HomeMy WebLinkAboutItem 4.2 First Responder Agmt82 STAFF STAFF REPORT CITY CLERK
CITY COUNCIL File # 600 -40
DATE: October 4, 2011
TO: Honorable Mayor and City Councilmembers
FROM: Joni Pattillo, City Manager a_ P,'a
SUBJECT: First Responder Advanced Life Support (FRALS) Agreement with the County of
Alameda
Prepared by Christopher L. Foss, Assistant City Manager
EXECUTIVE SUMMARY:
The proposed item would approve a five -year First Responder Advanced Life Support (FRALS)
agreement with the County of Alameda. The agreement will reimburse the City of Dublin for
providing four (4) first responder units, which is an enhancement to the emergency medical
services within the City of Dublin.
FINANCIAL IMPACT:
The proposed agreement will compensate the City for four (4) FRALS units a total of
$892,870.91 over the five year term of the agreement.
RECOMMENDATION:
It is Staff's recommendation that the City Council adopt Resolution authorizing a Five -Year
(November 1, 2011 to October 31, 2016) First Responder Advanced Life Support (FRALS)
Agreement with the County of Alameda.
Submitted By
Fire Chief
Reviewed By
Assistant City Manager
Page 1 of 3 ITEM NO. 4.2
DESCRIPTION:
The County of Alameda is designated, by California Health and Safety Code Division 2.5,
Section 1797.94, as the responsible agency for establishing policies and procedures for the
approval and designation of paramedic service providers within its jurisdictions, including the
City of Dublin. The County of Alameda established an Emergency Medical District and has
entered into contracts with public and private providers to assure that emergency medical
services are available within the jurisdictions.
The City of Dublin is provided fire protection services through a contract with the Alameda
County Fire Department (ACFD). The contract calls for ACFD to provide, in addition to basic
fire suppression and prevention, emergency first aid, Basic Life Support (BLS), and Advanced
Life Support (ALS)- Paramedic services on its First Responder units to enhance the emergency
medical services provided to the residents as well as to allow the private ambulance provider
with the ability to meet certain response time requirements. The private ambulance provider
must meet the response time of being on scene at a Code 3 (lights and sirens) medical
assistance call within eight minutes and thirty seconds no less than ninety percent (90 %) of the
time within any month.
The City of Dublin currently provides for a paramedic on each of the department's four units (3
Engine companies and 1 Truck company) and thus has four (4) First Responder Advanced Life
Support units. The proposed agreement will compensate the City for four (4) FRALS units as
follows..
The City of Dublin has approved First Responder Advanced Life Support ( FRALS) agreements
with the County of Alameda in 2000, 2004 and again in 2009. The City Council considered a
letter amending the 2009 agreement on June 7, 2011 (see Attachment 1). Staff is requesting
the City Council to adopt the proposed resolution (Attachment 2) approving the agreement. The
proposed FRALS agreement (Attachment 3, entitled Exhibit A to Resolution) shall be in effect
Page 2 of 3
Amount per FRALS
%
Quarterly
Time Period
COLA
Unit x 4
Funded
Amount
Total Amount
11/01/2011 -
10/31 /2012
$42,893.16 x 4 =
0%
$171,572.64
100%
$42,893.16
$171,572.64
11/01/2012 -
10/31 /2013
$43, 751.02 x 4 =
2%
$175004.08
100%
$43,751.02
$175,004.08
11/01/2013 -
10/31/2014
$44,626.04 x 4 =
2%
$178,504.16
100%
$44,626.04
$178,504.16
11/01/2014 —
10/31 /2015
$45,518.56 x 4 =
2%
$182,074.24
100%
$45,518.56
$182,074.24
11/01/2015 -
10/31/2016
$46,428.94 x 4 =
2%
$185,715.76
100%
$46,428.94
$185,715.76
The City of Dublin has approved First Responder Advanced Life Support ( FRALS) agreements
with the County of Alameda in 2000, 2004 and again in 2009. The City Council considered a
letter amending the 2009 agreement on June 7, 2011 (see Attachment 1). Staff is requesting
the City Council to adopt the proposed resolution (Attachment 2) approving the agreement. The
proposed FRALS agreement (Attachment 3, entitled Exhibit A to Resolution) shall be in effect
Page 2 of 3
for five years beginning November 1, 2011 to October 31, 2016 unless terminated early. The
proposed agreement also allows a five -year extension upon mutual consent of both parties
The proposed agreement provides a higher level of emergency services for the residents of
Dublin, and provides a funding source to compensate for the additional training necessary to
upgrade the service. The agreement will reimburse the City of Dublin for providing first
responder units, and will be a further enhancement to the emergency medical service within the
City of Dublin.
NOTICING REQUIREMENTS /PUBLIC OUTREACH:
1► •CTiO
ATTACHMENTS: 1. June 7, 2010 Staff Report
2. Resolution Authorizing a Five -Year (November 1, 2011 to
October 31, 2016) First Responder Advanced Life Support
(FRALS) Agreement with the County of Alameda
3. Exhibit A to the Resolution - Agreement with Alameda County
Page 3 of 3
TO: Honorable Mayor and City Councilmembers
FROM: Joni Pattillo, City Manager
SUBJEC : Letter of Agreement with the County of Alameda for the.continuance of First
Responder Advanced Life Support (FRALS) services
Prepared By. Christopher L. Foss, Assistant City Manager
EXECUTIVE SUMMARY:
The proposed item is a Letter of Agreement between the City of Dublin and the County of
Alameda to extend the current First Responder Advanced Life Support (FRALS) agreement
until October 31, 2011 to allow both parties adequate time to complete a new agreement.
FINANCIAL IMPACT:
There is no financial impact to this action at this time.
RECOMMENDATION:
It is Staffs recommendation that the City Council adopt a Resolution approving a Letter of
Agreement between the City of Dublin and the County of Alameda for continued First
Responder Advanced Life Support services (FRALS Services).
Submi d B
Assistant City Manager
Page 1 of 2 ITEM NO
DESCRIPTION:
The County of Alameda is designated, by California Health and Safety Code Division 2.5,
Section 1797.94, as the responsible agency for establishing policies and procedures for the
approval and designation of paramedic service providers within its jurisdictions, including the
City of Dublin. The County of Alameda established an Emergency Medical District and has
entered into contracts with public and private providers to assure that emergency medical
services are available within the jurisdictions.
The last First Responder Advanced Life Support ( FRALS) agreement the City executed with the
County of Alameda was on May 5, 2009 (Attachment 1). The current agreement expires on
June 30, 2011. The proposed Letter of Agreement (Attachment 2) would extend the agreement
until October 31, 2011 (or until the new agreement is executed) to allow both parties an
opportunity to finalize the new agreement, The City Manager would execute the agreement on
the City's behalf.
NOTICING REQUIREMENTS/PUBLIC OUTREACH:
None.
ATTACHMENTS: 1. May 5, 2009 Staff Report on FRALS Agreement
2. Draft Letter of Agreement
3. Resolution Approving a Letter of Agreement between the City of
Dublin and the County of Alameda for Continued First Responder
Advanced Life Support Services ( FRALS Services)
1654541.1
Page 2 of 2
AGENDA STATEMENT
CITY COUNCIL MEETING DATE: May 59 2009
SUBJECT: Extension of the First Responder Advanced Life Support ( FRALS)
Agreement with the County of Alameda
Report Prepared by: Christopher L. Foss,
Assistant City Manager
ATTACHMENTS: 1. October 51 2004 Staff Report and FRALS Agreement
2. Resolution and proposed Amendment to First Responder
Advanced Life Support ( FRALS) Agreement commencing
July 1, 2009 and -continuing until June 30, 2011
RECOMMENDATION: Adopt Resolution authorizing a Two -'Year Extension (July 1, 2009
to June 30, 2011) to the First Responder Advanced Life Support
( FRALS) Agreement with the County of Alameda.
FINANCIAL STAT NT: The proposed amendment will compensate the City for four (4)
FRALS units at a rate of $42,893.16 per unit per year for a total of
$343,145.28 over the two year term on the amendment.
DESCRIPTION: The County of Alameda is designated, by California Health and
Safety Code Division 2.5, Section 1797.94, as the responsible agency for establishing policies and
procedures for the approval and designation of paramedic service providers within its jurisdictions,
including the City of Dublin. The County of Alameda established an Emergency Medical District and has
entered into contracts with public and private providers to assure that emergency medical services are
available within the jurisdictions.
The City of Dublin is provided fire protection services through a contract with the Alameda County Fire
Department (ACFD). The contract calls for ACFD to provide, •in addition to basic fire suppression and
prevention, emergency first aid, Basic Life Support (BLS), and Advanced Life Support (ALS)- Paramedic
services on its First Responder units to enhance the emergency medical services provided to the residents
as well as to allow the private ambulance provider with the ability to meet certain response time
requirements. The private ambulance provider must meet the response time of being on scene at a Code 3
--- ----------------------- --------------------------------------------
..: -
COPY TO: I
Page I of 2 ARAI� I
GAChriffirelAgenda Statement FRALS May 2009.doc
(lights and sirens) medical assistance call within ten' (10) minutes no less than ninety percent (90 %) of the
time within any month.
The City of Dublin currently provides for a paramedic on each of the department's four units (3 Engine
companies and 1 Truck company) and thus has four (4) First Responder Advanced Life Support Units.
The proposed amendment will compensate the City for four (4) FRALS units at a rate of $42,893.16 per
unit per year for a total of $343,145.28 over the two year term.
The City of Dublin has approved First Responder Advanced Life Support (FRALS) agreements with the
County of Alameda in 2000 and again in 2004 (see Attachment 1 for 2004 staff report and agreement).
The proposed amendment to the FRALS agreement shall be in effect for two years beginning July 1, 2009
to June 30, 2011 unless terminated early.
The proposed agreement provides a higher level of emergency services for the residents of Dublin, and
provides a funding source to compensate for the additional training necessary to upgrade the service. The
agreement will reimburse the City of Dublin for providing first responder units, and will be a further
enhancement to the emergency medical service within the City of Dublin.
RECOMMENDATION: It is staffs recommendation that the City Council adopt Resolution
authorizing a Two -Year Extension (July 1, 2009 to June 30, 2011) to the First Responder Advanced Life
Support (FRALS) Agreement with the County of Alameda.
4 rr7, . ,
3 a I-
AGENDA STATEMENT .
CITY COUNCIL. MEETING DATE: October 5, 2004
SUBJECT: Authorization of a Five -Year (July 1, 2004 until June 30, 2009) First
Responder Advanced Life Support ( FRALS) Agreement with the
County of Alameda CINA
Report Prepared By: Joni Lm Pattillo, Assistant City Manager
ATTACHMENT:. 1) Resolution and Proposed'First Responder Advanced Life
Support ( FRALS) Agreement for a period commencing July
1, 2004 and continuing until June 30, 2009
2) June 28, 2004 Staff Report and Amendment to FRALS
Agreement
RECOMMENDATION: Adopt Resolution authorizing Mayor to sign. the First Responder
Advanced Life Support ( FRALS) Agreement for a period
commencing July 1, 2004, and continuing until June 30, 2009, unless
terminated earlier in accordance with this Agreement.
FINANCIAL STATEMENT: This proposed agreement will compensate the City for the additional
fire engine company that is associated with Fire Station 18. The
City will now be compensated for four (4) FRALS units at a rate of
$37,000 each for a grand total for FY 2004 -2005 of $148,000. The
additional compensation for the fourth FRALS, unit was included as
part of the City of Dublin's FY 2004 -2005 budget (the compensation
rate budgeted was $37,377 and the County rounded down to
$37,000). The Agreement also includes a. 3% escalator for
subsequent fiscal years.
DESCR MON: 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
services on its First Responder units to enhance the emergency medical services provided to Dublin
residents. This allows the .private ambulance provider the ability to meet the response time of being on the
COPIES TO:
GACCL rrrS\2004 a;► 0d\104"4\ ft-RU.a"
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.
Y * All
At the June 28, 2004, City Council meeting, the Council agreed to extend the FRALS Agreement until
August 31, 2004 until a new agreement could be completed. The County of Alameda, along with a work
group made up of Fire Chiefs from the various jurisdictions in Alameda County, developed this new
agreement, which includes the recognition of the City of Dublin's additional fire engine. Due to the
complexities, the new agreement took a little longer than expected; however, the agreement acknowledges
a full year of reimbursement for the City of Dublin's four (4) FRALS units.
Staff recommends that the City Council adopt the Resolution authorizing the Mayor to sign the First
Responder Advanced Life Support ( FRALS) Agreement for a period commencing July 1, 2004, and
continuing until June 30, 2009, unless terminated earlier in accordance with this Agreement.
�j
RESOLUTIoN No. 04 j 4-
A RESOLUTION OF THE CITY COUNCIL
OF' CITY OF DUBLIN
AUTHORIZING A )F &YEAR (JULY It 2004. -- JUNE 301, 2009)
FIRST RESPONDER ADVANCED LIFE SUPPORT ( FRALS) AGREEMENT
WITH THE COUNTY OF ALAMEDA
WHEREAS, the City of Dublin supplies fire protection services through a Fire Protection and
Emergency Medical Services Agreement with the Alameda County Fire District (ACFD), as known as the
Alameda County Fire Department; and
WHEREAS, the Fire Protection and Emergency Medical Services Agreement calls for ACFD to
provide basic :hre suppression and prevention, emergency first aid, Basic Life Support (BLS), and
Advanced Life Support (ALS) Paramedic services on its First Responder units to enhance the emergency
medical services provided to the residents of Dublin; and
WHEREAS, at its June 28, 2004, meeting, the City Council agreed to extend the existing FRALS
Agreement until August 31, 2004, until a new FRALS Agreement g ed as E*ibit A , which
reimburses the City of Dublin for providing four (4) first responder units, could be completed.
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Dublin hereby
authorizes the Mayor to sign the First Responder Advanced Life Support ( FRALS) Agreement for a period
commencing July 1, 2004 and continuing until June 30, 2009, unless terminated earlier in accordance with
the Agreement:
PASSED, APPROVED AND ADOPTED this 5th day of October, 2004.
AYES:
NOES:
ABSENT:
ABSTAIN:
ATTEST:
T ^ City Clerk - -
0:=— MTOMW4.q 4Zd\lO- 05 -04Ltsafrak-doe
-1-
Mayor
M6
ADVANCED LIFE SUPPORT (ALS)
FIRST RESPONDER SERVICES AGREEMENT
BETWEEN
ALAMEDA COUNTY AND CITY OF DUBLIN
SECTION I
INTRODUCTION
1.1 The COUNTY is designated as the Local Emergency Medical Service Agency (LEMSA)
as defined in the California Health and Safety Code Division 2.5, Section-1797.94
responsible 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- 19$3 -1) and
has entered Into agreements with various Emergency Medical Services (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 first paramedic response to requests for all
medical calls as defined by the algorithms in the County EMS approved Emergency
Medical Dispatch (EMD) protocols.
1.3.1 The CONTRACTORS include the agencies /cities listed below:
City of Dublin Fire Department 4 FRALS Units
The number of First Responder Advanced Life Support (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). Additional units will be negotiated between the
Contract Administrator and Contractor with justification.
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 Hoalth &Safety Code Section 1797.178, a paramedic servlce- provider
agreement under Title 22 CCR Section 100168(b)(4), and a written agreement- regarding
the provision of prehospital emergency medical services under Health & Safety.Code
Section 1797.201.
1.4.2 Neither CONTRACTOR nor COUNTY waives any rights it may have pursuant to Section
1797.201.
SECTION. 2
TERM
2.1.1 This Agreement shall be in effect for a period commencing July 1, 2004, and continuing
until June 30, 2009 unless terminated earlier in accordance with this Agreement.
SECTION 3
! EEINITIONS
For the purposes of this Agreement, the following words and phrases shall have the meanings
respectively ascribed to them by this section.
3.1 Advancer! L fe Support (ALS) — Special services designed to provide definitive
prehospital emergency medical care as defined In Health and SafetyCode 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
Callfornia 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, ohd a person from whom paramedics may take medical
direction by radio or other remote communications device.
3.6 Basic Life Su ort BLS — as defined in Health and Safety Code Section 1797.80.
3.7 Conn uter -Aided D 14patch 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 circumstances that a delay In prbvlding such services may
aggravate the medical condition or cause the loss of life.
3.10 EtargeMy Medical Technician -- I or-EMT-1 -- Personnel as defined In the Health and
Safety-Code Section 1797,80.
3.11 Fire De artment Dispatch IFac'ilt — A facility that directly dispatches Fire Department
resources "to 9 -1 -1 calls that come into a PSAP.
2
f'
3.12 Mrst Responder — A fire department vehicle,. police vehicle with personnel capable of
providing necessary pre - hospital care.
3.13 First Responder ALS Unit (FRALS j — 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.
3.14 Life Thr2atening Emergency Response jCode 3 ) — Any emergency that is designated
as life threatening in strict accordahce with County approved EMD protocols. Code 3 will
be counted as an emergency response.
3.15 Medical Direction — Direction given ALS personnel by a base hospital.
3.16 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.
3.17 Medical__Protacol —Any diagnosis- specific or problem - oriented written statement of
Standard procedure, or algorithm, promulgated by the Medical Director as the normal
standard of prehospltal care for the given clinical condition.
3.18 Non-Life Threatening Response Code 2 — Any emergency 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 County approved
EMI) dispatch protocols.
3.19 Non - Emergency Response (Code 1) — Any request for service that falls outsfde the
established protocols for emergency life threatening and emergency non -life threatening
responses. pre- scheduled transfers for response time purposes shall be considered
non - emergency responses. Non- emergency calls may be of private-or public origin.
Code 1 will not be counted as an emergency response.
3.20 On Scene Time — The time a unit arrives at the location requested.
3.21 Paramedic - Personnel as defined in the Health and Safety Code Section 1797.134.
3.22 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 patients), and
designated as a paramedic unit by the Medical Director.
3,23 Public Safety Answering Point (PSAP) —Public safety answering point where 9 -1 -1
calls are first received
3.24 Public Safety Officer Any person designated as a public safety officer by the law of
the State of California. .
3.25 Physician — Any person duly licensed to practice medicine in the State of California.
3.26 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
3.27 Qu-a-lity Improvement — The evaluation of prehospital emergency medical services to
Identify where personnel performance or the system itself can be improved, the
Implementation of potential Improvements, and their re- evaluation and refinement In a
continuous cycle. While Quality Assurance traditionally focuses on the detection of
3
defects, Quality Improvement strives to prevent them. Thus. a Quality Improvement
program must include, but not be limited to, Quality Assurance.
128 Response Time -- The actual elapsed time between receipt of a call at a PSAP or Fire
Department Dispatch Facility that a unit Is needed and the on -scene time, consistent with
sect €on 5.
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 medical requests for emergency medical services originating withln the area.
SECTION 5
SCOPE OF PRACTICE BY CONTRACTOR
Contractor shall provide as part of a FRALS unit AL'S -level medical service to patients until
contractor relinquishes medical control of the patient to the contract ambulance provider or a
medical physician of competent authority In accordance with EMS Physician On Scene policy.
SECTION 6
PERFORMANCE STANDARDS
6.1 Response 'Times — CONTRACTOR'S response time on requests for.emergenoy medical
services originating-from within the Primary Service Area shall meet the following
performance standards:
6.1.1 Code 3 CONTRACTOR shall place a First Responder Advanced Life Support
( FRALS) unit on -scene of each Code 3 medical assistance call within eight (8)
minutes thirty (30) seconds from time of receipt of call at Fire Department
Dispatch Facility or primary Public Safety Answering Point (PSAP) for those
Departments not using a Fire Department Dispatch Facility, on not less than
ninety percent (90 %) of the responses within any month.
6.1.2 Code 2) — Response times are calculated as 150% of Code 3 time. (12 minutes
and 45 seconds)
6.1.3 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.
6.1.4 • If a FRALS unit is reassigned en route from one call to another before arrival at
the scene of_the first call, the response --time clock shall not stop on the first call
until the arrival of a FRALS unit at the scene of the first call.
6.2 - Exceptions -- In COUNTY'S calculation of CONTRACTOR'S performance In regard to
these standards, every medical emergency request originating from within
CONTRACTOR'S Primary Service Area shall be included except as follows:
6.2.1 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.
06a9
6.2.2 The response time requirements-shall be suspended during any declared
disaster in the County of Alameda, declared state of emergency within a local
jurisdiction, or during a declared disaster in a neighboring jurisdiction which has
requested assistance frorn the COUNTY and/or jurisdiction within the County.
6.2.3 Good 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. Exemptions must be documented In detall In the
quarterly response time data report.
6.2.4 The response time requirement shall be suspended during 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.
6.2.5 The response time requirement shall be suspended for Incidents on all freeways
or Interstate highways within; when traffic congestion Impedes response; or when
unclear or inaccurate dispatch information is given as to scene location.
6.2.6 Other circumstances require contractor to submit details in writing to the
Contract Administrator or his/her designee for consideration.
6.3 Exception Request Procedure CONTRACTOR must file a response time exemption
with the quarterly report. Such requests must Include all of the following information:
6.11 a detailed description of the circumstances causing the response delay
6.3.2 date and time of the occurrence
6.33 dispatch agency name
6.3.4 FRALS unit number
6.3.6 originating location of responding FRALS unit
6.4 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.
6.5. FRALS Units — CONTRACTOR agrees that to qualify a response unit as a FRALS Unit in
order to receive revenue under the terms of this agreement the unit must be staffed 24
hrs /day, 7 days /week.
6.5.1 EXCEPTION: Service which is reduced greater than 12 hours In a 24 hour time
period shall result In a prorata reduction of the total revenue provided to a full -
time FRALS unit. Contract Administrator will be notified via email within 24 hours
of such decrease In service. Hard copy to be sent via US Mail.
5
(/ Al
SECTION 7
IDITIONAL SERVICE PROVISION
71 CONTRACTOR to the best of Its ability shall respond to any medical disaster,. declared or
undeclared, within Alameda County or adjacent counties when directed by the Alameda
County l=ire Mutual Aid Coordinator.
7.2 CONTRACTOR agrees that 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.
7.3 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.
7A CONTRACTOR shall have an EMS coordinator or delegee who holds a valid State of
California paramedic license or equivalent. The EMS Coordinator will be the primary
representative at the EMS Section meetings.
SECTION 8
QUALITY IMPROVEMENT
8.1 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) license. This Quality Improvement
coordinator is responsible for evaluating on an ongoing basis CONTRACTOR'S Medical
Quality Assurance Program for COUNTY- contracted services.
8.2 CONTRACTOR agrees to participate in the creation of a comprehensive Emergency
Medical System Quality Improvement program. ,
8.3 CONTRACTOR shall follow all Alameda County EMS Policies regarding Quality
Assurance and Quality Improvement, which have been provided to the contractor.
8.4 Under this Agreement, CONTRACTOR shall submit a written detailed Quality
Improvement plan to the EMS Agency for approval within ninety (90) days of the start
date of the contract. Any changes to the QI Flan shall be submitted in writing as they
occur to the EMS Agency..•A written detailed QI Plan shall be submitted at the start of
each contract period.
SECTION 9
MEDICAL DIRECTION
The Medical Director shall provide medical oversight to the Contractor's paramedics and EMT's
on issues relating to patient care in collaboration with Contractor's Medical Director In those
Departments where there Is a Medical Director.
1
SECTION 10
SERVICES PROVIDED
.COUNTY and CONTRACTOR will provide the.following respective services:
10.1 Incorporation of CONTRACTOR'S operations into the County EMS plan, Including
CONTRACTOR'S participation on relevant.County EMS committees;
10.2 Incorporation of CONTRACTOR'S operations into the County ALS system;
10.3 Authorization and monitoring of EMS training programs,-base hospitals, and service
providers;
10.4 Certification and/or accred0tion of CONTRACTOR'S EMS personnel;
10.5 Provision of medical control, through its Medical Director. For those Departments with a
Medical Director, the EMS Medical Director will work in collaboration with himther.Medical
control requirements Include medical dispatch, patient destination policies, patient care
guidelines, and quality assurance/ Improvement;
10.6 CONTRACTOR'S voluntary participation in COUNTY trial studies /pilot projects /research
studies, if approved by the State EMS Authority (EMSA) and approved by Alameda
County Counsel when pertinent;
10.7 Incorporation of CONTRACTOR'S operations Into the COUNTY trauma system;
10.8 System data collection and evaluation In accordance with mutually agreed upon annual
calendar of due dates;
10.9 Disaster planning; and
90.10 EMS expendable supplies. and equipment used during the provision of services by
PRALS units under this agreement shall be restocked by the County contract ambulance
provider.
SECTION 11
EQUIPMENT
11.1 Vehicle Marking - -FRALS vehicles used in providing Contract services shall bear the
marking "Paramedic" on both sides..
11.2 General Equipment Required for Vehlcles - Each FRALS unit shall carry emergency
supplies and equipment as required by the Alameda County E=MS Policy Manual.
Vehicles, equipment, and supplies shall be maintained in a clean, sanitary, and safe
mechanical condition at all times.
11.2.1 Equipment and supply requirements maybe changed with the approval of the Contract
Administrator in accordance with best practices in collaboration with Contractor with
consideration given to annual budget timelines.
7
SECTION 12
COOPERATION WITH EVOLVING EMS SYSTEM
CONTRACTOR agrees to participate and assist in the development of system changes subject to
negotiated costs, if any.
COUNTY agrees to continue a consensus model of obtaining Input from all participating
Contractors prior to Implementing change to system policies and procedures.
SECTION 13
ACCESS TO RECORDS AND DEPORTING REQUIREMENTS.
CONTRACTOR shall comply with the following record keeping and reporting requirements:
13.1 Performance Se ports — Within thirty (30) days after the end of each quarter, the
CONTRACTOR shall document and report to Contract Administrator In writing, using Tractile
response time method, each emergency call dispatched which did not meet the performance
standards set forth In Section 6.1 (Response Times) and each failure to properly report on-
scene time. The specific reporting requirements are as follows:
a) CONTRACTOR monthly calls which are less than or equal to response times of 8
minutes 30 seconds are added to the monthly exceptions, and this total is divided by
the total monthly calls; this yields a fraction represented as a percentage;
b) If the fraction in (a) above equals or is greater.than 90 %, then no report is filed on
specific calls with response times over 8 minutes 30 seconds.
c) if the fraction in (a) above Is less than 90 %, then the CONTRACTOR must report on
each call with greater than an 8 minute 30 second response time. The
CONTRACTOR must report on each'call the causes of such failures of performance,
and shall document efforts to eliminate these problems.
13.2 Patient Report f=orms — The CONTRACTOR shall utilize the COUNTY'S "Patient Care
Report" (PCR) system for all assignments including patient contact and non - transport.
This form will be accurately completed and distributed according to established Alameda
County, EMS. Policies and Procedures.
The COUNTY will provide PCR forms via CD. The form is subject to revision by the
Contract Administrator at any time.
13.3 Business Records — COUNTY shall have reasonable access to CONTRACTOR'S
financial data relating to the provision of First Responder Advanced life Support
operations.
13.4 Observation of Operations — COUNTY representatives may, with appropriate notification,
directly observe CONTRACTOR'S medical dispatch center operations, and may ride to
observe the operation of any of CONTRACTOR'S FRAI_S units. The COUNTY'S
representatives shall conddct 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.
13.5 cen ure /Accred ton — CONTRACTOR shall ensure that all of its employees are
appropriately llicensedlaccredited and shall retain a record of their certification /licensure.
N.
EMT -is and paramedics shall comply with all training requirements as established by the
State of California and all. applicable provisions of the Alameda County EMS Policy
Manual
Contractor shall submit via email an annual list of all paramedics with license dates and
expiration dates as per mutually agreed upon annual calendar.
SECTION 14
ADDITIONAL. CONSIDIERATIONS
14.1 Fee Schedules — The-CONTRACTOR shall not bill patients or payors for supplies or
medications that the- private ambulance provider restocks CONTRACTOR.
14.2 Nothing is this agreement shall preclude CONTRACTOR from billing patients for non-
transport services, supplies, or medications provided beyond the scope of the FRALS
scope of practice as additional patient service and which has not been re- stocked by the
contract ambulance provider. Such billing will be approved in writing by Contract
Administrator prior to start of such billing procedures.
SECTION 15
NON. COMPETITION
The CONTRACTOR acknowledges the exclusive nature of COUNTY'S authority to operate
and/or contract for emergency ambulance services within the Primary Service Area.
During the term of this Agreement, neither the CONTRACTOR, officers, agents, key personnel, or
employees shall compete with the COUNTY for the same emergency ambulance services
contracted for in any other area of the COUNTY.
SECTION 16
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 all requirements
thereof.
CONTRACTOR agrees to defend, to indemnify, to save and hold harmless the County of
Alameda, Its officers, employees, .and agents from any and all acts, claims, omissions, liabilities,
and losses by whomever asserted arising out of acts or omissions of CONTRACTOR in the
for
permance of the scope of work except those arising by reason of the sole negligence of
COUNTY, its officers, employees, or agents,
The COUNTY agrees to defend, indemnify, and hold harmless CONTRACTOR, its officers,
employees, and agents, from any and all acts, claims, omissions, liabilities, and losses by
whomever asserted arising out of acts or omissions of COUNTY in the performance of the scope
of work except those arising by reason of the sole negligence of CONTRACTOR, Its officers,
employees, or agents.
0
SECTION 17
ASSIGNMENT NOT• ALLOWED
CONT RACTOR 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 18
INDEPENDENT CONTRACTOR
This Agreement is an agreement by and between two public agencies and Is not Intended, and
shall not be construed, to create the relationship of agency, servant, employee, partnership, Joint
venture, or association.
COUNTY shall not'be considered the employer of CONTRACTOR'S employees for any purpose,
and CONTRACTOR holds harmless COUNTY to that extent.
SECTION • 19
COMPLIANCE WITH LAW AND SAFETY.
19.1 CONTRACTOR shall observe and comply with all applicable laws, ordinances, codes,
and regulations of governmental agencies, including federal, state, municipal, and local
governing bodies, having Jurisdiction over the scope of services or any part hereof,.,
Including the provisions of the Occupational Safety and Health Act of 1979 and all
amendments thereto, and all applicable federal, state, municipal, and local safety
regulations. All services performed by CONTRACTOR must be In accordance with these
laws, ordinances, codes, and regulations. CONTRACTOR shall indemnify and save
COUNTY harmless from any and all liability, fines, penalties, and consequences from any
noncompliance or violations of such laws, ordinances, codes, and regulations.
SECTION 20
TERMINATION PROVISIONS
20.1 Termination bv_CQUNTY -- 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.
20.2 Termination by CONTRACTOR — CONTRACTOR may terminate this Agreement, at any
time, upon ninety (90) days' written notice to COUNTY.
20.3 Termination Mutual A reemen — COUNTY and CONTRACTOR may otherwise agree
In writing to terminate this Agreement In a mutually satisfactory manner,
END TERM PROVISIONS
SECTION 21
10
M0110
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 22
CONTRACTOR' Ott 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 23
COMPENSATION RELATED PROVISIONS
For the performance of this Agreement, COUNTY shall pay to CONTRACTOR the amounts
specified in Exhibit B.
SECTION 24
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 thirty (30) calendar days following the
service on it of a written notice by COUNTY specifying the default or defaults complained of
and the date of Intended termination of rights hereunder absent cure.
B_ Definitions of Br ach - Conditions and circumstances which shall constitute a material breach
by the CONTRACTOR shall include but not be limited to the following:
9) Failure of the CONTRACTOR to operate the FRAI-S service system in a manner which
enables the COUNTY or the CONTRACTOR to remain in substantial compliance with the
requirements of the applicable Federal, State, and County laws, rules, and regulations;
2) Falsification of data supplied to the COUNTY by CONTRACTOR during the course of
operations under this Agreement;
.3} Failure by CONTRACTOR to maintain equipment in accordance with good maintenance
practices;
4) Repeated failure by CONTRACTOR to meet response -time requirements after receiving
notice of noncompliance from the Contract Administrator (material breach for response -
time requirements is defined in the monthly financial performance penalties table in
Exhibit A.); .
5) Failure by CONTRACTOR to maintain the required Insurance.
11
SECTION 25
PAYMENT AND PATIENT FEES
CONTRACTOR agrees that It will not, without prior approval of COUNTY, bill patients for service
provided under this Agreement.
SECTION 26
MISCELLANEOUS PROV161ONS
A. or rs Fees
In any claim, suitor proceeding brought or Instituted by either of the parties to enforce any of
the provisions of this Agreement or to seek damages, the prevailing party shall be entitled to
recover reasonable attorney's fees, costs, and necessary disbursements.
13. Notice
All notices required hereunder will be in writing and served personally or by -mall:
CONTRACTOR: City of Dublin
100 Civic Plaza
Dublin, CA 946 6$
COUNTY: Alameda County EMS District
1000 San Leandro Boulevard, Suite 100
San Leandro, CA 94577
C. Entire Agreement
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. Binding Effect
This Agreement will Inure to the benefit of and bind the respective parties, (heir successors,
personal representatives and permitted assigns.
E. Headings
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. Invalidity
If any term, provision, covenant or condition of this Agreement, or any application thereof,
should be held by a court of competent jurisdiction to be Invalid, void, or unenforceable, all
terms, provisions, covenants, and conditions of this Agreement, and all applications thereof,
not held invalid, void, or unenforceable, shall continue in full force and effect and shall In no
way be affected, Impaired or invaildated thereby. The laws of the State of California shall
apply to the enforcement of this Agreement.
12
G. Delay in Commencement
If the delay in'the commencement date of this Agreement is caused by events outside the
direct and immediate controf of the parties hereto, neither party shall be liable to the other for
any loss caused by such-delay.
H. Waiver
The failure of either party to insist upon strict performance of any of the terms, covenants or
conditions of this Agreement in any one or more instances shall not be construed as a waiver
or relinquishment of any such terms, covenants or conditions, and all of the same shall be
and remain in full force and effect.
f. Third Party Beneficiary
This Agreement shall not be deemed to have been made for the express or implied benefit of
any person who Is not a party hereto.
J. Modification of Agreement
From time to time, amendments or modifications to the provisions of this Agreement may be
Initiated by either party hereto and may be incorporated into this Agreement by mutual
consent and in writing as evidenced by resolution of the Board of Supervisors approving such
modification.
13
IN WITNESS WHEREOF. the parties hereto have executed this Agreement the day and year first
above written.
COUNTY OF ALAMEDA
sy
President, Board of supervisors
Approved as to form:
County Counsel - -- --
14
CONTRACTOR
Sy.
Title
Address: 100 Civic Plaza
Dublin, CA 94568
Contractor ID Tax Number 94- 2825202
Attest:
City Clerk
Approved as to Form:
City Attorney
i% a9
FVi �f /
WE
EXHIBIT B
PAYMENT SCHEDULE
Basic Subsidy for
Emergency First Responder Advanced Life Support (FINALS) Services
CITY OF DUBLIN
In consideration for the provision of services described in this Agreement,
COUNTY shall pay CONTRACTOR based on the following schedule which
includes an increase of 3% each County fiscal year.
For the pddod*July 1, 2004 to June 30, 2005: 1148,000
(Authorized FRALS Units: 4 4 Units @ $37,000 = $148,000)
For the period ,July 1, 2005 to June 30, 2006: $152,444
(Authorized FRALS Units: 4 4 Units @ $38,110 = $152,440)
For the Period July 1, 2006 to June 30, 2007: $157,013.20
(Authorized FRALS Units: 4 4 Units @ $39,253.30 = $157,013.20)
For the period July 1, 2007 to June 30, 2008; $161,723.60
(Authorized FRALS Units: 4 4 Units @ $40,430.90 = $161,723.60)'
For the Period July 1, 2008 to June 30, 2009: $166,575.32
(Authorized FRALS Units: 4 4 Units @ $41,643.83 = $166,575.32)
Payment to CONTRACTOR will be made in equal quarterly installments upon
receipt of quarterly Invoice beginning with the receipt of the first payment on .
completion of the first quarter, September 30th.
COUNTY shall make every effort to remit payments within thirty (30) days.
Payment to CONTRACTOR will be held until receipt of the required quarterly
data per mutually agreed data calendar..
15
o
EXHIBIT S -1
MONTHLY FINANCIAL PERFORMANCE PENALTIES
FOR CODE 3 RESPONSES
CONTRACTOR agrees and recognizes that community performance standards
are reasonable and that any and all requests for First Responder ALS (FRALS)
service should adhere to the standards outlined in this contract. All emergency
cases that are outside the standard and cannot be justified by acceptable
mitigating circumstances are subject to compliance measurement.
A. Contractor Fails to Meet 90% Compliance:
For each calendar month the CONTRACTOR has submitted to the Contract
Administrator a report showing a failure to meet the 90 %.response time
standards, COUNTY shall assess the CONTRACTOR the following penalties:
18t report of non - compliance
2nd report of non - compliance
3'd report of non compliance
Letter of deficiency sent
$ 800 x number of FRALS units under contract
$4,875 x 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 $1,875 times the number of FRALS units under contract penalty or find
CONTRACTOR in major breach of contract. .
A report of non - Compliance may be expunged after six (6) consecutive months of
compliance, however, financial penalties are not subject to reversal.
FRALS FWAL 8/31/04
Dublin
16
, NO",
RESOLUTION NO. -- 09
A RESOLUTION OF THE CITY COUNCIL
OF THE CITY OF DUBLIN
AUTHORIZING A TWO -YEAR EXTENSION (JULY 1, 2009 — ,TUNE 30, 2011) TO THE
FIRST RESPONDER ADVANCED LIFE SUPPORT ( FRALS) AGREEMENT
WITH THE COUNTY OF ALAMEDA
WHEREAS, the City of Dublin supplies fire protection services through a Fire Protection and
Emergency Medical Services Agreement with the Alameda County Fire District (ACFD), as known as the
Alameda County Fire Department; and
WHEREAS, the Fire Protection and Emergency Medical Services Agreement calls for ACFD to
provide basic fire suppression and prevention, emergency first aid, Basic Life Support (BLS), and
Advanced Life Support (ALS) Paramedic services on its First Responder units to enhance the emergency
medical services provided to the residents of Dublin; and
WHEREAS, at its October 5, 2004, meeting, the City Council agreed to extend the existing
FRALS Agreement until June 30, 2009, (attached as Exhibit A), which reimburses the City of Dublin for
providing four (4) first responder units.
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Dublin hereby
authorizes the Mayor to sign the extension to the First Responder Advanced Life Support ( FRALS)
Agreement with the County of Alameda for a period commencing July 1, 2009 and continuing until June
30, 2011, unless terminated earlier in accordance with the Agreement.
PASSED, APPROVED AND ADOPTED this 5th day of May, 2009.
AYES:
NOES:
ABSENT:
ABSTAIN:
ATTEST:
City Clerk
GAChrisWire csolulion FRALS May2004.doe
Mayor
�T'PAC�Y9' L
Contract Reference No: C 2004-807
AMENDMENT TO CONTRACT
This Amendment is effective on: July 1, 2009
Reference is made to that contract made and Initially entered into on the 1st day of July, 2004, by and
between the County of Alameda, a body corporate and politic of the State of California and The City
of Dublin, herein referred to as "CONTRACTOR ".
Said contract is hereby amended as follows: .
1. The expiration date of the original contract is June'30, 2009. This amendment extends said
contract for two (2) years beginning July 1, 2009 through June 30, 2011.
2. Exhibit B — Payment Schedule, that establishes compensation for the provision of First
Responder Advanced life Support, is also amended to continue said compensation at the
current rate of $42,893.16fper unit/year, The CONTRACTOR has been approved for 4
units, totaling $343,145.28 for the two year period of the extension.
Except as herein amended, said contract is continued in full farce and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Amendment as of the day and year
first above written.
COUNTY OF ALAMEDA CONTRACTOR
By: By: for
President
Board of Supervisors
Date
Approved as to Form:
County Counsel
Date:
Date:
Exhibit A
to Attachment 2
EXHIBIT B
`T�iTi1M-91ii1
BASIC SUBSIDY FOR EMERGENCY FIRST RESPONDER SERVICES.
[ G
1. in consideration for the provision of services described in this Agreement, COUNTY shall pay
CONTRACTOR $343,145.28 based on the following schedule:
For the period July 1, 2009 to June 30, 2010 a sum of $42,893.16 per FRALS unit
Number of authorized FRALS- units: 4 x $42,893.16 per unit/year = $171,572.641year
$42,893.16/quarter
For the period July 1, 2010 to June 30, 2011 a sum of $42,893.16 per FRALS unit
Number of authorized FRALS units: 4 x $42,893.16 per unitlyear w $171,572.641year
$42,893.1 Glquarter
2. Payment to CONTRACTOR. will be made In equal quarterly installments upon receipt of a
quarterly invoice, beginning with receipt of the first invoice after October 1, 2009.
3. COUNTY shall make every effort to remit payments within thirty (30) business days.
4. Payment to CONTRACTOR will be held until receipt of the required quarterly data per mutually
agreed data calendar.
5, Total payments to be calculated- and determined by the number of authorized - FRALS units
actually in service. CONTRACTOR must adhere to section 1.4 of the original agreement to add or
subtract units.
LETTER OF AGREEMENT BETWEEN
The County of Alameda and the City of Dublin
Purpose
The County of Alameda, Emergency Medical Services (County), and the City of Dublin (City) are
currently negotiating an agreement for continued First Responder Advanced Life Support services
( FRALS Services). Currently, the County and the City have an agreement for Services that is
scheduled to expire on June 30, 2011. In order to ensure continuous emergency 911 services to
residents and visitors and to allow both parties to have adequate time for review and possible
revisions for the new agreement, the following is established:
1. Agreement
1.1 Services: The City will continue to provide FRALS Services under the same terms
and conditions of the current agreement (expiring 6/30/2011). City will continue
to provide FRALS Services until October 31, 2011 or until the date the new
agreement is executed by both the City and County, whichever date is sooner.
1.2 Authority: The County will continue to authorize the City as a provider of First
Responder Advanced Life Support Services within the Alameda County EMS system
under Health & Safety Code Section 1797.178, a paramedic service provider
agreement under Title 22 CCR Section 100167, and a written agreement regarding
the provision of prehospital emergency medical services under Health & Safety Code
Section 1797.201. The County will continue such authorization until October 31,
2011 or until the date the new agreement is executed by both the City and County,
whichever date is sooner.
1.3 Payment: No payments from the County to the City shall be provided under this
Letter of Agreement. In lieu of payments, the payment schedule described in the
subsequent FRALS Services Agreement shall be retroactive to 7/1/2011 and shall
be based on the terms of the subsequent agreement.
1.4 Ec1uWpment Loan: In order for distribution and training to proceed on schedule, an
equipment loan between ACFD and Paramedics Plus to be contained in the new
agreement, shall be operative during the effective dates of this letter of Agreement.
See attached Equipment Loan Agreement (Exhibit G).
2, Amendments
Any change to this Letter of Agreement, including its cancellation or replacement, requires
the consent of the County and the City. This applies to the substance of the change as well
as to its date of applicability. Any change shall be made by exchange of correspondence
with acknowledgement by all signatories.
Signatories
County of Alameda .
By:
Signature
Name: Nate Miley
Title: President of the Board of Supervisors
Date:
Approved as to Form:
By:
County Counsel Signature
City
By:
Signature
Name: Joni Pattillo
Title: City Manager
Date:
Approved as to Form:
Signature
Title: City Attorney
=A*
EXHIBIT G - EQUIPMENT LOAN AGREEMENT
A. INTRODUCTION:
�14
Paramedics Plus has contracted with County to loan the following equipment to Contractor for
use on FRALS units at no cost to Contractor:
1. Four (4) LIFEPAK 15 System
a. LP 15 monitor - defibrillators capable of wireless transmission of 12 -lead ECG's
for each unit and sufficient data plan to accommodate and support this process.
b. Temporary replacement Lifepak 15s for units undergoing repairs
c. Velocitor charger
d. Station charger
e. One (1) spare battery
2. Four (4) Physio- Control chest compression system (LUCAS device)
a. Lucas CPR device
b. One (1) spare battery
c. One (1) station charger
B. CONDITIONS:
1. Acceptance of Paramedics Plus equipment is optional. By accepting equipment under this
agreement, Contractor commits to utilizing equipment in the delivery of all ALS First
Response services. If Contractor is not utilizing the equipment for the delivery of care (e.g.:
closure of a station, reduction of FRALS units) all equipment must be immediately returned
to Paramedics Plus.
2. Paramedics Plus shall maintain ownership of the equipment at all times. The terms of this
exhibit and the responsibilities outlined herein are not transferable. By accepting
Paramedics Plus equipment, the Contractor agrees to comply with all terms and conditions
set forth herein associated with the loan of equipment.
3. The Contractor shall be solely responsible for the proper use and deployment of the
equipment. Paramedics Plus shall be responsible for training personnel using the
equipment on the proper use of the equipment in accordance with any equipment use
procedures. The Contractor accepts sole responsibility for operating the equipment at its
sole risk.
4. Contractor agrees to give this equipment the same level of care as similar property
purchased by Contractor. Equipment shall be returned to,Paramedics Plus in as good a
condition as when received by the Contractor, reasonable wear and tear excepted. During
the loan period Paramedics Plus agrees to assume all responsibility for maintenance and
repair due to normal wear and tear.
5. The Contractor is responsible for the full cost of repair or replacement of any or all of the
'equipment that is damaged by intentional misuse, abuse, or neglect, lost, or stolen from the
time Contractor assumes custody. If the equipment is lost, stolen or damaged, Contractor
must immediately notify the Paramedics Plus representative.
6. Paramedics Plus shall pay for all insurance, regularly scheduled maintenance and
maintenance agreements for the equipment.
7. All maintenance and repair of equipment shall be performed by personnel authorized by
Paramedics Plus. Any unauthorized maintenance voids all original equipment warranties.
The Contractor shall be liable for the cost of purchasing a new warranty for the equipment
if unauthorized maintenance is performed on the equipment by Contractor's personnel.
8. Contractor shall make the equipment available for inspection and maintenance during
regular business hours with adequate advance notice and notify Paramedics Pius in writing
of any necessary repairs or if the equipment malfunctions. Inventory management and
return notification.
9. Contractor shall maintain and provide annual inventory reports to Paramedics Plus when
requested. These reports shall include the Paramedics Plus inventory control number and
well as the Contractor unit where the equipment is assigned.
10. Failure to adhere to the conditions described above may result in withdrawal of use and
possession of the equipment, through written notice by Paramedics Plus and endorsed by
County.
11. Contractor shall return the equipment to Paramedics Plus upon termination of 9 -1 -1
Ambulance Agreement between Paramedics Plus and County. The current agreement is for
the period beginning November 1, 2011, and ending October 31, 2016. County has an
option to renew for five additional years, ending October 31, 2021.
12. In consideration for the equipment loan, the Contractor agrees to indemnify, defend and
hold Paramedics Plus and County harmless from any and all damages, losses, claims, causes
of actions, expenses and liability of any nature whatsoever associated with its use of the
equipment.
Name:
Signature:
Title:
Date: f f
�1
RESOLUTION NO. —11
A RESOLUTION OF THE CITY COUNCIL
OF THE CITY OP DUBLIN
APPROVING A LETTER OF AGREEMENT BETWEEN THE CITY OF DUBLIN AND THE COUNTY OF
ALAMEDA FOR CONTINUED FIRST RESPONDER ADVANCED LIFE SUPPORT SERVICES
( FRALS SERVICES)
WHEREAS, the City of Dublin and the County of Alameda are parties to a First Responder
Advanec Life Support Services ( FRALS) agreement; and
WHEREAS, the Fire Protection and Emergency Medical Services Agreement calls for ACFD to
provide basic fire suppression and prevention, emergency first aid, Basic Life Support (BLS), and
Advanced Life Support (ALS) Paramedic services on its First Responder units to enhance the
emergency medical services provided to the residents of Dublin; and
WHEREAS, at its May 5, 2009, meeting, the City Council agreed to extend the existing FRALS
Agreement until June 30, 2011, which reimburses the City of Dublin for providing four (4) first responder
units; and
WHEREAS, in order to ensure continuous emergency 911 services to residents and to allow the
City of Dublin and the County of Alameda to have adequate time to develop a new FRALS agreement,
the City and County wish to enter into a Letter of Agreement extending the current FRALS agreement
until October 31, 2011 or until the date a new agreement is executed by both the City and County .
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Dublin hereby
approves the Letter of Agreement for continued First Responder Advanced Life Support ( FRALS)
Services (attached as Exhibit A), and authorizes the City Manager to sign said Letter of Agreement.
PASSED, APPROVED AND ADOPTED this 7th day of June, 2011.
AYES:
NOES:
ABSENT:
ABSTAIN:
ATTEST:
City Clerk
GAChns'Alameda County FirelResofution FRALS May 2011.doe
1654590.1
Mayor
A19AMEAR 3
RESOLUTION NO. —11
A RESOLUTION OF THE CITY COUNCIL
OF THE CITY OF DUBLIN
AUTHORIZING A FIVE -YEAR (NOVEMBER 1, 2011 — OCTOBER 31, 2016)
FIRST RESPONDER ADVANCED LIFE SUPPORT ( FRALS) AGREEMENT
WITH THE COUNTY OF ALAMEDA
WHEREAS, the City of Dublin supplies fire protection services through a Fire Protection
and Emergency Medical Services Agreement with the Alameda County Fire District (ACFD), as
known as the Alameda County Fire Department; and
WHEREAS, the Fire Protection and Emergency Medical Services Agreement calls for
ACFD to provide basic fire suppression and prevention, emergency first aid, Basic Life Support
(BLS), and Advanced Life Support (ALS) Paramedic services on its First Responder units to
enhance the emergency medical services provided to the residents of Dublin; and
WHEREAS, at its May 5, 2009, meeting, the City Council agreed to extend the existing
FRALS Agreement until June 30, 2011, which reimburses the City of Dublin for providing four
(4) first responder units; and
WHERAS, at its June 7, 2011 meeting, the City Council approved a Letter of Agreement
with the County of Alameda extending the existing FRALS Agreement until October 31, 2011 to
allow the time necessary to complete an agreement;
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Dublin
hereby authorizes the City Manager to sign the First Responder Advanced Life Support
( FRALS) Agreement with the County of Alameda for a period commencing November 1, 2011
and continuing until October 31, 2016, (attached as Exhibit A) unless terminated earlier in
accordance with the Agreement.
PASSED, APPROVED AND ADOPTED this 4th day of October, 2011.
AYES:
NOES:
ABSENT:
ABSTAIN:
ATTEST:
City Clerk
Mayor
Reso No. M-1 1, Adopted XX/XX/XX, Item XX Page 1 of 1 ATTACHMENT 2
Emergency Medical Services
First Responder Advanced Life Support
Services Agreement
County of Alameda
and
The City of Dublin
Date: November 1, 2011
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
TABLE OF CONTENTS
DEFINITIONS AND ACRONYMS ................................................................................................................. .............................ii
SECTION1
- INTRODUCTION .................................................................................................................... ..............................1
SECTION2
- TERM .......................................................................................................................................... ..............................2
SECTION 3
- SERVICES /PRIMARY SERVICE AREA ......................................................................... ..............................2
SECTION 4
- FIRST RESPONDER COOPERATION /DESIGNATION .......................................... ..............................3
SECTION 5
- PERFORMANCE STANDARDS ........................................................................................ ..............................3
SECTION 6
- ADDITIONAL SERVICE PROVISION ............................................................................. ..............................6
SECTION 7
- QUALITY IMPROVEMENT ................................................................................................ ..............................7
SECTION 8
- PERSONNEL REQUIREMENTS ....................................................................................... ..............................9
SECTION 9
- ELECTRONIC PATIENT CARE REPORT AND DATA COLLECTION SYSTEM ..........................9
SECTION 10
- MEDICAL OVERSIGHT /COMPLIANCE WITH MEDICAL PROTOCOLS ...... ..............................9
SECTION 11
- CONTRACTOR REVENUE / SUPPORT ........................................................................ ..............................9
SECTION 12
- VEHICLES AND EQUIPMENT ..................................................................................... .............................10
SECTION 13
- REQUIRED REPORTS ..................................................................................................... .............................10
SECTION 14
- PENALTY PROVISIONS ................................................................................................. .............................12
SECTION 15
- COOPERATION WITH EMS SYSTEM /COMMUNITY EDUCATION ............ .............................14
SECTION 16
- ADMINISTRATIVE PROVISIONS ............................................................................... .............................14
SECTION 17
- GENERAL PROVISIONS ................................................................................................. .............................17
SIGNATORY....................................................................................................................................................
...............................
26
EXHIBIT A -
DEPICTION & DEFINITION - CONTRACTOR'S PRIMARY RESPONSE AREA /EOA .............
E-
Error! Bookmark not defined
EXHIBIT B - DEPICTION & DEFINITION OF SUB - AREAS ..................... E- Error! Bookmark not defined.
EXHIBIT C - MINIMUM INSURANCE REQUIREMENTS ............................................................ ............................... E -5
EXHIBIT D - DEBARMENT AND SUSPENSION CERTIFICATION ...... E- Error! Bookmark not defined.
EXHIBIT E - FIRST RESPONDER SUPPORT /PAYMENT SCHEDULEE- Error! Bookmark not defined.
EXHIBIT F - REPORT ON INTERMITTENT OR ROTATIONAL SERVICE INTERRUPTION ...................... E -8
EXHIBIT G - EQUIPMENT LOAN AGREEMENT ............ .............................E - Error! Bookmark not defined.
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
DEFINITIONS AND ACRONYMS
iii
Services involving a patient who has been (or shall be) placed on a hold for psychiatric
5150 Call
evaluation, including transport to a psychiatric facility in accordance with the California
Code of Regulations Welfare and Institutions Code, §5150 and EMS Policies.
As defined pursuant to Title 13 of the California Code of Regulations, §1100.2. A vehicle
Ambulance
specially constructed, modified or equipped, and used for the purpose of transporting sick,
injured, convalescent, infirm, or otherwise incapacitated persons, and compliant with state
requirements.
ACRECC
Alameda County Regional Emergency Communications Center.
Alpha Call
A 911 call designated by a Medical Dispatch Center as an Alpha call based on use of the
Medical Priority Dispatch System.
ALS
Advanced Life Support - service as defined in California Health and Safety Code, Division 2.5,
§1797.52.
Arrival at Incident
The moment the FRALS is fully stopped at the Incident Location and Field Personnel notifies
the County Dispatch Center of the arrival.
Base Hospital
As defined in California Health and Safety Code, Division 2.5, §1797.58. The Base Hospital
for Alameda County is Alameda County Medical Center, Highland Campus.
BLS
Basic Life Support - EMT level of service, as defined in California Health and Safety Code,
Division 2.5, §1797.60.
Board
Alameda County Board of Supervisors.
Bravo Call
A 911 call designated by a Medical Dispatch Center as a Bravo call based on use of the
Medical Priority Dispatch System.
CAD
Computer Aided Dispatch.
Charlie Call
A 911 call designated by a Medical Dispatch Center as a Charlie call based on use of the
Medical Priority Dispatch System.
Continuing Education (CE)
As defined in the California Code of Regulations, Title 22, Chapter 11.
Contractor
City of Dublin
A California licensed physician, experienced in the field of emergency medical services, and
Contractor's medical director
employed by the contractor to provide medical oversight to Contractor's field personnel, in
conjunction with the EMS medical director.
County
The County of Alameda.
The Contractor selected by the County through a competitive process, and under
County Contracted Private
agreement with the County, to provide 911 emergency medical ground ambulance
Provider
response and transportation in Zones 2 -5 at an Advanced Life Support (ALS) level of service,
and where specified in their Agreement, Basic Life Support (BLS) level of service (herein
known as Paramedics Plus LLC.)
County Designated Emergency
A medical dispatch center designated by the County that uses call prioritization and
Medical Dispatch Center or
prearrival instructions based on the Medical Priority Dispatch System, and is accredited as a
Medical Dispatch Center
Center of Excellence by the National Academies of Emergency Dispatch. Referred to as
"Medical Dispatch Center" in this document.
iii
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
1V
Used in this Agreement to refer to Alameda County Emergency Medical Services, a Division
COUNTY EMS
of the Public Health Department as part of the Health Care Services Agency, and designated
as the Local EMS Agency for Alameda County.
COUNTY EMS DIRECTOR
The director of the Alameda County Emergency Medical Services, a Division of the Public
Health Department, as part of the Health Care Services Agency.
The physician in the position of Medical Director for Alameda County Emergency Medical
COUNTY EMS MEDICAL
Services, a Division of the Public Health Department, as part of the Health Care Services
DIRECTOR
Agency.
Policies and procedures issued by the Alameda County Emergency Medical Services that are
COUNTY EMS POLICIES
contained in the Alameda County Emergency Medical Services Field Manual and /or
Administration Manual, which may be revised from time to time.
DATA COLLECTION SYSTEM
The software and hardware used to collect, store and report on information from the
provision of Services, which includes the Patient Care Reports.
DELTA CALL
A 911 call designated by a Medical Dispatch Center as a Delta call based on use of the
Medical Priority Dispatch System.
DISASTER
An occurrence of a natural catastrophe, technological accident, or human caused event that
has resulted in severe property damage, deaths, and /or multiple injuries."
A 911 call designated by a Medical Dispatch Center as an Echo call (non- breathing and /or
ECHO CALL
ineffective breathing) based on use of the Medical Priority Dispatch System.
EMSA
Emergency Medical Services Authority of the State of California.
EMT
Emergency Medical Technician.
Emergency Response Zone, as depicted In EXHIBITA - DEPICTION AND DEFINITION OF CONTRACTOR'S
ERZ
PRIMARY RESPONSE AREA.
FEDERAL
Refers to United States Federal Government, its departments and /or agencies.
Contractor's paramedics and EMTs responsible for responding to 911 requests for
FIELD PERSONNEL
emergency first responder services pursuant to this Agreement.
A method of measuring data in which all applicable data are stacked in ascending order and
PERCENTILE (FRACTILE)
the total number is calculated as a percentage of the total number of calls. (e.g.: a 90th
percentile standard is one where 90% of the applicable calls are answered within the
response standard, while 10% take longer than the standard.)
FIRST RESPONDER (AGENCY)
Entities with an agreement with the County to provide first responder service to the scene
of a medical emergency.
FIRST RESPONDER ADVANCED
Contractor's provision of 911 emergency medical response and obligations as required by
LIFE SUPPORT (FRALS)
this Agreement and in accordance with EMS Policy.
SERVICE(S)
Fire response vehicle staffed and equipped with a minimum of one California State licensed
FIRST RESPONDER ADVANCED
and Alameda County accredited paramedic, as defined in EMS policies, capable of providing
LIFE SUPPORT UNIT (FRALS)
ALS care at scenes of medical emergencies.
INCIDENT LOCATION
The destination address or location of the patient to which the FRALS is dispatched.
LEMSA
Local Emergency Medical Services Agency, as defined in California Health and Safety Code,
Division 2.5, §1797.94.
1V
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
MEDICAL PRIORITY DISPATCH
The system that categorizes emergency calls using an escalating scale of severity assigned to
SYSTEM( "MPDS ")
medical conditions, relative to the level and timeliness of response.
A Multi- Casualty Incident (MCI) is any incident where the number of injured persons exceeds
MULTI - CASUALTY INCIDENT
the day -to -day operating capabilities and requires additional resources and /or the
( "MCI")
distribution of patients to multiple hospitals.
MUTUAL -AID
Emergency service performed by neighboring providers during periods of severe weather,
multi - casualty incidents, or other events that overwhelm existing resources.
PARAMEDIC
As defined in California Health and Safety Code, Division 2.5, §1797.84.
PCR
Patient Care Report, in either print or electronic form.
The City jurisdictional limit or area(s) for which the responding agency is responsible to
PRIMARY SERVICE AREA
provide emergency response. See EXHIBIT FOR A DESCRIPTION OF THE CONTRACTORS PRIMARY
SERVICE AREA.
The time elapsed from the time a call is received by Contractor from the dispatch center,
RESPONSE TIME
until Arrival at the Incident Location by the FRALS.
QUALITY IMPROVEMENT
As defined in the California Code of Regulations, Title 22, Chapter 12 and EMSA #166: EMS
System Quality Improvement Guidelines.
STATE
The State of California, its departments and /or agencies.
Designation of Metro /Urban, Suburban /Rural and Wilderness Primary Service Area, as
SUBAREA
depicted In EXHIBIT B - DEPICTION AND DEFINITION OF SUBAREAS.
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
SECTION 1- INTRODUCTION
1.1 The County is designated as the Local Emergency Medical Service Agency (LEMSA) as
defined in the California Health and Safety Code Division 2.5, Section 1797.94 responsible
for establishing policies and procedures for the approval and designation of paramedic
service providers within its jurisdiction.
1.2 The County has established an Emergency Medical Service District (EM- 1983 -1) and has
entered into agreements with various Emergency Medical Services (EMS) providers, both
public and private, to assure the availability of emergency medical response and
transportation services within the District.
1.3 The Contractor is willing to provide first response to requests for all medical calls as defined
by the algorithms in the Medical Priority Dispatch System (MPDS) protocols and as
approved by County EMS. As per MPDS and State regulations, call prioritization must be
determined under the direction of the Medical Director.
1.4 Contractor agrees to follow all medical and operational policies as defined in Alameda
County EMS policy manuals.
1.5. Contractors with First Responder Advanced Life Support ( FRALS) Units include the
agencies /cities listed below:
Alameda County Fire Department
11 FRALS
City of Newark Fire Department
3 FRALS
City of Union City Fire Department
4 FRALS
City of Dublin Fire Department
4 FRALS
City of San Leandro Fire Department
7 FRALS
City of Emeryville Fire Department
2 FRALS
City of Fremont Fire Department
13 FRALS
City of Hayward Fire Department
11 FRALS
City of Livermore Fire Department
5 FRALS
City of Oakland Fire Department
26 FRALS
City of Pleasanton Fire Department
5 FRALS
1.6 The number of authorized FRALSs to be funded will not change during the duration of this
agreement unless approved by Contractor and EMS Director, and funding is available.
Contractor has been authorized for 4FRALS units.
1.7 The parties hereby execute this single agreement which will constitute formal designation
of Contractor as an authorized provider of First Responder Advanced Life Support Services
within the Alameda County EMS system under Health & Safety Code Section 1797.178, a
paramedic service provider agreement under Title 22 CCR Section 100167, and a written
Page 1 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
agreement regarding the provision of prehospital emergency medical services under Health
& Safety Code Section 1797.201.Nothing in this agreement is intended to extinguish any
existing rights of the parties under Section 1791.201 or 1797.224 of Division 2.5 of the
California Health and Safety Code.
SECTION 2 - TERM
2.1 This Agreement is for the provision of 911 First Responder Advanced Life Support Services.
The term of the agreement will be as follows:
a. July 1, 2011 through October 31, 2011 - the time period described in the Letter of
Agreement, previously signed by the parties.
b. November 1, 2011 through October 31, 2016, with an option to extend for an
additional five (5) year period upon mutual agreement between County and Contractor.
SECTION 3 - SERVICES /PRIMARY SERVICE AREA
3.1 Contractor shall identify and provide a representative, available to respond at all times
within Contractor's Primary Service Area, and authorized to act on behalf of Contractor in
all operational matters. Contractor shall provide the specific means for contacting the
designated representative.
3.2 Contractor shall be responsible for ensuring dispatch and responding to requests for
emergency medical services originating within its primary service area.
3.3 First Responder Advanced Life Support ( FRALS) Services
The Contractor shall provide FRALS services to all requests for medical assistance as
defined by MPDS protocols (TABLE A - PERSONNEL AND RESPONSE TIME REQUIREMENTS) including
5150 calls. As per MPDS and State regulations, call prioritization must be determined under
the direction of the Medical Director.
a. Contractor shall provide FRALS service to patients until transfer of patient care to
arriving ambulance personnel, according to County EMS Policies, or a medical physician
of competent authority in accordance with County EMS Physician -on -scene policy.
b. Services shall be provided to all areas within the Primary Service Area and as otherwise
required by this Agreement. A map of the Contractor's Primary Service Area is attached
as EXHIBIT A - DEPICTION AND DEFINITION OF CONTRACTOR'S PRIMARY SERVICE AREA.
Page 2 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
3.4 Standards
a. Contractor shall be available to provide FRALS services 24 hours per day, 7 days per
week, 52 weeks per year without interruption, for the full term of the Agreement. These
services shall be provided without regard to the patient's race, color, national origin,
religion, sexual orientation, age, sex, or ability to pay.
b. Contractor shall work cooperatively with the County EMS Director, EMS Medical
Director, and other County staff and agencies to fulfill the terms and conditions of this
Agreement.
3.5 Primary Service Area
Contractor, within the area designated herein as Contractor's Primary Service Area, which
includes the entire area within the City of Dublin, and as described in EXHIBIT A - DEPICTION
AND DEFINITION OF CONTRACTOR'S PRIMARY SERVICE AREA.
SECTION 4 - FIRST RESPONDER COOPERATION /DESIGNATION
4.1 Contractor's 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.
4.2 In order to receive the maximum subsidy under the terms of this agreement, Contractor
agrees that to qualify as a FRALS Unit, each unit shall be staffed 24 hours a day, 7 days a
week.
4.3 Intermittent or Rotational Service Interruption
a. FRALS Service which is reduced more than 12 hours in a 24 hour time period shall result
in a prorata reduction of the total revenue provided for a full -time FRALS unit.
b. Contractor shall send a quarterly report (EXHIBIT F - REPORT ON INTERMITTENT OR
ROTATIONAL SERVICE INTERRUPTION) to the County EMS Director within 10 calendar days of
the end of each quarter, showing the number of out -of- service days and locations in
excess of 12 hours.
SECTION 5 - PERFORMANCE STANDARDS
5.1 Response Times
Contractor's response time for requests for emergency medical services shall be dispatched
according to MPDS categories and shall meet the following performance standards:
Page 3 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
a. Contractor's Response Times shall be calculated on a monthly basis for reporting
purposes to determine compliance using Percentile (Fractile) Response Time
measurements. Response Times for departments with low call volume (less than 100
calls per month) shall be calculated once the Contractor has responded to 100 calls.
b. Contractor's Response Time for Services in the Primary Service Area shall meet the
requirements in Table A. Contractor shall be assessed a penalty if Response Time
compliance falls below 90 %.
c. Contractors not using MPDS shall respond to all calls using the ECHO Response Times.
d. It is the goal of the County to improve response times for high acuity patients. The
County will monitor response time data for the first six months of the agreement, and if
all municipal departments are consistently meeting a shorter response time, this
agreement will be reopened for renegotiation of response time requirements.
MPDSCATEGORY:
Metro /Urban
Suburban /Rural
Wilderness
ECHO
08:30 min.
08:30 min.
08:30 min.
DELTA
08:30 min.
08:30 min.
08:30 min.
CHARLIE
08:30 min.
08:30 min.
08:30 min.
BRAVO
12:45 min.
12:45 min.
12:45 min.
ALPHA
12:45 min.
12:45 min.
12:45 min.
TABLE A - PERSONNEL AND RESPONSE TIME REQUIREMENTS
5.2 Response Time Measurement
a. Response Time shall be measured in minutes and integer (whole) seconds from the time
the call is received by Contractor from the Medical Dispatch Center until arrival at the
Incident Location by the FRALS, or until the call is cancelled by a public safety agency or
Medical Dispatch Center.
b. Contractor's FRALSs shall report on -scene time or staging location time to its dispatch
center immediately upon arrival at the scene /staging location.
5.3 Calculating Changes in Call Priority
a. Upgrades - If an assignment is upgraded prior to the Arrival at Incident of the FRALS
(e.g. from a Charlie to Delta), Contractor's compliance and fines shall be calculated based
on the shorter of:
• Time elapsed from dispatch to time of upgrade plus the higher priority Response
Time standard, or,
• The lower priority Response Time standard.
Page 4 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
b. Downgrades - If a call is downgraded, prior to arrival on scene of theFRALS(e.g. from a
Delta to a Charlie), Contractor's compliance and fines shall be determined by:
• If the time of the downgrade occurs after the FRALS has exceeded the higher priority
Response Time standard, the higher priority Response Time standard shall apply; or,
• If the time of the downgrade occurs before the FRALS has exceeded the higher
priority Response Time standard, the lower priority Response Time standard shall
apply.
• In all such cases, documentation must be presented for validation of the reason why
the priority status was downgraded. If the downgrade was justified, in the sole
discretion of the County, the longer standard shall apply.
c. Reassignment Enroute
If a FRALS unit is reassigned en -route or turned around prior to Arrival at Incident
Location (e.g., to respond to a higher priority request), compliance and fines shall be
calculated based on the Response Time Standard applicable to the assigned priority of
the initial response. The Response Time clock shall not stop until the arrival of a FRALS
on the scene from which the unit was diverted.
d. Canceled Calls
If a call is canceled prior to the FRALS Arrival at Incident, the compliance and fines shall
be calculated based on the elapsed time from dispatch to the time the call was canceled.
In situations where the FRALS has responded to a location other than the Incident
Location (e.g. staging areas for hazardous materials /violent crime incidents, non -
secured scenes, or where rugged terrain precludes access), Arrival at Incident shall be
the time the FRALS arrives at the designated staging location or the nearest public
access point to the patient's location
5.4 Response Time Late Response Exemptions ( "Exemption ")
a. Contractor may request that a late response be excluded from the calculation of
Response Time standards ( "an Exemption "), if that call falls into one of the following
categories:
• A declared Multi - Casualty Incident ( "MCI ") or disaster that the County EMS Director
determines has had a material impact on Contractor's resources.
Page 5 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
• There was a delay because information relayed by the Dispatch Center was
substantially incorrect so as to prohibit timely arrival at the call.
b. Request for an Exemption must be in writing, and received by the County EMS Director
within ten (10) calendar days following the end of the month in which the event
occurred. Response Time Exemptions may be granted by the County on a per call basis,
following review and investigation by the County. Calls that are approved as an
Exemption shall not be included in the calculations for Response Time compliance. Such
requests must include all of the following:
• Detailed description of the circumstances causing the response delay
• Date and time of the occurrence
• Dispatch agency name
• Unit number
• Originating location of responding unit
• The request must include performance reports for the month in which the incident
occurred and written documentation supporting the request.
SECTION 6 - ADDITIONAL SERVICE PROVISION
6.1 5150 Response
a. Contractor shall respond paramedic ALS level personnel to 5150 Calls dispatched as an
Echo, Delta, or Charlie. If MPDS is not used, Contractor shall respond a paramedic to all
5150 calls for medical clearance.
b. If the patient does not require medical clearance at an emergency department, the
Contractor may cancel the ALS ambulance and request through ACRECC, that a BLS
ambulance from the County Contracted Private Provider transport the patient to the
appropriate psychiatric facility, in accordance with County EMS Policies regarding
psychiatric patient care.
c. 5150 calls initially dispatched as Alpha or Bravo by a Medical Dispatch Center will be
responded to by the County Contracted Private Provider. Contractor is not required to
respond to 5150 calls dispatched as Alpha or Bravo
6.2 Multi - Casualty Incident /Disaster Response
a. Contractor shall cooperate with County in rendering emergency assistance during a
declared or an undeclared disaster or Multi - Casualty Incident ( "MCI "), in accordance
with County EMS Policies.
Page 6 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
b. If County EMS Director directs Contractor to respond to a medical disaster in an adjacent
jurisdiction, fines for Response Times shall be suspended. Contractor shall use its best
efforts to maintain primary emergency services and may suspend non - emergency
services as necessary.
c. Incident Notification- Contractor shall have a mechanism in place to communicate
current field information to ACRECC during a medical response to: a) MCIs, b) disaster
responses, c) hazardous materials incidents, and d) other unusual occurrences, as
described in EMS Policies.
d. Interagency Training for Exercises /Drills- Contractor is encouraged to participate in
County- sanctioned exercises, disaster drills, and interagency training.
SECTION 7 - QUALITY IMPROVEMENT
7.1 Contractor shall work with County EMS to develop a Quality Improvement template that
shall be used to develop a Quality Improvement Plan. The Quality Improvement Plan shall:
a. Be consistent with the requirements of the State California for emergency medical
system quality improvement, including those contained in Title 22, Chapter 12.
b. Be consistent with County EMS Policies.
c. Be integrated with the County Contracted Private Provider, Medical Dispatch Centers,
and County EMS.
d. Incorporate compliance assurance, process measurement and control, and process
improvements.
e. Measure clinical indicators as developed through collaborative efforts with the County.
f Be based on current EMS research and call demand.
g. Endeavor to ensure the long -term economic viability of the EMS system while
maximizing value to the community. Contractor shall service targets through process
improvement, standardization, and evaluation of internal programs.
7.2 The final Quality Improvement Plan must be submitted to the County EMS Director for
approval six (6) months following the Agreement Start Date. The County EMS Director may
revise the requirements of the Quality Improvement Plan no more often than annually.
7.3 Contractor shall ensure that personnel in leadership positions actively oversee the
implementation of the Quality Improvement Plan, including but not limited to:
a. Ensuring that the agency is represented at County EMS workgroups and /or committees
dealing with quality management
Page 7 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
b. Designating a manager to oversee Contractor's quality improvement plan.
c. Submitting required reports to the County
d. Actively participating in quality improvement and /or research projects designed to
improve the quality of emergency medical services in Alameda County
SECTION 8 - PERSONNEL REQUIREMENTS
8.1 Contractor shall provide a highly qualified and experienced physician, Registered Nurse, or
Paramedic to implement and oversee Contractor's Quality Improvement Plan. This
individual shall be responsible for the medical Quality Improvement /Assurance evaluation
of Contractor's services.
8.2 CONTRACTOR shall ensure appropriate personnel represent the department at County EMS
meetings.
8.3 Contractor shall submit via email an annual list of all paramedics with license dates and
expiration dates as specified in County EMS Policies.
8.4 First Responder Staffing:
Contractor shall staff First Responder personnel as specified in Alameda County EMS
Policies.
8.5 Personnel Licensure /Certification /Training Requirements:
a. Field Personnel performing First Responder services under the Agreement shall at all
times be appropriately certified and /or licensed to practice in the State of California and
in the case of Paramedics, accredited in Alameda County.
b. Contractor shall, at all times, retain copies of current licenses, certifications, and training
documentation for Field Personnel performing First Responder services and provide
electronically if requested by EMS Director.
SECTION 9 - ELECTRONIC PATIENT CARE REPORT AND DATA COLLECTION SYSTEM
9.1 Contractor shall use Patient Care Reports ( "PCR ") described in EXHIBIT G - EQUIPMENT LOAN
AGREEMENT for patient documentation on all calls, including:
a. patient contacts;
b. canceled calls; and,
C. non - transports, with the exception of refusal of service and disaster response, pursuant
to County EMS Policies.
Page 8 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
9.2 First Responder personnel:
a. First responder personnel shall provide to responding ambulance personnel a report, at
a minimum field notes, on all care provided and assessment prior to arrival of the
ambulance.
b. The PCR shall be completed and entered into the County data collection system prior to
the end of shift but no later than 24 hours following the call.
9.4 Data Collection System for Patient Care Reports
a. Contractor shall ensure its employees are trained on the Data Collection System
described in EXHIBIT G - EQUIPMENT LOAN AGREEMENT.
b. The data collection system shall be NEMSIS (National EMS Information System)
compliant.
SECTION 10 - MEDICAL OVERSIGHT /COMPLIANCE WITH MEDICAL PROTOCOLS
10.1 All parties shall function in, and comply with the Firefighter Bill of Rights.
10.2 The EMS Medical Director shall provide medical oversight to the Contractor's paramedics
and EMTs on issues relating to patient care in collaboration with Contractor's Medical
Director in those Departments where there is a Medical Director.
10.2 Contractor shall comply with medical protocols, online medical control, and other
requirements as established by the County EMS Medical Director, and /or provided by the
County (e.g.: Base Hospital services, authority to perform certain medical interventions,
etc.).
SECTION 11 - CONTRACTOR SUPPORT
11.1 Contractor shall be compensated for FRALS Services on a per unit basis as defined in EXHIBIT
E - BASIC SUBSIDY FOR FIRST RESPONDER ADVANCED LIFE SUPPORT SERVICES. Funding shall be
increased 3% per year for the term of the Agreement, beginning November 1, 2012. It is
agreed by Contractor and the County that under this agreement 1% of the increase will be
set aside in an account created by the County for eventual increases in the number of FRALS
units or other projects that enhanced Fire EMS response. The use of funds from the 1% set -
aside account shall be reviewed by a panel of three, including the EMS Director and two fire
chiefs selected by the Alameda County Fire Chiefs Association not involved in the matter
being considered for funding.
Page 9 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
11.2 Other than invoicing County, as described in EXHIBIT E, Contractor shall not bill for any 911
medical First Responder services unless approved by the County Board of Supervisors.
SECTION 12 - VEHICLES AND EQUIPMENT
12.1 In compliance with Exhibit G, Contractor, shall acquire and maintain FRALS units and on-
board medical supplies and equipment, to be used to perform FRALS services.
12.2 By signing this agreement, Contractor agrees to the terms and provisions described in
EXHIBIT G - EQUIPMENT LOAN AGREEMENT.
12.3 FRALS Unit Markings
FRALSs units shall display the following signage, on both sides:
a. Level of service (e.g., "Paramedic Unit ")
b. Contractor's name
12.4 Equipment:
a. All on -board equipment, medical supplies and personal communications equipment
used by Contractor shall meet or exceed the minimum requirements of the EMS Policies
and this Agreement.
b. Contractor shall have and submit to County policies regarding the acquisition, stocking
and security of controlled substances carried on Service Vehicles.
c. Equipment and supply requirements may be modified with the approval of the EMS
Director, including modifications due to changes in technology.
d. The County may inspect FRALS units for EMS related equipment and supplies at any
time without prior notice.
12.5 Failure to meet minimum in- service equipment /supply requirements:
a. If any Service Vehicle fails to meet the requirements, as contained in EMS Polices, the
County may assess a penalty to Contractor, as specified in this agreement.
b. In addition to any penalty, if the EMS Director determines that the failure to meet
requirements is critical, the Service Vehicle shall be removed from service until the non-
compliance is corrected.
SECTION 13 - REQUIRED REPORTS
13.1 Contractor shall provide, within thirty (30) calendar days after the first day of each month,
reports addressing its performance during the preceding month with respect to the clinical,
operational, and financial performance requirement, in the form and manner required by
Page 10 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
the EMS Director.. To the extent that EMS is able to generate reports from data collection
system; Contractor will be relieved of the responsibility to submit these reports. Reports
shall include, but are not limited to:
a. Response Time Compliance reports
b. Reports on patient /customer complaints
c. Clinical Reports (e.g.: protocol compliance, intubation success rate, etc.)
d. Other reports as requested by County with reasonable notice.
13.2 Other reports may be required less frequently than monthly, as determined by the EMS
Director.
13.3. County shall provide notice to Contractor at least two (2) months in advance of any change
to required reports, frequency, or due dates.
13.4 Response Time Performance:
a. Response Time data, including reports received from the dispatch center, shall be used
by Contractor and County to evaluate Contractor's performance and compliance.
b. If Response Time compliance is below 90% for any calendar month, or longer period if
required to accumulate 100 responses (see Section 5.1), Contractor shall identify the
causes and shall document efforts to eliminate problems on an ongoing basis.
c. Contractor shall submit a performance improvement plan with the Response Time
performance report. The performance improvement plan shall identify each problem
that contributed to a failure to meet Response Times and steps being taken to correct
the problem.
d. Response Time reporting and times shall be documented as set forth in this Agreement.
13.5 Compliance with Protocols
a. Contractor shall report monthly on the overall compliance with EMS Policies and
performance on all calls in a format by the Quality Council and provided by EMS.
b. Data for compliance shall be submitted in aggregate and stratified by categories
identified in the Quality Management Plan and approved by the EMS Director.
13.6 Quality Improvement
a. Contractor shall develop a clear and concise set of processes and practices designed to
identify and address opportunities for improvement. The description of these processes
shall include the approach for achieving and maintaining measurable outcomes.
b. Contractor shall provide reports that update progress on quality improvement projects
Page 11 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
as requested by the EMS Director.
c. Contractor shall participate with the County's Quality Improvement Plan and follow all
EMS policies regarding quality improvement and provide appropriate data.
SECTION 14 - PENALTY PROVISIONS
14.1 Penalties described in this section shall not exceed to total annual FRALS funding, under this
agreement. Penalties may be disputed as described in Section 14.7.
14.2 Response Time Penalty - Penalties shall be withheld by County from FRALS support funds.
a. Contractor shall be penalized anytime Response Time compliance drops below 90% for
any calendar month. Response Times for departments with low call volume (less than
100 calls per month) shall be evaluated when the Contractor has responded to 100 calls.
Once the 100 call level is exceeded, the number of calls to achieve the 100 call threshold
will start over in the next month.
b. Calculating FRALS response time penalties:
• Compliance will be calculated based on combining the Echo, Delta, and Charlie levels
of responses and all subareas (Metro /urban, Suburban /Rural, Wilderness). If
compliance falls below ninety percent (90 %) the subsidy will be reduced by 10% for
the next month.
• Compliance for Contractors with low response volume (less than 100 calls per
month) will be determined by accumulating the monthly call volume until a total of
100 calls is exceeded. Failure of the Contractor to meet the 90% compliance level
will result in a 10% reduction of the subsidy for a period equal to the number of
months required to exceed the 100 call minimum. For example, if it takes a
Contractor three months to respond to more than 100 calls, the penalty deduction
will be applied to the next three subsidy payments. Once the 100 call level is
exceeded, the number of calls to achieve the 100 call threshold will start over for the
next calendar month.
c. If FRALS calls are not categorized at the Contractor's dispatch center, compliance will be
measured as if all calls are within the ECHO Category.
d. If Response Time compliance drops below 90 %, a performance improvement plan
must be submitted to the EMS Director with the monthly compliance report. The
performance improvement plan must identify each problem that led to the delayed
response and the steps being taken to correct each such problem.
Page 12 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
14.3 Failure to Respond- Contractor's subsidy shall be reduced by a penalty of $2,500for each
failure by the Contractor, with the exception of operational necessity, to provide FRALS, to a
location within the Primary Service Area where a response has been requested by the
dispatch center. The imposition of a penalty does not release Contractor of any other
liability from its failure to respond. A request for an exemption of this penalty due to
operational necessity may be submitted to the EMS Director. The request shall be reviewed
by a panel of three, including the EMS Director and two fire chiefs selected by the Alameda
County Fire Chiefs Association who are not involved with the issue.
14.4 Failure to Provide Timely Reports - Contractor shall promptly deliver each required
report to the County. Contractor's subsidy shall be reduced by a penalty of $50 per day for
each day a report is late.
14.5 Failure to Meet Minimum In- Service Equipment /Supply Requirements- Contractor's
subsidy may be reduced by a penalty of up to $1000 per failed inspection for any FRALS that
fails to comply with EMS Policies with respect to equipment and supplies. Penalties shall be
proportionate with the potential for impact on patient care.
14.6 Failure to Provide Arrival at Incident Time
a. Contractor's subsidy shall be reduced by a penalty of $50penalty each and every time a
FRALS Unit is dispatched and Contractor fails to document the Arrival at Incident time.
b. When the Arrival at Incident time for a call is not obtained, the response to that call shall
be deemed to have exceeded Response Time.
c. If Contractor has failed to document an Arrival at Incident Time, an exemption from the
penalty may be granted if Contractor demonstrates, to the satisfaction of the EMS
Director, an accurate Arrival at Incident time.
14.7 Penalty Disputes
a. Contractor may appeal any penalty to the EMS Director in writing within fourteen (14)
calendar days of receipt of notification of the imposition of a penalty.
b. The EMS Director shall review all appeals and make the decision to eliminate, modify, or
maintain the penalty. The EMS Director's decision shall be final.
14.8 Payment of Penalties
a. County shall withhold penalties from the Contractor's quarterly FRALS Support funds
for any penalty under this Agreement based on the Contractor's monthly performance
reports. The parties shall make a good faith effort to resolve any disputes within a 30-
Page 13 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
day period. If the parties are unable to mutually resolve the dispute within that 30 -day
period, the funds shall be withheld in full and subsequent funds distribution shall be
adjusted to reflect the resolution of the dispute.
b. Failure by the County to assess or impose any penalties at any point, for any reason, does
not impact County's right to do so in the future for the same or other incidents; however,
County may not impose penalties retroactively greater than three (3) months after
discovery and completion of its investigation of the incident causing penalties.
c. Fire service penalty money under this agreement will be set aside in an account created
by the County for eventual increases in the number of FRALS units or other projects that
enhanced Fire EMS response. Requests shall be reviewed by a panel of three, including
the EMS Director and two fire chiefs selected by the Alameda County Fire Chiefs
Association not involved in the matter being considered for funding.
SECTION 15 - COOPERATION WITH EMS SYSTEM /COMMUNITY EDUCATION
15.1 Contractor shall submit its plan for medical education programs for the community in its
service area and submit a report to EMS no later than April 1, 2012 describing these
programs.
15.2 Contractor agrees to participate and assist in the development of system changes subject to
negotiated costs, if any.
15.3 County agrees to continue obtaining input from all participating Contractors prior to
implementing change to system policies and procedures.
15.4 Contractor shall participate and assist in changes related to emergency medical services in
Alameda County through their participation in committee meetings, and work groups(e.g.:
Emergency Medical Oversight Committee, Quality Council and Data Steering Committee).
SECTION 16 - ADMINISTRATIVE PROVISIONS
16.1 Material Breach
a. Willful failure of Contractor to provide Services under this Agreement in substantial
compliance with the requirements of the applicable Federal, State, and County of
Alameda laws, rules, and regulations shall constitute a material breach by Contractor.
Minor infractions of such requirements shall not constitute a material breach unless
such infractions are willful and repeated.
Page 14 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
b. Acts or omissions that shall constitute a material breach by Contractor include but are
not limited to the following:
• Willful falsification of data supplied to County during the course of operations,
including but not limited to dispatch data, patient report data, Response Time data,
financial data, or falsification of any other data required under Agreement;
• Willful failure to maintain equipment in accordance with the requirements of this
Agreement;
• Willful attempts to intimidate or punish employees who participate in protected
concerted activities, or who form or join any professional associations;
• Chronic and persistent failure to require employees to conduct themselves in a
professional and courteous manner, and to present a professional appearance;
• Repeated failure to meet Response Time requirements after receiving notice of non-
compliance from the EMS Director;
• Failure to maintain required insurance;
• Willful and repeated refusal to respond to requests for FRALS Services into another
jurisdiction.
• Failure to timely obtain and maintain the necessary licensing and /or certification
required by law to provide Services;
16.2 Notice and Cure of Material Breach
a. County shall give Contractor written notice, return receipt requested, setting forth with
reasonable specificity the nature of a material breach.
b. Contractor shall have the right to cure the material breach within ten (10) calendar days
of receipt of notice. Within three (3) calendar days of receipt of a material breach notice,
Contractor shall deliver to County, in writing, a plan of action to cure the material
breach.
c. If the material breach, by its nature, cannot reasonably be cured within ten (10) calendar
days, Contractor may request additional time to complete cure of the breach.
16.3 County Remedies
a. County shall have the right to terminate this Agreement in addition to any other legal
remedy in the event of a material breach that is not cured within ten (10) calendar days
or additional time granted by County.
Page 15 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
b. County's remedies for any breach are non - cumulative and in addition to any other
remedy available to the County.
c. If the County determines any breach has occurred, County may require Contractor to
submit a corrective action plan. Failure to submit and implement any requested
corrective action plan may be considered a material breach.
16.4 Continuous Service Delivery - Contractor agrees that there is a public health and safety
obligation to assist County in every effort to ensure uninterrupted and continuous service
delivery in the event of a material breach, even if Contractor disagrees with the
determination of material breach.
16.5 Annual Performance Evaluation
a. The County may evaluate the performance of the Contractor on an annual basis.
Contractor shall provide a report to the County to assist in this evaluation within 60
calendar days of written notice by County of its intention to conduct a performance
evaluation.
b. The report may require the following information:
• Response Time performance
• Clinical performance in accordance with the Quality Management Plan
• Innovative programs that have been initiated to improve system performance
• Update on community education programs and other community initiatives
• Other information as requested by County
• Other information Contractor would like considered by County.
16.6 Assurance of Performance
a. If at any time, the County believes Contractor may not be adequately performing its
obligations under this Agreement or that Contractor is not performing the Services as
required by this Agreement, County shall provide notice to the Contractor specific
nature of Contractor's deficient performance and may there upon request from
Contractor prompt reply as to the notice of deficiency, and a written plan acceptable to
County, for the correction of deficiencies in Contractor's performance.
b. Contractor shall provide such reply and a written plan within ten (10) calendar days of
the receipt of the County's notice, and shall thereafter diligently commence and fully
perform such written plan.
Page 16 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
c. Contractor's failure to reply to such notices or to provide a written plan within the
required time is a material breach of this Agreement.
16.7 Mutual Termination -This Agreement may be terminated early by mutual consent of the
Contractor and the County.
16.8 Termination for Cause
a. If Contractor fails to cure any material breach, following notice and opportunity to cure,
County, upon written notice to Contractor, may terminate this Agreement for cause. The
termination shall be effective on the date specified in the written notice.
b. Contractor shall be responsible for all costs incurred by County due to termination for
cause.
SECTION 17 - GENERAL PROVISIONS
17.1 Permits and License
a. Contractor shall be responsible for and shall hold any and all required Federal, State or
local permits or licenses required to perform its obligations under the Agreement.
b. It shall be entirely the responsibility of Contractor to schedule and coordinate all
applications and application renewals as necessary to ensure that Contractor is meeting
its obligation under the Agreement and is in complete compliance with Federal, State
and local requirements for permits and licenses as necessary to provide the services.
c. Contractor shall be responsible for ensuring that its employee's State and local
certifications as necessary to provide the services, if applicable, are valid and current at
all times.
17.2 Observation and Inspections
a. County representatives may at any time directly observe Contractor's operations at the
Dispatch Center or Fire Stations that house FRALS units. Prior to any inspection the
County shall notify the on -duty Battalion Chief at least 1 hour in advance.
b. A County representative may schedule a ride -along or ride as "third person" on any of
Contractor's units at any time, provided that in exercising this right to inspection and
observation, County representatives shall conduct themselves in a professional and
courteous manner, shall not interfere with Contractor employee's duties, and shall at all
times be respectful of Contractor's employer /employee relationships.
c. At any time during normal business hours and as often as may be reasonably deemed
necessary by the County, County representatives may observe Contractor's office
Page 17 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
operations, and Contractor shall make available to County for its examination any and all
business records, including incident reports, patient records, financial records of
Contractor pertaining to the provision of emergency medical services. County may
audit, copy, make transcripts, or otherwise reproduce such records as needed for County
to fulfill its oversight role.
d. County shall notify Contractor of any critical issues discovered during an observation or
inspection.
17.3 Relationship of the Parties
Nothing in this Agreement shall be construed to create a relationship of employer and
employee or principal and agent, partnership, joint venture, or any other relationship other
than that of independent parties contracting with each other solely for the purpose of
carrying out the provisions of the Agreement. Nothing in the Agreement shall create any
right or remedies in any third party, it being solely for the benefit of the County and
Contractor.
17.4 Independent Contractor
a. No relationship of employer and employee is created by this Agreement; it being
understood and agreed that Contractor is an independent Contractor. Contractor is not
the agent or employee of the County in any capacity whatsoever, and County shall not be
liable for any acts or omissions by Contractor nor for any obligations or liabilities
incurred by Contractor.
b. Contractor, its employees, subcontractors and agents shall have no claim under this
Agreement or otherwise, for seniority, vacation time, vacation pay, sick leave, personal
time off, overtime, health insurance medical care, hospital care, retirement benefits,
social security, disability, Workers' Compensation, or unemployment insurance benefits,
civil service protection, or employee benefits of any kind.
c. Contractor shall be solely liable for and obligated to pay directly all applicable payroll
taxes (including Federal and State income taxes) or contributions for unemployment
insurance or old age pensions or annuities which are imposed by any governmental
entity in connection with the labor used or which are measured by wages, salaries or
other remuneration paid to its officers, agents or employees and agrees to indemnify
and hold County harmless from any and all liability which County may incur because of
Contractor's failure to pay such amounts.
Page 18 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
d. Contractor shall comply with all applicable Federal and State workers' compensation
and liability laws and regulations with respect to the officers, agents and /or employees
conducting and participating in the work; and agrees that such officers, agents, and /or
employees shall be considered as independent Contractors and shall not be treated or
considered in any way as officers, agents and /or employees of County.
17.5 Indemnification
Each party shall indemnify, defend, protect, hold harmless, and release the other, their
elected bodies, officer, agents, and employees, from and against any and all claims, losses,
proceedings, damages, causes of action, liability, costs, or expense (including attorney's fees
and witness costs) arising from or in connection with, or caused by any negligent act or
omission or willful misconduct of such indemnifying party. This indemnification obligation
shall not be limited in any way by any limitation on the amount or type of damages or
compensation payable to or for the indemnifying party under workers' compensation acts,
disability benefit acts, or other employee benefit acts.
17.6 Insurance
Contractor shall at all times during the term of the Agreement with the County maintain in
force the insurance coverage specified in EXHIBIT C - MINIMUM INSURANCE REQUIREMENTS, and
shall comply with all those requirements as Stated therein.
17.7 Conformity with Law and Safety
a. In performing Services under this Agreement, Contractor shall, at all times, observe and
comply with all applicable laws, ordinances, codes and regulations of governmental
agencies, including Federal, State, municipal, and local governing bodies, having
jurisdiction over the Services, including, but not limited to, all applicable provisions of
the California Occupational Safety and Health Act. It shall be Contractor's sole
responsibility to be fully familiar with all such applicable laws, ordinances, and
regulations.
b. Contractor shall indemnify and hold County harmless from any and all liability, fines,
penalties and consequences from any failure by Contractor to comply with such laws,
ordinances, codes and regulations.
c. If a death, serious personal injury, or substantial property damage occurs in connection
with Contractor's performance of this Agreement and warrants submission of an
Alameda County EMS Unusual Occurrence Report (as per EMS Policy). Contractor shall
Page 19 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
immediately notify County by contacting the Alameda County Regional Emergency
Communications Center (ACCREC), as per EMS policy, and asking to speak to the EMS
person on call Contractor shall promptly submit to County a written report, in such form
as may be required by County of all accidents, which occur in connection with this
Agreement. This report must include:
• the name and address of the injured or deceased person(s);
• the name and address of Contractor's sub - Contractor, if any;
• the name and address of Contractor's liability insurance carrier; and,
• a detailed description of the accident and whether any of County's equipment, tools,
material or staff were involved.
d. Contractor shall take all reasonable steps, as per EMS policy, to preserve all physical
evidence and information which may be relevant to an accident involving personal
injury, death, or property damage, while maintaining public safety, in order to afford
County the opportunity to review and inspect such evidence, including the scene of the
accident
17.8 Debarment and Suspension Certification
a. Contractor shall comply with applicable Federal suspension and debarment regulations,
including but not limited to 7 Code of Federal Regulations ( "CFR ") 3016.35, 28 CFR
66.35, 29 CFR 97.35, 34 CFR 80.35, 45 CFR 92.35 and Executive Order 12549.
b. Contractor certifies to the best of its knowledge and belief, that it and its principals:
• Are not presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntary excluded by any Federal department or agency; and,
• Shall not knowingly enter into any covered transaction with a person who is
proposed for debarment under Federal regulations, debarred, suspended, declared
ineligible, or voluntarily excluded from participation in such transaction.
17.9 Ownership of Documents
Contractor shall pay all royalties and license fees which may be due for any patented or
copyrighted materials, methods or used by Contractor for the Services, and shall defend,
indemnify and hold County harmless from any claims for infringement of patent or
copyright arising out of such use. The County's rights under this Paragraph shall not extend
to any computer software used to create such Documents and Materials.
Page 20 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
17.10 Documents and Materials
a. Contractor shall maintain and make available to County for its inspection and use during
the term of this Agreement all EMS related Documents and Materials. This duty shall
continue for three (3) years following termination or expiration of this Agreement.
Contractor shall not dispose of, destroy, alter, or mutilate such Documents and Materials,
for three (3) years following termination or expiration of this Agreement.
b. Retention of Records - Contractor shall retain all documents pertaining to the Agreement
including patient care records, as required by Federal and State laws and regulations,
and no less than seven (7) years from the end of the fiscal year following termination or
expiration of this Agreement. In addition, patient care records for minors shall be
retained for a minimum of seven (7) years and /or until the minor turns age 18 plus one
year. Upon request, and except as otherwise restricted by law, Contractor shall make
these records available to authorized representatives of the County, the State of
California, and the Federal government.
c. Time of Essence - Time is of the essence in respect to all provisions of this Agreement
that specify a time for performance. This requirement shall not be construed to limit or
deprive a party of the benefits of any grace or use period allowed by this Agreement.
17.11 Notices
a. All notices, requests, demands, or other communications under this Agreement shall be
in writing. Notices shall be given for all purposes as follows:
b. Personal Delivery: When personally delivered to the recipient, notices are effective on
delivery.
c. Certified Mail: When mailed certified mail, return receipt requested, notice is effective
on receipt, if delivery is confirmed by a return receipt.
d. Overnight Delivery: When delivered by overnight delivery (e.g., Federal
Express /Airborne /United Parcel Service /DHL Worldwide Express) with charges
prepaid or charged to the sender's account, notice is effective on delivery, if delivery is
confirmed by the delivery service.
e. Facsimile Transmission: When sent by facsimile to the last facsimile number of the
recipient known to the party giving notice, notice is effective on receipt, provided that: a)
a duplicate copy of the notice is promptly given by first -class or certified mail or by
overnight delivery, or b) the receiving party delivers a written confirmation of receipt.
Page 21 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
Any notice given by facsimile shall be deemed received on the next business day if it is
received after 5:00 p.m. (recipient's time) or on a non - business day.
17.12 Addresses for purpose of giving notice are as follows:
To County: County of Alameda
Alameda County EMS
1000 San Leandro Blvd
San Leandro, CA 94577
Attn: EMS Director
To Contractor: City of Dublin
100 Civic Plaza
Dublin, CA94568
Attn: Joni Pattillo, Title: City Manager
a. Any correctly addressed notice that is refused, unclaimed, or undeliverable because of
an act or omission of the party to be notified shall be deemed effective as of the first date
that notice was refused, unclaimed, or deemed undeliverable by the postal authorities,
messenger, or overnight delivery service.
b. Any party may change its address or telex or facsimile number by giving the other party
notice of the change in any manner permitted by this Agreement.
17.13 Equal Employment Opportunity Practices Provisions
a. Contractor shall comply with Title VII of the Civil Rights Act of 1964 and Contractor
agrees that no person shall, on the grounds of race, creed, color, disability, sex, sexual
orientation, national origin, age, religion, Vietnam era Veteran's status, political
affiliation, or any other non -merit factor, be excluded from participation in, be denied
the benefits of, or be otherwise subjected to discrimination under this Agreement.
b. Contractor shall, in all solicitations or advertisements for applicants for employment
placed as a result of this Agreement, State that it is an "Equal Opportunity Employer" or
that all qualified applicants shall receive consideration for employment without regard
to their race, creed, color, disability, sex, sexual orientation, national origin, age, religion,
Vietnam era Veteran's status, political affiliation, or any other non -merit factor.
c. Upon request by County, Contractor shall certify that it has not, in the performance of
this Agreement, discriminated against applicants or employees because of their race,
creed, color, disability, sex, sexual orientation, national origin, age, religion, Vietnam era
Veteran's status, political affiliation, or any other non -merit factor.
Page 22 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
d. Upon request by County, Contractor shall provide County with access to copies of all of
its records pertaining or relating to its employment practices, except to the extent such
records or portions of such records are confidential or privileged under State or Federal
law.
e. Nothing contained in this Agreement shall be construed in any manner so as to require or
permit any act that is prohibited by law.
17.14 Waiver
No waiver of a breach, failure of any condition, or any right or remedy contained in or
granted by the provisions of this Agreement shall be effective unless it is in writing and
signed by the party waiving the breach, failure, right or remedy. No waiver of any breach,
failure, right or remedy shall be deemed a waiver of any other breach, failure, right or
remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless
the writing so specifies.
17.15 Assignment Not Allowed
a. 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.
b. CONTRACTOR's subcontracting of services under this Agreement to the Alameda County
Fire Department is a subcontract and not an assignment, and does not violate this
provision.
17.16 End Term Provisions
Contractor agrees to return all COUNTY- issued equipment, including equipment purchased
by Paramedics Plus, to COUNTY in good working order, normal wear and tear excepted, at
the termination of this Agreement.
17.17 Entire Agreement
This Agreement, including all attachments, exhibits, and any other documents specifically
incorporated into this Agreement, shall constitute the entire agreement between the parties
relating to the subject matter of this Agreement.
This Agreement supersedes and merges all previous understandings, and all other
agreements, written or oral, between the parties and sets forth the entire understanding of
the parties regarding the subject matter thereof.
Page 23 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
17.18 Headings
Headings herein are for convenience of reference only and shall in no way affect the
interpretation of the Agreement.
17.19 Modification of Agreement
This Agreement may be supplemented, amended or modified only by the mutual agreement
of the parties. No supplement, amendment, or modification of this Agreement shall be
binding unless it is in writing and signed by authorized representatives of both parties.
Where there is mutual agreement by Contactor and the EMS Director, the following exhibits
may be modified, by a written amendment signed by Contractor and the Director of Health
Care Services Agency:
EXHIBIT A - DEPICTION AND DEFINITION OF CONTRACTORS PRIMARY SERVICE AREA
EXHIBIT B - DEPICTION AND DEFINITION OF SUB -AREAS
EXHIBIT F - REPORT ON INTERMITTENT OR ROTATIONAL SERVICE INTERRUPTION
17.20 Survival
The obligations of this Agreement, which by their nature would continue beyond the
termination or expiration of the Agreement, including without limitation, the obligations
regarding Indemnification, Ownership of Documents, and Conflict of Interest, shall survive
termination or expiration.
17.21 Severability
If a court of competent jurisdiction holds that any provision of this Agreement is illegal,
unenforceable, or invalid in whole or in part, for any reason, the validity and enforceability
of the remaining provisions, or portions of them, shall not be affected, unless an essential
purpose of this Agreement would be defeated by the loss of the illegal, unenforceable, or
invalid provision.
17.22 Patent and Copyright Indemnity
Contractor represents that it knows of no allegations, claims, or threatened claims that the
materials, services, hardware or software ( "Contractor Products ") provided to County under
this Agreement infringe any patent, copyright, or other proprietary right. Contractor shall
defend, indemnify and hold harmless County, from and against all losses, claims, damages,
liabilities, costs expenses and amounts (collectively, "Losses ") arising out of or in connection
with any claim that any Contractor Products or the use thereof, infringe any patent,
copyright or other proprietary right of any third party. County shall: a) notify Contractor
promptly of such claim or suit; b) permit Contractor to defend, compromise, or settle the
Page 24 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
claim; and, c) provide, on a reasonable basis, information to enable Contractor to do so.
Contractor shall not agree without County's prior written consent, to any settlement, which
would require County to pay money or perform some affirmative act in order to continue
using the Contractor Products.
If Contractor is obligated to defend County pursuant to this Section and fails to do so after
reasonable notice from County, County may defend itself and /or settle such claim or suit,
and Contractor shall pay to County any and all losses, damages and expenses (including
attorney's fees and costs) incurred in relationship with County's defense and /or settlement
of such claim or suit.
In the case of any such claim of infringement, Contractor shall either, at its option: a)
procure for County the right to continue using the Contractor Products; or b) replace or
modify the Contractor Products so that that they become non - infringing, but equivalent in
functionality and performance.
Notwithstanding this Section, County retains the right and ability to defend itself, at its own
expense, against any claims that Contractor Products infringe any patent, copyright, or other
intellectual property right.
17.23 Choice of Law and Venue
This Agreement shall be governed by the laws of the State of California. Venue for actions
and proceedings between the parties related to this Agreement shall be Alameda County
Superior Court for state actions and the Northern District of California for any federal
action.
Page 25 of 26
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
SIGNATORY
By signing this agreement, signatory warrants and represents that he /she executed this Agreement
in his /her authorized capacity and that by his /her signature on this Agreement, he /she or the
entity upon behalf of which he /she acted, executed this Agreement.
IN WITNESS WHEREOF, the parties execute this Agreement:
County of Alameda
By:
Signature
Name: Nate Miley
Title: President of the Board of Supervisors
Date:
Approved as to Form:
In
County Counsel Signature
Contractor
By:
Signature
Name: Joni Pattillo
Title: City Manager
Date:
Approved as to Form:
I
Title City Attorney
Page 26 of 26
Signature
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11(1/2011)
EXHIBIT A - DEPICTION & DEFINITION - CONTRACTOR'S PRIMARY RESPONSE AREA /EOA
1. There are five (5) Emergency Response Zones (ERZ) in Alameda County, which include
cities and all unincorporated areas. The following are cities contained in each ERZ:
a. Zone 1- Alameda, Albany, Berkeley, Piedmont
b. Zone 2 - Oakland, Emeryville
C. Zone 3 - San Leandro, Castro Valley, Hayward
d. Zone 4 - Fremont, Newark, Union City
e. Zone 5 - Dublin, Pleasanton, Livermore
2. The following is a depiction of the Emergency Response Zones (ERZ) by city and
unincorportated areas within Alameda County.
Page E- I
1 - Albany
2 - Berkeley
3 - Emeryville
4 - Piedmont
5 - Oakland
6 - Alameda
7 - San Leandro
8 - Ashland
9 - Cherryland
10 - San Lorenzo
11- Castro Valley
12 - Fairview
13 - Hayward
14 - Union City
15- Newark
16 - Fremont
17 - Dublin
18 - Pleasanton
19 - Livermore
20 - Sunol
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
EXHIBIT B - DEPICTION & DEFINITION OF SUB -AREAS
1. Density Area Designation: Designations of call density areas were accomplished by
reviewing the call density for every square kilometer grid in the County. The grids were
normalized by examining the underlying road structure with the goal of creating zones with
Rural /Suburban contiguous with Metro /Urban, eliminating anomalous pockets of high or
low density in the midst of one of the density areas, and creating a map that can be
incorporated into the computer aided dispatch system.
Sub -area definitions are for general descriptive purposes only; the actual sub -areas are
identified on the maps in this Exhibit. The map defines the subarea, not the actual number
of calls received during any period. The identified Sub -areas are subject to change at the
discretion of the County.
2. Sub - Areas: There are 3 possible Sub -areas contained within each ERZ.
Metro /Urban call densities are determined by identifying the square kilometers that
average 2 or more calls per month and at least half of the surrounding square kilometers
also average 2 or more calls per month.
Rural /Suburban areas are those in which the average calls per square kilometer are
between 0.25 and less than 2.0 calls per month on average.
Wilderness /Low Call Density is determined by identifying the square kilometers that
average less than 0.25 calls per month (or one call every 4 months, on average)
Alameda County:
San
Francisco
Bay a
burlmgame '
. „Foster city
0
San Mateo
Belmont ,.San Carlos
Airetlon
Contra costa
Page E -2
■ Urban
We Rural
E
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
Zone 2:
a1
.. 0tl e� bra L�fapfL Walnvl
M ��W Rncem v�,kY Orsa4
■ � .. .a ura. _.n
i A l J F 0 R N 1,A
- LaR/on
r
. r • _
�y r
° ■
Zone 3:
r
r
timalpamow I ( •
am Mon m ■rrrrr.rt. ■ ■ ■■
f m
r ■
in-iIn ■ ■ %,%
w, r
ar■■■■■
m �
�
mF+i m ON N3- s m? r 1
V Sr owsli ■■some, ■
■INwa r ■mmme■ ■■s ■rU�.
err \■rmmm■■samml Iftu
�mmis *tr•e•■■empim "m
mrm, ■•K■■ a■m ■■■■2
■■■■r' ■fipmim ■00` ■■r :e■■■■
SEEN. _■■■-m- ■m■mom -NAMA
Pa ,-e E -',
S Urban
Ir Rural
N Wddernss
i Urban
M Rural
0 Wilderness
. -
'`
4 ■ •
■
■
■
■
■
■
■
L
A1■
■
■
■
m
■
■,,
�,r
■r.
■
■
■■
■■yam
...
r r
r
r
r
r■
f
err
14 +i
■rr■
■
timalpamow I ( •
am Mon m ■rrrrr.rt. ■ ■ ■■
f m
r ■
in-iIn ■ ■ %,%
w, r
ar■■■■■
m �
�
mF+i m ON N3- s m? r 1
V Sr owsli ■■some, ■
■INwa r ■mmme■ ■■s ■rU�.
err \■rmmm■■samml Iftu
�mmis *tr•e•■■empim "m
mrm, ■•K■■ a■m ■■■■2
■■■■r' ■fipmim ■00` ■■r :e■■■■
SEEN. _■■■-m- ■m■mom -NAMA
Pa ,-e E -',
S Urban
Ir Rural
N Wddernss
i Urban
M Rural
0 Wilderness
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
Zone 4:
MESNq
SEES
MESS
Ems s
EMEME
NONE
SEEM
M sow
�7 ■ ir-4kf ■
Zone 5:
■■■■■ O's ■f\ ■0j f`■0■av0
a ■0rZ ■ /r■ ■ammar■
■ ■frr ■ ■r■"tirrr
■ ,� R1jLjb �i a 0 0 a 0 a
■ ■� ■a.a,m■ / ■fi ■■ ■flit
■ ■■■■■ Ir ■■■■
■ ■, km■■i■ ■fir■■■ ■l
I.■ ■■■ -i ■ ■ff■
■'i, ■ ■Ili ■iLi ■ ■f
MMMM
EMS ■■ ■■■■/ MMMMM
■■■ ■f ■■■■f
■■■■■i ■f ■f
■ ■f■■f ■■■■
if■■■■ ■■■■
■ ■f ■■■lwI■ ■f ■
`■■
Santa clam
Page E -4
u
ft Urban
Rural
■ Wilderness
Urban
r Rural
r Wddenn ss
EMERCENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
EXHIBIT C - MINIMUM INSURANCE REQUIREMENTS
Without limiting any other obligation or liability under this Agreement, the Contractor, at its sole cost and expense, shall secure and keep in force
during the entire term of the Agreement m longer, as may be specified below, the following insurance coverage, limits and endorsements:
Page E -5
TYPE OF e
MINIMUM LIMITS
A.
Commercial General Liability
Premises Liability, Products and Completed Operations; Contractual
$2.000,000.00 per occurrence (CSL)
Liability, Personal Injury and Advertising Liability, Abuse, Molestation,
Bodily Injury and Property Damage
Sexual Actions, and Assault and Battery
B.
Commercial or Business Automobile Liability
$2,000,000.00 per occurrence (CSL)
All owned vehicles, hired or leased vehicles, non - owned, borrowed and
Any Auto
permissive uses. Personal Automobile Liability is acceptable for individual
Bodily Injury and Property Damage
Contractors with no transportation or hauling related activities
C.
Workers' Compensation (WC) and Employers Liability (EL)
EL Statutory Limits
$injury or per accident for
Required for all Contractors with employees
disc
bodil injury or disease
bodily
D.
Professional Liability/Errors & Omissions
$2,000,000.00 per occurrence
Includes endorsements of contractual liability and defense and
$5,000,000.00 project aggregate
indemnification of the Count
E.
Endorsements and Conditions:
1.
ADDITIONAL INSURED: All insurance required above with the exception of Professional Liability, Personal Automobile
Liability, Workers' Compensation and Employers Liability, shall be endorsed to name as additional insured: County of
Alameda, its Board of Supervisors, the individual members thereof, and all County officers, agents, employees and
representatives.
2.
DURATION OF COVERAGE: All required insurance shall be maintained during the entire term of the Agreement with the
following exception: Insurance policies and coverage(s) written on a claims -made basis shall be maintained during the
entire term of the Agreement and until 3 years following termination and acceptance of all work provided under the
Agreement, with the retroactive date of said insurance (as may be applicable) concurrent with the commencement of
activities pursuant to this Agreement.
3.
REDUCTION OR LIMIT OF OBLIGATION: All insurance policies shall be primary insurance to any insurance available to
the Indemnified Parties and Additional Insured(s). Pursuant to the provisions of this Agreement, insurance affected or
procured by the Contractor shall not reduce or limit Contractor's contractual obligation to indemnify and defend the
Indemnified Parties.
4.
INSURER FINANCIAL RATING: Insurance shall be maintained through an insurer with a minimum A.M. Best Rating of A-
or better when applicable, with deductible amounts acceptable to the County. Acceptance of Contractor's insurance by
County shall not relieve or decrease the liability of Contractor hereunder. Any deductible or self - insured retention amount
or other similar obligation under the policies shall be the sole responsibility of the Contractor. Any deductible or self -
insured retention amount or other similar obligation under the policies shall be the sole responsibility of the Contractor.
S.
SUBCONTRACTORS: Contractor shall include all subcontractors as an insured (covered party) under its policies or shall
furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject
to all of the requirements stated herein.
6.
JOINT VENTURES: If Contractor is an association, partnership or other joint business venture, required insurance shall
be provided by any one of the following methods:
— Separate insurance policies issued for each individual entity, with each entity included as a "Named Insured (covered
party), or at minimum named as an "Additional Insured" on the other's policies.
- Joint insurance program with the association, partnership or other joint business venture included as a "Named
Insured.
7.
CANCELLATION OF INSURANCE: All required insurance shall be endorsed to provide thirty (30) days advance written
notice to the County of cancellation.
B.
CERTIFICATE OF INSURANCE: Before commencing operations under this Agreement, Contractor shall provide
Certificate(s) of Insurance and applicable insurance endorsements, in form and satisfactory to County, evidencing that all
required insurance coverage is in effect. The County reserves the rights to require the Contractor to provide complete,
certified copies of all required insurance policies. The require certificate(s) and endorsements must be sent to:
- Department /Agency issuing the agreement
- With a copy to Risk Management Unit 125 - 12th Street, 3ro Floor, Oakland, CA 94607
Page E -5
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (11/1/2011)
EXHIBIT D - DEBARMENT AND SUSPENSION CERTIFICATION
loni Pattillo under penalty of perjury, certifies that, except as noted below, the company, its
principal, and any named subcontractor:
1.1 Is not currently under suspension, debarment, voluntary exclusion, or determination
of ineligibility by any Federal agency;
1.2 Has not been suspended, debarred, voluntarily excluded or determined ineligible by
any Federal agency within the past three years;
1.3 Does not have a proposed debarment pending; and,
1.4 Has not been indicted, convicted, or had a civil judgment rendered against it by a
court of competent jurisdiction in any matter involving fraud or official misconduct
within the past three years.
If there are any exceptions to this certification, insert the exceptions in the following space.
Exceptions shall not necessary result in denial of award, but shall be considered in
determining Proposer responsibility. For any exception noted above, indicate below to
whom it applies, initiating agency, and dates of action.
4. Providing false information may result in criminal prosecution or administrative sanctions.
The above certification is part of the Agreement. Signing the Agreement on the signature
portion thereof shall also constitute signature of this Certification.
Name: loni Pattillo
Signature:
Title: City Manager
Date:
Page E -6
EMERCENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED Lin- SUPPORT AGREEn4ENT (11/1/2011)
EXHIBIT E - FIRST RESPONDER SUPPORTPAYMENT SCHEDULE
1. In consideration for the provision of services as described in the Letter of Agreement (LOA)
between the Contractor and the County for the period July 1, 2011 through October 31, 2011,
the County shall subsidize the Contractor on 4 authorized FRALS units at 100% of the available
funding for a total of $57,190.88 for the term of the LOA. Payment to Contractor will be made
upon receipt of an invoice to be submitted after November 1, 2011.
2. In consideration for the provision of services described in this Agreement, COUNTY shall
subsidize CONTRACTOR on 4 authorized FRALS units at *100% of the available funding for a
total of $892,870.91 for the term of the agreement:
3. * FRALS Services shall be funded based on the following:
0 Responding to requests for Emergency Medical Services
60%
Amount per
2
Quarterly
Total
and response designation as ECHO, DELTA, CHARLIE, BRAVO, ALPHA prior to response
COLA
FRALS Unit x 4
Funded
Amount
Amount
11/01/2011—
0 �°
$42,893.16 x 4 =
100%
$42,893.16
$171,572.64
10/31/2012
$171,572.64
11/01/2012-
%
$43,
$43, 751.02 x 4 =
100%
$43,751.02
$175,004.08
10/31/2013
$175004.08
11101/2013-
%
$44,626.04
$44,626.04 x 4 =
100%
$44,626.04
$178,504.16
10/31/2014
$178,504.16
11/01/2014 -
2%
$45,518.56 x 4 =
100%
$45,518.56
$182,074.24
10/31/2015
$182,074,24
11/01/2015-
2 ° �0
$46,428.94 x 4 =
100%
$46,428.94
$185,715.76
10/31/2016
$185,715.76
3. * FRALS Services shall be funded based on the following:
0 Responding to requests for Emergency Medical Services
60%
I@ Transferring EMS calls to a designated Medical Dispatch Center for pre - arrival instructions
20%
El Transferring EMS calls to a designated Medical Dispatch Center for MPDS call categorization
and response designation as ECHO, DELTA, CHARLIE, BRAVO, ALPHA prior to response
20%
3. If Contractor adds or subtracts services contained in #2 during the term of the agreement,
funding shall be amended during the next quarter following the change of services.
4. Payment to Contractor will be made in equal quarterly installments upon receipt of an invoice,
beginning with receipt of the first invoice after February 1, 2012.
S. County shall make every effort to remit payments within thirty (30) business days.
6. Payment to CONTRACTOR will be held until receipt of the required quarterly data per mutually
agreed data calendar.
7. Total payments to be calculated and determined by the number of authorized FRALS units
actually in service. (See Exhibit F and Section 4.3 &4.4 for intermittent or rotational closure of
stations).
8. The number of FRALS units specified in #1 above will not increase during the life of this
agreement unless approved by Contractor and the EMS Director and funding is available.
9. To subtract units CONTRACTOR must notify the EMS Director prior to the reduction.
Page E -7
EMERGENCY MEDICAL ScRVICES Fli,ST RESVONDER ADVANCED LIFE SUPPORT AGREEMENT (1 111112 01 1)
EXHIBIT F - REPORT ON INTERMITTENT OR ROTATIONAL SERVICE INTERRUPTION
FY 20 / Quarter #
Department:
*Service Interruptions Days per Month
Subsidy
Intermittent
Rotational
Total
Station:
Reduction
Days
Days
Days
1" Quarter:
July
$()
August
$()
September
$0
Total
$()
2nd Quarter:
October
$()
November
$()
December
$()
Total
$()
3'd Quarter:
January
$q
February
$p
March
$()
Total
$0
4`h Quarter:
April
$()
May
$()
June
$()
Total
$O
Annual subsidy: $
Days /year: Quarterly Invoice: $
Daily subsidy: $ Subsidy Reduction $()
# FRALS units / day: Total subsidy payment: $
Daily unit subsidy: $
*Days in which FRALS service is reduced greater than 12 hours (see Section 4)
Page E -8
EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPRORT AGREEMENT (111%2011)
EXHIBIT G - EQUIPMENT LOAN AGREEMENT
A. INTRODUCTION:
Paramedics Plus has contracted with County to loan the following equipment to Contractor for
use on FRALS units at no cost to Contractor:
1. Four (4) rugged mobile personal computers and Tablet PC software for the PCR data
collection system:
a. Panasonic CF -19 Toughbook
b. One (1) spare battery
c. One (1) AC charging cable
d. IT support and updates when required
e. Routine scheduled maintenance.
2. Four (4) LIFEPAK 15 System
a. LP 15 monitor - defibrillators capable of wireless transmission of 12 -lead ECG's for each
unit and sufficient data plan to accommodate and support this process.
b. Temporary replacement Lifepak 15s for units undergoing repairs
c. Velocitor charger
d. Station charger
e. One (1) spare battery
3. -Four (4) Physio - Control chest compression system (LUCAS device)
a. Lucas CPR device
b. One (1) spare battery
c. One (1) station charger
B. CONDITIONS:
1. Acceptance of Paramedics Plus equipment is optional. By accepting equipment under this
agreement, Contractor commits to utilizing equipment in the delivery of all ALS First
Response services. If Contractor is not utilizing the equipment for the delivery of care (e.g.:
closure of a station, reduction of FRALS units) all equipment must be immediately returned
to Paramedics Plus.
2. Paramedics Plus shall maintain ownership of the equipment at all times. The terms of this
exhibit and the responsibilities outlined herein are not transferable. By accepting
Paramedics Plus equipment, the Contractor agrees to comply with all terms and conditions
set forth herein associated with the loan of equipment.
3. The Contractor shall be solely responsible for the proper use and deployment of the
equipment. Paramedics Plus shall be responsible for training personnel using the
equipment on the proper use of the equipment in accordance with any equipment use
procedures. The Contractor accepts sole responsibility for operating the equipment at its
sole risk.
4. Contractor agrees to give this equipment the same level of care as similar property
purchased by Contractor. Equipment shall be returned to Paramedics Plus in as good a
Page E -9
EmGRcENcy MEDICAL SERVICES FIRST RESPONDER ADVANCED UFF SUPPORT AGREEMENT (11/l/20111
condition as when received by the Contractor, reasonable wear and tear excepted. During
the loan period Paramedics Plus agrees to assume all responsibility for maintenance and
repair due to normal wear and tear.
5. The Contractor is responsible for the full cost of repair or replacement of any or all of the
equipment that is damaged by intentional misuse, abuse, or neglect, lost, or stolen from the
time Contractor assumes custody. If the equipment is lost, stolen or damaged, Contractor
must immediately notify the Paramedics Plus representative.
6. Paramedics Plus shall pay for all insurance, regularly scheduled maintenance and
maintenance agreements for the equipment.
7. All maintenance and repair of equipment shall be performed by personnel authorized by
Paramedics Plus. Any unauthorized maintenance voids all original equipment warranties.
The Contractor shall be liable for the cost of purchasing a new warranty for the equipment if
unauthorized maintenance is performed on the equipment by Contractor's personnel.
8. Contractor shall make the equipment available for inspection and maintenance during
regular business hours with adequate advance notice and notify Paramedics Plus in writing
of any necessary repairs or if the equipment malfunctions. Inventory management and
return notification.
9. Contractor shall maintain and provide annual inventory reports to Paramedics Plus when
requested. These reports shall include the Paramedics Plus inventory control number and
well as the Contractor unit where the equipment is assigned.
10. Failure to adhere to the conditions described above may result in withdrawal of use and
possession of the equipment, through written notice by Paramedics Plus and endorsed by
County.
11. Contractor shall return the equipment to Paramedics Plus upon termination of 9 -1 -1
Ambulance Agreement between Paramedics Plus and County. The current agreement is for
the period beginning November 1, 2011, and ending October 31, 2016. County has an
option to renew for five additional years, ending October 31, 2021.
12. In consideration for the equipment loan, the Contractor agrees to indemnify, defend and
hold Paramedics Plus and County harmless from any and all damages, losses, claims, causes
of actions, expenses and liability of any nature whatsoever associated with its use of the
equipment.
Name: loni Pattillo
Signature:
Title: City Manager
Date: / /
Page E -10