HomeMy WebLinkAbout1995-136
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RESOLUTION NO. 95-136
RESOLUTION OF THE CITY OF SAN BERNARDINO APPROVING A
MEMORANDUM OF UNDERSTANDING FOR AMBULANCE TRANSPORT SERVICES WITH
COURTESY AMBULANCE SERVICES OF SAN BERNARDINO.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AS FOLLOWS:
SECTION 1. The Mayor is hereby authorized and directed to
approve a Memorandum of Understanding for ambulance transport
services with Courtesy Ambulances Services of San Bernardino in a
form as attached hereto as Exhibit A.
SECTION 2.
The authorization to execute the above-
referenced Agreement is rescinded if the parties to the Agreement
fail to execute it within sixty (60) days of the passage of this
Resolution.
I HEREBY CERTIFY that the foregoing resolution was duly
adopted by the Mayor and Common Council of the City of San
Bernardino at a
regular
meeting thereof, held on
the
1st
, 1995 by the following
May
day of
vote, to wit:
Council Members:
NEGRETE
CURLIN
HERNANDEZ
OBERHELMAN
DEVLIN
POPE-LUDLAM
MILLER
;}/<'//:7'_
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RESOLUTION.. . APPROVING A MEMORANDUM OF UNDERSTANDING FOR
AMBULANCE TRANSPORT SERVICES WITH COURTESY AMBULANCE SERVICES OF
SAN BERNARDINO.
?~
May
The foregoing resolution is hereby approved this
of
Approved as to form
9 and legal content:
JAMES F. PENMAN
City Attorney
day
1995.
-> CJY'''-.} Z/c_t'k-~
T0m Minor, Mayor -
City of San Bernardino
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95-136
MEMORANDUM OF UNDERSTANDING
AMBULANCE TRANSPORT SERVICES
This Memorandum of Understanding is made by and between the
City of San Bernardino (hereinafter referred to as "City"), and
Courtesy Services of San Bernardino, Inc. (hereinafter referred to
as "Courtesy").
I. Term:
The agreement set forth in this Memorandum of Understanding
shall take effect on May 1, 1995, and will continue for one year
periods and will be renewed annually unless at least 90 days prior
to the expiration of any term written notice of election to not
renew shall be presented by either party to the other.
Ci ty and Courtesy shall review the terms and provisions
hereof on a regular basis to insure that they remain in conformity
with all applicable laws.
II.
Responsibilities of Parties:
A. City shall:
1. Staff and operate an emergency 9-1-1 system that
will allow for the answering of emergency calls and the subsequent
dispatch of all emergency medical responders at a level designated
by City.
2. Pursue the training of all dispatchers in an
approved priority dispatching program so that all 9-1-1 calls can
be professionally evaluated as to type and level of emergency.
Upon successful completion of such training, City will dispatch
calls based upon the screening done and resources available.
Designation of resources needed will be at the reasonable
discretion of City.
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3. Comply
regulations,
with all applicable
standards, policies,
state and local
procedure and
statutes,
protocols;
B. Courtesy shall:
1. Provide all ambulance service needs of whatever
nature within the City on a continuous, twenty-four (24) hour per
day basis, except when prevented from doing so by an act of God.
If for any reason Courtesy is at any time unable to provide the
requested level of ambulance service, it will promptly inform City
and shall promptly arrange for backup by way of mutual aid from
adjacent ambulance providers;
2. Be the exclusively dispatched emergency
transportation provider for medical aid requests. Upon Courtesy's
arrival and evaluation of the medical aid request, Courtesy shall
follow all relevant medical protocols as prescribed by INLAND
COUNTIES EMERGENCY MEDICAL AUTHORITY ("ICEMA"). Upon Courtesy's
evaluation of an emergency medical condition, Courtesy shall
promptly notify City's dispatch of same without interruption or
delay of patient treatment or transport.
3. Immediately notify City dispatch of any direct
requests for emergency ambulance service from a private person,
and to proceed to the incident location in compliance with
applicable standards and procedures;
4. Maintain all ambulances with safety and emergency
equipment as required by the California Vehicle Code and the
California Code of Regulations, and other administrative rules
promulgated from time to time by the San Bernardino County Health
Officer
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DAB/j
III. Ambulance Rate Schedules:
1. The initial rates for ambulance service shall be
in accordance with schedule "A" attached hereto and incorporated
herein by reference, and shall remain in effect until at least May
1, 1996 or until a Court of competent jurisdiction rules that the
Ci ty does not have the authority to regulate ambulance rates.
Modifications of rates shall be considered each year, and new
rates shall be determined not less than 30 days before each annual
renewal date of this Memorandum.
2. Rates shall be established for each of the
following:
a. Basic Life Support (BLS) as defined under
California law and ICEMA regulations;
b. Advanced Life Support (ALS) as defined under
California law and ICEMA regulations;
c. All-inclusive Advanced Life Support;
d. Unscheduled response/emergency;
e. Night/weekend surcharge, for patients
transported between 7:00 p.m. and 7:00 a.m., or on Saturday or
Sunday;
f. Additional patients;
g. EKG monitoring;
h. Oxygen administration;
i. Additional mileage;
j. Waiting time.
3. Attached hereto as Schedule "B" and incorporated
herein by reference are further ambulance rate definitions
applicable to the rate categories set forth in sub-paragraph 2
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[Rates.MOU]
1 above.
2 4. a. Courtesy will accept assignment from Medicare
3 for ambulance service which is medially allowable for Medicare
4 enrollees. The enrollee shall be responsible for payment of
5 Medicare deductible and co-payments.
6 b. For financial hardship cases, Courtesy will
7 accept Medicare assigned payment as payment in full for ambulance
8 service which is medically allowable for Medicare enrollees. A
9 Medicare enrollee claiming hardship shall sign a Financial
10 Hardship Disclosure form and provide same to Courtesy, which will
11 include the form in the patient's file. In such validated
12 financial hardship cases, Courtesy will write-off any remaining
13 Medicare annual deductible and co-payments. It is understood that
14 Medicare has the right to validate financial hardship. If such
15 hardship is not validated, Medicare may require the enrollee to
16 pay the annual Medicare deductible and co-payments.
17 c. For financial hardship patients not covered by
18 Medicare, Courtesy will accept third party payment as payment in
19 full. A Non-Medicare financial hardship case is defined as a
20 person who qualifies for City's Utility Tax Exemption Program, or
21 who is covered by the Medi-Cal program.
22 d. No bi11ings or charges shall be made by Courtesy
23 or any of its personnel prior to any emergency services being
24 rendered.
25 IV. Inspection of Records:
26 In order to reasonably assure itself that Courtesy is
27 making proper charges for the services performed, upon receipt of
28 any written complaint from any user wi thin City of Courtesy's
DAB/j {Rates.MOU]
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1 service, where such user contends that he/she has been requested
2 to pay an excessive charge for service, City shall have the right,
3 upon reasonable request, and during ordinary business hours, to
4 review Courtesy's billing records pertaining to the complaining
5 patient at Courtesy's place of business. However, to the extent
6 that City shall examine the billing records of Courtesy as herein
7 provided, City shall faithfully maintain the confidentiality of
8 all such records so as not to interfere with, or diminish, the
9 right of privacy and confidentiality of any of Courtesy's
10 patients.
11 V. Assignment
12 This Agreement may be assigned by Courtesy only with the
13 prior written approval of City, which approval shall not be
14 unreasonably withheld.
15 VI. Indemnification
16 The parties hereto agree to defend, indemnify, save and hold
17 the other party, its officers, agents and employees harmless from
18 any claims or suits that may be brought by third persons on
19 account of persona 1 injury, death, or damage to property, or a
20 property or business or personal interest, arising from any
21 negligent act or omission by that party while performing services
22 or duties under this agreement.
23 VII. Insurance
24 During the term of this Agreement, Courtesy shal1 maintain
25 in effect policies of public liability and property damage
26 insurance and automobile liability insurance both in the amounts
27 of at least $2,000,000 and naming the City as an additional
28 insured covering only City's liability that may exist because of
DAB/j [Rates.MOUl 5
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1 Courtesy's acts or omissions. Courtesy shall also maintain in
2 effect Workers' Compensation insurance in statutory limits. Upon
3 request by City, Courtesy shall provide copies of all policies of
4 insurance.
5 VIII. Litigation
6 The parties recognize and understand that they are involved
7 in litigation entitled County of San Bernardino, et al. v. City of
8 San Bernardino, et al. Subject to any further rights of appeal,
9 the parties agree to be bound by a final decision in that
10 litigation and such decision, where in conflict with this
11 Agreement, shall prevail.
12 IX. Continuing Discussion/Medicare Bil1ing.
13 Prior to the entry into this Agreement, City and Courtesy
14 have had discussions regarding Medicare billing and the
15 possibility of Courtesy obtaining Medicare funds, either directly
16 or indirectly, for the benefit of City.
17 It is understood that the parties intend to continue, in
18 good faith, to discuss such matter, but that its resolution or
19 failure to be resolved is free of impact upon the agreement being
20 reached by this Memorandum.
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22 / I /
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24 I / /
25 ///
26 / / /
27 / / /
28 11/
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95-136
X. Notice
Any notice to be given from one party to the other pursuant
to this Agreement shal1 be in writing and deposited with the
United states Posta 1 Service, postage prepaid and addressed as
follows:
To City:
To Courtesy:
City Administrator
City of San Bernardino
300 North "0" Street
San Bernardino, Ca 92418
Courtesy Services of
San Bernardino, Inc.
338 West Seventh Street
San Bernardino, CA 92401
Nothing in this paragraph shall be construed to prevent the
giving of notice by personal service.
Executed this 'ilL day of /11tJJ ' 1995.
CITY OF SAN BERNARDINO
B~~l!l~~~
f
Mayor
ATTEST:
ByaM ('~
~i (5j~fh2c11~~/ ~
Approved as to form
24 and lega1 content:
25 James F. Penman
City Attorney
:,~~
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DAB/j [Rates.MOUl
By
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B.
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95-136
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SCHEDULE OF AMBULANCE RATES
Basic Life Support response to a routine
non-emergency
Unscheduled responselemergency
Additional Charges:
1. Each mile or fraction of a mile
2. Waiting time after first fifteen-
minute period or fraction thereof
thereafter
3. Night surcharge, 7:00 p.m. to
7:00 a.m. Monday through Friday,
or weekend service
4. Each additional patient, fifty
percent over charge for one patient
5. Paramedic Rates:
a.
Advanced Life Support Response
to a call
b.
EKG monitoring
c.
All Inclusive Advanced Life
Support Service
6.
Oxygen administration
7.
Response to a call for ambulance not
used
8.
Rigid Collar
SCHEDULE A
285.62
112.29
11. 80
25.23
80.40
419.21
57.40
622.10
69.64
-0-
-0-
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DABI
95-136
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AMBULANCE RATE DEFINITIONS
BLS Base - this response to call charge applies when:
1) An EMT-1A staffed ambulance responds to a call.
2)
A paramedic staffed ambulance responds to a scheduled
call and/or a paramedic is not requested and paramedic
intervention is not provided.
6 ALS Base - this response to cal1 charge applies when:
7 1) A paramedic staffed ambulance responds to an
unscheduled response call and does not provide ALS intervention.
2) A paramedic staffed ambulance is requested to respond
to a scheduled call which does not require ALS intervention.
ALS-Al1 Inclusive Service - this response to call charge applies
when a paramedic staffed ambulance provides paramedic intervention
beyond the EMT I-A scope of practice. The ALS All Inclusive
Service includes the following services:
1) Emergency service
2) EKG monitoring
3) Paramedic services and supplies (paramedic radio
contact, I.V. administration, MAST application, drug
administration, defibrillation, blood draw, etc.)
Unscheduled responselEmergency charge - the charge applies for an
immediate dispatch of an ambulance. This charge coincides with
BLS and ALS Base rates. This charge is included in the ALS-Al1
Inclusive Service and should not be charged as an additional line
item in this situation.
Scheduled cal1 - those requests for ambulance service which are
submitted directly to Courtesy which do not require Courtesy to
respond on an emergency or immediate basis, but to reasonably
schedule performance in accordance with its existing resources.
Mileage - the charge applies for each patient mile or fraction
thereof from point of pick-up to destination. Mileage may also be
charged if an ambulance has to fOllow-up a helicopter transport to
retrieve mandated equipment.
Night Service - the charge occurs between the hours of 1900 to
0659 military time. This charge is included in the weekend
service and should not be charged as a separate line item in that
situation.
Weekend Service - the charge occurs from 0001 hours Saturday
through 2400 hours Sunday. The weekend rate is inclusive of any
night service charges.
SCHEDULE B
[Rates.MOU]
95-136
.
- Medicare Assignment Comparison
Current Rates
Medicare Medicare Patient Amount of
Rate Allowed Pavs Pays Write-off
BLS 178.84 167.49 134.00 44.84 0.00
Emergency 81.24 76.03 60.82 20.42 0.00
Mileage 8.94 6.90 5.52 3.42 0.00
Wait Time 16.38 0.00 0.00 16.38 0.00
Night 52.18 48.77 39.02 13.16 0.00
ALS Base Rate 272.00 167.49 134.00 138.00 0.00
EKG Monitoring 37.25 0.00 0.00 37.25 0.00
All Inclusive 403.75 378.10 302.48 101.27 0.00
Oxygen 22.37 20.95 16.76 5.61 0.00
Rigid Collar 45.00 0.00 0.00 45.00 0.00
Proposed Rates
Medicare Medicare Patient Amount of
Rate Allowed Pavs Pays Write - off
BLS 285.62 167.49 134.00 33.49 118.13
Emergency 112.29 76.03 60.82 15.21 36.26 I
Mileage 11.80 6.90 5.52 1.38 4.90
Wait Time 25.23 0.00 0.00 0.00 25.23
Night 80.40 48.77 39.02 9.75 31.63
ALS Base Rate 419.21 167.49 134.00 33.49 251.72
EKG Monitoring 57.40 0.00 0.00 0.00 57.40
All Inclusive 622.10 378.10 302.48 75.62 244.00
Oxygen 69.64 20.95 16.76 4.19 48.69
Rigid Collar 0.00 0,00 0.00 0.00 0,00
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95-136
Oxygen - the charge occurs when oxygen is administered.
charge is inclusive of materials such as tubing, masks, etc.
may be used for the administration of oxygen.
This
which
Wai ting Time - the charge occurs when there are circumstances
occurring which are beyond Courtesy's control that delay the
normal commencement of transport. Waiting time is billed in
fifteen (15) minute increments. The first fifteen (15) minutes
are not billed. However, anything after that is billed in
increments of fifteen (15) minutes per unit.
Rates for multiple loads:
1) Each additional stretcher or gurney patient carried at the
same time shall be charged the full base rate for response
to the call and half the mileage rate.
2)
Each additional sit-up patient shall be charged half the
base rate for response to the call and half the mileage.
DAB/j [Rates.MOUl