AMR Shasta County Ambulance Service Provider Contract

25 Pages·2014·0.31 MB·English

AMBULANCE AGREEMENT

SHASTA COUEITY
This AGREEMENT, ia entered into this _\H4"“aay of glen 2014 ctfectiva
Date)

Between Sierra-Gacramento Vallay Emargency Medical Services Agency
{AGENCY), and American Medical response West d.b.a. Americen Medical
Response, a Callfornia Comporation (PROVIDER),

WHEREAS, Siarra-Sacramento Valley Emergency Medical Services Agency is a
Regional Joint Powers Local Emergancy Madical Sarvves Agency (JPA) for the
counties of Placer, Nevada, Sutter, Yuba, Butte, Golusa, Tehama, Shasta and Siskiyou:
and

WHEFESS, the County of Shasta, (denoting the polit cal entity), has delegated to
AGENCY various EMS responstilties contained in COUNTY'S Ambulance and
Medical Transportatian Ortinance, including the davelonmant of provider agreements
{or qualifid "non-exclusive" 91 1 PROVIDERS operaling with the COUNTY and the
‘moritering of ambulance operations generally within County: and

WHEREAS, the PROVIDER desires to be approved by AGENCY to provide Advancad
Lite Support Services in cartain parts of COUNTY and

WHEREAS, AGENCY, contingent uzon PROVIDER complying with the conditions eet
forth below, appravas PROVIDER as an Advanced Life Support Transport Provider,

\ow THEREFORE, i is agreed by and between the patties hereto as follows:
DEFINITIONS

Advanced Life Support Ambulance (ALS ambulance) - An ambulance staffed,
‘quipped and prepared to provide advanced lite support in compliance with
California Code ol Regulations, Title 22, Inspected and licansed by California
Highway Patrol, and in compliance with all prehospitel care policies and procedures
adopted by AGENCY

Automatic Aids defined as the closest ambulance transportation agancy balng
dispatched and responding to an omergency in an idantfied adjacent ambulance
response zone on bahalf af the approved provider of that zone. Uhrough @ prior
wrlten agreement.

Automatic Vebicle Locetor (AVL) a wireless communications system that utllzes
tho US military satolites, which broadcast unique radio, signals that an onboard
vehicle black box can tum into a latituderlongllude and time record. This infarmation
ie linked with the Computer Aided Dispatch (CAD) system to assist with the proper

a
ABABULANCE AGREEMENT
SHASTA COUNTY

Unit assignments based on the position from the Global Positioning Satalite end
recommendations from the CAD. AVL allows for ambulance tracking

‘Base Hospital or Modified Base Hospital A hospital that currently has an
agreement with AGENCY to provide medical eitection in the prehospital care system
in accordance with H8SC, Diision 26 Chapter 2, sectlon 1797.58

Gasic Life Support (BLS) An ambulance stated, equipped, and prepared to
provide basic Ife support in oompllance with H8SC, Div'sion 2.5, Chaplar 2, section
1797.80

Codis 3 - See Emergency Response below

Emergency Response — Emergency Response shall hava the same meaning as
sel forth in the applicable rules or raguiations established by the Centers for
Medicare & Medicaid Sarvices, Deparinent of Health & Human Services. Tha
‘currant definition may be found af 42 CFR — 414,605

Emergency - The function involved in responding to & request far an ambulance te
‘transport or assist persons in apparent sucden naod of medical attention in
accordance with the request of Shasta County Publle Safety Answering Point
(PSAP) or Cada 3 raquastad through a seven (7) allt private call.

EnIS Provider Dispatch Center — A communications center capablo of diracly, via
Pagar and/or radia communications, dispatching an ambulance crawfunit using
Ieformetion provided by a PSAP and lor secondary PSAP.

Exclusive Operating Area (EOA}— an EMS area or sub area defined by the
emergency medical services plan for which the AGENCY restricts operations ta ona
provider af Emergency Ground Ambulance Services.

Fiacal Year ~ July 1 through June 30.

factdent Commander — The Incident Commander is the individual responsible for
the management ofall incidents operations at tha incident sie,

Insufficlent Ambulance Unite

4. PROVIDER has no units available to respond to an emeriency within sixty (60)
seconds of PROVIDER'S cispaich center plek up: or

2. Aunit curently on an emergency Incident cannot bacoms available €0 as to
provide for & shorter response tima than a mutual aki ambulance, or

3. A unitis available in a saparate geographic response zone/distiict, but cannot
provide for a shorter respones time than a mutual afd ambulance Code 3
AMBJLANCE AGREEMEN!
SHASTA COUNTY

Mutual Ald ~ a request for emergency ambulancs rasponse originating outside of

PROVIDER'S response area (Wastam Shasta County), for emergeney ambulance

at the sosne. The requast could be inated through dispatch centers, public salety

enforcemant agencies or by S-SV EMS.

Operational Report - The monthly operational report shall contain, but is not limited
ta, ha following: Ineldent reports, mission failures, and any other infomation the

AGENCY deems appropriate that is standard within the emergency medical services
industry.

Paramadie ~ A Califomia licensed individual whose soope of practica isto provide
advanced life support according to the standards prascribed by the Calfornla Gode
‘of Regulations, Tile 22. Division 8, section 100144, in compliance with AGENCY'S
‘approved scope af practica and is accredited to practice In the Sietra-Sazramanta
Valley EMIS Region,

Posting ~ A unit which Is strategically located geographically 1o meel or reduce
response time requirements,

PSAP-Public Safety Answering Paint Tha designated public salety agency or
secondary PSAP al which tha 9-1-1 call ig frst recelved! and/or transferred.

Response Time Measurement The time measuted from the first CAD key-
stroke of a 9-1-1 call atthe PROVIDERS dispatch centsr until the unit artives on
scene,

Response Time Standards - all responsc me slondards which are adopted by
the AGENCY with input from Matical Control Commitee (MCC), Emergency

Medical Advisory Group (EMAG] and Fire Chiels Committees and sat forth in
Exhibit ,

‘Standby —A unit slaged near an activity in which itis presumed there is @ Algh
likelihood that a medical emergency will cour

Stentiantized Emergency Management System (SEMS)— The system dofined
in Governmont Code section 8607(a) for managing multi-agoncy and mult-
Jurisdiction emergencies in Califamia.

System Status Management Plan (SSMP) - The system putin place to match
demand for service (customar requests) ath the supply of service (resourcas
available}. This is @ technique of allocating ambulance resourcas ta efficiently
meet call demand at acceptable response timas.
AMBULANCE AGREEMENT

SHASTA, COUNTY
Third Party — Any individual requesting an ambulance for anil or injured person,
‘when the requesting party ie not the patent,

Unified Command ~ Unitied Command Is @ unified toarn offort yiich allows all
jurisdictional agencies with responsibilty for ihe inckdant, elthar gaogranhle or
functional, to menage an incident by establishing a common set of Incident
objectives and stratagies. This is accomplished without lasing or abulicating
jurisdictional agency authorly, reapensibilly, or accountability,

I, TERM OF AGREEMENT

A. This agreement shail, subject lo the limitations contained hereln, be for an
initial pertod of twenty-four (24) months beginning July 11, 2074 and shall ba
automatically renavad for successive twenty-four (24) month pariods upon
review of acceptable performance by the PROVIDER,

5. AGENCY, or If's duly autharized designee, may suspend this ACREEMENT
immediately upon giving written notice io PROVIDER if PROVIDER'S license
{a operate is revoked or suspended. Any such action by AGENCY shall ke
subject ta the review procedures for suspansione established hereln, If such
4 suspension order has been issued and remains in effect for a period of at
least sixty (60) days, AGENCY may terminate this AGREEMENT by glving at
least thiy (20) days prior written notice to PROVIDER,

. PROVIDER shall continua to parform during any Hol, Insurrection, civil unrast,
natural disaster, labor action or similar event if such perionmanca ramalns
Practical under the prevailing standards af the emargeney medlcal service
industy. PROVIDER's parformanca under this agreement may be waived or
suspended by AGENCY in the event of rot, Insurrection, civil unrest, natural
disaster, labor action or other similar event beyond tha control of PROVIDER,
which affects the delivery of 9-1-1 sarvices {intertuption). f any interruption
‘continues for 3 pariad in excess of ninety (80) Calaridar days and PROVIDER
cannot resume performance within one hundred eighty (180) calendar days
from the intial date of the intemuption, AGENCY may terminate this
AGREEMENT upon giving at least thirly (80) days priar writen notice to
PROVIDER

0. AGENCY may suspend this AGREEMENT immediately If PROVIDER or
employees are cngaging in a continuing course of conduct which poses an
imminent dangar to the Ife or health of patients receiving or requesting
ssarviees from PROVIDER, Notification of any such suspension shall be in
‘iting and shail state raasons for the suspension and length at suspension,

E. Either party may terminate this AGREEMENT at any time, without cause, by
providing at least one hundrad eighty (180} calendar day's ptior written notico
tothe other party
ANBU-ANCE AGREEWENT
SHASTA COUNTY

Il, SPECIFIG RESPONSIBILITIES OF AGENCY:

A. Administration

1. Agency Director or designee is authorized fo ac on bohalf af AGENCY in
ail mattorsreatad o this AGREEMENT.

2. Al any time during normal business hours {8:00 a.m. to 8:00 p.m. Monday
through Friday) and at other times as my reasonably be doomed
necessary by AGENGY, AGENCY'S duly designated represertatve(e)
may observe PROVIDER'S oporations with reascnable nolee. During any
abservations, AGENCY shall not interfere with PROVIDER'S operations

8. AGENCY may conduct audts of all AGREEMENTS, frarcalstatomonts
and records, invoioes, peyrols, inventory records, records of personel,
daily logs, conditions of employment, and ether data relsted to any and ll
matters in connection wth this AGREEMENT. At AGENCY'S request
PROVIDER will provide copies of spectc records as allowed by law within
three business days of request. All applicable lans willbe adhered to with
regard to patient and personnel records’ confidentiality. Auct
roprosontatves will bs duly dasignatod ard authorizaé by AGENCY.
AGENCY shall give PROVIDER fifteen (15) days prlor written notice of
any aucits under tis paragraph

4. AGENCY represantates shall conduct hemsalvasin 3 profassional and
eourteous manner, shall not interfere In any wey wth PROVIDER s
personnel in the performance of their duties, and shall at allies bo
respactul of PROVIDER'S employariemplayee relationship.

8. PROVIDER shall designate In wrllng one or mre persons who chal be
assigned as lisison to AGENCY to adress day-to-day perfornance
issues and PROVIDER'S performance under the AGREEMENT

8. AGENCY'S duly authorisd representatives) may does tied person
on any of PROVIDER'S ambulance unis or supervisor units when
sxercising AGENCY'S right t inspect or abserve. AGENCY wil revise
reasonable nctice to PROVIDER to Init ary potential confit with intems,
normally scheduled ears, or ongoing operations.

7. AGENCY may, trom time to tina, publish infarmiation an provider
erfrmanes a deemed appropiate by AGENCY,

8. The COUNTY may adopt procedures fr reviawing and regulating
amtulana rats in the county. if ragulaed, PROVIDER shel not charge
more than the rates adopted by COUNTY. IF regulated, the schedule of
rates may be adjusted by COUNTY upon the recent of raquest by
AGENCY,
AMULANCE AGREEMENT
‘SHASTA COUNTY

8. To prevant cost shiing that is notin the interests af tha Caunty systorn;
PROVIDER shal not discount publshod charges to any patient, thie paity
payor of other rasponsibla party, excep for palonts who demonsate
financial hardship on an indvidual case by case basis as datarmined by
‘he PROVIDERS under PROVIDER'S financial hardship pales.

B, Emergency Medical Advisory Group EMAG

1, AGENCY shall faciltata the formation ofthe Emergency Medical Advisory
Group. The Emergency Medical Advisory Group should consist of at least
eight (8) members made up ofthe folowing participant:

a} AGENCY or duly authorized des gneets}.

b} One member of tha Shasta County Fie Chiefs Associaton

©) One inemiber from each Hospital Emargency Feom

‘8) One Management Fapreseriative from each ambulance operator

2} One representative from each clly government (Redding, Andorson &
Shasta Lake City} appointed by the ety manager.

1) Inmates affecting madical care standards or performance,
AGENCY'S Madical Ditector shal also seve on the Ambulance
Advisory Group.

2, The EMAG shell meet on a quaderly basis and serve only in an advisory
capacity to AGENCY on issues affecting the quality of deve of
ambulance services in Shasta County

©. Madical Control

1, AGENCY'S Medical Director shall provide madicel control to assure
medical accountability throughout the planning, implementation, ard
evaluation of the EMS eystern

2, AGENCY, using state minimum standards, shal estabish policies and
procedures approved by AGENCY'S Director and Medical Diractor to
assure medical control of the EMS system,

8, PROVIDER shall rotain or employ a Mecioal Diector for mecical oversight
and to interact asa liaison with AGENCY.

IV, SPECIFIC RESPONSIBILITIES OF THE PROVIDER

A. Ambulance Persennel
1, PROVIDER agrees to maintain records of erivar’s licenses and
appropiate EMS cartficates and will provide records as requasted by
AGENCY,
2, PROVIDER shall assura that all required licenses are current and valid
‘and that personnel are tained as required in the $-SV ragion.
‘AMEU_ANCE AGREEMENT
SHASTA COUNTY

B, Crews Quarters
1. PROVIDER agrees that crews quartars in each ofits facies from which
e1-4 emargancy ambulanes servces are provided under this
AGREEMENT shal be clean and maintained in & saritary condition and
have suitable kitchens, showers, slecping quarters, soparate and private
‘rom opsratianal araas, far craws whe are scheduled ta work a twenty-four
(24) hour shit,

©. Deployment of Ambulance Units and Posting Plan (SMP)

AGENCY acknowledges thal the responsiblly for deployment of the Shasta

County System Status Management Plan (SSMP) is shared between thres

ambulance providers,

1. PROVIDERS acknowledge tha, under the tens ofthis AGREEMENT,
thay are required lo participate in the Shasta County SSMP with any unit
tassigned to serve within the Shasta County 9-1-1 System

2, PROVIDERS shell, at a minimum, meet with AGENCY to review the
Shasta County SSMP on an annual basts or as requested by AGENCY.

8. The Shasta County SEMF shall be pressntad by the PROVIDERS to
AGENCY upon creation af the SSMP, after the axecution ofthis
AGREEMENT, and shall provide for adequate ambulance coverage within
the mutually agreed response areas,

4, The SSM shall additionally address pasting and backup coverage.

5. PROVIDER shall notify AGENCY within thity (20) days In writing of any
proposed change in the SSMP,

8. AGENCY'S raviow and/or racommendations on the SSMP or any
‘maatication of plan is nat an approval or acceptance by AGENCY, roria it
«a substitute for PROVIDER'S minimum performance requirerrents under
this AGREEMENT.

7. Subject to the provisions of subparagraph 8 (Immediately below)
PROVIDER may Implement temporary adjustments or modfications, not
axceeding three days, te its SSMP to meet operational needs or changes
in demand without notice lo AGENCY, If edlustments or modifications
exceed three days, AGENCY shall be notified thereof

8. During the frst 80 days of oporations undar this AGREEMENT.
PROVIDER shall adhere to the Initial SMP submitted herein unless
ctherwise agreed to by the parties. Thereafter, forthe torm of this,
AGREEMENT, tha SSMP may be alterad by PROVIDER only with the
anwstn ANCE BREE ENT
shasta count?
AGENCY'S approval, to prodtice tha required response time performance
vith the greatest possible effilency.

8. The intial SSMP shall specty the speci boundaries and ganeral
locations of the mutually agrecd upon response zones and Unit Stations
This SSMP shalt adeiionally speciy each post locetion, post prorties,
and tha number of vehicles to be deployed during each hour of tne day
and each day ofthe neck

10. The SSMP shall address how PROVIDER aciusts and prioritizes sttfing
and back-up coverage when unforeseen Inereased staffing issuas
develop.

11.The SSMP shall additionally addrass speciticinlormation on echedules to
demonstrate the types of shifts PROVIDER intends to emplay in
implementing the SSMP (e.g., 24 hour shifts, 12 hour shits)

12. 1seues arising irom the PROVIDER'S oporatonal report may be relered
to tha EMAG by AGENCY.

Portormance

1. PROVIDER is expected to utilize reasonable management practices which
‘ensure that fiekd personnel working extended shifts. parime jabs,
voluntary overtime, or mandatory ovartime are not exhausted to an extent
‘which might impair judgment or motor skis

2, PROVIDER agroas that its performance shall conform to the standards of
the emergency medical services industry. PROVIDER shall comply with
the applicable protocols for patiant transporation and treatment as isaued
by AGENCY.

3, PROVIDER shall (when provider provides ambulance dispatch services),
dispatch the closest avaliable AGENCY authorized 9-1-1 ambulance to
the scene of the emergency, except as otherwise provided herein armay
be required by law.

4, An ALS 9-1-1 ambulance may be usad for scheduled non-emergency
intertacilty transfer only when the Digpateh Center has released the unit
for such non-emergency use, and there are other ALS 8-1-1 ambulances
staffed and immediately availabla to moat parformance tandards ae
defined harain. Inno avent shall the Dispatch Center release more than
‘ang ALS 9-1-1 uni par provider assigned to the 9-1-1 system to conduct a
non-emergency traneport unless ordered by an Emergency Floom
Physician or as otherwise provided herein or may be requited by law.

5. PROVIDER shall not permit any ofits employaos, including dispatchers. to
perform services hereunder while under the influence of any alooholic
AMBULANCE AGREEMENT
SHASTA COUNTY

beverage, medication, narcotic, or other substance which might impair the
‘employee's physical or mental perfarraance.

6. Ambulance personnel shall be neat and clean in publ; shall be properly
idanttled by a name tag, company name and insigria, and the employec's
level of prehospital care certification

7. Employees shall traat athar professionals, patients, and their farnlies wth
professionalism and courtesy.

E. Response Times

1. Each PROVIDER must mest the ambulance responee times standards set
forth in Exhibit "A" and S-SV Polly. Every ambulance urit must be
equipped and stated to oparata at the advanced lite support (paramedic)
lovel on all 9-1-1 ambulance responses.

2, PROVIDER shell have « writen policy and shall make al reasonable
efforts to immediately ney the jasdictional PSAP of tha ecaton from
‘wre the ambulance s responding

3, PROVIDER shall submit « monthly resnonse time compliance repart,
ullizing CAD data to AGENCY. 11 CAD data is not available, PROVIDER
‘ill provide @ monthly response time compliance report in a format agreed
to by the AGENCY.

4, PROVIDER may request that AGENOY issue a writen response time
waiver fora period of ime. PROVIDER hall submit any Response
Walver Request in wring to AGENCY within ten (10} days of
circumetances that form the basis of tho Respanso Waivar Poquast. The
Response Waivar Reques! shall he detailed and arleulate specie
teasons forthe request. PROVIDER(S) Response Waiver Request may
be prospective or retrospactive depending on the circumstances.
AGENCY shall issue its writen decision on the lesponse Waiver Request
‘within ten (10) days af submission by PROVIDEH. AGENCY may grant ar
deny any Response Waiver Request at its sol aiscraton.

5. Tho calculation af he ninety percent (202%) requirement shall be mace on
monthly basis and shell be calculated independently for each
PROVIDER.

8. PROVIDER shall nolly AGENCY of any stuatlon fe
omits) hat hinders 8-1-1 response

7. During any period of tims that PROVIDER has insuficiant ambulance
Units for avallale service, PROVIDER shall make reasonable efforts ta
dbiain backup. move up, posting, mutual aid and standby servic tram an
AGENCY authorized aminulance provider in adjacant arses to provide
covaraga

clly cadestuse
ssLULANCE AGREEMENT

sHasta couNTY

8, PROVIDER shall always inform the PSAP of auch altemate service
mavamants, tha back-up providers estimated t me af arrival (ETA) to the
‘emergency and responding location, immediately upon dispatch,

9, In cases of mutuaVaulomtic aid responses inte the Shasta County 9-1-1
system from adjacent EMS provider(s) the responge time standard will be
considered to be "best effrt’ unless ollerwise dasignated by the
AGENCY.

10. Within reascnable limits, PROVIDER agrees to provide automatic aid,
backup or mutual ald emergency ambulance services when requastad by

the AGENCY, an EMS Dispatch Cantor, a PSAP or by EMS providere

trom neighboring araas. PROVIDER shall ensure that responge times are
provided to AGENCY in PROVIDER'S monthly report

Inthe event that the monthly operations raport indicates that PROVIDER

has net met the standards reference in Policy 415, PROVIDER shell

prepare and submit, with the monthly operations report, a written plan

‘Which shall detal the comective actions ta be taken by PROVIDER 10 meet

the response time standard, and the time frame for those corrective

actions to occur.

1

isaster/Emergencies

4. PROVIDER(S) shall participate in all countywide emergency disaster
oils

2. All field and supervisory personnel shall bs trained in SEMS, Incident
‘Command and the OES Ragion Ill or other AGENCY epproved plan ast
relatos to provision of emergency and disaster cara

3, Attha scene of an emergency or disaster, PROVIDER shall follow the
direction of the Incident Gommandar or the direction of the Unified
‘Command except as provided in H&SC section 1788.6(a). This includes
but Isnt Iinted! to following directions pertaining to raquesting aduitional
resources,

4, PROVIDER(S) shall respond fo any emergency or dleaster that my taka
place within COUNTY or adjacent counties within ths Sierra Sacraments
Valley EMS region, when requested by DIRECTOR or duly authorized
designee, or by 2 9+1-" communications center in accordance with an
approved Disaster Plan.

5, PROVIOER shall take steps to ensure the continuation of services in the

‘vont that labor actions effect PROVIDER operations, in ardor ta ensure

continuous, uninterrupted service by PROVIDER undar this

AGREEMENT,

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