HomeMy WebLinkAboutItem 4.04 FirstRespndrAgmt CITY,CLERK
File #
AGENDA STATEMENT
CITY COUNCIL MEETING DATE: JUne 28, 2004
SUBJECT: Extension of the First Responder Advanced Life Support (FRALS)
Agreement with the County of Alameda
Report Prepared By: Joni L. Pattillo, Assistant City Manager
ATTACHMENT: 1) Amendment to First Responder Advanced Life Support (FRALS)
Agreement
2) February 15, 2000 Staff Report and FRALS Agreement
RECOMMENDATION: Authorize the Mayor to sign the amendment to the First Responder
Advanced Life Support ~(FRALS) Agreement continuing this
~ agreement until August 31, 2004,
unless
terminated
earlier
in
accordance with this Agreement.
' FINANCIAL STATEMENT: None at this time.
DESCRIPTION: At the February 12, 2000 City Council meeting, the Council entered
into a First Responder Advanced Life Support (FRALS) Agreement with the County of Alameda that
would be in effect until June 30, 2004, unless terminated earlier. The City of Dublin supplies 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 basic fire suppression and prevention, emergency first aid, Basic Life
Support (BLS), and Advanced Life Support (ALS)-Paramedic serv/ces on its First Responder units to
enhance the emergency medical services provided to the residents. This allows the private ambulance
provider the ability to meet the response time of being on the scene at a Code 3 (lights and sirens) medical
assistance call within ten (10) minutes; no less than ninety percent (90%) of the time within any month.
Under the current FRALS Agreement the City of Dublin is compensated for a paramedic on each of the
departments' three units (2 engine companies and 1 truck company). The compensation rate for fiscal
2004-2005 for each unit will be $37,377. Although, the City added an additional engine company with
the opening of Fire Station 18 in July 2003, the cUrrent agreement does not allow for reimbursement until
a new agreement is approved.
COPIES TO: ~
ITEM NO.
IUcc-forms/agdastmt.doc [~_.,
The County of Alameda, along with a work group made up of Fire Chiefs from the various jurisdictions in
Alameda County, have been working on a new agreement. Due to the complexities, the current
agreement will need to be extended until August 31, 2004. The additional FRALS unit that the City of
Dublin has supplied since July 2003 is being recommended for reimbursement under the proposed new
FRALS Agreement. This would increase the compensation from three (3) FRALS units to four (4) units.
Recommendation: Authorize the Mayor to sign the amendment to the First Responder Advanced Life
Support (FRALS) Agreement, continuing this agreement until August 31, 2004, unless terminated earlier
in accordance with this Agreement.
Contract Reference No C2000-480
AMENDMENT TO ALS FIRST RESPONDER SERVICES AGREEMENT BETWEEN
COUNTY OF ALAMEDA AND CITY OF DUBLIN
Reference is made to that contract made and entered into on the 20th day of June, 2000,
by and between the COUNTY OF ALAMEDA, a body corporate and politic of the State
of California, and City of Dublin.
Said Contract is hereby amended:
Section 2. TERM
2.1.1 This agreement shall be in effect for a period commencing January 1, 2000
and continuing until August 31, 2004, unless terminated earlier in accordance
with this Agreement.
All other contract terms and conditions shall remain in full force and effect.
In Witness Whereof, the parties hereto have executed this Amendment this day
of 2004.
COUNTY OF ALAMEDA
President, Board of Supervisors Mayor
City of Dublin
100 Civic Plaza
Dublin, CA 94560
Tax Payer ID: 94-2825202
APPROVED AS TO FORM:
Richard E. Winnie, County Counsel ATTEST:
City Clerk
By.
Deputy County Counsel
Amendment to Dublin Frals
ATTACHMENT 1
..... .,.. ...... .. :.. .. . . ,. AGEN.DASTATE~MENT
~-' ' ',',:'.Ci~ COUNCIL-M.EETING DATE:'~'Februa
.. .... ....',..~ ~.. -:.. .... . .... :.- :~:..'.'..-.'. ry 1:5, 2000 .... .'
' ~.'.:':;i'i:":' ":' ' ' - ' '~ ' -: ' q' '
SUBJECT: - '"FirSt.:Rcspondcr Ac]vanC~Cl I. if¢..SUpport (FRALS).^~r~.~nt'.wi.'~
- · ?'- ...'- '....':'.i,'- - m~'.d'O~y Of La~':'~:'-": :' '":" . i.-.-~..'- ·" ..' i:,..'
.. Report:Prepared by:'; ChristOpher £. Foss, .
. ' ' - ' Economic'Dm~eloPment Director
: .': .~. ': ."': "'." ~7" ., . ..,. :..<' . · : "-". ',i '. ': ' '.~; .-..:' .'.. :'::.. .... : ',
ATTA~INTs:''' ' 1. Draft. First Responder'Advanced Life Support Agree. ~ment:
. .' :'-: .[:'" "~. "::: ..':.!:: : ':: :")? ."i- ';': ': :'. "' :"i' k,~,Cal ~...' :.'( Ma~.0.r ,.~.. ox ~'.e .':.th~]:.];'Ffm'; msponder... Advancext': Lifo.. Supp°rt
.--..':-.'...:' .:..:.'. )'::. '.-:.:".('.:.'.:-. !::..:...~.,:. :. ~. ~sy~~tl-wltU:aie!co--v.-ofAi~e~a., .-:
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FINANCIAL STATEMENT: '.:.. The'"'-City: ::of:DUI>ii`n: ;'~':.receiYe; ..net expenses,' apprOXimatelY
:..: .. ":: '-.."..[ ...... .. ' ' $65;000' per-year over'the.'fourryeax:life 0fthe agreement.'.
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DESCRIPTION:'[, :. ::..~i:::) [·"'::~'.:/:'.:.· Th~.Fi~s{..ti~,.¢~';Ad~canc~iLife support Agreement with'the
("-' ¢6mi~:'.0~f'~eda.rli~reSents- a·s~ce"e~¢em~t t.tb:'.~'-cF~[0f DUbtin·'and a' new, !revenue source
to: the- city. oi-r~ubiia:........ . ... - ..... :./-.....:'............ ......
· ' ' . .' .-:'-,::-; .... .'..'.: ...'.-. ': '.'.,:,.-,-.-. ..... ...:-'.'..':;,'..~ :..'::.--..~(:..',i~,. ! ",-.'-!,. :/: ' :. .: '.:"' /.:. '-' i: ,'i'-'. 2'.-~. 2'.' -.:i. o ,
· '-'BACKGRO~: :??': - ; .:' .-': F...'i:Th¢:"County.:of ~eda.. ~s...desagna!ed, by Califorma Health and
safg~.,·.C~aot:/:r~ivisi6n: 2A. se~tio~t,.,:]7~z/~a; .'as' i~'.':i~iu~i:ageiicY, for estab~_h~,,g polioies .~a '
· ~t~?i,to:'~i, teacts'.:~th~ipub~i'a>, ana-..p~iVate;: pro~ia~.:~.to.-..".assare :.~ .em.e..rge,,Cy. :'medical Serdoes
' 'av~16:~tlilli'i~JM~dia°ns?'".'ii'":':"':":" ' ::[":;::::'.'::".i:':".' "".:"L.::::.::"' i')'..:"' :' "'.:i....:'.': '.."..' '.' :' "...': .'
-F~i:~],~-~::'~.i::me ::o0nt~t ;o~u~ ': foe'"iA~.:: ~o.;pro, da~;' .h-.~aa~io~-..,o. ~ r=e.
'pr~ventioa,/~erg~*y'ftrs~ al~ ]~asie· r~ife si/~f~t. ~s);' ana'Xdva-~a Lee-Support (Azs)q~arameai..'o:
'as-:well' ~.:::.td..-ailbw':.:..the': private:?- ambulah~'-~.pi0vider:ilwi, thl the. a:bili~:i'to., meet certain .re~o.nse', time .
re~eaien.ts2':"m~'.'.:city' Of r>ub]iii:.',~tiY p,/~a/,s.:far a paam~,...on ,~h.of tae a~pm~e~t's
SUpport,units:, ':--.":.':' "" .?-:-.. ' . . ...
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· · .- - COPIES TO: . '
· ' ' ATTACHMENT 2
lt/cc-formStagdastmt.doc -. ·
'The County of Alameda, on November 16, 1999, approved a new ambulance contract eric'an
Medical'ReSPonse (A_MR)to.Prov/de ambulance transport services to the Alameda County areas they..
' "e~ently serve..The contact was designed to increase AMt~'s accountability for meeting specified
emergency reSponse times and instituted higher .penalties for not meeting Stated response times,..
re.configured ambulance staffing 'to include.. 1 paramedic and 1 Emergency .. Medicat Technician, and~
"provided reimbursement fOr fire-department based farst'responder'paramedie service, These Changes are a
prOduct ofthe recOmmendations'of the Alameda COUnty Emergency Medical Services (EMS) Task Force.
· : . The. specifids of the' proposed First ReSpOnder agreement between the City of Dublin (contractor) andthe
County ofAlameda 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 Ad, ced Life .Support (FRALs) units .on scene .at a Code. 3'medical assistance 'call.
. - ~ ten(10)', minutes'nm.less 'than .~inety percent (90%) Of the time within ally month. There are
c~ih~ 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
"" 'performanee.:p.enalfies:for non-attainment of the Code 3'response standards. As an eXample, for each
ealen~m0nth..in Whieti the contractor has met less than 90% of the response, lime standards, the County
shall aSsesS the .follOWing penalties:
1~ occurrence: Letter of Deficiency
.... 2'd oCCurrence:'. . $1,000'time~ the number of FRALS O) under contract
' -3'a occurrence:'. : $2,500 times the number of FRALs (3) under contract, or a major breach :of
· ' :': '" ' If there are any. penalties imposed forlaek of performance, the city of,.
....... ......:.: -. -... "... '.. :Dublin wOuld' be :financially responsible for such financial penalties.
-~- ":" :"' Ci/Y::ReimburSement: The agreement calls for the City of Dublin to be'compensated for the
i-; "-:pr°~si°n o/~.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 rote Will increase 5% per..
year over ~e life Of.the'contract.
'"~ ::"-:' "CiOg COSts:'. 'In'0rder to meet the 'conditions of the contract, the'city, thrOughits cOntract with
' ' ACFD, Will be' required to Pr0vid~"new training and certifications for 'the involved empl0yees2 It Wilt
· '.. require '~hat.:'mPloyeeS 'have'Advanced Cardi~ Life Support (ACLS), Pediatric Advanced Life sUPPort
.(PALS), ..and'Pre-.Ielo .~.ital Tram'Life Support (PHTLS). A prerequisite for ACLS is the attainment of.
CP .R". Pro~der CertifiCation, Which is an Upgrade l~om the Current requirement of CPR Training only.' The-
- ?contractor' will."'also be mandated, to evaluate COmpany' level professional Skills and paramedic.
peff0rman~e. Bgth ,.the.new certifications and evaluations Will'require an additional commimaent-0f staff
:time"and witI reSUlt"in'additiOnat, expenses.- ACFD has estimated that the additiOnal costs .(overtime; feeS,'
- books, and..administration): will be approximately $24,50.0 for the first 2 years: of the .contract and
, . approXimately $14,560'for the last two years. The. final two year c°sts'wil! be. lower 'due to' the lower
. .. costs'Ofreeertilieation.
.protection agreement. Staff'is working on a Letter iof 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.
The proP°sed agreement provides.a- higher level .of' cm,rgencY services for the residents of Dublin, and
provides a.funding source.to compensate for'the.ad~tional' trai~ing neeess~ to upgrade, the'service. The
. agreement .will 'reimburse the City'Of Dublin-for pro~rling first:responder imits, and Will be'a further
enhancement .tome emergency medical serviee ~wit._hin:the.' City of.Dublin~..The reimbursement, CalCulated
at $90,000 pet'.year, will: mom.than offset the ad~ti0.nrd....costs involved in upgrading the certifications of
-the City's'-. Paramedics. .- -~ . ' ' '
. ' -',.,' .-- .:i !''. .', .. ' . -. ' ' ':' ' ' · ""
.Recommendation::-.'.:':':...::' :.'..: ...' - ~ ....-.-...
It is" staff's :rec°ramendation that the'City-Council aUthorize :the Mayor.tO'execute the First Responder
Ad~anCeXt lsife:Support'.'(FKALS)"Agre .ement betWeenthe citY.ofDublin and the .coUnty of Alameda.
' ..' '~ ..... . .'...:...... "::.i'. :.'..: -..i ' _: ........~.. '.: ..- .':: ~ ..-...: ' '
. :'i. :.'.':'I~ :::".i'- :":::" '. '"' :' . ...... ' '"' ' ' '"~ '"' ' .'
- '" ":......~i' ..
ALS FIRST RESPONDER SERVICES AGREEMENT BETWEEN COUNTY OF
ALAMEDA AND CiTY OF DUBLIN
· -, Section 1.
INTRODUCTION
1.1 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.
1.2. The COUNTY has established an Emergency Medical Service District (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_
1.3 The CONTRAcTOR(S) are Willing to provide firs{ 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
private ambulance provider to meet response time requirements.
1.3.1 The CONTRACTORSinclude the agencies/cities listed beiow: ..
Alameda County.Fire Department. .*, 11 FRALs Units
· Dublin .. ~ *' 3 FRALS.UnitS
Emeryville.. ':. ..:. ~ 2 FRALS Units
Fremont. ~.. 13 FRALS Units
Hayward 1'~ FRALS Units.
Livermore 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 wheth_er
or not the additional FRALS unit(s) will be compensated; approval for additional units shall
not be unreasonably withheld. ~
1.4.1 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
'i-file 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.
.~---. 1.4.?. .Neither CONTRACTOR nor COUNTY Waive any rights it may have pUrsuant to Section
' 1797.201. ,~,~,~,¢,¢'~,'~¢'' ~f,~.,~
First Responder ALS Agreement
Page 2
Rev. 02/09/00
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 Sul3~ort (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. L'de Support (BLS) - as defined in Health and Safety Code Section 1797.60.
3.7 Computer-Aided Dispatch or CAD -~Computer-Aided Dispatch system consisting of associated
hardware and software'to facilitate call taking, unit selection, resource dispatch and deployment,
event time stamping, creation and real time maintenance of incident database,, and Management
Information System.
3.8 Contract Administrator- An agent of the COUNTY designated by the Director of the Alameda
County Health Care Services AgencY,
3.9 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.
3.10 ." Eme .r~ency MedicaI TechniCian - ! or IEM'r-! - 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
· California State licensed and Alameda. County accredited paramedic capable of providing ALS at
scenes of medical emergencies.
3.13 Life Threatenin_q Emergency Resl3°nse (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 strict accordance with approved' dispatch protocols.
3.18 'Non-EmergencY ReSponse(Code 1)- Any requestfor service that falls.outside the established
protocols for.emergency life tlbreatening and emergency non-life.threatening responses. Pre-
scheduled transfers for response time purposes'shaEI be con'sidered 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 On'Scene Time - The time a *unit an-ives at the location requested.
3.20 Paramedic - Personnel as defined i~ 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 Ans.wefin.q 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 Quality improveme ..nt- The evaiua§on 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-evatuation and refinement in a continuous cycie. While
Quality Assurance traditionally focuses on the detection of defects, Quality Improvement strives
to prevent them. Thus a Quality improvementprogram must include, but not be limited to, Quality
Assurance.. '..
3.27 Resl3onse 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~t Responder ALS Agreement
Page 4
Rev. 02109100
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.
Section 5~
PERFORMANCE STANDARDS .
5.1 ReSponse Times - CONTRAcTOR's response time on requeSts for. emergency medical
services originating from within the Pdmary Service Area shall meet the following performance
standards:
5. i.1 (COde3! - CONTRACTOR shall place a First ResPonder.Advanced Life sUpport
(FRALS) unit on-scene of each Code 3 medical assistance ceil'within ten (10) minutes
zero (0) seCOnds from time of receipt of call at primary Pubiic Safety Answering Point
(PSAP) on nat 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 mute from One call to another before arrival atthe scene
of the first call, the response-time clock shall not stop on the first call until the ardval of e
FRALS.unit at the scene of the first call.
5.2 Exceptions -In cOUNTY'S calculation of CONTRACTOR'S 'perfc;rmance 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 dudng a
declared disaster in a neighboring jurisdiction Which has requested assistance from the
COUNTY and/c~r 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 period 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. 02t09/00 '
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 the
· 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 hfs/day, 7
days/week.'
.. Section 6:,
' ADDITIONAL SERVICE PROVISION
6.1 CONTRACTOR to the'best of its ability sl~all respond to any medical disaster, declared or
undeclared~ within Alameda County or adjacent counties when directed by the' Alameda CoUnty
Fire Mutual Aid Coordinator..
6.2 CONTRACTOR agrees th'at the performance of Work and services pursuant to-this Agreement
shall conform 'to high professional standards and shall comply with all applicable provisions of the
Alameda County EMS Policy Manual.
6.3 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.. - :- ·
6.4 CONTRACTOR shall have an EMS coordinatorwho holds a valid State of California paramedic
license or equivalent as determined by the local EMS agency..
· Section 7. -
OU^LI
~ 7.1 CONTRACTOR shall either have on staff or contract with a Quality Improvement coordinator who
holds either a valid State of California .Registered Nurse (RN) licenSe or a valid State of
California Medical Doctor (MD) [icense. 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. 02/09t00
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 paramedicsand EMT's on issues
relating to patient care. The Medical Director shall provide guidance, on the operational components of
the Contractor's delivery of pre-hospital ca.re. 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 I~cal 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 lncorpor~ion 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 Authorization and monitoring of EMS training programs, base hospitals, and service providers;
9.4 Certification and/or accreditation of CONTRACTOR'S EMS personnel;
9.5 Provision of medical control, through its Medical Director. Medical control requirements include
medical dispatch, patient destination policies, patient care guidelines, and quality aSSurance/
· ' improvement;
9.6' 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 date 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:
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EQUIPMENT '
10.1 Vehicle Markin~ -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 emergen.cy 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 ali 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 Contra~ors prior
to implementing-change to system policies and procedures.
· .. Section 12.'
ACCESS TO RECORDS AND REPORTING REQUIREMEN~'S
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 COiJNTY'S "Patient Care Report"
(PCR) system for ali 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 [o CONTRACTOR'S financial data
relating to the provision of First Responder Advanced Life Support operations.
~ ~ '.' .
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12.4 Observation of Operations - COUNTY representatives may, with appropriate notification,
directly observe CONTRACTOR'S medical dispatch center operations, and may dde 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 certificati0n/Jicensure.
EMT-ls and paramedics shall comply with all training requirements as establishedby the State of
California and all applicable provisions of the Alameda County EMS Policy Manual.
Section 13.
ADDITIONAL CONSIDERATIONS
13.1 Fee schedules -The CONTRACTOR shall not bill patients or payors for supplies or medications
that the private 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 Pdmary 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 Agreement maintain in force those insurance
policies and bonds as designated in Exhibit C and will comply with ali requirements thereof.
CONTRACTOR agrees to defend, to indemnify, to save and hold harmless the County of Atameda, its
officers, empi0yees, 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 harmiess 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.
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· 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 andbetween two pubiic 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. . .
Section 18.
COMPLIANCE WiTH LAW AND SAFETY
18.1 CONTRACTOR shall observe and comply with alt 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 appJicable
fed.eral, state, municipal, and local safety regulations. Ail services performed by CONTRACTOR
must be in accordance with these 'laws, 'ordinances, codes, arid regulations. CONTRACTOR
shall indemnify.and saveCOUNTY harmless from an~) and all liability, tines, penalties, and
consequences from any noncompliance or'violations of such taws, ordinances, codes, and
regulations.
Section 19.
TERMENATION PROVISIONS
19.1' 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 Transport Provider Contract is terminated, or if the
COUNTY service area funding is no longer available.
19.2 Termination by CONTRACTOR - CONTRACTOR may terminate this Agreement, at any time,
upon ninety (90) days' written notice to COUNTY.
19.3 TerminatiOn by.Mutual A,clreement - COUNTY and CONTRACTOR may otherwise agree in
wdfing to terminate this Agreement in a mutually satisfactory manner.
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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
A..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-thiA'y (;30).calendar days foliowin9 the service on it of a
written notice by COUNTY specifying the defaultor defaults complained of. and the date of intended
termination of fights hereunder absent cure.
~3. Definitions of Breach
ConditionS and circumstances whichshall constitute a material broach by the CONTRACTOR shall
include but not be limited to the following:
'1) ~ Failure of the CONTRACTOR to operate.the FRALS service systemin a manner which enables
the COUNTY or the CONTRACTOR to remain in substantial compliance wi~h the requirements of
the applicable Federat, 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 performance penalties table in Exhibit B-1.);
5) Failure by CONTRACTOR to maintain the required insurance.
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Section 24.
PAYMENT AND PATIENT FEES
24.1 CONTRACTOR agrees that it will not, without pdor approVal of COUNTY, bill patients for services
provided under this Agreement.
Section 25.
MISCELLANEOUS PROVISIONS
A~ Affomev's Fees
in any claim, suit or proceeding brought or instituted bYeither of the parties to enforce any of the
provisions of this Agreement or to seek damages, the prevailing party shall be enffiled to recover
reasonable attorney's fees, costs, and necessary disbursements.
B. Notice
All notices required hereunder will be in writing and Served P~rs°nally or by mail;.
CONTRACTOR: City of Dublin
100 Civic Plaza
.._... Dublin, CA 94568
COUNTY: Alameda County EMS District
1000 Broadway~ Ste. 5024
Oakland, CA 94607
C. Entire Aoreement
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. Bindino Effect
:l'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. Counteroar~s
This Agreement may be executed in any number of counterpafits, all of which shall constitute the
.---. Agreement between the parties.
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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 unenfoi'ceable, 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 furnishing of any services pursuant to this Agreement
the. CONTRACTOR. shall make available, upon written 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 author'~zed representatives, this Agreement, and such books,
idoc~.ments', 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. '.
J. 'Waiver
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 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 ,
Th.is 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. M0dification of A.qreement
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'wr'rting
as evidenced by resolution of the Board 'of Supervisors approving such modification.
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IN WITNESS W"HEREOF, the parties hereto have executed this Agreement the day and year first above
written.
'COUNTY Of ALAMEDA CONTRACTOR
By By
President, Board of Supervisors
Title
Address
Approved as to f~rm:
City Attomey
Clerk
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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
2. Reimbursement rates will increase 5% per year
3, 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 cimumstances 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:
'1 st occurrence Letter of deficiency sent
2"d occurrence $i000 times the number of FRALS under contract
3r~ 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.
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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 witl be fined
$1,500/incident
Should the CONTRACTOR excccd 10 incidents in two consecutive months, COUNTY
shalt, at its option, assess a $25,000 penalty in addition to the above stated fines and/or
find CONTRACTOR in major breach of contract.