County of San Diego - MOU Dangerous Drugs & Devices , • L, ..,,•
MEMORAIV�UM OF iJNDERSTANDING
BETWEEN THE HEALTH AND II[JMAN SERVICES AGENCY,
EMERGENCY MEDICAL SERVICES DIVISION,AND THE AGENCY FOR THE
PROCiJREMENT, TRANSPORT, STORAGE,DISTRIBUTION AND ADMIlVISTRATION OF
DANGEROUS DRUGS AND DEVICES
I. PURPOSE
This Memorandum of Understanding is entered into by and beriveen the County of San Diego,Health and
Human Services Agency,Emergency Medical Services Branch(EMS),and Po�vav Fire Deoartment for
the procurement, transport, storage, distribution and administration of Dangerous Drugs and Devices.
IL ADMINISTRATION
1. The County has designated the following individual as the Contractiug Officer's Technical
Representative(COTR), and may also be called the Contract Administrator:
Cannel Angelo, Interim EMS Director
Emergency Medical Services
Health and Human Services Agency
6255 Mission Gorge Road
San Diego, CA 92120
(619)285-6429
2. Contractor shall designate the following individual as the Contractor's Administrator:
Mark Sanchez, Fire Chief
Poway Fire Deparhnent
13050 Community Road
Poway, CA 92064
III. DEFINITION
Danqerous Drues and Devices: Any drug or device unsafe for self-use (e.g., N solutions and
medicarions carried on the Advanced Life Support Unit Inventory), and any drugs or devices bearing
the legend, "Caution, federal law prohibits dispe�sing without prescriptions"or words of similar
import.
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IV. RESPONSIBILTTIES OF PARTIES
A. Resoonsibilifies of Countv of San Diego Health and Human Services A2ency Division of
Emereency Medical Services(EMS)
I. To provide a policy for agencies to procure, store and distribute medical supplies and
pharmaceuticals identified in the Inventory(See Policy 5-416 "Supply and Re-supply of
Designated EMS Agencies and Vehicles"and Policy S-400 Management of Controlled
Dmgs on ALS Units).
2. To provide medical authorization consistent with County Policy for the procurement of
Dangerous Drugs and Devices.
B. Responsibilities ofAQency
1. Develop policies consistent with Policy 5-416 and Policy S-400 that include the following:
1.1 Identification (by title) of individuals responsible for procurement and distribution.
1.2 A determination of reasonable quantities of supplies and pharmaceuticals that must
be maintained to re-supply agencies.
1.3 Maintenance of copies of all drug orders, invoices, and logs associated with
Dangerous Drugs and Devices for a minimum of h�-o(2)years.
1.4 Procedures for completing a monthly inventory of Dangerous Drugs and Devices
which include:
1.41 Ensuring medications are sfored in original packaging
1.4.2 Checking medications for expiration dates, rotating supplies for
use prior to expiration, and exchanging current medicarions
1.43 Properly disposing of expired medications that cannot be
exchanged
1.4.4 Dishibuting of Dangerous Drugs and Devices to agency
1.4.5 Retuming medications to pharmaceutical distributor if notified
of a recall.
1.5 Storage of drugs (other than those carried on a vehicle) compliant with the following:
1.5.1 Drugs must be stored in a locked cabinet or storage azea.
1.5.2 Drugs may not be stored on the floor (storage of drugs on
pallets is acceptable).
1.5.3 Antiseptics and disinfectants must be stored separately from
internal and injectable medications.
1.5.4 Flammable substances(e.g., alcohol) must be stored in a metal
cabinet, in accordance with local fire codes.
2. Develop, implement and mainfain a quality assurance and improvement program that
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includes a cvritt n plan describing the program objectives, organization, scope, and
mechanisms for overseeing the procurement, transport, storage, distribution and
administration of Dangerous Drugs and Devices.
V. TERM
This Memorandum of Understanding shall be effecrive upon signature and will remain in effect until
terminated by either parry.
VI. NOTICE
Notice Pursuant to this Memorandum of Understandine: Any notice or notices required or
permitted to be given pursuant to this Memorandum of understanding may be personally sen�ed
on the other party by the party giving such notice, or may be served by certified mail or registered
mail, to the officials cifed in Paragraph I.
VII. MALNTENANCE OF RECORDS
Copies of all drug orders, invoices, and logs associated with this contract shall be maintained by
Agency and available for audits for a minimum of two (2)years.
VIII. INSiJRANCE REQLJIREMENTS FOR CONTRACTORS
Without limiting Contractor's indemnification obligafions to County, Contractor shall provide af its sole
expense and maintain for the durarion of this contract, or as may be further required herein, insurance
against claims for injuries to persons or damages to properry which may arise from or in connection with the
performance of the work hereunder and the results of the work by the Conttactor, his agenfs,
representatives, employees or subcontracfors.
A. Minimum Scoue of Insurance
Coverage shall be at least as broad as:
1. Commercial General Liability, Occurrence form, Insurance Services
Office form CG0001.
2. Automobile Liability covering all owned,non owned, hired auto
Insurance Services Office form CA0001.
3. Workers' Compensation,as required by State of California and
Employer's Liability Insurance.
4. Professional Liability required if Contractor provides or engages any type of
professional services including but not limited to medical professionals,
counseling services, or legal services.
B. Minimum Limits of Insurance
Con�ractor shall maintain limits no less than:
1. Commercial General Liability including Premises, Operations, Products and Completed
Operarions, Contractual Liability, and Independent Contractors Liability: $1,OOQ000 per
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occurrence for bodily injury, personal injury and property damage. The Genera] Aggregate
limit shall be $2,000,000.
2. Automobile Liability: $1,000,000 each accident for bodily injury and
property damage.
3. Employer's Liability: $1,000,000 each accident for bodily injury or disease.
Coverage shall include waiver of subrogation endorsement in favor of County of San Diego.
4. Professional Liability: $1,000,000 per claim with an aggregate limit of not less than
$2,000,000. Any self-retained limit shall not be greater than $25,000 per oceunence/event
without County's Risk Manager's approval.
Coverage shall include conhactual liability coverage.If policy contains one ormore aggregate
limits, a minimum of 50% of any such aggregate limit must remain available at all times; if
over 50%of any such aggregate limit has been paid or reserved,County will require addiriona]
coverage to be purchased by Conuactor to restore the required limits. This coverage shall be
maintained for a minimum of two years following termination of completion of Contractor's
work pursuant to the Contract.
C. Deductibles and Self-Insured Retentions
Any deductible or self-insured retention must be declared to and approved by the County's Risk
Manager.At the option ofthe County,either:the insurer shall reduce or eliminate such deductibles or
self-insured retentions as respects the County,the members of the Board of Supervisors ofthe County
and the officers, agents, employees and volunteers; or the Contractor shall provide a financial
guarantee sarisfactory to the County guazanteeing payment of losses and related investigations,claim
administration,and defense expenses.
D. General Provisions
1. Qualifyictg Insurers
All required policies of insurance shall be issued by companies which have been approved to
do business in the State of California by the State Department of Insurance, and which hold a
current policy holder's alphabetic and financial size category rating of not ]ess thau A-, VII
according to the current BesYs Key Rating guide,or a company of equal financial stability that
is approved in writing by County's Risk Manager.
2. Evidence of Insurance
Prior to commencement of this Conh-act, but in no event]ater than the effective date of the
Contract, Contractor shall furnish the Counry with certificates of insurance and amendatory
endorsements effecting coverage required by this clause. Contractor shall furnish certified
copies of the actual required insurance policies within thiriy days after commencement of
Contract.Thereafter,copies ofrenewal policies,certificate and amendatory endorsements shall
be fisnished to County within thirty days of the expiration of the term of any required policy.
Contractor shall permit County at all reasonable times to inspect any policies of insurance
which Contractor has not delivered to County.
3. Failure to Obtain or Maintain Insurance; County's Remedies
Conuactor's failure to provide insurance specified or failure to furnish certificates of insurance,
amendatory endorsements and certified copies of policies, ar failure to make premium
payments required by such insurance, shall constitute a material breach of the Contract, and
County may, at its oprion,terminate the Contract for any such default by Contractor.
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4. No Limitation of Obligations
The foregoing insurance requirements as to the Types and limits of insurance coverage to be
maintained by Contractor, and any approval of said insurance by the County are not intended
to and shall not in any manner limit or qualify the liabilities and obligations otherwise assumed
by Contractor pursuant to the Contract,including,but not limited to,the provisions concerning
indemnification.
S. Review of Coverage
County retains the right at any time to review the coverage, form and amount of insurance
required herein and may require Contractor to obtain insurance reasonably sufficient in
coverage, form and amount to provide adequate pmtection againsf the Idnd and extent of risk
which exists at the time a change in insurance is required.
6. Self-Insurance
Contractor may,with the prior written consent of County's Risk Manager,fulfill some or all of
the insurance requirements contained in this Contract under a plan of self-insurance.
Contractor shall only be permitted to utilize such self-insurance if in the opinion of County's
Risk Manager, Contractor's(i)net worth, and(ii)reserves for payment of claims of liability
against Contractor, are sufficient to adequately compensate for the lack of other insurance
coverage required by this Contract. Contractor's utilization of self-insurance shall not in any
way limit liabilities assumed by Confractor under the Contract.
7. Claims Made Coverage
If coverage is written on a"claims made"basis,the Certificate of Insurance shall clearly so
state. In addirion to the coverage requirements specified above, such policy shall provide
that:
a. The policy retroactive date coincides with or precedes Contractor's commencement
or work under the Contract(including subsequent policies purchased as renewals or
replacements).
b. Contractor will make every effort to maintain similar insurance during the required
extended period of coverage following expiration of the Contract, including the
requirement of adding all additional insureds.
c. If insurance is terminated for any reason, Coniractor shall purchase an extended
reporting provision of at least two years to report claims arising in connection with the
Contract.
d. The policy allows for reporting o£circumstances or incidents that might give rise to
future claims.
8. Subcontractors' Insurance
Confractor shall require that any and all Subcontractors hired by Contractor are insured in
accordance with this Coniract. If any Subcontractors coverage does not comply with the
foregoing provisions, Contractor shall defend and indemnify the County from any damage,
loss,cost or expense,including attorney fees,incurred by County as a resuit of Subcontractors
failure to maintain required coverage.
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9. Waiver of Subrogation
Connactor and County release each other, and their respective authorized representatives, from any
Claims(as defined in the Article entitled`9�demnity”of the Coi�tract), Wir�Ly�ioiin �1,,,o�Q.�.w
), but only to the
extent that the proceeds received from any policy of insurance camed by County or Contractor,
other than any self-insurance, covers any such Claim or damage. Included in any policy or
policies of insurance provided by Contractor hereunder shall be a standard waiver of rights of
Subrogation against County by the insurance company issuing said policy or policies.
IX. I�'DEMNITY
Agency 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 an
I person or proper[y, induding injury to Agency 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 Agency 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 Agency duty to indemnify and hold harmless shall not
include any claims or liability ansing from the established sole negligence or willful misconduct of County,
its agen[s, officers or employees.
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Agenc` M. SHEPARD, Dii ctor
Health&I3uman Services Agency
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DaTe Date
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