HomeMy WebLinkAboutItem 3.4 Emergency Ambulance Service -3,0
CITY OF DUBLIN
AGENDA STATEMENT
MEETING DATE: June 13 , 1983
SUBJECT EMERGENCY AMBULANCE SERVICE AGREEMENT MODIFICATION
EXHIBITS ATTACHED Letter from Emergency Medical Services Administrator
dated 5/26/83 ; Modification of Emergency Ambulance
Agreement ; Emergency Ambulance Agreement
RECOMMENDATION ` C-" : Approve Modification of Emergency Ambulance Service
g Y
Agreement and Notify County
FINANCIAL STATEMENT: Cost Savings Approximately $2 ,000 Annually
DESCRIPTION The City has been notified by the Health Care
Services Agency that it has presently negotiated a modification to the
County ' s existing emergency ambulance service agreement with the ambulance
provider. This modification would result in a reduction of the dry run
costs incurred by the City from $31 .50 to $18.50 per dry run, and would
result in a reduction of the costs incurred by the County for
uncollectibles . In return for a reduction in City and County subsidies to
the ambulance provider for dry runs and uncollectibles , the County would
allow the ambulance provider to increase private rate charges approximately
32%.
As you may recall , the County directly enters into an agreement for the
provision of ambulance services by the ambulance provider on behalf of the
unincorporated area and a number of cities in Alameda County. Cities , in
turn, enter into agreements with the County for the provision of ambulance
services . During Fiscal Year 1982-83, the City entered into such an
agreement with the County for provision of emergency ambulance service .
Before the Board of Supervisors can approve the modification to the
existing emergency ambulance service agreement , the written consent of the
City of Dublin and other contracting agencies is required. The County has
requested that the City transmit notice of such approval to the County by
June 15 , 1983 .
RECOMMENDATION
It is Staff ' s recommendation that the City Council notify the Board of
Supervisors of its approval of the modification to the existing emergency
ambulance agreement .
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COPIES TO: Ben H. Mathews , Administrator
ITEM NO.
Emergency Medical Services
�.
ALAMEDA COUNTY
HEALTH CARE SERVICES 4
AGENCY 40-
�►y
�)Ula Mfflffi Wy Director
AGENCY HEADQUARTERS
499 Fifth Street
Oakland, California 94607
(415) 874-6828
May 26, 1983
RECEIVED
MAY 31 1983
Richard Ambrose, City Manager CITY OF DOBVI4
City of Dublin
P.O. Box 2340
Dublin, CA 94566
Dear Mr. Ambrose:
At its meeting of May 24, 1983, the Board of Supervisors authorized the Health
Care Services Agency to negotiate Modifications to the exisiting Emergency
Ambulance Service Agreements which would result in savings to the County and to
the cities averaging approximately 50 percent countywide. Attached is a copy of
the proposed Modification of Agreement between the County and the emergency
ambulance provider(s) serving your city. The proposed Modification would result
in a reduction from $31 .50 to $18.00 in the average amount paid per dry run (a
cost to the city and from $97.10 to $60.00 in the amount paid per uncollectible
(a cost to the County) . The loss in subsidy revenue to the provider would be
offset by an increase in allowable private rate charges averaging 32 percent.
Private rates in Alameda County are currently well below the prevailing rates in
the Bay Area.
It is our hope that these Modification can be approved by the Board prior to
July 1 , 1983, to be effective on July 1 , 1983.
The City-County Emergency Ambulance Service Program Agreement, to which the
County-Provider Agreement is an attachment, requires that any modification to the
County-Provider Agreement receive the written consent of the City.
Since the proposed modification will result in a savings to your city and since
no contract standards or operational procedures are being made in the City-
Provider agreements, I would expect that the City of Dublin will have no
objection to the proposed modification. In accordance with the City-County
agreement I am requesting that your City approve this Modification of Agreement
and transmit notice of said approval to this office by June 15, 1983, in order
to effect this savings to the city and the County by July 1, 1983.
Richard Ambrose
Page Two
May 26, 1983
If you have any questions or forsee any problems, please contact me or Mr. Art
Lathrop.
Sincerely,
Ben H. Mathews, Administrator
Emergency Medical Services
BHM/ms
Enclosure
0425A
Approved as Form:
i, RICHARD J. MOORE County Counsel
By
lUlitF..G(�"i 1ON OF ;AGREEMENT
Em'ZRGE lCY AMBULANCE
C",iS ONE IX
This Modification of Agreement, made and entered into this day of
1983, by and between the County of Alameda, a body corporate and
politic of the State of California, hereinafter referred to as "COUNTY" and
Tri-Cities Ambulance, Inc., dba Regional Medical Systems, hereinafter referred to
as "CONTRACTOR."
WITNESSETH:
Whereas the COUNTY and the CONTRACTOR entered into an Agreement commencing
the first day of July, 1982, for the provision of Emergency Ambulance Service in
EMS Zone IX; and
Whereas COUNTY and CONTRACTOR desire to modify the reimbursement rates
for uncollectible emergency calls, dry runs, and standby services specified in
Exhibit D of said Agreement; and
Whereas COUNTY and CONTRACTOR desire to modify the allowable charges for
private billing applicable to emergency call services specified in Exhibit E of
said Agreement;
NOW, THEREFORE, IT IS HEREBY MUTUALLY AGREED THAT:
1 . The reimbursement rates for uncollectible. emergency calls, dry runs, and
standby services shall be as stated in Exhibit A attached, which supersedes
Exhibit D of the original Agreement.
2. The allowable charges for private billing applicable to emergency call
services shall be as stated in Exhibit B, attached, which supersedes Exhibit E of
the original Agreement.
3. The provisions of this Modification of Agreement shall be effective com-
mencing July 1, 1983.
4. Except for this Modification of Agreement, all other provisions and -
exhibits shall remain in full force and effect.
EMERGENCY AMBULANCE AGR,_.,ENT MODIFICATION
' PAGE TWO
,,. IN WITNESS WHEREOF the parties have executed this Modification of
Agreem nt th- day and year f�rst above written.
COUNTY OF ALAMEDA CONTRACTOR
By By
Chairman, Board of Supervisors
Title: k
`. Address: 37525 Glenmoor Drive
Fremont, CA 94536
r
EXHIBIT A
-- REIMBURSEMENT SCHEDULE
EMERGENCY CALL (Uncollectible)
Emergency call base $60.00
k
Mileage no reimbursement
DRY RUN 18.50
STANDBY SERVICES
No transport provided:
First 15 minutes 18.50
Each additional 15 minute period or
portion thereof 5.00
Transport provided:
First 30 minutes no reimbursement
Each additional 15 minute period or
portion thereof 5.00
The maximum amount payable for uncollectible emergency calls, dry runs, and standby
services provided during any fiscal year (July 1 through June 30) under all
Emergency Ambulance Service Agreements between COUNTY and Fremont Ambulance, Inc.
or Tri-Cities Ambulance, Inc. in effect on the date of this Modification of
Agreement by COUNTY to CONTRACTOR shall not exceed $130,000. This maximum amount
shall not apply to payments to CONTRACTOR by COUNTY made under provisions of the
County Medical Services Plan.
r
f, EXHIBIT B
ALLOWABLE CHARGES FOR P!1+.i1:�TE B.LI.Ys'1G RPPE ICABLE
TO EMERGEIIN'"t SERVICE"
PRIVATE RATES:
Base Rate $127.00
Emergency Charge (Code 2 or 3) 30.00
Mileage (per mile) 6.00
Night Call (7:00 p.m. to 7:00 a.m.) 25.00
Oxygen (includes mask and resuscitation) 25.00
Extra Handling (unusual, dangerous, including
restraints, special loading, or unloading 25.00
Waiting Time (after 15 minutes; per 10-minute
period) 20.00
DISPOSABLE SUPPLIES
As required to provide authorized and appropriate services not to exceed a
mark-up of 100 percent of over cost. No charges shall be added for use of
equipment required by this Agreement or any services requiring EMT skills,
except as provided for above.
+11 Of Att_ CONTRACT N0.
J '
O
-,�` RECEIVED
�•c,�oaM D. DEC 91982
OFFICE OF THE CITY OF DUBLIN
2AK. BOARD Or SUPURVISow2`
DEC -7 1982
City of Dublin
P.O. Box 2340
Dublin, CA 94566
Gentlemen:
SUBJECT: AGREEMENT/CONTRACT (or modification thereof) between the County of Alameda
and CITY OF DUBLIN, providing for certain emergency ambulance services for
EMS Zone IX
the Chairman of the Board of Supervisors of the County of Alameda was
authorized to execute said document by Resolution No. 195-14,3 ,
adopted on pE C -7 1982 . a copy of which is attached to each do current.
Forwarded for further processing are the original and copy/copies
of subject document.
XX Forwarded for your files is a/are fully-executed copy/copies of subject
document.
Forwarded for further distribution are copies of subject document.
Please return the original of the subject document, marked "Clerk's File
Copy," together with additional copy/copies of same, fully-
executed, to: Clerk of the Board of Supervisors, 1221 Oak Street, Oakland,
California 94612.
XX We have retained the original of subject document for our files rnd hrL e
forwarded a copy of same to the County Auditor-Controller and the Health
Care Services AQencv.
Other:
Very truly your /
William Mehrwein, Clerk
WM:YQ: dd
Enclosure(s)
cc: County Auditor-Controller
Health Care Services Agency
1221 OAK 2TIRECT• 2UITi 186 •OAKIA►i D. CAl)FO11M)A ON11•1412) 874-4194
Approved as to Form
RICHARD J. NIOORE, County Counsel
EMERGENCY AMBULANCE SERVICE PROGRAM AGREEMENTLY:--------____.............................
This Agreement, made and entered into this _ day of C
J , , 19a by and between the CITY OF DUBLIN ,
ere-in�fter• referred to as "CITY" and the COUNTY'OF ALAMEDA, hereinafter referred
to as "COUNTY."
WITNESSETH:
WHEREAS, the City finds it in the public interest to assure the
availability of emergency ambulance services within its jurisdiction, and
WHEREAS, the County is capable and willing to arrange for and
coordinate the provision of such emergency ambulance services;
NOW, THEREFORE, IT IS HEREBY MUTUALLY AGREED AS FOLLOWS:
Services
1. County shall secure the services of an ambulance contractor(s) to provide
emergency ambulance services within the City limits, in accordance with the
Emergency Ambulance Agreement, Exhibit A. attached hereto and by reference
incorporated herein.
2. The County Shall provide the. services of the Central Medical Emergency
Dispatch (CMED) for-dispatch and .coordination of emergency ambulance
services.
3. The County shall monitor the quality of ambulance services including
personnel , equipment,. and procedures.
4. The County will review and monitor all ambulance contractor billings.
5. The County will immediately notify. the appropriate City public safety agency
of all emergency ambulance requests originating within the territory of the
City, which are reported to CMED.
Public Safety Agencies
6. The City shall relay all requests for emergency ambulance service received
by its public safety agencies to CMED or to such other dispatch center as
may be mutually agreed to by City and County.
7. The City's Public Safety Agencies shall respond, according to their custom,
practice, and procedures, to assist as needed at the scene of a medical
emergency when notified by CMED of such an emergency.
EMERGENCY AMBULANCE SERVICE PROGRAM AGREEMENT
Page Two
Data Collection
8. The City shall make reasonable efforts to assist-the County in the collection
of pertinent data regarding public- safety response to medical emergencies..
9.- The County shall involve: such designees of- the City Manager 'in any review of
Exhibit A regarding -(-i) any complaints arising thereunder, .(ii) changes in
its operating procedures,. and (iii) contract administration policies relating
thereto.
Payment
10._ City- shall reimburse County for all payments made by County to ambulance
contractor(s) for a -1- dry run services rendereii wi:th-i n the jurisdiction
of City, r.egardTess of the• orfgi nof the: request, and. all: standby services:
requested by- a City Publ:id Safety- Agency.- -It. is_ expressly- agreed and-
understood- by the. parties.-.that City. s.. obligation. to reimburse_ County for-
dry run services sha1T not exceed- the amounts set forth in- the. Reimbursement
Schedule (Exhibit-. "D".-which is. a part: of Uh-i bi t. "A") as said: exhfbi t read
on. July 'l, 1982 `
11_ County shall submit claims for-payment.to: City- within. 30 days after County's
payment to the ambulance contractor(s); pursuant.-ta Exhibit A. Such- claims
shaT-T be accompanied. by supporti ng=documentati on as may- be reasonably
req ui red by- Ci ty.-
12.. The City shaTT: reimburse: the County~witftirrr 30: days: of the receipt of County's
claim for payment.
13. City may,.. at City-'s option„ bill the- patient or other person- responsible
for reques-ting- emergency ambulance response when such a-request terminates
as a dry rurr. County's Emergency Ambui'ance Contractor for EMS Zone: IX .
shall provide to._ City,: when requested by City, information reasonably
available for such Dry Runs- necessary for City's billing.
14: This Agreement may be modified in writing by mutual consent of the parties
hereto. County shall not enter -into a modification of Exhibit A with an
ambulance contractor without the- written consent of City thereto.
EMERGENCY AMBULANCE SERVICE PROGRAM AGREEMENT
Page Three
Term
15_ This Agreement shall. commence on July 1, 1982 and shall terminate
on June 30, 1985
IN WITNESS WHEREOF, the parti'es. have executed this Agreement the
day and year first above written.
COUNTY OF ALAMEDA CITY OF DUBLIN
CP
By By P
Ch n of the Board of Supervisors
Title Mayor
Date �' Date September 28, 1982 .
1, ''si•;:,;..• ,-,:_>�,,, C . . ,. - --•
C.o"inty, C.O i'+ ... " J l'n ;`�i _ ;i�•y -'-t` C
copy et the c.,:jci-_d �vcu;rr +{ iia� ��-rr. ydaEl'JP,! d .c
C n, p,f n :;. ,�, t.:)u:;ty Board of
Supervisc•rs, as provi-ed in 2:;lOJ of the Govern-
_.rnent Code.
-7 1982 r
WII-LIA,Vk ARE "Y`%EiiV, C!E,NK ^t
THE BOARD OF �Lar^yi'
Al` CONTRACT NO: 1 2 4 3 9
0
C�lIrOlk
orrJCL Or TM[
.tea• DOAMO or rupt"VISCRA 414&
Tri-Cities Ambulance, Inc.. AUG 16 198' MSAn'441 ly'Z'Q
37537 Glenmoor Drive ��/G 3 M �_
Fremont, CA 94536 J9
R 82
Gentlemen:
SUBJECT: AGRELMENT/CONTRACT (or modification thereof) between the County of Alameda
and TR - .T TF.S AMBULANCE. INC, - orovidinQ for emereencv ambulance services
within FmervPncy Mpdiral SeryJc s_ 7on TX
s
the Chairman of the Board of Supervisors of the County of Alameda. was
authorized to execute said document by Resolution. No. 1 9 4 2 '1 0 ,
adopted on Aug 3, 1982 , a copy of'which is attached to each document.
Forwarded for further processing are the original and copy/copies
of subject- doc=ent.
xx Forwarded for your files is a/are fully-executed copy/copies of subject
document. _
Forwarded for further distribution are copies of subject document.
Please return the original of the subject document,. marked "Clerk's File
Copy," together with additional copy/copies of same,. fully-
executed, to: . Clerk of the Board of Supervisors, 1221 Oak Street, Oakland,
California 94612.
We have retained the original of subject document for our files and have
forwarded a. copy of same to the County Auditor-Controller and the Health
Care Services Agency.
Other:
Very truly 7ourr,
'-William Hehrwein, Clerk
WM:YQ:cc
Enclosure(z)
cc: County Auditor-Controller
',�iealth Care Services Agency
112% Oaa •TACKT• WITL S84 0 CAMLAMO. Ca611.O1RM1&1"13•1418 474-4704 -
RlCkARD jp ��ed as fo Form T
QY:... RZ UnIY CaUnsel
EMERGENCY A,'•1BUL4NCr AGREEMENT
EMS ZONE IX
This Agreement, made and entered into this ? - day of
I4 �, by and between the COUNTY OF ALAMEDA, a tiody corporate
an4 olitic. of the State of California, hereinafter referrsd .to as "COU;ITY,"
and Tri-Cities Ambulance, Inc. hereinafter- referred to as
"CONTP.AC-1 OR."
WITNESSET14:
WHEREAS,. the County finds it in the; pub]ic interest to assure the:
availability of' efficient emergency ambulance services within the areas
served by this Agreement, and
WHEREAS, the Contractor is capable of and.. willing to provide such -
emergency ambulances:
NOW, THEREFORE, IT IS HEREBY MUTUALLY AGREED as follows: -
DEFINITIONS' OF TERMS'
I_ The following definitions of terms shall app Ty throughout this Agreement:
A. Ambulance - Any vehicle licensed as an ambulance by the to 'f 'a
Highway Patral.
B. Ambulance Unit - An ambulance staffed. with qualified personnel and \
equipped with appropriate medicaT equipment and sucplies.
C:_ Backup Service - The refocatiorr' of- an ambulance unit-to a io n predesigna-
t_d. Iacat from whence it will be availab.le. for emergency calls.-to
serve the Contractor's Zone, as weiT as an adjacent zone which
ambulance- unit shall remain under- the control of Ci•jED.
0 Contract Administrator - An agent of the County designated by the
director of the Heaith Care Services Agency.
E. CMED" - The County of Alameda Central Medical Emergency Dispatch
r 1 i ty.
F.. CNED lfunber (Code II.) - A number issued. by C."ED. indicating that the
emergency or- non-emergency call was. dispatched or cleared through
CMED. --
G. Ori Run - Any trip made by an ambulance unit in resconse to an
emergency call whereupon after responding to said c_11 , it is round
that no ambulance is needed.
H. ETarcencv - Any sudden or serious it i ness or injury requiring irr:edict_
medical or psychiatric attention under circLmstanc=s such :hat delay
in providing such services nay aceravate such medical c::nditic,n or
cause t^e loss of Ii`e; =:fir_:er more, any case d._1_. _= t _n
zrereency �y a physician.
.all ;:estia^ sn _sccrSa _.c
a�^.11.ance unl,: tC an xer=ercy. An s:rz':=nc• ca'
both Code , (rid ?'cr` and siren`• , -a rd Coda ice° :10:5 r�s=1 5c
wit`out red iicht :rd siren; calls.
Oef1ni*_'ens of Tar'!T, continued
1. Mi T - "c_ua 1 :�i l n _ -
n'ne ., °_cE 'r3Ye'I?•� •GR n _r�nsuartlrc a -:.Zin.^,t�S)
Mi ea shall no: be datarzined by a c:ulti:iter of tr,a nu;i.`_=r of
patients carried over the distanc_. ::��v21ed.
K. Van-Emet'GenC'! Call A request for an :^bU1anC2 !Jell 'rl(iiCh rUESt
does not require an Immediate response_. ;ton-eTer_en_y calls ira'/
be of private or pu=lic oriaim. - '
L. Public Safety QfTicar Any person designated as a pub IIc sare:y
arric_r by the a:•, or the Stata of Cali'orria.
M. =%T�sfclan Any person duT. Tic_as :a. pr_ctic_ -medicine Ic !,",e
tam—Caiifornia.
t�.. Resaonsjble Third-Party Pa-/or-.- Any federal or stet_ madical care
program under wnich' a patient is eiiaibie for benefits;. also any
Person, partnership, assaciation, car-;oration, or o'her entity
under a cantractual or leaai
obligation to provide medical bare-Fits
to. a' patient, and. which customarily !makes di•r_ct payment to a
provider of medical services including ar.,bularca service. _
Q. Standbv Ser•rics - T'ne- dispatch 61-_ -" an emergency ambulance unit(s)
at the request of a pub sfc. safetj agency to a-specific location
where it refrains. under the direction- of the requesting. pub Iid safety
agency until released or put into servica am an emergency basis.
P. Void Call - Any dry run of Tess than three. (3) minutes duration .
ccmputed from time, of request by-CNED. or notification of intent to
respond_ by Contractor to. time a= canceilation; or any ambulance
service request which Contractor is unable to. service due to deficiency
in equiFment,. personnel , or location identification; or any ambulance
" ser�iic_:request. cancelled_ by ,ME7 prior to the contractor's ambulance
diii-t-reporting to CIIE7 that- it is underway (10-a).
sgwIC^s
- Z. Contractor agrees to provide on a- i4-hour basis all necessary ambulance
units,. facilities and. personnel for tfie.. purpose of responding. to emergency
•'- "'e zone as descr'b�d I;r E;hibit A' attached ^ern+; and by
ca s:xt ,;r
referent_ incorporated herein.
3. i"ne. Contractor shali .maintain the caoabilfty o responding to not Tess.
than 47"percant of the emergency calls oriainatina in his Zone. as
reasured' by any 36a-day period during the term o` this Agreement_ ,Ambulance
units will be stationed: 'in such a manner so as- to permit arrival at tyP_
sc_ra of an emergency (response time) within ten (10) minutes From the
't'i 17jCat1C^ to the Contract ar of such _a„: I , for not less. 90
percent of ali such delis as measured by any 30-day pericd.
The• Contractor shall nal rnspcnd to any non-emergency request ':ihan doing -
so r_cuirns the use a' the las: or only armular:ca knit ava4l_3b a to -
s�rle t'? C,rrl.rac-i,:r'S =ors, or 3- any :'c :o ]cr`!ic_s :"a ~n'nC
%:zd to z=-a1 _, ,iCr siia; 4;ii. =CC _
_ny ar`•ra^CJ •'a^fns= o 2 Tcc""I =uaiC= _r.a CJr,_'r,C_ar' s-=nc
-. Can:r.c_=:- ;ha i a Service a-. any l ocsc l on ':!i_h;n ,i
::re or in znc_her -.-.ne r r? a 4?�< :'��_:ra_ liar :�_./ r:.I=l
DIERGENCY AMBULANCE AGREEMENT
PAGE THRrE
Services, continued
S. Addi.tionaily, the Contractor shall provide Backup Services to adjacent
zones upon direction of COED. Ouring any period of time that all of the
Contractor's ambulance units !gay be unavailable for service, the County
will' make reasonable efforts to obtain backup services from adjacent
zones. to provide coverage for Contractor's zone.
6. The Contractor to the best of his ability shall assist in the provision
Of ambulance services to any County zone in which emergency ambulance
services pursuant to a contract wish the County have been suspended or
terminated.
T. The Contractor agrees that the performance of work and services
pursuant to the requirements of this Agreement shall conform to high
professional standards and shall comply with Exhibit 8, Operational
Procedures, attached hereto and. by reference incorporated herein, and
such other protocois for patient transport. and treatment as may be
issued by Contract Administrator.
8. It is agreed and understood that County desires to track all of
Contractor's. ambulance units which respond regularly or frequently to
either emergency or non-emergency calls originating within his zone.'
It is mutually agreed, therefore, that Contractor (i) shall keep C14ED
informed on. a current basis as to the status, availability,and location
Of all such ambulance*units and (ii) 'shall not respond to any emergency
or non-emergency tail within his zone or which such an ambulance unit -
without informing C4E0 of the: type of call and destination, and without -
receiving a 'C4ED number therefor. -
9. Notwithstanding- paragraph 8,. the Contract Administrator may from time
to- time dispense with the requirement that: Contractor notify COED of
his ambulance units responding to non-emergency calls.
. . .. .... ..
10. Contractor shall" respond-to' unit(s) located
nearest to the scene of the incident unless otherwise specifically
directed- by CMED.
II. Contractor's personnel shall provide such patient. assessr,.ent and medical
treatment as may be appropriate.
PERSO.4NC-1
12. When responding to any emergency call , the ambulance unit shall be
staffed with a minimum of t-do. (2) personnel including (i) a driver, and
(ii) a. patient attendant, both of whom are certified as Emergency
Medical Technicians I-A. All ambulance personnel shall obtain an
identification card with photograph from the Contract. Administrator and
shall wear such card an the outside of the uniform and where easily
visible. Upon termination, of. an employee, and :Yithin fifteen. (15)
days thereof, Contractor shall return employee's identification card to
the Contract Administrator. ,
13. Emergency Medical Tachnician personnel shall comply with all trraining
requirements as established by the State of Uli-ornia inciuding re`rasher
or certification renewal trainlnc. -= - _
:� aC'c:i �iv��, �.:.ruaCi: iii�..:.a.J. ,
may, frcm time to time, racuire such additional training as County May
arrange at Ccurty's cton expense.
IT. The Count,
.1 shall make reasonable efforts to imake available Emergency
Medic_l Technician trainine, refresher Ccurses, and chalience exarninaticns
for G i-IA certification.
?55. Contractor shall, not pe' iit- a:y :Tployees, including disoatci2rs, to
:erTC.... :erg c -
r - :i 5 CCr._e lz=an nor°'i;C_°r '.tii ila under -�c -r-'i•rarC_a
"17CT;t impair t:: .•r r^�'�iC�i c- .7mantz! ;er-:r7 anca.
D IERGENCY Af•1SULANCE AGREEIME"T
PAGE FOUR
Personnel , continued
I6'. Patient attendant and driver both shall be neat and clean, at least 13 _
years of age, and physically capable of performing the duties required
of them.
VEHICLES ANO EQUIPMENT
17. Ambulance vehicles shall meet standards of Title XIII, Chapter 2,
California Administrative Code and each shall possess .a valid emergency
Vehicle Permit issued by the California Highway Patrol. A vehicle
identification- number which meets. Stat_ ambulance identification
regulations shall be displayed an each vehicle employed under the "terms
of this Agreement.. Contractor shall identify and utilize these ambulance
vehicles to be. used for- the- provision of. emergency services hereunder.
Only those: ambulances identified in Exhibit F, attached hereto and by
reference- incorporated herein, shall be used to provide such services.
Contractor may substitute another vehicle far the vehicle listed in
Exhibit F,. only after receiving written permission from the Contract
Administrator. Vehfcle MEDNET identification, as assigned.by the
Contract. Administrator,. must be displayed an the roof of the- vehicle
in lettering at least four inches in width, and at least 24 inches in
height._ Each vehicle must be identified with the name of the
contractor as it appears.. in this. Agreement..
IS- Each ambulance unit shall carry such emergency supplies and. equipment
as listed in Exhibit C, attached hereto and.by reference incorporated
herein.. Vehicles, equipment, and supplies shall be maintained clean
and in sanitary and safe mechanical condition at all times. '
L.- Contract. Administrator or his. agents may at any time xithout, prior
notice. inspect Contractor's ambulance units, in order to ascertain
Contractor's compliance with this Agreement in respect thereto. An
inspection- may- be--pcstponed if it is shown that the inspection would
unduT
Y—deTay an� ambiance: uniti from responding to an emergency call ..
A memorandum of the inspection.. specifying any deficiencies and. stating
date, unit. number, and names of driver and attendant shall- be provided
to: the Contractor. Contractor shall show proof of correction for any
deficiencies noted in said inspections, within three (3) working days,.
to the. Contract Administrator.
COMMUNICATIONS
20. County shall furnish to Contractor and maintain MEDNET two-way radio
equipment. in his. ambulance units for his use under this Agreement. Radio
equipment approved by the Contract Administrator must be installed prior
to assignment of a vehicle for zone: coverage under the terms of this
Agreement..
21. Contract Administrator shall determine the number of Contractor's -
ambulance units to be. MEDNET equipped_
22. Such radio(s) sha1T remain- the -property of County and be subject to its
control , supervision, and removal . Contractor shall pay the County the
cost of any repairs and maintenance over and above that caused by
ordinary ;jeer and tear and shall return radio s; to e Coun_y upon -
cempleticn-or termination of this Agreement. Contractor shall be liable
for any loss or damage to County's radios while in the possession of
Contractor.
Contractor s;,all maintain at h's =_xp2.^,sa neces .'rl. cc^��;;ti - -
C��iv^nS _�_::2_tl
his dispatch off ices) and a,I his arl-bulanca units. %Jnzractor's Lisp tch
iLr. shat i to ava:latle by to1Ephcn a at cl1 t:uC1 -^ answer calls -rc'
MERGENCY AMBULANCE AGREE24ENT
PAGE FIVE
PAYMENT
24. For the performance of this Agreement, County shall pay to Contractor _
the amounts specified in Exhibit 0, attached 'hereto and .by reference
incorporated herein, for the following only:
A.. UncoTlectible billings for emergency call services.
S. Standby Services directed by Ci4ED. In the event that an emergency
transport is provided when an ambulance unit is' "standing by",
reimbursement will be made in accordance with emergency rates, in
lieu of payment for Standby Services; provided, however, if standby
time exceeds 112 hour, then authorized waiting time shall be
reimbursed for the. period exceeding 1/2 hour.
C_ Response to emergency call requests which result in dry runs. Void
caTTs. shall not be reimbursed.
D'. Uncollectible billings. for emergency transfer services to or from
any County medical facility when authorized by appropriate County
medicaT. personnel..
25. NO' Claim for payment submitted. to County by Contractor shall be paid in
the absence of.reasonable proof that- the particular ambulance service
involved was. irr fact provided by the Contractor. _
26.. Contractor's failure to comply with the requirements of, this Agreement -
incTuding but not limited to his failure (i) to obtain A CMED number at
the time_.of service; (ii) to submit a completed medical report form;
(iii) to respond with service within the required time periods; (iv) to
follow approved protocol in selection of a receiving hospital; and
(v) to follow- dispatch and communications procedures shall be
the basis for a rejection by County of Contractor's claims for payment.
In the: event: that service is provided without strictly meeting the
requirements of this Agreement,. the Contract Administrator may. neverthe-
Tess approve, cI'aims for payment upon determining that the service was
provided. substantially in accordance with the, intent of this Agreement.
27. The County shall not be obligated tb pay Contractor for services provided
to any person eligible;. to receive benefits from. any responsible third
party payor; unless such claims for payment are accompanied by written
notification of rejection of eligibility. County shall not be obligated
to pay Contractor for services for which payment in- any amount is due
or has been received from any responsible third party payor. County
shall not be. obligated_ to pay for- more than one patient trip on any
particular emergency call service, nor shall County be obligated to
pay for any emergency call service in which the Contractor receives
payment fro.-,T any are- of multiple patients. transported.
2g. All payments..made to Contractor by a patient, patient's estate, responsible
relatives and friends, or from any other source shall be credited to the
patient's account and the amount specified in Exhibit 0 claimed to be due
from County to Contractor shall be decreased by a like amount.
29. Contractor shall make every*
reasonable effort to collect payment for his
sarlfces f"m the Pa lznt, or , =sp-.i!S ibl_- rclaz—lve or a rsspons ibl2
third party payor, or any appropriate government agency. With IS days
of rendering service, Contractor shall send tee first of at Teas". three
(3) separate billings to the patient which are spaced at least fifteen
(15) days apart_; provided further, however, that responsible third party
„o,. e� _
Via, .'=y +E 5111 only tli ..T, t:e same per?cd. E_ch .3i 1 Siid1 i
be separately ?led by Contractor and all "ils snail be renter=d in
1-ha as:-e c= tha Con".ractcr end shall r��ues� - = pat-.ent - 7y
Ccntr_ctcr a- Insurinc_ =ver_� _ `- _ _.
61ERGENCY AMBULANCE AGRMENT
PAGE SIX
30. Each claimable tali at- service shall be separately billed to County by
Contractor an forms provided ar. approved by, and in such form, substance,
detail, and exhibits thereto as required by Contract. Administrator.
Contractor shall submit bills to the Contract Administrator no sooner
than 90 days and no later than 150 days after the service was rendered,.
and if Contractor does not bill County within this time frame, County
shall not be obligated to pay Contractor for the particular service.-
However,. c1airrs for payment for dry runs, backup and standby services
may be submitted prior to g0 days; and said prior submittal may be
allowed for earlier payment within the discretion of the Contract
Administrator. Rejected responsibye third party payor billings may
be submitted Tater than 150 days of the date of service, provided that
such claims are accompanied by written refection of the billing by the
responsible third party payor.
31. After paymentta Contractor by County orr a patient's account, the
Contract Administrator may direct and~upon such direction Contractor
sha1.T assign- to. County all of Contractor's right,. title, and interest
in and to any such account.
In. the event of such assignment, Contractor shall cease all further
attempts at collection from the- patient, the patientIs .estate or
family,. or from. anyone else. Any an4 all payments Contractor may -
receive. from. a private party, insurance company, court settlement or
any, government agency withirr thirty (30) days of assignment shall be
remitted to the County within thirty (30) days of receipt,. but not
to exceed. the amount paid to Contractor by County. Any and all payments -
toward an assigned account which the Contractor may receive more than "
thirty (30) days. after assignment. shall be submitted in full to the
County by Contractor- Contractor agrees to notify County in writing
within fourteen (14) days of all amounts received on assigned. accounts
and. to remit to the County all amounts due within thirty (30) days
of receipt of payment from any sourca. . Qate of..assignment shal.l be
the date..on the County warrant making payment on ac<igned_Account.
If Contract Administrator does not direct such an assignment, 'Contractor
shall continue to make reasonable- efforts under the circumstances to-
Cc]lect the.account, and shall' refynd to County the call ections. not to
exceed the amount paid to. Ccntractcr by County_ -
M Withirr thirty (30) days after receipt by Contract Administrator of any,
claim for payment; the County shall. make payment to the Contractor or
the Contract Administrator shall notify Contractor that such claim is
rejected by County and give the reasons therefor. Upon audit or
examination of Contractor's records, the Contract Administrator may
disallow- invalid claims) for which payment to Contractor has been
made and may deduct the amount of disallowed claim(s) in following
payment(s), to Contractor, or Contractor shall forthwith refund to ,
County said. disallowed amounts upon demand, of Contract. Administrator.
PRIVATE BILLINGS -
33. All bills submitted by Contractor to any private party or third party
payor for emergency seriices rendered within the Zone shall not exceac,
the rates Tisted in Exhibit E.
Contractor shall not bill any party for any service unlisted in
Exhibit E, except for approved specialized service above the level of
service provided by E:
EMERGENCY AMBULANCE AGREaIENT
PAGE SEMEN
PAYMENT FOR EXCESS 3ACMp
.34. Contract Administrator shall maintain records of backup service for _
each zone by each Emergency Ambulance Contractor. . Upon receipt of
written complaint from any Emergency Ambulance Contractor that an
excessive amount of backup service has been provided by that Contractor
to an adjacent zone contractor, Contract Administrator shall compile
data shoring the backup time provided by each of the affected Contractors
to the other(s) and may- direct a contractor found to be receiving excess
backup to reimburse the Contractor providing said backup an amount
based upon the rate specified in Exhibit 0 for Standby Services. In
determining an amount for. excess backup reimbursement, consideration
shall be limited. to a period beginning not more than 180 days prior
to the receipt of written complaint.
REPORTS AND RECORDS
35_
Contractor-shal T maintain compTete financial records in auditable
form. and content and according to good accounting practices for all
casts, expenses,.. expenditures,. revenues, accounts. receivable, and
bil'Tings, pertinent to and during the- performance- of this Agreement.
Contractor shall' maintain an active list of employee ambulance. personnel
Including their qualifications, dri-ver's certificate and licenses with-
expiration dates. Contractor shall. provide County with a list of all
ambulance personnel and shall notify'County within thirty (30) days or-
any new ambulance employees or terminations.
37. Contractor shall maintain records of all calls. includincg. data and time
of service, OWED number., type of service, response time, and traveling
code. ,
38_ ATI records maintained pursuant to. this Agreement shall be available
for inspections,.. audit or examination by the Contract Administrator or,
other agents-. of the County and shall' be. preserved by Contractor for at
least three (3) years from the end of, the contract year in whfch they
were;, made or- if- the term of this Agreement is less than one (1) year,
then three: (3) years from the term-snation or- compietion of this
Agreement-
39-34. Upon request of Contract Administrator; Contractor shali prepare and
submit reports providing justification, if any, for his failure to
respond within required time periods, his failure to obtain a CMED.
number prior to an ambulance response or to submit an adequately
completed medical report. form.
Contractor shall provide such additional information and reports as
the Contract,. A(trzintstrator-may require fr;,z tire. to time to �ronitor
properly the performance.. of the Contractor under this. Agreement..
INSURANCE-
40. Contractor shall at all times during the term of the Agreement with the
County, maintain in force those insurance policies and bonds as
designated in Exhibit H and will comply with all requirements thereof.
NO ADVERTISING
41. Contractor shall not advertise, promote, or endorse in any way any
emergency ambulance service telephone numbers except the "911" emergency
telephone number.
NO DISCRIMINATION
42. The Contractor shall be an equal opportunity/affirmative action
organization in all of its practices, policies, and procedures. The
Contractor shall not discriminate on the basis of race, color, national
. origin, ancestry, religion, sax, marital status, age, physical or
mental disability in any matters related to access, provision of services,
or employment.
PAGE EIGHT
43.. Ccntractcr shall c c '.h ••federal , state, tr ly ••' � a: r rules, regulations, Ic::S, 3i:C C:.deS
al ate, iocal yeverrr:art in the pEr=orra ca of th;S
•4greement fnC!Ud{nC,' t;:-. not ii-ited t:7: "r:1-le 1, Su C"a tar =,
Chzp=er ?s C:.lijo'Tlia hL�T.^.i5tr3ti'1°. 1:� :1:?0 (TrT
44. Contractor -r__ t !; the t: .
'-.;• °as e e_p _ Ccn:ract A�*iiini;tratcr advised at
all
tir es of t.7e name and 10cation of :'le Contractor's par_nr. CCr"pany, it
any.
45• ire Ccntractcr agrees to d�-end,. inder^nifv, z^d- held hc'^1E55 t
County of A'a."da ard. the CitY(ies) of Dublin, Livermore, and
.Pleasanton and any all orric_rs, pioyees, agent,,
and servants of said County and cars,
for any and all tiabil*'.tv
caused. by the ne7lieence or arongful act of the Ccntractcr arising
Out of 6,..a: per d=ance of this Agreement, and t0 pay ail Claims, d ua as,
3udgments, legal costs, adjuster fees, and attorney fees related. thereto.
THIRD PART'i SEN- E:ICi'.RY '
45. This Agreement shall not be desmed.t0 have been made for Vie exoressed
or implied benefit of any person who is not a ~arty hereto, except *_he'-
afor--mentioned Cities and any breach- or violation o= this ,cr,eerient
shall not be dented to create- or establish any claic, or cause of actior,
in behalf of any such person.
ASSIGNMENT'
4 7.. part+ier. County.riot±-Contractor shall assign- this Agrae third
part I without: written cen5ent or the other parry to this Acree-ent; nor
shall Contractor assign any monies due- `ram County under this AgreE7ant
to any third party without consent of the County- In the event of
att--nptad assignment in violation of this .4areement, the non-consenting
party may declare. this contract to be null and void in retard tc t::e
ZONE EYCLUSIVrTV
Exc_ptincr the. prayisicn 0- Sackup Servicas, or the susoensicn of `. i5
Agreement, the County shall not enter into any Agr?�-rEnt. ':1it1 any Otner
Contractor for the provision of elr:er_ency an-,bulanca services wi:tin tl a
Ccntractcr'S Zone during the tarm of this ,creemart.
rmAELFT•i TO ?E,-Fapm
49. Should Contractor be unable to p=_rfor..r sarvic_s urd=r this Acre_-ar.t a;
rasulr i C' anczs _ y n 5 CCnt 01 r t. "
^f c r �rst c d hi r , th_ �.:n_i Shal
coss:=S iv- and use JT
��r `e. _cr
Cn - C-=
ra=icra:;i wa=r anCV.a=. .:cL.= �C. _x'11.- :P�I• __/ ...�. �......• =___r,-_ __, -
-C:nta'y re := , sc: ':r=h i _:r:i7 i _ _, ccC c_ .icre=- ?^` �y r. = •?r
i^ccr^Or3t r,ar=in, :=r =ui_ a :c- -:� 5` -- --
ail 1 '- - -_=� =.'-o1:a:ic_ _ :ou. c/ s a'i :__.... _ .
iztii �r; =n:: - - -
3ir. :ut 1st -
Ei`9ERGENCY AMBULANCE AGREEMENT
PAGE NINE
DEFAULT
50. In the event that the Contractor defaults in the performance of the
terms of this Agreement, the Contract Administrator shall so notify
Contractor in writing specifying the nature of the default and the
amount of time within which the Contractor shall have to remedy such
default. If after receipt of such notice the Contractor shall fail -
to remedy such default within the time period specified, the Contract
Administrator may forthwith suspend this Agreement in whole or in
part and the County may terminate the Agreement in whole or in part.
INDEPENDENT CONTRACTOR
51. This Agreement is an agreement by and between two (2) independent
contractors and is not intendeU to and shall not be construed to create
the relationship of agency, servant,. employee-, partnership, joint
venture, or association.
MODIFICATION OF AGREEMENT
52. Fronr time to time,, amendments or modifications to the. text of the
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.
TERM OF AGREEMENT `
53. This Agreement shall commence on July 1, 1982, and shall terminate on
June 30, 1985, provided, however, this Agreement shall remain in force
after said termination date to the extent- necessary to process claims
for payment which may become due and payable for services rendered by
Contractor prior- to said termination date.
TERMINATION FOR CONVENIENCE
54. This Agreement may be terminated by either party for any reason such
party shall determine that such termination is in the best interest.
Such termination shall be effectivq,: at the end of the contract year
upon 120 days prior written notice thereof. The- period from January 1
to December 31 constitutes a contract year.
WAIVER
55. The failure of either party 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
for the future of any such tests, convenants, or conditions, but all
of the same shall be and remain in full force- and effect.
IN WITNESS WHEREOF, the parties hereto have executed. s
Agreement the day and year first above written. j
r
COUNTY OF '�t- ,�;E�,�, CONTRAC I R
BY BY
Title CJ " ' ��— eS�C�e-J
A F F I D A V I T
I, Yvonne Quan, Administrative Assistant, Clerk, Board of Supervisors, Alameda
County, do hereby certify under penalty of perjury that a copy of the attached
document has been delivered to the Chairman, Alameda County Board of Supervisors,
as provided in Section 25103 of the Government Code.
� J
I-WILL EHRWEIN, Clerk,=Boa of Supervisors AUG 0 3 1982
ONNE QUAN, Administrative Assistant Dated
{./.4,{4.4-6--.6 X1111-1i i i i---J.y ii.�.....�.......•.r.. . . . • . . . . . . . .
i
• EXI;I S I' .^.
Zone IX - This zone will include the unincorporated territories of
Pleasanton and Murray Townships and the Cities of Oublin,
Livermore, and Pleasanton.
w
E.(HIBIT a
OPEP.ATIONAL PROCE^URES
I. AVAILABILITY
A. Contractor shall keep GIED informed at all times of the number,
location,. and status of all- ambulance units utilized in serving the
zone at any time. Contractor shall not respond to any call , nor
take an ambulance out of szrvics without immediately notifying C,*-,E0.
Contractor's dispatch office(s) small be available by telephone at
all times. to respond. to calls from CRIED.
II.. C0141UNICATIONS
A.- Contractor shalT operate. MMIET radios in conformance with all-
applicabie rules and reguTations of the Federal Ccmmunications-
Commission and in conformance with all applicable County procedures
and protocols...
B. Contractor's ambulance units shall maintain continuous radio
communications. with DIED at all ti-nes when ambulance is on any
calT requested.. by CIMED and when providing backup or standby
services.
III. PERSONNEL
A. The ambutance driver shall have in his possession at: all ,times a `
valid California Driver's License and. current Ambulance Driver's
Certificate issued by the California Department of Motor Vehicles.
B. For the health-,.. safety, and comfort of both patient and ambulance
personneT,- smoking shall not-be permitted in the patient compart-
ment; of any ambulance at any time by either ambulance personnel ,
patients,. ar- passengers.:. Smoking shall not. be permitted in the
drimer's. compartment when any patient. or other non-ambulance
personnel are located in same, or at any time the ambulance is
traveling. Code 3. Smoking is ndt permitted at the scene of any
emergency when it may in any way endanger the safety or health of
any individual.
IV.. REOUESTS FOR SERVICE
A. Requests received by CMEO: Upon receipt of a request for emergency
ambulance originating within the designated zone of responsibility,
Ci"ED wiTl immediately contact Contractor and provide the following
information: Location and nature of the incident, CMED number, and
traveling. code.. FIC'O. wi 11- also Worm, the appropriate, public safety
agencies serving the location of the incident.
S. Requests received by 'Contractor: Upan receipt of a. request for
emergency ambulance service, Contractor stall immediately contact -
GdED and provide the follc:vin: information: _:cation and nat::r2 cf
the incident and traveling code. CIIIED. will then contact the
Contractor seYv 1 rz tlla zone In '::h::? the 'nC'ran: pcc-_; - ' r -,-ji 1 t
provide the foiio'ning info r^aticn: Locat;or,, nature of incident,
traveling code and Code II number. C:�ED shall contact *_he appropr'ate
public safety agencies serving the location of the incident.
�. Upcn raceip- of request, fo.r risocnse :n, E'D .n.'-:,-ter , .'tout aC-n-
shat 1 ?d1= 1v r-_Snt and A • sn. a �
-�_ _, � 5 SCC. a5 .;r .1,.Y, 'he 3.^..bI.ic!1Ce
repast ty r diC
out unCar no c i rc=s tanc_s shat r__,:r,- '-a .,or_
utcs ire !ctlrl:aticr t %::e C.'..^.tract.:r f one C31 i
i
EY4I3IT 6
PAGE TWO
OPERATIONAL PROCEDURES
V. Response to Emereencv Calls, continued
B. Under no circumstances shall Contractor respond to any requests _
for emergency service originating in another zone of responsibility
without the specific prior approval of DIED. If such a request
is placed by a physician, the name of the physician shall be
Provided to CMED.
C. CMED may assign ambulance to cross zone lines when deemed
necessary for the most efficient response to an emergency call.
0. Upon arrival at the location to which the ambulance has been
dispatched, ambulanca personnel shall notify CiED, and again when
departing the location with a patient to a hospital .
E.. While at the emergency scene or immediately upon departing,
ambulance personnel sha11 notify the: receiving- hospita.l via MEDNE1
radio of the- anticipated delivery of patient(s) , a description of
the possible injury(ies) or, illness with appropriate vital signs,
and the expected time of arrival at the hospital emergency department.
F. Upon arrival at the hospital, CMED shall be notified.
G. Upon becoming again available- for'service, CMED shall be notified.
VI. NON-EMERGENCY CALLS '
A. Prior to responding any ambulance unit previously reported to CMED .
as available for emergency response, to any ncn-emergency request,
the Contractor shall contact C•iED and inform CMED of the intent to
respond, and the destination. Upon returning to the zone of
responsibility and available for service, the ambulance unit shall
contact CMED to inform CMED of availability. The Contractor shall
not respond to- any non-emergency request when by-doing so *requires ' - -the use of the last or only ambulance units available to serve the
zone, or- at any time the Contractor's zone is being provided backup
service.
VII. STANDBY SERVICE.
A- Upon receipt Of' & request for standby service originating within
Contractor's zone of responsibility, CMED shall contact Contractor
and provide Information regarding the location and nature of the
incident far which standby services have been requested and assign
a CMED number. Standby services ahll be provided only in response
to requests from officials of public safety acencies. Contractor
shall immediately respond and as soon as it is underway, the
ambulance unit. shall again .notify Ci _D. upon arrival at the.sc_re.
The- ambulance personnel shall report to- the public safety official
in charge of* the scene and shall serve under his or her supervision
while on standby.
B. In the event that standby se mice should result in the transport of
a patient, Contractor shall immadiately inform. C:-?E7 and shall
Z
allow procedures established herein for response to erercencv C=il_.
C. When released from servic_ by the official in charce, the ambulance
unit shall in-Fan C.IEJ of such.
7.
EXHIBIT 8
PAGE THREE
OPERATIONAL PROCEDURES
ViII. BACKUP SERVICE
A. When any Contractor does not have an ambulance unit available to
respond, CMED shall request backup coverage from an available
ambulance from an adjacent zone. In the instance that the
Contractor is providing service to t::o adjacent zones, CiMED will
first attempt to obtain backup coverage from the same Contractor..
However, no ambulance shall be used to provide coverage to more
than t a zones of responsibility at any one time.
B. The backup ambulance will be relocated to a pre-designated
location. Such locations will be designated. wi*_hin each zone to
cover each adjacent zone. Such locations will be mutually aereed
upon by the Contractors involved and the Contract Administrator.
C. Contractor agrees to respond to request- from CIMEO to relocate any
available ambulance to the pre-designated backup. location.
0.. CMED will dispatch the backup ambulance to any immediate response
call in the vacant zone and immediately notify the ambulance'
Contractor providing backup service.
IX. PROCEDURES AT THE SCENE OF AN EMERGENCY
A. Upon arrival at the scene of an emergency, Contractor's ambulance
personnel' shall assess the. ccndition of the patient(s) and provide
the appropriate medical treatment. A medical report form shall be
completed for each patient to whom treatment is provided.
B.. Prior to transporting or immediately upon leaving the scene,
ambulance personnel shall contact the receiving hospital and
provide the following information- about- the patient: Age, sex,
primary complaint,. leve.I of consciousness, and vital signs, as
well as any additionai information which may be requested. If
the patient has a personal physician and requests that he or she
be informed, this information shall also be provided to the
hospital_
C. The selection of appropriate receiving facility and traveling
code shall be made irr c Hance. with protocols estabishc�d by
Alameda County and provided to Contractor by the Contract
Administrator.
0. The transport of any patient to a facility when selection of the
facility is not in compliance with established protocols shall not
be reimbursable under the terms. of this Agreement.
E. Should arty patient refuse transport, ambulanca personnel shall
complete a medical report form so indicating and shall offer a copy
Of the medical report to ,the patient or •responsible relative. Should
any patient refuse al.I service, the ambulance personnel shall notify
CMED of the refusal and shall complete a medical report form with
whatever information is available to the ambulance personnel .
X. RECEIVI4G HOSPITAL
A. Before leaving the receiving facility, ambulance persor.reT shah
complete and submit a completed ammbulance medical report form. In
the instance that an agent of the hospital re?nests the ambu?ant_
unit to wait at the hospital in order to transfer the patient, _11e
3 b 3 =e per• rs '
r-, 11 n ._. so.... i .till l ac a_aiy so i.,I.Orl
E:(NIBIT 6 '
PAGE FOUR
OPERATIONAL PROCEDURES
XI. ORY RUNS
A. In the event .hat Ci•tED is informed that an ambulance which is en
route to an emergency is no longer required, CMED shall immediately
contact the ambulance unit and inform them of such. In the event
that the ambulance unit arrives at the location and determines that
there is no need. for emergency ambulance services, the ambulance .
personnel shall immediately contact CMED and inform C111ED of the
nature of the incident or reason for not providing transport.
XII.. DISASTER ANO DISASTER DRILLS
A. In the event of a disaster or disaster drill, CMED inform the
Contractor's office of such. The Contractor's office shall confirm
tn. CMEO the location .and number of available units and the number
of units- which may be made available upon request. Contractor's
Office shall inform all ambulance units- of the condition and all
units shall maintain continuous radio communications with CMED until
released from this requirement by CMED. In the event of a disaster,
CMED will dispatch ambulances and no non-emergency service will be
provided without CMED approval.
EXHIBIT C
STANDARDS FOR BASIC LIF= SUPPORT AMBULANCE EOUIPMENT. AMO SUPPLIES
Standard Ambulance Specifications and ;ton-medical Equipment for all 6LS and
ALS Mobile Units:
Size
All ambulances will have adequate space in the patient care campartment
to accom-r:odate one litter patient and two providers. There must be
sufficient space to allow for patient care activities during transport.
r
Z. Safety Equipment
Seat. Belts (3) -- two irr front compartment, one in rear compartment.
Heating and Air- Conditioning -
Approved. Siren
Red. Warnin.T Lamp
Fire Extinguisher (I) Orl Chemical or Carbon Dioxide
Portable, battery operated light (I)
Spare, Wheel with inflatad. tine 1
Jack and tools for wheel' change
Maps of Service Area
Flares
Floodlights ,
Patient..compartment doors must- be operable from inside and outside
II. - Patient Care Eguioment
Stretcher - Collapsable and-. adjustable-
Able to elevate head and foot
Covered with non-permeable material
Ambulance Cat (1)
(All stretchers must be.equipped with straps to secure patient to
stretcher and. a. means of securing stretcher in the vehicle.)
Linens. - sheets (4 sets), pillow cases (4) , blankets (3) , pillows. (3)
III. Basic Life Succor-t Medical EQUicrent and Suoolies
Inservice
Suggested Required
Item Quantity (ISR
Ace bandages, 4" 2 0
Airways: Nasophar nceal (so-,Ft rubber)
30 Fr. 2 t
32 rr.
s4 Fr. 2 L
Orapha rfngeal (sizes 0 through o') 2 each 1 each
EMISIT C
PAGE TWO i
SiANOAROS FOR BLS AMPULANCc EQUIPMENT ANO SUPPLIES
Inservice
Item Suggested Required
Quantity iSR1
Bandages and bandaging supplies*
12x4" sterile bandage compresses or
equivalent I I.
3x3" sterile gauze pads 4 4
2" or 3" roller bandages 6 4
40" triangular bandages 4 4
1Ox3O" or larger universal dressings Z 1
;1", I",. and 2" cloth adhesive type Z rolls ea. I roll ea.
Tourniquets (far hemari-hage. cantraT. 2 1
Bandage shears I 1
Large safety pins 6 2
VaseI ine- gauze. 4 I
Bedpan L L
Bite sticks,. padded (commercial or. homemade) Z I
Blood-pressure cuffs (portable)
Adul t. I 1
Large arm, (obese I 0
Pediatric 1 I
Burrr sheets (steriTe) Z L
Cervical collars
Soft: Medium 2 I
Long Z 1
Hard: Medi urr
2 I
Large. 2 1
Cold packs. 4 Z
- E^sesiT.basins or enesis bags with cantainer Z I
Irrigation equipment.and. supplies.
Tubing for irrigation L 1
Saline, sterile:: 1,000cc Z I
Water, sterile: . I,000cc A Z I
Obstetrical kit. (sterile; pre-packaged ta: I I
Include minimum a•f 2 umbilical' cord• clamps,
scissors. or scapeT, aspr. bulb syringe,
gloves-,. drapes, antiseptic solution)
Oxygen equipment and supplies
Face masks for 02 administration (transparent)
Adult: 3 3.
Pediatric - 2 2.
Infant . 2 2
Nasal cannula for 0 administration 4 3 +
OZ humidification divices- (sterile) 2 2
OZ tanks
Fixed in vehicle 1 I
Pbrtable L I
Resuscitation equipment and supplies
CPR backboarj r t
Oetmand-valve resuscitator Vat meets ;::e
requirement of Vehicle Code Sec_;an Z^18.S 1 1
Face masks for resuscitaticn (clear)
Adult Z 2
Pediatric 2 1
?•.cke_ -.7-=sk
lesusci to:l cn "ac-'.ls 1 ve :1 i�h U2 ras ar'!0'
.^-.c:1Tt _
r:c r
Restraints, ankle and wrists (leather or
soft ties) 2 sets I sets
EXHIBIT C
PAGE THREE
STANDARDS FOR SLS AMSULANCE EQUIPMENT AINO SUPPLIES
• Inservice
Suggested Required
Item Ouantitv ISR)
Sandbags, 760 lbs. each 4 2 -
Scoop stretcher I I
Spineboards
Long with accessories I 1
Short with accessories I I
Splints
With a soft or cushioned surface or
equivalent padded board, wrap ladder,
inflatable or cardboard splints**
Arm 3xI5" 4 2
Leg 3x36" 4. 2 _.
Splints, traction (reco=end: Here•. traction
Sp Ti nts)
Adult T I
Pediatric I. 0
Stethoscopes 2 I
Suction equipment and supplies
Pharyngeal tonsil tip (rigid) for'
suctioning 2 I
Suctforr apparatus (portable) I I
Suction catheters, No. I8 4 2 -
Trash- bags
Paper 3 0 Plastic: 3 0
Urinal I I.
rt��r=rah - 7-.l❑ - ' �;i-�rSi_ ..��i..ij (���'!� r ray r�=iC?e , '..:�ulanc_
EXHIBIT 0
REIMSURSEIM Yf SCHEDULE
July 1, 1982 - Jul y 1, 1983 - July 1,
June 30, 1983 June 30, 1984 June 30, 1985
DIERGENCY CALL
Emergency Call Base Rate 563.50
Mi 1 eage 4.20;.
DRY RUN 31.50
SiAN08Y SERVICES
No transport provided:
First 30. minutes 31.50
• r
Each additional 10-minute
Period or portion thereof 3.00
Transport provided:. Emergency rate, plus standby rate
30 minutes for time exceeding
(Rates for July i,. L083, through June. 30, 1985, or a•_ ortlon thereat, to be
established by mutual agreement prior to. Jul'yr 1, 1983,
EXHIBIT E
ALLOWABLE CHARGES FOR PRIVATE BILLING APPLICABLE
TO EIMERGENCY CALL SERVICES
PRIVAT July I, 1982 -
E RATES: June 30, 1983
Irmcediate Response (Code 3. or Code 2) 5110.00
Night Cali (7:00 p.m. to 7:00 a.m.) 20.00
Mileage (Per Mile) 5.50
Oxygen (Includes Mask and Resuscitation) 18.00
Extra- Handling- (Unusual, dangerous, including restraints,
special loading or unloading) 25.00
'alaiting Time (After 15 minutes; per 10 minute period) 11.00
1
OISPOSABLE SUPPLIES
As required to provide. appropriate. E4r-IA services and first-aid; not to
exceed a mark-up, of 100 percent of over cost. No charges shall be added
for use of equipment required by this Agreement, or any services requiring `
Ei-17-IA skills, except as provided for above_
EXHIE F
A[•16UL4f•ICE VEa1CLES
I. Vehicle License Na. # 1X84187
Make, Yodel , Year 1981. CW. Van
2. Vehicle License No. # 1L98963
Make, Mcd_l , Year 1978, Chevy, Van
3. Vehicle License No. IR94,512
Make, Model , Year 1979, Chevy, Van
4. VehicTe License No. # 1R94509 ,
Make, Model , Year 1979, Chevy, Van
5. VehicTe License No. # IP34065 -
Make, Model, Year 1979, GE, Hieh Sierra Truck
-.-"Ar 2A94&26– — -
fi.. 'Vehicle- Cic�nse No.�
Make, Model , Year 1981, Cam, Van
T. Vehicle License-No. #-=490
Make, Model , Year 1981, GdC, Van
8. Vehicle License No. # IR95665
Make, Model , Year 1979, CMC, Van
9. Vehicle License No. # 1L98951
e, do d a T , __r 1978, Chevy, Van
Lic_anse t1c.
-
EXHIBIT G
RENTAL RATES FOR Ai IBULAPJCE EOUIF'�E`IT
Vehicle and Basic Ecuioment
$723.00 per month per unit
23.00 per day per unit
Above rates include mileage, normal Year and tear and equipment.
EXH(8IT H Page I
Service Contract
C,ntract°.•Tri-Ci ties Ambulance Service
Health Care Services Agency
Contract Taro: 7/1182 - 6130/83 County Aq&icy c epar=4mt
• I
O011C7/80't0 CNCORSE"°-jr RECUlgV1EMr1
Ccntractar's polf:ir_ a- twos shall be endorsed as follows:
Mane Alameda County, its Hoard of Supervisors•, officers, agents.and Malay"" as
Additional flamed Insured/v^thee-_s, but County IS not liable to the insurance czmaany
AnyGremiumi, cos:s or assessments In connection with Contractor's policy/bond, as
a result Of being in Additional Mawd Insured.
Provide County 30 days advance written notice of cancellation, non-renewal or
reduction in limits or =versge including the name of :ne Contract, mailed to the
following address:
Health Care Services
cities of Fremont. Newark. and Union City, Cc tr y,oneper�t to aceive 1+0tica(s)
their City Caurrcils, officers, agents. and Yet; tl• Netnews
employers also named AS Additional Insured/ lv a o cinatir•q Contracts
obIIgess. 499-lth street
Oakland, CA a�s44607
C.Ity, scatiI. Zia
State-the Contractor's policy/bond is prdmary insurance to any other insurance
available to County ritlr respect ta- any claim arising-out•of this-contract:
Contractor is. responsible for pal+eent:of Irmuru+cw.deductibles.
Insurance cmaoanies must haw-at •>Z.1i: Best-rating of 'S*`or better.
_C q U t A C J C 7777=. C ) r C A r G
1.. varte,rs. Cpa00"atiow State Compensation Insurance Fund
a` statutory czVoisatipn ewerege. _ UTam8 ny(s
b. Employer's liability insurance with i o icy uner s Period-— a'd. (peen)
limit not less than- 5100.000 per
oeturrencw. 51gasturt OU Indivicuai aucmrizm y
f InsuraMs CmWy to'bi nd Camoany to
eavvage shoe, and Abow endorsement
Jeac iettl'ufo --District Representativ
S-3- Santa Clara Avenue
a Yand, CA 94610
ate. city. Zip -
i -
Camprehetsiw Go it] Liability NATIONAL UNION INS . Co .ITYP"n a- Minimum Limits of Liability: 55,000,000)aa may s / r.
per accurremce-cbined Single, limiC 8 =--
bodily injury and.pmmerty dmage.- Policy •umder s Policy er,oa datesi
is c averages: • 611442 - 6/1/83
ri Bodily Injury Signature Or individual Authorized oy
Ci Property Oaaage Insurance-Co many W bind.Campany-ta.
L3r Bla"at-Csntractual
Cover hww Wwosaent
Q Personal Injury requi Above PridijawCamolatad Oberatiarte
Braad,Farm Property Oaeage` Nmo 3 3 0 19th Scree t
r7Fir,r Oawage Legal Liability
ss
c- OedLCti b le not to asCeed S1.000 Oakland _ r A 9 4 A l2
Der ocrorrtncr. may. au.. p
Cross LIADIIIty ar SevenbiIIty of
Interests Clause-in policy
Q 3. Camarmnensive•Auteadbile Liability NATIONAL. UNION INS . CO.
nsuru+cr an s /
a: Minimum Limits of Liability: B A 9 0 8 9
J-01 icy numroerlsi o�� 7 rer,o° �aata.5
55.000,000 per oc=rrence C3mbfned 6/1/3 2 - 6�1/8 3.
single licit Bodily Injury and Sign4turx of Irm—oual autnarized oy
P.'aoerty Oeeage. Insuranca Company to bind Camoany to -
Assigned risk insurance at available crequiW
��Gvq n ent.
State financial responsibility limits.
Marne
b. Coverages: 330 19th Street
Owned Autamooiies, if any asakland , CA 94612
L.11 Mon-Owned Au C^aoiie3 city. Stata. .71P
Hired Au taco,t es
rTi Cass Liability Or Severability of
Interests clause in policy
EXHIBIT H Paqe 2
Service Contract
[ Q U F a E U C 0 V [ [ C E 2 T 1,; 1 C A
[r 4. Profnsicnal Liability NATIONAL UNION INS .
nsurance amoanv s
�. For all professional emoloyees iicensea FBP 981 4182E
as a Condition of emaloyrmint at Vie. a %Cy .ygo�rj 2 0 'CY6/ It d$ ldaLBS�
beginning of Contract term or hired bb�� // / 3 _
during the Contract terms, insuring Signature or Individual autncrszea by
Against error or oseission in rendering a Insurance Ca+oany to bind Coeoany to
failing to render professional services. coverage shown, a above endorsement
re Quire
A. Minimum Limits of Liability: 14'13USSEY CANTOR & T PLETT INC.
S5400,000 per claim Address
330 19th Street
b. Deductible not to exceed SI,000 City, State. Zip
' per claim. Oakland ,. CA 94612
Cross Liability or Severacility of
Intartsts Clause in policy 3. One of the foliowing must be checked:
2.. Contractor certifies there art• ma li- Q Professional liability is on an
caned Cr certified professional enoloyess "occurrence" basis.
at contract effective date and will notify Professional liability is an a
County and-camoty with-this professional li "Claims made" basis and contains
ability inurancs provision if prafessional rov,1,1. for an extended discovery
eaplaytes• are Mrtd during.Contract: term:. penoa err ve vears.
gnswrt
Mad .1434 Title
-
S. SMOUCAMe INSUMICE
Q 1. Fidelity Inuranct Bond •
" insurance aapanyts
a.. Faithful Performancr Coverage of all
officials. agents. and-aVloyees wins o icy Numaertsi Foiicy Period sated
accass.to funds received by Contrac-.ar. `
Signature of Incivicuti au viorizea by
b. Limits shall at least be equal to Insurance Cawany to bind Comoany to
CUIOA Cauntv funds in contractor's coverage shown, and above endorsement
possession or control during contract requirements.
term.
aLa. .i ty.. LIP
Q 2. Money and. securities Policy
a. Insurance against the disapptaranc:..
destruction or-wrongful abstraction Insurance ComroanY it
of funds at anct off premises. of =tractor.
Policy rkmoert s Policy Period dares
b. Lions shalt be at least• equal to the
sasimtian Caunty funds in contractor's Signature of LtiolvicW41 autrarizec oy
possessia ar control during contract tam. Insurance Comsaany to bind Caroany to ,
coverage shown. and above endorsement
requirments.
Name
,�, aarass
City, 5tats. Lip
MZS. M-m- (Describe below) NATIONAL UNION INS .
nsuran ay 6,d
Umbrella Insurance BE 306y
Policy Mumuerts Policy Period tdates
6/ 1/82 - _6/j/83
Limit : $ 2,000 ,000 . per 0ccurren j natur_ dr jnoFvjou4j aut:jorizea sy
am
Insurance Coany cn bind C=any to
Limit to be increased to $5 , 000 , OOO .c'veraq s�pwn, above endcrsesa+t
requir ,r+it:
as of 7/l/82. C�
ne BUSSEY-CANTOR TRIPLE-TT IN
acrtss
330 19th Street
City. > at l 'p
Oa and , CA 94612
* Comprehensive General Liability , Automobile 'Liability and ,
Professional Liability policies are to be issued with a
limit of $500 ,000. Combined Single Limit.- A_separate
Umbrella policy is to be issued as noted�ror an adai[ional I
limit of liability $5 , 000 , 000. as of. 7/1/82.
)Mrrics =�ntrlt:
z
Catrac_rs seff-irrsur-s fV• snY risks Sno+r+ in Set_ias stove snaH ittu.: n =ntrac. avt-
Cansi 1aCtslaC:--'-7 3 C:un:y of CGntr%"a .S financial acility (W1 = as a =rr-nC financial
Ma aawt" =. rtsCtnd = lasses in awcunts Sncwt aoove. fS tar-,I r-isk Self-insured.
C=n"C=r 5.-417 —1 ate and sign =e Sal lcyi's stat"Olt and atIMc= C cnc-act.
Ths .�+trat is self-irttyrtd for•:aa fatting caveragss wit"r res:a-t : :lis ca+C-act:
11 iarter•s C=wnatiar
C. C=rirensive-aw raj ouility is :.t* limit of S
TY• injt77
-'roccr:y dxu4gs.
Calualat Cyst-ac-�al
C?tridnal:Injury
QJrzcsx--:/c:mvlacrd saarati=s .
—areas tarps :raa—ty.:amaga
Quire crags 1ag41 Ttaaility
1; GQMvrerstvt auc¢I t anf 1 i ty t>w t-'ss limit of S
!••swtaQ,iu tasant T K 1
L7ar-cwed au t- 'atlos: e
`Musa atttaaatlas.
R PMfassiasal 614.Cil1 ty C tft Tian of S
Rats: If t=c=ss insuranca it nr-dad = matt tae limits rrsuired fs insurancn in UniRit C.
L.—a SUMwi:t4 rec".4antative of tta e=Cass insuiranC= C=any(S) RLS: stgn t.:e czrtSficl:aS to
isnitit C ow'-3tning t: t.`a necessary Cvertgas. `
tgnatura'a aur-=F1:=a. 1 tL t aCa
reCr9sanLatira:cf :=trzc=r
iy
1.
August 3, 1982
Approvcd us ;o Form
I•'•rAG1: RICHARD j. N100RE, Cooky Counsel
Hy................. ............. .. ........ ... Deputy
THE BOARD OF SUPERVISORS OF THE COUNTY OF ALANIEDA, >[A'I'F OF CALIF-0PNIA
Oil motion of Supervisor.......................Chairman Bort ......... Seconded by Supervisor........George
and approved by the following vote, '
Ayes: Supervisors................................Cooper, "George," Santana and Chairman Bort - 4
... .................................................... ............
\,ics: Supervisors. None
...... ................................... .. ... .
. ............ . ................................................ .....l�cused c: Supervisory..........Esce1....-..1.............
CC'
THE FOLLOWING RESOLUTION' WAS ADOPTED: NU�NIBER.1 9 4 2_1 0
EXECUTE AGREEMENT
BE IT RESOLVED that Jpseph P. Bort, Chairman of this Board of Supervisors,
be. and he is hereby authorized and directed to execute on behalf of the County of
Alameda that certain Emergency Ambulance Agreement by and between the County of
Alameda and. TRI-CITIES AMBULANCE, INC. , providing for emergency ambulance services
with alS (Emergency Medical. Services) Zone LX, which includes the unincorporated
territories of Pleasanton and Murray Townships and the Cities of Dublin, Livermore
and Pleasanton,- covering -the period. July 1, 1982 through June 30, 1985; and
BE IT' FURTHER RESOLVED that this Resolution supersedes Resolution No. 193902
(Contract No. 12295) adopted on June 29, 1982.
CONTRACT :NO: . 12439 -,
COUNTY. CAUFORI-;:A
WILLIAM MEHRWEIN. CL_RK OF
OF SUPE:2Vi5CR5 1
BYE
DEC - 7 1982
Approved as to Form
REEL __I1�fAGL• _ RICHARD j. MOORE, County Counsel
By................................................... Deputy
THE BOARD OF SUPERVISORS OF THE COUNTY OF ALANIEDA, STATE OF CALIFORNIA
On motion of Supervisor....................................................... .
Seconded by Supervisor.
and approved by the following vote,
Ayes: Supervisors................................................................................ ............ ................................................................ . ..........
Noes: Supervisors--------------------------------------------------------•--------------------------------•-- •..----------------•--------------•-- -•----------------•--------------------
Excusedor Absent: Supervisors----------------------------------------------------------------------. ..-----------------------------------------•---------------------•-•--.....--
THE FOLLOWING RESOLUTION WAS ADOPTED: NUMBER-195143...
EXECUTE AGREEMENT
BE IT RESOLVED that Joseph P. Bort, Chairman of the Board of Supervisors of
the County of Alameda, be and he is hereby authorized and directed to execute on
behalf of the County of Alameda that certain agreement by and between the County
of Alameda and CITY OF DUBLIN, providing for certain emergency ambulance services
for EMS Zone IX, covering the period-July 1, 1982 through June 30, 1985.
CONTRACT NO.
I CERTIFY THAT THE FORF0NG IS A COR-
PELT COPY OF A RE.01.1710N ADOPTED BY F'!
THE BOARD OF SUPERVISORS, ALAMEDA C-i
CourrTY, CAL!FOU.1!A -.-_.DE.0......71582 4
A1TrST• .......-.....................IlE�------7. 982
W,ILHAM MEHRWEIN K O�
(;THE BO OF S PERVIS RS
BY:
dd