County of San Diego - Paramedic and Defibrillation ServicesCounty Contract #37148 A
AGREEMENT
FOR
EMT -PARAMEDIC / EMT -DEFIBRILLATION SERVICES
THIS AGREEMENT is made between the COUNTY OF SAN DIEGO, hereinafter referred
to as COUNTY, and the CITY OF POWAY, hereinafter referred to as CITY, to provide
EMT -Paramedic (EMT -P) and EMT -Defibrillation (EMT -D) services.
WITNESSETH:
WHEREAS City possesses certain skills, experience, education and competency to perform
certain specialized services regarding the provision and management of advanced life support;
and
WHEREAS, pursuant to the provisions of Division 2.5, Chapter 4, Article 1 of the California
Health & Safety Code, the County of San Diego is required to enter into a contract which
authorizes and standardizes the provision of such services within a given region.
NOW, THEREFORE, the parties hereto do mutually agree to the terms and conditions as
attached and set forth in this Agreement.
IN WITNESS THEREOF, COUNTY AND CITY have executed this AGREEMENT to be effective
upon the date authorized by the Board of Supervisors of COUNTY:
CITY:
NAME:
TITLE
DATE: C ` 1O—�
COUNTY OF AN DIEGO:
BY: '
Ro ert K. Ross, MD, Di ecto
Department of Health Services
r County of San Diego
lOs�
DATE:
Agreement to Provide Advanced Life Support / EMT -D Services
City of Poway
I. ADMINISTRATION OF AGREEMENT
COUNTY's ADMINISTRATOR, COMMUNITY HEALTH PROGRAMS, hereinafter called
COUNTY's ADMINISTRATOR, shall represent COUNTY in all matters pertaining to the
performance. under this Agreement and shall administer this Agreement on behalf of COUNTY.
City's Fire Chief, shall represent CITY and shall administer this Agreement in accordance with its
terms and conditions on behalf of CITY. All reports, letters, notices and/or other correspondence
shall be sent to the attention of the designated representatives at their respective addresses.
I1. TERM OF AGREEMENT
The term of this Agreement shall be from 7/16/98 , and will continue indefinitely until
terminated. Either party may terminate this agreement without cause upon forty-five (45) day notice
of termination to the other party.
III. RESPONSIBILITIES OF PARTIES
1- a
1. To provide, under the authority of Section 1797 et. seq. of the Health and Safety Code,
the following services:
a. Approval of the EMT -Paramedic (EMT -P) and EMT -Defibrillation training
program(s) in the County of San Diego pursuant to the California Code of
Regulations, Title 22, Division 9.
b. Standards for accreditation/authorization of EMT -Paramedics (EMT -Ps), EMT -
Ds (Defibrillation) and Mobile Intensive Care Nurses (MICNs), in San Diego
County, pursuant to California Code of Regulations, Title 22, Division 9.
C. Contracts with designated base hospitals to provide immediate medical direction
and supervision of the ALS system for the area defined by the local EMS agency.
For the purpose of this Agreement, the area is defined is the geographic area within the
city limits of the City of Poway, which is hereby designated as an "exclusive operating
area" pursuant to California Health & Safety Code, Division 2.5, Section 1797.224.
2. To provide prehospital report forms or the framework for an electronic data collection system in
accordance with California Code of Regulations, Title 22, Division 9, Chapter 4.
3. To review this Agreement every two years to ensure compliance with applicable
standards, regulations, policies, procedures and protocols.
4. To take immediate corrective action where there is a failure to meet "Responsibility of
the COUNTY".
Agreement to Provide Advanced Life Support / EMT -D Services
City of Poway
C• M1911101=16194i 161
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1. To provide EMT -Paramedic and EMT -Defibrillation services within the boundaries of
its local jurisdiction and within designated adjoining areas as specified by agreements
with adjoining jurisdictions.
2. To participate in the ALS program consistent with applicable provisions within Title 22
of the California Code of Regulations, Division 9, Chapters 2 & 4.
3. To develop and operate EMT -P and EMT -D services consistent with applicable
provisions within the California Code of Regulations, Title 22, Division 9, Chapters 2 &
4. CITY may subcontract all or a portion of these services. However, CITY is
responsible for ensuring that any and all subcontractors provide services consistent with
this Agreement and applicable provisions within the California Code of Regulations,
Title 22, Division 9, Chapters 2 & 4.
4. To maintain and operate fully equipped, supplied and staffed EMT -P unit(s) (including
ambulances and EMT -P staffed fire engines ["ALS first responder units"]) seven days a
week, twenty-four hours a day, consistent with the policies, procedures, and protocols
established by County. City shall operate this service at or exceeding the level of
service provided on December 1, 1997; any alteration in the level of service (i.e.
change in the number of ambulances, limitations on service hours, alternate staffing
patterns) must be pre -approved by County.
5. To staff each EMT -P responding ambulance with at least two EMT -Ps at all times (or
with a number agreed upon between City and County), and to staff each EMT -P (ALS)
first responding unit with at least one EMT -P and one EMT -I at all times (or a number
agreed upon between City and County). For the purposes of this agreement, an EMT -P
is an individual licensed by the State of California as an EMT -Paramedic, and
accredited by the County of San Diego Emergency Medical Services Director to operate
as an EMT -P in San Diego County, pursuant to Section 1797 et seq. of the Health &
Safety Code. An EMT -I is an individual certified as an EMT -I within the State of
California.
6. To maintain and operate at least one fully equipped, supplied and staffed EMT -D Unit
seven days a week, twenty-four hours a day, in accordance with the policies, protocols
and procedures established by San Diego County.
7. To maintain a community education / public relations program directed toward the
residents of the primary service area. This program shall include in its content such
topics as: Home Safety, Seat Belt Usage, Proper Utilization of the 9-1-1 System, and
CPR Instruction.
S. To provide sufficient unit security, safety and housing such that supplies and equipment
are secured and controlled pharmaceuticals are double locked.
9. To cooperate with the approved EMT -P training programs in providing field internship
locations for paramedic interns.
Agreement to Provide Advanced Life Support / EMT -D Services
City of Poway
10. To develop mutual aid and/or call-up plans for providing service in an area in the event
the unit assigned to the area is not operable or is away from the area for other reasons.
Automatic response plans may be developed by the City with the concurrence of
adjoining EMS services.
11. To immediately notify the Administrator, Community Health Programs, or designee,
whenever any condition exists which adversely affects the local jurisdiction's ability to
meet the conditions of this Agreement.
12. To appoint an Agency Paramedic/EMT-D Coordinator, to serve as liaison between the
agency, the COUNTY, base hospital, receiving hospitals, basic life support (BLS)
provider agencies and public safety agencies operating within the service area.
13 To provide orientation for first responder agencies to ALS functions and role.
14. To use best efforts to provide for a planned maximum ALS first responder response
time of 8 minutes, 90% of the time, and a planned ALS ambulance response time of 12
minutes, 90% of the time.
15. To participate in local EMS planning activities, including disaster management.
16. To comply with all applicable State statutes, regulations, local standards, policies,
procedures and protocols.
17. To implement and maintain a Quality Assurance/Quality Improvement Program that
interfaces with the local EMS agency's system -wide Quality Improvement Program,
which includes cooperation with the base hospitals' quality improvement process and is
approved by the local EMS agency.
18. To implement staffing patterns for ambulance personnel that do not routinely require
them to work scheduled shifts as paramedics or first responders for greater than 48
hours within any 60 hour period.
19. To comply with County policies and procedures regarding the documentation of patient
care activities.
20. To take immediate corrective action where there is a failure to meet "Responsibilities of
the CITY" .
V. CITY'S STANDARDS
CITY shall adopt CITY'S own performance standards for the purposes of Section III.B. above and
shall monitor its compliance with them.
VI. NOTICE
A. Notice Pursuant to this Agreement Any notice or notices required or permitted to be given
pursuant to this Agreement may be personally served on the other party by the party giving
such notice, or may be served by certified mail or registered mail, to the officials cited in
Paragraph I.
City of Poway 4/98 4
Agreement to Provide Advanced Life Support / EMT -D Services
City of Poway
B. Notice of Delay CITY shall, within five (5) days of the beginning of any delay in the
performance of this Agreement, notify the COUNTY'S Administrator, in writing, of the said
delay, causes and remedial action to be taken by CITY.
COUNTY shall, within five (5) days of the beginning of any delay in the performance of this
Agreement, notify the Fire Chief, in writing, of the said delay, causes.and remedial action to
be taken by COUNTY.
VII. AMENDMENTS, OPERATING MEMORANDA AND TERMINATION
A. Amendments COUNTY and CITY may request written amendment to this Agreement. Such
amendments, as agreed upon in writing, by and between COUNTY'S Administrator,
Community Health Programs and CITY are not in force until approved by the COUNTY
and the CITY.
B. Termination of Agreement for Cause -- Upon breech of this Agreement County shall have the
right to terminate this agreement by giving written notice to CITY of such termination and
specifying the effective date of such termination.
C. Termination of ALTr_'eement for Convenience Either party may terminate this Agreement upon
forty-five (45) days written notice to the other party.
VIII. INDEPENDENT CONTRACTOR
Independent Contractor - It is agreed that CITY shall perform as an independent contractor under
this Agreement. CITY is, for all purposes arising out of this Agreement, an independent
contractor, and shall not be deemed an employee of the COUNTY. It is expressly understood and
agreed that CITY shall in no event be entitled to any benefits to which COUNTY employees are
entitled, including, but not limited to, overtime, any retirement benefits, workers' compensation
benefits, and leave benefits.
VIII. SUB -CONTRACTS OF CITY
All subcontracts for Paramedic services entered into by CITY shall be in writing and the
subcontractor shall be authorized by the CITY to deliver such services in accordance with Title 22
of the California Code of Regulations, Division 9, Chapter 4.
No such contract shall act to terminate any legal responsibility of CITY to COUNTY to assure
complete performance of all activities and functions required of CITY under this Agreement.
IX. CONFIDENTIALITY
CITY shall maintain the confidentiality of its records, including but not limited to prehospital patient
records and quality assurance audits, in accordance with all applicable State and Federal laws
relating to confidentiality. CITY shall inform all its officers, employees and agents, and others
providing services hereunder of said confidentiality provisions. COUNTY shall maintain the
confidentiality of all records made available hereunder during and after the terms of this Agreement.
Agreement to Provide Advanced Life Support / EMT -D Services
City of Poway
X. MAINTENANCE OF RECORDS
All quality assurance and medical control records under this Agreement shall be maintained by
CITY for a minimum of three (3) years. COUNTY, at its option, may make a copy, at COUNTY
expense, of CITY'S quality assurance and medical control records.
XI. PERFORMANCE AUDITS AND INSPECTION OF RECORDS
Authorized Federal, State or County representatives shall have the right to monitor, assess and
evaluate CITY'S performance pursuant to this Agreement. Said monitoring, assessments and
evaluations to include but not be limited to audits, inspection of premises, reports (excluding
personnel records and reports), patient records and interviews of staff in matters dealing with issues
covered by this Agreement. During normal business hours CITY shall make available to
COUNTY, State and Federal officials for examination of all its records with respect to matters
covered by this Agreement and will permit authorized County, State or Federal officials to audit,
examine, copy and make excerpts or transcripts from such records, and to make audits of all
pertinent information regarding patients' receiving services, and other data. It is understood that
COUNTY shall coordinate all such audits and inspections through the CITY Paramedic Coordinator
or Paramedic Contract Administrator.
XII. CITY'S STANDING
This Agreement shall constitute a written agreement pursuant to Health and Safety Code Section
1797.201.
XIII. HOLD HARMLESS
CITY agrees to defend, indemnify, protect and hold COUNTY and its agents, officers and
employees harmless from and against any and all claims asserted or liability established for damages
or injuries to any person or property, including injury to CITY employees, agents or offices, which
arise from or are connected with or are caused or claimed to be caused by the acts or omissions of
CITY and its agents, officers or employees, in performing the work or services herein, and all
expenses of investigating and defending against same; provided, however, that CITY'S duty to
indemnify and hold harmless shall not include any claims or liability arising from the established sole
negligence or willful misconduct of the COUNTY, its agents, officers or employees.
COUNTY agrees to defend, indemnify, protect and hold CITY and its agents, officers and
employees harmless from and against any and all claims asserted or liability established for damages
or injuries to any person or property, including injury to COUNTY employees, agents or officers,
which arise from or are connected with or are caused or claimed to be caused by the acts or
omissions of COUNTY, its agents, officers or employees, in performing the work or services
herein, and all expenses of investigating and defending against same; provided, however, that
COUNTY's duty to indemnify and hold harmless shall not include any claims or liability arising
from the established sole negligence or willful misconduct of CITY, its agents, officers or
employees.
Agreement to Provide Advanced Life Support / EMT -D Services
City of Poway
fir.• ,i• Val meM•- ,ffien ,
COUNTY and CITY agree to the mutual objective of a safe, healthful and productive work place
and the prohibition of drugs or alcohol use or impairment from same while performing EMT -P
services. Both agencies and their subcontractors have and shall maintain policies and procedures to
ensure drug and alcohol -free work place and services within their organizations.
COUNTY and CITY shall not deny any person the full and equal enjoyment of, or impose less
advantageous terms, or restrict the availability of, the use of any County facility or participation in
any County funded or supported service or program on the grounds that such person has Acquired
Immune Deficiency Syndrome (AIDS), AIDS-related complex (ARC) or AIDS-related status
(ARS), as those terms are defined in Chapter 1, Section 32.1203, San Diego Code of Regulatory
Ordinance, a copy of which can be obtained from the Clerk of the Board of Supervisors, 1600
Pacific Highway, San Diego, CA 92101.
3 11M. oil M4
COUNTY and CITY shall comply with the Americans with Disabilities Act of 1990, pertaining to
discrimination against qualified people with disabilities in employment, public services,
transportation, public accommodations, and telecommunications services.
There shall be no religious worship, instructions or proselytization as part of or in connection with
the performance of this Agreement.
R� Me ROMMMET Me.
The County of San Diego, in recognition of it's unique geographical location, and the utilization of
Welfare and Medi -Cal system by foreign nationals who are not legal residents of this County or
Country, has adopted a Zero Tolerance policy and shall aggressively prosecute employees and
contractors who coach undocumented immigrants.
A. As a material condition of this Agreement, the CITY agrees that the CITY and the
CITY'S employees, while performing service for the County, on County property, or
while using County equipment:
Shall not in any coach, instruct, advise, or guide any Medi -Cal or Welfare clients
or prospective clients who are undocumented immigrants on ways to obtain or
qualify for Medi -Cal assistance.
2. Shall not support or provide funds to any organization engaged directly or
indirectly in advising undocumented immigrants on ways to obtain or
qualify for Medi -Cal assistance.
Agreement to Provide Advanced Life Support / EMT -D Services
City of Poway
a. The CITY shall inform all employees that are performing service for
the County on County property or using County equipment, of the
County's Zero Tolerance policy.
b. The County may Terminate for Default or Breach this Agreement and
any other Agreement the CITY has with the County, if the CITY, or
CITY employees are determined by the Contracting Officer not to be
in compliance with conditions listed herein.
ROBERT K. ROSS, M.D.
DIRECTOR
(619) 515-6555
FAX: (619) 515-6556
EMERGENCY MEDICAL SERVICES
6255 MISSION GORGE ROAD
SAN DIEGO, CA 92120-3599
(619) 285-6429; FAX (619) 285-6531
August 4, 1998
(�uuu#la vr# 'San 'Btega
HEALTH AND HUMAN SERVICES AGENCY
1700 PACIFIC HIGHWAY, SAN DIEGO, CALIFORNIA 921 01-241 7
Mark A. Sanchez, Director of Safety Services
City of Poway
13050 Community Road
Poway, CA 92064-5702
Dear Mr. Sanchez:
AREA AGENCY ON AGING
COMMISSION ON CHILDREN, YOUTH
AND FAMILIES
DEPARTMENT OF HEALTH SERVICES
DEPARTMENT OF SOCIAL SERVICES
VETERANS SERVICE OFFICE
Enclosed is your copy of the fully executed Agreement between the County of San Diego and the City of
Poway for providing EMT -Paramedic (EMT -P) and EMT -Defibrillation (EMT -D) services. This
Agreement covers the period July 16, 1998 and will continue indefinitely until mutually terminated.
If you have any questions pertaining to any portion of this Agreement, please call me directly or Bruce
Leicht at 285-6429.
Sincerely,
GAIL F. COOPER, Administrator
Community Health Programs
GFC:PHD:pd
Enclosure (1)
Poway.letter
"Focusing on Families As Our Customers„