Engine companies and 1 TrUck company)and thus has three (3) First Responder Advanced Life Support unitS~ lt/cc-forms/agdastmt.doc COPIES TO: ITEM NO. The County of Alameda, on November 16, 1999, approved a new ambulance contract with American Medical Response (AMR) to provide ambulance transport services to' the Alameda County areas they currently serve. The contract was designed to increase AlvfR's accountability for meeting specified emergency response times and instituted higher penalties for not meeting stated response times, reconfigured ambulance staffing to include 1 paramedic and 1 Emergency Medical Technician, and~/ provided reimbursement for fire-department based first responder paramedic service. These changes are a product of the recommendations of the Alameda County Emergency Medical Services (EMS) Task Force. The specifics of the proposed First Responder agreement between the City of Dublin (contractor) and the County of Alameda include: Term: The agreement shall be in effect until January 30, 2004 unless terminated early. Response Times: The City, through its agent - Alameda County Fire Department, shall place a- First Responder Advanced Life Support (FRALS) units on scene at a Code 3 medical assistance call within ten (10) minutes not less than ninety percent (90%) of the time within any month. There are certain exceptions allowed in the calculation of meeting the response criteria that must be filed for every event and will be maintained in a quarterly report. The contract also includes certain financial performance penalties for non-attainment of the Code 3 response standards. As an example, for each calendar month in which the contractor has met less than 90% of the response time standards, the County shall assess the following penalties: Ist occulTence: 2nd occurrence: 3~l occurrence: Letter of Deficiency $1,00Otimes the number of FRALS (3) under contract $2,500 times the number of FRALS (3) under contract, or a major breach of contract If there are any penalties imposed for lack of performance, the City of Dublin would be financially responsible for such fmancial penalties. City Reimbursement: The agreement calls for the City of Dublin to be compensated for the provision of these additional services; The City will receive $90,000 per year ( 3 First Responder Advanced Life Support (FRALS) unit x $30,000 per unit). The reimbursement rate will increase 5% per year over the life of the contract. City Costs: In order to meet the conditions of the contract, the City, through its contract with ACFD, will be required to provide new training and certifications for the involved employees. It will require that employees have Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Pre Hospital Trauma Life Support (PHTLS). A prerequisite for ACLS is the attainment of CPR Provider Certification, which is an upgrade from the current requirement of CPR Training only. The contractor will 'also be mandated to evaluate company level professional skills and paramedic performan6e. Both the new certifications and evaluations will require an additional commitment of staff time and will resUlt in additional expenses. ACFD has estimated that the additional costs (overtime, fees, books, and administration) will be approximately $24,500 for the first 2 years of the contract and approximately $14,560 for the last two years. The final two year costs will be lower due to the lower costs of recertification. .The adoption of the FRALS agreement creates certain discrepancies with the City's existing fire protection agreement. Staff is working on a Letter of Understanding (L.O.U.) with the Alameda County Fire Department to clarify the discrepancies that will be considered at the March 7, 2000 Council meeting. Anahysis: The proposed agreement provides a higher level of emergency services for the residents of Dublin, and provides a funding source to compensate for the additional training necessary to upgrade the service. The agreement will re'nnburse the City of Dublin for providing first responder units, and will be a further enhancement to the emergency medical service within the City of Dublin. The reimbursement, calculated at $90,000 per year, will more than offset the additional costs involved in upgrading the certifications of the City¥ paramedics. Recommendation: It is staff's recommendation that the City 'Council authorize the Mayor to execute the First Responder Advanced Life Support (FRALS) Agreement between the City of Dublin and the County of Alameda. ALS FIRST RESPONDER SERVICES AGREEMENT BETWEEN COUNTY OF ALAMEDA AND CITY OF DUBLIN Section 1. INTRODUCTION 1.1 1.2 1.3 1.3.1 1.4.1 1.4.2 The COUNTY is designated as the local EMS Agency (LEMSA) as defined in the California Health and Safety Code Division 2.5, Section 1797.94responsible for establishing policies and procedures for the approval and designation of paramedic service providers within its jurisdiction. The COUNTY relies on the municipalities to provide the first paramedic on scene in most cases. The COUNTY has established an Emergency Medical Service Distdct (EM-1983-1) and has entered into agreements with various EMS providers, both public and private, to assure the availability of emergency paramedic service within the territory of the District. The CONTRACTOR(S) are willing to provide first response to requests for emergency medical assistance in Alameda County, to render emergency first aid, Basic Life Support (BLS), and Advanced Life Support (ALS) (Paramedic) services on its First Responder Units as a cost effective mechanism to enhance emergency medical services to their residents and to enable the pdvate ambulance provider to meet response time requirements. The CONTRACTORS include the agencies/cities listed below: Alameda County Fire Department 1 t FRALS Units Dublin 3 FPALS Units Emeryville 2 FRALS Units Fremont 13 FRALS Units Hayward 11 FRALS Units Liverrnore 5 FRALS Units Newark 4 FRALS Units Oakland 33 FRALS Units Pleasanton 5 FRALS Units San Leandro 7 FRALS Units Union City 3 FRALS Units The number of FRALS units listed will not change during the life of this contract unless it is determined that the system would benefit from adding additional unit(s). Due to the adjustment that would be required in the Ambulance Transport agreement approved by the Board of Supervisors. it will be the sole determination of the Contract Administrator whether or not the additional FRALS unit(s) will be compensated; approval for additional units shall not be unreasonably withheld. The parties hereby execute this single agreement which will constitute formal Designation of ;Contractor as an authorized provider of ALS services within the Alameda County EMS system under Health & Safety Code Section 1797.178, a paramedic service provider agreement under Title 22 CCR Section 100168(b)(4), and a written agreement regarding the provision of prehospital emergency medical services under Health & Safety Code Section 1797.201. Neither CONTRACTOR nor COUNTY Waive any rights it may have pursuant to Section 1797.201. Attachment First Responder ALS Agreement Page 2 Rev. 02/09100 Section 2. TERM 2.1.1 This Agreement shall be in effect for a period commencing January 1, 2000, and continuing until June 30, 2004, unless terminated earlier in accordance with this Agreement. Section 3. DEFINITIONS For the purposes of this Agreement, the following words and phrases shall have the meanings respectively ascribed to them by this section. 3.1 Advanced Life Support (ALS) - Special services designed to provide definitive prehospital emergency medical care as defined in Health and Safety Code Section 1797.52, 3.2 ALCO-CMED - The facility designated by the COUNTY as the central communications Center from which EMS requests may be processed and routed to the CONTRACTOR. 3.3 Ambulance - Any motor vehicle equipped with facilities to convey infirm or injured persons in a reclining position and licensed as an ambulance by the California Highway Patrol. 3.4 Ambulance Unit- An ambulance staffed with qualified personnel and equipped with appropriate medical equipment and supplies. 3.5 Base Hospital Physician - A physician licensed to practice medicine in the State of California and approVed as a Base Hospital Physician by the Medical Director, and knowledgeable in the medical protocols, radio procedure and general operating policies of the County EMS system, and a person from whom paramedics may take medical direction by radio or other remote communications device. 3.6 Basic Life Support (BLS) - as defined in Health and Safety Code Section 1797.60. 3.7 3.8' 3.9 3.10 Computer-Aided Dispatch or CAD -Computer-Aided Dispatch system consisting of associated hardware and software to facilitate call taking, unit selection, resoume dispatch and deployment, event time stamping, creation and real time maintenance of incident database, and Management Information System. Contract Administrator - An agent of the COUNTY designated by the Director of the Alameda County Health Care Services Agency. Emergency - Any sudden or serious -illness or injury requiring immediate medical or psychiatric attention under cimumstances that a delay in providing such services may aggravate the medical condition or cause the loss of life. .: Emergency Medical Technician - I or EMT-I - Personnel as defined in the Health and Safety Code Section 1797.80. 3.11 First Responder - A fire department vehicle, police vehicle with personnel capable of providing necessary pre-hospital care. · First Responder ALS Agreement Page 3 Rev. 02/09/00 3.12 First Responder ALS Unit (FRALS) - A unit staffed and equipped with a minimum of one Califomia State licensed and Alameda County accredited paramedic capable of providing ALS at scenes of medical emergencies. 3.13 Life Threatening Emergency Response (Code 3) - Any emergency that is designated as life threatening in strict accordance with approved dispatch protocols. Code 3 will be counted as an emergency response. ' 3.14 Medical Direction - Direction given ALS personnel by a base hospital. 3.15 Medical Director- Person designated pursuant to Section 1979.204 of the Health and Safety Code to serve as administrative officer in carrying out the duties and powers of the Health Officer. 3.16 Medical Protocol - Any diagnosis-specific or problem-oriented written statement of Standard procedure, or algorithm, promulgated by the Medical Director as the normal standard of prehospital care for the given clinical condition. 3.17 Non-Life Threatening Response (Code 2) - Any response that is designated as non-life threatening at call reception by ALCO-CMED personnel or other PSAP authorized by Contract Administrator in stdct accordance with approved dispatch protocols. 3.18 Non-Emergency Response (Code 1) - Any request for service that falls outside the established protocols for emergency life ti'ireatening and emergency non-life threatening responses. Pre- scheduled transfers for response time purposes shall be considered non-emergency responses. Non-emergency calls may be of private or public origin. Code 1 will not be counted, as an emergency response. 3.19 3.20 On-Scene Time - The time a unit arrives at the location requested. Paramedic - Personnel as defined in the Health and Safety Code Section 1797.84. 3.21 Paramedic Unit- An ambulance unit staffed and equipped to provide Advanced Life Support at the scene of a medical emergency and during transport of a patient(s), and designated as a paramedic unit by the Medical Director. 3.22 Public Safety Answering Point (PSAP) - Public safety answering point where 9-1-1 calls are first received 3.23 Public Safety Officer - Any person designated as a public safety officer by the law of the State of California. 3.24 Physician - Any person duly licensed to practice medicine in the State of California. 3.25 Quality Assurance - The sum of all activities· undertaken to assure that prehospital emergency medical services maintain the standard of care established for those services, as defined by the County Medical Director 3.26 3.27 · Quality Improvement- The evaluation of prehospital emergency medical services to identify . where personnel performance or the system itself can be improved, the implementation of potential improvements, and their re-evaluation and refinement in a continuous cycle. While Quality Assurance traditionally focuses on the detection of defects, Quality Improvement strives to prevent them. Thus a Quality Improvement program must include, but not be limited to, Quality Assurance.. Response Time - The actual elapsed time between receipt of a call at a PSAP that a unit is needed and the on-scene time, consistent with section 5.1.1. Fi,st Responder ALS Agreement Page 4 Rev. 02~09/00 Section 4. PRIMARY SERVICE AREA CONTRACTOR, within the area designated herein as the "Primary Service Area," which includes the entire area within City of Dublin city limits, shall be responsible for dispatch and response for all requests for emergency medical services originating within the area. 5.1 5.2 Section 5. PERFORMANCE STANDARDS Response Times - CONTRACTOR'S response time on requests for emergency medical services originating from within the Primary Service Area shall meet the following performance standards: 5.1.1 (Code 3) - CONTRACTOR shall place a First Responder Advanced Life Support (FRALS) unit on-scene of each Code 3 medical assistance call within ten (10) minutes zero (0) seconds from time of receipt of call at primary Public Safety Answering Point (PSAP) on not less than ninety percent (90%) of the responses within any month. In the event that CONTRACTOR receives a Code 3 medical assistance call from a PSAP other than its own, the response time requirement shall be eight (8) minutes zero (0) seconds from the time CONTRACTOR is notified. 5.1.2 CONTRACTOR'S responding crew shall report on-scene time or staging location time to its dispatch center immediately upon arrival at the scene/staging location. 5.1.3 If a FRALS unit is reassigned en route from one call to another before arrival at the scene of the first call, the response-time clock shall not stop on the first call until the arrival of a FRALS unit at the scene of the first call. Exceptions - In COUNTY'S calculation of CONTRACTOR'S performance in regard to these standards, every medical emergency request originating from within CONTRACTOR'S Primary Service Area shall be included except as follows: 5.2.1 in case of a multiple-response incident (i.e., where more than one FRALS unit is sent to the same incident), only the response time of the first arriving FRALS unit shall be counted. 5.2.2 The response time requirements shall be suspended dudng any declared disaster in the County of Alameda, declared state of emergency within a local jurisdiction, or during a declared disaster in a neighboring jurisdiction which has requested assistance from the COUNTY and/0r jurisdiction within the County. 5.2.3 ~;ood cause for an exception as determined by the Contract Administrator may include, but is not limited to, substantially incorrect or inaccurate' dispatch information. The alleged grounds for exception must have been a substantial factor in producing a particular excess response time, and CONTRACTOR must have acted in good faith. 5.2,4 The response time requirement shall be suspended dudng the time pedod of mutual aid re-deployment that occurs due to multiple first alarms, or a greater alarm incident where mutual aid is required. Re-deployment is the time period from the time of the request of mutual aid to the arrival of mutual aid units within the jurisdiction. First Responder ALS Agreement Page 5 Rev. 02~09~00 5.2.4 Other circumstances require contractor to submit details in wdting to the Contract Administrator or his/her designee for consideration. 5.3 Exception Request Procedure - CONTRACTOR must file a response time exemption with quarterly report. Such requests must include all of the following information: 5.3.1 a detailed description of the circumstances causing the response delay 5.3.2 date and time of the occurrence 5.3.3 dispatch agency name 5.3.4 FRALS unit number 5.3.5 originating location of responding FRALS unit 5.4 Cooperation - CONTRACTOR'S FRALS personnel shall cooperate fully with transporting ambulance personnel to facilitate the timely and effective transfer of patient care at the scene; according to Alameda County EMS policy. 5.5 FRALS Units - CONTRACTOR agrees that to qualify a response unit as a FRALS Unit in order to receive revenue under the terms of this agreement the unit must be staffed 24 hrs/day, 7 days/week. the 6.1 6.2 6.3 6.4 Section 6. ADDITIONAL SERVICE PROVISION CONTRACTOR to the best of its ability shall respond to any medical disaster, declared or undeclared, within Alameda County or adjacent counties when directed by the Alameda County Fire Mutual Aid Coordinator. CONTRACTOR ag tees that the performance of work and services pursuant tothis Agreement shall conform to high professional standards and shall comply with all applicable provisions of the Alameda County EMS Policy Manual. CONTRACTOR shall provide a representative, available to respond at all times within CONTRACTOR'S Primary Service Area, and authorized to act on behalf of CONTRACTOR in all operational matters. CONTRACTOR shall have an EMS coordinator who holds a valid State of Califomia paramedic license or equivalent as determined by the local EMS agency. 7.1 Section 7. QUALITY IMPROVEMENT CONTRACTOR shall either have on staff or contract with a Quality Improvement coordinator wh-o holds either a valid State of California Registered Nurse (RN) license or a valid State of Califomia Medical Doctor (MD) license. This Quality Improvement coordinator is responsible for evaluating on an ongoing basis CONTRACTOR'S Medical Quality Assurance Program for COUNTY-contracted services. First Responder ALS Agreement Page 6 Rev. 02/09100 7.2 CONTRACTOR agrees to participate in the creation of a comprehensive Emergency Medical System Quality Improvement program. 7.3 CONTRACTOR shall follow all Alameda County EMS Policies regarding Quality Assurance and Quality Improvement, which have been provided to the contractor. 7.4 Under this Agreement, CONTRACTOR shall submit a written detailed Quality Improvement plan to the EMS Medical Director for approval. Section 8. MEDICAL DIRECTION The Medical Director shall provide medical direction to the Contractor's paramedics and EM'Fs on issues relating to patient care. The Medical Director shall provide guidance, on the operational components of the Contractor's delivery of pre-hospital care. Medical control is the responsibility of a qualified Medical Director and should be absolute with regard to clinical issues such as treatment protocols and patient care. The physician should have an advisory role on operational issues. Section 9. SERVICES PROVIDED BY THE COUNTY COUNTY has been designated as the local EMS agency for Alameda County under Health & Safety Code Section 1797.200. As such, COUNTY shall provide CONTRACTOR with services including, but not limited to, the following: 9.1 Incorporation of CONTRACTOR'S operations into the County EMs plan, including CONTRACTOR'S voluntary participation on relevant County EMS committees; 9.2 Incorporation of CONTRACTOR'S operations into the County ALS system; 9.3 Author'~.ation and monitoring of EMS training programs, base hospitals, and service providers; 9.4 Certification and/or accreditation of CONTRACTOR'S EMS personnel; 9.5 9.6 Provision of medical control, through its Medical Director. Medical control requirements include medical dispatch, patient destination policies, patient care guidelines, and quality assurance/ improvement; CONTRACTOR'S voluntary participation in COUNTY trial studies, if approved by the State EMS Authority (EMSA); 9.7 Incorporation of CONTRACTOR'S operations into the COUNTY trauma system; 9.8 System data collection and evaluation; 9.9 Disaster planning; and 9.10 Initial supply and replenishment of "Patient Care Report" (PCR) forms as described in Section 12.2 below: First Responder ALS Agreement Page 7 Rev. 02/09/00 .Section 10. EQUIPMENT 10.1 Vehicle Marking -FRALS vehicles used in providing Contract services shall bear the marking "Paramedic" on both sides. 10.2 General Equipment Required for Vehicles - Each FRALS unit shall carry emergency supplies and equipment as required by the Alameda County EMS Policy Manual. Vehicles, equipment, and supplies shall be maintained in a clean, Sanitary, and safe mechanical condition at all times. 10.2.1 Equipment and supply requirements may be changed with the approval of the Contract Administrator in accordance with best practices. Section 11. COOPERATION WITH EVOLVING EMS SYSTEM CONTRACTOR agrees to participate and assist in the development of system changes subject to negotiated costs, if any. COUNTY agrees to continue a consensus model of obtaining input from all participating Contractors prior to implementing change to system policies and procedures. Section 12. ACCESS TO RECORDS AND REPORTING REQUIREMENTS CONTRACTOR shall comply with the following reCord keeping and reporting requirements: 12.1 Performance Reports - Within fifteen (15) working days following the end of each quarter, the CONTRACTOR shall document and report to Contract Administrator in writing, using fractile response time method, each emergency call dispatched which did not meet the response time requirement and each failure to properly report on-scene time. The CONTRACTOR shall identify the causes of such failures of performance, and shall document efforts to eliminate these problems. 12.2 . Patient Report Forms - The CONTRACTOR shall utilize the COUNTY'S "Patient Care Report" (PCR) system for all assignments including patient contact and non-transport. This form will be · accurately completed and distributed according to established Alameda County EMS Policies and Procedures. The COUNTY will provide an initial supply of forms. COUNTY shall periodically replenish forms upon CONTRACTOR'S request. The form is subject to revision by the Contract Administrator at any time. 12.3 -' Business Records -COUNTY shall have reasonable access to CONTRACTOR'S financial data relating to the provision of First Responder Adva'nced Life Support operations. First Responder ALS Agreement Page 8 Rev. 02~09~00 12.4 Observation of Operations - COUNTY representatives may, with appropriate notification, directly observe CONTRACTOR'S medical dispatch center operations, and may ride to observe the operation of any of CONTRACTOR'S FRALS units. The COUNTY'S representatives shall conduct themselves in a professional and courteous manner, shall not interfere with CONTRACTOR'S employees in the performance of their duties, and shall at all times be respectful of CONTRACTOR'S employer/employee relationship. 12.5 LicensurelAccreditation - CONTRACTOR shall ensure that all of its employees are appropriately/licensed/accredited and shall retain a record of their certification/licensure. EMT-Is and paramedics shall comply with all training requirements as established by the State of California and all applicable provisions of the Alameda County EMS Policy Manual. 13.1 Section 13. ADDITIONAL CONSIDERATIONS Fee Schedules -The CONTRACTOR shall not bill patients or payors for supplies or medications that the pdvate ambulance provider restocks CONTRACTOR. Section 14. NON-COMPETITION The CONTRACTOR acknowledges the exclusive nature of COUNTY'S authority to operate and/or contract for emergency ambulance services within the Primary Service Area. During the term of this Agreement, neither the CONTRACTOR, officers, agents, key personnel, or employees shall compete with the COUNTY for the same emergency ambulance services contracted for in any other area of the COUNTY. Section 15. INSURANCE AND INDEMNIFICATION CONTRACTOR shall at all times during the term of the Ag reement maintain in force those insurance policies and bonds as designated in Exhibit C and will comply with all requirements thereof. CONTRACTOR agrees to defen d, to indemnify, to save and hold harmless the County of Alameda, its officers, employees, and agents from any and all acts, claims, omissions, liabilities, and losses by whomever asserted arising out of acts or omissions of CONTRACTOR in the performance of the scope of work except those arising by reason of the sole negligence of COUNTY, its officers, employees, or agents. The COUNTY agrees to defend, indemnify, and hold harmless CONTRACTOR, its officers, employees, and agents, from any and all acts, claims, omissions, liabilities, and losses by whomever asserted arising out of acts or omissions of COUNTY in the performance of the scope of work except those arising by reason of the sole negligence of CONTRACTOR, its officers, employees, or agents. First Responder ALS Agreement Page 9 Rev. 02/09/00 . Section 16. ASSIGNMENT NOT ALLOWED CONTRACTOR shall not asSign thiS Agreement to a third party without written consent of the COUNTY; nor shall CONTRACTOR assign any monies due from COUNTY under this Agreement to any third party without written consent of the COUNTY. Section 17. INDEPENDENT CONTRACTOR This Agreement is an agreement by and between two public agencies and is not intended, and shall not be construed, to create the relationship of agency, servant, employee, partnership, joint venture, or association. COUNTY shall not be considered the employer of CONTRACTOR'S employees for any purpose, and CONTRACTOR holds harmless COUNTY to that extent. 18.1 Section 18. COMPLIANCE WITH LAW AND SAFETY CONTRACTOR shall observe and comply with all applicable laws, ordinances, codes, and regulations of governmental agencies, including federal, state, municipal, and local governing bodies, having jurisdiction over the scope of services or any part hereof, including the provisions of the Occupational Safety and Health Act of 1979 and all amendments thereto, and all applicable federal, state, municipal, and local safety regulations. All services performed by CONTRACTOR must be in accordance with these laws, ordinances, codes, and regulations. CONTRACTOR shall indemnify and save COUNTY harmless from any and all liability, fines, penalties, and consequences from any noncompliance or violations of such laws, ordinances, codes, and regulations. 19.1' 19.2 19.3 Section 19. TERMINATION PROVISIONS Termination by COUNTY - COUNTY may terminate this Agreement in the event of CONTRACTOR'S material breach of any provision of this Agreement as described in Section 24, CONTRACTOR'S violation of law, the Transpo[t Provider Contract is terminated, or if the COUNTY service area funding is no longer available. Termination by CONTRACTOR - CONTRACTOR' may terminate this Agreement, at any time, upon ninety (90) days' written notice to COUNTY. TerminatiOn by Mutual Agreement - COUNTY and CONTRACTOR may otherwise agree in writing to terminate this Agreement in a mutually satisfactory manner. First Responder ALS Agreement Page 10 Rev. 02/09/00 Section 20. END TERM PROVISIONS CONTRACTOR agrees to return all COUNTY-issued equipment to COUNTY in good working order, normal wear and tear excepted, at the termination of this Agreement. Section 21. CONTRACTOR'S LABOR AFFAIRS The CONTRACTOR shall have full autonomy and responsibility for conducting its affairs with its workforce, including managing personnel and resources fairly and effectively in a manner that assures compliance with this Agreement_ Section 22. COMPENSATION RELATED PROVISIONS For the performance of this Agreement, COUNTY shall pay to CONTRACTOR the amounts specified in Exhibit A. Section 23. BREACH OF CONTRACT Notice of Default - COUNTY shall have the right to terminate or cancel the Agreement or to pursue any appropriate legal remedy in the event the CONTRACTOR materially breaches the Agreement and shall fail to correct such default within thirty (30) calendar days following the service on it of a written notice by COUNTY specifying the default or defaults complained of and the date of intended termination of rights hereunder absent cure. B. Definitions of Breach Conditions and circumstances which shall constitute a material breach by the CONTRACTOR shall include but not be limited to the following: Failure of the CONTRACTOR to operate the FRALS service system in a manner which enables the COUNTY or the CONTRACTOR to remain in substantial compliance with the requirements of the applicable Federal, State, and County laws, rules, and regulations; 2) Falsification of data supplied to the COUNTY by CONTRACTOR during the course of operations under this Agreement; 3) '. Failure by CONTRACTOR to maintain equipment in accordance with good maintenance practices; 4) Repeated failure by CONTRACTOR to meet response-time requirements after receiving notice of noncompliance from the Contract Administrator (material breach for response-time requirements is defined in the monthly financial per[ormance penalties table in Exhibit B-1.); 5) Failure by CONTRACTOR to maintain the required insurance. First Responder ALS Agreement Page 11 Rev. 02/09f00 Section 24. PAYMENT A ND PATIENT FEES 24.1 CONTRACTOR agrees that it will not, without prior approval of COUNTY, bill patients for services provided under this Agreement. Bo Section 25. MISCELLANEOUS PROVISIONS Attorney's Fees In any claim, suit or proceeding brought or instituted by either of the parties to enforce any of the provisions of this Agreement or to seek damages, the prevailing party shall be entitled to recover reasonable attorney's fees, costs, and necessary disbursements. Notice Ail notices required hereunder will be in wdting and served personally or by mail;. CONTRACTOR: City of Dublin 100 Civic Plaza Dublin, CA 94568 COUNTY: C. Entire Aareement Alameda County EMS District 1000 Broadway; Ste. 5024 Oakland, CA 94607 This Agreement constitutes the entire agreement between the CONTRACTOR and the COUNTY and there are no agreements, understandings, warranties, or representations between the parties except as provided herein. D. Bindina Effect ~'his Agreement will inure to the benefit of and bind the respective parties, their successors, personal representatives and permitted assigns.. E. Headinos The headings in this Agreement are inserted for convenience of reference only and are not to be used in construing or interpreting any provisions of this Agreement. F. Counterparts This Agreement may be executed in any number of counterparts, all of which shall constitute the Agreement between the parties. Fi, st Responder ALS Agreement Page 12 Rev. 02/09/00 G. Invalidity If any term, provision, convenant or condition of this Agreement, or any application thereof, should be held by a court of competent jurisdiction to be invalid, void, or unenforceable, all terms, provisions, covenants, and conditions of this Agreement, and all applications thereof, not held invalid, void, or unenforceable, shall continue in full force and effect and shall in no way be affected, impaired or invalidated thereby. The laws of the State of California shall apply to the enforcement of this Agreement H. Omnibus Provision Until the expiration of four (4) years after the fumishing of any services pursuant to this Agreement the CONTRACTOR shall make available, upon wdtten request, to the Secretary of the United States Department of Health and Human Services or to the United States Controller General, or to the State of California, or any of their fully authorized representatives, this Agreement, and such books, documents, and records as are necessary to certify the nature and extent of the reasonable cost of services. I. Delay in Commencement If the delay in the commencement date of this Agreement is caused by events outside the direct and immediate control of the parties hereto, neither party shall be liable to the other for any loss caused by such delay. Waiver The failure of either pady to insist upon strict performance of any of the terms, convenants or conditions of this Agreement in any one or more instances shall not be construed as a waiver or relinquishment of any such terms, convenants or conditions, and all of the same shall be and remain in full force and effect K. Third Party Beneficiary This Agreement shall not be deemed to have been made for the express or implied benefit of any person who is not a party hereto. L. Modification of Aqreement From time to time, amendments or modifications to the provisions of this Agreement may be initiated .by either party hereto and may be incorporated into this Agreement by mutual consent and in writing as evidenced by resolution of the Board of Supervisors approving such modification. First Responder ALS Agreement Page 13 Rev. 02~09~00 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written. COUNTY Of ALAMEDA CONTRACTOR By. President, Board of Supervisors By Title Address Approved as to form: City Attorney Attest: City Clerk First Responder ALS Agreement Page 14 Rev. 02/09/00 EXHIBIT A PAYMENT SCHEDULE 1. Basic Subsidy for Emergency First Responder Advanced Life Support (FRALS) Service: in consideration for the provision of services described in this Agreement, COUNTY shall pay CONTRACTOR: For the period January 1, 2000, to June 30, 2004, a sum of $30,000.00 per FRALS unit per year. Number of FRALS Units 3 X 30,000 Total $90,000 Reimbursement rates will increase 5% per year Payments will be made in equal quarterly installments upon receipt of quarterly invoice, beginning with the receipt of the first payment upon completion of the first quarter. Every effort should be made is to remit payments within 30 days. EXHIBIT B MONTHLY FINANCIAL PERFORMANCE PENALTIES FOR CODE 3 RESPONSES CONTRACTOR agrees and recognizes that community performance standards are reasonable and that any and all requests for First Responder ALS (FRALS) service should adhere to the standards outlined in this contract. All emergency cases that are outside the standard and cannot be justified by acceptable mitigating circumstances are subject to compliance measurement. A. Contractor Fails to Meet 90% Compliance: For each calendar month in which the CONTRACTOR has met less than 90% of the response time standards, COUNTY shall assess the CONTRACTOR the following penalties: 1st occurrence Letter of deficiency sent 2nd occurrence $1000 times the number of FRALS under contract 3"~ occurrence $2500 times the number of FRALS units under contract, or major breach of contract If, in any calendar month, regardless of prior deficiencies, the CONTRACTOR meets less than 88% of the response time standard, COUNTY at its option shall assess a $2500 times the number of FRALS units under contract penalty or find CONTRACTOR in major breach of contract. An oCcurrence may be expunged after six (6) consecutive months of compliance; however, financial penalties are not subject to reversal. First Responder ALS Agreement Page 16 Rev. 02~09~00 B. Contractor has Single Incident Response Time(s) Greater than 15 minutes If any single emergency response exceeds fifteen (15) minutes or more, and the extended response time cannot be justified by acceptable mitigating circumstances, COUNTY shall assess CONTRACTOR the following penalties: If there are between 5 and 8 incidents in any calendar month the Contractor will be fined $500/incident If there are between 9 and 12 incidents in any calendar month the Contractor will be fined $1,000/incident if there are 13 or greater incidents in any calendar month the Contractor will be fined $1,500/incident Should the CONTRACTOR exceed 10 incidents in two consecutive months, COUNTY shall, at its option, assess a $25,000 penalty in addition to the above stated fines and/or find CONTRACTOR in major breach of contract.