HomeMy WebLinkAboutSanta Clara County - 2011 Agreement - Amendment No. 1 adding Annex C
First Amendment to Agreement
Between the County of Santa Clara
and
The City of Gilroy
for 911 Emergency Medical Services
This is the first amendment to the 911 Emergency Medical Services Agreement (the "Agreement"), by
and between the County of Santa Clara (COUNTY) and the City of Gilroy (CONTRACTOR), effective as
of 12:00 a.m. July 1, 2011, to provide 911 emergency medical services in the County of Santa Clara.
The Agreement is amended as follows effective upon execution:
1. Annex C, "EMS Trust Fund Disbursements," attached hereto and incorporated herein by this
reference, is hereby added to the Agreement.
All other terms and conditions of the Agreement remain in full force and effect. In the event of a conflict
between the original Agreement and this Amendment, this Amendment controls.
SIGNATURES
COUNTY OF SANTA CLARA:
By: /~MJJ) 14J3f II
Rae Wedel, Division Director ' Date
Public Health Department
_J
c!Iu~~ ~
Linda Callon, Berliner Cohen Date
City Attorney
APPROVED AS TO FORM AND LEGALITY:
OJ z- 10 1/ It
Date
APPROVED:
.~/2. 2Z-jt,
Emily 'son 0 e
Deputy County Executive
Exhibits/Attachments:
Annex C
First Amendment to City of San Jose -911 Emergency Medical Services
For County Use Only - SAP
SCC Vendor
Number:
Account General Cost Amount WBS Internal Order
Assignment Ledger Center
Line 1
Line 2
H, I or J Expense Code Dept. Code Capital Project Code "PCA" code - Optional
D Please give the reason for an increase in price, where there is no change in scope of service or term
date:
D Amend amount of aareement as follows:
A. Maximum Financial Obligation: $
(Current Contract Amount)
B. Requested amount to be amended: $
C. Revised maximum contract amount: $
(A + B will equal C)
CONTRACT HISTORY
If agreement covers services that occur in more than one fiscal year, enter information below.
Total financial obligation from prior fiscal year(s): $
First Amendment to City of San Jose -911 Emergency Medical Services
Annex C
EMS Trust Fund Disbursements
I. PURPOSE AND USE OF EMS TRUST FUND FUNDING
This Annex identifies the process by which the Provider accesses funding from the
EMS Trust Fund for projects that have been previously approved and budgeted from that
Fund. The Provider operating within the EOA must comply with the provisions of the
Agreement to be eligible for funding described herein.
II. ALLOCATIONS BY COUNTY
Each year, through the County budget process, the Board of Supervisors approves
an EMS Trust Fund budget that provides funding that can be used by Santa Clara County
EMS System stakeholders to complete projects that improve the EMS System. These
allocations are categorized and limited to only those projects reviewed by the Trust Fund
Advisory Group, the Emergency Medical Services Committee, and approved by the EMS
Director.
In FYI2, the County has encumbered $500,000 of the EMS Trust Fund for the
implementation phase of the County EMS System Data Project. This project creates a
common interface and data repository that allows the Provider and other providers to
report their data to the EMS Agency to evaluate response time, operational, and quality
improvement compliance. In addition, $58,000 from the EMS Trust Fund has been
approved to assist in the funding of the computer aided dispatch links to the response
time performance software package and hardware associated with the County EMS
System Data Project.
The County shall determine, in its sole and absolute discretion, the amount of
funds, if any, that shall be allocated to Provider pursuant to this Annex.
III. CONTINUATION OF FUNDING BEYOND FIRST YEAR OF
AGREEMENT
Provider must apply for EMS Trust Funds in each year for which it wishes to
receive funding. The County does not guarantee any funding.
In the event that the Emergency Medical Services Agreement, effective as of July 1,
2011, between County and Rural/Metro is terminated or this Agreement between the
County and Provider is terminated, all funding opportunities described within this Annex
may cease. Termination of funding pursuant to this paragraph shall be effective
immediately upon written notice to Provider, and Provider shall return to County any
911 Emergency Medical Services
Provider Agreement Annex C
Page I of2
funds which were allocated to Provider but which were unspent at the time of notice of
the termination in funding.
IV. PURCHASES AND EQUIPMENT
The EMS Agency must approve and the Provider must maintain a record of all
equipment purchased with this funding that includes a detailed description, brand name,
model number, serial number and location. These items may not be transferred, sold or
otherwise disposed of without approval of the County.
911 Emergency Medical Services
Provider Agreement Annex C
Page 2 of2
911 EMERGENC);' MEDICAL SERVICES PllOVIDER AGREEMENT'
B.ET\VEEN
CITY OF GILROY
AND
THE COUNTY OF SANTACLiARA
. EMERGENCY MEDICAL SERVltCES AGENCY
. This Emergency Medic,al.Scrvic.es Agreement (the "AgrcCHteut") is made by and
between the City of Gilroy ("Provider"), and the County of Santa Clara (the "County")
(collectively, the "Parties"), with respect to the provision of 911 emergency medical
services illihe County of Santa Clara.
RECITALS
'VHEREAS, the Emergency Medical Services Agency ("EMS Agcncy") of the
County of Santa Clara is responsible filr regulating advancc~d life SUPPOlt ("ALS")
providers within. Santa Clara County, and for authorizing the provision of ALS response
and transport within the County; and
WHEREAS, Health and Safety Code Section 1797.178 specifies that no persol1
or organization shall provide ALS or lililited advanced life support unless that person or
organization is atl authorized part of the emergency medical services system; (lJ~d
WHEREAS, pursuant to Health and SafetyCode Sections J 797.204 and 1798,
among others, the EMS Agency is responsible for system coordination, medical
o\lcrsight, and support Of the delivery of all cmcrgellcy medical services by provider
agencies such as the Gilroy Fire Department CProvider");and
WliEREAS, the EMS Agency and the Provider agree to cooperate with each
other for the purpose of delivery , rnaintenancc, and improvement of emergency medical
care within Santa Clara County and the areas served by the County of Santa Clara, in
order to meet the needs of Santa Clara County 9-1- I patients efficiently and
appropriately; and
WHli~REAS,the Emergency Medical Services System ("EMS System")
represents a colla.borative effort between the County, cities, districtsandothcr
stakeholders to assure for the timely and efficient response to emergency medical calls,
. .
and n)!" high quality patient outcomes; and
WHEREAS, the COUllty entered into a contract for Advanced Life Support First'
RespOllse and Paramedic Ambulance Transportation fCll'theCounty's EOA, ex.cluding
the City afPalo Alto and "St.anford L~lYcls" parc.els, with Rural/Mct.roofCalifornia, Inc.
for the period of July 1, 2011 through June 30,2016.
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.Provider Agreement
Page 1 of 13
WHEREAS, the EMS Agency, by this Agreement, wishes to designate Provider,
and allowProvidcr to operate within the Santa Clara County EMS Systemio respol1dt~
9-1-1 cmergency medical service requests.
NOW THEREFORE,.thc partiesagr~e as fol1o~rs:
. ARTICLE.I ...
, ~y.~ ~ ;:'
DEFINITIONS
.''? ~+ .
1.] Contract Administrator: shall be defined as the Emergency Services
Director of the Count)' of Santa Clara, .
.1.2 Contract Manager: shall be defmed as the. EMS Agency staff designated by
. the EMS. Director ~o act a~ the Immagerof'this Agr~emcnt.
. 1,.3 . Provider: shall be defip,ed as allY agency or entity providillgfil'st re~ponse.at
the basIC life support, limited advanced life siIpport, or advaJ.1C€{d lifeSUPPoi1: lcvd.
1,4 The definitiOns included in California Code of Regulatiolls, Title 22,
Division 9, Chap.ters.l~9; CalifOrnia Code of ReguIatipns, Title 13, Division 2, Chapter 5, ,
Article land the CalifomiaJlea]th and Safety Code, 'Division 2. 5, Chapters. 2~ II,. shall
. apply to this Agreement uIiless ihe Agreement indicates oth.erwise.
ARTICLE II
TERM/OPTIONTO EXTEND
2.1 Teinl of Agreement. This Agreement ~hallbe effective as ~f 12:00 a.in~ ,
July 1,2011 andshall bc iufarce and effcctfot a period offive (5) years thereafter,ul1til
11:59 p-m. June 30,201.6.. .
2.2 Option to Extend. . The County shall have the right to extend the'tenn of the
Agreement for two (2)additiol1al three (3) year periods if desired by Provider. The
Count)rmay excrcis'e its rightto ettend the ternl Of this Agreement by providing written
notice no less than one huiidred eighty '(180) days prioi to the expira,tion of the tenn.
Upon extension ofthis Agreel1ient, the Provider shall providc the sei'vicesset fOlt~ in:this
Agreement in aCCOl'dancewith the.terms in effecfimmediately prior to the cxtcnd~d term.
ARTICLE III
PROVIDER BREACH AND PROVISIONs FOR EARLY TERMINA TlON
. 3.1 ProviderBreach. Conditions and circumstances that constitute a. breach of
this Agreement include, butare:notlimitcd to; the following:
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Provider Agreenwnt
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3.1.1 Failure of the Provider to operate within the EMS system in a . .
. manner which enables the County alldthc Provider to 't;emain in compliance
with federal and state laws, rules and regulations, and\Jiith t.he requirements
of the S.anta Clara .county Prehospital Care Manual and any related rules
and regulations:
3.1.2 Falsification of infoI'-!nation or data supplied by the Provider,
. .
, " .
3.1.3 Acceptance pi' p~)'meIit by the Providcr or Provider's employees of
any blibe, kickback or consideration of any kind in exchange for any
consideration whatsoever, when such consideration or action on the part of
the Provider 9r Provider's ~mployees could be reasonably construed as a
violation of federal, state or 10ca1" law.
3.1.4 F allure to meet' the provision; identified in this Agreement.
3.1.5 Repeated .failurc of Provider to 'provide reports, and clatagcncrated in
the course of operatio~ including;.butnotlim~ted to, dispatch data, patient
report data, response time data or financial data, within the time periods
specified in the Agreement. ".
3; 1.6. Failure ofProvid~i to meet system standard of care as established by
the Medical D'iiector, following reasonable notice and opportUnity to.
address any such failure. . "
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. 3,1,7 Any failure of performance, qlinical or other,requiredin aCCordance
with the Agreemellt and which is determined by the Conti'act Adrrdnistrator
and confirnled by the EMS Medical Director to constitute an endangerment
to public health and safety. . .
3.2 .'.Declaration 6fMaterial Breath and County;s Remedies for Performance
Failures. If conditions or circumstances constituting a preach ,as set forth above arc
deterrriit:cd to ~xist; the County shall have all rights and remedies available at law or in
cquityunder the Agreement, specifically iti.cl1.l;ding.the right to tetilliri.ate the Agreement. .
. hl the event the County determines that ~ ma,terial breach hilS OCCWTed, the County shall"
provide reasonable notice of such breach to Provider. Provider shall have up to thirty
(30) days to either cure the bre.ach or provide evidence to the reasonable" satisfaction of
the County that a materialbreach does riot exist. TheCourity's remedles for material
breach includes but is not limited to the ability to terminate Provider's participation in
Annex A and Anne(( B of this Agreement. In the event the County determines that
conduct or nQn-performance poses.endangerment to public health arid safety, the County
may, in its discretion, decide not to allow the Provider to have a'curepcriod. .
3.3 Termination Without Cause. Either Party may terminate this Agreement at
any time without cause, by giving at least one hundred eighty (180) calendar days prior
written notice thcreoftb the other when not addressed otherwise in this Agreement.
911 Emergency Medical Services \
Provider Agreement.
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ARTICLE IV
SCOPE OFWORK
4.1 " General. The basis of this Agre.emcnt is i~he desire and intention of the
Patties to ei1.ablish and def1nethe roles ,and responsibilities of the EMS Agency and the
Provider relative to thy dclivelY of COmIJ1'ehcnsiye emergency medical care 'within Santa
Clara County, and Pr9viderdoes not waive or 1I1Odify any present rights up.dert.any statute
by its execution of this Agreement.. . . '.
4.1.1: This Agrc~ment in accordance with the intentions of the Parties, will
servc as a writtcnagreement as required under Title 22, California Code of
Regulations, Sections] 00] 67(b)(4) ,and 100300(h)(4), between the EMS
Agency and the Provider, for the purpose of developing and maintaining'the .
working' relationship betWeen the Parties~ and
4.1.2 This Agreement does not confe!' any l'ights, privileges or ownership
to the Provider to provide services and/or respond to medical emergenCies .
requested within any of the exclusive operating areas in Santa Clara County
that arenot expressly detailed herein or authoriied byother applicablehrws
such as th<;>se provided to public safety authorities, fire departments and/or
districts, etc., "
4.2 Non-Transport Emergency Adva.ncedLife Support (Paramedic) First
RespOlise Services. The Provider, by this Agreement, is authorized to continue to
provide'the following seryices: . " '..
NOI?--transpOlt emergency Advanced Life Support (paramedic) first-response
services in order to suppoit and/or auginent the services provided by RUl'allMetro within
the County Exclusive Operating Area. The roles.and responsibilities of theParties in
providing these services are described below. .
4.3 Roles and Responsibilities of the EMS Agency. The EMS Agency shall be
responsible for, but not limited to, the following:'
4.3,1 Perform EMS Agency responsibilities in a spirit of c6operation and
collaboration with the Provider,
4.3.2 Establish and promulgate medical cont.rol policies and EMS System
procedures consistent with federal and, state law and regulations, as well as'
County ordinances, policies' and standards.
4.3.3 'In accordance with the Health and Safety Code Division 2.5,
administer and coordini;lte the Santa Clara County EMS System,
. 911 Emergency Medical Services
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4.3.4 I;:ngage in efforts at local, state, and feder~llevels related to the
proem-enieltt of necessa.ry funding fo~' the purpose of maintaining the Santa
daraCounty EMS System, . .
4.3.5 Colhlborate with the Proviqer on. an ongoing basis 'to promote the
en11aIJ.Cenwnt of the Santa: Clara County EMS System.
. .
4.3.6 Provide access to standardizedEMSSystelll. p6liciesandlor
protocols as containeQ.ill the "Santa Clara County Prehospital Care
. Manual." '.
4.3.7 In ae,cordance with Title 22 of the Califol1ua Code of Regulations
~tndas approved by the EMS ,Agency, implerncn,t an EMS Quality . .
rnlp:rovcment Plan (EQIP)as a 1)J.eans of evaluating c1inic;il emergency
mediCal services provided. .
. .
4,3.8 Manage the hospital radio system or equivalent and provide'access
to the County Emergency,Medical Services COJ:nmunication System '(the
Provider shallbercsponsible for the cost for equipment.us.~d by the
Provider to includeprograiilming, niaintenarice,. and replacenient),
4.35) Assess compliance with policies and procedures of the EMS System
b? means of schedi.11~d revjews, which may include site visits of Provider's
program.
)
4,3.10 Assess the Provider's emergency medical services program by
observing, through field observations and/or atteIldance at the Provider-
offered training, exercises,orientatiqn, or other programs, Routine site
visits wiifbe scheduled betvv:een t11e Parties, when approptiate.
4.3,11 lIicOli.sultation with various EMS System stakeholdercom.niittees
.and providers, coordinate a comprehensive emergency medical.services
data collecticm system; which includes required data deme~ts, data analysis,
report ge.i1~ration, and other details related to ensuring the quality ofthe .
EMS System. .
4.3,12 In collab.or~tion with the Provider, may participate in research
endeavors ar~d other programs, 'including, but not liniited to, pilot studies.
4.3.1~In accordance with Health and Safety Code Section 1797.153,
coordinatealld a\l.thorizeMedicalHealth Mutual aid through the authority
of the Medical Health Operational AreaCoorq.inator (MHOAC).
. .
4:3.14' The EMS Agency/Coooty EMS Medical Director shall. establish and
provide medical control by means of the following:
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Provider Agreement
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1. Develop alldapprovc medical protocols in accordance with Title
22 an:d otherpolicies pertaining to base hospitals, paramedic and
EMT perso1111el,EMS service providers, and thc EMS Agcncy,
2. Whencver possible, .significmit systetn~wide changes will be .
adopted 011 an annual basis to ensmethere is. sufficient time for
advance plmming and the training of all personnel. This may include
Clinical protocols and orders, and master plans.
3. Ensure Provider compliance with all applicable state and federal
laws andrcgulatiolls, including but not limited to, confidentiality and
disclosure, narcotic tontr()l, mandator)> hcalthcare reporting, as
related to thc provisi6n' of services undei' this Agreement.
4. Consult with thcProvider Agency Medical Advisor through the
EMS Agency's Medical AdvisOlyComm,ittce to develop written
medical policies and procedures.
4.4 . Roles and Responsibilities of Provider. Responsibilities of the Provider
under this Agreement shall include the following:
4.4.1' Respond to requests for emergency medical services within
.... .. .. I
Provider's authorizedju,risdictionincluding those established through
automatic and inuuml aid agreements.
4.4.2 Perform responsibilities of Provider in a spirit of cooperation and
collaboration with the EMS Agency and tbe County Exclusive Operating.
Area amb111ance providyr,
4.4.3 Implement arid insure adhereilce to the policies, guidelines and
procedures-of the EMS Agency as sct forth. in the Santa Clara County
Prehospital Care Manual and all other,policies, procedures and guidelines
related to emergency medical ser"ices providers.
4.4.4 Complywith all applicable state and federal laws and regulations
with respect to tbe provision of emergency medical services in Santa Clara
County.
4.4,5 Place authorized units into service as identified in the County's asset
permitting process and operate units as authorized.
. . )
404.6 Equip each approved ALS/paramedic unit with at least one.pOliablc
radio capable of voice communications with base hospitals and transportable
to the patient's side for the purpose of receiving direct medical' control frotn .
the Base Hospital (currently, Santi Clara Valley Medical Celi.ter).Each radio
s11a11 meet the technical requirements as specified by the EMS Agency.
911 Emergency Medical Services
Provider Agreement
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4.4.7 Equip ea~h apprO\ied ALS/par~medic alld.BLS unit with atlc~st one.
portable'l'adio .capable of voice eonimunicatiolls with Santa 'Clara County
Communi.catiops on the designed emergency medical services dispatch,
emi1l1i.arid; and tactical chaIlllel.s; the EMS Agen~y; and Rurall1\1etro forthe
pUTpose of EMS System.cOol'dinl:1tion,. . .
. . .
. .
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4.4,8 , l'r~yide'r:agrees tb be Sllbject tom~(Ucal control by the 'lo.calEMS
agency, asspecifie'd inHealth & Safety Code Section 1798 et seq;,alidshall.
comply with p9liCies and procedures' enacted by the ~ocal EMS agency ill
. the administrati,on ofthe local EMS System, anci to bcsubject to the.
,Provision of medical direction' 'by the c.omi.ty to the Provider as related to the.
provision of Basic Life-Support Seivices at t4c Emergency Medical.
Technicial11evel that exceed.Health and. Safety Code Sections 1797.182 and
1797.1'83 as applicable.
'. .
4,4.9 Have a designated physician or 'cquivalentlicensed provider (nurse.
. practitioner or physician assistflllt) approved by the EMS Mecj.ical.bii'ector
to address quality impi'ovenient ml'!-tters. This position is riot authOl'izedto
provide medkal directiori, but is to assist in clinical assurance and
contil1uous .quality ll1anageinentactiviiies. If a non-physician is designated
above, a physician shall be retained to authorize narcotiC procurement and.
control ~s required by law. . .
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4.4.10 . In collaboration with the EMS Agency, Providertnay participate in
research endea'Vors :and other programs1 jnciuding; but not limited to, 'pilot
sUidies~ .
4.4.11 In accordance withHealthai1d Safety Code Section i 797.153 access
aU Medical Health: (EMS) Mutual Aid throu~ theMedical~ea1th
Operational Area Coordinator (1'v~l~IOAC) via the County EMS Duty Chief.
1. This includes; but is not limited to reque~ts for ambulances;
medical pers6nnel~.supp1j~s, equipm~nt,and services. .
2. Mutual aid related to param:edic staf~ed appariltus, othe1' than
ambulan~cs, Rhall be inanaged through th~ Operationalj\.rea Fire and
Rescue Coordinator. The Operational Area Fire and ~escuc
Coordinator shal1notif)r the EMS Duty Chief as soon as possible and
'pr.actical when paramedic resources are requested from orin to'the
. County. ..
3. In or~er tofilcilitate cmdcoordinateappropriate Operational Area
Mutual Aid effectively and efficiently ,nothing in this agreement .
shalllimittbe ability of the Operational Area: Fire and. Rescue
.' Mutual Aid Coordinator and the Medical Health Operational Area
911 Emergency Medical Services
ProviderAgreenient
}lage 7 of 13
,",I'ill;
Coordinator frani agreeing. to an alternative resource request process
that will bCllcfitthe OpcratiOllal Area:
4.4.12 Maintain,. in accordaIiye with ;lpplicable State law, licensing,
certification, andacctedltation of all ALS and basic. life support pcrsoi11lel.
. .
4.4.13 The EMS Systcni (or otherrepla'ccmcnt systeIl') approved by the
.. . . ~ounty) shall be. online 'and avail~~ble to djspa~ch cen~cl' pel:smmc~ at all..
tlrnes and/or .avall11ble through a lmk to a computer aIded dIspatch.' system or
trl'\l1sm:itted limn EMS System via electronic data transfer to fieid persomicl
asappr6ved by the County. . .
4.4.14 Provider will participate in the Bay Area 'Urban Area SecUl"it)' .
Initiative funded,. CAD-'CAD/CROP project in.order to transmit CAD data
from Provider to. COU1Ity ComillUilicatioris. Thetr81ismissici.ll of data is to
reduce call pl~6cessing time thus reduCing ambulance resPQnse thiles. ahd to
. provide performance data reporting to the County. . Provider agrepsto
cooperC\.te withCourityCoinn;mnications to completeimplementalion of
fire/medieaICADprograniming. Should Provider discontinue participation
in fhcproject, Provider agre,es toimplemcnt,at provider's cost, no less than
a one-w'ay CAD datalinkfrolh Provider's dispatch center to County
COlnmuniCations by June 30,2016.
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4.4.15Coordiuate themitigatiOli of potential ot actual emergency evcnts
with the EMS Agelicy (through the EMS Duty Chiefor -other assigned staft)
when a Ine(jicalor health threat exists.
4.4.16 ~rocess emergclicy medical seiviccs.calls through aCoiinty...
Authorized EmcrgencyMedica,1 Dispatch (EMD) program in atcord;illce
with Santa Clara County Prehospital Carc Manual. .
4.4,17 D.eliveron-scene care'supportively and cooperatively with
. Rural/Metro and/or other E~SSystem participants. This may include, but.
is not limited to, accompanying the patierit to the 'hospital in the ambulance
when necessary, .
4.4,18 Actively participate in disaster and eniergencymedical services
surge plarmingarid related drills, simulations, and exercises quarterly, as
resources alloW,' .
4.4.19 Respond to the best of Provider's ability and to the extcnt necessary
and'appropriate to any disaster, emergeiwy medical.scrvices surge yvent,
proclaimed or not. '.. .
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4.4.20 Ensui'e 'Provider's personnel remain current and competent in the
performance of EMT and/or paramedic skills as applicable. .
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4.4.21 Coordinate routine pt1blic infOlmation as related t() the services
providedtUlder this Agteemcnt with the Cotillty.Jncident related public
i'nformation shall bel1ia~laged in accordance with the Standardized
Emergency]\1anagemeilt Syste1n,
4.5 Advanced Life Support Emergency Ambulance Services.' Public safety
responders (department ofpublic:safetylfire departments) provide the niajority'ofbasic
and' advanced life support fil;stresponder services in the 'County; theCoulity' s Exclusive
Operating .Area agrecnient with Rural/Metl:o docs not enable fire dcpari111cnt providers to
provide ambulance 11"ansportatioil under routine circumstances. . The uSe of fire
department ambulances shall be operated in accordance with Santa Clara C~unty
Prehospital Care Manual and in accOl'dunce with Annex A: Santa Clara County EOA Fire
Department Emergency Ambulance Authorization attached to this Agreement and
incorporated by reference. .
4.6 First Responder ]lunding. The Provider is eligible for firSt rcsponder
fun4ing.Performal1.ce criterili required to receive fuilding is identified ill Annex B: First
ResponderFundiIig in the Santa Clara County ExClusive Operat~ng Area, attached tothis
Agreement .and incorporated by reference. .
ARTICLE V
INDEMNIFICATION AND INSURANCE
3.1 hldemnification.Provider agrees to defend, indemnify, protect, and hold
County and its agents, officers, aIld employees harmless fr6mand against any and all '
claims. asserted or liability established for damages or injuries to any person or property,
. including injury to County's oiiProvider's employees, agents, or officerS which arise
froin,orare caused, or claimed to be caused by the acts, or omissions of Provider and its
agents; officers, in performing, providing, manufacturing; or supplying the work.,
serviCes, piodnct, or equipment relating to this Agreeme~t, ~nd all.expenses of
investigating and defending against same; provided, however, that provider's duty to
indemnify and hold harmless shall not inClude any claims orliabilityaI1.shig from the sole
negligence or willful misconduct of the County, its agents, officers, or employees.
5,2 '. Insurance, Provider shall comply wi'th the insurance requIrements attached
as Exhibit H.
ARTICLE VI
COMPLIANCE WITH STATE STANDARDS AND COUNTYEOA
. .' .
6.1 Compliance with State Standai-ds. The Parties agree to cOl11plywith the
Califomia Health & Safety Code, including, but not limited to, sections 1797 .201;
1797.204; 1774.124; 1797.226, as they now existoras they'may be amei1dcd from time'
911 Emergency Medical Services
Prov,ider Agreeluenl
Page 9 of 13
to Lime, Should any amendrnei1t o1'l11e Hcalth & Safety code materialJyaftcct Ihis
Agreement, the Parties may consider amending this Agreemcilt.
6,2 Compliance 'Y!t11 Coull\Y.-BOA. This -agreement maybe amended from
time to time or immediately if tb~ County's ag.-eement wilhltural/Melro is modified nr
tcrinmated, to ensure Its apphcatlOn to then currcnt condltlOns, pOhCICS, and Protocols
and provisions oflhe County's Exc1usiveOperatillg Area. . .
A:RTICLEVII
MISCELLANEODS PROVISIONS
7..1 Entire Agreement. This doculUent represents the entire agreemeJlt between
the Parties. All prior negotiations and written and/or oral agreements between the Pmiies
with respect to the subj eet In'atter of thc agreement are merged into this Agreement.. .
7.2 Governing Law, Venue. This Agreement has been executed and delivered
in, and shall be constriled and enforced in aCcor~ance with; the laws Mthe State of
California, Proper venue for legal action l'egardingtltis Agreement shall be in the COUllty
of Santa Clara. .
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7.3 Assignment. No assign,ment of tllis Agreement or of the rights and
obligations h~reundershaIl be vaW without the prior written consent of the other Party.
7.4 Waiver. No delay or failure to require performance of any provision of this
Agreement shall 'constitUte a waiver of that provision as to that or any other instance.
Any waiver granted by a Party must be in writing and shall apply to the specific jllstance
expressly stated. .
. 7.5 Independent Provider Status, This Agreement is not intended, and shall not
be construed, to create the i-elatiOliship of agent, servant, employee~ partnership, joint
venture, or association, bctweeneithei" Partyto this Agreement,. The.provider
understands and agrees that all Provider employees rendering prehospitaJ emergency
medical c.are seivices under this Agreement are, for pUrposes of Workers' Co~pensatjon
liability, employees solely of the ProvideI' and not OfColmty,
7,6 Notices. Any and all notices required, permitted, or desired to be given
. herelmder by one Party to the other shall be in writing and shall be delivered to'the other
. PaityelcctronicaIly and either pcrsbnally or by United States mail, certified or registered, .
postage prepaid, return receipt requested, to the Parties at the following addresses and to
the attention of the person named.
The EMS Agency Contract Manager shall have' the authority to issue all notices
which arc required or pennitted by County hercu11der: Provider shall address all matters
related to this Agreement, ilicluding notice, to the Contract Manager. Addresses and
persbns to be i10tified may be.changedby oneParty by giving at 16ast ten (1 OJ calendar
days prior written notice thercof to the other,
911 Emergency Medical Services
Provider Agreement
Page 10 of 13
Notices to County shall be addressed as follows: .
911 provider Contract Manager
County of Santa Clara
Emergency Medical Services Agency
976 Len'zen Avenue, Suite 1200
San Jose; California 95126
. .
Notices to Provider shall be addressed. as follows:
Tom Haglund, City Administrator
City of Gilroy
7351 ROSalU1a Street
Gilroy, California 95020
7.7 DisputeResolution,
1)
The Provider shall name specific indIviduals within the Providcfs
agency, upon execution: oHhis Agreement, who are authorized to
assist the EMS Agency with dispute resolution under this Agreement.
2)
The Provider shall respond to WIi~en requests ofthe EMS Agency for
informati6n regarding any perceived dispute within five (5)business
days, unless otherwIse mutually agreed, following receipt of such
'req'.1est, .
3)
The Provider is encouraged to resolve normal day-to~day operational
concems directly with involved parties (other EMS System providers,
hospitals, ete,), If a dispute is not resolved at this level, the Provider
may" refer it to the EMS Agency-Contract Manager for fUlther review .
aild action. .
4)
Disputes perceived by the Provic.ler to have'a system-wide impact
should be referred directly to the EMS. Agency.
\,
7.8 No Third Party Rights. No provision in this Agreement shall be constnied
to confer any rights to any third person or entity"
. .
. . 7.9 Partial Invalidity: if fat any reason, any provision ofthis Agreement is held
inv~lid, the remaining provisionS shall remain in fuH force and effect.
7.10 Amendment. No. addition to or alterationofthe terms of this Agreement,
w1,J.ether by written or verbal111lderstanding of the Parties, their officers, agents, or
. employees, shall be valiqunless made ill the form of a Written amendment to this
Agreement which is forn1ally approved and executed by the Parties.
911 Emergelicy Medical Services
Pl'Ovider Agreement
Page 1l of 13
,,7.11 County No,Smokil1g Policy~ Contractol' and its employees, agcIitf-l and
subcontractors, shall comply with the County's No~Smokiil1;?; Policy, as set f01ih in the
Board of Supervisors Policy Manual seCtion 3 A 7 (as' amended from time to time), w11ich
prohibits smoking: (1) at the Santa Clara Valley MedicalCentei' Campus and all County-
owned and operated health facilities; (2) within 30 feet: surrounding C()uniy-:owncd
buildings and leased buildings where the Comity is the sole occupant, and (3) in aU
CouJ:ity vehiQles. .
7.12. Debarment. ProviQ,cr certifies that (i) cn1ployees who provide servic,es
hereunder have notbeen convicted ofa criminal offense related to health care and that
they areuot listed by any federal or statc agency as debarred, excluded or otherwise
ineligible fol' patiici.pationin federal or state. funded health care programs; (ii) Pr.ovider
has perfonnedan appropriate screen of these cinployees prior to making this eeltification;
and (iii) it will screen ,all new eli1ployees who provide services under this Agree:ment. .
Pi-ovider cCliifies that Provider has not been convicted of a crimillal' offense related to,
health care, nor is Pl'Ovider listed by any federal oj: state agen~y 'as debm.Ted,exCluded or
otherwise ineligible for participation in federal or state funded health care progral'l.1s,
Providetagrees that if any of its employees providing services under this Agreenieiit ai-e
cOIlvictedof a crime related to health care or debarred, such employees shall be.removed
from anyresponsibHity or involvement in the provision of servicesurider this Agreement
once the criminal conviction or debarment i~ final. Provider shall notify EMS Agency of
the pendency of Slich, charges' or proposed debatmentor exclusion against it oraga.iIist
Provider's, employees,. Provider will indemnify, defendandh~ld harmless EMS Agency
for any loss or damage resulting from Provider's or Provider's employees' criminal
conviction, debarment or exclu~ion. .' , .
7.13 Nondiscrimination. . Parties shall comply with all applicable Federal, State,
and local laws and regulations. Such laws include but are not limited to the followiIig:
Title VII ofthe Civil Rights Act of 1964 as amended; Americans with Disabilities Act of
. 1990; The Rehabilitation Actof 1973 (Sections 503 and 504); California Fair
Employment arid HOllsing Act(Government Code sectiol1S 12900 et seq.); and California
Labor Code sections 110 1 and 1102. Patties shall not discriminate against any
subconti'actor, employee, or applicant for employment because of age, rac,e, color,.
nationalorigin,an.cestry, religion, sex/gender, sexllaI orientation, mental disabilitYl
physical disability, medical condition, political beliefs, organizational affiliations, or
marital status in the recruitment, selection for training including apprenticeship, hiring,
cmp1oY1'Pcnt, utilization, promotion, layoff, rates of pay or other forms of comp,ensation,
Nor shall the partics discriminate in the provision or services provided und,er this contract
becauseofa:ge, race, color, national origin, ancestry, religion, sex/gender, sexual
. . orientation, mental disability, physical disability, medical condition, political beliefs,
organizational affiliations, or marital status.
911 Ernergcncy Medical Services'
Provider Agreement
Page 12 of 13
IN WITNESS WHEREOF, this Agreement is entered into this}-)H~day of :Tu, \'~
2011 by the County of Santa Clara, and the City ofGilioy.
Provider Authorization for Emergency Ambulance use within the Santa Clara
County Exclusive Operating Area
First Responder Funding in the Santa Clara Comity Exclusive OperaJing
Area .' , .
Insurance
.COUNTY OF SANTA CtARA
,By:
.. {"01!l2:; ~tl..l(1I
DanPeddyconV .
Public Health Department, Director
APPROVED AS TO FORM AND LEGALITY:
By:
APPROVED:
By:
(I
Emily son
Deputy County Executive
~F~ILROY.' . .. .... . .
By: ~/\/'--
1'0111 Haglund .
City. Administrator
APPROVED AS TO FORM
By:
1 . ....)
X" '/ /t? 12
__.2 . 1-<A1r:t. Ce!.(.' .~'LA-
J61ida Callon
Berliner Copen
Attachments:
Annex A:
Annex 13:
Exhibit II:
911 Emergency Medical Services.
Provider Agreement
Page 13 of 13 .
\ .
('
)tXIUllIT H
INSURANCE
":t"
I, msurance .~nd Indenmi~cat~o~ll
.. Without lill1iting the Contractorus' indemnification tQthe CO.Ullty, the Contractor
. shnUprovide aild maintain, at its sole expense, durlngthe term of theC()ntract. or as may be
further requited herein, the following insurance coverages and agreements:
. A. Evidenc~ of .coverage.
Prior to conu.uencement of llie Contract, the Contractor shall provide aCeruficate
ofJn~urance certifying that coverage as required herein ha$ been obtained. The County"s
. Special Endorsement form shall accompan,y the certificate. Indlvidualertdo.rsements execuieq
by the insuranCtcamer piayl;Je substituted for the COUt;lty' 'sSpecialEndorscment form if they
pl'ovlde the cO.vei:age as required; .In addition, a certifi~copy oithe polley or-policies shall t>p...
provided by the Coritractor up~>n request. ..
. Thl$ verification of coverage shall be' sent to fuerequesting County depirtment,
uriless otherwise directed. . The Contractor Ilhall not receive a Noti9~ tQ ProCeed with the work
\ltider the Contract until i~h;\Sobtained.al1 insurance require~and such insurance.hl1$.been~'
approved by th,e CouJlty~rhis approval of insurarice shall neither :relievenord~reil$e the '.
( .. liability ofthe Contractor. '
B. j)u~1ifYingInsu~rs.'
~,..'
. .. AU co~eri.tges,exc~ptsu~ty,- shall beissued by companies W&1.Cll hold a."'
currentpolicyholder"s alphabetic andfirianCial size categoryratirig of not less than A v, .
according to~e cUrrent Best" sKey Rating Guideol' a company of.equal finanCi~ stability that
, is approved bYtl1oCounty':'s InsurancelRisk Manager. . ' , .
C. .. Insum,\ce Re<nIired '
1.
. .,
. Conuneroial General liability Insurance
a. Coverage Limits
, .
!.
Contractor s~all oblain.and maintain ~ommercial general
, liability insurance for b9dily injury (including death) and.
. property damage which provides liirots as follows:
(i)
.(ii).
(Hi)
Each occurrence . $5,000,000
General aggtegale $5,000,000
ProductslCompleted Operations aggregate ~ .
. $5,000.000
1
,,,
.~
(iv) Personal Injury
$5.000,000
..........
A minim~m of 50% of 'each of the aggregate limits.
mustremalnavailable at all times unless coverage
is project&pcclfic. .
b. Scope of Coverage
General liability coveragesh?Jl include:
(0 PremJ,ses and Operations,
(ii) Products/Completed
'. :'. ,'.' ~ ,
(ill. . ConttaoWalliability, expressly inCluding liabilitY'
assu~edundeI this Agreement. .
, .
. (iv) Personal Injury liability
. (v).
Owners'~ and Contractors" Protective liability
. . .
, .
(vi) . Severability of interest
. .
c.Endu~ellleI1ts .
Gerieralliability coverage sh~iinclude the following
endorsementsi copies of which shall be provided to the .
County: .
(i) Additionallnsured Endorsement:
In..' surance afforded by this policy shall also apply to .
. the County,andlllembers of the Boacd of' .
. Supervisors of the County, and the officers, agents, ..
. and employees of the <;ounty, individually and
collectively, as additional insured. . Suchirisurance
shall also apply. to anyml,1nicipality arid fire district.
in which the work occurs and they shi\ll be named'
on the policy as additionaliilsured (if applicable).'
2
~
2. i'~utom9bi~1iaQility lnsunmcc<
'r
ContractorshaU obtain and. InifI)tain automobile liabilityinsunmc:e for
bodily injury (indudhig death) and property damage Which provides total
limits of-not les~thanfivem;,llion dollars ($5,000,000) combined single
limit per occurrence applicable to all owned, non-owned and hhed.
vehicles.':- ..
\, !
~.- "...- '-.':'
3. :YVo(kers'" COmpensation...g,nd Emplm:.cr"s LirtbilitilDsurance
a. Coverage: Contractor shaH obtairi and maint...'lin the
following coverages: ..
'"
'(i). Statutory Califomla Workers" Compensation
coverage including broad form all-states coverage.
(ii) Elll.ployert' s Liability coverage for not less than one
million dollars ($1,000,000) per occurrence.
(
(Hi) Coverag~under the United States Longshoremen"s .
and Harbor Workers" Act shall be provided when
applicable. .
4 . Prof6ssiQnal Error.p and Omissions Liability Insurance
- Contractor shall obtain and maintain professional errors
and omissions liability insurance as follows:
a. Coverage.
(i) . Coverage shall be in an amount of not less than five
million dollars ($5,000,000) per
occurrence/aggregate.
(ii) If coverage contains a,deductible or self-retention, it
shall not -be greater than fifty thousand dollars
($50,000) perQCcurrencelevent.
b. Claims Ma,de Coverage
If coverage is written on a claims made basis, the
Certificate of Insurance shall clearly state so. In addition to
3
, .
coverage requirements above~ such policyshnll provide
that:
(i)' Policy retrQactive date coincides withorpreceQes
th~ CQn~~t()l''' s stlUt of services (includillg, "
.' subseque~tpoHcies pu~chased a.s renewa1s~l;
replacements). "
(Ii)
Contractor will make ev.eryeffort to mainWn
siinilar lnsutanc:e during the requiJ:'C{i extended
period of coverage following conclusion of the
Contract, inc1udlng the requirement of adding all
additional insureru,~ .'
,:i
(m) -Ifin~urance iSterp1inat~ fOrimy.~asol1t Con~a~.tor
. " a~s topui'9has~' an extended repO~hg provision
of at least' two (2) years to. report Claimsarl~itig' .
from. wo,:kperformedinconnection witbtlle
,Contract.
(
(iv)Policy allows for reporting of citCum.stances Qr
. incidents that might rove rl~ to future claiIns.
5. ' '. Special Provisions
TheJoUowing'p~visions shall apply to the Contract
. '
a. The forego.ing requIrements as to the tYPes and. limits of . .
insunmce coVeragetCi:be inaintain~ by the Contractor and
anyappioval.of said ins~ce by the CQuntyof its .. .
insurance cons'!lltant(s) ,are notintend~.d toa:nd shall not in
atlymanrter linut .or quallfy the iiabilltiesimd obligations
otherwise assumed by the C.ontractor pursuant to the
Conn-a.cti including but not lirriitOd\o the provisions
concerning inderrmiflcaUon. .
. b. The County aclmowledges that some insurance ,
reguiJ:ements c.ontained.in tneC,ontract may befulfiUedby
self-insurance .on the partoft~e Contractor. However, this
shallnot i1) any way Hrnifliabilities assumed by the , .
Contractor under the C.ontract. Any self~in$urance shall be
approved {n wrllingbythe Countyup6n evidence of '
. financial capacity satisfactory to the Couilly" s insurance
4
manager.
c.
Should any otHic worl~ under the'Contract to the ex.tent as
. permitted uuderthe contract be sublett the Contractor shaH
requir~ each of its subcontractors..ofany tier to carry the "
aforementioneci coverages, or CoritJ.'actormay bisure '.'
subcontractoJ;S underil.S oWn policies.
..
.:;.
-'
I.
5
Annex A
, Pi'ovider Autho~jzation for Emergency Ambulance Use Within the
Santa. Clara County Exclusive QpcratingArea
,,'J.' Purpose
This AIUlex is intended to authorize a pub lip fire departmcntwith existing .
emergency ambulance transportation capabilities, operating within the County'Sel'Yice
Area BOA, to continue to providetransportatibn serviCesin order to augment the services
provided byRural/Metr~, . The use of fit'c department emergency ambulances is intended
to provide a "safety~net" to the .SantaClara County EMS System.
Nothing intllis .A1mex sl.1alllimit the ability 'ofthcfirc' department to respond to
calls using a fire department emergency ambulance as an emergency response vehicle.
This Annex IS intyrided to codify when and how a fire department emergency ambulance
maybe used for the transportation of patients..
This Allnex and a~sociatedSanta Clara County PrehospitalCare Policies shall
replace all previous Agreements related to the use of Supplemental Transport Ambulance
Resources (STAR) by Provider in theEOA.', .
Th~County does not require imy fire departmentin the County to provide any
emergency ambulance services whatsoever except where stipulated in this Agreement.
II. Authorized Use
Afire department may not operate an emergency ambulance without the approval
()fthc EMS Agency. Any such operationshal1 be a violation of the ~ou.i1ty's Exclusive
Opcrating Area. All fire department emergency ambulances:under this Agreement shall
be considered part of the Medical Health Mutual Aid System. -
. .
Departments may use emergency ambulanccs as an en1ergency vehicle for purposes
of responding to sCrVice requests as authorized by applicable law. If). these cases, as long
.as the resource js not scrvin~ or has been requested as ~ 'emergency ambulance, it shall
be considered part of the Fire/Rescue Mutual Aid System.
The Provider shall pay for an ambulance service permit including individual
ambulance unit permit fees approved by the Board of Supervisors, to the EMS Agency in
July of each year. .
III. lIitended Use
The use offire department. emei"gehcy ambulances to provide patient transportation
~hal1be permitted when (1) immediate life saving transportation is required, or (2)
911 Emergency Medical Services
Provider Agreeinent, AnnexA
Page 1 of7
material failure of RuraVMetro when emergency transport is required, or (3) delay of
RuraJ/Metro when emergency transport is required red lights and sirens ("RLS")or (4)
when approved by the County EMS Duty ChieforCOllllty EOA EMS Field Supclviso:t as
identified in Santa Clara County Prehospital Care Policy 614: Fire Department
Emergency Ambulance Use (which has been attached as Exhibit 1) and maybe modified
fl:om time to time consistent with Santa ClaraCounfJ;Preho8p~tal Care Policy #109.
. ,
, ,
Iti addition to Provider-initiate.d:use of fire dcpattment emergency ambulances,.
Provider agrees to assist the Cotmty as identified below: '
When requested by the County; only the requested fire department emergency
ati1bulance (s) shall respond. Other reSo\u'Ces routinely dispatched with fire department
emergency ambulances within their home jurisdiction shall !lot accompany County-
requests for fire department emergency ambulances whellleaving the home jurisdiCtion.
. .
COl.mtywide EMS
System Impact
Countyw~de EMS
System Impact
MedicallIealth Mutual
Aid System in the
Region
Specialized Resource
Need withhdhe '
Operational Area
Cost of Service and Billing
, ,
(Standard Dispatch Ordel'#l1}From time to tin;l.e, Standard'
Dispatch ()rdernumbers maybe revised.
(Standard Dispatch Ord.er #12) From time to time, Standard
Dispatch Orderllumbers may be revised,
Regional Medical Health Mutual
Aid is requested and authorized
by the Medical Health : .
Operational Area Coordinatbr.
}>rovidet may make
emergency ambulances
availablc for Operational "
Area response when
requested by County,
The County may request ftre
department emergency
ambulances when thc need fOf a
specific resoW'ce would benefit
the County.
. Provider may make .
. emergency ambulances
available for Operational
Area response when
. requested by County.
The cost of fire department emergency ambulance services is the sole responsibility
of the jurisdiction.
Provider shall bill for, and make reasonable effdlts at collecting fees, for ambulance
services provided either directly or through a third party biller which mayincIude
911 Emergency Medical Services
Pj"oviderAgrecment,'Annex A'
Page 2 of7
Rural/Metro, Unless specified in'Ulls Agreei.ncnt, Provider mainot provide
eompleil1entary or reduced billing for tri.msportation services ullless. such relief is
provided in a County approved procedure feir those that may be impcivclished or unable
. to provide immbdiate payment for services rendered. . "
Provider D1ay not bill for ambulance response when a patient is .not trallsporteQ .
except whellspec:ifically authQrized by the Couhtyot asauthori.z;edbyothei; applkab1e
, law, ordinance, 'oft:egulatton, An example may Include, but is 'ubi liIhited"to;respondillg
to a funded SEMS mutual aid request
In the event that Provider is not able to cal1eeler bill fora transport, the County
shall riot be responsible for any tostsunless the County had authorized payment prioi' to
use,
". ..
The Providertnay only.billat the rates established by the County that are equal to
those a\lthorized under the County's agreement with Rural/Mctro. Provider agrees that it
~l1'use practices siliiilar to those used for billing.and collecting.that are used by
RtiralIMetro. . , . .
Provider 'will submit copies of all bills for ambulance service provided under this
Agieementand evidence of anlount actually collected to the EMS Agency in July and, .
December of each year,
. .'
'Provider sball obtain and maintain a Medicare and MediCal provider number/status
and any and all other certifications that are necessary to legally bill for the services
provided. .' .
. The Medicare and MediCal provider number/status shaH only be used for serVices
provided under this Agreement.
IV. Fire DepartmentEmergency Ambulances
In addition to any. standards identified in Santa Clara County Prehospital Care
Policy, fir~ departmcl,1t emergellcyambulances spall: . .
(a) Bear the approved County of Santa Clara Emel'genc)' Medical Services seal,
iuat least 12 inch diameter, on both sides of the ambulance in an area .
approved by theCounty~ The word "ambulance" shall not appear on the
vehicle and all previously required lettering and wording must beremovcd
prior'to July.i. 2011..
(b) . Be numbc;;redand typed accqi'ding to County EMS Standards to faCilitate
integration ihto the countywide ambulance system, Thjs nuinbering and
typing shall not infringe on FIRES COPE standards, The County has approved
the terms "Medic" and ":R.escueIMedic" as acceptable identification for fire
department emergency ambulances. . .
911 Emergency Medical Services
Provider Agreement, Annex A
Page 3 of?
(c) Be limited to no more than 1 fire departmcnt emergcncy ambulances in
service, For purposes ofthis provision, "in service" shall mean a fire
department emergency ambulance used to respond to emergency calls as 3n
ambulance for transpOltation. Increases in the number of fire department
emergency ambulances must be authorized by the County, .
V:'. ,Communications
In addition to the requiremcnts identified in Santa Clara County Prehospita1 Care
Policy, fire department emergency arilbulances shaU be equipped with radios capable of
communicating with the Santa Clara C0U11ty Communications and on designated
frequencies. This shall include a mobile radio and at least one portable radio.
VI. Training
Provider will work collaborativcly with tile EMS Agency and Santa Clara County
Comnllmic'atiolls to develop a fire department emergency ambulance orientation and
review program for Provider's personnel, Rural/Metro, and other EMS System
participants. This program will be provided to the County and shall be updated from time
to time.
Provider will participate in at least two full-scale or functional exercises per-year, in
cooperation with the Rural/Metro and the EMS Agency to practice AmbulanceStrike
Team!Task Force operations. The EMS Agency will cooperatively schedule training
annually. This training may be included as part of other exercises as long as ambulance
operations are included.
VII. Response Times
Provider shall maintain records in order to provide dispatch, arrival on the scene,
departure from the scene, aITivalat hospital, and time available for each emergency
ambulance response. These tiriles shall be reflected on the patient care record.
VIII. Patient Care Record
A copy of the patient care record shall be provided to the County when a transport
oceul's.
IX. Non Ambulance Transport Requirements
Provider shall not require ambulance transportation for patients that arc not in need
of transport by ambulance and Provider shall offer various non-transport options to
patients as approved by the County.
911 Emergency Medical Serviycs
Provider Agreement, Al~nex A
Page 4 of7
X.Marketing and Information Materials
. . , . . .
Ail marketing anq information related to J:>rovider's emergency am,bu1al),cc sCl'vice
must bc approved by the County and contain theSanta Clara County EMS System logo,
XI. Requited Staffing.
. .
Fire departmcnteinergency amoulallcesshaUbe staf{edwith at least one Santa'
Clara County Acdedited Paramedic an.d one State certified Emergency Mcdical
Technician that has coni.pleted the required training identified within this agl:eement.
. XII. Supplies
. The replacement of equipment and supplies used to treat and transport the patient is
the sole rcspollsibility of Provider. . .
Billing for such supplies to the patient shall bein ~ccorqance with the fee schedule
approved for RurallMe'tl-o (Refereuce:' Exhibit M,. Table 2 of ErnergencyMedic~1
Service~ Agrein~ent between RuraliMetro ofCaUforriia, Inc. and County afSanta Clara),
Xllr.Utilization Review Process
. .
Fire Department emfirge;ncy ambulance use will be' reviewed by the EMS' Agency
Contract Manag~r. The EMS Agency has established ,a' mechanism for review of all fire .
departincntf.r~nsports covered under this Agreement.. This process is.~ontained Within'
. the Santa Clara County Prehospital Care Manual, Reference Section which may be
m04ificd from time to time. ....
. .
. TranspQrts executed in vioI~ticm of the established criteria may result in penalties as
identified'in thetablcbelow, . .
Second violation $5,000.00
within 12 months,
. .. pemiltyid'-be'dei>Ited 'fro~ 'thefirst.respbhder"
incentive payniellt or by direct payment to the
Count for de osit to the EMS Tlust Fund; .
J?enalty to be debited from the first responder
incclitive payment or by direct payment to the
Cowi for.de osit to.the EMS Tmst Fund. .
Penalty to be debited from the first respolider
incentive payment or bydjrectpayment to the .
Coull for deosit to the EMS Trust Fund, .
Third (and beyond) $5,000:00
violation withi1l12
m011ths..
911 Emergency Medical Services
. Provider Agreement, Annex A
Page 5 of7
-------..-.----- ..-.. --.------......" ..--.'".
Fen.trth violation
wit.hin ]2 months.
$5,QOO.00 pcr
occurrence *
Penalty to bcdebi.tcdfrornlhe firstrcspOllder
incentive payment or by direct payment to the
County for deposit to the EMS Trust Flind,
*In addition to fitles,the provider's ambulance
permit may be censured including suspension or
revocation,
XIV. Payments for Damages
Provider shall make payment to the EMS Trust Fund within thirty days of
notification by the County.
. . If Provider receives First ResponderFunding as authotizedinthis Agreement Ulider
AIUlCX B; liquidated damages will first be deducted {rom Providers aimual fundi1Jg
allocation. Ifdarrmges exceed the annual aIl1ountauthorlzed forProvider's First
Responder FlUlding; Provider shrill make d.irectpaymcritiotheCounty.
, .
. , ,
. A late payment chiu'ge oftc~percel1t per..:mol1th wm be assessed by the County if
payIi1ent is liot received.by County on or before the 30th day ifpaYlnent has not been
debit~d fronlthe first respol).der'fu1lding allocation.
Failuretoillgkc payment within thirty days may result in suspension or
discontinuation of Provider's authorization to provide emergency ambulance seryices.
xv. . Appeal of Decision
, In theevent that Provider disagrees with the Contract Manager's detennination,
related to appropriate use and/or issuance ofliquidated damages, a petition niaybe made'
to the Ambula~lce PennitOfficer within thirty (30) calenclar days of receipt of Contract
Manager's de~ision. . '".
(:-)
":~ '
The petition must be submitted in writing and contain the basisfor the appeal, any.
appropriate evidence, and requested remedy.
The Ambulance Permit Officer niay request additional infornlation or base a
decision on niaterials that have been provided. by the Contract Manager and Provider,
The decision of the Ambli1ancePermit Officer shall be final. .
. - - . .
XVI. Annual Review .
Am1Ually, the County shi:111 provide a report to the Board of Supervisors that
describes the utilization' of fhe' depaltment emergency ambulances within the County
Exclusive Operating Area, This report shall include, but is rtotlimitcd to, Provider
'adherence to this 'agreement, evalu:ition of need and necessity for the service provided,
911 Emergency Medical Services
Provider Agreement, Antlex A
Page 6 of?
and actions taken by Rur,allMctro to remedy any variances that may have caused the
need for fire department emergency ambulauce transportation.
XVII. .Desigllat~d Liaison
Provider shall identify a liaison between the County EMS Agency al1d Provider for
routine,ll1attersrelatcd to t11cprovisions of this 'agreement-c.. .
XVIII. EMS System Orientation
Provider shan assign a representative to participate in the Santa Clara County EMS
System()rientatiol1 program to assist in teaching the 1110dule related to fire depattment
cmergclicy ambulances as agreed upon by the Parties.
"'-'Ix. Ambulallce Locations,
Annu~l1y proviqei- shall notify the County of the. locations wJ:ier~ Provider's
. eniergencYarnbulallces will be.toutinely stationed.
. . .
. . .
Provider may station emergency ambulances at any location,butshall notify. the
County when the location ofroutillely statioIled ambulances is changed,
XX. Tennination,
"
In additioll to the Terminationlj~ovisions in this Agreement, Jhe following
. provisiollsapply to this Annex:,: The provisiOliS containedwithin 'this Annex shall expire
at the same titne as the Agreement.
The Pai:ties further agree that the Santa Clara County Board of Supervis.ors, by' a
majority vote, mayimmediately,tenniriate the provision of services-under this Annex at
any time at their sole and absolute disCretion. .
E.xhibits:
Exhibit L:. S anta Clam County Prehospital Care Policy 614:Fire Department Emergency
Ambulance Use '
. .
Exhibit 2: . Santa Cla~a County Prehospital Care Form EMS #902: Fire Department
Emergency Ambulance Use . .
911 Emergency Medical Services
. Provider Agreement, Annex A
'. Page 7 of7
. . . .
FIRE DEPARTMENJ,EMERGENCY AMBULANCE USE
; ,"..
Effective Date
Replaces
July 1,2011
January 22, 2007
I. Purpose
. To establish Policy for the use of fire department emergency amb,ulahces.
,in the Santa ClaraCounty and the Palo Alto Exclusive Operating Areas for.
use by field responders.
. I .
Adherance to the detailed provisions required for.authorization of fire '. .
department emergency ambulanCes is the responsibility ofthe County and
fire department providing s~rvices;notthe field providers. This Policy is .
intended to provide only the ope'rational information necessary for field
providers wOrking with fire, department emergency ambulances.
II. Appficability
. .
A. Fire Department Emergency Ambulanc,esauthorized within the
Palo Alto Exclusive' Operating Area are not subject to the provisions
of this Policy.' .
B. Fire Department Emergency Ambulances .authorized within the
Santa ClaraC6untyExclusi\(e Operating Areaare not intended.to
provide routine transport services. They are intended to serve as
an addfffon,altransport resource during times when County's
contractedambulance provider is delayed as identified in this
Policy, . . . ,
Santa .Clara County E~ergency Medical Services
Prehospital Care Manual - Policy 614 .
Page 1 of 4
~ 'I
III. Authorized Fire De"partmentEmergency Ambulance Tr~n!;PQrts
When the folloWing Grit~ria are met, patients may be transported by fire'
department emergency ambulances:. .
A. Fire departments may initiate the transport of patients ifthe their
authorized emergency ambulance isonthe scerieandthe patient .
preserlts with the need for immediate Hfe~saving transportation (with
red lights/siren) for conditions.such as:
. . ,.
. .
1. .' The patient is inneed of a red Iights/~iren transPbrtto the
ho?pitari'ind the County ambulance hasnotarrived on the
scenewithineighte~n (18) minutes; or
. .'
.' .
2. Cardiac or respiratory arrest; or'
. . .
3. Uncontrollable airway/inability to ven"tilate; or
4. Patient MeetsSTEMIAlert Criteria;-or
5, Pc;ltieritMeetsStroke AI$rt Criteria; Or
6. PatierttMeetsMajor Trauma Victim Criteria; or .
7. If the patient is.inneed of immediate transportation, after
appropriate on-:-scene care and/or aSSessments due to a
condition that will only benefit from immediate transport.
. .
S', The .county may authorize fire qepartmenLemergency ambulance
transport in the following conditions:
. . .
1, When authqrized py the l::Ms Duty Chief reg(:i.rdless of
circumstance~ The EMS DLityChief may designate authority
'. for authorization to the County EOA EMS Field Supervisor.
,
. 2. When authorized by the County EOA 'EMS Supervisor during
a MPMP Level 2 activation or greater, or when fheEOA
ambulance ha$ mechanically failed on the scene or in route
to a call.
Santa Clara County Emergehcy Medical Services
Prehospital Care Manual- Policy 614
Page2of4
~- ~':... '" , .
~ ,.." "
G;'" Authorized fire departments shall respond to requests by the
County in the following circumstances: .
1, Standard Dispatch Order #11 is implemented
2. Standard Dispatch Order #12 is implemented
0, Authorized fire departments may respond to requests by the
County in the following circumstances: .
:");' .~c.
1. Requests for out~bf-County Medical-Health Mutual Aid
2. Requests for specialized resource needs within the County
IV. Operations Considerations .
A. Communications.
1. On scene fire department per$onnel (which may include the
firegepartments dispatch center) shall be responsible for
requesting thE;! estimated time of arrival of the County EOA
ambulance prior to initiating patient transport,
2. Once the decision to transport has been made, fire
department emergency ambulance personnel shall notify
County Communications on the C<;>untydesigned radio
channel. The ambulance shall aSsess hospital availability
prior to transport and then continue to status with County
Communications to include "transporting", "arrived at
destination", and "available", .
3, Fire department emergency ambulance personnel shall
adhere to all applicable Policy related to hospital
communication and notification,
Santa Clara County Emergency Medical Services
Prehospital Care Manual- Policy 614
Page 3 of 4
B. Scene Considerations ..- ..
. .
1,ln the event that a patient!TIeetingthecriteriaidentified in
Section III issecuredtQ~he ampulance gurneyandthe
COuiltyEOAarnbulancearrives on t~e scene,' the fire
department eniergencyambulance shall transport. '
. .,
, .
2, In the event.thatthe circumst~mCe desCribed in Section IV,
B,10cCUI'l?,; and. thepqtiel1t reqUires additional paramedic .
care ,or stqffing;the'CqLlntyqEQAambulance paramedic shqll
. accompany the patiehtiri.thefiredepartmentemergency' '
ambulance .it appropriate. .'
'C. Reporting
1. On scene fire department emergency ambu!ancepersonnel
shall complete. EMS Form #902 iliili1ediately following
transport.' This form shall be routed to the County Contract
Manager after review by the d.epaitments' authorized
representative but Withi.n 10bUsinessdays.'.
Santa Clara County Efl1?rgency Medical Services
Prehospital Care Manuai ;... Policy 614 .
Page 4 of 4 .
~~~
STI;P1: " ,'. '" '.
T!letrailspOliing Paramedic shall select which .2.!:!Q...ofthe foHoWlngcriteria W[iS used to make a transportation
dete~millat!<;in: . '" "
, .
Fire Department'iriiHate,d Ti'amHiort " .
TinwC<;J1Jnty EOA Ambulaoce ETA was req\.IEisted: . .ET A provided:
,. .' '.,.. ..."...' ,." ""l'-'C, , " '. . , .
o (IU.A.1) ,The palient;is Inn~ed ora red If9hts/sirelifranspoli to the hospit<:1landtheGourity EOA AMEH.iLANCE HAS NOT
ARRIVi::D on the sceneWITHIN.18 MINUTES. ' ',. '. '. . . , ,'. '
o (IH.A.2)C<.lrdiacor respiratory ARREST
o (IIIA3) lJncontrolh~ble AI RWAY or hiabilityto vEmtilate .
o (IILA.4;S,6) STEMIALER!or S'r~9KEALERT or Major Trauma Victim (MTV) ALERT
. . . . . .
o (III.A. 7). ,If the patient is in n~ed ofinlm~diate transportation, afterappropr!ate on-~cenecare and/or assessments due to a
conclitionthat will only benefitfron:lirrimedi<;ifetran~port.
. . '. .'. . . .' '. ~ . .,' .
County Authorlzed,TransDort, "
0(111..'3.1 Jc:;qUNTYEMS 'DUlY CHIEF , .
O(1lI.~.2) couNTY EOA EMS SUPERVISOR . ,
Seled Reason: [) MPMP L$vel2 or Greater 0 Mech<.lnicalFailure
STEP 2:. .
Attach the followina dOCUments: . . , , '. ... ',. . . ,
o Patient Care Record ,,0 CADRecord with times (dispatch, oriscene. transport, at hospita.I, available)
STEP 3:. ,
Complete the follovylng:'
Name Of Pfjrariledic Completing Form:
Signature:'
Date:
STEP 4: '
Fire Agenyy Statement _
As an authortzeddepartnient official, I verify that this use of a fire department emergenqy ambuli!lnce was appropriate;
Represeritative'sSigna[ure& Date: ' ,
STEP5 '... ".. , ' . '
Subn1it'to the Santa Clara C'oLinty EMSAgency Cqntract Manager within ten (10) husinessdays,
Meets Utilizatici.n Critefia:O Yes . 0 No' .
Contract Manager's Signatl!re & Date:
Ailnex B
, !?i.-st Responder Funding i.ntbe .
S~nta Clara County Exclusive Opcr~tingA.rea
I.PURRQSEOF FUNDING
. . .
This .A1mex is intended to Identify the criteria and processes related to Provider
access to available firstnisponderfunding within the Santa Clara Cou~ty Exclusive.
Ope:ratil.1g Area (EOA): .Fire depa11ments operating within the EOA must be compliant
with the provisions ofthe'911 Emergency Medical SenJices Provider Aireem(!nt in order
to be eligible foi- the flmding opportunities afforded herein.
Provider's participation ill this funding oppOltunityis voh;mt?ty; However, i.1lorder
to receive f'llnding,: the performance criteria detailed herein-lDust be met Providers that.
choose to terminate the Agreement shall be re~ponsible for any'liquidated damages
incurredwhilepel'fonni.ngundel: the Agreement, and damages shall not exceed the
allocated funding. .
In the event of termination of the agreement betwyci:tthe County and Rural/Metro
or termiIlation of the Agreement between the County and Provider, all applicable fullding
opportunities wiil Cease. -
. Fun.ding is provided for nieeting specific performance. standards that benefit the
EMS System.. ' . .
II, ALLOCATIONS BY COUNTY
By July of each year, the County will issue a notice indicating the maximum
amountoffun(jing avai1~ble to ea,ch Provider. . The amoUnt of 'eligible fundin.g will be
. . . ..
determinedus~g a formula that considers, but is not limited to, illcreases in EOA
atithbrizedbilling charges, C-onsumer Price Index changes, and the Provider's EMS call
. volume. Aimualallocations may .increase; remain the same, or decrease.based.on EMS
call volume (defined as an EMS call where County BOA ambulance was dispatched),
available funds, damages leyied, and other factors, .
. .
. lncl:ellses to first l:esponderfundingwill be determined based 011 Section 3.5 First
Responder Fees. of the Agreement between the County and Rural/Metrci.First responder
program~l1dingshall be subject to increase annually by 3/5 of the authorized rate oUhe
ainblllan~e fee increase. . For exainple, if ambulance rate~ increase by 5 perccnt, the -first ..
responder stipend will increase by 3 percent that '~_ame year. lithe ambulance fees do, not
increasc,prograin funding will not decrease. However; thc County shall determine the
exact al1<?catlon to Pr'lwider based Oil the formula c1es~tibcdabove.
911 Emergency Medical Services
P~ovider Agreement Annex B
Page 1 ~f J 2
"'if,
Any unused allocation of first responder program fU1lding will be deposited into the
EMS Trust Fund annually,
. First responder funding will be allocated in two areas; CategoryA: EMf) Resource
Management anclCategOl]J 1J: Rfsp011se TimePeifornu1l1ce, as specified below. .
CategOlY A fimdingallocations will be base~ on EMS Gall volume during the past . .
. . calelldaryear. Category A funding avai1ability;&orthe fil'styearofthis Agreement will
be based on Calendar Yea~'201O EMS volumemsreportcd to the County through the .
reviewproce'ss used under the AMR contraeUsllbeolltractwhieh expires June 30, 2011.
Catego'ry B funding will match the amount providedto eligible responders through the
AMR subeontTact tbat expires June 30,-2011. .
The EMS Agency shall verify compliance with established standards l;I.nd
agreements prior to authorizing the payment of stipends, RurallMetro shall make
quarterly payments (in I1rrears) equal to .0I1e- fOUrth .of the annual stipend to each Provider.
The pay.ti1ent will be adjusted for debits and darnages. .
Ill. CONTINUATION OF FUNDING BEYOND FIVE YEARS.
If Providers wish to request that the first responder funding programcoiltinuesin
the next County EOA service agreelnent (beyond June 30, 2016); a proposa1must be
submitted to the EMS Agency Director by December 31, 20l36r later as detemiined by
. the EMS . Agency.
It is re.commended that the.. SantaC...laraCClunty..' Fire.,. Chiefs A.ssociatiofiparticipate
in developing reQoinm,endations that address collective fire serviCeissues in addition to
any city/department specific :prbposals, At a mininium the proposal must inc1uq.e the.
total amount requested, rational for continuation of funding eligibility, exact performance
criteria that will benefit the entire Santa Clara COU1ity EMS System. .
P-rClposed performance standards must be specific, measurable, attainable; relevant,
and time-bound, The proposed methodology must detail how funds would be.distributed
to participating departments, liquidated damages structures, and/or other financial
considerations,
Nothing in this AgrecD,1entshall eliminate the ~bility of each fire department to
submit individual recommendations in addition to the collective proposal identified
above. .
. .
.IV. CATEGORY A: EMS RESOURCE MANAGEMENT,
The purpose of ~ategory A (EMS Resource Management) is consistentwith
utilizing CAD to CAD data and associated reporting ofeventclata as well as tlw
continued use of Emergency Medical Dispatch (EMD) and the Medical Priority Dispatch
System (MI>DS) to more effectively and efficiently deploy and utilize emergency medical
resources.
911. EmergeJ)cy Medical Services
ProvideiAgreement Annex B
Page 2 of 12
"'<
,')'
CategOl'Y A funding is calculated using the following fomiula:
[Total Fl~llds Allotted for EMS Resource Management] -+- .
[Previous CalCndal; Yem' Total EMS EventS for all First Responder Agencies] x
[Previous Calendar Year Total EMS Events for Individual First Responder Agency] =
[Total Allotment for Current Calendar Y ear].
:t ......
Example: .
[$100] -+- [50] x [10] = [$20]
Allotted Funds CY 1 0 cy 10
CYli
In order to receive funding, Provider must meet the perfon:hance staildards
described herein.
Pcrforri1ance standards in this section'iridude the following:
. .
1. Reduction in Unnecessary Ambulance Response
2, EmetgcncyMedical Dispatch AsSessment Project
3. Use ofM6dical Priority Dispatch System
A. Redudion in Unnetessary Ambulance Response
. In ()rder to better all<;>cate County EOA ambulances~ Provider agrees to cooperate
with the County and RurallMetro to reduce unnecessary ambulance dispatches aneVor
canCel ambulances when'appropriate: . .
. IIi order to facilitate this process, Provider shall submit bjaimual reports ,
demonstrating a review of all calls that resulted iIi no patient being transported, . At a
minimum this report shall contain (1) total nUll),ber of responses where a patient was not
transported, (2) the reason the patient was not trlUlsportcdl and (3)' the Medical Ptiorify
DispaJch System determinant. that was used if known, Analysis of this data by th~ EMS
Agency will emtb1e the review of policies and procedures so that adjustments maybe
made ifnecessary.
The Provider agmes to work cooperatively with the EMS Agency to develop and
implement operational practices to continucnisly reduce inappropriate ambulance use.
. Providers are requir~d to submit the report by thelast business day in Jal}uary
(petiodof July-December) and July (period of January to June) of each year. If Provider
fails to provide the report, damages of $ 250.00 per-day or portion thereof, may be levied
by the County, up to a maximum of $2,500.00 pe,:- reporting period. No funds will be
madG available to the Provider until the reporl is submitted to the EMS Agency.
911 Emergency Medical Services
Provid~:l; Agreement Annex B
Page 3' ofl2
B. Emergency Medical Dispatch Assessment Proje.ct
The purpose of this projcCt is to determine the 1110St effective use of Emcrgency
Medical Dispatching (E.MD) and Medical Pri.ority Dispatch System {MPDS) use and to
identify ob.kctivc criteria and establish bencl1marks that may be used to improve system
. efficiencies 'and patient outcoines, In order to develop Ii coni.pl;ehetlSive reconunendation
to the EMS Agency, Provider agrees to cooperate with the County;,and .RurallMetro to
assess.and 1n,ikerecommendations related to t~le use of EMD alld/or MPDS. The
intentioll of this project. is to help provide funding to Provider to work with the EMS
Agency t6 develop, implement arid revise the Santa Clara County Prehospital Care
Manual and/or standard operating procedures related to EMD. Provider agrees t6
collaborate with the Santa Clara County Fire Chiefs Association to make
rccommendations to the EMS Agency related to this project: The EMS Agency shall
coordinate this effort and will include other appropriate stakeholders as ilecessary.
C. Medical Pl'iority Dispatch System U~e
;.::fr
The use and reporting of MPDS is a critical t601 in assessing the type of EMS calls
processed tht;ough a dispatch center. In addition, the provision of pre-ani val medical and
safety instructions to the callerfromthc dispatcher is a key component in starting medical
care as soon as possible.
As fire departments are cUlTe:i1tly using MPDS, the following performance
standard"s apply for eligi)Jility for funding in this section of Category A funding.
Period
Fiscal Year
2012
Standard
In addition to pre-arrivalinstructions, the Medical
Priority DispatCh System is used to initiate call
triage no less than 30% of the time when use is
os sible and a ro date..
In addition to pre-an-ivaI instructions, the Medical
Priority Dispatch System is used to initiate call
triage no less than 35% of the time when use is
ossible and a ro riatc.
In addition to pre~airival instructions, the Medical
Priority Dispatch System is used to initiate call
triage 110 less th1).1140% of the time when use is
ossible auda ro riate.
In addition to pre-arrival instIuctions, the MediCal
Priority Dispatch System is used to initiate call
triage no less than 45% of the time when use is
ossiblea.lld a 1'0 date.
Validation
YeslNo
Fiscal Year
2013
Y cslNo
Fiscal Year
2014
Yes/No'
Fiscal Year
2015
Yes/No
911 Emergency Medical Services
Provider Agreement Annex B
Page 4 of 12
I Fiscal Y ear
2016
,In l:idditiontb pre~a1Tival instructions, the: Medical
PriodtyDispatch Sys~em is used to illitia~e call ,
triage no less than 50% of the ti)1le when use is
.possihle and appropriate. '
Yes/No
t'
. C.! Validation/Required Reporting:,
Data reporting for Table 1 shall include (1 Jihe tbP:tl EMS calls peH1~0~ith,(2) total
n1imberofcalls that were processed using MPr>S,ancl (3) theMPDS calldctemlinanf
. that was used, ,The dat~-musi be incornputer-readahle fOl1n~t, suitable for statistical
, ami lysis and integtate with "FirstWatch;'. Once CAD/CAD is it). place, reporting may be
autolnated. Provider will have 60 days to irilplel1l.ent Cluinges to required reporting.
elements, ". .
C.2 Liquidated Damages:
, .
:rrbvid~rs are requjred to submit the repQrtbythe last~usine~s day in J<inw=\ry. , . '
(period of July'- De.eember) alldJ~ly (period of Janu\lry to June) of each year:.,' If :provider "
fails to provide thereport, damages Of $ 250,90 per:'day or portion thereof, may be levjed
by the CountY, up to a maximum of $2;500.00 per reporting period. No. fundswillbe
niadeavailab1e to the Provider untiLthe report iss1ibmitte1to the EMS Agency. .
If Provider fails to meet the :requir~ments~ontained in Table!, 50% of eligible'
Category A funds wi11be.dedu~ted.:for each D?ontl1Where co:tnp~iarlce vias riot achieved,
and the amountbf datnMesdeposited in to th.e EMS TrustFUild. The. mnount of damages
shall noha exceed the'totafavaila.ble' Ca~g~ryA'f'u~ding allotation." ,
. .
, ,
. .
. Within,any consecutive twelve. mo'ri.thperiod, three or more OCCUITe11CCS of meeting ,
less than the required peJ::centage ill Table 1100% ofthe remaining eligible funds will be
dedl.i.cted as a pena.ltYaiJ.d'pia~ed into the EMS TrustF\llld.Continuation of the Provider
, in the Category A ft.mding eligibilitywillbe;restored uponPr~)Vider meeting the .
standards prescribed in Table .1 for no less than three consecutive ll).cinths,andwill beat
the sole discretion of the COUIity. .
{' .. . . .
V. CATEGORYB: RESPONSE TIME PERFORMANCE
- .
. Each participating Pr<)Vider must meet the response time criteria included in Tables
3, 4, al'l.d 5 alldprovide at least one panimedic.percresponse ciassified as Charlie, Delta,
Echo;Q:t a response that h\ls 110t been classified and has iInplemerited Emergency Medical
Pispatch{Medical Priolity Dispatch System) in accoidancewith Santa ClaraCoun:ty
Pioeh6spital Care ManuaJ Shall be eligibleJo;rfundmg. '
Providers not pl:ovidi11g para.medic level service and/or those not opeioating in
accordance'withSaJita Clara County Prehospital Care Manual related to the clinical
aspects of emergency medical dispatch shall not be eligibleforfun<;li11g. . An annUal
alloca.tion willbc held inteserve should the Su~ltlyvalebepaitment of Public Safety
911 Emergency Medical Services
Provider Agreement Ami.ex B
.../ .
Page 5 of 12
implement a paramedic progrmil \vithinils jurisdiction, Until that time, theJunding will
be deposited i11to the EMS Trust Fund and used for Countywide system cl*allcements.
The fuilds !lhall not accrue for use by City of Sumiyvale, Depaiimentof Pu blicSafety:
"
A.. Compliance Performance Standal"d .
Satisfactory compliailce is ,achieved whcn 90 percent or marc of responscs,ineach ,
code of response (both Rcd Lig4ts'al1dSirells llud non-Red LigiltS and Sirens) mcctthe..,
specified response timc rcquii:ements. The C~unty e!icol.l1~agesProvider tei utilize EMD
t6 make the best use of its Advanced Life Support units,. Provider is encouraged to .
implell1~nt Basic Life Support First Response to 911 emergency medical services calls.
that, are Classifledas Alpha lind 1;11'avo level calls. . .
., . .
Urban, Suburball alld Rural/Wilderness classifications are defined by population
density, Tab1e.2 identifies the fonnj}ia fordetelInining each classification...
SubUrban
Rural/WIlderness
<50
T bl 'R
T' R
'. 'h U b ;R'
zo
" I
, Provider
DIspatch '1\1': N
('I 't"' '1 aXIl11U11l DICS
aSSl IcatlOn .
- Res ul1Se Tune
MPDS.... .'
Classlficatiol1: Al ha
MPbS.. .
.qassificatjon:Bravo
MPDS",
Classification:
~harlie
MPDS'
Classification: Delta .
MPDS .
ClaSsification: Echo
Non-: Triaged or
NOli-MPDS
Classified
12:59
7:59
First Response unitALSoi,'7)LS."
First ResponseunitALS orBLS
7:59
First Response ALS ,
7:59
First Response ALS
7:59
First ResponseALS
7:59
First Response ALS
911 Emergency Medical Services
Provider Agreement Annex B
Page 6 of 12
.,.
,1.1 .
T bI 4 R'
T' R
t.thSb b R
z
. . I
'1 PrOlidcr -'
DIspatCll, "\.,
CI '1- :'I I ,1:\ Ill1Ul1l '..,OkS
, aSSI lC<ltlOIl _:
R~s )onsc llln~ -
MP))S.
Classification:'Al ha
MPpS . ,
Chi$Sificaiion:"B!'avo .
MPDS
Classification:
Chl:irlie
MPDS
Classification: Delta
MPDS .
ClassificatiOll: Echo
No:n~ Tri~ged or
N6n-:MPDS
Classified
14:59'
9:59
'Fit'st RespbnsetinitALSdr 13LS .,'
First RGsponse unit Ai:;s or.BlcS
9:59
First Response ALS
9:59
First ResponseALS
.9:59
First ReSpOllSC ALS
9:59
First"ResponscALSu, "
ThIS R'
11
R ".
'fh R
.-,
1 ' dWild "Z *
I I
Dispatch , PIO\'idcr
Classi ricH i~'ll I ~laxilllulH l\oh:s
Rcspul1:>\? TJlBC
MPD$.:- ' " u '. ., FYtst'Resp{jDSe\ihii 4fS6rBL$' ,'. " , ~.'
21:59 "
, C1~ssifi9ation: Alpha' ".
MPDS..' 1,1:59 .First ResponseuriitALS or BLS
Classincation: Bravo
MPDS First Re~pon$c ALS ,
Classification: '11:59
Cha1'lie , .
MPDS 11:59 First Response ALS
ClassificlJ.tion: Delta ,
MPPS 11:59 First Response ALS
Classification: Echo '.
Non- Triaged or 11:59 First Response ALS
No:n-MPDS
Classified
"':",
* Hard to serve areas apply,
B. Response Time Measurem'ent
The following methods shall be used to measllre responsetil}les.
91 I Emel'ge1}cy Medical Services
. Provider Agreement AOllCX B
Page 7 afol2
c. Re:;;pollse Time Clock
.' For purposes of measuring response intervals, the Response TiIAe Clock (RTC)
shall be tile tinie displayed by piovider's Computer Aided Dispatch (CADfsystem.
D. Time Jntervalsfor Response Reporting
Response intervals will b~;rneasmed frOlTI ~he'tlmethe caUisdispatched by the
PSAP until the Provider's apparati.1sarrhies:at dispatc11ed incident location:. Response
time intei-vals many also be measured using technologie.s such as GPS, A VL,proximity
repoj-ting, etc. as approved by the County. In situations where Provid.er has responded to
a location othcrthatldireetly to the scene (e.g. staghlg ai:eas' for hazardous scellcSs or non-
sj)ccitlc highway locations),arriva) "on scene'~sh~U be thc tillie that Provider's apparatus
an-ive's at the designated staging point or other location.
A "dispatch" shall be defined as the broadcast; by any means, of (1) incident.
location or suspected location and (2) unitidciltification for a (3) known or suspected call
for emergency medical sei-yices. .
Provider may issue atl "alert" prior to the dispatch for the purpose of preparing
rcsponsepersonnql and decreasing response time. An"alert" shall be defined as a.
b:roadcl,l.st,l:>Yliny mearis, of (1) incid~nt location or SUllpected 10catiQnaIld(2) .'
infonnatioii that. indicate an emergency medical resp otis e may b~necessary. The
selection and notification of a speCific up.it shall constitute a "dispatch", not an "alert". If
an "alert" is 110t cancelled or changed Into a "dispatch" within sixty (60) seconds of
initiatio11 i1:sha11 constitute a "dispatch". ..
. .
JfProvider's unit fails to report "on scene/' the time ofthenext corriiTI':Irtication
with Proyider'sdispatch center willbc used as the "on scene" time unless other County
approved validation systems are in place to accomplish the saine tracking (AVL, GPS,
Mobile Data Computers,. etc;).
Medically tl'aincd first responders, law ,enforcement officers, authorized
comumnications 'center personnel, and the County may initiate downgrades or
cahcellatiOll of Provider response to mediCal calls. This shall notJimit the Provider's
ability to continue, callccl, or nlOdify their resources response to the incident.
If Providet is cancelled by an authol'izedagency, after an assignment,has been made
but prior to the arrival, the r~sponsetiil1e clock will stop at the moment of cancellation. If
the elapsed response time at the moment of cancellation exceeds the response time
rcquiremel1t for the assigned priority and zone of the ca1l, the unit will be determined to
be "late," . .
Ifan assignment is downgraded prior' to arrival to the scene, the lower priority
response time stand aid will apply.
911 Emergency Medical Services
Provider Agreement Annex B
Page 8 of 12 .
. .
If an assigmnent is upgraded prior to arriv1'(ol1 the scene, the response time clock
will rest a.t the timethe upgrade is dispatched and compliance with :response time
standards will be the shorter of (a) the non-Red Lights andSilcllS .(RLS}response
. reqllirenient measured fr'9mthe time the'unit was originally dispatched, or (b) the RLS
response times measured from the time of the upgrade,
. .
. .
. -. -
Ifthe elapsed response 'time' aLthe moment of cancellation is l~sthan the response
time requirel11ent for the assigned prio:rityarid urhani;latibn codii~g of th~ call, the. '
providers response time shall not be included in the aggregate overall fTactile tespcinse
time compliancc;but will be reported monthly to the County. .
E. Response Time Exceptions and Exemption Requests
The following responses are automatically exempt from response time calculations:
. Responses outside th~ County's EOA;. Respon~es in estibiished Hard to 'Serve Areas
(HSA) as identified inEMSPolicy 830, as the salliemayhe flI~cnd.ed or renumbered .
.from time to time;an.d/oi substaIitiatedProviderdispatch.centerfailui:es,.
. Equipment failures, traffic congcstio;l, unit mechanical fai~ures,and inability to
staffunits'and otherca1.1sesare not automatically grounds for granting .all exemption to
compliance with the respons~ time;l'eqtiir~ments.
In the case of a MUltiple Patient Man;lgement Plan Activation 1101' greater,
. response time perlormance maybew~lived'bythe County. ..
ill the eVel}t of a proclamation oflocal ef!1ergeilcy or disaster within the Prav,ider's
dist~ict or. city or by th9CO\lnty of Santa Clara; response time performance may be
. waived by the County. '. '" .
. .
" ..
If Provider believ~s. thaI any response Of" group of responses s~ould be excluded
from the compliance calcUlations due .to ''ul1usual factors beyond the Provider'.s
reasonable control," theProvidern:iay"provide detailed. do cunl.eIltati on . and request that
. these runs be excluded froml,'esp<nise time calcuiations alid associatedqamaMs. Any
such requ~st mi.1st be made'iriwritinga.nd in accordance with the County's Exemption
Review Process, Ex~mples niay include, but are not limited to, greater alarm structure or
. wild land fires, provisionofhlUtUal aid. . .
VI. LIQUlDA TED -DAMAGESFOR FAI~URE TO COMPLY
ThePrbvider understan4s and agrees that the failure to cdmp1y with any
performance standards or other requirements in this Annex will r~su1tin loss ofhenefit to
the .County and that if will be impraCticable' to determine the aotual arriount of damage
whether in theevei1't of delay, nOnperformance, failure to meet standards, or any other
deviation. Therefore, the'Providerand Countyagre'e to the liquidated damages specified
. in this Annex, .
911 Emergency Medical ServiCes
Provider Agreement Atmex B
Page 9 Of 12
.." I'
It is expressly understood and agreed that the liquidated damages amounts are not to
be considered a penalty, but shall be deemed, taken and.treated as reasonable ~stimate of
the damages. It is also expressly understood and agreed that County's remedies in the
event of the Provider's breach or any noncompliance, are not limited to this Almex.
Chronic failure to comply with the response time or other performance requirements may
constitute breach of contract
Superior, response time performance during one pmt of the moptlFshall not justify
inferior response time performance during the r~waillder of the morith.
. .
. .. Responses to requests fOl: service originating outside of the Proyider's service area
(excluding automatic aid agreetn.ents) will not be counted in the number of total EMS
calls used to detenlli.ne response time under this Agreement.
When Provider responds to another Provider's jurisdiction as part of anexeeuted
automatic aid agreement, the entity holding authority for response shall be responsible for
insuring response time compliance and shall pay any applicable datilages, All automatic
aid agr~erilents related to response t9 EMS calls tnustbcprovided to the County annually
for the purpose of verification of respoilsibility for EMS service coverageJo a given lueas
within the County. '
VII. LIQUIDATED DAMAGES FOR LATE RESPONSES
Liquidated damages will accrue for each response that exceeds the response time
requirements.
Table 6: Li. uidated Dama es forRes ouse Time Non-Performance
RESPONSE TIME PERFORMANCE LIQUIDATED
DAMAGES
. Pei'.Res<),Qse.. .
Up to 2:59
3 to 4:59
5-9:59
10 - 14:59
15 - 19:59
20 - 24:59
25 - 34:59
35+
Up to 2:59
3 to 4:59
5 - 9:59
10 - 14:59
15 - 19:59
20 - 24:59
25 ~ 34:59
35+
9] 1 Emergency Medical Services
Provider Agreement Annex B
Up to 2:59
3 to 4:59
5 - 9:59
10 - 14:59
15 -19:59
20 - 24:59
25 - 34:59
35+
.$50
$100
$250
$500
$1,000
$2,500
$5,000
$7,500
Page 10 ofI 2
, .
. . ProVider's late 'responses will accrue fines up to, but not exceeding, the amount of
the allocated fii'st i"esponder fun4ing for Provide!'; The liquidated damages amount shall
increaSe according to the number of minutes the unit is delayed pastthe mandated
response time.
VIII. PROVIDER FINANCIAL HARDSHIP
,:."...,~ ".
"I{Provider experiences all unusual hardship , r.csultin:g- from the, accumulation of
liquidated damages that extend~ ,qe,yond t4ree (3) reporting periods related to the inability
to meet the establishedrespollse ti111cperfonnancc Cliteria, and has implemented a .
con-ective action plan, the Provider may ~ub111it a writtenl:eqm:st for temporary f111ancial
reHefto the Colltract Manager. .
This request must clearly identify the reason for ilie bardship, a proposed corrective
action plan (must inch~de actions that have already been completed and additional
reme<,iies), and timeiine'for meetingccimpliance~
. At a mi~imum thereqllest must inClude how the Medical Pribrity Disp!,\tchipg
. System (MJ:'DS) has been implemented using the most appropriate resource for the call
type; how non-pa,ra.l11edic units have been used on calls classified as Alpha and Bravo;
and the reason that Provider has.11ot been able to anive on the scep.~ in accordance with
the established response time criteria.
. ' ,
Requests must be reCeived in writing w~thin fifteen (15) days' after the close of the
calendar month. Requests not submitted within fifteen (15) days aftertheclose of the
.' calendar month :will not be considere~.. The Contract Manager will reviewthe request
and provide a disposition within thirty (30) business days. .
IX. MONTHLYNO.N..;COMPLIANCE
Ninety percent (90%) response timeeompliance in each dispatchclassiflcatiori as
adjusted for excrhptioIts shall be considered compliant with this Agreemenf. . . .
The Provider shall be deemed in material bre~cli. of contract if the Pr<?vider fails to
meet the response time.requirements for at least 90% ofresponses each month for three
consecutive months or for four months in any 12 inonth period. A material breach of
contract may result in termination of the abiiity to participate in the first responder
funding program and I~ay result in the ~oIfeiture of first responder funding.
X. INCENTIYE FOR SUPERIOR RESPONSE TIME PERFORMANCE.
For every monthly reporting period in which Providet's compliance with respo;nse
time requirements exceeds 95% for each response time priority claSSIfication no per
lIiinuteliquidattld '~!l.!llag~~ sl:~n. ~~flle for the monthly reporting peliod.' A11.1iquiga1~d
damages for per call response times shall be forgiven for any month in whioh Provider
meets or exceeds 95% compliance with response time performance standards.
911 Emergency Medical Services .
Provider Agreeli:1ent Annex B .
Pagell ofl2
XI. REMEDIES
; '~-,,:'..; :
If circumstances constituting a.material br~ach as set forUi above are determined to
exist, andthc Provider fails to cure such breach, the County shall haveal~ rights and
remedies available at law 'or in equity uilder 111econtract, includiilg termination of the
Agreement. The County maypursue one or morerel1~edies, atp11Y tinie; provided, ..
howyver, that pw;suing any i'emedy-shall not be deemed. an election of remedies by the'
County pi'ecludingthe exercise of 1111ot11'er r~medy by the. County,
XII, REQUIRED RESPONSETIME DATA REPORTING
Within thirty.(30) calendar days of the close of each calendar month; Provider will
submit a report detailing its response time performance. data during the imrl,1cdiately
precediIig month (reporting period) in a manner and format acCeptable to the County. !fa
Provider fails to provide the report, dainages of $250.00 per-day or portion thereof,. may
be Jevied by'the County. . .
.' . .
Once a CAD. to CAP lii1k has been established that provides data directly to
EirstWatch, the Provider shall provide to the CouIltydailyresponsc time perfonnance
dataina forinflt approved by-the County, transmitted each day.
0., "
'-
...
XIII;PAYlVIENTS FORDAMAGES
The total amo).l1lt of darnages will be deducted. from the payment due to 'the
Prqvider and will be deposited into the EMS Trust Fund.
XIV. APPEAL OF I>;ECISION
In the event that Provi4er disagrees with the detennination by the ContrattManager' ..
related to appropriate use arid/or issuance of penalty, a petitiol1 may be made .tothe
Contract Administrator within 30 business days of receipt of Contract Manager's
decision. . . . .. .
. The petition must be submitted in writing alidcontain the basis for the appeal; any.
appropriate evidence,alld requested remedy. .
The Contract Administrator <;>r delegate may request additional inforn1atiollor base
a decision on materials that have been provided by the Provider and EMS Agency stkff.
The decision of the Contract Administrator shall hefillal,
.,.
911 Emergency Medical Services
P.roviderAgreemcnt Annex. B
Page 12 ofl2