HomeMy WebLinkAbout03-Fire Department
'CITY OF SAN BE~NARDINO - REQUEST FOR COUNCIL ACTION
From:
Dept:
Date:
Larry R. Pitzer
Ci~I' ~ j',r"/~L
Subject:
San Bernardino City Fire
Department and American Medical
Response Are Requesting
Authorization To Enter Into A Long-
term Contract Regarding Enhanced
Pre-Hospital Paramedic Service.
Fire
January 22, 2001
Synopsis of Previous Council Action:
4/1 9/99
7/19/99
Fire Department and American Medical Response staff presented information regarding
the subject issue, at a workshop to Mayor and Council.
Adopted resolution 1999-186 approving a contract with American Medical Response
relating to a 180-day pilot program to assess enhanced pre-hospital paramedic services.
Adopted resolution 2000-45 approving a 120-day extension for pre-hospital paramedic
service pilot program, as set forth in the contract with American Medical Response, Inc.
(AMR).
RECOMMENDATION:
3/6/00
1 . Adopt Resolution.
2. Authorize the Director of Finance to amend FY 2000-2001 budget and increase revenue
account #001-000-4881 (Paramedic Reimbursement Contract Revenue by $64,000 (rounded)
to reflect the revenue to be received from AMR and to also increase the Fire Department's
budget by $64,000 (rounded) to reflect the corresponding expenditures as outlined in the staff
report.
Contact Person:
Larrv R. Pitzer
Phone: (909)384-5286
SupportinQ data attached: Staff Report
Ward: Citv Wide
FUNDING REQUIREMENTS: Amount:
$63,973,38
Source: (Acct. No.) Revenue account #001-000-4881 will
receive $63,973,38 from AMR for FY 2000-2001 /Jdt; Vuy ~t1h!I-
Council Notes:
P/LuJ(~ / /gcr)J( .fidl'j
Agenda Item N
I/JCJ!o/
d:i:3
STAFF REPORT
SUBJECT:
San Bernardino City Fire Department and American Medical Response Are Requesting
Authorization To Enter Into A Long-term Contract Regarding Enhanced Pre-Hospital
Paramedic Service.
BACKGROUND:
The public/private partnership pilot program between San Bernardino City and
American Medical Response (AMR) has been ongoing since August 1, 1999. Data that
has been collected indicates that the program has been highly successful. All
interested parties, San Bernardino City Fire, AMR and Inland Counties Emergency
Medical Authority (ICEMA) have expressed that they are pleased with the results.
Therefore, ICEMA has approved City and AMR entering into a long-term contract
regarding providing paramedic service in the City of San Bernardino.
Prior to the establishment of the public/private partnership program, 44% of the City's
emergency medical aid victims had to wait for a second engine to arrive to receive
paramedic service. This was due to the fact that there were only five paramedic
engines within the City. Under the partnership, all eleven engines are staffed with a
paramedic.
By using a team concept, on scene patient care has improved because of earlier arrival
of paramedics to approximately 44% of medical aid calls and the use of like equipment
by City and AMR paramedics, Results have also shown that AMR has improved its
time from their receipt at dispatch to arrival at the hospital from 48 minutes 90% of the
time to 46 minutes 90% of the time.
In accordance with ICEMA, there are performance standards that must be met for this
contract to remain valid. San Bernardino City Fire Department must arrive on scene 7
minutes 59 seconds 90% of the time from receipt at dispatch, AMR must arrive on
scene 11 minutes 59 seconds 90% of the time from receipt at dispatch. Current
statistics show the City meeting its standard 92% of the time, while AMR is meeting its
standard 96% of the time,
This public/private partnership program has allowed AMR to eliminate 1.5 ambulance
units within the City, resulting in a cost savings of $370,201,20 annually, AMR will
share this cost savings with the City as follows: 60% [$222,120,72] to the City and 40%
[$148,080.48] to AMR. The City will receive its portion of the savings in monthly
payments of $18,510.06. Per City Resolution 1999-186, the City will reimburse AMR for
start-up costs incurred in the pilot program, Total start-up costs were estimated to be
$94,174, This $94,174 will be paid back to AMR over a twelve month period in monthly
installments of $7,847.83. AMR will deduct the monthly payment from the monthly
1
revenue to be remitted to the City. Therefore, for the first twelve months of the contract,
the monthly net revenue to the City, after the $7,847,83 deduction for start-up costs, will
be $10,662.23. Payback of the start-up costs to AMR will be completed in December
2001, In January of 2002, monthly revenue from AMR will increase to $18,510,06,
REVENUES
Annual estimated revenue through FY 2002-2003 is as follows:
FY 2000-2001
Gross Revenue $18,510.06 x 6 months =
Less Payback $ 7,847,83 x 6 months =
Net Revenue (6 months)
$111,060.36
$ 47,086.98
$ 63,973.38
FY 2001-2002
Gross Revenue $18,510.06 x 12 months = $222,120,72
Less Payback $ 7,847.83 x 6 months = $ 47,086.98
Net Revenue (6 months) $175,033.74
Gross Revenue
No deductions
Net Revenue (12 months)
FY 2002-2003
$18,510.06 x 6 months = $222,120,72
$222,120.72
EXPENDITURES
We recommend that the revenues over the next two and a half fiscal years fund the
following high priority needs in the Fire Department:
1. Establish an Emergency Medical System (EMS) Coordinator position, This
position would be responsible for oversight of the EMS program. This individual
would also work with emergency operations staff and outside agencies to
effectively delivery EMS services. The EMS Coordinator will provide and/or
coordinate necessary training for all department paramedics, The annual salary
and benefits costs for this position are estimated at $81,159, For the reminder of
FY 2000-2001 the EMS Coordinator's position will cost $27,053, To provide
adequate office space and equipment for this position, internal office construction
and equipment costs will be $19,754.25 for FY 2000-2001. Staff will develop a
iob description and recommended salarv ranqe to be presented to the Personnel
Committee at a later date for review and approval.
Estimated Costs: FY 2000-2001
FY 2001-2002
FY 2002-2003
$ 46,807.25
$148,235,74
$116,161.00
Note: FY 2001-2002 includes $41,272.74 for EMS program equipment and a one
time cost of $25,857 for an EMS Coordinator Vehicle. FY 2002-2003 includes
$31,000 for EMS program equipment.
2
2. The current Dispatch Supervisor will be dedicated 3 days a week to
administrative duties and quality assurance (QA) for the new Emergency Medical
Dispatch (EMD) System, This new system will require the Dispatch Supervisor
to perform the medical dispatch case review, evaluate EMD data, continuing
dispatch education, and QA. These duties are necessary for EMD to be effective
and assure quality of patient care, Currently, the Dispatch Supervisor is required
to function as a dispatcher 32 hours per week, The additional QA duties cannot
be accomplished by the Dispatch Supervisor if time is not dedicated to this
function. Part-time Dispatchers and overtime will be used to fill the open
dispatch shifts that are normally filled by the Dispatch Supervisor, and will cost
$11,165.85 for FY 2000-2001.
Estimated Costs: FY 2000-2001
FY 2001-2002
FY 2002-2003
$ 11,165.85
$ 26,798,00
$ 28,138,00
3. Hire a consultant to assist in the development of the City's priority dispatching
which is a component of the Emergency Medical Dispatching System. This
consultant will work with the Department's dispatch staff and Chief Officers to
develop a priority dispatching system that will be the most effective and efficient
for the City, By establishing the proper EMD priority dispatching system, the City
will be on its way to obtaining national certification. The cost for this consultant is
a one time $6,000 expenditure.
Estimated Costs: FY 2000-2001
FY 2001-2002
FY 2002-2003
$ 6,000.00
$ 0
$ 0
4. Use remaining undedicated funds from the AMR revenue to fund the final four
pieces of fire apparatus from the department's approved fire apparatus
replacement plan (2 Type III Brush Engines, 1 Heavy Rescue Unit, and 1 Air
Truck). This will be an annual cost of $136,005 for nine years under a lease
purchase agreement. One piece of fire apparatus, a heavy rescue unit, will be
partially funded by a grant received form the California Office of Traffic Safety.
This grant will fund approximately $50,000 of the cost of this apparatus, The final
three pieces of apparatus and the remaining balance on heavy rescue will be
partially funded by AMR revenue beginning in fiscal year 200212003 (see Exhibit
C). Staff will request bids and brinQ forward to Council a recommendation for
purchase and financinQ at a later date,
Estimated Costs: FY 2000-2001
FY 2001-2002
FY 2002-2003
$ 0
$ 0
$136,005,04
NOTE: The revenue received from AMR will pay for this program until FY 2002-2003,
At that time the program will need an additional $58,183,32. Additional funding will
need to be identified at that time.
3
FINANCIAL IMPACT:
As discussed above, the agreement with AMR will result in net revenues of $63,973.38
to the City for the remainder of FY 2000-2001, Also discussed above is the Fire
Department plan to spend this additional revenue for additional staff and apparatus,
Therefore, a budget amendment is needed to increase the Fire Department's budget by
$64,000 (rounded) to reflect these expenditures and also increase General Fund
revenues by $64,000 (rounded) to reflect the reimbursement to be received by the City
from AMR.
RECOMMENDATION:
1. Adopt Resolution.
2, Authorize the Director of Finance to amend FY 2000-2001 budget and increase
revenue account #001-000-4881 (Paramedic Reimbursement Contract Revenue)
by $64,000 (rounded) to reflect the revenue to be received from AMR and to also
increase the Fire Department's budget by $64,000 (rounded) to reflect the
corresponding expenditures as outlined in the staff report.
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RESOLUTION
RESOLUTION OF THE CITY OF SAN BEIUI/ARDINO APPROVING A CONTRACT
BETWEEN THE SAN BERNARDINO CITY FIRE DEPARTMENT AND AMERICAN
MEDICAL RESPONSE REGARDING ENHANCED PRE-HOSPITAL PARAMEDIC
SERVICE.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY OF
SAN BERNARDINO AS FOLLOWS:
SECTION 1. That American Medical Response (AMR) and San Bernardino City ~ire
Department wish to enter into a long-term public/private partnership program to provide
enhanced pre-hospital paramedic service; and
SECTION 2. That the Mayor or her designee is hereby authorized and directed to
execute a contract, a copy of which is attached as Exhibit A;
SECTION 3. The authorization to execute the above referenced contract is rescinded if
not executed within sixty (60) days of the passage of this resolution.
1111
1111
1111
1/1/
1111
1111
1111
1111
1111
1111
RESOLUTION OF THE CITY OF SAN BERNARDINO APPROVING A CONTRACT
BETWEEN THE SAN BERNARDINO CITY FIRE DEPARTMENT AND AMERICAN
MEDICAL RESPONSE REGARDING ENHANCED PRE. HOSPITAL PARAMEDIC
SERVICE.
I HEREBY CERTI~Y that the foregoing resolution was duly adopted by the Mayor and
Common Council of the City of San Bernardino at a
meeting thereof, held
on the
<jay of
,2001, by the following vote, to wit:
COUNCILMEMBERS
AYES
NAYS
ABSTAIN ABSENT
ESTRADA
LIEN
MCGINNIS
SCHNETZ
SUAREZ
ANDERSON
MC CAMMACK
The foregoing resolution is hereby approved this
day of
, 2001.
Rachel Clark, CMC
City Clerk
Judith Valles, Mayor
City of San Bemardino
Approved as to form
and legal content:
JAMES F. PENMAN
City Attorney
By:
2
_--I
EMERGENCY AMBULANCE TRANSPORTATION SERVICES
SUBCONTRACT AGREEMENT
THIS AGREEMENT is made and entered into this _ day of January 2001, by and
between American Medical Response of Inland Empire (hereafter "AMR"), and the CITY
OF SAN BERNARDINO, (hereinafter "City").
WHEREAS, pursuant to the provisions of sections 1445 of the Health and Safety Code
and 17000 of the Welfare and Institutions Code of the State of California, the County of San
Bernardino (hereinafter "County") is charged with the care and maintenance of the indigent ill
and injured lawfully resident in County; and
WHEREAS, County has designated AMR, pursuant to Health and Safety Code section
1797.224, as the County's exclusive provider of emergency ambulance services for Area 6
and 7 which encompasses the municipal boundaries of the City of San Bernardino
(hereinafter "City"); and
WHEREAS, AMR has and will continue to provide the primary response for
emergency ambulance services within Area 6 and 7, which includes the City of San
Bernardino. Further, AMR contends that it has been providing such service without
interruption in the manner and scope in which the service has been rendered in said area by
AMR's predecessor company Courtesy Services of San Bernardino; Inc,; and
WHEREAS, AMR is willing to coordinate paramedic and transportation services with
City Fire paramedics to maximize efficiency and quality of prehospital medical services within
City, subject to AMR performing all emergency ambulance services in conformity with the
provisions of this Agreement and AMR's primary contract with the County of San Bemardino
for Area 6 and 7; and
WHEREAS, because AMR's agreement with the County requires them to provide
services to both the City and other geographical areas of County's Area 6 and 7, it is
necessary that all of the citizens of Area 6 and 7 receive the enhanced services contemplated
by this Agreement, where City is currently responsible for providing first responder service;
and
WHEREAS, City is willing to provide first responder services within the Areas 6 and 7.
where City is currently responsible for providing first responder service to ensure that the
citizens of City receive the enhanced services provided for pursuant to the terms of this
Agreement and the aforementioned County Contract; and
WHEREAS, AMR has accordingly selected City, with the approval of County, to serve
as AMR's subcontractor for the provision of emergency paramedic medical services in City;
and
WHEREAS, the parties have entered into this Agreement with the understanding that
the City of San Bemardino will dispatch AMR units concurrently with City paramedic engines,
CitySB/ AMRPartnershipJan22,200 I
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NOW, THEREFORE, the parties hereto agree as follows:
1. TERM:
A. This Agreement shall become effective January _, 2001, and shall continue
from year to year, until terminated by either party hereto in the manner specified hereinafter.
This Agreement shall in any event terminate concurrently with the termination of AMR's
contract with the County of San Bernardino for Area 6 and 7.
B. Notwithstanding the foregoing provisions regarding the effective date, the
parties agree that this Agreement shall not become operative unless and until the following
have occurred or been waived in writing by the parties hereto:
1. The within Agreement has been approved by Administrator of County's
Health Care Agency or hislher duly authorized designee (hereinafter the "Administrator"); and
2. The County of San Bernardino EMS Agency (hereinafter, "ICEMA") has
approved changes in applicable policies and procedures regarding the paramedic staffing on
ambulances to permit one Emergency Medical Technician - Paramedic (herein "EMT-P") and
one Emergency Medical Technician (herein "EMT") as approved staffing in Area 6 and 7,
where City currently has responsibility of providing first responder service of the County of
San Bernardino and incorporated cities under EMS jurisdiction of the County where such
staffed units are required to respond for services coverage in AMR's system status staffing
and deployment plan,
C. Notwithstanding any of the foregoing provisions, either party may cancel or
terminate this Agreement at any time, with or without cause, by giving at least ninety (90)
days prior written notice thereof to the other. The Mayor of the City of San Bernardino may
exercise such authority on behalf of the City.
D. City shall fully cooperate with County and AMR representatives to provide for
the transition to whatever service replacement method County determines to be in its best
interest prior to the expiration date of this Agreement or prior to an earlier termination date
hereof. This is subject to such rights the City may have under existing statutory and case law
to continue to provide emergency medical services.
2. ADMINISTRATION:
A. The parties agree and acknowledge that County is not a party to this
Agreement and has no involvement in or responsibility for administration of this Agreement
as a party, Nonetheless, the parties acknowledge that the County acts as the regulating
authority with regard to EMS services provided within San Bernardino County and, as well,
may take certain actions vis a vis AMR under AMR's primary contract with the County for
services to Area 6 and 7. References to "County," "Administrator," "ICEMA" and the like in
this Agreement are intended to be understood in the foregoing context. Nothing herein is
intended to impose any obligations upon County as it relates to the parties and their
CitySB/ AMRPartnershipJan22,200 I
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performance of this Agreement. The City contends its Bureau of Franchises has the right to
regulate ambulance services under the City's Municipal Code. By entering this agreement
the City is not waiving these rights if any including, without limitation, Chapters 2.43 and 5,76.
of the San Bemardino Municipal Code. In addition, City does not agree that the County of
San Bemardino has any regulating authority beyond that set forth in the decision by the
California Supreme Court in County of San Bernardino v. City of San Bernardino (1997), 15
Cal.41h 909.
B. City shall designate in writing one or more persons who shall be assigned to
function as liaison to AMR to address day-to-day performance issues and City's performance
under this Agreement. Such person(s) shall also be City's liaison with the County with
respect to any County involvement with regard to City's actions.
3. EXCLUSIVITY:
The parties acknowledge that services to be provided by City will not be exclusive in
nature, but will be provided in concert with AMR and its backup provider's authority, all of
which may be used within Area 6 and 7 to provide emergency paramedic and ambulance
transportation services. The city is not relinquishing any rights it may have under statutory
and case law to provide emergency medical services,
City's paramedic services shall be provided in Area 6 and 7, where City currently has
responsibility for providing first responder service of AMR's exclusive operating area with the
. County of San Bernardino and in other areas as requested in connection with mutual aid.
Area 6 and 7 is more accurately described in Exhibit "B", attached hereto and incorporated
herein by reference. City shall be responsible to provide on a regular basis emergency
medical first responder services to urban areas of Area 6 and 7, where City currently has
responsibility for providing first responder service and will respond elsewhere in Area 6 and 7
when requested through Mutual Aid.
4. DESCRIPTION OF SERVICE:
City agrees to provide emergency medical first responder services with personnel
licensed and trained to a level of Emergency Medical Technician Paramedic (EMT-P) to
persons in need of such service in the manner and form described in the body of this
Agreement and in Exhibit "A", attached hereto and incorporated herein by reference, within
the operating area described in Exhibit "B", as limited by Section 3 above. City shall provide
at its sole cost and expense, except as otherwise provided herein, first responding personnel
and such equipment sufficient to meet AMR's obligations under AMR's contract with the
County of San Bernardino and the State of California and/or the County of San Bernardino
deems necessary or appropriate to carry out the paramedic first responder services
contemplated by this Agreement. AMR shall be responsible for providing supplies utilized by
City in the provision of ALS services under this Agreement.
CilySBI AMRPartnershipJan22,200 1
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5. GENERAL RESPONSIBILITIES OF CITY:
A. Paramedic Personnel: City agrees to maintain records of the EMS
certificates, including license or certificate numbers and expiration dates, for all its paramedic
personnel answering calls. Qualifications for personnel staffing City's responding paramedic
engines shall be at least at the minimum certification level required by applicable law or
ICEMA policy, whichever is greater.
B. Emplovee Performance: City shall not knowingly permit any of its employees,
including dispatchers, to perform services hereunder while under the influence of any
alcoholic beverage, medication, narcotic, or other substance, which might impair the
employee's physical or mental performance, Personnel of each paramedic engine when
answering a call shall handle the ill and injured in a manner consistent with proper
emergency care procedures.
C. Eauipment: City shall maintain all of the first responder equipment used
hereunder according to the provisions of the City of San Bernardino Fire Department's
Apparatus and Equipment Standard Operating Procedures or in accordance with
maintenance procedures recommended by the manufacturerlsupplier, whichever is more
comprehensive. This equipment shall be subject to inspection upon request by Administrator
or AMR. All ambulances provided by AMR or its backup providers shall be equipped with
adequate equipment and supplies as required by AMR's contract with County and any
applicable laws, regulations and ICEMA policies and procedures,
D. Supplies: It is understood by the parties hereto that AMR will bill patients for
medical service and transportation provided to patients during the course of treatment by
both AMR and City paramedics. AMR agrees to furnish medical supplies and non-regulated
drugs used by City paramedic personnel in conjunction with services to be performed
pursuant to this Agreement. City shall stock at its own expense controlled drugs for use in
the provision of the services contemplated by this Agreement.
6. COMPLIANCE WITH APPLICABLE LAWS:
City shall abide by all applicable rules and regulations of the State Department of
Health Services, and all other State and local laws and regulations and all ICEMA policies
and procedures pertaining to the operation of emergency medical services as applicable.
7. LICENSES. PERMITS. REGISTRATIONS AND CERTIFICATES:
City shall obtain and maintain in effect during the term of this Agreement, all licenses,
permits, registrations, and certificates required by law for the operation of its first responder
services provided for hereunder. City shall ensure that all of its personnel, employees, and
agents, and their respective personnel, employees and agents, obtain and maintain in effect
during the term of this Agreement, all licenses, permits, registrations, and certificates required
by law which are applicable to their performance of services hereunder.
CitySB! AMRPartnershipJan22,200 I
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8. INDEMNITY:
To the fullest extent permitted under applicable law, City shall indemnify, defend (at
County's request) and hold harmless the County, its officers, agents, volunteers, and
employees, from and against any and all liability, claims, loss, damage, or expense of
whatsoever nature (including, without limitation, attomeys fees and all other costs of defense)
arising out of or related to any injury or death to any person or any damage to any person or
property arising from or related to County's approving this Subcontract Agreement between
the City and AMR , or any negligent or wrongful act or omission by City, its officers, agents,
volunteers or employees in the performance of providing first responder services as a
subcontractor to AMR, including without limitation all consequential damages, Except as
provided above, AMR shall indemnify, defend and hold harmless City, its officers, agents,
volunteers, and employees, from and against all liability, claims, loss, damage, or expense of
whatsoever nature arising out of or related to any injury or death to any perSon or any
damage to any person or property arising from or relating to any negligent or wrongful act or
omission by County, its officers, agents, or employees, in connection with County's
performance or implementation of the County's Agreement with AMR that City is
subcontracting under. Neither City nor its officers, agents, volunteers, or employee's, are to
be deemed an agent or agents of County.
9. RESPONSE WITHIN OPERATING AREA AND STATION LOCATIONS:
City shall respond to all calls made by duly authorized representatives of an authorized
9-1-1 communications center (including AMR), County's Sheriff's Department, County's Fire
Department, the Califomia Highway Patrol, Administrator, or of any other public safety
agency authorized by Administrator to dispatch emergency ambulance vehicles to Area 6 and
7, where City currently has responsibility for providing first responder service with their
closest appropriately staffed engine(s) to the scene of the incident. In the event City does not
have an engine immediately available to respond in accordance with this Agreement, City will
notify AMR as soon as possible and give AMR a time estimate as to when the City will be
available. Upon such notice AMR will be primarily responsible for ALS first responder
services in Area 6 and 7, including the utilization of mutual aid. In the event of a medical
emergency that prevents City from responding to new calls or causes the need for more
resources, City will notify AMR. Either AMR andlor its backup providers shall, pursuant to
AMR's mutual aid agreements, upon request from AMR, provide assistance to City. If City's
response will be delayed for any reason beyond its original estimated time of arrival at the
scene of the emergency, City shall immediately inform AMR of this delay. City shall maintain
accurate electronically time stamped dispatch communication tapes and records of response
times, These tapes and records shall be made available for review by AMR, Administrator, or
to authorized representatives of San Bernardino County, or all, at all reasonable times upon
request. City and AMR agree to synchronize their communication recording/dispatch system
to the National Institute of Standards and Technology time, as broadcast from the W W V site
out of Fort Collins, Colorado,
CitySBI AMRPannershipJan22,200 I
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City shall provide AMR and Administrator with a list of all of its paramedic crewlstation
locations prior to the effective date of this Agreement. City shall thereafter notify AMR in
writing in the manner specified of any change in station locations at least thirty (30) days prior
to the effective date thereof.
10. TRANSPORTATION TO MEDICAL FACILITY:
City Paramedics shall fully cooperate with AMR personnel, and shall accompany
seriously injured andlor ill patients to the hospital upon request by an AMR Paramedic.
11. UNLAWFUL SOLICITATION:
City shall inform all of its employees performing services hereunder of the provisions
of Article 9 of Chapter 4 of Division 3 (commencing with Section 6150) of the California
Business and Professions Code (Le., State Bar Act provisions regarding unlawful solicitation
as a runner or capper for attorneys) and shall take positive and affirmative steps in its
performance hereunder to ensure that there is no violation of such provisions by its
employees.
12. BILLING AND PAYMENT:
All compensation to City for services rendered pursuant to this Agreement shall be
paid by AMR. City shall be compensated for services rendered pursuant to this agreement in
the following manner:
A. Base Compensation: All compensation to City for services rendered pursuant
to this Agreement shall be paid by AMR. AMR acknowledges that City will bill a First
Responder fee independent and aside from this Agreement, provided the billing of that fee
does not impact AMR's right to bill for transportation fees, This agreement is solely contingent
on ICEMA's continued approval of AMR's current modified response time requirements within
the City Zone such that AMR shall be required to respond to all 9-1-1 PSAPoriginated
emergency medical responses within eleven minutes and fifty-nine (11 :59) seconds or less
90% of the time.
City shall be compensated by AMR for services rendered pursuant to this agreement
in the following manner:
AMR shall pay to City the sum of two hundred twenty-two thousand, one hundred
twenty dollars and sixty-nine cents ($222,120,69) as Base Compensation per year for
services performed pursuant to this Agreement. Said sum shall be paid to City in twelve
equal monthly installments of eighteen thousand, five hundred ten dollars and six cents
($18,510.06). The above compensation is based upon a mutually agreed to proportionate
share of AMR's unit hour staffing savings within the City of San Bernardino.
City acknowledges that the compensation provided for above is equal to or less than
its actual cost of providing the services. It is expressly agreed that City's compensation for
services shall be at all times no greater than its cost.
Upon execution of this Agreement AMR shall pay the City the amount of $18,510.06
for the first month of this Agreement less four thousand, eight hundred twenty-one dollars
($4821.00) per month for reimbursement of Start-Up cost as noted in Resolution 1999-186
CitySBI AMRPartnershipJan22,200 1
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until Start-Up cost has fully been re-paid. Total of Start-Up cost to date is fifty-seven
thousand, eight hundred fifty-two dollars ($57,852.00,) Said sum includes all payments due
under the Agreement for Advance Life Support First Responder. In addition to the agreed
upon payment deduction for reimbursement of Start-Up cost, AMR will also deducted three
thousand, twenty-six dollars and eighty-three cents ($3,026.83) per month for the first twelve
months for the total of thirty-six thousand, three hundred twenty-two dollars ($36,322.00) as
reimbursement for the purchase of Startup Equipment and Supplies as outlined in Resolution
1999-186 Exhibit A.
Parties agree to review annually the unit hour efficiency of this Agreement to
determine the need if any, to adjust compensation. Adjustment of unit hour savings will be
adjusted up or down as appropriate. This review shall occur no later than sixty (60) business
days prior to the annual anniversary date of this Agreement. Any agreed upon adjusted
compensation need be affected by amendment only, upon the signing by both parties,
3. Modification of Base Rate Increases:
AMR agrees to review as necessary the base rate compensation to City upon
AMR meeting a threshold of a response time compliance of eleven minutes, fifty-nine
seconds (11 :59), ninety-five percent (95%) or better for three (3) consecutive months
in Areas 6 and 7, where City currently has responsibility for providing first responder
service. Once the threshold has been met, AMR will then decrease its staff by one (1)
ambulance unit, which equals twelve unit hours for the City of San Bernardino system,
for a period of three months. Upon the completion of the three (3) month test period it
is established that the decrease in unit hours will continue to permit AMR to meet a
minimum compliance of ninety-two (92) percent compliance or better in Areas 6 and 7,
AMR will make an adjustment to the base rate. Adjustment will be based on tile
current formula (salary and related benefit cost) of savings being divided in a sixty/forty
ratio between City and AMR. In no event shall compensation from all sources
provided by AMR exceed City's actual costs of providing the service specified herein,
13. RECORDS AND REPORTS
A. Retention and Location of Records: City shall maintain accurate books,
documents, and records reflecting services provided as well as records and all other
information specifically required by other provisions of this Agreement or AMR's Agreement
with the County as applicable to the services, obligations or performance to be provided by
City under this subcontract. All such books, documents, records, and information shall be
prepared and maintained in accordance with generally accepted accounting principles and
shall be retained by City and AMR at locations in San Bernardino County. During the term of
this Agreement, and for a period of five (5) years thereafter, all such books, records,
documents, and information shall be made available during normal business hours to City
and AMR, authorized representatives of County's Department of Emergency Medical
Services and Administrator for inspection, audit, and copying.
B. Federal Access to Records: If and to the extent that Section 1986 (v){I){I)
of the Social Security Act [42 U.S.C. Section 1395x(v)(1)(I)] is applicable. City agrees that for
a period of seven (7) years from the date services were rendered under this Agreement, City
shall maintain and make available, upon written request, to the Secretary of the United States
CitySBI AMRPannershipJan22,200 1
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Department of Health and Human Services or the Comptroller General of the United States,
or to any of their duly authorized representatives, the contract, books, documents, and
records of City which are necessary to verify the nature and extent of the cost of services
provided hereunder,
C. Dispatch Communication Records: City shall maintain electronically time
stamped dispatch communication records on the dispatch of all emergency medical
personnel provided for hereunder. Each such record shall be retained for a minimum period
of one hundred-eighty (180) days following its preparation and shall be made available
during that period to City, AMR and Administrator or to authorized representatives of San
Bernardino County, or all, for review and copying at all reasonable times upon request. City
and AMR shall coordinate the regular synchronization of their respective electronic time
stamping equipment with time from the National Institute of Standards and Technology, as
broadcast from the W W V site out of Fort Collins, Colorado,
D. Response Time Records: City shall keep adequate records of response
times, number of emergency medical responses made, location of initiation of response,
location of patient in relation to point of initial response and length (time) of response in a
manner that can be audited by AMR and County staff designated by Administrator. Such
records shall be maintained and retained in the manner and for the period prescribed in
subparagraph A of this Paragraph.
14. CONFIDENTIALITY:
. City shall not release or disclose information or records of any patient receiving
services hereunder to third parties without the prior written consent of the patient or hislher
lawful representative or unless otherwise authorized by law. City shall inform all its officers,
employees, and agents providing services hereunder of these confidentiality provisions, City
agrees to maintain the confidentiality of its records, including billings, in accordance with all
applicable State and Federal laws relating to confidentiality, Notwithstanding the
aforementioned provisions of this Paragraph, authorized representatives of AMR,
Administrator, County's Auditor-Controller, or the State and Federal governments shall have
the right to request and receive access to all City records in order to administer, monitor, and
audit City's performance under this Agreement or under applicable laws, regulations or
ICEMA policies or procedures,
15. AUDITS:
A. In the event that an audit is conducted of City by any Federal or State Auditor,
or by an auditor or accountant employed by City or otherwise, relating to services hereunder,
City shall file a copy of each such audit report with AMR and the County of San Bernardino,
Auditor-Controller, within thirty (30) days of City's receipt thereof, unless otherwise provided
under this Agreement, or under applicable State or Federal regulations. AMR shall make
reasonable efforts to maintain the confidentiality of such audit reports.
CitySBI AMRPannershipJan22,200 I
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B. Failure of City to comply with the terms of this Paragraph shall constitute a
material breach of this Agreement upon which AMR may cancel, terminate, or suspend this
Agreement.
16. REPORTS:
City shall make reports as reasonably required by AMR conceming City's activities and
operations as they relate to the services hereunder. In no event, however, may AMR require
such reports unless it has provided City with at least thirty (30) days prior written notification
thereof. AMR shall provide City with a written explanation of the procedures for reporting the
required information. Further provisions regarding reports are set forth in Exhibit "A".
17. NONDISCRIMINATION IN SERVICES: No person shall, on the grounds of race,
color, creed, national origin, religious affiliation or non-affiliation, sex, sexual orientation,
marital status, age (over 40), disability, medical condition, political affiliation, union
membership or any other unlawful basis be excluded from participation in, be denied the
benefits of, or be subjected to discrimination under this Agreement. City shall provide that
patients are accepted for care without discrimination on the grounds of race, color, creed,
national origin, religious affiliation or non affiliation, sex, sexual orientation, marital status,
age, disability, medical condition, political affiliation, ability to pay for services or any other
unlawful basis.
18. NONDISCRIMINATION IN EMPLOYMENT: City shall insure equal employment
opportunity based on objective standards of recruitment, selection, promotion, classification,
compensation, performancp. evaluations, and management relations, for all employees under
this Agreement. City's personnel policies shall be made available to AMR.
19. INDEMNIFICATION:
A. AMR shall defend, indemnify and save harmless the City and all of its officers,
volunteers, employees and representatives from and against any and all suits, actions, claims
or demands, of any character whatsoever, brought for, or on account of, any injuries or
damages sustained by any third person or property resulting or arising as a result of the
performance of any services under this Agreement or pursuant to the provision of ambulance
services by AMR and all of its officers, volunteers, employees and representatives.
B. AMR shall defend, indemnify and save harmless the City and all of its officers,
volunteers, employees and representatives from and against any and all suits, actions, claims
or demands, of any character whatsoever, brought for, or on account of, any injuries or
damages sustained by any third person or property resulting or arising from acts of a City
employee which are non-negligently performed at an emergency medical services call at the
specific direction of a AMR officer, employee, representative, or agent.
C. City shall defend, indemnify and save harmless AMR and all of its officers,
volunteers, employees and representatives from and against any and all suits, actions, claims
or demands, of any character whatsoever, brought for, or on account of, any injuries or
damages sustained by any third person or property resulting or arising as a result of the
CitySB/ AMRPartnershipJan22,200 I
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performance of any services under this Agreement by City and all of its officers, volunteers,
employees and representatives.
D. City shall defend, indemnify and save harmless AMR and all of its officers,
volunteers, employees and representatives from and against any and all suits, actions, claims
or demands, of any character whatever, brought for, or on account of, any injuries or
damages sustained by any third person or property resulting or arising from acts of an AMR
employee which are non-negligently performed at an emergency medical services call at the
specific direction of a City officer, employee, representative, or agent.
E. As used in this paragraph "at the specific direction of' shall not include
responding to a request for assistance pursuant to this Agreement. This indemnification
agreement shall be operative as to an employee providing pre-hospital emergency medical
care, whose act is being sought to be indemnified, if such employee is the holder of a
certificate issued pursuant to Division 2,5 of the Health and Safety Code from a certifying
agency to provide pre-hospital emergency field care treatment at the scene of an emergency,
as defined in Health and Safety Code section 1799.102,
F. By entering into this Agreement neither party waives nor limits in any respect
any immunities or protections from liabilities conferred on such party or their respective
employees pursuant to the California Government Code, Health and Safety Code or any
other law,
20. INSURANCE:
Without limiting City's indemnification of AMR and County and during the term of this
Agreement, City shall provide and maintain at its own expense the following programs of
insurance. Such programs and evidence of insurance shall be satisfactory to County's Risk
Manager and shall be primary to and not contributing with any other insurance maintained by
AMR or County, Certificates or other evidence of coverage shall be delivered to AMR and
County's EMS Agency prior to commencing services under this Agreement, shall specifically
identify this Agreement, and shall contain the express condition that AMR and County be
given written notice by registered mail at least thirty (30) days in advance of any modification
or termination of the programs of insurance. In lieu of the following, City in the event it is self-
insured, shall provide to County and AMR written confirmation of its self-insured status and
its present and ongoing ability to cover claims equal to or higher than the coverage set forth
below. Such written confirmation shall be sent to AMR at its notification addresses set forth
herein and to County's EMS Agency.
A. General and Automobile Liability: Such insurance shall be endorsed
naming AMR and County as additional insured and shall include:
1. General liability insurance written on a Commercial General Liability
Form or on a Comprehensive General Liability Form covering the hazards of
premises/operations, contractual, independent contractors, productsl completed operations,
broad form property damage, and personal injury with a combined single limit of at least
$1,000,000 per occurrence, $2,000,000 combined single limit.
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If any coverage is on a "Claims Made" Form, City must for a period of three (3)
years after the date when this Agreement is terminated, completed, or non-renewed, maintain
insurance with a retroactive date that is on or before the start of Agreement services OR
purchase an extended reported period endorsement (tail coverage),
2. Comprehensive auto liability endorsed for all owned, non-owned, and
hired vehicles with a combined single limit of at least $2,000,000 per occurrence. Said
insurance shall also include Uninsured/Underinsured Motorists coverage in the minimum
amount of $100,000 when there are owned vehicles. City shall also maintain auto insurance
in the minimum of $100,000 combined single limit bodily injury and property damage for all
employees and volunteers associated with this Agreement.
B. Professional Liabilitv: Insurance covering liability arising from any error,
omission, or negligent act of City, its officers, or employees, with a limit of liability of at least
$1,000,000 per occurrence and $2,000,000 combined single limit.
C. Workers' Compensation: Insurance in an amount and form to meet all
applicable requirements of the Labor Code of the State of Califomia, including Employers
Liability with a $1,000,000 limit, covering all persons who provide services for City or for its
subcontractor( s).
D. Failure to provide Insurance: Failure by City to procure and maintain the
required programs of insurance shall constitute a material breach of contract upon which
AMR may immediately terminate or suspend this Agreement. There is no breach so long as
the City is adequately self-insured.
21. INDEPENDENT CONTRACTOR STATUS:
A. This Agreement is by and between AMR and City and is not intended, and shall
not be construed, to create the relationship of agent, servant, employee, partnership, joint
venture, or association, as between AMR and City. City is an independent contractor. The
employees and agents of one party shall not be, or be construed to be, the employees or
agents of the other party for any purpose whatsoever.
B. City shall be solely liable and responsible for providing to, or on behalf of its
employees, all legally required employee compensation and benefits, AMR shall have no
liability or responsibility for the payment of any salaries, wages, unemployment benefits,
disability benefits, Federal, State, and local taxes, or other compensation, benefits, or taxes
to or on behalf of any personnel provided by City,
C. City understands and agrees that persons fumishing emergency first responder
medical services pursuant to this Agreement are, for purposes of workers' compensation
liability, employees of City and not employees of AMR. City shall bear the sole liability and
responsibility for any and all workers' compensation benefits to any of its employees as a
CitySBI AMRPartnershipJan22,200 1
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result of injuries arising from or connected with services performed by or on behalf of City
pursuant to this Agreement.
22. FAIR LABOR STANDARDS:
City shall comply with all applicable provisions of the Federal Fair Labor Standards
Act, and shall indemnify, defend, and hold harmless County, AMR and their respective
agents, officers, and employees from any and all liability, including, but not limited to, wages,
overtime pay, liquidated damages, penalties, court costs, and attomeys' fees arising under
any wage and hour law including, but not limited to, the Federal Fair Labor Standards Act for
services performed by City's employees for which AMR or County may be found jointly or
solely liable in connection with this Agreement.
23. EMPLOYMENT ELIGIBILITY VERIFICATION:
City warrants that it fully complies with all Federal statutes and regulations regarding
employment of aliens and others, and that all its employees performing services hereunder
meet the citizenship or alien status requirements contained in Federal statutes and
regulations. City shall obtain, from all covered employees performing services hereunder, all
verification and other documentation of employment eligibility status required by Federal
statutes and regulations as they currently exist and as they may be hereafter amended. City
shall retain such documentation for their respective covered employees for the period
prescribed by law. City shall indemnify, defend, and hold harmless AMR and County, and
their respective officers and employees from employer sanctions and any other liability which
may be assessed against City, AMR, or County in connection with any alleged violatioflJ)f
Federal statutes or regulations pertaining to the eligibility for employment of persons
performing services under this Agreement.
24. DELEGATION AND ASSIGNMENT: City may not delegate its duties or assign its
rights hereunder, either in whole or in part. Any attempted delegation or assignment shall be
null and void. It is understood that this provision is inapplicable to City agreements with
"backup" or "mutual aid providers" who shall provide first responder emergency. medical
services when City's own units are being utilized for other calls,
25. CITY'S OFFICES: City shall notify in writing AMR at the notice address set forth in
Paragraph 37 herein and County's EMS Agency of any change in its business address at
least ten (10) days prior to the effective date thereof.
26. EMERGENCY MEDICAL SERVICE QUALITY IMPROVEMENT PROGRAM:
City shall cooperate in all respects with all AMR or County medical quality
improvement programs for emergency medical services as it relates to services provided
under this Agreement and permit access by AMR andlor County quality improvement
representatives to City's patient run reports and other records, In addition, City shall
establish an internal quality improvement program to ensure compliance with Agreement
requirements and adherence to medical protocols and performance standards as established
by ICEMA. In the performance of AMR or County quality improvement audits, identified
CilySBI AMRPartnershipJan22.200 I
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problems associated with Agreement compliance, other than those listed, as issues for
review by the ICEMA Agency, will be promptly addressed by City.
27. DEFAULT:
A. AMR may, subject to the provisions of subparagraph B below, by written notice
of default to City, suspend or terminate the whole or any part of this Agreement in anyone of
the following circumstances:
1. If City fails to perform the services within the time specified herein or any
extension thereof; or
2. If City fails to perform any of the other provisions of this Agreement, or so
fails to make progress so as to endanger performance of this Agreement in accordance with
its terms.
B. If anyone of the circumstances identified in subparagraph A above occurs,
AMR shall give City written notice of default. AMR may suspend or terminate City's rights
under this Agreement at such time, In the event AMR elects to suspend City, and City does
not cure such failure within a period of thirty (30) days (or such longer period as AMR may
authorize in writing) after receipt of notice from AMR specifying such failure, AMR may, in its
discretion, give City written notice of termination, and AMR or its other subcontractors shall
provide the services otherwise contracted for herein by City.
C. City shall not be liable for any excess costs to AMR if its failure to perform this
Agreement arises out of causes beyond the control and without the fault or negligence of
City, Such causes may include, but are not limited to, acts of God or a public enemy, acts of
County in either its sovereign or contractual capacity, acts of the Federal or State
governments in their sovereign capacities, fires, floods, epidemics, quarantine restrictions,
strikes, freight embargoes, or unusually severe weather; but in every case, the failure to
perform must be beyond the control and without the fault or negligence of City.
D. The rights and remedies of AMR provided in this Paragraph shall not be
exclusive and are in addition to any other rights and remedies provided by law or under this
Agreement.
28. CAUSE FOR IMMEDIATE SUSPENSION: AMR shall have the right to
immediately suspend services under this Agreement in the event of a suspension or
revocation of City's authority or right to provide first responder paramedic services under
applicable laws or regulations.
29. SEVERABILITY: If any provision of this Agreement or the application thereof to any
person or circumstances is held invalid, the remainder of this Agreement and the application
of such provision to other persons or circumstances shall not be affected thereby,
CitySBI AMRPartnershipJan22,200 I
13
30. WAIVER: No waiver of any breach of any provision of this Agreement by AMR shall
constitute a waiver of any other breach of such provision. Failure of AMR to enforce at any
time, or from time to time, any provision of this Agreement shall not be construed as a waiver
thereof, The remedies herein reserved shall be cumulative and additional to any other
remedies in law or equity.
31. GOVERNING LAWS: This Agreement is made and executed and to be
performed in San Bernardino County and shall be construed in accordance with and
governed by the laws of the State of California,
32. MERGER: The body of this Agreement and Exhibits "A" and "B" attached hereto
shall constitute the complete and exclusive statement of understanding between the parties
which supersedes all previous agreements, written or oral, and all other communications
between the parties relating to the subject matter of this Agreement.
No addition to, or alteration of the terms of this Agreement, whether by written or
verbal understanding of the parties, their officers, employees, or agents, shall be valid or
effective, unless made in the form of a written amendment to this Agreement which is
formally executed by the parties in the same manner as this Agreement.
33. PERFORMANCE DURING CIVIL UNREST OR DISASTER:
City recognizes that health care facilities maintained by County provide care essential
to the residents of the communities they serve, and that these services are of particular
importance at the time of a riot, insurrection, civil unrest, natural disaster, or similar event.
Notwithstanding any other provision of this Agreement, full performance by City during any
riot, insurrection, civil unrest, natural disaster, or similar event is not excused if such
performance remains physically possible. Failure to comply with this requirement shall be
considered a material breach by City for which AMR may immediately terminate this
Agreement.
The parties hereto agree that the performance of the services provided for herein
require integrated uninterrupted service to the residents of Area 6 and 7. In order to avoid
disruption of service and to protect the health, safety and welfare of the residents served by
this Agreement, the parties agree that consistent levels of paramedic staffing are necessary.
Accordingly, the parties mutually agree to provide paramedic staffing and other system
critical personnel to other in the event employee job actions, work slow downs, or
unanticipated short term staff shortages occur, provided such personnel is available and the
provision of same does not violate any collective bargaining agreement either party may
have, as the same is determined in the sole discretion of the party from whom the services
are requested, In such event, the party requesting personnel shall notify the other in writing
of the anticipated need, the circumstances surrounding the need, the estimated time frame
for additional personnel and the plans for minimizing the need in the future. The requested
party shall inform the requesting party, in writing, within twenty-four (24) hours of the
availability of the staff and the estimated cost to the requesting party of providing the
personnel. In no event shall the requesting party be required to pay more than the actual
payroll cost of personnel being provided.
CitySBI AMRPartnershipJan22.200 I
14
34. NOTICES: Notices hereunder shall be in writing and shall be personally delivered or
mailed by certified or registered mail, postage prepaid, return receipt requested, to the parties
at the following addresses to the attention of the persons named. The addresses and
persons to be notified may be changed by either party by giving ten (10) days prior written
notice thereof to the other party. .
To City:
CITY OF SAN BERNARDINO
Mayor
300 North "0" Street
San Bernardino, CA 91415
CITY OF SAN BERNARDINO
Fire Chief
200 E. 3rd Street
San Bernardino, CA 92415
To AMR:
American Medical Response
20101 Hamilton Avenue, Suite 300
Torrance, CA 90502
Attention:
Lawrence Monson
Vice President, Administration
CitySBI AMRPartnershipJan22.200 I
15
IN WITNESS WHEREOF, each party hereto has caused this Agreement to be
subscribed in its behalf by its duly authorized officer, the day, month, and year first above
written.
CITY OF SAN BERNARDINO (CITY)
BY:
Mayor
American Medical Response-Inland Empire
BY:
ATTEST:
CITY CLERK
APPROVED AS TO FORM:
7--~
CITY ATTORNEY
CitySBI AMRPartnershipJan22,200 1
16
EXHIBIT A
To
EMERGENCY AMBULANCE TRANSPORTATION SERVICES
SUBCONTRACT AGREEMENT
I. SERVICES TO BE PERFORMED BY CITY.
1. Summary of Services.
A. Uninterruoted First Resoonder Services. City shall provide
continuous uninterrupted Advanced Life Support first responder services and
prehospital emergency medical care 24 hours a day, 7 days a week throughout
the term of this Agreement. All requests for prehospital emergency medical care
for life threatening incidents should be met by City Paramedic-Assessment
Engines staffed with Advanced Life Support personnel. The service shall be
provided according to the specifications set forth in this agreement and according
to standards, policies and procedures established by ICEMA.
B, Data Collection and Reoortina Functions. City and AMR shall
provide EMS system data collection and reporting functions according to
specifications set forth by ICEMA.
C, Comoliance Provisions, City shall comply with all provisions of
the ICEMA's Policies and Procedures Manual or its successor, the ICEMA
Continuous Ouality Improvement ("CO I") Plan or its successor.
2. First Responder Advanced Life Support Enaine ("FRALSE")
Response Time Performance Standards and Penalties.
A. Calculation of Resoonse Times. Response time shall be
calculated from the time San Bernardino City Fire dispatch center receives the
call, until the time that responding FRALSE personnel notifies the dispatcher of
its arrival at the scene of the emergency or until the FRALSE is canceled by the
dispatcher. This shall be hereinafter known as the response time interval of,
"First Notification to Arrival at Scene".
B, If a FRALSE response is downgraded by the dispatcher while en
route to the scene, only the time from its initial dispatch until the time that it is
downgraded to below Code Three (3) shall be counted as its response time for
purposes of response time compliance calculation and reporting pursuant to this
Agreement.
CitySB/AMRPartnership ExOI-22.2001
1
3. Response time compliance standard for all FRALSE
emeraencv medical responses.
City shall respond to emergency calls pursuant to this Agreement in a
manner so as to assure response time compliance to the below standard:
A. City shall place a FRALSE at the scene within seven (7) minutes
fifty-nine (59) seconds, with a 90% minimum compliance to this standard for all
emergency medical responses measured from time of First Notification to Arrival
at Scene, as entered into the Computer Aided Dispatch ("CAD"), which shows
time in hours, minutes, and seconds calibrated to the National Bureau of
Standards, in all areas identified as City's primary response areas of
responsibility within ICEMA designated Exclusive Operating Areas ("EOA")
currently known and geographically defined as EOA's #6 and #7.
4. Response Time Exemptions.
The following requirements in this section can be ignored if City meets its
response time standards of seven (7) minutes fifty-nine (59) seconds, with a 90%
minimum compliance for the given month the statistics are being calculated for.
In the monthly calculation of the Provider's response time performance,
every 9-1-1 Public Safety Answering Point ("PSAP") originated emergency
medical response originating from within the City's primary response area
:"PRA") shall be included except as follows:
A. In a multiple FRALSE response to a single incident, only the
response time of the first arriving FRALSE shall be counted.
B. Good cause for an exemption as determined by the EMS Agency.
The burden of proof that there is good cause for the exemption shall rest with the
City and City must have acted in good faith. The alleged good cause must have
been a substantial factor in producing the excessive response time. If the
County EMS Agency disallows the exemption, such determination is conclusive
as to City. Good cause for an exemption may include, but is not limited to the
following scenarios:
i. Incorrect or inaccurate dispatch information received from a
calling party or 9-1-1 PSAP or from a public safety agency.
ii. Disrupted voice or data transmission.
iii. Inability to locate address due to non-existent address.
iv, Delay caused by unavoidable traffic congestion or gridlock
encountered while en route to the emergency incident scene.
CitySB/AMRPartnership ExOI-22-2001
2
v. Unavoidable delay caused by road construction andlor
closure,
vi. Unavoidable delays cause by trains,
vii. Off-road or Un-paved road locations.
viii. Weather conditions, which impair visibility and create other
unsafe driving conditions.
ix. Gated, locked communities.
xi. Unsafe scenes due to police or fire department activity or
hostage situations requiring staging away from incident location.
xiii. Power outages, which affect ability to dispatch.
C. Citv Reauest for Resoonse Time Exemotion. City shall submit
data electronically or on disk for all responses that exceed response time
minimum standards as defined above to AMR on a monthly basis. Additionally,
City shall note the calls for which a response time exemption will be requested in
the listing of such calls and make any requests for response time exemptions
within 15 days of the end of the previous month, Such response report and
exemption request shall list the date, all associated response time intervals, and
the specific circumstances causing the delayed response, The format of the
response time exemption report shall include, but not be limited to, the following
information: Date of incident, Time of incident, Dispatch agency number,
Prehospital Field Report Number, Provider Agency Identification Number, Geo
Code, and Exemption Request Category.
5. Response Time Performance Penalties. Repercussions & Incentives.
A. Penalties. Commencing when AMR gives City written notice that
the County is enforcing any form of financial penalty or other method of
evaluating response time compliance that would have a financial impact to this
agreement. City agrees to immediately review with AMR this agreement and
make appropriate adjustments as needed to the following, but not limited to:
Response Time penalties
Reporting Formats
CAD interlink
CitySB/AMRPartncrship ExOI-22-2001
3
II. LEVEL OF CLINICAL SOPHISTICATION.
1. Medical Control.
A, Prospective medical control of Emergency Medical Technician-
Paramedic ("EMT-P") personnel shall be in accordance with the policies and
procedures of the ICEMA andlor its Medical Director.
B. Immediate medical control shall be provided to EMT-P personnel
by Base Hospital physicians, mobile intensive care nurses, or prior to
contacUcommunication failure protocols according to the policies and procedures
of ICEMA.
C. Retrospective medical control shall be provided according to the
standards set forth by ICEMA through quality improvement programs, including
continuing education programs, conducted cooperatively by AMR, City, ICEMA
and the Base Hospitals.
2. Qualitv Improvement Proaram.
A. City shall designate a Ouality Improvement Coordinator who shall
meet the educational and training qualifications for such a position as defined by
ICEMA.
B, City shall work with AMR in tl-,e development and implementation of
a detailed quality improvement program, which shall be subject to approval by
ICEMA.
C. City and AMR's quality improvement program shall be based on
ICEMA's COI Plan and shall involve cooperation with base hospitals and first
responder agencies.
D. City shall establish an on-going 01 Committee, which shall include
field EMT-Ps,
E. The 01 program shall emphasize and include peer review.
3. Trainina/Education/Cerlification/Accreditation.
A, Field Care Audits (Tape Review), City shall work cooperatively with
the Base Hospitals, AMR and the ICEMA in identifying and assisting with field
care audits,
B. Mandatory Education for Local EMT-P Accreditation. City shall
cooperate fully with ICEMA and Base Hospitals to notify EMT-Ps of mandatory
education programs
CitySB/AMRPartnership ExOI-22-2001
4
C. Soecialtv Education Proarams. All EMT-Ps will achieve and
continuously maintain Advanced Cardiac Life Support (ACLS) certification. If an
EMT -P is not ACLS certified at the time of hislher employment. such certification
shall be obtained within three months of employment. All EMT-Ps will be
Pediatric Advanced Life Support certified (or equivalent as determined by the
ICEMA) within six months of employment, or for currently employed EMT-Ps, by
the expiration date of his/her EMT -P license, after this Agreement is in place,
D. FRALSE Staff. All FRALSE performing work under this
Agreement shall be staffed with a minimum of one (1) California licensed EMT-P
who is accredited in San Bernardino County.
4. Personnel and Workina Conditions.
City will have in place programs that address the following:
A. Criticallricident Stress Debriefina and On-aoina Stress Reduction,
B. Chemical Deoendencv.
C, Immunizations,
D. Infection Control.
5. Kev Personnel.
City shall have key personnel responsible for the following areas
employed at all times:
A. Quality Imorovement Proaram,
B. Trainina and Education Proarams.
C. Overall Analvsis and Coordination of Resource Deolovment.
D. Safetv Committee.
III. VEHICLES AND EQUIPMENT.
1. Vehicles.
City shall institute and maintain the following:
A. Fleet Maintenance Proaram.
B. EauiomenUSuoolies Inventory oer FRALSE.
C. Eauioment Maintenance.
2. Communications EauiDment.
A. Advanced Life Suooort Communications.
City shall provide two-way communication between the Emergency
Medical Technician - Paramedic ("EMT-P) and Base Hospital for Advanced Life
CitySBlAMRPartnenhip ExOI-22-2001
5
Support communications. Biocom or cellular telephone may be utilized. ALS
units shall have Med-Net available for BLS communications and ALS backup. All
radio equipment used for ALS communication shall operate within the frequency
requirements of the San Bernardino County Communications.
3. VHF Radio Eauipment.
A. City shall provide two-way radios with Emergency Medical Network
frequency and other necessary communications equipment as determined by the
ICEMA and San Bernardino County Communications for all approved FRALSE.
B. Approved two (2) way radios for FRALSE shall be simplex (pUSh to
talk), have appropriate power ranges, multiple private line and frequency
capabilities, not less than thirty-two (32) channels that recognize the needs of
City for multiple agency access, operations in varied terrain, and communications
capacity.
C. City shall re-program radios as new frequency(s) are developed
and implemented.
D. City shall provide one hand-held radio per FRALSE as an
alternative to a paging system.
4. Radio Charaers and Spare Radios.
City shall provide a radio charger for each portable radio or a spare
battery pack. City shall stock a surplus of EMS portable radios. These radios
shall be available as replacements for radios undergoing repair and for incidents
requiring more EMS radios than available on participating FRALSE.
IV. MISCELLANEOUS REQUIREMENTS.
1. Dispatch Center.
City and AMR will coordinate an assessment of programming, logistical,
and cost requirements to develop and implement a communications interface
system directly between City and AMR. This assessment will occur during the
first twelve months from execution of this contract. Initiation of development and
implementation of the system, if both parties agree, will be targeted for the
second year of this contract. If interface is implemented, any cost including but
not limited to software, hardware, training and communication connections the
cost shall be shared equally between City and AMR.
2. Multiple Victim Responses.
A. In-County Maior Multiole Victim Incidents or Disasters. City
agrees to adhere to the medical incident response plan specified by the EMS
CilySBJAMRPartnership ExO\.22.200\
6
Agency, which includes Standard Emergency Management System ("SEMS"). In
large multiple victim incidents, City shall make best efforts in calling back off-duty
personnel and placing additional FRALSE in service to supply sufficient
resources to meet the needs of the incident. In long-term disaster situations,
such as a major earthquake, City shall make best efforts to accommodate its field
personnel's physical and emotional needs. In each incident, AMR shall make
best efforts to obtain necessary additional ambulances, equipment, and supplies
from other locations.
B. Drills. City agrees to participate with personnel and vehicles in
County sponsored drills at least twice per year.
C. Interaoency Plans. City agrees to develop and implement plans for
interagency training and utilization of equipment.
3. Data Collection and Record Keepina.
A. EMS System and Patient Data. City shall be responsible for the
provision of detailed patient and EMS system data, both periodic written reports
as well as computerized data, according to specifications set forth by ICEMA and
any future guidelines promulgated by ICEMA. Hard copies and computer images
C'f patient care records are to be treated as confidential information, in
accordance with applicable law.
B. ICEMA Access to Data. ICEMA will have access to provider's
data according to data collection needs described in ICEMA guidelines, policies,
and procedures or ICEMA requirements.
C. Patient Medical Records. The patient care record form will be
specified by ICEMA. This form shall be such that all routine documentation
completed by the EMT-P for an emergency response (such as patient
assessment and treatment) can be completed on the form. City shall retain
copies of all patient medical records for at least seven (7) years. These records
shall be stored in a manner conducive to easy retrieval. A copy of the patient
record shall be supplied to ICEMA upon request.
D. Emeroency Medical Technician-Paramedic ("EMT-P") and
Emeroency Medical Technician ("EMT") Records. City shall be responsible for
maintaining records for EMT-P and EMT personnel according to the
specifications of the County including, but not limited to, licensure, accreditation,
and employment status, continuing education records, and performance in
accordance to continuous quality improvement standards. These records shall
be available to ICEMA upon request.
CilySBJAMRPartnership ExOl.22.200\
'7
E. EMT-P and EMT Certification/Accreditation Disciolinarv
Proceedinos. City shall cooperate fully with the Base Hospital Prehospital
Care Coordinators and ICEMA in corrective proceedings pertaining to an EMT-
p's or EMT's certificate or accreditation. Such cooperation shall include, but not
be limited to, provision of relevant patient records and incident reports.
4. Dispatch Services and CAD Provisions.
A. Emeroencv Medical Disoatch Committee. An Emergency Medical
Dispatch Committee will be established to include representatives of the dispatch
centers, ICEMA, and providers. This Committee will be responsible for
development of dispatch policies and procedures, training programs, and
continuous quality improvement programs. In addition, City does not agree that
the County of San Bemardino has any regulating authority beyond that set forth
in the decision by the Califomia Supreme Court in County of San Bernardino v.
City of San Bernardino (1997),15 Cal.4th 909.
B. Emeroencv Medical Disoatch Standards.
i. Policy and Procedures. Dispatch of emergency
ambulances shall be according to the policies, procedures, and protocols
promulgated by ICEMA.
ii. CAD Training. All dispatchers performing EMS
dispatch procedures in San Bernardino County will be trained in operating CAD
equipment.
iii. Emergency Medical Dispatch. It is the goal of City and
AMR to have a minimum of one (1) dispatcher, who is certified as an Emergency
Medical Dispatcher by ICEMA.
iv. Training and Certification. It is the goal of City and AMR to
have Emergency Medical Dispatchers who have successfully completed an
Emergency Medical Dispatch Program according to the standards specified by
ICEMA. It is the goal of City and AMR to have Emergency Medical Dispatchers
who have successfully completed an EMD program and authorized as EMD's by
the ICEMA'S Medical Director by July 1, 2001.
5. Material Breach.
AMR may, subject to provisions below, by written notice of material breach
to City, suspend or terminate the whole or any part of this Agreement in anyone
of the following circumstances:
CilySB/AMRPartnership ExOI-22-200\
8
A. Failure of City to operate the first responder advanced life services
in a manner which enables AMR to remain in substantial compliance with the
requirements of applicable local, Federal and State laws, rules and regulations.
B. Failure to meet the monthly response time requirements set forth
above for a period of three (3) consecutive months or a total of four (4) months
during any year commencing on the effective date of this Agreement or during
any subsequent year.
C. Failure to consistently meet the various clinical standards required
in this Agreement.
D. Intentional falsification of data supplied to County or AMR during
the course of operations, including by way of example, but not limited to, dispatch
data, patient report data, response time data, financial data, or downgrading of
presumptive run code designations to enhance City's apparent performance, or
falsification or deliberate omission of any other data required under this
Agreement.
E. In the event of any dispute hereunder, prior to initiating a legal
action the parties shall submit in good faith to mediation before a mutually
agreeable mediator. If the parties are unable to agree upon a mediator, a
mediator shall be designated by the administrator of the JAMS/EN DISPUTE
panel in San Bernardino County. The cost of the mediator shall be shared
equally. The foregoing shall not prevent either party from seeking injunctive or
other provisional relief.
V. OTHER PROVISIONS.
1. Riaht of Inspection.
Administrator of ICEMA or his/her designee shall have the right to make
inspections or investigations at any time without prior notice for the purpose of
determining whether City and/or AMR is complying with the terms and conditions
of this Agreement.
A. City shall make its records with respect to all matters covered by
the Agreement available to Administrator or his/her designee, who may make
excerpts or transcripts from such records and make audits of all contracts,
invoices, materials, daily logs, conditions of employment and other data related
to all matters covered by the Agreement.
B. Administrator or his/her designee may inspect any FRALSE at any
time without prior notice.
CilySBJAMRPartnership ExOI-22-200\
9
C. Administrator or his/her designee may inspect any CAD records
relating to the provision of first responder services at any time without prior
notice.
2. Reportina Deficiencies.
In the event that City is found to be in violation or breach of any of the terms and
conditions of this Agreement, AMR shall notify City of such deficiency and City
shall make necessary corrections within thirty (30) days to the full satisfaction of
AMR. Such violations shall include, but are not limited to, deficiencies in first
responder personnel qualifications/certifications/accreditation, required training,
equipment, supplies, continuous quality improvement program and actions which
are not in the best interest of efficient and effective patient care.
3. Notice to County,
Throughout the life of this Agreement, the parties agree to notify County
and each other in writing of any and all claims, accidents, and/or incidents which
might give rise to litigation arising out of City's or AMR's performance pursuant to
this Agreement or AMR's primary agreement with the County within forty-eight
(48) hours of receiving or becoming apprised of such information.
CilySB/AMRPartnership ExOl-22-2001
10
OFFICE OF THE CITY CLERK
RACHEL G. CLARK, CM.C. . Crn CLERK
'"
P.O. Box 1318. San Bernardino. CA 92402
300 North "D" Street. San Bernardino. CA 92418-0001
909.384.5002. Fax: 909.384.5158
Business Registration Division: 909.384.5302
Passport Acceptance Facility: 909.384.5128
www.ci.san-bernardino.ca.us
February 2, 2001
Lawrence Monson
American Medical Response
20101 Hamilton Avenue, Suite 300
Torrance, CA 90502
Dear Mr. Monson,
Enclosed is a copy of City of San Bernardino Resolution 2001-27, and one original signed
agreement between American Medical Response and the City of San Bernardino. I am
fOlwarding this agreement to you for your files.
If you have any questions, please call me at (909)384-5002.
Sincerely,
Michelle Taylor
Senior Secretary
CITY OF SAN BERNARDINO
ADOPTED SHARED VALUES: Integrity. Accountability. Respect for Human Dignity. Honesty
.-.-
CITY OF SAN BERNARDINO
Interoffice Memorandum
CITY CLERK'S OFFICE
Records and Information Management (RIM) Program
DATE:
February 2,2001
TO:
Larry Pitzer, Fire Chief
FROM:
Michelle Taylor, Senior Secretary
RE:
Resolution 2001-27 - Executed Agreement
CC:
Finance
Attached is a copy of Resolution 2001-27 and one original executed services agreement between
the City of San Bemardino and American Medical Response (AMR).
If you have any questions, please call me at ext. 3206.
** FOR OFFICE USE ONLY - NOT A PUBLIC DOCUMENT **
RESOLUTION AGENDA ITEM TRACKING FORM
Meeting Date (Date Adopted):
Vote: Ayes f-
1-,99-0\ Item #
I Nays-tr
~
Resolution #
Abstain
,..f=T
200 I - ~ f)
Absent -&
Cbange to motion to amend original documents:
Reso. # On Attachments: ~
Contract term: ---
5-30-0\
NnlUVoid Mter: 'pO PA<f
Note on Resolution of Attachment stored separately: -==-
Direct City Clerk to (circle I): PUBLISH, POST, RECORD W/COUNTY Date:
See Attached: .::::...
\
Date Sent to Mayor: I -?, 1- 0 \
Date of Mayor's Signature: .) - \ - ell
Date of ClerklCDC Signature: :) - ~-o 1
Reso. Log Updated: ./
Seal Impressed: v"
Date MemolLetter Sent for Si
60 Day Reminder Letter Sent on 30th day:
90 Day Reminder Letter Sent on 45th day:
See Attached:
See Attached:
See ched:
Date Returned:
e:
Request for Council Action & Staff Report Attached:
Updated Prior Resolutions (Other lban Below):
Updated CITY Personnel Folders (6413, 6429, 6433, 10584, 10585, 12634):
Updated CDC Personnel Folders (5557):
Updated Traffic Folders (3985, 8234, 655, 92-389):
Yes L No By
Yes No ,/ By
Yes No / By
Yes No /' By
Yes NoV By
Copies Distributed to:
City Attorney /
Parks & Rec.
Code Compliance
Dev. Services
EDA
Finance
./ MIS
Police Public Services
Water
Others:
F, /2.6'
Notes:
BEFORE FILING. REVIEW FORM TO ENSURE ANY NOTATIONS MADE HERE ARE TRANSFERRED TO THE
YEARLY RESOLUTION CHRONOLOGICAL LOG FOR FUTURE REFERENCE (Contract Term. etc.)
Ready to File: ~
Date: ;}-- ;;l.-a \