HomeMy WebLinkAboutMINUTES - 04182017 - Fire Protection DistrictCALENDAR FOR THE BOARD OF DIRECTORS
CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT
BOARD CHAMBERS ROOM 107, ADMINISTRATION BUILDING, 651 PINE STREET
MARTINEZ, CALIFORNIA 94553-1229
FEDERAL D. GLOVER, CHAIR
KAREN MITCHOFF, VICE CHAIR
JOHN GIOIA
CANDACE ANDERSEN
DIANE BURGIS
DAVID J. TWA, CLERK OF THE BOARD AND COUNTY ADMINISTRATOR, (925) 335-1900
JEFF CARMAN, FIRE CHIEF
PERSONS WHO WISH TO ADDRESS THE BOARD DURING PUBLIC COMMENT OR WITH RESPECT TO
AN ITEM THAT IS ON THE AGENDA, WILL BE LIMITED TO TWO (2) MINUTES.
The Board Chair may reduce the amount of time allotted per speaker at the beginning of each item
or public comment period
depending on the number of speakers and the business of the day.
Your patience is appreciated.
A closed session may be called at the discretion of the Board Chair.
Staff reports related to open session items on the agenda are also accessible on line at
www.co.contra-costa.ca.us.
ANNOTATED AGENDA and MINUTES
April 18, 2017
Present: Director John Gioia; Director Diane Burgis; Director Karen Mitchoff; Director Federal D. Glover
Absent: Director Candace Andersen
Staff Present:David Twa, County Administrator
Jeff Carman, Fire Chief
1:30 P.M. Convene and call to order.
CONSIDER CONSENT ITEMS (Items listed as C.1 through C.5 on the following agenda) –
Items are subject to removal from Consent Calendar by request of any Director or on request
for discussion by a member of the public. Items removed from the Consent Calendar will
be considered with the Discussion Items.
PRESENTATIONS
April 18, 2017 CCCFPD Minutes 1
PR.1 PRESENTATION on the Fiscal Year 2017-2018 Contra Costa County Fire
Protection District Recommended Budget. (Jeff Carman, Fire Chief)
DISCUSSION ITEMS
D. 1 CONSIDER Consent Items previously removed.
There were no items removed from consent for discussion.
D. 2 PUBLIC COMMENT (2 Minutes/Speaker)
Speakers: Bill Granados, Contra Costa County Fire Protection District
Advisory Board.
D.3 CONSIDER adopting Resolution No. 2017/127 approving the side letter
between Contra Costa County Fire Protection District and IAFF, Local 1230,
for the period of January 10, 2017 through February 10, 2017, to allow Trainers
to receive the differential under the MOU. (David Twa, County Administrator)
AYE: Director John Gioia, Director Diane Burgis, Director Karen Mitchoff,
Director Federal D. Glover
Other: Director Candace Andersen (ABSENT)
D.4 HEARING to consider adopting urgency Ordinance No. 2017-08 and Ordinance
No. 2017-09, authorizing the Contra Costa County Fire Protection District to
revise its emergency ambulance service fees within Emergency Response Areas
1, 2, and 5 in Contra Costa County. (Jeff Carman, Fire Chief)
CLOSED the public hearing; ADOPTED Ordinance No. 2017-08, which
becomes effective immediately and continues in effect through the end of the
day on May 17, 2017; and ADOPTED Ordinance No. 2017-09, which
becomes effective on May 18, 2017.
AYE: Director John Gioia, Director Diane Burgis, Director Karen Mitchoff,
Director Federal D. Glover
Other: Director Candace Andersen (ABSENT)
D.5 CONSIDER accepting a report from the Fire Chief providing a status summary
for ongoing Fire District activities and initiatives. (Jeff Carman, Fire Chief)
AYE: Director John Gioia, Director Diane Burgis, Director Karen Mitchoff,
Director Federal D. Glover
Other: Director Candace Andersen (ABSENT)
CONSENT ITEMS
C.1 APPROVE and AUTHORIZE the Purchasing Agent on behalf of the Fire Chief,
April 18, 2017 CCCFPD Minutes 2
C.1 APPROVE and AUTHORIZE the Purchasing Agent on behalf of the Fire Chief,
or designee, to execute a purchase order with All Star Fire Equipment, Inc., in
an amount not to exceed $350,000, for the purchase of self-contained breathing
apparatus equipment in the Contra Costa County Fire Protection District. (100%
CCCFPD General Operating Fund)
AYE: Director John Gioia, Director Diane Burgis, Director Karen Mitchoff,
Director Federal D. Glover
Other: Director Candace Andersen (ABSENT)
C.2 APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a contract
amendment with American Medical Response West (AMR), effective April 1,
2017, to revise the payment provisions and update Exhibit D (Ambulance Unit
Hour Rates) in the Service Plan with no change to original term or payment
limit, for emergency ambulance services. (Cost Neutral)
AYE: Director John Gioia, Director Diane Burgis, Director Karen Mitchoff,
Director Federal D. Glover
Other: Director Candace Andersen (ABSENT)
C.3 APPROVE and AUTHORIZE the Fire Chief, or his designee, to execute an
agreement with the City of El Cerrito Fire Department for the provision of fire
and emergency medical dispatch services for the term July 1, 2017, through
June 30, 2020. (Cost Neutral)
AYE: Director John Gioia, Director Diane Burgis, Director Karen Mitchoff,
Director Federal D. Glover
Other: Director Candace Andersen (ABSENT)
C.4 APPROVE and AUTHORIZE the Purchasing Agent to execute, on behalf of the
Fire Chief, a purchase order to American Medical Response West in an amount
not to exceed $435,030 for ambulance dispatching and system status
management services provided from February 1, 2016 through March 31, 2017.
(100% CCCFPD EMS Transport Fund)
AYE: Director John Gioia, Director Diane Burgis, Director Karen Mitchoff,
Director Federal D. Glover
Other: Director Candace Andersen (ABSENT)
C.5 APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a contract
with Peter Benson, M.D., for the period May 1, 2017, through April 30, 2020,
with a payment limit not to exceed $360,000, for physician oversight of
emergency ambulance and fire-based emergency medical first responder
services. (100% EMS Transport Fund)
AYE: Director John Gioia, Director Diane Burgis, Director Karen Mitchoff,
Director Federal D. Glover
Other: Director Candace Andersen (ABSENT)
April 18, 2017 CCCFPD Minutes 3
Other: Director Candace Andersen (ABSENT)
GENERAL INFORMATION
The Board meets in its capacity as the Board of Directors of the Contra Costa County Fire
Protection District pursuant to Ordinance Code Section 24-2.402. Persons who wish to address the
Board of Directors should complete the form provided for that purpose and furnish a copy of any
written statement to the Clerk.
Any disclosable public records related to an open session item on a regular meeting agenda and
distributed by the Clerk of the Board to a majority of the members of the Board of Directors less
than 72 hours prior to that meeting are available for public inspection at 651 Pine Street, First
Floor, Room 106, Martinez, CA 94553, during normal business hours. All matters listed under
CONSENT ITEMS are considered by the Board of Directors to be routine and will be enacted by
one motion. There will be no separate discussion of these items unless requested by a member of
the Board or a member of the public prior to the time the Commission votes on the motion to
adopt. Persons who wish to speak on matters set for PUBLIC HEARINGS will be heard when the
Chair calls for comments from those persons who are in support thereof or in opposition thereto.
After persons have spoken, the hearing is closed and the matter is subject to discussion and action
by the Board. Comments on matters listed on the agenda or otherwise within the purview of the
Board of Directors can be submitted to the office of the Clerk of the Board via mail: Contra Costa
County Fire Protection District Board of Directors, 651 Pine Street Room 106, Martinez, CA
94553; by fax: 925-335-1913.
The District will provide reasonable accommodations for persons with disabilities planning to
attend Board meetings who contact the Clerk of the Board at least 24 hours before the meeting, at
(925) 335-1900; TDD (925) 335-1915. An assistive listening device is available from the Clerk,
Room 106. Copies of recordings of all or portions of a Board meeting may be purchased from the
Clerk of the Board. Please telephone the Office of the Clerk of the Board, (925) 335-1900, to make
the necessary arrangements. Applications for personal subscriptions to the Board Agenda may be
obtained by calling the Office of the Clerk of the Board, (925) 335-1900. The Board of Directors’
agenda and meeting materials are available for inspection at least 96 hours prior to each meeting at
the Office of the Clerk of the Board, 651 Pine Street, Room 106, Martinez, California.
Subscribe to receive to the weekly Board Agenda by calling the Office of the Clerk of the Board,
(925) 335-1900 or using the County's on line subscription feature at the County’s Internet Web
Page, where agendas and supporting information may also be viewed:
www.co.contra-costa.ca.us
ADVISORY COMMISSION
The Contra Costa County Fire Protection District Advisory Fire Commission is scheduled to meet
next on Monday, June 12, 2017 at 7:00 p.m. at the District Training Center, 2945 Treat Blvd.,
Concord, CA 94518.
April 18, 2017 CCCFPD Minutes 4
AGENDA DEADLINE: Thursday, 12 noon, 12 days before the Tuesday Board meetings.
Glossary of Acronyms, Abbreviations, and other Terms (in alphabetical order):
The Contra Costa County Fire Protection District has a policy of making limited use of acronyms,
abbreviations, and industry-specific language in its Board of Supervisors meetings and written
materials. Following is a list of commonly used language that may appear in oral presentations and
written materials associated with Board meetings:
AB Assembly Bill
ABAG Association of Bay Area Governments
ACA Assembly Constitutional Amendment
ADA Americans with Disabilities Act of 1990
AFSCME American Federation of State County and Municipal Employees
ARRA American Recovery & Reinvestment Act of 2009
BAAQMD Bay Area Air Quality Management District
BART Bay Area Rapid Transit District
BayRICS Bay Area Regional Interoperable Communications System
BGO Better Government Ordinance
BOC Board of Commissioners
CALTRANS California Department of Transportation
CAER Community Awareness Emergency Response
CAL-EMA California Emergency Management Agency
CAO County Administrative Officer or Office
CCE Community Choice Energy
CBC California Building Code
CCCPFD (ConFire) Contra Costa County Fire Protection District
CCHP Contra Costa Health Plan
CCTA Contra Costa Transportation Authority
CCRMC Contra Costa Regional Medical Center
CCWD Contra Costa Water District
CFC California Fire Code
CFDA Catalog of Federal Domestic Assistance
CEQA California Environmental Quality Act
CIO Chief Information Officer
COLA Cost of living adjustment
ConFire (CCCFPD) Contra Costa County Fire Protection District
CPA Certified Public Accountant
CPF – California Professional Firefighters
CPI Consumer Price Index
CSA County Service Area
CSAC California State Association of Counties
CTC California Transportation Commission
dba doing business as
EBMUD East Bay Municipal Utility District
April 18, 2017 CCCFPD Minutes 5
ECCFPD East Contra Costa Fire Protection District
EIR Environmental Impact Report
EIS Environmental Impact Statement
EMCC Emergency Medical Care Committee
EMS Emergency Medical Services
et al. et alii (and others)
FAA Federal Aviation Administration
FEMA Federal Emergency Management Agency
FTE Full Time Equivalent
FY Fiscal Year
GIS Geographic Information System
HCD (State Dept of) Housing & Community Development
HHS (State Dept of ) Health and Human Services
HOV High Occupancy Vehicle
HR Human Resources
HUD United States Department of Housing and Urban Development
IAFF International Association of Firefighters
ICC International Code Council
IFC International Fire Code
Inc. Incorporated
IOC Internal Operations Committee
ISO Industrial Safety Ordinance
JPA Joint (exercise of) Powers Authority or Agreement
Lamorinda Lafayette-Moraga-Orinda Area
LAFCo Local Agency Formation Commission
LLC Limited Liability Company
LLP Limited Liability Partnership
Local 1 Public Employees Union Local 1
Local 1230 Contra Costa County Professional Firefighters Local 1230
MAC Municipal Advisory Council
MBE Minority Business Enterprise
MIS Management Information System
MOE Maintenance of Effort
MOU Memorandum of Understanding
MTC Metropolitan Transportation Commission
NACo National Association of Counties
NEPA National Environmental Policy Act
NFPA National Fire Protection Association
OES-EOC Office of Emergency Services-Emergency Operations Center
OPEB Other Post Employment Benefits
OSHA Occupational Safety and Health Administration
PACE Property Assessed Clean Energy
PARS Public Agencies Retirement Services
PEPRA Public Employees Pension Reform Act
RFI Request For Information
RFP Request For Proposal
RFQ Request For Qualifications
SB Senate Bill
April 18, 2017 CCCFPD Minutes 6
SBE Small Business Enterprise
SEIU Service Employees International Union
SUASI Super Urban Area Security Initiative
SWAT Southwest Area Transportation Committee
TRANSPAC Transportation Partnership & Cooperation (Central)
TRANSPLAN Transportation Planning Committee (East County)
TRE or TTE Trustee
TWIC Transportation, Water and Infrastructure Committee
UASI Urban Area Security Initiative
UCOA United Chief Officers Association
vs . versus (against)
WAN Wide Area Network
WBE Women Business Enterprise
WCCTAC West Contra Costa Transportation Advisory Committee
April 18, 2017 CCCFPD Minutes 7
RECOMMENDATION(S):
PRESENTATION on the Fiscal Year 2017-2018 Contra Costa County Fire Protection District Recommended
Budget.
FISCAL IMPACT:
Presentation only. Budget hearing was conducted at the meeting of the Contra Costa County Board of Supervisors on
April 18, 2017, at 9:00 a.m.
BACKGROUND:
At the morning meeting of the Contra Costa County Board of Supervisors on April 18, 2017, a public hearing was
conducted on the Recommended County and Special District Budgets for fiscal year 2017-2018. As follow up to that
hearing, the Contra Costa County Fire Protection District (Fire District) is providing a more detailed presentation of
the 2017-18 Fire District Recommended Budget during its regularly scheduled meeting.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/18/2017 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
Contact: Jackie Lorrekovich, Chief Admin
Svcs (925) 941-3312
I hereby certify that this is a true and correct copy of an action taken and entered on the
minutes of the Board of Supervisors on the date shown.
ATTESTED: April 18, 2017
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: , Deputy
cc:
PR.1
To:Contra Costa County Fire Protection District Board of Directors
From:Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:April 18, 2017
Contra
Costa
County
Subject:Presentation on Fiscal Year 2017-2018 Recommended Fire District Budget
April 18, 2017 CCCFPD Minutes 8
ATTACHMENTS
FY 2017-18 Recommended Special District
Budget
FY 2017-18 Rec Budget Presentation
April 18, 2017 CCCFPD Minutes 9
Jeff Carman, Fire Chief
Contra Costa County FPD
Special District
County of Contra Costa FY 2017-2018 Recommended Budget 425
Contra Costa County Fire Protection District – Fire Protection Summary
CCCFPD Operating Fund
2015-16
Actuals
2016-17
Budget
2017-18
Baseline
2017-18
Recommended Change
Expense
Salaries And Benefits 83,603,910 91,659,392 95,180,242 94,028,953 (1,151,289)
Services And Supplies 8,228,306 10,339,203 10,070,037 10,070,037 0
Other Charges 4,339,091 4,268,647 4,631,583 4,631,583 0
Fixed Assets 231,697 1,347,000 472,800 472,800 0
Expenditure Transfers 18,983,615 16,673,103 17,382,941 17,382,941 0
Expense Total 115,386,619 124,287,345 127,737,603 126,586,314 (1,151,289)
Revenue
Other Local Revenue 111,716,957 120,455,136 125,704,862 125,704,862 0
Federal Assistance 4,533,433 55,000 0 0 0
State Assistance 874,426 881,452 881,452 881,452 0
Revenue Total 117,124,816 121,391,588 126,586,314 126,586,314 0
Net Fund Cost (NFC):(1,738,197)2,895,757 1,151,289 0 (1,151,289)
Allocated Positions (FTE)338.6 352.6 352.6 350.6 (2.0)
Financial Indicators
Salaries as % of Total Exp 72%74%75%74%
% Change in Total Exp 8%3%(1%)
% Change in Total Rev 4%4%0%
% Change in NFC (267%)(60%)(100%)
Compensation Information
Permanent Salaries 33,084,435 37,497,693 39,618,332 38,943,585 (674,747)
Temporary Salaries 282,541 275,000 275,000 275,000 0
Permanent Overtime 10,753,444 9,646,160 10,815,395 10,815,395 0
Deferred Comp 20,510 29,580 25,000 25,000 0
Comp & SDI Recoveries (336,348)0 0 0 0
FICA/Medicare 647,870 710,710 725,898 718,322 (7,576)
Retirement Expense 22,219,271 24,863,020 26,601,809 26,267,568 (334,241)
Excess Retirement 52,108 53,000 80,000 80,000 0
Employee Group Insurance 5,176,419 5,983,500 5,944,842 5,877,626 (67,216)
Retiree Health Insurance 5,314,469 5,637,000 5,365,000 5,365,000 0
OPEB Pre-Pay 1,959,289 1,959,289 1,959,289 1,959,289 0
Unemployment Insurance 0 0 0 0 0
Workers Comp Insurance 4,429,902 5,004,440 3,769,678 3,702,169 (67,509)
Department Description
The preceding table represents information in
aggregate summarizing expenditures and
revenue for the fire suppression/emergency
medical response crews, fire prevention bureau,
communications center, apparatus shop, training
section, emergency medical services office, and
administration functions section.
April 18, 2017 CCCFPD Minutes 10
Contra Costa County FPD
Special District
426 County of Contra Costa FY 2017-2018 Recommended Budget
Major Department Responsibilities
The Contra Costa County Fire Protection District
(CCCFPD) is responsible for providing fire
suppression responses to both structure and
wildland fires; emergency medical services
including paramedic responses, rescue
responses, hazardous materials responses; plan
review, code enforcement, fire/arson
investigation, weed abatement, public education,
permits issuance required by Fire Code; and
ensuring water supply needed for fire flow,
compliance-based inspections, and training.
CCCFPD Operating Fund Summary
Service:Mandatory
Level of Service: Discretionary
Expenditures: $126,586,314
Financing: 126,586,314
Net Fund Cost: 0
Funding Sources:
Property Taxes 89.5% $113,325,530
Charges for Svcs 6.2% 7,881,222
Intergovernmental 3.0% 3,779,562
Misc. Revenue 1.3% 1,600,000
FTE:350.6
April 18, 2017 CCCFPD Minutes 11
Contra Costa County FPD
Special District
County of Contra Costa FY 2017-2018 Recommended Budget 427
Contra Costa County Fire Protection District – EMS Transport Summary
CCCFPD EMS Transport Fund
2015-16
Actuals
2016-17
Budget
2017-18
Baseline
2017-18
Recommended Change
Expense
Salaries And Benefits 0 0 0 1,910,854 1,910,854
Services And Supplies 16,907,950 38,992,842 39,632,000 41,389,146 1,757,146
Other Charges 0 0 0 200,000 200,000
Expenditure Transfers 170,387 2,039,230 1,500,000 1,500,000 0
Expense Total 17,078,337 41,032,072 41,132,000 45,000,000 3,868,000
Revenue
Other Local Revenue 17,365,282 40,745,128 45,000,000 45,000,000 0
Revenue Total 17,365,282 40,745,128 45,000,000 45,000,000 0
Net Fund Cost (NFC):(286,944)286,944 (3,868,000)0 3,868,000
Allocated Positions (FTE)0.0 0.0 0.0 7.0 7.0
Financial Indicators
Salaries as % of Total Exp 0%0%0%4%
% Change in Total Exp 140%0%9%
% Change in Total Rev 135%10%0%
% Change in NFC (200%)(1,448%)(100%)
Compensation Information
Permanent Salaries 0 0 0 1,077,364 1,077,364
Permanent Overtime 0 0 0 100,000 100,000
Deferred Comp 0 0 0 4,000 4,000
FICA/Medicare 0 0 0 15,190 15,190
Retirement Expense 0 0 0 445,300 445,300
Employee Group Insurance 0 0 0 162,000 162,000
Workers Comp Insurance 0 0 0 107,000 107,000
Description:The EMS Transport Fund was
created in 2015 following the award of a contract
to the District by the County EMS Agency to
provide emergency medical services throughout
the County. The Fund allows the District to track
reimbursement revenue from governmental,
commercial and private payers for EMS services
rendered along with expenditures associated
with the provision of those services.
CCCFPD EMS Transport Fund
Service:Discretionary
Level of Service: Discretionary
Expenditures: $45,000,000
Financing:45,000,000
Net Fund Cost: 0
Funding Sources:
Cost Recovery 100.0% $45,000,000
FTE:7.0
April 18, 2017 CCCFPD Minutes 12
Contra Costa County FPD
Special District
428 County of Contra Costa FY 2017-2018 Recommended Budget
Non-Operating Funds
Non-operating fund budget units include
developer fee accounts that are restricted to
capital needs necessitated by growth, Pension
Obligation Bond (POB) Debt Service and
Stabilization fund budget units that were created
pursuant to the issuance of pension obligation
bonds in July 2005, and the EMS Transport
Fund (reported on the previous page) created in
2015 to track expenditures and reimbursement
revenue associated with the provision of
ambulance service.
CCFPD Capital Outlay Fund
The Capital Outlay Fund includes funds
collected during the building permit process and
is intended to ameliorate the impact of new
construction service demands on District capital
needs. This fund is primarily intended for major
capital outlay projects such as new fire stations.
CCCFPD Capital Outlay Fund
Service:Discretionary
Level of Service: Discretionary
Expenditures: $2,906,358
Financing:60,400
Net Fund Cost: 2,845,958
Funding Sources:
Fund Balance 97.9% $2,845,958
Developer Fees 2.1% 60,000
Use of Money 0.0% 400
CCCFPD Fire Developer Fee Fund
The CCCFPD Developer Fee includes funds
collected during the building permit process in
the unincorporated areas of the former CCCFPD
(prior to the July 1994 consolidation). This fund
no longer receives developer fees because it
has been replaced by the CCCFPD New
Development Fee Fund that was established in
August 2006. Residual monies in this fund are
intended to mitigate the new construction
service demands on District capital needs, and
are primarily used for construction projects.
CCCFPD Developer Fee Fund
Service:Discretionary
Level of Service: Discretionary
Expenditures: $894
Financing:0
Net Fund Cost: 894
Funding Sources:
Fund Balance 100.0% $894
Riverview Fire Developer Fee Fund
The Riverview Fire Developer Fee Fund, which
includes monies previously collected during the
building permit process in the unincorporated
areas of the former Riverview Fire Protection
District, no longer receives developer fees and
has been replaced by the CCCFPD New
Development Fee Fund established in August
2006. Residual monies in this fund are intended
to mitigate the impact of new construction
service demands on District capital needs, and
are primarily used for construction projects.
Riverview Fire Developer Fee Fund
Service:Discretionary
Level of Service Discretionary
Expenditures: $26,256
Financing:0
Net Fund Cost: 26,256
Funding Sources:
Fund Balance 100.0% $26,256
Pittsburg Special Fund
The Pittsburg Special Fund is comprised of fees
collected in the Pittsburg area and by agreement
with the City of Pittsburg for capital purchases.
April 18, 2017 CCCFPD Minutes 13
Contra Costa County FPD
Special District
County of Contra Costa FY 2017-2018 Recommended Budget 429
Pittsburg Special Fund
Service:Discretionary
Level of Service: Discretionary
Expenditures: $863,656
Financing:600
Net Fund Cost: 863,056
Funding Sources:
Fund Balance 99.9% $863,056
Use of Money 0.1% 600
CCCFPD New Development Fee Fund
The CCCFPD New Development Fee Fund,
established in August 2006, replaces both the
CCCFPD and Riverview Fire Developer Fee
Funds. This fund includes monies collected
during the building permit process in all of the
unincorporated areas of the District and is
intended to mitigate the impact of new
construction service demands on District capital
needs.
CCCFPD New Development Fee Fund
Service:Discretionary
Level of Service: Discretionary
Expenditures: $252,163
Financing:60,000
Net Fund Cost: 192,163
Funding Sources:
Fund Balance 76.2% $192,163
Developer Fees 23.8% 60,000
CCCFPD POB Debt Service Fund
The Pension Obligation Bond Debt Service Fund
was created due to the issuance of Pension
Obligation Bonds in July 2005 to refinance the
District’s Unfunded Actuarial Accrued Liability
(UAAL) as of December 2004 with the Contra
Costa County Employees’ Retirement
Association. The refinancing resulted in savings
in excess of $50 million over 18 years as the
POB interest rate paid to the bondholders was
significantly lower than the interest rate charged
by the Retirement Association. This fund is
created to pay the bondholders via the trustee.
CCCFPD POB Debt Service Fund
Service:Discretionary
Level of Service: Discretionary
Expenditures: $13,815,959
Financing:13,815,959
Net Fund Cost: 0
Funding Sources:
Reimbursements 100.0% $13,815,959
CCCFPD Stabilization Fund
The Pension Obligation Stabilization Fund was
created pursuant to the issuance of Pension
Obligation Bonds in July 2005. The savings
realized from the lower interest rates are set-
aside in the Stabilization Fund to extinguish new
Retirement System Unfunded Actuarial Accrued
Liabilities (UAAL); replenish reserves; and, upon
a unanimous vote of the full Board, for any other
lawful purpose of the District.
CCCFPD Stabilization Fund
Service:Discretionary
Level of Service: Discretionary
Expenditures:$2,600,630
Financing:2,600,630
Net Fund Cost: 0
Funding Sources:
Transfers 100.0% $2,600,630
CAO’s Recommendation
The FY 2017-18 Recommended Budget
provides for the funding of 25 fire stations,
including 26 fully functional engine/truck
April 18, 2017 CCCFPD Minutes 14
Contra Costa County FPD
Special District
430 County of Contra Costa FY 2017-2018 Recommended Budget
companies, one limited functionality squad, and
350.6 FTEs. The Recommended Budget
includes negotiated and projected wage
adjustments, benefit cost increases, building and
grounds maintenance and repair projects, and
capital and non-capital equipment replacement.
The District is primarily funded by property tax
revenues. In FY 2016-17, the District
experienced a 6.3% growth in secured property
assessed valuation and a 5.9% growth in total
assessed valuation. This represents the fourth
consecutive year of growth in assessed
valuation after several years of declines. The
District received additional property tax
distributions during the course of the fiscal year
due to the dissolution of redevelopment
agencies. Additionally, the City of Pittsburg
resumed making RDA Successor Agency pass-
through payments and repaid arrearages from
the suspension of prior year payments.
The FY 2017-18 Recommended Budget
anticipates a 6% growth in secured property
assessed valuation and revenue from the
continued winding down of the former
redevelopment areas. The budget also
anticipates the continuation of some new
sources of revenue, such as emergency medical
services (EMS) first responder fees and sales
tax for enhanced EMS services in the City of
San Pablo. These increases in revenue have
allowed the District to re-staff some of the
operational resources that were taken out of
service during the Great Recession.
In FY 2017-18 employer retirement contribution
rates will increase due largely to changes in
demographic and economic actuarial
assumptions adopted by the Contra Costa
County Employees’ Retirement Association
(CCCERA) Board of Trustees. It’s important to
note this takes into account the decrease in
CCCERAs assumed rate of investment return
from 7.25% to 7.00% per annum.
This increase is compounded by the elimination
of the 9% employee subvention of the employer
cost towards retirement negotiated in the current
contract with the District’s largest labor group,
the International Association of Firefighters
(IAFF) Local 1230. In FY 2017-18, the District
will pay the full employer base rates for most of
its employee groups.
The FY 2017-18 Recommended Budget is
balanced and requires no use of fund balance.
The District continues to meet its Board adopted
policy to maintain a minimum reserve of 10% of
general operating fund budgeted expenditures.
On January 1, 2016, the District became the
County’s exclusive operator of emergency
ambulance service (not including the areas
covered by the Moraga-Orinda Fire Protection
District and the San Ramon Valley Fire
Protection District). This new program appears
to be financially sustainable based on the first
year of operations. The FY 2017-18
Recommended Budget contemplates
reallocating the funding for approximately 6.75
FTEs from the District’s Operating Fund to the
EMS Transport Fund. Of this amount 4.0 FTEs
will be transferred from the Operating Fund to
the EMS Transport Fund. The remaining 2.75
FTEs represent a portion of several positions
that support the EMS Transport operation, but
not in a full-time capacity. A portion of the costs
for those personnel will be charged to the EMS
Transport fund, but the positions will remain in
the Operating Fund.
In addition to the position transfers described
previously, the Recommended Budget includes
the addition of 3.0 FTE new, dispatcher
positions in the EMS Transport Fund. This
makes the total FTE count in the EMS Transport
Fund 7.0 FTE for FY 2017-18. In the Operating
Fund, 2.0 FTE positions are proposed to be
added, including one Departmental Media
Relations Coordinator and Storekeeper.
It is important to note that the uncertainty
associated with federal healthcare and tax
reform makes it difficult to project financial
impacts to the EMS Transport program. There is
no doubt that such reforms, if passed and
signed into law, will have a financial impact on
EMS Transport reimbursements. This is
primarily due to the majority of patients
transported by the local EMS system being
covered by Medicare or Medi-Cal. The County
Administrator will work with the Fire Chief to
monitor any legislative impacts to the EMS
system during FY 2017-18.
April 18, 2017 CCCFPD Minutes 15
Contra Costa County FPD
Special District
County of Contra Costa FY 2017-2018 Recommended Budget 431
Performance Measurement
During FY 2016-17 the District:
x Responded to approximately 65,500
incidents in calendar year (CY) 2016.
This represents a 4.6% increase in call
volume compared to CY 2015
x Implemented a standardized, more
accurate system for capturing and
reporting incident response data.
x Conducted 17,700 life safety
inspections and plan reviews of new
and existing buildings and fire/life
safety systems for compliance with
state and local fire and building codes
during CY 2016. This represents an
11% increase compared to CY 2015.
x Repositioned and added internal
resources to effectively manage, both
operationally and financially, the
emergency ambulance program and
Alliance with AMR.
x Fully transitioned the dispatching of
ambulance units to the District and
reduced call processing time by an
average of 51 seconds.
x Reopened Fire Station 87 in the City of
Pittsburg.
x Re-staffed Engine 6 at Fire Station 6 in
the City of Concord.
x Initiated the rebuilding of Fire Station 16
in the City of Lafayette.
x Developed five-year plans that address
current and projected maintenance
needs for existing facilities, maintenance
and replacement needs for the District’s
fleet, and maintenance and replacement
of critical equipment such as protective
clothing, SCBA, radios, hose, thermal
cameras, cardiac monitors, etc.
x Acquired a 32’ fire boat and established
a Maritime Response Team to respond
to fires, spills, rescues, and medical
emergencies occurring within 30 miles
of navigable waterways with multiple
high value target hazards.
x Placed new heavy fire apparatus into
service including four (4) Type I Fire
Engines, two (2) Heavy Rescues, three
(3) 105’ Tractor-Drawn Ladder Trucks,
one (1) 105’ Straight Ladder Truck, one
(1) Mobile Command Unit, and one (1)
Bulldozer Transport.
x Continued to develop plans for fire
station replacement/relocation.
x Using the updated Capital Improvement
Plan, initiated work on new funding
mechanisms such as development
impact fees and creation of Community
Facilities Districts in areas of new
development.
x Entered into an agreement with the City
of San Pablo to share the costs of
building a new Fire Station 70.
x Conducted and completed Firefighter
Recruit Academy 50.
x Continued to develop our relationship
with AMR in an effort to maximize our
operational efficiency and deliver
exemplary services to the citizens of
Contra Costa County.
x Conducted a comprehensive energy
usage assessment and entered into an
energy services contract and equipment
lease-purchase agreement to implement
long term energy conservation
measures, including the installation of
solar panels at three different sites.
x Completed a comprehensive study of
the District’s fleet services division.
x Continued to pursue grant funding
opportunities as they became available.
April 18, 2017 CCCFPD Minutes 16
Contra Costa County FPD
Special District
432 County of Contra Costa FY 2017-2018 Recommended Budget
Administrative and Program Goals
During FY 2017-18, the District will:
x Continue to reposition and add internal
resources to effectively manage, both
operationally and financially, the
emergency ambulance program.
x Add new dispatcher positions to
increase efficiency with single point call
processing, dispatching, and resource
tracking.
x Complete the rebuilding of Fire Station
16 in the City of Lafayette.
x Initiate construction work on a new Fire
Station 70 in the City of San Pablo.
x Develop long term funding plan for fire
station construction projects.
x Complete District-wide energy
infrastructure upgrade.
x Begin deploying fire personnel at the
hazmat specialist to hazardous
materials incidents.
x Continue periodic replacement of capital
equipment, such as heavy fire
apparatus and support equipment.
x Continue much needed facility and
grounds maintenance projects, such as
painting, roofing, and asphalt repair.
x Pursue new funding mechanisms such
as development impact fees and
creation of Community Facilities
Districts in areas of new development.
x Hire and conduct Firefighter Recruit
Academy 51.
x Continue to develop our relationship
with AMR in an effort to maximize our
operational efficiency and deliver
exemplary services to the citizens of
Contra Costa County.
x Pursue federal supplemental
reimbursement for ambulance services
provided to individuals with government
payer plans.
x Continue to pursue grant funding
opportunities as they become available.
April 18, 2017 CCCFPD Minutes 17
Contra Costa County FPD
Special District
County of Contra Costa FY 2017-2018 Recommended Budget 433
FY 2017-18
Program Modification List
Order Reference to
Mand/DiscList
Program
Name Service FTE
Net Fund Cost
Impact Impact
1 N/A Operations
Support
Services 1.0 85,405
Adds one (1)
Storekeeper
position.
2 N/A Operations
Public
Information 1.0 139,150
Adds one (1)
Departmental
Community and
Media Relations
Coordinator position.
3 N/A Operations EMS (4.0) (759,965)
Transfer one (1)
Assistant Fire Chief
and three (3) Fire
District Dispatchers
to the EMS
Transport Fund.
4 N/A Operations EMS 0 (615,879)
Allocate oversight
and support services
costs from the
Operating Fund to
the EMS Transport
Fund.
Total
Operating Fund (2.0) ($1,151,289)
5 N/A EMS
Transport
Fund
EMS Transport 7.0 1,910,854
Transfer one (1)
Assistant Fire Chief
and three (3) Fire
District Dispatchers,
adding (3) new Fire
District Dispatcher
positions and
allocating overhead
costs from the
Operating Fund to
the EMS Transport
Fund.
6 N/A EMS
Transport
Fund
EMS Transport 0.0 1,957,146
Increased
expenditure
appropriations for
EMS Transport
services and supply
costs.
Total EMS
Transport Fund 7.0 3,868,000
April 18, 2017 CCCFPD Minutes 18
Contra Costa County
Fire Protection District
Recommended Budget
Fiscal Year 2017-18
April 18, 2017 CCCFPD Minutes 19
Budget Drivers/Challenges
New revenue and enterprise opportunities have resulted in significantly
increased workload demands and the need for a larger investment in
professional services, equipment, and staffing.
Employer retirement contribution rates continue to be a significant cost
driver. Safety Tier A employer base rate for FY 2017-18 is 77.88%.
Debt service payments for Pension Obligation Bonds (POBs) are high
($14.8 million in FY 17-18) relative to the District’s overall budget.
Must continue to address critical infrastructure and capital needs,
including building maintenance/repair and heavy fire apparatus
replacement.
MOUs expiring June 30, 2017:
IAFF, Local 1230 (Safety)
United Chief Officers Association (Safety)
2April 18, 2017 CCCFPD Minutes 20
Property Tax Experience
Over the four year period from 2009-10 to 2012-13, property tax revenues
decreased by 13.3%. In the last four years, the increase was 28%.
This means the total net increase over the past eight years was 14.7% and
the average annual increase was 1.84%.
Actual CCCFPD experience:
–2009-10 (7.8%)
–2010-11 (2.4%)
–2011-12 (1.9%)
–2012-13 (1.2%)
–2013-14 5.9%
–2014-15 9.3%
–2015-16 6.9%
–2016-17 5.9%
–2017-18 6.0% Budgeted 3April 18, 2017 CCCFPD Minutes 21
Revenue Sources
2017-18 Fire District General Operating Fund
Property Taxes & Related
Charges for Services
CSA EM-1 Allocation
Miscellaneous
4April 18, 2017 CCCFPD Minutes 22
Prior Year Comparison
FY 2016-17 Adopted Budget
$124.3 Million *
No Projected Net Use of Fund Balance
353 FTEs *
25 Fire Stations Open
–26 Companies
–1 Squad
* After Adjustments
FY 2017-18 Recommended Budget
$126.6 Million
No Projected Net Use of
Fund Balance
351 FTEs *
25 Fire Stations Open
–26 Companies
–1 Squad
* Some positions moved to the EMS
Transport Fund.
5April 18, 2017 CCCFPD Minutes 23
2017-18 Recommended Budget ($)
6
Salaries and Benefits 94,028,953
Services and Supplies 10,070,037
Interagency/Other 4,631,583
Capital Equipment 472,800
Debt Transfers (POBs)17,382,941
126,586,314
PROJECTED REVENUE 126,586,314
Major Expenditure Objects
TOTAL EXPENDITURES
April 18, 2017 CCCFPD Minutes 24
Notable 2016-17 Accomplishments
Responded to over 65,000 incidents in calendar year 2016 (4.6% increase
over prior year) and approximately 17,700 life safety inspections and plan
reviews (11% increase over prior year).
Implemented a standardized, more accurate system for capturing and
reporting incident response data.
Repositioned and added internal resources to effectively manage, both
operationally and financially, the emergency ambulance program and
Alliance with AMR.
Fully transitioned the dispatching of ambulance units to the District and
reduced call processing time by an average of 51 seconds.
Reopened Fire Station 87 in the City of Pittsburg.
Re-staffed Engine 6 at Fire Station 6 in the City of Concord.
Initiated the rebuilding of Fire Station 16 in the City of Lafayette.
7April 18, 2017 CCCFPD Minutes 25
Notable 2016-17 Accomplishments (Continued)
Developed five-year plans to address maintenance and replacement of
facilities, the District’s heavy fleet, and critical equipment such as SCBA,
radios, thermal imaging cameras, gas monitors, defibrillators, etc.
Acquired a 32’ fire boat and established a Maritime Response Team.
Placed new heavy fire apparatus into service: four (4) Type I Engines, two
(2) Heavy Rescues, three (3) 105’ Tractor-Drawn Ladder Trucks, one (1)
105’ Straight Ladder Truck, one (1) Mobile Command Unit, and one (1)
Bulldozer Transport.
Conducted and completed Firefighter Recruit Academy 50.
Conducted an energy usage assessment and entered into an energy
assessment contract and equipment lease-purchase agreement to
implement long-term conservation measures, including the installation of
solar panels at three different sites.
Completed study of the District’s fleet services division.
8April 18, 2017 CCCFPD Minutes 26
2017-18 Plans and Goals
Continue to reposition and add internal resources to effectively manage,
both operationally and financially, the emergency ambulance program.
Pursue federal supplemental reimbursement (i.e., GEMT) for ambulance
services provided in FY 2016-17.
Fill new dispatcher positions to increase efficiency with single point call
processing, dispatching, and resource tracking.
Expand dispatcher user agency services and update user agency fees.
Complete construction work at Fire Station 16 in the City of Lafayette.
Initiate construction work on a new Fire Station 70 in the City of San
Pablo.
Develop long term funding plan for fire station construction projects.
9April 18, 2017 CCCFPD Minutes 27
2017-18 Plans and Goals (Continued)
Complete District-wide energy infrastructure upgrade project.
Begin deploying fire personnel as HazMat Specialists to hazardous
materials incidents.
Continue periodic replacement of capital equipment, such as heavy fire
apparatus and support equipment.
Continue addressing deferred facility and grounds maintenance projects,
such as painting, roofing, and asphalt repair.
Pursue new funding mechanisms such as development impact fees and
creation of Community Facilities Districts in areas of new development.
Hire and conduct Firefighter Recruit Academy 51.
10April 18, 2017 CCCFPD Minutes 28
Contra Costa County
Fire Protection District
Emergency
Ambulance
Service
April 18, 2017 CCCFPD Minutes 29
Ambulance Service Overview
Effective January 1, 2016, the Fire District became the exclusive operator of emergency ambulance service within EOAs I, II, and V in Contra Costa County.
AMR provides emergency ambulance service on behalf of the District, as the ambulance service sub-contractor, pursuant to the establishment of the Alliance.
Effective February 1, 2016, the dispatching of ambulance resources was transitioned from AMR to the Fire District. This reduced call processing times.
The District continues to develop its relationship with AMR in an effort to maximize operational efficiency and deliver outstanding service to the citizens of Contra Costa County.
The new endeavor has required substantial adjustment. The District continues to reposition internal resources to effectively manage the operational and financial components of the ambulance service program.
12April 18, 2017 CCCFPD Minutes 30
CCCFPD EMS Transport Fund
FY 2017-18 Recommended Budget
13
Salaries and Benefits 1,910,854
Services and Supplies 41,589,146
Expenditure Transfers 1,500,000
45,000,000
PROJECTED REVENUE 45,000,000
Major Expenditure Objects
TOTAL EXPENDITURES
April 18, 2017 CCCFPD Minutes 31
Alliance Performance
Transports
•January-December 2016: 71,283 (366 days)
Averaging 194.8 transports/day in 2016. AMR averaged 187.8 transports/day in 2015.
Ambulance Units Hours (Provided by AMR)
•January-December 2016: 236,709.50
AMR provided an average of 646.75 ambulance unit hours/day and 4,527 ambulance unit hours/week in 2016.
Contemplated using 5,173 unit hours/per week in ambulance bid proposal.
14April 18, 2017 CCCFPD Minutes 32
Alliance Performance
Despite the service transition and lower than anticipated unit hours, the Alliance has been able to exceed the contractual response time performance standard of 90% within each zone.
At current payer mix, collections rate, and contract expenses, system is financially sustainable.
More work needs to be done to establish appropriate reserves and prepare for future uncertainties in health care system and payer plans.
Staff will provide a retrospective financial overview of the ambulance program during its first year of operation (2016) at the Fire Board meeting in May.
15April 18, 2017 CCCFPD Minutes 33
Questions?
16April 18, 2017 CCCFPD Minutes 34
RECOMMENDATION(S):
Adopt Resolution No. 2017/127 approving the side letter between Contra Costa County Fire Protection District and
IAFF, Local 1230 to temporarily amend section 5.18 of the parties' Memorandum of Understanding (MOU) for the
period of January 10, 2017 through February 10, 2017, to allow Trainers to receive the 10% differential for the
duration of their training assignment which ended February, 2017.
FISCAL IMPACT:
There are three eligible employees who will receive the differential of 10% of base-pay (excluding differential) for
one month. The total cost is estimated to be approximately $2,500.
BACKGROUND:
There are 3 employees governed by the IAFF, Local 1230 MOU who were appointed in September, 2016 to a
40-hour training position to enable them to teach in the Fire Academy. The recruits did not graduate from the
Academy until February 10, 2017 and the Academy needed the Trainers through that time. Section 5.18 of the MOU
provides for payment of a differential for these employees that lasts "...for either the duration
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/18/2017 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover,
Director
ABSENT:Candace Andersen,
Director
Contact: Shanna Edwards, Labor
Relations, 925-335-1782
I hereby certify that this is a true and correct copy of an action taken and entered on the
minutes of the Board of Supervisors on the date shown.
ATTESTED: April 18, 2017
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc: Haj Nahal, Assistant Auditor-Controller
D.3
To:Contra Costa County Fire Protection District Board of Directors
From:David Twa, County Administrator
Date:April 18, 2017
Contra
Costa
County
Subject:Consider adopting Resolution No. 2017/127 approving the side letter between Contra Costa County Fire Protection
District and IAFF, Local 1230
April 18, 2017 CCCFPD Minutes 35
BACKGROUND: (CONT'D)
of the 40-hour work week assignment or four (4) months, whichever comes first" and in this situation, the
differential ended January 17, 2017, 4 months after the appointment. A side letter modification is required to allow
for payment to the Trainers through February, 2017, when the recruits graduated. The side letter will be effective
following its approval and is only for the period of January 10, 2017 through February 10, 2017.
CONSEQUENCE OF NEGATIVE ACTION:
The Trainers will not be paid the differential for the last month they served as Trainers in the Fire Academy.
ATTACHMENTS
Resolution No. 2017/127
Local 1230 side letter
April 18, 2017 CCCFPD Minutes 36
THE BOARD OF DIRECTORS OF THE CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT
Adopted this Resolution on 04/18/2017 by the following vote:
AYE:
John Gioia
Diane Burgis
Karen Mitchoff
Federal D. Glover
NO:
ABSENT:Candace Andersen
ABSTAIN:
RECUSE:
Resolution No. 2017/127
In the Matter of: The Side Letter Agreement between the Contra Costa County Fire Protection District and IAFF, Local 1230,
authorizing a 10% pay differential for the period of January 10, 2017 through February 10, 2017 for Trainers.
The Contra Costa County Fire Protection District Board of Directors acting solely in its capacity as the governing board of the
Contra Costa County Fire Protection District RESOLVES THAT:
Effective April , 2017 for the period of January 10, 2017 through February 10, 2017, the attached Side Letter of Agreement
dated March 13, 2017, between the Contra Costa County Fire Protection District and IAFF Local 1230, be ADOPTED.
Contact: Shanna Edwards, Labor Relations,
925-335-1782
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the
date shown.
ATTESTED: April 18, 2017
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc: Haj Nahal, Assistant Auditor-Controller
4
1
April 18, 2017 CCCFPD Minutes 37
April 18, 2017 CCCFPD Minutes 38
April 18, 2017 CCCFPD Minutes 39
RECOMMENDATION(S):
A. OPEN the public hearing on the following two ordinances:
1. Ordinance No. 2017-08, an urgency ordinance authorizing the Contra Costa County Fire Protection District
to revise its emergency ambulance service fees on and from April 18, 2017, through May 17, 2017.
2. Ordinance No. 2017-09, an ordinance authorizing the Contra Costa County Fire Protection District to revise
its emergency ambulance service fees beginning May 18, 2017.
B. RECEIVE testimony and CLOSE the public hearing.
C. ADOPT Ordinance No. 2017-08, which becomes effective immediately and continues in effect through the end of
the day on May 17, 2017.
D. ADOPT Ordinance No. 2017-09, which becomes effective on May 18, 2017.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/18/2017 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover,
Director
ABSENT:Candace Andersen,
Director
Contact: Jeff Carman, Fire Chief
(925) 941-3500
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of
the Board of Supervisors on the date shown.
ATTESTED: April 18, 2017
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
D.4
To:Contra Costa County Fire Protection District Board of Directors
From:Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:April 18, 2017
Contra
Costa
County
Subject:Emergency Ambulance Service Rate Schedule Revision
April 18, 2017 CCCFPD Minutes 40
FISCAL IMPACT:
The ordinances will allow the Contra Costa County Fire Protection District to recover the increased costs
associated with the provision of emergency ambulance services in Emergency Response Areas (ERAs) 1, 2, and 5
within Contra Costa County effective April 18, 2017.
BACKGROUND:
The Emergency Ambulance Services contract between the Contra Costa County EMS Agency (“CCCEMSA”)
and the Contra Costa County Fire Protection District (“District” or “Contractor”) establishes the rates the District
is authorized to charge for providing emergency ambulance services. Exhibit D, Service Rate Schedule, of the
Emergency Ambulance Services Contract provides as follows:
For each Ambulance responding to a call, Contractor shall charge the patient the Emergency Ambulance
Response Base Rate, plus mileage costs at the Mileage Rate. If oxygen is administered to a patient,
Contractor shall charge the patient the Oxygen Administration Charge, whether transported or not. If a
patient is treated and refuses transport, Contractor will charge the patient the Treat and Refused Transport
rate.
Emergency Ambulance Response Base Rate $ 2,100.00
Mileage Rate (for each mile traveled with a loaded patient)$ 50.00
Oxygen Administration Charge $ 175.00
Treat and Refused Transport $ 450.00
The District is not authorized to charge more or less than the rates specified in the District-CCCEMSA contract.
The rates became effective January 1, 2016. The contract is attached.
The Emergency Ambulance Services contract between the District and American Medical Response West
(“AMR” or “Subcontractor”) establishes the hourly rates the District pays AMR for providing emergency
ambulance services. The hourly rates (Ambulance Unit Hour Rates) became effective January 1, 2016. The hourly
rates are specified in Exhibit D of the District-AMR contract. The contract is attached.
Section P.2, Ambulance Unit Hourly Rate Adjustments, of the District-AMR contract requires the hourly rates
paid to AMR to be adjusted annually. Beginning on April 1, 2017, and on each April 1 thereafter, the
Subcontractor’s Ambulance Unit Hour Rate (“Per Unit Hour Rate”) increases by the percentage equal to the
product of (a) the Contractor’s collection realization percentage and (b) the greater of three percent (3%) or the
increase in the Consumer Price Index, All Urban Consumers for Medical Care (U.S. city average) (1982-84=100)
(“CPI”) for the subject calendar year. The CPI increase for calendar year 2016 was 3.8%. The “collection
realization percentage” is the percentage of patient billings actually collected.
AMR’s collection realization percentage for calendar year 2015 was 26.6%. Currently, the District’s collection
realization percentage for calendar year 2016 is 21.6%, but that will likely improve as the billing accounts
continue to mature. The District and AMR estimated a collection realization percentage of 24.6% in the
ambulance bid proposal to CCCEMSA.
Ambulance system costs include, but are not limited to, payments to AMR, billing service provider payments,
dispatcher wages and benefits, administrative wages and benefits, system software and hardware upgrades,
consulting fees, banking fees, and other costs. The largest cost driver in the ambulance system is payments to
AMR. These payments to AMR account for over 95% of actual system costs.
The District is mandated by the terms of its contract with AMR to provide Ambulance Unit Hour Rate increases
on an annual basis beginning in year two of the contract, and those increases are contractually determined by the
formula specified in Section P.2 of the District-AMR contract. Therefore, the rates charged by the District for
ambulance service must increase by a commensurate amount. Section P.2 of the District-CCCEMSA contract
April 18, 2017 CCCFPD Minutes 41
requires CCCEMSA to approve annual increases, based on changes in the CPI, to the Service Rate Schedule when
requested by the District.
Applying an approximate 3.8% increase to the Service Rate Schedule results in the modified rates shown below.
Emergency Ambulance Response Base Rate $ 2,180.00
Mileage Rate (for each mile traveled with a loaded patient)$ 52.00
Oxygen Administration Charge $ 182.00
Treat and Refused Transport $ 467.00
These rates have been approved by the CCCEMSA Director. If approved by the District Board of Directors, these
rates will go into effect on April 18, 2017.
CONSEQUENCE OF NEGATIVE ACTION:
If Ordinance No. 2017-08 and Ordinance No. 2017-09 are not adopted, the District will not be able to recover the
increased costs of providing emergency ambulance services under its contract with the County and AMR.
CHILDREN'S IMPACT STATEMENT:
Approximately 10% of emergency medical service responses involve children under the age of 15.
CLERK'S ADDENDUM
CLOSED the public hearing; ADOPTED Ordinance No. 2017-08, which becomes effective immediately and
continues in effect through the end of the day on May 17, 2017; and ADOPTED Ordinance No. 2017-09,
which becomes effective on May 18, 2017.
AGENDA ATTACHMENTS
Ordinance No. 2017-08
Ordinance No. 2017-09
CCCEMSA-District Contract
District-AMR Contract
MINUTES ATTACHMENTS
Signed Ordinance No. 2017-08
Signied Ordinance No. 2017-09
April 18, 2017 CCCFPD Minutes 42
ORDINANCE NO. 2017-08
1
ORDINANCE NO. 2017-08
(Uncodified)
URGENCY INTERIM COST RECOVERY ORDINANCE FOR EMERGENCY
AMBULANCE SERVICES
The Contra Costa County Board of Supervisors, as and constituting the Board of
Directors of the Contra Costa County Fire Protection District, ordains as follows:
SECTION I. Authority. This ordinance is enacted pursuant to Health and Safety Code
sections 13910 through 13919, and Government Code section 25123.
SECTION II. Findings and Purpose.
A. Effective January 1, 2016, the Contra Costa County Fire Protection District (the “District”)
began providing Emergency Ambulance Services in Emergency Response Areas 1, 2 and 5
of Contra Costa County (the “Service Area”) pursuant to the Emergency Ambulance
Services contract (the “Ambulance Contract”), between Contra Costa County (the
“County”) and the District.
B. Under the Ambulance Contract, the District is required to employ all resources necessary to
continuously provide Emergency Ambulance Services to persons in the Service Area 24
hours a day, every day, when requested by an emergency medical dispatch center.
C. The District does not possess the infrastructure or personnel necessary to directly perform
the Emergency Ambulance Services required under the Ambulance Contract. American
Medical Response West (the “Ambulance Services Subcontractor”) provides Emergency
Ambulance Services in the Service Area on the District’s behalf under a subcontract with
the District (the “Ambulance Subcontract”).
D. The District responds to a high volume of calls for Emergency Ambulance Services
through its Ambulance Services Subcontractor, which deploys personnel to incidents and
provides Emergency Ambulance Services treatment and transport to persons at those
incidents.
E. The Ambulance Contract sets the rates the District is authorized to charge for providing
Emergency Ambulance Services. During the first year of the Ambulance Contract, the
County required the District to charge Emergency Ambulance Services patients the
following amounts: (1) an Emergency Ambulance Response base rate of $2,100; (2) a
mileage rate (for each mile traveled with a loaded patient) of $50.00 per mile; (3) an
oxygen administration charge of $175.00; and (4) a treat and refused transport charge (in
some cases) of $450.00 (the “Original Rates”).
F. The Ambulance Contract, requires the County, when requested by the District, to increase
the Original Rates by the greater of 3%, or the increase in the Consumer Price Index, All
Urban Consumers for Medical Care (U.S. city average) (1982-84=100) (“CPI”) for the
preceding calendar year. The CPI increase for calendar year 2016 was 3.8%.
April 18, 2017 CCCFPD Minutes 43
ORDINANCE NO. 2017-08
2
G. The Ambulance Subcontract requires the hourly rates paid by the District to the Ambulance
Services Subcontractor to increase annually by the percentage equal to the product of the
District’s average medical billing collections rate for the preceding calendar year,
multiplied by the greater of 3% or the CPI increase for the preceding calendar year.
H. The District has reasonably calculated its costs of providing Emergency Ambulance
Services to persons at an incident. These costs include the District’s costs of its
Ambulance Services Subcontractor, the costs of its billing and collections subcontractor,
and the cost of District staff to provide Emergency Ambulance Services on a per-patient
basis. The Emergency Ambulance Services fees established by this ordinance are
calculated based on the District’s actual costs of providing Emergency Ambulance Services
on a per-patient basis, and are equivalent to a 3.8% increase in the Original Rates
established by District Ordinance No. 2015-24.
I. This ordinance is necessary for the District to begin billing patients receiving Emergency
Ambulance Services beginning on April 18, 2017, the effective date of this ordinance. A
threat to the public health, safety, and welfare would result if the District is unable to begin
billing patients receiving Emergency Ambulance Services as of this date. This ordinance is
being adopted on April 18, 2017. At the same meeting, the District is adopting a non-
urgency ordinance authorizing the District to charge increased emergency ambulance
services fees. The effective date of the non-urgency ordinance is May 18, 2017. If the
District were only to adopt an Emergency Ambulance Services fee ordinance on a non-
urgency basis, it would not be able to begin billing patients receiving Emergency
Ambulance Services the increased fees until 30 days after adoption of the ordinance; i.e.,
May 18, 2017. Because of the high volume of Emergency Ambulance Service calls
provided by the District, it would forego a significant amount of revenue if it could not bill
Emergency Ambulance Service patients the increased fees for Emergency Ambulance
Services until May 18, 2017. The failure to enact this urgency Emergency Ambulance
Ordinance would result in the District paying increased rates to it Ambulance Services
Subcontractor effective April 1, 2017, without being able to charge increased Emergency
Ambulance Services fees until May 17, 2017.
SECTION III. Definitions. For purposes of this ordinance, the following terms have the
following meanings:
(a) “ALS” means advanced life support emergency medical services designed to provide
definitive prehospital emergency medical care that are administered by authorized
personnel (i) under the direct supervision of a facility designated by Contra Costa County
Emergency Medical Services Agency (“CCCEMSA”) pursuant to Health and Safety Code
section 1798.100, or (ii) by utilizing approved prehospital treatment protocols or standing
orders as part of the County EMS system, and which are administered at the scene of an
emergency, during transport to an acute care hospital or other approved facility, during
inter-facility transfers, and while in the emergency department of an acute care hospital
until responsibility is assumed by the emergency department or other medical staff of that
hospital. ALS may include, without limitation, cardiopulmonary resuscitation, cardiac
monitoring, cardiac defibrillation, advanced airway management, intravenous therapy,
April 18, 2017 CCCFPD Minutes 44
ORDINANCE NO. 2017-08
3
administration of specified drugs, and other medicinal preparations, and other specified
techniques and procedures.
(b) “BLS” means basic life support emergency medical services including, but not limited to,
emergency first aid and cardiopulmonary resuscitation medical care procedures which, as a
minimum, include recognizing respiratory and cardiac arrest and starting proper application
of cardiopulmonary resuscitation to maintain life without invasive techniques, unless
authorized by state law or regulation, until the victim may be transported or until ALS
medical care is available.
(c) “Emergency Ambulance Services” means emergency ambulance services involving the
administration of ALS, BLS, or critical care transport, provided in response to 911 calls
and/or requests for emergency medical services through a public safety agency where 911
calls are first received for a particular jurisdiction, or prehospital emergency calls received
directly by the District.
SECTION IV. Emergency Ambulance Services Fees.
(a) The Emergency Ambulance Services fees to recover the District’s actual costs of providing
Emergency Ambulance Services to each patient are established in the amount specified in
Exhibit A attached hereto and incorporated herein.
(b) During the period beginning April 18, 2017, and continuing through the end of the day on
May 17, 2018, the Emergency Ambulance Services fees shall be charged to each person
who receives District Emergency Ambulance Services during a single incident.
SECTION V. Fee Collection.
(a) If the District provides Emergency Ambulance Services to a person through its Ambulance
Services Subcontractor, the Fire Chief, or designee, including the District’s Emergency
Ambulance Services billing subcontractor, will send an invoice seeking payment of the
Emergency Ambulance Services fees to the person, and to the insurance company that
provides medical insurance coverage for the person (the “Insurer”) if the person or his or
her representative has identified to the District or to its Ambulance Services Subcontractor
the Insurer to which the invoice should be sent.
(b) The Fire Chief, or designee, has approved and adopted policies and procedures for
invoicing, billing, and receiving payments for each Emergency Ambulance Services fee
charged under this ordinance. The policies and procedures include a process to discharge
from accountability accounts that are not collectible.
SECTION VI. No Effect on Emergency Ambulance Services. This ordinance neither
expands nor limits Emergency Ambulance Services. Nothing in this ordinance relieves the
District from providing Emergency Ambulance Services. Emergency Ambulance Services will
continue to be provided without regard to whether a person is insured by an Insurer, and without
regard to whether a person has the ability to pay the Emergency Ambulance Services fees.
April 18, 2017 CCCFPD Minutes 45
ORDINANCE NO. 2017-08
4
SECTION VII. No Waiver of Other Means of Cost Recovery. This ordinance does not
preclude the District from recovering its Emergency Ambulance Services costs in any other
manner authorized by law.
SECTION VIII. Severability. If any fee or provision of this ordinance is held invalid or
unenforceable by a court of competent jurisdiction, that holding shall not affect the validity or
enforceability of the remaining fees or provisions, and the Board declares that it would have
adopted each remaining part of this ordinance irrespective of any such invalidity.
SECTION IX. DECLARATION OF URGENCY. This interim ordinance is hereby
declared to be an urgency ordinance for the immediate preservation of the public safety, health,
and welfare of the County, and it shall take effect immediately upon its adoption. The facts
constituting the urgency of this interim ordinance’s adoption are set forth in Section II.
SECTION X. Effective Period. This ordinance becomes effective immediately upon passage
by four-fifths vote of the Board and shall continue in effect through the end of the day on May
17, 2017. Within 15 days after its passage, this ordinance shall be published once with the
names of the directors voting for and against it in the Contra Costa Times, a newspaper
published in this County.
PASSED ON _________________________________ by the following vote:
AYES:
NOES:
ABSENT:
ABSTAIN:
ATTEST: DAVID J. TWA, ____________________________
Clerk of the Board of Supervisors Board Chair
and County Administrator
By: ________________________ [SEAL]
Deputy
ESG:
H:\ConFire\Ambulance Services Contracts\Fee Ordinance\2017 Increase\CCCFPD Urgency Emergency Ambulance Services
Fee Ord - County Counsel 4-11-17 Comments (Clean).docx
April 18, 2017 CCCFPD Minutes 46
ORDINANCE NO. 2017-08
5
Exhibit A
Emergency Ambulance Services Fee Calculation
For each Emergency Ambulance Service call, District shall charge the patient the
Emergency Ambulance Response Base Rate, plus mileage costs at the Mileage Rate. If oxygen is
administered to a patient, District shall charge the patient the Oxygen Administration Charge,
whether transported or not. If a patient is treated and refuses transport, District shall charge the
Treat and Refused Transport rate.
1. Emergency Ambulance Response Base Rate ................................................. $2,180.00
2. Mileage Rate (for each mile traveled with a loaded patient) .............................. $52.00
3. Oxygen Administration Charge ........................................................................ $182.00
4. Treat and Refused Transport ............................................................................. $467.00
April 18, 2017 CCCFPD Minutes 47
April 18, 2017 CCCFPD Minutes 48
April 18, 2017 CCCFPD Minutes 49
April 18, 2017 CCCFPD Minutes 50
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April 18, 2017 CCCFPD Minutes 52
April 18, 2017 CCCFPD Minutes 53
ORDINANCE NO. 2017-09
1
ORDINANCE NO. 2017-09
(Uncodified)
COST RECOVERY ORDINANCE FOR EMERGENCY AMBULANCE SERVICES
The Contra Costa County Board of Supervisors, as and constituting the Board of
Directors of the Contra Costa County Fire Protection District, ordains as follows:
SECTION I. Authority. This ordinance is enacted pursuant to Health and Safety Code
sections 13910 through 13919.
SECTION II. Findings and Purpose.
A. Effective January 1, 2016, the Contra Costa County Fire Protection District (the “District”)
began providing Emergency Ambulance Services in Emergency Response Areas 1, 2 and 5
of Contra Costa County (the “Service Area”) pursuant to the Emergency Ambulance
Services contract (the “Ambulance Contract”), between Contra Costa County (the
“County”) and the District.
B. Under the Ambulance Contract, the District is required to employ all resources necessary to
continuously provide Emergency Ambulance Services to persons in the Service Area 24
hours a day, every day, when requested by an emergency medical dispatch center.
C. The District does not possess the infrastructure or personnel necessary to directly perform
the Emergency Ambulance Services required under the Ambulance Contract. American
Medical Response West (the “Ambulance Services Subcontractor”) provides Emergency
Ambulance Services in the Service Area on the District’s behalf under a subcontract with
the District (the “Ambulance Subcontract”).
D. The District responds to a high volume of calls for Emergency Ambulance Services
through its Ambulance Services Subcontractor, which deploys personnel to incidents and
provides Emergency Ambulance Services treatment and transport to persons at those
incidents.
E. The Ambulance Contract sets the rates the District is authorized to charge for providing
Emergency Ambulance Services. During the first year of the Ambulance Contract, the
County required the District to charge Emergency Ambulance Services patients the
following amounts: (1) an Emergency Ambulance Response base rate of $2,100; (2) a
mileage rate (for each mile traveled with a loaded patient) of $50.00 per mile; (3) an
oxygen administration charge of $175.00; and (4) a treat and refused transport charge (in
some cases) of $450.00 (the “Original Rates”).
F. The Ambulance Contract, requires the County, when requested by the District, to increase
the Original Rates by the greater of 3%, or the increase in the Consumer Price Index, All
Urban Consumers for Medical Care (U.S. city average) (1982-84=100) (“CPI”) for the
preceding calendar year . The CPI increase for calendar year 2016 was 3.8%.
April 18, 2017 CCCFPD Minutes 54
ORDINANCE NO. 2017-09
2
G. The Ambulance Subcontract requires the hourly rates paid by the District to the Ambulance
Services Subcontractor to increase annually by the percentage equal to the product of the
District’s average medical billing collections rate for the preceding calendar year,
multiplied by the greater of 3% or the CPI increase for the preceding calendar year.
H. The District has reasonably calculated its costs of providing Emergency Ambulance
Services to persons at an incident. These costs include the District’s costs of its
Ambulance Services Subcontractor, the costs of its billing and collections subcontractor,
and the cost of District staff to provide Emergency Ambulance Services on a per-patient
basis. The Emergency Ambulance Services fees established by this ordinance are
calculated based on the District’s actual costs of providing Emergency Ambulance Services
on a per-patient basis, and are equivalent to a 3.8% increase in the Original Rates
established by District Ordinance No. 2015-25.
SECTION III. Definitions. For purposes of this ordinance, the following terms have the
following meanings:
(a) “ALS” means advanced life support emergency medical services designed to provide
definitive prehospital emergency medical care that are administered by authorized
personnel (i) under the direct supervision of a facility designated by Contra Costa County
Emergency Medical Services Agency (“CCCEMSA”) pursuant to Health and Safety Code
section 1798.100, or (ii) by utilizing approved prehospital treatment protocols or standing
orders as part of the County EMS system, and which are administered at the scene of an
emergency, during transport to an acute care hospital or other approved facility, during
inter-facility transfers, and while in the emergency department of an acute care hospital
until responsibility is assumed by the emergency department or other medical staff of that
hospital. ALS may include, without limitation, cardiopulmonary resuscitation, cardiac
monitoring, cardiac defibrillation, advanced airway management, intravenous therapy,
administration of specified drugs, and other medicinal preparations, and other specified
techniques and procedures.
(b) “BLS” means basic life support emergency medical services including, but not limited to,
emergency first aid and cardiopulmonary resuscitation medical care procedures which, as a
minimum, include recognizing respiratory and cardiac arrest and starting proper application
of cardiopulmonary resuscitation to maintain life without invasive techniques, unless
authorized by state law or regulation, until the victim may be transported or until ALS
medical care is available.
(c) “Emergency Ambulance Services” means emergency ambulance services involving the
administration of ALS, BLS, or critical care transport, provided in response to 911 calls
and/or requests for emergency medical services through a public safety agency where 911
calls are first received for a particular jurisdiction, or prehospital emergency calls received
directly by the District.
April 18, 2017 CCCFPD Minutes 55
ORDINANCE NO. 2017-09
3
SECTION IV. Emergency Ambulance Services Fees.
(a) The Emergency Ambulance Services fees to recover the District’s actual costs of providing
Emergency Ambulance Services to each patient are established in the amount specified in
Exhibit A attached hereto and incorporated herein.
(b) The Emergency Ambulance Services fees shall be charged to each person who receives
District Emergency Ambulance Services during a single incident.
(c) The District Board of Directors (the “Board”) may adjust the amount of the Emergency
Ambulance Services fees established by this ordinance pursuant to Health and Safety Code
section 13916.
SECTION V. Fee Collection.
(a) If the District provides Emergency Ambulance Services to a person through its Ambulance
Services Subcontractor, the Fire Chief, or designee, including the District’s Emergency
Ambulance Services billing subcontractor, will send an invoice seeking payment of the
Emergency Ambulance Services fees to the person, and to the insurance company that
provides medical insurance coverage for the person (the “Insurer”) if the person or his or
her representative has identified to the District or to its Ambulance Services Subcontractor
the Insurer to which the invoice should be sent.
(b) The Fire Chief, or designee, has approved and adopted policies and procedures for
invoicing, billing, and receiving payments for each Emergency Ambulance Services fee
charged under this ordinance. The policies and procedures include a process to discharge
from accountability accounts that are not collectible.
SECTION VI. No Effect on Emergency Ambulance Services. This ordinance neither
expands nor limits Emergency Ambulance Services. Nothing in this ordinance relieves the
District from providing Emergency Ambulance Services. Emergency Ambulance Services will
continue to be provided without regard to whether a person is insured by an Insurer, and without
regard to whether a person has the ability to pay the Emergency Ambulance Services fees.
SECTION VII. No Waiver of Other Means of Cost Recovery. This ordinance does not
preclude the District from recovering its Emergency Ambulance Services costs in any other
manner authorized by law.
SECTION VIII. Severability. If any fee or provision of this ordinance is held invalid or
unenforceable by a court of competent jurisdiction, that holding shall not affect the validity or
enforceability of the remaining fees or provisions, and the Board declares that it would have
adopted each remaining part of this ordinance irrespective of any such invalidity.
SECTION IX. Effective Date. This ordinance becomes effective 30 days after its passage.
Within 15 days after its passage, this ordinance shall be published once with the names of the
directors voting for and against it in the Contra Costa Times, a newspaper published in this
County.
April 18, 2017 CCCFPD Minutes 56
ORDINANCE NO. 2017-09
4
PASSED ON _________________________________ by the following vote:
AYES:
NOES:
ABSENT:
ABSTAIN:
ATTEST: DAVID J. TWA, ____________________________
Clerk of the Board of Supervisors Board Chair
and County Administrator
By: ________________________ [SEAL]
Deputy
ESG:
H:\ConFire\Ambulance Services Contracts\Fee Ordinance\2017 Increase\2017 CCCFPD Emergency Ambulance Services Fee Ord -
County Counsel 4-11-17 Comments (Clean).docx
April 18, 2017 CCCFPD Minutes 57
ORDINANCE NO. 2017-09
5
Exhibit A
Emergency Ambulance Services Fee Calculation
For each Emergency Ambulance Service call, District shall charge the patient the
Emergency Ambulance Response Base Rate, plus mileage costs at the Mileage Rate. If oxygen is
administered to a patient, District shall charge the patient the Oxygen Administration Charge,
whether transported or not. If a patient is treated and refuses transport, District shall charge the
Treat and Refused Transport rate.
1. Emergency Ambulance Response Base Rate ................................................. $2,180.00
2. Mileage Rate (for each mile traveled with a loaded patient) .............................. $52.00
3. Oxygen Administration Charge ........................................................................ $182.00
4. Treat and Refused Transport ............................................................................. $467.00
April 18, 2017 CCCFPD Minutes 58
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Contra Costa County
Standard Fonn L-1
.Revised 2014
1: Contract ldentificadon.
STANDARD CONTRACT
(Purchas ~ of Services -Long Form)
Department: Contra Costa County Fire Protection Disbict
Subject: Emergency Ambulance Services
Number:
Fund/Org:
Account:
Other:
2 . Parties. The County of Contra Costa, California (County), for its Department named above, and the following named
Contractor mutually agree and promise as follows:
Contractor: American Medical Response West
Capacity: California Corporation
Address: 5151 Port Chicago Highway, Suite A, Concord. CA 94520
3. Term. The effective date of this Contract is Januazy 1. 2016. It tcnninates on December 31. 2020 unless sooner
terminated as provided herein.
4 . Pavment Limit. County's total payments to Contractor under this Contract shall not exceed
$ 200.000.000.
S. County's Oblig11tio11s. County shall make to the Contractor those payments described in the Payment Provisions
attached hereto which are incorporated hetein by reference, subject to all the terms and conditions contained or
incorporated herein.
6. Contractor's Obligations. Contractor shall provide those services and carry out that work described in the Service
Plan attached hereto which is incorporated herein by reference, subject to all the terms and conditions contained or
incorporated herein.
7. General and Special Conditions. This Contract is subject to the General Conditions and Special Conditions (if any)
attached hereto, which are incorporated herein by reference .
8. Proiect. This Contract implements in whole or in part the following described Project, the application and approval
documents of which are incorporated herein by reference.
Fonn L-1(Page1 of2)
April 18, 2017 CCCFPD Minutes 147
Contra Costa County
Standard Form L-1
~evised 2014
STANDARD CONTRACT
(Purchase of Services -Long Form)
Number:
Fund/Org:
Account :
Other:
9. Legal Authority. This Contract is entered into under and subject to the following legal authorities:
California Health and Safety Code Section 13861 and all legal authorities cited in the HIPAA Business Associate
Addendum attached to this Contract and incorporated herein by this reference.
10. Signatures. These signatures attest the parties' agreement hereto:
COUNTY OF CONTRA COSTA. CALIFORNIA
BOARD OF SUPERVISORS ATIEST: Clerk.ofthe Board of Supervisors
By:~~
CONTRACTOR
Signature A
Name of business entity: American Medical Response
West, a California corporation
Timothy Dorn, COO/CFO
(Print name and title A, if applicable)
Signature B
Name of business entity: American Medical. Response
West, a California corporation
f;JV>/avl /;. Vf.i.i /1(),ri't.~, ~>1~t
(Print name and title B, if applicable.
Npte !o Contracl.OC For corpomions (protit or nonprofit) md limltcd liability <l<JmpmUei, the c;ontract must be aigncd by two officers. Signature A must be that
of the dlainnan of the board. praiclent, or ~idmt; and Signature B must be that of the &CCl'daty, any assistant secrdll'ry, chief financial officer or any
assisrant treasun:r (Civil C-Ode Scc;tion l 190 and Corporations Code Section 313). All sigoatureS must be acknowledged as set forth on Fonn lr2.
Fonn L-1(Page2 of2)
April 18, 2017 CCCFPD Minutes 148
Contra Costa County
Standard Form I....2
Revised 2014.2
ACKNOWLEDGMENT/ APPROVALS Number:
(Purchase of Services -long Form)
ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed
the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA Colora~
)
COUNTY OF CONTRA COSTA Ar~ahoe
On December 18, 2015 (Date),
before me, Angela M Willoughby (Name and Title of the Officer),
personally appeared, Timothy Dorn
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within
instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacicy(ies), and that
by his/her/their signature(s) on the instrument the person(s). or the entity upon behalf of which the person(s) acted,
executed the instrument.
I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and
com:ct. ~----------------------, I I
I I
I I
t ANGELA M V'ALLOUGHBY I S MY HAND AND OFFICIAL SEAL.
I NOTARY PUBLIC I
I STATE OF COLORADO I
I Notaiy ID 20014015310 I
I My Commission E>cpil9S 11116/2017 I
I I
I I L----------------------1
Place Seal Above
ACKNOWUIDGMENT (by Capontion, Pmtnenhip, or lndiv;dual)
(Civil Code §1189)
APPROVALS
REco."'-.. ·• µVJ,.l.''11.l .VED BY DEPARTMENT
~
B~
Fonn L·2 (Page 1 of 1)
April 18, 2017 CCCFPD Minutes 149
Contra Costa County
Standard Fonn P-1
Revised 2008
PAYMENT PROVISIONS Nwnber
(F~ Basis Contrads • Long and Short Form)
1. Payment Amounts. Subiect to the Payment Limit of this Contract and subject to the following Payment
Provisions, County will pay Contractor the following fee ao; fUH compensation for aJl services, work, expenses
or costs provided or incurred by Contractor:
ICheck one alternative only.I
Da. s
Ob.$
Or..$
monthly, or
per unit.. as defined in the Service Plan, or
;tller completion of all obligations and conditions herein.
181 d. Other. As set forth in Section P (Payment Provisions) of the Service Plan.
2. Payment Demands. Contractor shall submit written demands for payment on County Demand Fonu D-15 in
the manner and fonn preS<.Tibed by County. Contractor shall submit said demamls for payment no later limn
30 days from the end of the month in which the contract services upori which such demand is based were
actually rendered. Upon approval of payment demands by the head of the County Deprnment for which tllis
Contract is made, or his dcsignee, County will make payments as specified in Paragraph 1. (Payment
Amounts) above.
3. Penalty for Late Submission. If County is unable to obtain reimbursement. from the State of California as a
result. of Contractor's failure to submit to County a timely demand for payment as specified in Paragraph 2.
(Payment Demands) abovet County shall not pay Contractor for b'Uch scrnccs to the extent County's recovery
of funding is prejudiced by the delay even though such services were fully provided.
4. Right to Wlthhold. County has the right to wid1h0Jd payment to Contractor when, in tl1e opinion of County
expressed in writing to Contra<.1or, (a) Contractor's perfonnance, in whole or in part, eitl1er has not. been
carried out or is insufficiently documented, OJ) Coutr.u.:tor has m.-gl.ccted, failed or refused to f'Umish
information ·or lo cooperate with any inspection, review or audit of its program. work ·or records, or (c)
Contractor has failed lo sufficiently itemize or docmnent its dcmand(s) for payment.
5. Audit Exceptions. Contrctctor agrees to accept responsibility for recci\ing, replying to, and/or complying with
any audit exceptions hy appropriate county, state or foderal audit agencies resulting from its pcrfonuance of
tllis Contract. Within 30 days of demand, Conlractor shaJl pay County the full amount of Conney's obligation,
if any, to the state and/or federal govemment resulting from any audit exceptions, to the extent such are
attributable to Contractor's failure to pcrlorm properly any of its obligations under tllis Contract.
hllriru~~
Contractor eouJJ1VDept.
Form P-1 (Page 1 of 1)
April 18, 2017 CCCFPD Minutes 150
SERVICE PLAN
(Purchase of Services p Long Form)
TABLE OF CONTENTS
Section Page Number
A. Purpose .............................................................................................................................. ~ ....•.. 2
8. Definitions ................................................................................................................................. 2
C. Contractor Subcontracting ............................................... ,, ........................................................ 5
D. Scope of Services ..................................................................................................................... 5
E. Clinical Performance Standards ................................................................................................ 8
F. Standards of Care ................................................................................................................... 14
G. Clinical Education Training ...................................................................................................... 17
H. Operations Performance Standards ......................................................................................... 22
I. Personnel Standards ............................................................................... "' .............................. ., 28
J. .Fleet and Equipment. ............................................................................................................... 32
K. Communications ..................................................................................................................... 34
L. Customer Service and Community Education ......................................................................... 36
M. Operational and Clinical Data Collection, Information Management and Reporting ................. 37
N. Integration with First Responder Programs ............................................................................. 39
0. Disaster, Multi-Casualty and Mutual Aid Response ................................................................. 40
P. Payment Provisions: Billing; Reporting ..................................................................................... 42
Q. Administrative .......................................................................................................................... 44
R. Workforce Engagement and Benefits ....................................................................................... 47
S. Risk Management Program ..................................................................................................... 47
Form L-3 (Page 1 of 55)
lnillals: I((
Contractor
April 18, 2017 CCCFPD Minutes 151
SERVICE PLAN
(Purchase of Services .~ Long Form)
A. Purpose. The purpose of this Contract is to set forth the respective obligations of the parties
regarding the delivery of emergency ambulance services in certain areas of the County . The
parties understand and agree that the purpose of this Contract is for the provision of
emergency ambulance services to Contra Costa County ("Countv"). ·
B. Definitions.
1. "Advanced EMT" or "AEMT" means a California certified emergency medical technician
with additional training in limited advanced life support pursuant to Health and Safety Code
section 1797 et seq.
2. "Advanced Life Support" or "ALS" means special services designed to provide
definitive prehospital emergency medical care including, but not limited to,
cardiopulmonary resuscitation, ·cardiac monitoring, cardiac defibrillatlon, advanced airway
management, intravenous therapy, administration of specified drugs, and other medicinal
preparations, and other specified techniques and procedures administered by authorized
personnel under the direct supervision of the Base Hospital or utilizing approved
prehospital treatment protocols or standing orders as part of the EMS System at the scene
of an emergency, during transport to an acute care hospital or other approved facility,
during Inter-facility transfers, and while in the emergency department of an acute care
hospital until responsibility is assumed by the emergency department or other medical staff
of that hospital.
3. "ALS Ambulance" means an ambulance equipped, or arranged and staffed for the
purpose of providing ALS care within the EOAs while under contract with the County.
4. "Ambulance" means any motor vehicle that meets the standards set forth in Title 13 of
the California Code of Regulations, and which is specifically constructed, mod ified or
equipped, or arranged, used, licensed, or operated for the purpose of transporting sick,
injured, convalescent, infirmed, or otheiwise .incapacitated persons in need of medical
care.
5. "Ambulance Strike Team" or "AST" means a team of five staffed ambulances, a
designated AST leader (herein, an "ASTL11
), and an ASTL vehicle.
6. "Ambulance Unit Hour'' means a 60 minute period of time during which Contractor has
made one appropriately supplied and staffed Ambulance (in accordance with the
provisions of this Contract) available to respond to requests for service within the Service
Area and for other approved events, services and obligations. ,
7 . "Annual System Improvement and Enhancement Goals" means those goals, mutua lly
agreed upon by the parties, that contain the EM& System improvements and
enhancements that are to be implemented by Contractor for the specified year.
8. "Arrival on Scene Time'' has the meaning set forth in Section H(5)(c) below.
9. "Base Hospital" means John Muir Medical Center, Walnut Creek campus, or other facility
designated by CCCEMSA pu~uant to Health and Safety Code section 1798.100;
10. "Basic Life Support" or "BLS" means emergency first aid and cardiopulmonary
resuscitation medical care procedures which, as a minimum, include recognizing
respiratory and cardiac arrest and starting proper application of cardiopulmonary
resuscitation to maintain life without invasive techniques, un less authorized by state law or
regulation, until the victim may be transported or until ALS medical care is available.
11. ••BLS Ambulance" means an Ambulance equipped, or arranged, and staffed for the
purpose of providing BLS care within the County .
12. °CCCEMSA" means the County agency having primary responsibility for the
administration of EMS within the county;
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13 . "CCCEMSA Contract" means the Emergency Ambulance Services contract, dated
January 1, 2016, between County and District for the delivery of emergency ambulance
services in the Service Area. ·
14. "CCCEMSA Medical Director'' means the physician designated by the County to serve
as the medical director of CCCEMSA pursuant to Health and Safety Code section
1797.202 .
15. "CCCEMSIS" means the Contra Costa County Emergency Medical Services Information
System as setforth in Section M(2).
16 . "Collaboration Committee" means the committee described in Section P(12).
17. "Continuous Quality Improvement" or "CQI" means the process of evaluating
prehospital EMS and non-emergency transportation services to identify where personnel
performance or the system itself can be improved, implementing potential improvements,
and reevaluating and refining them in a continuous cycle. While quality assurance
traditionally focuses on the detection of defects, COi strives to prevent them.
18. "County EMS System" or "EMS System" means the specifically organized system of
local EMS communications centers (law enforcement, fire, and ambulance), emergency
ambulance providers , non-emergency ambulance providers, lo~I fire agencies, air
ambulance/rescue providers, local hospitals, local and state law enforcement agencies ,
EMS training programs, and EMS continuing education providers that provide the
coordinated delivery of EMS services within the County.
19. "County" .has the meaning set forth in the first paragraph of this Contract.
20. "County EMS Plan" means a plan for the delivery of emergency medical services
pursuant to Health and Safety code section 1797 et seq.
21. "Disaster Medical Support Unit" or "DMSU" means a vehicle owned by EMSA and
provided to CCCEMSA for disaster medical response .
22 . "District" means Contra Costa County Fire Protection District, a fire protection district
existing under the laws of the State of California.
23. ..District's Contact Person" has the meaning set forth in Section C(2) below.
24. "Emergency Ambulance" means an Ambulance pennitted pursuant to Division 48 of the
County Ordinance Code and operated by a CCCEMSA authorized emergency ambulance
provider in an EOA as identified in the County EMS Plan.
25. "Emergency Ambulance Services" means Ambulance services provided at any
CCCEMSA authorized level (ALS, critical care transport, or BLS) provided in response to
9-1-1 and/or seven (7} digit or ten (10) digit requests for EMS through an authorized
PSAP, or prehospital emergency calls received directly by Contractor.
26. "Emergency Ambulance Transport" means any Ambulance transport originating from a
9-1-1, seven (7) digit or ten (10) digit request for service through an authorized PSAP, or
originating from prehospital emergency calls received directly by Contractor, or an
Ambulance transport of a patient suffering a medical emergency from the prehospital
environment to a CCCEMSA authorized acute care facility or hospital emergency
department.
27. "Emergency Medical Dispatch Center" means an emergency medical dispatch center
that has been approved by CCCEMSA for dispatching Ambulances under this Contract.
28. "Emergency Medical Dispatch System" means a system that enhances services
provided by emergency medical dispatchers by allowing the call taker to quickly narrow
down the caller's type of medical or trauma situation using nationally standardized medical
triage, so as to better dispatch emergency services and provide quality instruction to the
caller before help arrives.
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29.
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SERVICE PLAN
(Purchase of Services-Long Form)
"Emergency Medical Servlces11 or "EMS" means the services delivered through the
EMS System in response to a medical emergency.
"Emergency Response Area" or 11 ERA" means ambulance emergency response areas
established by CCCEMSA and delineated on the map entitled "Emergency Response
Areas of the County", as amended, which is on file in the office of CCCEMSA and the
Clerk of the County Board of Supervisors.
"EMS Quality Improvement Plan" or uE.QIP" means the EMS System-wide quality
improvement plan and activities stated in the plan submitted by CCCEMSA and approved
by the EMSA pursuant to California Code of Regulations, Title 22.
"EMSA" means the California Emergency Medical Services Authority.
"EMT" means a person certified to render BLS medical care pursuant to Health and
Safety Code section 1797 et seq.
"EOA" means an exclusive operating area or subarea defined by the County EMS Plan
where operations are restricted to one (1) or more Emergency Ambulance Service
provider or providers of ALS services pursuant to Health and Safety Code section
1797.224.
"Emergency Response Zone" or "ERZ" means those areas defined by the County EMS
Plan that establishes an emergency response zone and which are set forth on Exhibit A
{Emergency Response Zones Map} as_ERZ A, ERZ B, ERZ C, and ERZ D.
14 ePCR" has the meaning setforth in Section M(6) below.
"ePCR System" has the meaning set forth in Section M(1) below.
"IHI" means the Institute.of Healthcare Improvement.
"Interim PCR" means a PCR that has not been completed, but includes patient care
findings and a description of pre-hospital treatment that is sufficient to allow the receiving
hospital staff to provide patient care continuity.
"KPI" has the meaning set forth in Section (E){12) below.
"Medical Health Operational Area Coordinator'' or .. MHOAC" means the County health
officer and the CCCEMSA Director acting jointly as the Medical Health Operational Area
Coordinator under California Health and Safety Code section 1797 .153 as responsible for
ensuring the development of a medical and health disaster plan for the Operational Area.
"MCI" means a medical emergency incident involving multiple or mass casualties.
••performance Report" means a report to be generated by Contractor for District on an
annual or monthly basis that details Contractor's activities performed pursuant to this
Contract and presents the performance metrics and compliance elements stipulated under
this Contract in a format approved by CCCEMSA.
.. Paramedic" means a person licensed and accredited to render ALS medical care
pursuant to Health and Safety Code section 1797 et seq.
upcR" means a patient care report, the form of which shall be approved by CCCEMSA for
patient documentation on EMS System responses including all patient contacts, cancelled
calls, and non-transports.
"Permitted Ambulance Providers" means those ambulance provider agencies issued a
permit to operate in the County pursuant to Division 48 of the County Ordinance Code.
11 PSAP" means the public safety answering point where 9-1-1 calls are first received for a
particular jurisdiction.
"Response Time" means the interval, in exact minutes and seconds, between the Time
Call Received and either the Arrival on Scene Time, or the time of cancellation by an
Emergency Medical Dispatch Center.
"Response Time Standards" has the meaning set forth in Section H(3).
lnitials: ~ ·
"Service Area" has the meaning set forth in Section D(1)(a) below. l-
Contractor Co .
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51. "Time Call Received" has the meaning set forth in Section H(5)(b) below.
52. "Transport Employees" means Contractor's employees that provide ambulance
transport services.
C. Contractor as Subcontractor.
1 . Subcontracting. District has entered into the CCCEMSA Contract, but does not have the
infrastructure or personnel necessary to directly perfoh'n the ambulance services required
thereunder. This Contract.is being entered Into for the purpose of Contracto r acting as
District's subcontractor to perform emergency ambulance services pursuant to the terms of
this Contract. This Contract is subject to all the terms and conditions of the CCCEMSA
Contract, and Contractor represents that it has received a copy of the CCCEMSA Contract
and is aware of its requirements. Contractor understands and agrees that certain
provisions of this Contract obligate it to comply with CCCEMSA's directions, and
Contractor agrees to comply with such oblfgations as set forth herein. Nothing contained
in this Contract shall create any contractual relationship between County and Contractor.
2. County Communications. Contractor shall direct all communications regarding its
performance of its obligations under this Contract to an individual designated by District in
writing to Contractor ("District's Contact Person"), or a designee within District's
organization designated in writing by District's Contact Person; provided, that District's
Contact Person may authorize Contractor to contact CCCEMSA in certain specified
situations. The parties shall discuss communications issues as necessary at monthly
Collaboration Committee meetings described in Section P(12) below. This provision shall
not abr6gate or otherwise restrict Contractor's direct communication with CCCEMSA
concerning Contractor's Transport Employees as required by regulation or law.
D. Scope of Seivices.
1. Service Activities. Contractor shall provide ambulance services in the County pursuant to all
the terms and conditions contained or incorporated herein, and subject to the proposal
submitted to CCCEMSA by Contractor and District, dated May 21, 2015, and the Plan B
Proposal submitted to CCCEMSA by Contractor and District, dated July 6,.2015
(collectively, the "Proposal"), which are on file with CCCEMSA located at 1340 Arnold
Drive, Suite 126, Martinez, CA and incorporated herein by reference. In the case of any
conflict between the provisions of this Contract and the provisions of the Proposal, the
provisions contained in this Contract's Service Plan, Specia l Conditions, General
Conditions, and Exhibits shall prevail . The ambulance services delivered under this
Contract shall be provided in accordance with the requirements of California Health and
Safety Code sections 1797 et seq., Division 48 of the Contra Costa County Ordinance
Code, and all regulations promulgated thereunder, as the same may be amended or
superseded. In performing services hereunder, Contractor agrees to work cooperatively
with CCCEMSA.
a . Scepe of Services. Contractor, throughout the term of this Contract and under the
general direction of District, shall employ all resources necessary to continuously
provide ALS Emergency Ambulance Services as specified undet this Contract to the
residents and visitors of County twenty-four (24) hours a day, every day, when
requested by an Emergency Medical Dispatch Center, in Emergency Response Areas
1, 2 and 5 (wService Area"). The parties understand and agree that durin the term of
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this Contract, Response Time requirements and deployment of ambulance resources
may be adjusted through amendments to this Contract. Contractor will work with
District and CCCEMSA to pilot and implement changes to Response Time
requirements, ERZs, and call density designations as necessary for the protection of
the public's health and safety as provided in this Contract.
i. EOA Adjustments. Contractor understands and agrees that County may, as
necessary for public safety, health and welfare to ensure an effective County EMS
System, make adjustments to the EOAs consistent with applicable laws.
b. Advanced life Support CALSl Mandate.
i. ALS Ambulance Response. Contractor shall place an ALS ambulance on scene for
every request for Emergency Ambulance Services, without interruption, twenty-four
(24) hours per day, for the full term of this Contract, unless otherwise authorized by
District through an approved Emergency Medical Dispatch Center and resource
response program that dictates the level and priority of ambulance response.
Contractor understands and agrees that the foregoing ALS mandate may be
suspended by CCCEMSA either directly or by policy/protocol during an MCI or
disaster response. Services provided by Contractor shall be provided without regard
to the patient's race, color, national origin,·religious affiliation, age, sex, sexual
orientation, sexual identity, or ability to pay.
ii. Penaltv. District shall impase a penalty on Contractor in the amount set forth in
Exhibit C (Penalties) for each instance in which Contractor is penalized under the
CCCEMSA Contract because an Emergency Ambulance is not dispatched to a call
originating within the Service Area and no Ambulance responds.
c. Ambulance Services Accreditation. Throughout the term of this Contract, Contractor
shall maintain accreditation through the Commission on Accreditation of Ambulance
Services.
d. Ambulance Staffing.
i. Subject to Section I (Personnel Standards) below, all Ambulances providing
Emergency Ambulance Services under this Contract shall be staffed with a
minimum of one (1) Paramedic and one (1) EMT and equipped to provide ALS care.
The Ambulance Paramedic shall be the caregiver with ultimate responsibility for all
patients.
ii. Contractor may send BLS Ambulance units staffed with two (2} EMT's to requests
for multi-unit response and to any calls in which an Emergency Medical Dispatch
Center determines that a BLS Ambulance response is appropriate according to
emergency medical dispatch protocols and policies approved by CCCEMSA.
iii. District may impose a penalty on Contractor in the amount set forth in Exhibit C
(Penaltles) for each instance in which a BLS Ambulance responds and transports a
patient that required ALS care according to pollcies approved by CCCEMSA.
iv. At Contractor's sole option, the requirement for EMT staffing levels on any or all
Ambulance units may be enhanced to higher levels of training without additional
obligation of District.
e. ALS Inter-Facility Transportation. Contractor and District shall negotiate in a good faith
effort to develop and implement an ALS inter-facility transportation services program
within 24 months of the effective date of this Contract.
f. Additional Services. During the term of this Contract, the parties agree to meet to
discuss additional services that Contractor may provide under this Contract, including
without limitation, special-event standby ambulance services, up-staffing of ambulances
for cities that want to pay for the costs of those services, and general up-staffing of
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ambulances at District's discretion, and to amend this Contract to provide for such
services if agreement is re.ached.
2. No Prehosoital Emeraency Medical Services Aareement. This Contract pertains to the
provision of emergency ambulance services only. District remains responsible for the
provision and administration of first responder prehospital emergency medical services
within its fire district.
3. Integration and Collaboration with the EMS Svstem. Contractor agrees to work
collaboratively with District, CCCEMSA, PSAPs, public safety partners, other Permitted
Ambulance Providers, hospitals and communities in an effort to provide an integrated and
coordinated system of readiness, emergency medical response, transport and continuity of
patient care. This includes requests from or approved through District and CCCEMSA for:
mutual and automatic aid; community education and injury prevention campaigns; work on
critical infrastructure; participation in planning activities; support for committees, joint
training programs, drills, educational events and conferences; research projects; preparing
grant or funding applications; supplying clinical reports and performance data, and
continuous QI initiatives.
a. Contractor agrees to provide community service, outreach and education as outlined
within Section L {Customer Service and Community Education) below.
b . Contractor shall assist other EOA and Non-EOA ambulance service providers and
provide mutual aid inside and outside Service Area as requested by D istrict. ·
c. Contractor's automatic aid and mutual aid policies, protocols and operational
procedures for deploying and receiving Ambulance resources from within or outside the
Service Area are subject to approval by District and CCCEMSA.
4. Local Infrastructure. Contractor shall provide all necessary operational, cli nical, and
support service infrastructure within the County to perform the services required under this
Contract.
5. Soecial Emergency Medical Services. Contractor may provide special EMS programs as
approved by District and CCCEMSA. Examples of special EMS programs include, but are
not limited to: event medical services; bicycle EMS services; tactical EMS services ; and
community paramedic services. Where applicable, such special EMS program services
shall conform to established CCCEMSA policies and EMSA guidelines. Contractor's
provisions of special EMS programs shall not conflict with or interfere with Contractor's
other obligations under this Contract.
6. Compliance with CCCEMSA Protocols. Policies. Procedures and Applicable Laws .
Contractor shall comply with CCCEMSA protocols, policies, procedures, performance
standards, and with applicable laws in the provision of all services required by this Contract.
7. Capitalization. Contractor shall invest in its infrastructure, technology, and equipment to
enable Contractor to perform its obligations under this Contract, including operational
effectiveness, clinical care, and support services.
8. Disaster Assistance and Response. Contractor shall be actively involved in planning for
and .responding to MCls and disasters in the County. Contractor will Implement its medical
surge plan and deploy ASTs and disaster response efforts as requested by Distric4-the
lnltlals: /rt// ~r Coty_.>
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Medical Health Operational Area Coordinator. Once an emergency operations plan is
activated by the MHOAC in response to a disaster, all Contractor resources and mission
tasking shall be coordinated through the District and the California Master Mutual Aid
System in support of the emergency operations plan.
a. Contractor shall designate an individual who will have primary responsibility for disaster
preparedness and planning coordination . This individual shall be the primary point of
contact between District and Contractor during the performance of an emergency
operations plan and for all disaster preparedness and planning coordination.
Contractor's disaster coordinator shall attend training courses, meetings, and drills as
requested by CCCEMSA, and support the MHOAC to provide adequate ambulance
resources are available during MCls and disasters.
9 . Adopting Plan B Option. If the CCCEMSA Contract is amended to adopt one or more of the
options presented in Plan B of the Proposal due to circumstances surrounding the EMS
System preventing the efficient and financially v iable delivery of Emergency Ambulance
Services under the CCCEMSA Contract, the parties agree to amend this Contract to
conform to the CCCEMSA Contract amendments. The proposed changes to the Contract
and th~ potential impacts will be discussed by both parties prior to presentation to either
party's board.
E. Clinical Performance §tandards.
1. Continuous Qualitv Improvement (CQI) Program.
a . Contractor shall cooperate with CCCEMSA to implement improvements and
enhancements of the EMS System in an effort to provide residents of, and visitors to,
the County the highest quality emergency medical transportation seivices and
associated emergency medical care. Contractor shall participate, as reasonably
requested by CCCEMSA, in achieving the goals set forth in the County EMS Plan and
the EQIP. As determined by CCCEMSA, this shall i nclude implementing and
conducting all services described under this Contract in a manner that seeks clinical
performance excellence combined with innovative strategies and technology that
optimize delivery of high quality out-of-hospital medical care, community service and
service acoountability. Contractor shall provide District and CCCEMSA with a clinical
education program that achieves contemporary benchmarks of clinical excellence in a
progressive and sustainable fashion. Contractor's CQI programs and activities must
be reviewed by the CCCEMSA Medical Director and approved by CCCEMSA. All
programs and activities shall be conducted in accordance with CCCEMSA prehospital
care policies. Contractor shall not modify its approved CQI program without prior
approval by District and the CCCEMSA Medical Director. The CQI program must
encompass the sum of all activities undertaken by all Transport Employees to maintain
the standard of care established for those services.
i. Contractor shall cooperate with District and CCCEMSA to develop Annual System
Improvement and Enhancement Goals and reports consistent with the priorities
established In the County EMS System Plan and EQIP. Contractor's achievement
of its annual goals, as evidenced by results demonstrated in the annual
Performance Report, will be considered as part of District's optional extension of
this Contract under Section Q{15) below.
b. Contractor shall work with CCCEMSA to develop and· implement a CQI program plan
that is designed to deliver opti mal patient care and effective operations for all seivices
provided under this Contract. 'f' l-
lnitials: <( lf {f ~r Cot .
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2. Quality Improvement Processes.
a. Contractor's CQI program shall provide an organized, coordinated, multidisciplinary
approach to the assessment of pre-hospital emergency medical response and patient
care. QI processes shall be utilized to improve outcome oriented patient care and
facilitate related continuing education. Contractor's CQI program will be implemented
and refined with input, approval, and oversight of CCCEMSA and the CCCEMSA
Medical Director.
b. Contractor's medical director and CQI staff shall interact and collaborate with the
CCCEMSA Medical Director and CCCEMSA staff as requested by District.
3. Medical Control.
a. Contractor shall permit CCCEMSA to oversee medical services provided by Contractor
under this Contract. Prospective and on-line medical control of EMT and Paramedic
personnel shall be according to the policies and procedures established by the
CCCEMSA Medical Director. Retrospective medical control shall be provided
according to the standards set forth by the CCCEMSA Medical Director through CQI
programs, including continuing education programs conducted cooperatively by
Contractor, CCCEMSA, partner pre-hospital provider agencies, and the Base Hospital.
b. Contractor shall allow CCCEMSA, through District, to investigate aspects of
Contractor's operation relevant to its delivery of patient care services to ensure they
are performed in a safe and reliable manner. Accordingly, Contractor shall provide, in a
timely manner, all records, information, and reports reasonably requested by the
CCCEMSA Medical Director, or designee, to evaluate the emergency medical services
provided by Contractor under this Contract.
4. Medical Reviews and Audits.
a. Contractor acknowledges that medical reviews and audits are a critical function of an
effective medical quality assurance and improvement program.
i. Contractor shall work cooperatively with CCCEMSA, the CCCEMSA Medical
Director, the Base Hospital, District, and other EMS System partners to identify and
support activities that provide case-based learning and feedback to Transport
Employees.
ii. Contractor shall cooperate with requests by the CCCEMSA Medical Director, or
designee, for employee attendance at medical reviews or audits.
5. Incident Review and Investigations.
a. Contractor shall provide reasonable cooperation and information requested by District
relative to incidents and inquiries and will make involved personnel available for
interview by CCCEMSA staff in a timely manner.
i. Contractor's supervisory and management personnel will assist CCCEMSA with
incident investigations and disciplinary activities as requested by District.
ii. Contractor shall make its employees available to District and CCCEMSA for
investigational interviews as necessary.
iii. To the greatest extent possible, incident investigations are to be scheduled in
adv1;1nce for the convenience of Transport Employees. Contractor shall arrange
schedule changes, if necessary, to make incident review or investigation more
convenient. District shall work with Contractor in an effort to avoid unnecessarily
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altering procedures and processes that are already in place in Contractor's
organization.
b. Contractor will respond to requests for information received from District within
reasonable time frames included in the information request. This shall include PCRs,
supplemental patient information, CAD records, incident narratives and reports,
inventory ordering, receipt and control documentation, fleet maintenance records,
critical failure reports, safety reports, and any other informatipn or records required by
CCCEMSA to fully complete thorough reviews and investigations related to any
services provided under this Contract.
c. Contractor shall foster a culture that is designed to rectify clinical mistakes and·
emphasize lessons learned for the benefit of the patient and caregivers (e.g., Just
Culture). In this model, caregivers are taught to recognize that mistakes are made and
feel able to report these mistakes and have them remedied in a non-punitive setting.
d. Contractor shall notify District of the occurrence of any· and all incidents, as defined in
the criteria, policies, and procedures established by CCCEMSA.
6. Field Treatment Guide Production.
a. Contractor understands that CCCEMSA (i) has made an electronic version of its field
treatment guide available to the public at no cost through an iOS and Android
application, (ii) will update and maintain all policies, treatment guidelines, procedures,
and other field care related information in the application as necessary, and (iii) will
make available a current electronic copy of the field treatment guide upon request at no
cost.
b. Contractor is financially responsible for the production of CCCEMSA Field Treatment
Gu ide manuals at its cost should Contractor choose to print manuals for Transport
Employees.
7. Clinical Education and Training. Contractor shall develop and implement a clinical
education and training program that is consistent with the CCCEMSA EQIP, and which
shall be approved by CCCEMSA. Contractor's clinical education and training program will
include new employee orientation, continuing education at no cost to participants, and a
Field Training Officer program as described in Section F(3) below for pre/post accreditation
paramedics. Contractor shall, and shall become a continuing education provider as
described in California Code of Regulations, Title 22, Division 9, Chapter 11, and maintain
its status as a continuing education provider during the term of this Contract.
8. Clinical Quality Improvement Program Staff Commitment. Contractor shall provide CQI
staff to coordinate and provide Contractor's CQI activities. Required CQI staff and
responsibilities include:
a. Associate Medical Advisor. Contractor shall retain a California licensed physician as an
associate medical advisor to support its chief medical advisor in his/her responsibilities.
b. CES Director. Contractor shall employ and maintain a Regional Clinical and Educational
Services (CES) Director who will provide oversight and management of KPls and
ongoing organization-wide quality management programs.
c. CES Manager. Contractor shall employ and maintain a minfmum of one (1) full-time
CES Manager, with specialized training and experience in quality improvement to
implement and oversee Contractor's ongoing quality management program. The CES
Manager shall be responsible for coordination of au clinical review activities, developing
lnitials:l(W' ~ ~ Counfy
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and supporting a comprehensive orientation academy for new employees, and
managing Contractors internal and system-Integrated CQI activities. ·
i. The CES Manager shall be currently licensed in California as a Paramedic .or
registered nurse and be based in the County.
d. CES Coordinator. Contractor shall and maintain a minimum of one (1) full-time CES
Coordinator who will be responsible for the medical quality assurance evaluation of all
services provided pursuant to this Contract.
i. The CES Coordinator shall be currently licensed in California as a Paramedic or
registered nurse and based in the County.
ii. It is preferable but not mandatory that at least one (1) CES Manager or one (1} CES
Coordinator position be filled by a licensed California registered nurse.
e. EMS Epidemiologist I Clinical Data Analyst. Contractor shall employ and maintain a
minimum of one ( 1) full-time Clinical EMS Epidemiologist I Clinical Data Analyst, who
shall be made available to work directly with CCCEMSA and the EMS Medical Director
to gather, analyze, and report EMS System wide clinical perfonnance data as specified
by the County. The Clinical EMS Epidemiologist I Clinical Data Analyst shall evaluate
PCRs.
i. The EMS Epidemiologist/ Clinical Data Analyst shall attain the Structured Query
Language (SQL) Developer competency level.
ii. The Clinical EMS Epidemiologist I Clinical Data Analyst shall be based in the
County.
f. Contractor shall make available a minimum of eighty (80) compensated hours per
month for designated field employees to participate in CQI activities.
9. IHI Certificate of Patient Safety. Quality and Leadership. Contractor's quality and clinical
personnel shall complete an IHI Open School online certificate program in Patient Safety,
Quality, and Leadership within eighteen ( 18) months of the effective date of this Contract or
of employee hire.
10. Integrated Quality Leadership Council (QLC). Contractor shall work with District and
CCCEMSA to implement and coordinate an integrated quality leadership council to identify,
evaluate, and recommend solutions to common issues related to an integrated EMS
response. The QLC shall include Contractor and representatives from fire agencies
providing paramedic service within Contractor's Service Area.
11. Coordination of Data Gathering and Quality Improvement Efforts.
a. Contractor shalt support implementation of a technological tool that will fully integrate
electronic records and alignment of data sets EMS system wide, in cooperation with
CCCEMSA and fire services. A fully implemented tool will be capable of the following
within the Service Area:
i. Allow for quantitative reporting of overall clinical performance, which can be tied to
providing integrated EMS System patient care solutions, training and community
prevention, meaningful data comparison and greater collaborative research
opportunities.
ii. Provide real-time data to fire agencies for use In fire CQI activities.
iii. Contractor shall reasonably cooperate with CCCEMSA on all data initiatives used to
support clinical care and Ql.
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12. Clinical and Operational Benchmarking and Research .
a . Key Performance Indicators and Benchmarks . Contractor shall use key performance
indicators (as detailed below, "KPls") as tools for measuring Contractor's performance
under this Contract. In addition Contractor shall identify benchmarks and other QI tools
to evaluate and set goals for improving the clinical and non-clinical performance of
Contractor's personnel. Contractor shall provide District with periodic reports detailing
its KPI and benchmarks progress according ·to a schedule approved by CCCEMSA.
b. Non-Clinical KPls. Contractor's non-clinical KPls shall include at least the following :
i. Customer satisfaction KPls
ii . Human Resources/Employee satisfaction KPls:
A. Shift holdovers per week
B. Employee turnover rate
C. Turnover factors/employee satisfaction
iii. Community health partnership KPls:
A. 9-1-1 calls for patient conditions targeted in commun ity health awareness
programs, which include:
x. B1forly falls
y. s·reMI transports
z. Early onset stroke transports
B. Number of community health improvement activities
x. Home inspections
y. Fall prevention for seniors
z. Track annual fire injuries/fatalities
iv. Fleet KPls :
A. Critical vehicle failures per 100,000 miles
B. Preventative maintenance cycles
v. Safety KPls:
A. Employee Injuries per 10,000 payroll hours
B. Vehicle collisions per 100,000 miles travelled
C. Types of injury events
D. Types of auto events
vi. Unusual occurrences and complaints KPls
vii. Financial stability KPls:
A. Unit hour utilization ratio
B. Net revenue per transport
viii . Response time performance by zone, priority, and county~wide
ix. Complaint management
x. Use of mutual aid
xi. Safety
c. Qinical KPls . Contractor's clinical KPls shall Include at least the following :
A. Presumptive impressions at dispatch compared to field intervention
B. Scene time and total prehospital time for time dependent clinical cond itions like
Acute Coronary Syndrome (ACS), stroke, and major trauma
C. Cardiac arrest survival in accordance with Utstein protocols
D. Fractal measurement of time to first defibrillation
E. Compliance with protocols , procedures , timelines, and destinations for ST-Elevation
Myocardial Infarction (STEMI) patients
F. Compliance with protocols, procedures , and timelines for patients with pulmonary
edema and congestive heart failure (CHF)
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G. Compliance with protocols, procedures, and timelines for patients with asthma or
seizures
H. Compliance with protocols, procedures, and timelines for patients with cardiac arrest
I. Compliance with protocols, procedures, and timelines and destinations for systems
of care patients (e.g. trauma, STEM!, stroke, and cardiac arrest)
J . Compliance with protocols, procedures, and timelines for assessment of pain relief
K. Analysis of high risk, low frequency clinical perfonnance issues and strategies to
support competent care
L. Successful airway management rate by entire system , provider type, and individual ,
Including EtC02 detection
M. Successful IV application rate by entire system, provider type, and ind ividual
N. Paramedic skill retention
d. Provide data developed through Contractor's COi process to District and CCCEMSA for
use in evaluating EMS System performance and in setting system improvement goals.
e. Incorporate any CCCEMSA approved benchmarking tools identified during the term of
this Contract into Contractor's COi process .
13. Medical Committee Participation . Contractor shall participate In all medical committees,
work gro.ups and task forces as requested by CCCEMSA.
14. Medical Research.
a. Contractor shall collaborate with D istrict and the CCCEMSA Medical Director to develop
pilot programs and research projects. Any costs to be incurred by the parties in
connection with pilot programs or research projects will be agreed upon at the
Collaboration Committee meetings. Any proposed pilot program and research project
must be approved in writing by District and the CCCEMSA Medical Director before
being undertaken.
b. If the requirements of a pilot program or research project conflict with Contractor's
perfonnance obligations under this Contract, District may temporarily suspend
Contractor's conflicting performance obligations for the purpose of the pilot program or
research project.
c. Except as set forth in subsection (b) above, Contractor agrees that Contractor's
services provided under pilot programs and research projects are in addition to the
other services it performs under this Contract.
15. Patient Satisfaction Program. Contractor shall develop and implement, upon approval by
District and CCCEMSA, a comprehensive patient satisfaction program ("PSP") that focuses
on services provided to patients in the County EMS System. The PSP shall contain
quantitative and qualitative assessment mechanisms that will enable CCCEMSA to validate
and benchmark patient feedback on the quality of services they were provided by
Contractor.
16. CQI Program Administration. If there are complaints or concerns regarding the
performance of any key COi personnel during the term of this Contract, Contractor shall
cooperate in good faith with CCCEMSA and District in addressing and resolving such
concerns. Any issues arising in the performance or administration of the COi program will
be addressed by Contractor, District, and CCCEMSA through the dispute resolution
process set forth in Section P(12).
lnillals: ,,( Nfl/' ~ JL
Couhty.,
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17. Cardiac Arrest Performance Reporting Svstem. Contractor shall work collaboratively with
CCCEMSA to strive to increase pre-hospital provider cardiopulmonary resuscitation (CPR)
performance by supporting the existing CPR performance reporting system (e.g.,
CodeStat). No later than January 1, 2017, Contractor shall timely and consistently annotate
all applicable cardiac arrest reports received through the CPR performance reporting
system.
18. Against Medical Advice Protocol.
a . Protocol Development. Contractor and District shall cooperate with CCCEMSA to
develop an Against Medical Advice (AMA) protocol, which shall be implemented and
followed by Transport Employees beginning no later than January 1, 2017.
b. Penalties. District may impose a penalty on Contractor in the amount set forth in Exhibit
C (Penalties) for a Transport Employee's failure to document an AMA according to the
requirements established in the AMA protocol.
F. Standards of Care.
1. Patient Care Goal. Contractor shall cooperate and collaborate with District and CCCEMSA
to develop, implement, and continuously improve clinical standards of care that optimize
patient outcomes. Contractor further agrees to continuously maintain optimal effort to
improve core indicators of quality service as established by CCCEMSA with the goal to
consistently provide excellent patient care and patient satisfaction.
2. Continuous Quality Improvement (CQI) Program Plan. Contractor shall work with District
and CCCEMSA to develop and implement, upon approval by District and CCCEMSA, a
CQI program plan that seeks optimal patient care and effective operations for all services
provided under this Contract. The COi program plan shall:
a . Be in compliance with California Code of Regµlations , Title 22, Division 9 , Chapter 12,
associated state guidelines, National Association of EMS Officials guidelines, and the
CCCEMSA EMS Quality Improvement Plan.
b. Utilize practices that promote Integration and collaboration for clinical excellence with all
EMS System participants, including:
i. Data collection and analysis
ii. Real-time and retrospective patient care record audits conducted by Field Training
Officers
iii. Observation and evaluation of clinical care performed by supervisors and
management staff
c. Establish and maintain a sufficient organizational structure within Contractor's operation
that supports effective clinical oversight and execution-of the plan.
d . Contain provisions to continuously monitor, evaluate, and report core performance,
process, and patient outcome indicators as established by CCCEMSA.
e . Establish and maintain clinical metric score cards for Contractor's EMTs and
paramedics that shall include, but are not limited to the following:
I. Safe and effective maintenance of airway and ventilation
·A. Shall include each employee's basic and advanced airway success rates and
number of attempts of each
ii. Reduction of pain and discomfort
A. Shall include each employee's mean patient pain and discomfort rating before
and after intervention. For paramedics, a usage percentage of controlled
substances for pain management a:
Initials (/ t (\J
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iii. Relief of respiratory distress
A. Shall include each employee's mean respiratory distress rating before and after
Intervention
iv. Cardiac arrest resuscitation -shall include the total number of cardiac arrest patients
for each employee, and include the following:
A. Percentage of return of spontaneous circulation
B. Number of patients transported to a hospital with return of spontaneous
circulation
C. Chest compression rate accuracy
o: Mean time between rounds of chest compressions
E. Percentage of cardiac arrests defibrillated
F. Percentage of cardiac arrest patients who were treated with epinephrine
G. Percentage of cardiac arrest patients treated with amiodarone
H. Percentage of cardiac arrest patients treated with sodium bicarbonate
I. Percentage of patients who received EtC02 monitoring
J. Percentage of vascular access devices (e.g. IV and 10) and placement location
K. The number of field pronouncements.
v , Recognition and care of ischem.ic syndromes -shall include the total number of
suspected STEMI patients identified for each Tran~port Employee, and include the
following:
A. Percentage of 12-Lead ECG's obtained calculated against total number of
STEMI patients
B. Mean 12-Lead ECG transmit time calculated from time arrived at patient's side
to time of 12-Lead ECG transmission
C. Percentage of suspected STEMI patients treated with aspirin
D. Percentage of suspected STEMI patients treated with nitroglycerin
E. Percentage of suspected STEMI patients treated with controlled substances for
pain management
F. Percentage of suspected STEMI patients treated with oxygen
G. Percentage of suspected STEMI patients who received an IV
H. Mean scene time for suspected STEMI patients calculated from time arrived at
patient's side to time of transport
vi. Shall include the total number of suspected stroke patients identified by each
Transport Employee, and include the following:
A. Percentage of suspected stroke patients who had a documented GCS
B. Percentage of suspected stroke patients who had a documented blood glucose
value
C. Percentage of suspected stroke patients who had a documented Cincinnati
Stroke Scale f LAMS evaluation
D. Percentage of suspected stroke patients treated with oxygen
E. Percentage of suspected stroke patients who received an IV
F. Mean scene time for suspected stroke patients calculated from time arrived at
patient's side to time of transport
vii. Effective and timely trauma care -shall include the total number of suspected
trauma patients identified by each employee, and include the following :
A. Percentage of blunt trauma patients
8. Percentage of penetrating trauma patients
C. Percentage of trauma activations
D. Percentage of trauma patients transported to a trauma ~ cl-
lnltlals:
ontractor Co t y/
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E. Percentage of trauma patients transported to a non-trauma hospital
F. Percen~e of adult trauma patients
G. Percentage of pediatric trauma patients
H. Percentage of trauma patients who received an IV/10
I. Total number of field pronouncements of traumatic arrest
J . Mean scene time for trauma patients calculated from time arrived at patient's
side to time of transport
viii. Ensuring safe patient care and transportation -shall include the total number of
patients attended to by each employee calculated by the number of patient care
records where each employee was listed as the primary patient care provider, and
include the total number of patient injuries that occurred as a result of unsafe care,
equipment failure, or vehicle collisions.
f. In addition to the provision of medical care, include the follow ing areas :
i. Customer-Patient Satisfaction
ii. Accountability for patient belongings
iii. Injury/Illness Prevention
iv. Community Education
v. Human Resources
vi . Safety
vii . Fleet. Equipment Performance and Materials Management
viii . Unusual Occurrences , Incidents, and Complaint Management
ix. Leadership
x. Communications (Deployment, System Status Management and Dispatching}
xi. Risk Management
g. Demonstrate progressive quality improvement results evidenced by annual written
updates to District CCCEMSA on the effectiveness of the plan and summary of
activities conducted under the plan.
h. Include procedures to provide an Interim PCR or a completed ePCR for each patient
response utilizing the CCCEMSA approved data system , and. for delivery of the Interim
PCR or ePCR to the receiving hospital in a timely manner.
i. Include linkages to continuing education programs .
j. Include action planning to improve performance based upon core ind icators as
established by CCCEMSA.
3. Field Training Officer (Train-the-Trainer} Program .
a. Contractor shall develop and implement a comprehensive Field Training Officer (FrO)
Program subject to approval by District and CCCEMSA. The FTO program shall, at a
minimum, include:
i. An outline of the responsibilities of the FTO and new hire ambulance employees .
ii. Establishing minimum and maximum number of shifts or hours required for each
new hire ambulance employee to complete during FTO evaluation.
iii . Establishing a clearly defined pathway for remediation of deficiencies discovered
during the field evaluation process .
iv. Using standard ized evaluation forms for all new hire ambulance employees
v. Utilize industry best practices that promote a friendly and cooperative learning
environment.
vi . Ensuring new hire ambulance employees are afforded time with a FTO prior to
working on an ambulance alone .
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vii. Utilize the education and personnel management process described in Section
E(5)(c) above.
viii. Ensuring that Contractor has sufficient number of qualified FTOs to support
execution of the CQI plan, Contractor and CCCEMSA education and training
programs, and other duties on behalf of Contractor.
ix. Incorporate an evaluation method for both FTO of new hire ambulance employee
and new hire ambulance employee of the FTO.
G. Clinlcal Education Training. Contractor shall develop and implement, upon approval by
District and CCCEMSA. a clinical ·education and training program that utilizes contemporary
performance-based methods and processes. The clinical education and training program shalt
be linked to Contractor's CQI program plan, and be consistent with the CCCEMSA EQIP. The
clinical education and training program shalt include elements as outlined below:
1. Comprehensive and Integrated Training Programs. Contractor shall have a comprehensive
training and education program for its paramedics, EMTs, management, and support staff.
Training and education classes shall be open to all Contractor employees. Contractor is
responsible for the training programs, but the programs shall adhere to CCCEMSA
requirements and be developed collaboratively with CCCEMSA, hospitals, educational
institutions, and other system partners.
2. Clinical Education Services·. Contractor shall provide District and CCCEMSA with its
Clinical and Educational Services (CES) organization schematic for approval. Contractor's
CES organization shall identify sufficient qualified personnel to provide that all education
and training requirements as stated in this Contract are implemented and maintained.
3 . Training Program Components.
a. Contractor shall require that all new Transport Employees complete an orientation that
is designed to prepare them to be fully functioning EMTs or Paramedics in the County.
The orientation program shall be approved by District and CCCEMSA and will include,
but not be limited to:
i. Contra Costa EMS System overview;
ii. A review of all relevant CCCEMSA plans, programs, policies, protocols, and
procedures as appropriate for the individual's level of credentialing and job
duties;
iii. Customer service expectations and cultural awareness and sensitivity education
iv. Demonstration of skills proficiency in optional and infrequent skills as identified
in CCCEMSA policies, protocols, procedures, performance standards, and EQIP
(This may be approved as a component of field evaluation and training);
v. Geography and map reading skills training including key landmarks, routes to
hospitals, and other major receiving facilities within the County and surrounding
vi.
vii.
viii.
ix.
areas;
Hospital receiving centers, trauma centers, and specialty care centers including
designated patient catchment areas:
Radio communications with and between the ambulance, Base Hospital,
receiving hospitals, county communications centers, and emergency operations
frequencies;
Contractor's policies and procedures;
Emergency vehicle operations course (EVOC);
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x. Clinical quality improvement (CQI) plan:
xi.
xii.
Human resources, benefits , payroll, and scheduling overview and training;
Corporate and/or department compliance policies ;
xiii.
xiv.
xv.
xvi.
OSHA/Federal Laws and Regulations:
Dementia and elderly citizen training;
Workplace health and safety;
Illness/Injury. Prevention;
xvii. Infection Control and personal protective equipment use;
xviii. Violence in the workplace:
xix.
xx.
xxi.
Diversity In the workplace;
Harassment.free workplace;
Medical and legal guidelines;
xxii . Assaultive behavior management training;
.xxiii.
xxiv.
xxv.
Performance improvement;
Billing and reimbursement processes;
Professionalism;
xxvi. Back safety ;
xxvii. Critical incident stress management
xxviii. Patient care record system training and documentation standards;
xxix. Trauma triage; ·
xxx. Mobile data terminal instruction and communication ;
xxxi. Health Insurance Portability and Accountability Act (HIPAA),and the Health
Information Technology for Economic and Clinical Health (HITECH) Act
confidentiality and regulation;
xxxii. Hazardous materials (first responder awareness level);
xxxiii. MCls
xxxlv. Gurney operations;
xxxv. Ambulance utilization and system status training;
xxxvi. Cultural competence and linguistic access :
xxxvii. Medical equipment familiarization, maintenance, user competency, and critical
failure reporting;
xxxviii . Code of conduct;
xxxix. Field training program and new employee expectations ;
xi. Tuberculosis screening and.Hepatitis B immunization;
xii. Vehicle maintenance, including mandatory daily vehicle check;
xiii. Hazardous material and communications and weapons of mass destruction; and
xliii. Patient focused care and advocacy.
b. Contractor shall provide refresher training for each of the topics listed above to all
Transport Employees as required by law.
c. Contractor shall make its general training and education programs available to all EMS
System stakeholders.
4. EMT Education and Training Reauirements.
a. The parties understand that required training may be modified by changes in
CCCEMSA plans, programs, policies, protocols, and procedures. Education/training
required for EMTs include:
i. EMT skills competency (i.e. skills competency verification for EMT recertification);
ii. Incident Command System r1cS"} 100 , 200 and 700, 800 must be completed within
three (3) months of hire; Lilt_ / Initials :~ _(\) __ _
Contractor Co\ilii?
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iii. Infrequent Skills Lab: annual hands-on experience demonstrating proficiency in
skills as defined by the EOIP;
iv. Annual CCCEMSA policy, protocol, and procedures updates:
v. Annual training courses/offerings as identified by the CCCEMSA Medical Director,
Contractor Medical Advisor. or CES Manager through COi activities;
vi. 9-1-1 ambulance/paramedic partner training;
v ii. Mandatory Contractor-based training no less than four (4) hours each between two
(2) and four (4) times per year;
viii. Annual attendance of two (2) hours of disaster training;
ix. Annual attendance of an additional two (2) hours of disaster training focused on
interoperability with fire and law enforcement;
x. Annual attendance of a Communications Center evacuation drill; and
x i. Prior to working on a 9-1 -1 ambulance with a Paramedic partner, EMTs will
complete Contractor's competency based Paramedic Partner curriculum. This
consists of a didactic curriculum and fjeld training/evaluation to be submitted to
CCCEMSA as part of Contractor's CQI plan. Following the didactic education, EMTs
will be assigned to an ambulance with an authorized field training officer and
complete a skills evaluation prior to being assigned to work one-on-one with a
paramedic partner.
5. Paramedfc Education and Training Requirements.
a. The parties understand that required training may be modified by changes in
CCCEMSA plans, programs, policies, protocols, and procedures. Education/training
required for paramedics include:
i. res 100, 200 and 700, 800 must be completed within three (3) months of hire;
ii. Infrequent Skills Lab: annual hands-on experience demonstrating proficiency on
low.frequency, high-risk skllls as defined by the EQIP;
iii. Annual CCCEMSA policy, protocol and procedure updates;
iv . Attendance at a minimum of one (1) Base Hospital (BH) tape review meeting per
year;
v. Annual attendance of two (2) hours of disaster training;
vi. Annual attendance of an additional two (2) hours of disaster training focused on
interoperability with fire and law enforcement;
vii. Annual attendance of a Communications Center evacuation drill;
viii. Annual tra ining courses/offerings as identified by the CCCEMSA Medical Director,
Contractor Medical Advisor or CES Manager through COi activities; and
ix. All new paramedics will complete the field evaluation program prior to being placed
on a field shift to work with an EMT partner. The field evaluation program shall
require that the new paramedic function under the direct supervision of a
CCCEMSA approved FTO during the evaluation period. The field evaluation
program shall be fn compliance with CCCEMSA policies and submitted as a part of
Contractor's COi plan.
6 . Supervisor Education and Training Requirements.
a. Contractor shall collaborate with District and CCCEMSA to develop and implement a
comprehensive field supervisor program that includes field operations guidelines and
policies to be followed by Transport Employee supervisors. The parties understand that
required training may be modified by changes in CCCEMSA plans, programs, policies,
Initials: AW ~r
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protocols, and procedures. Education/training required for Transport Employee
supervisors include:
L Applicable training arid education requirements for the supervisor's level of
certification; and
ii. Attend at least one (1) disaster exercise and two (2) hours of disaster training
annually.
7 . Management and Key Support Staff Training and Education Reauirements.
a. The parties understand that required training may be modified by changes in
CCCEMSA plans, programs, policies, protocols, and procedures. Education/training
required for management and key support staff include:
i. Applicable training and education requirements for the manager or support staff's
level of certification;
ii. National Incident Management System (NIMS) training, to include at a minimum
Independent Study, 100, 200, 300, 400, 700, and 800; and
Iii. Completion of an IHI certificate program focused on patient safety, quality, and
leadership by June 30, 2017, for existing personnel and within eighteen (18) months
of hire for new employees. IHI guidelines will be incorporated into the execution of
the clinical quality improvement (CQI) plan, training, and education.
8. Quality and Clinical Supervisory Staff
a. The parties understand that required training may be modified by changes in
CCCEMSA plans, programs, policies, protocols, and procedures. Education/training
required for Quality and Clinical Supervisory staff include:
L Applicable training and education requirements for the quality and clinical
supervisory staff's level of certification; and
ii. Completion of an IHI certificate program focused on patient safety, quality, and
leadership by Ju.ne 30, 2017, for existing personnel and within eighteen (18) months
of hire for new employees. IHI guidelines will be incorporated into the execution of
the CQI plan, training, and education.
9. Driver Training and Safety
a. All Contractor employees that operate emergency vehicles shall complete the following:
i. All persons driving an ambulance or support emergency response vehicle (ERV)
providing service under this Contract shall have successfully completed Contractor's
16-hour driver training program which is consistent with the Emergency Vehicle
Operator Course (EVOC) curriculum of the U.S. Department of Transportation, but
wilt include:
A. California state vehicle codes pertaining to emergency vehicle operation;
B . Case studies of emergency vehicle collisions and litigation;
C; Vehicle characteristics;
D. Defensive driving;
E. Placement of vehicles at emergency incidents;
F. Driving policies and procedures;
G. Collision avoidance -split-second classroom simulations and decision-making
drills behind the wheel of potential collision conditions:
H . Controlled speed -line-of-entry, hand positioning on the steering wheel,
apexing, vehicle dynamics, and braking techniques;
lnlllals: ,(Ji./ Q ~r ~
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I. Precision maneuvering -behind the wheel drills that include parallel parking; off-
set lanes, three-point turnaround, backing in and out of parking stalls, and
serpentines;
J. Training on all of Contractor's vehicle safety policies; and
K. Mapping, Navigation and Area Familiarization Training.
ii. Contractor will subscribe to the California Department of Motor Vehicles' "Pull
Notice" Program which tracks employee infractions of the California Vehicle Code.
iii. Contractor shall have a driver acceptability policy that establishes eligibility criteria
for individuals to whom Contractor extends the privilege of emergency vehicle
operation.
iv. Contractor shall provide remedial driver training to employees who have been
involved in a preventable collision or who have been identified as needing to
improve their ambulance driving skills.
10. Infection Control Training. Contractor shall implement an expanded infection control
program focused on decreasing cross-contamination among patients and protecting
employees from infections, as outlined in Contractor's California Occupational Safety and
Health Exposure Control Plan. Contractor shall train all Transport Employees during new
hire orientation on infection control, including how to use personal protective equipment as
well as practices to reduce cross-contamination between themselves and patients and
patient-to-patient. Ongoing practices and education, at a minimum. will include:
a. Infection control training (airborne and blood borne);
b. Cleaning, disinfection, and disposal;
c. Sharps exposure prevention;
d. Personal protective equipment;
e. Post-exposure management;
f. Respiratory protection program, including Cal OSHA 5199 Aerosol Transmissible
Disease standard, that includes annual respirator fit testing:
g. Annual Tuberculosis testing at no cost to the employee; and
h. Employee vaccinations including Hepatitis Band general influenza at no cost to the
employee.
11 . On-Going Evaluation of Training Programs. Contractor shall continuously evaluate the
effectiveness of the training programs required under this Contract. At the monthly
Collaboration Committee meetings, Contractor and District shall update CCCEMSA on
current revisions to the training programs required under the CCCEMSA Contract and this
Contract, and shall provide an annual summary of training program evaluations.
12. Quality Improvement Hotline. Contractor shall establish an ambulance service quality
improvement telephone number (the "QI Hotline") giving customers and EMS System
participants the ability to leave commendations or suggestions for service improvements on
a voice mailbox. Contractor shall publicize the QI Hotline telephone number at local
healthcare facilities, first responder stations, and public safety agencies. Members of
Contractor's QI/Leadership Team are to be automatically notified of any incoming calls to
the QI Hotline. Incidents that require feedback are to be attended to by the end of the next
business day.
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the development of a cultural-competency training program and materials for emergency
responders. Contractor shall recruit and employ employees that possess culturally
appropriate skills when interacting with the diverse County population.
H. Operations Performance Standards.
1. Emergency Response Zones <ERZ's). For the purposes of Ambulance staffing, Response
Time monitoring, reporting, and compliance, the Service Area has been divided into four (4)
ERZ's. Exhibit A (Emergency Response Zones Map), attached hereto and incorporated
herein by thi~ reference, illustrates the following ERZs:
a. ERZ A: The territory of the City of Richmond.
b. ERZ B : The territories of the City of El Cerrito, Kensington Fire Protection District, City
of Pinole, Rodeo-Hercules Fire Protection District, Crockett-Carquinez Fire Protection
District, and that portion of the District covering San Pablo, El Sobrante, North
Richmond, and other areas of western Contra Costa County.
c. ERZ C: That portion of the territory of the District covering Walnut Creek, Concord,
Clayton, Lafayette, Martinez, Pleasant Hill, and other areas of central Contra Costa
County.
d. ERZ D : That portion of the territory of the District covering Antioch, Pittsburg, Bay Point.
and unincorporated areas of east Contra Costa County served by the District, and the
territory of East Contra Costa County Fire Protection District covering Oakley,
Brentwood, and the unincorporated area of East Contra Costa County Fire Protection
District.
2 . Response Density Zones. For the purposes of Response Time monitoring, reporting, and
compliance, the Service Area has also been divided into two (2) Response Density Zones -
High Density and Low Density as shown on Exhibit B (Response Density Map), attached
hereto and incorporated herein by this reference. Upon Contractor's request, District shall
provide this information as a map layer for use with geographic information systems (GIS).
3 . Response Time Performance Standards. Contractor shall respond to each request for
paramedic emergency medical service originating from within Contractor's Service Area to
meet the Response Time standards listed below (the "Response Time Standards·):
a. Potentially Ufe Threatening Emergency Response (Priority 1). Priority 1 calls are calls
for a response to a potentially life threatening situation, and are dispatched with
emergency lights/sirens ("Priority 1 "). When contacted by a PSAP with a Priority 1 call
originating in Contractor's Service Area, Contractor shall place an ALS Ambulance on
the scene with maximum Response Times as follows :
i. Ten minutes and zero seconds {10:00} to calls originating in ERZ A.
Ii. Eleven minutes forty-five seconds (1"1 :45) to calls originating in ERZ's B, C, and D,
except for low density designated areas.
iii. Sixteen minutes forty-five seconds (16:45) to calls in Bethel Island.
iv. Twenty minutes and zero seconds (20:00) to calls within areas designated as low
de.nsity on Exhibit B (Response Density Map).
b. Non-Life Threatening Emergency Response CPrioritv 2). The parties may establish a
definition for what constitutes a Priority 2 call. If the parties amend this Contract to add
a definition for a Priority 2 call, then the following Response Times shall apply to Priori.ty
2 calls. When contacted by a PSAP with a Priority 2 call originating in Contractor's
Initials: lf'IM1/ \\ ~r ~
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Service Area, Contractor shall place an ALS Ambulanee on the scene with maximum
Response Times as follows:
i. Fifteen minutes and zero seconds (15:00) in designated high-density areas .
ii. Twenty minutes and zero seconds (20:00) to calls in Bethel Island.
iii. Thirty minutes and zero seconds (30 :00) in areas designated as low density.
c. Non-Emergency Response {Priority 3). Priority 3 calls are calls for a response to a
non-emergency ambulance situation, and are dispatched with no emergency
lights/sirens {"Priority 3"). When contacted by a PSAP with a Priority 3 call originating in
Contractor's Service Area, Contractor shall place an ALS Ambulance on the scene with
a maximum Response Time of thirty minutes and zero seconds (30:00) In areas
designated as high density, and a maximum Response Time of forty-five minutes and
zero seconds ( 45:00) in areas designated as low dens ity.
d . Non-Emergency lnterfacility ALS Transports (Priority 4)
i. Scheduled: Three Hours Notice. If Contractor receives a call for an ALS interfacility
non-emergency transport with at least three (3) hours notice, Contractor shall place
an ALS Ambulance on the scene within fifteen minutes zero seconds (15:00) of the
scheduled pickup time .
ii. Scheduled: Less Than Three Hours Notice. If Contractor receives a call for an ALS
interfacility non-emergency transport with less than three (3) hours notice,
Contractor shall place an ALS Ambulance on the scene within sixty minutes zero
seconds (60:00) of the time of the request.
4 . Medical Dispatch Improvement Collaboration. Contractor and District shall cooperate to
improve the dispatch of Emergency Ambulances during the term of th is Contract, including
without limitation, efforts to improve more specif ic prioritization of calls and mod ification of
Response Time requirements, and taking into consideration the costs to Contractor in
implementing changes.
5 . Response Time Calculation .
a . Response Time Calculations . Contractor understands and agrees that on a monthly
basis CCCEMSA will use Response Time data from District's CAD system via
CCCEMSA's online compliance utility tool to calculate Ambulance Response Times to
determine compliance with the Response Time Standards in Section H{3) above. At
the end of each calendar month, a date within the last fifteen (15) days of the month will
be randomly selected . The thirty-day period ending with the randomly selected date will
be used to measure Response Time compliance.
i. Resoonse Time Area Subsets. Response Times will be measured for all responses
within each ERZ in Contractor's Service Area, and are grouped by priority level . The
different density areas within each ERZ will be grouped for compliance Response
Time measurement.
b . Time Call Received. For all requests for service,-the term ·Time Call Rece ived " means
the earlier of: (i) the time when an Emergency Medical Dispatch Center that directly
d ispatches the Ambulance receives adequate information to identify the location of the
call and the priority level, and dispatches the call ; and (ii) the time when an Emergency
Medical Dispatch Center that directly dispatches the Ambulance receives adequate
information to iden tify the location of the call and the priority level , and resources have
been assigned , plus thirty (30) seconds.
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c. Arrival On Scene Time . For all requests for service, the term "Arrival On Scene Time"
means the moment the first Emergency Ambulance arrives and stops at the exact ·
location where the ambulance shall be parked while the crew exits to approach the
patient, and notifies the Emergency Medical Dispatch Center that it is fully stopped;
provided, that in situations where the Emergency Ambulance has responded to a
location other than the scene (e.g., stag ing areas for hazardous materials/violent crime
incidents, non-secured scenes, gated communities or complexes or wilderness
locations), the term "Arrival On Scene Time" means the time the Emergency Ambulance
arrives at the designated staging· location or nearest public road access point to the
patient's location; provided further, and subject to subsection (d) below, if an
Emergency Ambulance fails to report its Arrival On Scene Time, the time of the next
communication between the Emergency Medical Dispatch Center and that Emergency
Ambulance sh~ll be used as the Arrival On Scene Time .
d . Failure to Report Arrival On Scene Time . If an Emergency Ambulance fails to report its
Arrival On Scene Time, the time of the next communication with that Emergency
Ambulance shall be used as the Arrival On Scene Time; provided, that Contractor may
document the Emergency Ambulance's actual Arrival On Scene Time through other
means (e.g., first responder, automatic vehicle location services, communications
tapes/logs, etc.} so long as an auditable or unedited computer generated report Is
produced.
e . Upgrades. If an Ambulance assignment is upgraded (e .g., from Priority.2 to Priority 1)
prior to an Emergency Ambulance Arrival On Scene Time, Contractor's Response Time
compliance shall be calculated based on the shorter of: (i) time elapsed from call receipt
to time of upgrade plus the higher priority Response Time; and (ii) the lower priority
Response Time .
f. Downgrades. If a call is downgraded prior to Arrival on Scene Time, (e.g . from Priority
1 to Priority 2), Contractor's Response Time compliance shall be determined as follows:
i. If the time of the downgrade occurs after the Ambulance has exceeded the higher
priority Response Time Standard, the more stringent higher priority Response Time
Standard will apply; or,
ii. If the time of the downgrade occurs before the ambulance has exceeded the higher
priority Response Time Standard, the less stringent lower priority Response Time
Standard will apply. In all such cases documentation must be presented for
validation of the reason why the priority status was downgraded. If the downgrade
was justified in the sole discretion of District, the longer standard will apply.
g. Reassignment Enroute. If an Emergency Ambulance is reassigned enroute to a call, or
turned around prior to Arrival On Scene Time (e .g ., to respond to a higher priority
request), compliance with Response Time Standards will be calculated based on the
Response Time Standard applicable to the priority assigned to the initial response . The
Response Time clock will not stop until an Ambulance has an Arrival On Scene Time for
the call from which the Ambulance was diverted.·
h. Cancelled Calls . If an Emergency Ambulance is cancelled by an authorized agency
after an assignment has been made, but prior to an Arriva l On Scene Time, Contractor's
Emergency Ambulance Response Time clock will stop at the time of cancellation, and
Response Time will be the elapsed time from the Time Call Received to the time the
call was cancelled.
6. Resoonse Density Reassessment. Contractor understands and agrees that under the
CCCEMSA Contract, CCCEMSA may evaluate the call density and den ily zorie str~u~·e
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to address changes occurring within each zone. Contractor shall work with District to define
and implement any proposed changes to density reassessment throughout the term of this
Contract. Response Time compliance changes pursuant to this section will be modified by
readjusting the then current map (Exhibit B) defining the density designations by mutual
agreement of the parties.
7. Response Time Exemptions. In calculating Contractor's Response Time performance,
every emergency request from an Emergency Medical Dispatch Center originating from
within Contractor's Service Area shall be included except as follows :
a. Multiple Responses. In case of a multiple-response incident (i.e., where more than one
ambulance is sent to the same incident). only the Response Time of the first arriving
ALS Ambulance shall be counted.
b. Responses During an MCI or Disaster. During an MCI or disaster declared by the
County, or during a declared disaster in a neighboring jurisdiction to which ambulance
assistance is being provided as requested by County, CCCEMSA will determine, on a
case-by-case basis, if Contractor may be temporarily exempt from response-time
criteria. When District notifies Contractor that multi-casualty or disaster assistance is no
longer required, Contractor shall return all of its resources to the Service Area and shall
resume all operations as required under the Contract.
c. Good Cause. Contractor understands that under the CCCEMSA Contract, CCCEMSA
may allow exemptions to Response Time requirements for good cause at CCCEMSA's
sole discretion. At a minimum, the asserted ground(s) for exemption must have been a
substantial factor in producing a particular excess Response Time and Contractor must
have demonstrated a good faith effort to respond to the call(s}. Good causes for an
exemption may include, but are not limited to: incorrect or inaccurate dispatch
Information received from an Emergency Medical Dispatch Center; disrupted voice or
data radio transmission (not due to Contractor equipment or infrastructure); material
change in dispatch location; unavoidable telephone communications failure; inability to
locate address due to non-existent address; inability to locate patient due to patient
departing the scene; delays caused by traffic secondary to the incident; unavoidable
delays caused by extreme inclement weather (e .g., fog); unavoidable delays caused by
trains; delays resulting from depletion of resources as a result of County authorized
mutual aid; calls to locations that are greater than ten (10) road miles from the nearest
boundary of the high-density area, or calls to off-road locations; and extended delays at
hospitals for transferring patients to receiving facility personnel.
i. Contractor understands that equipment failure, Ambulance failure, lost Ambulance
crews , or other causes deemed to be within Contractor's control or awareness are
not grounds to grant an exemption to a Response Time Standard.
8. Exemption Request Procedure .
a. CCEMSA Exemption Request Procedure. CCCEMSA has developed and adopted a
Response Time Exemption Request Procedure (the "Exemption Request Procedure")
that Contractor will assist District in following when CCCEMSA is considering whether
an exemption to a Response Time Standard is appropriate.
b. Request for Exemption Consideration.
I. Application for Exemption. Contractor will assist District in the Exemption Request
Procedure process . Upon District teaming that a penalty will be imposed under the
CCCEMSA Contract, Contractor and District will discuss whether District should file
a request for a Response Time exemption. If Contractor and · tri ta ree:l-t a
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request for a Response Time Exemption should be filed, District shall file a timely
request for a Response Time exemption with CCCEMSA. If Contractor requests
that District file a request for a Response Time Exemption, but District declines to do
so, and a penalty is i mposed on District, Contractor will not be required to pay such
penalty to District as provided in this Contract.
ii. Exemption Request Procedure. If District makes a request for an exemption to a
required Response Time Standard to CCCEMSA. Contractor shall provide District
with detailed documentation for each response for which it is seeking an exemption
in connection with District's request that CCCEMSA exempt the identified responses
from Response Time calculations and associated penalties. Any request for a
Response Time exemption must be received by the CCCEMSAwithin ten (10)
business days after the completion of the resp·onse. A request for an exemption
received more than ten business days (10) after the completion of the response will
not be considered. .
iii. Exemption Review Process. If District disagrees with CCCEMSA's decision
regarding a Response Time exemption request, it may follow the dispute resolution
process set forth in the CCCEMSA Contract.
c . Dispatch to Enroute Exemptions. Contractor understands and agrees that, at the sole
discretion of CCCEMSA, calls with an extended period of time between ambulance
dispatch and the ambulance being· enroute of more than two (2) minutes may be
excluded from consideration as exemptions.
9 . Response Time Performance Reporting Requirements.
a. Documentation of Incident Time Intervals. Contractor shall document all times
necessary to determine total ambulance Response Time including, but not limited to,
time call received by the Emergency Medical Dispatch Center, time ambulance crew
assigned, time enroute to scene, arrival at scene time, total on-scene time, time enroute
to hospital, total time to transport to hospital, arrival at hospital time, and t ime of transfer
of patient care to hospital personnel. All times shall be recorded in an ePCR form and
in District's computer aided dispatch system. Other times may be required to document
specific activities such as arrival at patient side, times of defibrillation, administration of
treatments and medications and other instances deemed important for clinical care
monitoring and research activities.
b. Interface to CAD and ePCR. Contractor and District shall work cooperatively to provide
an interface with the CAD database and ePCR System for District and CCCEMSA to
extract and corroborate Response T!me performance. Contractor may not make
changes to times entered into the CAD during or after the event. Any changes to times
will be managed via the Exemption Request Procedure and documented In a separate
system after review and approval by District and CCCEMSA.
c. Response Tlme Perfonnance Report.
i. Within ten (10} business days after the end of each month, Contractor shall
document and report Response Time performance to District in writing, Jn a manner
specified by District ..
fi. Contractor shall report performance for each priority level in each ERZ.
iii. Contractor shall use· Response Tlme data in an on-going manner to evaluate
Contractor's performance and compliance with Response Time Standards in an
effort to continually improve its Response Time performance levels.
iv. Contractor shall identify the causes of failures of performance, and shall document
efforts to eliminate these problems on an on-going basis. ~
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v. Contractor shall provide an explanation for every call exceeding the required
Response Time Standard.
vi. District may impose a penalty on Contractor in the amount set forth in Exhibit C
(Penalties) for each instance In which a report was not delivered on time .
d. Penalty Provisions .
i. Penalty for Failure to Report Arrival On Scene Time. District may impose a penalty
on Contractor in the amount set forth in Exhibit C (Penalties) for each time an
Emergency Ambulance is dispatched and the ambulance crew fails to report and
document an Arrival On Scene Time. Contractor, in order to rec tify the failure to
report an Arrival On Scene Time and to avoid District incurring a penalty under the
CCCEMSA Contract, may demonstrate to the satisfaction of District and CCCEMSA
an accurate on-scene time . Where an Arrival On Scene Time for a particular
emergency call is not documented or demonstrated to be accurate, the Response
Time for that call shall be deemed to have exceeded the required Response Time
for purposes of determining Response Time compliance.
ii. Penalty for Failure to Comply with Response Time Requirements. District may
impose a penalty on Contractor for each month District is penallzed under the
CCCEMSA Contract based on a failure to comply with the R.esponse Time
requirements in at least ninety pe rcent {90.0%).of calls in any ERZ based on the
percentage of compliance for all responses in the ERZ in the categories represented
in Exhibit C (Penalties) attached hereto and incorporated herein. Failure of
Contractor to achieve at least 88% Response Time compliance in each ERZ for
Emergency Ambulance requests will require that Contractor submit and implement
an Ambulance deployment plan that includes additional staffed ambulance hours
aimed to achieve_ 90% compliance with Response Time Standards.
ill. Priority 4 Response Time Measurement. Priority 4 (non-emergency ALS interfacility
transfer) Response Times will be measured using Contractor's entire Service Area
and not by priority levels for each ERZ .
iv. Repetitive Non-Compliance. For the purpose of measuring Response Time
compliance , the term "Repetitive Non-Compliance" means. for any measured
Response Time subset.that (i) Contractor's Response Time compliance has been
less than 90% for three (3) consecutive months, or {ii) there have been five (5)
instances where Contractor's Response Time compliance was less than 90% in any
twelve-month period. If Contractor's Response Times result in Repetitive Non-
compliance, District shall provide Contractor with written notice thereof, and
Contractor shall submit a p lan of corrective action to District within thirty (30) days
after being notified of its Repetitive Non-Compliance.
v. Isolated Instances. Isolated instances of individual deviations from Response Time
Standards shall not be treated as instances of Repetitive Non-Compliance.
vi. Insufficient Call Number. Any measured Response Time subset of measurement of
calls that does not exceed 100 responses in a single month shall be added to the
next month's responses and accumulated until the minimum of 100 responses is
documented.at which point compliance determinations will be mad~.
10. Penalties for Outlier Responses. An ·outlier Response" means a Response Time that is
excessive for the category, such that it represen ts a potential threat to health and safety.
District may impose a penalty on Contractor for any instance in which District is penalized
under the CCCEMSA Contract because the actual Response Time e Is r exce~the
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applicable Outlier Response Time set forth in Exhibit C {Penalties). Penalties.will be based
on ERZ and the priority level assigned to the call. The impos ition of a penalty for an Outlier
Response is in addition to a penalty assessed for Contractor's Response Time compliance
requirements .
11 . Additional Penalty Provisions. District may impose financial penalties on Contractor as
delineated in Exhibit C (Penalties).
12 . Stand-by. Contractor shall provide, at no charge to County or another requesting public
safety agency, stand-by services at the scene of an emergency incident within the Service
Area when directed by an Emergency Medical Dispatch Center. An ambulance unit placed
on stand-by shall be dedicated to the incident for which it has been placed on stand-by.
Any stand-by periods scheduled to exceed eight (8) hours must be approved in advance by
District in writing. Contractor shall immediately notify the requesting agency incident
commander when a stand-by exceeding one (1) hour may limit Contractor's ability to meet
the Response Time Standards for the impacted ERZ, and shall notify District in writing by
the following business day.
I. Personnel Standards.
1 . Employee Character. Contractor shall employ employees who are highly qualified.
competent, and of high moral and ethical character, and who understand that they
represent the County as emergency service providers .
2. Prescreening of Employees. Contractor shalt prescreen all Transport Employees and
Transport Employee candidates to determine their qualifications, moral and ethical
character, and that they are not prohibited from performing the duties for which they were
hired.
a.. Background Check. Contractor shall conduct background checks on all of its potential
employees prior to employment. or if already employed, to undergo rechecks as
needed . Contractor will additionally perfonn annual Department of Motor Vehicle
driving record pulls for all Transport Employees. The initial background check shall
include criminal history, verification of employment, verification of license/certifications
and train ing required under this Contract for the position for which the individual was
hired. Contractor shall provide the results of the criminal and background checks to
District and CCCEMSA when background information is revealed that would result in
licensure or certification action under California Health and Safety Code section
1798.200(c)(1) through (c)(12); or when requested by District or CCCEMSA . Contractor
shall bear the costs associated with pre-employment and periodic background checks
b, U.S. Government Excluded Parties List System (EPLS) .. Contractor shall check all
Transport Employees against the EPLS . Contractor shall not employ any person who
has been listed as an excluded person on the EPLS .
c. Office of Inspector General (OIG). Contractor shall check all Transport Employees
against the OIG's exclusion list. Contractor shall not employ any person who has been
listed as an excluded person by the OIG .
3. Drug Testing . Contractor shall cause a biological fluid test for drugs to be conducted on all
Transport Employees prior to employment, and require that the results of the drug test are
negative to qualify for employment as a Transport Employee . The use or consumption of
marijuana pursuant to a medical recommendation is not an exemption the zero tol~ce
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policy for drug use under this provision. Contractor will comply with the Drug-Free
Workplace Act (41 U.S .C. section 8101 et seq.). Contractor shall implement (a) implement
a zero tolerance policy for drug use and alcohol abuse that includes ensuring that
employees are free from the influence of alcohol and intoxicating drugs while on-duty, and
(b) prohibit any employee from using, possessing, concealing, manufacturing, transporting,
selling, buying, or promoting the sale of any illegal drug.
4. Physical Ability. Contractor shall cause all Transport Employee candidates to undergo a
physical ability test prior to employment, and upon returning to employment from leave of
absence in excess of thirty (30) days, and upon returning from any injury that resulted in an
employee· missing at least thirty (30) days of work, by a licensed healthcare provider
qualified to perform such tests. The physical ability test shall simulate the physical abilities
needed to lift and transport patients and equipment in the field.
5. Credentials. Contractor shall cause all of its Transport Employees to be currently and
appropriately credentialed.
a. Contractor shall retain on file at all times, copies of all current and valid licenses,
certifications, and/or accreditations of all emergency medical personnel performing
services pursuant to this Contract. Contractor shall make available to District and
CCCEMSA, for inspection and copying during business hours, all records and
documents retained on file pursuant to this provision.
b . Contractor shall employ Transport Employees that are currently certified, licensed
andlor accredited· at all times when assigned to provide services pursuant to this
Contract. Contractor shall verify all state licenses and certifications for prehospital
providers through the State's Central Registry, and for nurses through the State's
Department of Consumer affairs nurse license search. Contractor shall visually verify
all credentials and certifications.
6. Employee Records!Termination. Contractor shall provide District and CCCEMSA with a list
of its currently employed Transport Employees, and shall update that list as soon as
practical, and in no event later than thirty (30} days, after a paramedic or EMT leaves its
employ. At minimum, the personnel list shall include the name, residential and mailing
address, telephone number, CPR expiration dates, and California Driver License number of
each person on the list. For each paramedic, the list shall also include the paramedic's
California paramedic license number and expiration date and ACLS, PEPP/PALS, and
PHTLS/ITLS expkation dates. For each EMT, the list shall also include the EMT's California
certification number and expiration date.
a. In those cases where a paramedic or EMT leaves Contractor's employ as a result of a
disciplinary cause, including administrative leave, suspension, retirement, or resignation
while the employee has knowledge of a pendi ng disciplinary cause, Contractor shall
provide District and CCCEMSA with the basis for the termination, resignation, or
retirement as well as the initial and final investigatory findings surrounding the alleged
misconduct as soon as practical, but in no case, more than three (3) days.
b. Contractor shall notify District and EMSA, on the paramedic investigation request form
or other form approved by EMSA for reporting paramedic misconduct, of each and
every paramedic that leaves Contra.ctor's employ as a result of a disciplinary cause,
including suspension, retirement, or res ignation while the employee has knowledge of a
pending disciplinary cause. Contractor shall provide District with a copy of the
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paramedic invesUgation request or other approved form submitted to EMSA with
supporting documents and attachments no later than the following business day.
7. Tuberculosis and Hepatitis. Contractor shall provide all new and existing Transport
Employees With initial and annual tuberculosis testing at no cost to the Transport
Employee . Contractor shall offer all of its new and existing clinical and operational
employees Hepatitis B and-annual influenza vaccinations.
8. Assault Management Training .
a. Contractor shall train all new and existing Transport Employees in the skills necessary
to effectively manage patients with psychiatric, drug/alcohol, or other behavior or stress
related problems, including communication, proper and legal use of force and restraints,
and how to handle these patients safely .
b . Contractor shall offer its employees an annual refresher course in assault management
that has been approved by CCCEMSA.
9. Paramedic Minimum Qualifications. Contractor's Transport Employees shall meet the
following minimum Paramedic qualifications. District may Impose a penalty on Contractor
in the amount set forth in Exhibit C (Penalties) for each instance in which District is
penalized under the CCCEMSA Contract based on a Paramedic Transport Employee failing
to satisfy these minimum qualifications.
a. Licensed as a paramedic in the State of California;
b. Accredited as a paramedic in the County, or alternatively , unaccredited but assigned to
an ambulance with an accredited paramedic while the accreditation is pending. If an
unaccredited paramedic is assigned .to an ambulance with an accredited paramedic, the
unaccredited paramedic pending accreditation shall not be permitted to perform any
skill in CCCEMSA's optional scope of practice for paramedics. The unaccredited
paramedic shall not work more than thirty (30) days without accreditation;
c. Currently certified in advanced cardiovascular life support according to the American
Heart Association {AHA);
d. Currently certified in prehospital trauma life support (PHTLS) or international trauma life
support (ITLS), or Contractor shall document that each paramedic has satisfactorily
completed compa~ble training to master competency in the skills included in the
PHTLS or ITLS curriculum and approved by the EMS Medical Director;
i. Paramedic personnel assigned to work with a currently PHTLS or ITLS certified
partner may have up to three (3) months from date of hire to obtain said certification.
e. Currently certified in pediatric education for prehospital. professionals (PEPP) or
pediatric advanced life support (PALS).
i. Paramedic employees assigned to work with a currently PEPP or PALS certified
partner may have up to three (3) months from date of hire to obtain said
certification.
ii. Contractor shall supplement required PEPP/PALS training with annual infant
and pediatric simulation training focused on early .recognition and management
·of pre-arrest and other life threatening conditions.
iii. Contractor shall require Transport Employees to review prehospital procedures
for Safely Surrende.red Baby 'Program.
f. Currently trained and certified in CPR according to the current AHA's Guidelines for
Cardiopulmonary Resuscitation and Emergency Cardiovascular Care at the
Healthcare Provider or Prehospital Care Provider level; ~ ~
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g. Valid California driver license, ambulance drivers' license, and Medical Examiner
certificate; and
h. Currently certified as an emergency vehicle operator according to the emergency
vehicle operations course or equivalent training.
10. EMT Minimum qualifications. Contractor's EMT Transport Employees assigned to provide
EMT services pursuant to this Contract shall meet the following minimum qualifications.
District may impose a penalty on Contractor in the amount set forth in Exhibit C {Penalties)
for each instance in which District is penalized under the CCCEMSA Contract based on an
EMT Transport Employee failing to satisfy these minimum qualifications .
a. Currently certified as an EMT in the State of California;
b. Valid California driver license, ambulance driver license, and a Medical Examiner
certificate;
c . Currently trained and certified in CPR according to the current AHA's Guidelines for
Cardiopulmonary Resuscitation and Emergency Cardiovascular Care at the Healthcare
Provider level or Prehospital Care Provider level; and
d. Currently certified as an emergency vehicle operator according to the vehicle operations
course or equivalent training or equivalent training .
11. Supervisors. Contractor shall employ personnel assigned to supervisory positions , whether
temporarily or permanently, that are well trained and qualified. Contractor shall take steps
to employ supervisory personnel that are continually trained and prepared for any
unforeseen event at no cost to the employee.
a . Credentials. All Transport Employee supervisory personnel shall be licensed and
accredited in the County at the paramedic level, have at least three years paramedic
experience with at least one of those years working in the County EMS System, and
shall have successfully completed the Federal Emergency Management Institute -
Incident Command System (ICS) series 100, 200, 300 and 400, and NIMS 700 and
800b, within 6 months of appointment. Supervisory personnel shall attend a CCCEMSA
approved Ambulance Strike Team Leader course and shall be certified as AST Leaders
within one (1) year of execution of this Contract. Transport Employee supervisory
personnel shall all be trained, and shall receive refresher training, in critical incident
stress management and actively participate as a CISM team member.
b. Professional Development. Prior to acting in a supervisory role, all candidates for
Transport Employee supervisorial positions shall have received training from Contractor
to enable the supervisor to effectively and successfully perform their duties. Examples
of said training include, but in no way shall be limited to, conflict resolution
management, training in relevant employment laws, multi-casualty incident plan and
response, Contractor's policies and procedures, CCCEMSA event notification
requirements, infection control and response to employee exposure, MHOAC activation,
and d ispatch procedures. Supervisory personnel shall receive annual refresher training
at no oost to the employee.
12. System Status Controllers. Contractor shall employ system status controllers that are
trained and highly qualified to provide system status management for ambulance
operations, including the pre-positioning of ambulances throughout the response zones in
a manner designed to meet Response Time Standards.
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13. Uniforms/Appearance. Contractor provide uniforms to its Transport Employees who
provide services pursuant to this Contract. The uniforms must be distinctive from all other
ambulance service providers and shall bear the County approved EMS patch and the field
providers' certification and license level, or supervisory capacity, and name. Uniforms and
their insignia shall be approved by District and CCCEMSA. Contractor shall require its
Transport Employees to properly wear their issued unifonn, are well groomed, and
maintain a professional appearance at all times.
14. Fatigue awareness and mitigation. Contractor shall develop a policy that stipulates the
maximum amount of time an employee can continuously be on-duty; and rest/sleep
requirements that must be followed for all employees that are continuously on-duty for
more than twelve (12) hours.
15. Paramedic Preceotors. Contractor shall cooperate with CCCEMSA-approved paramedic
training programs and with District and CCCEMSA to develop a paramedic preceptor
program. The paramedic preceptor program shall provide adequate paramedic field
internship positions in support of CCCEMSA approved programs. Preferential placement
for paramedic field internships shall be provided to CCCEMSA approved paramedic
programs.
J. Fleet arid Equipment.
1. Vehicles. Contractor shall acquire and maintain all ambulances and support vehicles
necessary to perform its services pursuant to this Contract. All costs of maintenance
including parts, supplies, spare parts and costs of extended maintenance agreements are
the responsibility of Contractor.
2. Fleet Ambulance Requirement. Contractor shall maintain the number of ALS equipped and
fully operating Ambulances that represents at least 120% of the peak staffing level
established by Contractor. If a fraction is derived when multiplying the peak number of units
by 120%, the number will be rounded up to the next whole integer (i.e., 32.4 would be
rounded to 33). For example, if Contractor's peak number of ambulances is twenty-seven
(27), then Contractor is to maintain a fleet of at least 33 ambulances (27 x 120% = 32.4
rounded to 33).
a. Contractor shall maintain a back-up fleet of Ambulances from its regional and national
fleet as needed to supplement special events or disaster response within the County.
b. Contractor will submit a plan detailing number of units available and time frames
needed to activate vehicles for system response, as well as the mechanism for assuring
that required equipment Is available on back-up units.
3. Fleet Vehicle Requirement. In addition to the fleet Ambulance requirement specified above,
Contractor shall maintain the following minimum vehicle fleet:
a. one ( 1) bariatric capable transport unit;
b. one (.1) specialized infectious disease capable transport unit
c. five (5) Supervisor vehicles;
d. three (3) support vehicles; and
e. One (1) disaster medical support unit or its equivalent
4. Vehicles.
a. Ambulances used in providing services under this Contract shall meet the sta dards of
Title XIII, California Code of Regulations.
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b. Ambulance vehicles used in providing services under this Contract shall bear the
markings "Contra Costa County Fire -EMS~ in at least four (4) inch letters on both
sides. Such vehicles shall display the "9-1-1" emergency telephone number and state
the level of service, "Paramedic Unit," on both sides.
c. All vehicles shall be marked to identify the company name, but shall not display any
telephone number other than 9-1-1 or any other advertisement.
d. Overall design, color. and lettering are subject to the approval of District.
e. Each ambulance shall be equipped with functional GPS route navigation capabilities.
f. Contractor shall replace any Ambulance.when it reaches five (5) years of service or
195,000 miles, whichever occurs first.
g. Contractor is responsible for all maintenance of Ambulances, support vehicles, and on-
board equipment used in the performance of its work. Any Ambulance, support vehicle,
and/or piece of equipment with any deficiency that compromises, or may reasonably
compromise its function, shall be immediately removed from service.
i. Contractor shall remove Ambulances, support vehicles, and equipment that have
defects, including significant visible but only cosmetic damage, from service for
repair without undue delay.
h. Contractor shall maintain a vehi.cle maintenance program that is designed and
conducted to achieve the highest standard of reliability appropriate to a modern high
performance ambulance service. Contractor's vehicle maintenance program shall use
appropriately trained personnel who are knowledgeable in: the maintenance and repair
of ambulances, developing and implementing standardized maintenance practices, and
shall incorporate an automated or manual maintenance program record keeping
system.
l. Contractor shall use patient point of care equipment on all Ambulances that meets
Clinical Laboratory Improvement Amendments (CUA) standards, and submit a
description of the program to District.
j. All costs of maintenance and repairs, including parts, supplies, spare parts and
inventories of supplies, labor, subcontracted services, and costs of extended
warranties, shall be at Contractor's expense.
5. Equipment.
a. All Ambulances performing services pursuant to this Contract shall carry all emergency
supplies and equipment identified in the County Ambulance Equipment and Supply list
on file at CCCEMSA, 1340 Arnold Drive, Suite 126 Martinez, CA. Acquisition and
maintenance of all equipment, including parts, supplies, spare parts, and costs of
extended maintenance agreements, are the responsibility of Contractor.
i. Contractor shall maintain inventory control and equipment maintenance systems
which keep the ambulance fleet fully stocked with quality equipment in good working
order at all times.
ii. Contractor agrees that equipment and supply requirements may be changed with
the approval of District due to changes in technology.
b. District may· inspect the Contractor's Ambulances at any time, without prior notice. If any
Ambulance fails to meet the minimum in-service requirements contained in the
Ambulance Equipment and Supply list as detennined by CCCEMSA or District,· District
may:
i. Immediately order the Ambulance removed from service until the deficiency is
corrected if the missing item is deemed a critical omission;
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ii. Subject Contractor to a per-incident penalty as described in Exhibit C (Penalties)
when District is penalized under the CCCEMSA Contract therefor;
iii. The foregoing shall not preclude dispatch of the nearest available Ambulance even
though not fully equipped, in response to a life threatening emergency so long as
another appropriately equipped ambulance of at least equal level of service is also
dispatched to the scene. Contractor understands and agrees that under the
CCCEMSA Contract, CCCEMSA may adopt protocols governing provisional
dispatch of Ambulances not in compliance with minimum in-service requirements
and Contractor shall comply with these protocols.
c. Contractor shall maintain a system to exchange on a one-for-one basis medical
supplies and equipment supplied by a fire first responder agency in connection with
patient transport.
K. Communications.
1. System Integration. Contractor shall establish policies and procedures for the integration of
radio and data communications with PSAPs, the Base Hospital, and on-scene incident
command.
2 . Interim Communications Center Operations: Costs. Until District has established its
Emergency Medical Dispatch Center, but in no event for more than ninety (90) days after
the effective date of this Contract (the "Interim Dispatch Period"), Contractor shall operate a
communications center and maintain all hardware and software (fixed, mobile, interfaces,
and networks) necessary to receive and fulfill requests for emergency ambulance services
made by County PSAPs . Contractor shall be capable of receiving and replying to requests
for emergency ambulance services by voice and by CAD interface. Contractor's Emergency
Medical Dispatch Center shall be capable of dispatching all Ambulance units used to
provide Emergency .Ambulance Services pursuant to this Contract. Contractor will invoice
District for the costs of providing the interim dispatch services on a daily-rate basis to cover
Contractor's costs of the interim dispatch services. District will pay invoices within 30 days
of receipt of the invoice. During the Interim Dispatch Period:
a. Contractor shall maintain a CAO system that provides a complete audit trail for all
Response Times and provides CCCEMSA access to the Response Time data at any
time to review Contractor compliance.
b. Contractor shall provide CCCEMSA staff electronic access to allow real-time monitoring
of CAD systems.
c. Contractor shall provide access to Contractor's CAD for CCCEMSA staff to audit and
create reports for system performance monitoring.
d. Contractor shall pay all costs incurred to provide required CCCEMSA access to the
CAD system.
3. Data Linkages. Contractor shall maintain data linkages specified in the current version of
the County Message Transmission Network. (MTN) Standard, which is incorporated herein
by reference. A copy of the MTN standard is on file at CCCEMSA, 1340 Arnold Drive,
Suite 126, Martinez, CA.
4 . Continuity of Operations Plan: Implementation. Contractor's information systems hardware,
software and personnel to be capable of receiving and processing required .data including ,
but not Umited to, the ability to continuously monitor data transfer system stability and
resolve system failures .
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5. Dispatch Staffing. During the Interim Dispatch Period, Contractor shall maintain emergency
medical dispatch staffing levels so that electronic or telephonic notifications from a PSAP or
an Emergency Medical Dispatch Center are answered or responded to within fifteen (15}
seconds 95% of the time, and that ambulances are dispatched to respond to emergency
requests within thirty (30) seconds 90% of the time, following the Emergency Medical
Dispatch Center's receipt of information establishing a location and priority for the
response . During the Interim Dispatch Period :
a. Lead Direction. Contractor shall have a senior dispatcher to supervise dispatch
operations twenty four (24} hours per day , every day.
b . Dispatcher/ Call Taker. Contractor shall have a comprehens ive dispatcher/call taker
program to provide dispatch operations twenty four (24) hours per day. The dispatcher
call taker program shall also contain requirements for employee eligibility, education
and training.
c. Post-Interim Dispatch Period. Immediately following the Interim Dispatch Period:
i . Contractor shall provide staff to perform System Status Management (SSM) of
ambulance crews , handle administrative phone calls relative to SSM, and carry out
any other provision of SSM as required from within the Contra Costa Regional Fire
Communications Center (CCRFCC).
ii. Contractor shall provide supervision, management, tra ining, and scheduling of its
SSM personnel in the CCRFCC.
iii . Contractor shall provide additional staffing, as deemed necessary by the District, to
handle the processing of phone calls, SSM, and dispatching of ambulances during
the period of time that a CAO-to-CAD interface between the City of Richmond
dispatch center and the CCRFCC is not available.
6. System Improvement. Contractor agrees to participate in a process to improve the
medical call-taking and dispatch processes to achieve full implementation of prioritization
of all requests for ambulance service and shall work with District and CCCEMSA to effect
such changes. Contractor agrees to negotiate with District and CCCEMSA in good faith to
achieve these goals.
7. Radio Equipment Reauirements . Contractor is respons ible for all mobile radio equipment
and cellular phones used in the field, including obtaining radio channels and all necessary
FCC licenses and other permits as may be required for the operation of the system.
a. Contractor shall cause its communications system to be capable of receiving and
transmitting all communications necessary to provide emergency ambulance services
pursuant to this Contract, including communicating with hospitals and other public
safety agencies as required in a declared disaster situation. Radio equipment used for
ambulance-to-hospital communi cations shall be configured so that personnel providing
patient care are able to directly communicate with the base or rece iving hospital staff
about the· patient. Communication equipment used by Ambulance crews shall be
capable of transmitting 12-lead ECGs to receiving facilities.
b. Contractor shall equip all Ambulances and supervisory vehicles used in performance of
services in Contra Costa County with radio equipment for communications with
Emergency Medical Dispatch Centers. Radios shall be programmed with appropriate
frequencies/talk groups to function on the East Bay Regional Communications System
and suitable for operation on the Californ ia On-Scene Emergency Coordination Radio
System.
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c . Contractor shall provide each crew member assigned to an Ambulance or supervisor
unit with a portable radio .
d. Contractor shall operate its two-way radios in conformance with all applicable rules and
regulations of the Federal Communication Commission (FCC), and in conformance with
all applicable CCCEMSA rules and operating procedures.
e. Contractor shall provide access to cellular telephones for use on Ambulances and
supervisory units.
8. AVUData Equipment Requirements. Contractor shall equip all ambulances with Automatic
Vehicle Location (AVL) devices and mobile data terminals/computers (MDT). Contractor
shall supply AVL feeds to District and other public safety agencies as authorized and
requested by District.
L. Customer Service and Communltv Education.
1. Community Education. Contractor shall undertake a program of health status improvement
and community education to support meaningful use, health information exchange, and
exploration of alternative mobile health services models in partnership with District,
CCCEMSA, Contra Costa County Public Health Services, and other health system
partners. No later than January 1, 2017, and prior to January 1 of each year thereafter,
Contractor shall provide District with: (a) a written plan of health status improvement and
community education activities for the coming year; and (b) a summary of the prior year's
health status improvement and community education accomplishments. Contractor shall
endeavor to carry out health status improvement and community education programs in
cooperation with existing healthcare and health promotion organizations, local public safety
agencies, and other community organizations.
a. Community Education Funding . Contractor shall allocate a minimum of $300,000
annually towards the goals of the community education programs identified in this
section and the annual plan referenced above, $50,000 of which shall be expended on
the activities set forth in subsections (c) through (e) below.
b. Public Health Initiatives. Contractor will participate in County public health initiatives to
support activities that reduce injury throughout the community and support population
health.
c. AED Program. At no cost to District, Contractor shall establish a program of automated
external defibrillator ("AED·) equipment placement, exchange and replacement
supporting public access defibrlllation and first responder AED programs. The AED
program shall include, but is not llmlted to the fol!owing components:
i. Placement of AEDs based on identified need by CCCEMSA, District and Contractor;
ii . AED pad/electrode replacement for public access defibrillators, fire, law and
community AED programs;
iii. AED and Hands Only CPR training· support for sites where devices are placed, upon
request; and
iv. Maintain an ATRUS dispatch platform in Contractor's communications center to
support use of AEDs of bystanders .
d . Hands Only CPR. Contractor shall train a minimum of 2,000 individuals within the
County in Hands Only CPR every year.
e . CCCEMSA Heartsafe Program. Contractor shall provide Hands Only CPR and AED
training in schools in coordination with the CCCEMSA Heartsafe Program.
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2. Community Outreach Coordinator. Contractor shall employ a full-time community outreach
coordinator whose primary responsibilities will be to work with District and CCCEMSA and
community organizations in carrying out Contractor's health status improvement and
community education program to include Physician Orders for Life Sustaining Treatment,
EMS for Children and injury prevention programs and events.
3. Customer Satisfaction.
a. No later than six months after the effective date of this Contract, Contractor shall
establish, monitor, and maintain patient and family friendly processes to support patient
satisfaction and complaint resolution.
b. Contractor shall establish a hotline giving customers and system participants the ability
to leave commendations, and suggestions for service improvements on a voice or
electronic mailbox (the "Customer Hotlinen).
i. Contractor shall cause its supervisory or COi leadership team to be automatically
notified of incoming calls and messages to the Customer Hotline.
ii. Contractor shall respond to complaints and inquiries from patients and families,
regardless of how notice occurs, withln twenty four (24) hours.
c. Contractor shall establish a single point of contact or ombudsmen responsible for
monitoring and improving patient satisfaction and complaint resof ution.
d. Contractor shall track, trend and report to District monthly on the number and
characteristics of comments, incidents or complaints including timeliness and
satisfaction or complaint resolution associated with billing and patient care, to include:
i. Intake time
ii. Type of complaint e.g. billing, patient care. other
iii. Date resolved and disposition
iv. Total resolution time to address
e . No later than twelve months after the effective date of this Contract, Contractor shall
establish and maintain the reporting of patient satisfaction using a validated patient
experience satisfaction survey tool based on Hospital Consumer Assessment of
Healthcare Providers and SY'stems.
4. No later than eighteen months after the effective date of this Contract, Contractor shall
incorporate clinical and patient safety performance metrics into the City and community
reports provided by Battalion Chiefs as a service report card to the community.
5 . Contractor shall participate in health care system partnerships and activities that improve
the patient experience for high risk or frequent user populations.
6. Contractor will participate with County Public Health initiatives to support activities that
reduce injury throughout the community and support population health.
a . Contractor shall collaborate with District, community, public health, CCCEMSA, and
health system partners to reduce disparities and support community resiliency for high-
risk populations.
M. Operational and Clinical Data Collection. Information Management and Reporting.
1. ePCR System. Contractor shall utilize an electronic patient care reporting system approved
by District for patient documentation on EMS System responses, which includes all patient
contacts, cancelled calls, and non-transports (the "ePCR System").
a. Contractor's ePCR System shall be National EMS Information System (NEMSIS) 3
Gold compliant.
b. Contractor shall make the ePCR System available to any interested Contra Costa
County fire first responder agency that respond within Contractor's Service re~a
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provided that the fire first responder agency agrees to compensate Contractor for its
cost of providing access to the ePCR System.
c. Contractor shall use the ePCR System to capture and transmit ePCRs and data, and
will be used by CCCEMSA to perform clinical quality oversight for medical services
provided by Contractor.
d. The ePCR System shall include the electronic sharing of data to the trauma registry, the
credentialing database, data analytic/visualization tools, EMSA, Contractor's billing
program, and any other appropriate database.
e. Contractor shall reasonably cooperate with District and CCCEMSA to i~entify and
implement improvements to the ePCR System that will enable the CCCEMSA Medical
Director and CCCEMSA staff to review the level of patient care being provided by
Contractor.
f. Contractor shall create, complete, and transmit an ePCR to its electronic patient care
system .(e.g ., Medserver) for every EMS response.
2 . CCCEMSIS . CCCEMSrs is a multi-system, multi-disciplinary data collection and
management system. Contractor understands and agrees that CCCEMSA will make any
comprehensive data analytic tool that is implemented, available to Contractor to facilitate
enhanced clinical provider analytics, including the development of clinical provider
performance scorecards . Contractor shall collaborate with District to develop an annual
fee to support CCCEMSIS, based on Contractor's total EMS response volume for the prior
calendar year. This amount shall not exceed sixty (60%) of the total cost for data system
management and vendor maintenance and support. All fees paid by Contractor for data
system management and vendor maintenance and support shall be used for this purpose
only. CCCEMSA has represented to District in the CCCEMSA Contract that this payment
shall be less than or equal to CCCEMSA's actual costs to provide CCCEMSIS and
associated information systems. No funds shall be used by CCCEMSA in a manner that
may violate 42 U.S .C. Section 1320a-7b, the federal Anti-Kickback Statute.
3. Dynamic Per[orrnance Monitoring. Contractor shall cooperate with District and CCCEMSA
to utilize a mutually agreed upon data reporting application for the near real time evaluation
of operational performance data, Response Time data , clinical data, and syndromic
surveillance. The data reporting application will allow secure web-based access to
CCCEMSIS . Contractor shall reasonably cooperate with District and CCCEMSA and the
data reporting application provider to implement a dashboard , which will be a web-enabled
platform that mines and presents data from a single or multiple disparate data sources for
quick access to near real-time data that is critical information to enable CCCEMSA to
monitor Contractor's performance and compliance with the provisions of this Contract. The
data reporting application shall interface with the CCC EMS IS,· Contractor's computer aided
dispatch (CAO) system, and other CAD or data systems as requested by District.
4. Performance Reports.
a. Monthly and Annual Performance Reports. Contractor shall provide detailed monthly
and annual Perfonnance Reports in a format specified by District . The monthly
Performance report shall be provided to District within ten (10) business days after the
end of each month. The annual Performance Report shall be provided to District by the
first work day in March of each year. The reports shall include, but not be limited to the
following elements :
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i. Aggregated responses, transports, and Response Time performance metrics, by
each response zone, and by individual city or community
Ii. Patient satisfaction metrics
Iii. Customer service metrics
iv. Billing complaints and feedback metrics
v. Workforce satisfaction and turnover metrics
vi. Vehicle and equipment performance and safety metrics
vii. Aggregate employee ·injury and exposure statistics ·
viii. Deployment and unit hour metrics
ix. Mental health service metrics
x. Metrics identifying high users of 9-1-1 EMS services
xi. Community education program metrics
xii. Strategic plan goals/objectives for the year -completed system improvements and
enhancements
xiii. Activities and results of the COi plan
xiv. Additional information as may be reasonably requested by District with sufficient
advance notice .
b. Penalties. District may impose a penalty on Contractor in the amount set forth in Exhibit
C (Penalties) for each instance in which District is penalized under the CCCEMSA
Contract because a report was not delivered on time.
5. Focused Performance Audit Reports. Contractor shall comply with requests by District for
data and audit reports on focused topics. These topics may include any services provided
under this Contract. District shall provide a reasonable timeline for submission of requested
focused audit reports at the time of the request.
6. Electronic Patient Care Record ( ePCR}; PCRs.
a. ePCR System. Contractor shall require Transport Employees to enter electronic
patient care reports (each,_an "ePcR·) entered in the ePCR System to be accura t ely
completed to include all information listed in Section 100170 of Title 22 of the California
Code of Regulations, and information shall be distributed according to EMS policies and
procedures adopted by CCCEMSA.
b. Interim PCRs. Contractor and District will cooperate with CCCEMSA to identify
required content and develop a procedure for Contractor's delivery of Interim PCRs to
hospitals, which shall be implemented and followed by Transport Employees beginning
no later than July 1, 2017. Once the Interim PCR policy has been agreed upon, and in
no event after July 1, 2017, Contractor shall leave an Interim PCR , or a completed PCR
at the hospital before departing the hospital.
c . Completed ePCR Submission. Contractor shall submit an ePCR to the treating facility
within 24 hours of patient delivery.
d . Penalties . District may impose a penalty on Contractor in the amount set forth in Exhibit
C (Penalties) for each instance in which District is penalized under the CCCEMSA
Contract based on a failure to comply with subsections 6(b) and 6(c) above.
N . Integration with First Responder Programs.
1. Contractor shall pursue opportunities to integrate fire first-response components of the EMS
System with the Emergency Ambulance Services provided under this Contract, and shall
cooperate and support paramedic or Advanced EMT first response programs.
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2. Contractor shall implement policies to facilitate scheduling time on ambulances to fulfill
paramedic training, internship, and accreditation requirements for paramedics working in
the County.
a. Contractor shall give precedence for field internships or ride-alongs to students from
EMT and/or paramedic training programs based in the County.
3. Contractor shall support the development of an integrated fire first-response program. At a
minimum Contractor shall:
a. Offer Contractor-sponsored CE programs to fire first responder personnel on a
comparable basis as made available to Contractor's personnel. The fees charged to fire
first responder personnel for Contractor-sponsored CE shall not exceed the fees
charged to Contractor's personnel. Fire first responder personnel shall have access to
enrollment.in Contractor-sponsored CE on the same basis as Contractor's personnel.
Contractor is not responsible for paying wages or stipends to the fire first responder
personnel for participation in Contractor-sponsored CE activities.
b. Designate from among Contractor's employees a single individual as Contractor's
contact person/liaison for fire agencies within the Service Area.
c. Establish a mechanism for first responder agencies to purchase equipment at
enterprise purchasing rates.
d. Provide pre-arranged transportation service to return firefighters who accompany an
ambulance to the hospital promptly to their engine companies.
O. Disaster, Multl·Ca&ualtv and Mutual Aid Response.
1. lnteoration With the Reaional Medical Health Operational Mutual Aid Svstem. Contractor
shall, to the best of its ability, assist in other EMS service areas both within and outside of
Contra Costa County as directed by District because of medical disaster, MCI, or other
reason necessitated for the safety, health and welfare of the public. During response to
MCls or disasters within or affecting the County, Contractor operations shall fall under
coordination of the MHOAC as a function of the Medical/Health Branch in support of the
County Emergency Operations Plan (EOP), and the California Master Mutual Aid System.
2. Mutual Aid Outside the County. Contractor shall not provide resources for mutual aid
outside of the County unless directed to do so by District. Contractor's provision of mutual
aid outside of the County shall be consistent with the California Public Health and Medical
Emergency Operations Manual (EOM) as authorized by the MHOAC and the California
Master Mutual Aid System.
3. MCI/Disaster Response Within the County. In the event of a MCI or other local emergency
within Contra Costa County, Contractor shall perform in accordance with the County MCI
plan and within the Incident Command System (ICS). Contractor shall use its best efforts to
maintain primary emergency services, including suspension of non-emergency services as
required.
a. Contractor shall maintain documentation of the number and nature of mutual aid
responses it makes outside its Service Area and nature of mutual aid responses made
by other agencies to calls originating within its Service Area.
b. Contractor shall provide a report on mutual aid activities to District when requested by
District.
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4. liaison Staff. Contractor shall assign a field or dispatch manager/supervisor upon District's
request, to respond to the designated emergency operations center as a liaison, in the
event the County declares a disaster within the County.
5. Suspending Non-Emergency Services. In the event District directs Contractor to respond to
a disaster in a neighboring jurisdiction, normal operations may be suspended at the
discretion of District and Contractor shall respond in accordance with the disaster plan.
Contractor shall use its best efforts to maintain primary emergency services and may
suspend non-emergency services upon notification and concurrence with District.
6. Ambulance Strike Team. Contractor shall be prepared to respond one Ambulance Strike
Team staffed and equipped to the EMSA Ambutance Strike Team Guidelines when directed
by District in accordance with a disaster mutual aid request.
7. Disaster Response Vehicle/Equipment. Contractor shall maintain a County-controlled,
state-provided Disaster Medical Support Unit. In the absence of a DMSU, Contractor shall
provide one vehicle as a disaster response vehicle. This vehicle shall not be an ambulance
used in routine, day-to-day operations, but shall be kept in good working order and
available for emergency response. This vehicle may be used to carry personnel and
equipment to a disaster site. The following equipment shall be stored in this disaster
vehicle: backboards and straps; cervical collars; head immobilization sets and foam
wedges; PPE; splints for legs and arms; oxygen equipment; extra dressing and bandages;
advanced life support equipment; especially IV therapy equipment; County approved
disaster tags; and checklists for medical Incident Command personnel. This vehicle may be
utilized as an ASTL v~hicle upon written authorization of District. If this vehicle is utilized to
support Contractor response within its Service Area, Contractor is responsible for
restocking equipment and supplies utilized.
8. Continuity of Operations. No later than ninety {90) days after the effective date of this
Contract, Contractor shall submit detailed written plans and procedures to District
describing how it will mitigate the impacts to the Emergency Ambulance Services provided
hereunder during all potential emergencies, disasters or work actions (i.e., power failure,
information systems failure, earthquake), and provide continuous operations.
a. As least annually, Contractor shall review and revise the disaster mitigation plan
submitted to District under this Section 8, and submit the revised version to District.
9. Internal Disaster Response Notification. Contractor shall implement a plan for immediate
recall of personnel during multi-casualty incidents or other emergency condition. This plan
shall include the capability of Contractor to alert off-duty personnel.
10. Incident Notification. Contractor shall have a mechanism in place to communicate current
field infonnation to appropriate District and CCCEMSA staff during multi-casualty incidents,
disasters or other unusual occurrences.
11. lnteragency Trainin.q for ExercisesJDrills. Contractor shall participate in CCCEMSA
sanctioned exercises and disaster drills and other interagency training in preparation for this
type of response.
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12. Ambulance Service Assistance. Contractor shall assist in providing ambulance service to
any other Emergency Response Areas if the County's contract with its emergency
ambulance service provider for that Emergency Response Area has been suspended or
terminated, and if requested to do so by District.
P. Pavment Provisions; Biiiing; Reporting.
1. Payment Provisions. Subject to the Payment Limit of this Contract and subject to the
terms of this Contract, District will pay Contractor for each Ambulance Unit Hour
depending on the number of Ambulance Unit Hours Contractor provides on a weekly basis
as set forth in Exhibit D (Ambulance Unit Hours Rates) attached hereto, as full
compensation for all services, work, expenses, and costs provided or Incurred by
Contractor in performing its obligations under this Contract (the "Per Unit Hour Rate"). For
billing purposes, each Ambulance Unit Hour may be divided into 15 minute increments.
2. Ambulance Unit Hourly Rate Adjustments. Beginning on April 1, 2017, and on each April 1
thereafter, the Per Unit Hour Rate will increase by the percentage equal to the product of
(a) District's collection realization percentage (i.e., the percentage of patient billings
actually collected} for the preceding year, times (b) the increase in the rates that District
charges for services under the CCCEMSA Contract that is based on changes in the
Consumer Price Index. ·
3. District Revenue Decrease: Contractor Cost Increase. In the event changed
circumstances that are beyond the control of the respective parties result in an increase in
the cost of Contractor providing services under this Contract, or a decrease In the revenue
generated by District under the CCCEMSA Contract, the parties agree to meet and
discus.s in good faith. proposed revisions to this Contract that are mutually beneficial to
both parties, including without limitation, increases or decreases in the Per Unit Hour
Rates.
4. Invoices: Payment.
a. Ambulance Unit Hours Invoicing and Payment. Contractor shall submit monthly
invoices to District for payment of Contractor's services. District shall pay Contractor
invoices no later than thirty (30) days of receipt of an invoice and sufficient
documentation to make payment therefor.
b. Penalty Invoicing and Payment. District shall invoice Contractor for any fines or
penalties within 30 days after District's receipt of Contractor's monthly Performance
Reports and after approval of the penalties determined by CCCEMSA. Contractor shall
pay District all penalties and fines no later than thirty {30) days after receipt of an
invoice. For any disputes that have not been resolved to the satisfaction of CCCEMSA.
District, or Contractor, the in\/oice shall be paid in full and subsequent invoices will be
adjusted if necessary to reflect the resolution of disputed amounts.
5. Cost Efficiencies and Operational Synergy. Throughout the term of this Contract,
Contractor and District agree to meet and confer at least semi-annually to research,
develop, and attempt to implement cost efficM!ncM!s and o~::::n {i;s :[
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possible. Examples of such initiatives include joint or preferred purchasing agreements,
joint training opportunities, and shared occupancy of facilities .
6. District Consulting Services Cost Reimbursement Within thirty (30) days after the
effective date of this Contract, Contractor shall reimburse District for consulting costs
associated with the preparation and evaluation of District's initial request for qualifications
of ambulance service providers, and District and Contractor's Proposal in response
County's Emergency Ambulance Request for Proposals. District will provide supporting
documentation and receipts of payments made for consulting services received.
Contractor's reimbursement obligation shall not exceed $200,000.
1. No Contractor Billing or Collection. Contractor shall not seek to collect any amounts from
patients, governmental agencies, insurance companies, or otherwise for the delivery of
ambulance services pursuant to this Contract.
8. Audits/Inspections.
c. Unaudited Quarterly Statements. Contractor will provide District quarterly unaudited
financial statements for its services provided pursuant to this Contract. These reports
shall be provided in a format prescribed by District.
d. Annual Financial Audit. Upon District's request, Contractor will promptly provide annual
financial statements in a format approved by District that have been audited by an
independent Certified Public Accountant in accordance with generally accepted auditing
standards. Statements shall be available within no more than one hundred twenty (120)
calendar days after the close of each fiscal year. If Contractor's financial statements are
prepared on a consolidated basis, then separately audited financial statements
specifically related to the services provided under this Contract will be required.
e. County.Auditor Requested Information. Contractor will provide any information
separately requested by the County Auditor-Controller's Office and allow full access to
its financial records by the County Auditor-Controller's Office for the period covered by
this Contract.
f. District Audit. Upon reasonable request, Contractor shall make its books, medical
records, productivity reports, and financial or operational records available to District for
review and audit as necessary to support District's application to County for a transport
rate increase.
9. Contractor Business Office. Contractor shall maintain a business office within the County
and a focal or toll-free telephone number for all patient questions, complaints, or disputes
made from locations within the County. Contractor shall provide prompt response to any
queries or appeals from patients.
g. Contractor shall describe its methods for receiving, monitoring and responding to
patient issues and complaints.
10. Patient Billing Information.
h. Contractor shall perform pre-billing functions for District and provide the patient billing
information for each ambulance transport to include, without limitation:
L Patient name unless Jotin or Jane Doe;
ii. Patient address and/or telephone number;
iii. Patient date of birth and/or social security number: /'(" !>() / Initials:~ (t\
Contractor ~
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SERVICE PLAN
(Purchase of Services· Long Form)
iv. Patient insurance information if available; and
v. Reason for ambulance transportation
i. Contractor shall provide patient billing information to District in a format and substance
that will allow District to:
i. electronically generate and -submit Medicare and MediCal claims;
ii. itemize all procedures and supplies employed on patient bills;
iii. transmit the information to District's billing and collections subcontractor; and
j. Contractor shall cooperate witb District as necessary to ensure that it is fulfilling
District's requirements with respect to the sufficiency and timely provision of patient
billing Information.
11 . Financial Reporting . On a monthly basis Contractor shall report to District trends in
monthly total expenses , number of deployed unit hours, cost per unit hour, number of
transports, cost per trip, and any other· relevant expense data reasonably requested by
District.
12. Contract Administration: Dispute Resolution Process.
k. Collaboration Committee Meetings .-At least once a month, staff of Cof'.ltractor, District,
and CCCEMSA. whose attendance are necessary and appropriate , shall meet to
discuss issues arising under this Contract. The purpose of the Collaboration Committee
meetings is to provide a forum for formal discussion and resolution of issues arising in
the performance and administration of this Contract.
I. Dispute Resolution Process. Without limiting the party's rights under Special Condition
32 (Event of Default} of this Contract, the parties agree to resolve any disputes arising
under this Contract as set forth in this section.
i. Collaboration Committee. The Collaboration Committee will discuss relevant issues
and make a good faith attempt to resolve them.
ii. Agency Heads. If the Collaboration Committee is unable to resolve an issue, the
agency head of the party seeking resolution of an issue arising under this Contract
shall contact the other party's agency head (i.e ., District's Fire Chief, or Contractor's
regional director} in an attempt to resolve the issue .
Q. Admi nistrative.
1. Federal Healthcare Program Compliance Provisions. Contractor shall comply with all
applicable Federal laws , rules and regulations fo r operation of its enterprise , ambulance
services , and those associated with employees. This includes compliance with all laws
and regulations relating to the provision of services to be reimbursed by Medicare,
Medicaid, and other government funded programs.
2. Medicare and Medicaid Compliance Program Requirements. Contractor shall implement
a comprehensive Compliance Program for all activities, particularly those related to
documentation. Contractor's Compliance Program shall subs tantially comply with the
current guidelines and recommendations outlined in the Office of Inspector General (OIG)
Compliance Program Guidance for Ambulance Suppliers as published in the Federal
Register on March 24, 2003 (03 FR 14255).
3. HIPM. CAL HIPAA and HITECH Compliance Proaram Requirements. Contractor shall
implement a comprehensive plan and develop lhe appropri~::l~ced:0~o
Form L-3 (Page 44 of 55)
April 18, 2017 CCCFPD Minutes 194
SERVICE PLAN
(Purchase of Services· Long Fonn)
comply with the provisions of the Health Insurance Portability and Accountability Act of
1996 and the current rules and regulations enacted by the US Department of Health and
Human Services as it relates to services provided under this Contract, including:
a . Standards for Privacy and Individually Identifiable Health Information;
b . Health Insurance Refonn : Security Standards; and
c . Heafth Insurance Reform : Standards for Electronic Transaction Sets and Code
Standards
4 . HIPAA. CAL HIPAA and HITECH violations. Any violations of the HIPAA, CAL HIPAA and
HITECH rules and regulations as they relate to the services provided under this Contract
will be reported immediately to District along with Contractor's actions to mitigate the effect
of such violations ..
5. State Compliance Provisions. Contractor shall comply with all applicable state and local
laws, rules and regulations for businesses, ambulance services, and all applicable laws
governing its employees; Contractor shall also comply with District and CCCEMSA
policies, procedures, and protocols with regard to the services described i n this Contract.
6. Performance Oversight and Monitoring. Contractor understands and agrees. that
CCCEMSA will continuously review, inspect and monitor all aspects of Contractor's
operations and perfonnance necessary to ensure all services provided by Contractor to
County residents and visitors meet the requirements stated ln this Contract, the EMS Plan,
CCCEMSA programs, polic ies, protocols, and procedures and as required by law.
Contractor shall reasonably cooperate with CCCEMSA to fulfill this function, including
providing access to all records, facilities and personnel as reasonably requested by
District. Contractor shall provide monitoring tools and technology to allow District to
monitor Contractor's performance under this Contract.
7. Observation of Ooerations. Contractor acknowledges that CCCEMSA is authorized to
investigate all aspects of Contractor's operation so that patient care services under
Contractor's operation are perfonned in a safe and reliable manner. Contractor
understands and agrees that CCCEMSA personnel may and will at any time directly
observe Contractor operations including ride-alongs (in accordance with Contractor
policies and applicable laws, e.g ., HIPM} with field supervisors and ambulance crews.
Contractor agrees to grant access to CCCEMSA personnel for announced or
unannounced observation, inspection, audit or review of any operational, clinical or
support function, including but not limited to records, facilities, equipment, veh icles and
personnel. During any inspection, audit or review, Contractor shall make requested
records pertaining to any service rendered under this Contract available to District
personnel and CCCEMSA personnel.
8. Approval of Contractor Subcontracts. Plans. Programs. Policies, Protocols and
Procedures. All plans, programs, policies, protocols and procedures that require
CCCEMSA's approval by law or CCCEMSA policy, and any Contractor subcontracts for
the performance of services under this Contract, shall be submitted to District for approval
prior to their implementation.
9. Contractor Obligation to Notify County. Contractor shall report to District in writing as soon
as practicable any instance where It did not meet, or has re::::
8
to ~ay ~:
Fonn L-3 (Page 45 of 55)
April 18, 2017 CCCFPD Minutes 195
SERVICE PLAN
(Purchase of Services -Long Form)
able meet, a material requirement stated in this Contract. Upon its receipt of a notice of a
failure to perfonn or an anticipated failure to perform under this Contract, District shall
perform a review and work with Contractor to develop the appropriate corrective action
plan to be implemented by Contractor.
10. Annual Performance Evaluation.
a. District shall evaluate the performance of Contractor at least annually to determine
compliance with this Contract. The following minimum Information may be included in
the evaluation:
i. Response Time performance standards assessed with reference to the minimum
requirements in the Contract;
II. Clinical performance standards assessed with reference to the minimum
requirements in the Contract;
iii. Initiation of innovative programs to improve system performance;
Iv. Workforce stability, including documented efforts to minimize employee turnover;
v. Compliance of pricing and revenue recovery efforts with rules and regulations and
this Contract;
vi. Compliance with information reporting requirements; and
vii . Financial stability arid sustainability .
b. Contractor agrees to participate as requested by District in an annual joint report
presentation by CCCEMSA and District to the County Board of Supervisors describing
the Emergency Ambulance Services provided under this Contract during the subject
year.
11. Ambulance Service Permit. Contractor shall comply with the County ambulance permitting
.process pursuant to Division 48 of the County Ordinance Code and CCCEMSA policies .
12. Sharina of Information. Contractor shall not discourage or prevent its employees or
agents from sharing information with District concerning the County's EMS System,
including issues related to Contractor's operations.
13. Notice of Labor Action . Contractor shall notify District of any threatened labor action or
strike that would adversely affect its performance under this Contract. At the time of such
a notice, Contractor shall provide District and other affected public entities with a written
plan of proposed action to deliver continued service delivery as stated in this Contract in
the event of any threatened work force action or strike.
14. Cooperation With Evolving System . Contractor agrees to participate and assist in the
development of system changes subject to negotiated costs , if any.
15. Earned Contract Extension. Notwithstanding Section 22 (Nonrenewal) of the General
Conditions of this Contract, District shall report to its Board of Directors on or before
December 31, 2020, on Contractor's compliance with the terms of this Contract and the
Board of Directors shall issue a finding as to Contractor's compliance with the terms of this
Contract. Notwithstand ing Paragraph 3 (Term) of th is Contract, unless (a) this Contract is
terminated by either party pursuant to its terms, or by mutual agreement prior to December
31 , 2020, or (b) the CCCEMSA Contract is not extended, upon a finding by the Board of
Directors that Contractor has been in substantial compliance with all terms of this
Contract, the term of this Contract shall be extended to December 31 , 202 Dur ing its
lnftials: -~ } ~
Form L-3 (Page 46 of 55)
April 18, 2017 CCCFPD Minutes 196
SERVICE PLAN
(Purchase of Services • Long Form)
extended term, this Contract is nevertheless subject to all the terms and conditions
applicable during its initial term. If this Contract is automatically extended, Contractor shall
continue to provide services as set forth in this Contract, subject to any amendments
hereto.
16. No Advertising . Contractor shall not, in the course of providing services pursuant to this
Contract, advertise, promote, or endorse any other service or product provided by
Contractor or any other firm, unless Contractor has obtained the prior written approval of
District.
R. Workforce Engagement and Benefits.
1. Workforce Engagement. Contractor shall adopt programs and key performance indicators
to engage its workforce, which shall include, but not be limited to, assessing and
evaluating the satisfaction of its employees on a regular basis and developing measures to
improve employee satisfaction. Examples of workforce engagement programs that should
be adopted by Contractor include, but are not limited to:
a. Annual employee reviews
b. Labor/Management Meetings
c . System Status Meetings/Deployment Improvement
d . Health and Safety Committee
e. Certification/Credentialing Support
f. Competitive Wage and Benefit Package
g. Employee Assistance Program (EAP).
h. Allied/ Interoperability Agency Training
i. Career Development
j. Critical Incident Stress Management
k. EMS Committee
I. Field Employee Recognition Program
m. Field/Base Communication Review
n. Professional Growth Opportunities/Training
o . Continued Education Opportunities
p. PEERS Pre Hospital Education and Evaluation Readiness Solutions Program
q. Newsletter
r. Healthcare charitable ·foundation program
s. Workforce harmony
S. Risk Management Program.
1. Illness and lniurv Prevention. Contractor shall develop, implement, and maintain a
comprehensive illness and injury prevention policy manual that includes an injury and
illness prevention program, an infection control program, and a risk management program.
2 . Incident Reporting, Investigation. and Corrective Actions
a. Contractor shall develop, implement, and maintain a program for incident reporting,
investigation , and corrective action that effectively addresses each incident recognized
or reported.
i. Incident Review -This performance improvement program shall include guidelines
and processes to retrospectively review incidents and outline how risks for
workplace safety for employees and patients ~an be improv'-1'" l\M /
Initials :~ ~
Contractor · County
Form L-3 (Page 47 of 55)
April 18, 2017 CCCFPD Minutes 197
SERVICE PLAN
(Purchase of Services· Long Fonn)
ii. Investigation and Documentation -This program shall establish strict incident
reporting standards that allow Contractor to respond Immediately to adverse
events, initiate a thorough and unbiased investigation, implement mitigation
measures, and carry out corrective action in a timely manner. The program shall
utilize an electronic safety reporting system that provides daily, monthly, and
annual tracking of collisions and worker's compensation claims . All information
shall be made available to CCCEMSA upon request.
3. Ethics and Comcliance Proaram. Contractor shall develop, implement , and maintai n a
program that focuses on employee education and Contractor's compliance with all federal,
state, and local payor regulations. The program must track changes in federal laws and
regulations, as well as government enforcement affecting Contractor and Contractor's
customers·, ensuring Contractor is always in full compliance with all laws and regulations.
The program shall, at a minimum, meet the guidance issued by the Office of Inspector
General.
lnWa~;~ ~
Contractor Coun1y
Form L-3 (Page 48 of 55)
April 18, 2017 CCCFPD Minutes 198
Legend
ZoneA
c::J zon.S
O z-c
.::J z-t>
6oufca: Conb'a Colla EMS
Selllember 2015
SERVICE PLAN
(Purchase of Services~ Long Fonn)
Exhibit A
Emergency Response Zones Map
Contra Costa County
Emergency Response Zones
0 4.26 17 Miles
Form L-3 (Page 49 of 55)
April 18, 2017 CCCFPD Minutes 199
• , iar.A
L:Ji-11
[::Jz-c
t "'''"f ~ZoneD
~~,...,....,
HlghDMldly
LowDmnlily
Source; Conlr.I Cotila EMS
8.....,.,., 2015
SERVICE PLAN
(Purchase of Services· Long Form)
Exhibit B
Response Density Map
Contra Costa County
High Density/Low Density Response Zones
N
0 17,,.. A
Initials:~ ~
Contractor ~
Form L~3 (Page 50 of 55)
April 18, 2017 CCCFPD Minutes 200
SERVICE PLAN
(Purchase of Services -Long Form)
I. Response Time Penalties
ExhibitC
Penalties
Emergency Ambulance Requests· Priority 1 Responses for ~ERZ
Complfance •1o
89%<90%
88%<89%
<88%
Pe nalty
$15,000
$25,000
$50,000
Emergency Ambulance Requests· Priority 2 Responses for !i1S!J_ofthe ERZ
Compliance •1.
89o/.<90%
88%<89%
<88%
Penalty
$5,000
:$10,000
$15,000
Emergency Ambulance Requests • Priority 3 Responses for each of the ERZ
Compliance%
.89%<90%
88%<89%
<88%
Penalty
$2,500
$5,000
$7,500
------.
Non-Emergency ALS lnterfacllity Transports ~ Priority 4 Responses for entire Service
Area
'rlorlty level
Priority 1
Priority 2
Priority 3
Compliance %
89%<90%
aa 0!.<89%
<88%
Penalty
$4,000
$6,000
$7,500
Outlier Response Time Penalties
Outlier ResponH Timee
High Density Call
>18:59
>22:59
>39:59
Low Density
CaH
>29:59
>44:59
>59:59
tnalty per
Out lier
$1,500
,$1,000
$750
lnlt~ls:~~
Contractor ~
Fonn L-3 (Page 51 of 55)
April 18, 2017 CCCFPD Minutes 201
Priority 4
SERVICE PLAN
(Purchase of Services -Long Form)
>29:59 late for
scheduled
>89:59 fo.r non-
scheduled
Form L·3 (Page 52 of 55)
$500
Initials :~ {N
Contractor ~
April 18, 2017 CCCFPD Minutes 202
SERVICE PLAN
(Purchase of Services • Long Form)
II. Other Penalties.
Performance Section Reference Penalty
Provide timely Section H(9)(c) -$50 per report for each day after
Response Time Operational and Response due date
reports and Time reports; Section M(4)
operational reports -Monthly and Annual
Leave Interim Section M(6)(b}-Interim $50 for every instance when the Interim
PCR at hospital PCR delivery PCR is not left at the receiving facility
prior to crew departure. (No later than
Submit Section M{6}(c)-ePCR Uuly 1, 2017, See Section M(6))
completed ePCR submission within 24 hours
within 24 hours ~penalty of $100 for every completed
of patient ePCR not provided to the facility within
delivery ~4 hours of patient delivery.
Response and Sections 0(1 )(b), and $1, 000 for each incident
transport by a BLS unit D( 1 )( d}{iii)
when the Priority level
calls for the patient to
be transported by an
ALS unit
Failure to provide Sections E(5), and E(12) $50 per report or data submission
timely quality for each day after due date
improvement data and
reports
Failure to provide Section E(5)(b); Section 1(6) $100 per report for each day after
timely unusual the date the particular report was
occurrence reports due
and investigation
Inn
.
Failure to respond to Section D( 1 )(b) $10,000 for each failure to respond to
an emergency an Emergency Ambulance request.
request for an
Emergency
Ambulance
Improper Paramedic or Section 1(9) (Paramedic); $250 per call responded to by
EMT certification Section 1(1 O} (EMT) improperly certified
Paramedic or EMT
Failure to document Section E(18) $500. for a Transport Employee's
Against Medical failure to document Against
Advice (AMA} Medical Advice (AMA)
Initials: I/~ ~
Con~actor Cou
Form L-3 (Page 53 of 55)
April 18, 2017 CCCFPD Minutes 203
SERVICE PLAN
(Purchase of Services .. Long Form)
Dispatched Sections H(5)(d), and $250 per incident
Emergency H(9)(d)
Ambulance crew fails
to report and
document Arrival On
Scene Time
Ambulance fails to Section J(S) $500 per Ambulance
meet the minimum in-
service requirements
Initials:~ C\
Contractor ~
Form L-3 (Page 54 of 55)
April 18, 2017 CCCFPD Minutes 204
SERVICE PLAN
(Purchase of Services -Long Form)
Exhibit D
Ambulance Unit Hours Rates
Ambulance Unit Hours Per Week Ambulance Unit Hour Rate
4,501 -4,668 $139.64
4,669 -4,836 $138.21
4,837 -5,004
I
$136.88
-
5,005-5,172 $135.64
5, 173 -5,340 $134.48
-
5,341 -5,508 $133.40
5,509 -5,676 $132.38
5,677 -5,844 $131.42
----,_ ___
5,845 and over $130.51
lnlHals: ,r!YJ1,/ (\j -&:£; ~
Form L-3 (Page 55 of 55)
April 18, 2017 CCCFPD Minutes 205
SPECIAL CONDITIONS
(Purchase of Services -Long Form)
The parties to this Contract agree that the Special Conditions set forth herein modify the
Payment Provisions (Form P-1), and the General Conditions (Form L-5) ofthe Contract, and are
part of this Contract Capitalized terms used herein and not otherwise defined have the
meaning given in the Service Plan of this Contract.
1. Right to Withhold. Section 4 (Right to Withhold) of the Payment Provisions (Fonn P~
1) is hereby deleted in its entirety and replaced with the following:
"4. Intentionally Omltted.n
2. Records. Section 3 (Records) of the General Conditions of the Contract is hereby
amended by adding the following language immediately following the end of subsection (b):
"c. Financial Records. Contractor shall maintain separate financial records for EMS
services provided pursuant to this Contract in accordance with generally
accepted accounting principles.
d. Records Review. With reasonable notification and during normal business
hours, District shall have the right to review any and all business records
including financial records of Contractor pertaining to this Contract. All records
sh~ll be made available to District at their office or other mutually agreeable
location. The District may audit, copy, make transcripts, or otherwise reproduce
such records, including but not limited to contracts, payroll, inventory, personnel
and other records, daily logs, and employment agreements ."
3. Termination and Cancellation . Section 5 (Termination and Cancellation) of the
General Conditions of the Contract is hereby deleted in its entirety and replaced with the
following:
"a. Written Notice. In the event that Contra Costa County terminates the
CCCEMSA Contract without cause, Distri~t may, In its sole discretion, terminate
this Contract by providing written notice to Contractor that this Contract will be
terminated on the same date that the CCCEMSA Contract is being terminated.
District may, in its sole discretion, terminate this Contract without cause by
giving Contractor twelve (12) months advance written notice of its intent to
terminate this Contract This Contract may be cancelled immediately by written
mutual consent.
b. Event of Default. If Contractor has committed an Event of Default (as defined in
Special Condition 32 (Event of Default) below), District may, upon written notice
to Contractor, terminate this Contract. If District terminates this Contract based
on an Event of Default, it may proceed with ·the work in any reasonable manner
it chooses. The cost to District of completing Contractor's performance shall be
deducted from any sum due the Contractor under this Contract, without
prejudice to District's rights otherwise to recover its damages.
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April 18, 2017 CCCFPD Minutes 206
SPECIAL CONDITIONS
(Purchase of Services -long Form)
c. Cessation of Funding . Notwithstanding any contrary language in Paragraphs 5
and 11 of the General Conditions, in the event that federal, state, or other non-
Dis"trict funding for this Contract ceases, District may term inate this Contract with
thirty (30) days written notice."
4. Modifications and Amendments. Section 8(b) (Minor Amendments) of the General
Conditions is hereby deleted in its entirety and replaced with "(Reserved.r
5. Disputes. Section 9 {Disputes) of the General Conditions is hereby deleted in its
entirety and replaced with "[Reserved.)"
6. Insurance. Section 19 (Insurance) of the General Conditions of the Contract is
hereby amended by deleting the section in its entirety and replacing it the following:
•19. Insurance. During the entire term of this Contract and any extension or
modification hereof, Contractor shall keep in effect insurance policies
meeting the following insurance requirements:
a. Liability Insurance. Contractor shall keep in effect malpractice
insurance and commercial general liability insurance, including
coverage for business losses, and for owned and non-owned
vehicles, each with a minimum combined single limit coverage of
$11,000,000 for all damages, including consequential damages,
due to bodily Injury, sickness or disease, or death to any person or
damage to or destruction of property, including the loss of use
thereof, arising from each occurrence. Such insurance shall be
endorsed to include County and District, and their officers and
employees as additional named insureds as to all services
performed by Contractor under this Contract. Said policies shall
constitute primary insurance as to County and District, the state
and federal governments, and their officers , agents, and
employees, so that other insurance policies held by them or their
self-insurance programs shall not be required to contribute to any
loss covered under Contractor's insurance policy or policies.
Contractor shall provide District with a copy of the endorsement
making the County and District an additional insured on
Contractor's commercial general liability policies as required
herein no later than the effective date of this Contract.
b. Workers' Compensation. Contractor shall provide workers'
compensation insurance coverage for its employees.
c. Certificates of Insurance. Contractor shall provide District with
certificates of insurance evidencing Contractor's liability, medical
malpractice (if applicable), and worker's compensation insurance
as required herein no later than the effective date of this Contract.
If Contractor renews an insurance policy or acquires either a new
2
April 18, 2017 CCCFPD Minutes 207
SPECIAL CONDITIONS
(Purchase of Services • Long Form)
insurance policy or amends the . coverage afforded through an
endorsement to the policy at any time during the term of this
Contract, then Contractor shall provide District with a current
certificate of insurance evidencing such renewal, new policy, or
amendment.
d. Additional Insurance Provisions. No later than five days after Contractor
receives: (i) a notice of cancellation, a notice of an intention to cancel, or
a notice of a lapse in the Contractor's insurance coverage required by this
Contract; or (ii) a notice of a material change to Contractor's insurance
coverage required by this Contract, Contractor will provide District a copy
of such notice of cancellation, notice of intention to cancel, notice of lapse
of coverage, or notice of material change. Contractor's failure to provide
District the notice as required by the preceding sentence is a default
under this Contract . n
e. Performance Securitv Bond. Contractor shall furnish performance
security in the amount of $1 ,000,000 in one of the following fonns:
i. A faithful performance bond issued by a bonding company,
appropriately licensed and acceptable to District; or ·
ii. An irrevocable letter of credit issued pursuant to this provision in a
form acceptable to the District and from a bank or other financial
institu.tion acceptable to the District. R
9. Section 22 (Nonrenewal) of the General Conditions of the Contract is hereby
amended by adding the following language the end of the section:
"Competitive Bid Required. Contractor acknowledges that District intends to
conduct a competitive procurement process for the provision of emergency
ambulance services within the Service Area following the expiration or
termination of this Contract. Contractor acknowledges and agrees that
District may select a different ambulance service provider to provide
exclusive emergency ambulance services within all or some of the Service
Area following the competitive procurement process.
Future Bid Cycles. Contractor acknowledges and agrees that its supervisory
personnel, EMT's, paramedics, and control center personnel working in the
EMS System have a reasonable expectation of long-tenn employment in the
EMS System, even though private party providers of EMS System services
may change from time to time. Ac;cordingly, Contractor shall not penalize or
bring personal hardship to bear upon any of its employees who apply for work
on a contingent basis with competing bidders, and shall allow without penalty
its employees to sign contingent employment agreements with competing
bidders ·at employees' discretion. Contractor may, however, prohibit its
employees from assisting competing bidders in preparing their bid proposals
by revealing Contractor's trade secrets or other information about
Contractor's business practices or field operations .·
3
April 18, 2017 CCCFPD Minutes 208
SPECIAL CONDITIONS
(Purchase of Services -Long Fonn)
10. Additional Special Conditions. The following new sections are hereby added
to the General Conditions immediately following Section 29 (No Implied Waiver) thereof
as follows:
"30. Emergency Takeover.
a. Public Health and Safety Risk Determination. If District has a reasonable belief
that Contractor's failure to perform its obligations under this Contract, or that a
labor dispute will prevent Contractor from performing its obligations under this
Contract, and that such failure to perform will endanger public health and
safety, and after Contractor has been given notice and reasonable opportunity
to correct the failure of performance, District shall present the matter to the
District Board of Directors. If the Board of Directors finds that Contractor's
failure to perform lts obligations under this Contract will endanger public health
and safety, and that permitting Contractor to continue providing services under
this Contract will endanger public health and safety, Contractor shall cooperate
with District and County to effect an immediate emergency takeover by County
of Contractor's ambulances and crew stations (an uEmergency Takeover").
The Emergency Takeover shall be completed within 72 hours after action by
the Board of Directors.
b. Delivery of Equipment. In the event of an Emergency Takeover, Contractor
shall deliver to District the ambulances and associated equipment used in the
Emergency Ambulance Services pursuant to this Contract, including
supervisors' vehicles. Each ambulance shall be equipped, at a minimum, with
the equipment and supplies necessary for the operation of an ALS Ambulance
in accordance with Contra Costa County ALS Policies and Procedures.
Equipment shall include the supplies at the minimum stocking levels for an
ALS Ambulance.
c. Lessor I Lessee Relationship.
i. Contractor shall deliver all ambulances, crew stations, and other facilities
located in Contra Costa County and used pursuant to this Contract for
storage or maintenance of vehicles. equipment, or supplies to District in
mitigation of any damages to District. However, during the County's
takeover of the ambulances, equipment, and facilities, District and
Contractor shall be considered a lessee and lessor. Monthly rent payable
to Contractor shall be equal to the aggregate monthly amount of
Contractor's debt service on the vehicles and equipment and occupancy
charges as documented by Contractor and as verified by the County
Auditor. The County Auditor shall disburse these payments directly to
Contractor's obligee. In the event an ambulance is unencumbered, or a
crew station is not being rented, District shall pay Contractor the fair market
rental value for the ambulance or crew station.
4
April 18, 2017 CCCFPD Minutes 209
SPECIAL CONDITIONS
(Purchase of Services -Long Form)
If. All of Contractor's vehicles and related equipment necessary for the
provision of Emergency Ambulance Services pursuant to this Contract are
hereby leased to District during an Emergency Takeover period.
Contractor shall maintain and provide to District a listing of all vehicles
used in the performance of this Contract, including reserve vehicles, their
license numbers, and the name and address of the lienholder, if any.
Changes in lienholder, as well as the transfer, sale, or purchase of vehicles
used to provide Emergency Ambulance Services hereunder shall be
reported to District within thirty (30) days of said change, sale, transfer and
purchase. Contractor shall inform and provide a copy of the takeover
provisions contained herein to the lienholders within five (5) days of an
Emergency Takeover.
d. Recovery of Damages. Nothing herein shall preclude District from pursuing
recovery from Contractor of rental and debt service payments made pursuant
to subsection (c) above. Contractor shall not be precluded from disputing the
Board's findings and the nature and amount of District's alleged damages.
However, failure on the part of Contractor to cooperate fully with District and
County to effectuate a safe and smooth Emergency Takeover shall itself
constitute a breach of this Contract, even if it is later determined that the
original declaration of breach by the Board of Directors was made in error.
e. Contractor lndemnitv. District shall indemnify, hold harmless, and defend
Contractor against any and all claims arising out of the District's use, care,
custody, and control of the stations, equipment and vehicles, includ·ing but not
limited to, equipment defects. defects in material and workmanship, and
negligent use of the vehicles and equipment during an emergency takeover.
District and County shall have the right to authorize the use of the vehicles and
equipment by another company. Should County require a substitute contractor
to obtain insurance on the equipment, or should the County choose to obtain
insurance on the vehicles and equipment, Contractor shall be a named
additional Insured on the policy, along with appropriate endorsements and
cancellation notice.
f . Return of Equipment. District agrees to return all Contractor vehicles and
equipment to Contractor In good working order, normal wear and tear
excepted, at the end of the Emergency Takeover perfod. For any equipment
not so returned, District shall pay Contractor the fair market value of the
vehicle and equipment at the time of takeover, less normal wear and tear, or
shall pay Contractor the reasonable costs of repair, or shall repair and return
the vehicles and equipment. ·
g. length of Emergency Takeover Period. District may unilaterally terminate the
Emergency Takeover period at any time, and return the facilities and
equipment to Contractor. The Emergency Takeover period shall last, in the
County's judgment, no longer than is necessary to stabilize the EMS System
5
April 18, 2017 CCCFPD Minutes 210
SPECIAL CONDITIONS
(Purchase of Services • Long Form)
and to protect the public health and safety by whatever reasonable means the
County chooses.
31 . End Term Provisions. Contractor shall return to District all District issued
equipment in good working order, normal wear and tear excepted, upon the
expiration or terminatio·n of this Contract. For any District equipment not so
returned, District shall repair or replace said equipment at Contractor's expense
and deduct the cost thereof from any payments owed to Contractor. In the event
Contractor is not owed any payments under this Contract. Contractor shall
reimburse District for the actual cost of repairs and/or replacement
32. Event of Default. Subject to the dispute resolution process set forth in Section
P(11) of the Service Plan, if District believes Contractor has failed to perform or
observe any material term, covenant or provision of this Contract (any such event,
a "Defaulr), District shall deliver a written notice to cure such Default to Contractor
("Notice to Cure•). Within thirty (30) days following the date of the mailing of the
Notice to Cure, Contractor shall cure the Default or, if the Default is not reasonably
capable of cure within thirty (30} days, Contractor will be allowed to cure such
Default if it provides District with a good faith plan to cure such Default, but only for
so long as it diligently pursues cure of such Default and provides evidence thereof
to District If Contractor fails to cure such Default within thirty (30) da~ of the date
the Notice to Cure is mailed or fails to provide a good faith plan to cure a Default
Incapable of cure within thirty (30) days, or fails to diligently pursue a cure of such
Default incapable of cure within thirty (30) days (an •event of Default"), then, in
addition to any other rights available to District under law· or equity, District may
terminate this Contract as provided in Special Condition Section 5(b):
6
April 18, 2017 CCCFPD Minutes 211
Contra Costa County
Standard Form ~5
Revised 2014
GENERAL CONDITIONS
(Purchase of Services -Long Form)
1. Compliance with Law. Contractor is subject to and must comply with all applicable federal, state, and local laws
and regulations with respect to its performance under this Contract, including but not limited to, licensing,
employment, and purchasing practices; and wages, hours, and conditions of employment, including
nondiscrimination.
2. Inspection. Contractor's performance, place of business, and records pertaining to this Contract are subject to
monitoring, inspection, review and audit by authorized representatives of the County, the State of California, and the
United States Government.
3 . Records. ·Contractor must keep and make available for inspection and copying by authorized representatives of the
County, the State of California, and the United States Government, the Contractor's regular business records and such
additional records pertaining to this Contract as may be required by the County.
a. Retentioo pf Records . Contractor must retain all documents pertaining to this Contract for five years from the
date of submission of Contractor's ·final payment demand or final Cost Report; for any further period that is
required by law; and until all federal/state audits are complete and exceptions resolved for this Contract's funding
period. Upon request, Contractor must make these records available to authorized representatives of the County,
the State of California, and the United States Government.
b. Access to Books and Records of Contractor. Subcontractor. Pursuant to Section 1861(v)(l) of the Social
Security Act, and any regulations promulgated thereunder, Contractor must, upon written request and until the
expiration of five years after the furnishing of services pursuant to this Contract, make available to the County,
the Secretary of Health and Human: Services, or the Comptroller General, or any of their duly authorized
representatives, this Contract and books, documents, and records of Contractor necessary to certify the nature and
extent of all costs and charges hereunder.
Further, if Contractor carries out any of the duties of thls Contract through a subcontract with a value or cost of
$10,000 or more over a twelve-month period, such subcontract must contain a clause to the effect that upon
written request and until the expiration of five years after the furnishing of services pursuant to such subcontract,
the subcontractor must make available to the County, the Secretary, the Comptroller General, or any of their duly
authorized representatives, the subcontract and books, documents, and records of the subcontractor necessary to
N"erify the nature and extent of all costs and charges thereunder.
This provision is in addition to any and all other tenns. regarding the maintenance or retention of records under
thls Contract and is binding on the heirs, successors, assigns and representatives of Contractor.
4. Reporting Regllirements. Pursuant to Government Code Section 7550, Contractor must include in all documents
and written reports completed and submitted to County in accordance with this Contract, a separate section listing the
numbers and dollar amounts of all contracts and subcontracts relating to the preparation of each such document or
written report. This section applies only if the Payment Limit of this Contract exceeds $5,000.
Form L-5 (Page 1 of?)
April 18, 2017 CCCFPD Minutes 212
Contra Costa County
Standard Form L-S
Revised 2014
5. Termination and Cancellation.
GENERAL CONDITIONS
(Purchase of Services -Long Ji'orm)
a. Written Notice. This Contract may be terminated by either party, in its sole discretion, upon thirty-day advance
written notice thereof to the other, and may be cancelled immediately by written mutual consent.
b. Failure to Perform. County, upon written notice to Contractor, may immediately terminate this Contract should
Contractor fail to perform properly any of its obligations hereunder. In the event of such termination, County
may proceed with the work in any reasonable manner it chooses. The cost to County of completing Contractor's
performance will be deducted from any sum due Contractor under this Contract, without prejudice to County's
rights to recover damages.
c. Cessation of Funding. Notwithstanding any contrary language in Paragraphs 5 and 11, in the event that federal,
state, or other non-County funding for this Contract ceases, this Contract is terminated without notice.
6 . Entire A2reement. TI1is Contract contains all the terms and conditions agreed upon by the parties. Except as
expressly provided herein, no other understanding, oral or otherwise, regarding tbe subject matter of this Contract will
be deemed to exist or to bind any of the parties hereto.
7 . Further Snecificatioos for Operating Procedares. Detailed ·specifications of operating procedures and budgets
required by this Contract, including but not limited to, monitoring, evaluating, auditing, billing, or regulatory changes,
may be clarified in a written letter signed by Contractor and the department head, or designee, of the county
department on whose behalf this Contract is made. No written clarification prepared pursuant to this Section will
operate as an amendment to, or be considered to be a part of, this Contract.
8 . Modificadons and Amendments.
a . General Amendments. In the event that the total Payment Limit of this Contract is less than $100,000 and this
Contract was executed by the County's Purchasing Agent, this Contract may be modified or amended by a written
document executed by Contractor and the County's Purchasing Agent or the Contra Costa County Board of
Supervisors, subject to any required state or federal approval. In the event that the total Payment Limit of this
Contract exceeds $100,000 or this Contract was initially approved by the Board of Supervisors, this Contract may
be modified or amended only by a written document executed by Contractor and the Contra Costa County Board
of Supervisors or, after Board approval, by its designee, subject to any required state or federal approval.
b. Minor Amendmegts. The Payment Provisions and the Service Plan may be amended by a written administrative
amendment executed by Contractor and the County Administrator (or designee), subject to any required state or
federal approval, provided that such administrative amendment may not increase the Payment Limit of this
Contract or reduce the services Contractor is obligated to provide pursuant to this Contract.
9. Disputes. Disagreements between County and Contractor concerning the meaning, requirements, or performance of
this Contract shall be subject to final written determination by the head of the county department for which this
Contract is made, or his designee, or in accordance with the applicable procedures (if any) required by the state or
fedeTar government. ({ f'rn/ Q
~~
Fonn L-S (Page 2 of7) April 18, 2017 CCCFPD Minutes 213
Contra Costa CoW1ty
Standard Form L·5
Revised 2014
GENERAL CONDITIONS
(Purchase of Services -Long Form)
10. Choice of Law and Personal Jurisdiction.
a. This Contract is made in Contra Costa County and is governed by, and must be construed in accordance with. the
laws of the State of California.
b. Any action relating to this Contract must be instituted and prosecuted in the courts of Contra Costa County, State
of California.
11. Conformance with J<'ederal and State Regulations and Laws. Should federal or state regulations or laws touching
upon the subject of this Contract be adopted or revised during the term hereof, this Contract will be deemed amended
to assure conformance with such federal or state requirements.
12 . No Waiver by County. Subject to Paragraph 9. (Disputes) of these General Conditions, inspections or approvals, or
statements by any officer, agent or employee of County indicating Contractor's performance or any part thereof
complies with the requirements of this Contract, or acceptance of the whole or any part of said performance, or
payments therefor, or any combination of these acts, do not .relieve Contractor's obligation to fulfill this Contract as
prescribed; nor is the County thereby prevented from bringing any action for damages or enforcement arising from
any failure to comply with any of the terms and conditions of this Contract.
13. Subcontract and Assignment. This Contract binds the heirs, successors, assigns and representatives of Contractor.
Prior written consent of the County Administrator or his designee, subject to any required state or federal approval, is
required before the Contractor may enter into subcontracts for any work contemplated under this Contract, or before
the Contractor may assign this Contract or monies due or to become due, by operation of law or otherwise.
14. Independent Contractor Status. The parties intend that Contractor, in performing the services specified herein, is
acting as an independent contractor and that Contractor will control the work and the manner in which it is performed.
This Contract is not to be construed to create the relationship between the parties of agent, servant, employee,
partnership, joint venture, or association. Contractor is not a County employee. . This Contract does not give
Contractor any right to participate in any pension plan, workers' compensation plan, insurance, bonus, or similar
benefits County provides to its employees. In the event that County exercises its right to terminate this Contract,
Contractor expressly agrees that it will have no recourse or right of appeal under any rules; regulations, ordinances, or
laws applicable to employees.
15. Conflicts of Interest. Contractor covenants that it presently has no interest and that it will not acquire any interest,
direct or indirect, that represents a financial conflict of interest under state law or that would otherwise conflict in any
manner or degree with the performance of its services hereunder. Contractor further covenants that in the
performance of this Contrac4 no person having any such interests will be employed by Contractor. If requested to do
so by County, Contractor will complete a "Statement of Economic Interest" fonn and file it with County and will
require any other person doing work under this Contract to complete a ''Statement of Economic Interest" form and file
it with County. Contractor covenants that Contractor, its employees and officials, are not now employed by County
and have not been so employed by County within tw~lve months immediately preceding this Contract; or, if so
employed, did not then and do not now occupy a position that would create a confli ~~ G~t
~ Coun ept.
Form L-S (Page 3 of 7)
April 18, 2017 CCCFPD Minutes 214
Contra Costa County
Standard Form I.r5
Revised 2014
GENERAL CONDITIONS
(Purchase of Senices -Long Form)
Code section 1090. In addition to any indemnity provided by Contractor in this Contract, Contractor will indemnify,
defend, and hold the County harmless from any and all claims, investigations, liabilities, or damages resulting from or
related to any and all alleged conflicts of interest. Contractor warrants that it has not provided, attempted to provide,
or offered to provide any money, gift, gratuity, thing of value, or compensation of any kind to obtain this Contract.
16. ConfidentiaUtt. To the extent allowed under the California Public Records Act, Contractor agrees to comply and to
require its officers, partners, associates, agents and employees to comply with all applicable state or federal statutes or
regulations respecting confidentiality, including but not limited to, the identity of persons served under this Contract,
their records, or services provided them, and assures that no person will publish or disclose or permit or cause to be
published or disclosed, any list of persons receiving services, except as may be required in the administration of such
service. Contractor agrees to inform all employees, agents and partners of the above provisions, and that any person
knowingly and intentionally disclosing such infonnation other than as authorized by law may be guilty of a
misdemeanor.
17. Nondiscriminatory Services. Contractor agrees that all goods and services under this Contract will be available to
all qualified persons regardless of age, gender, race, religion, color, national origin, ethnic background, disability, or
se xual orientation, and that none will be used, in whole or in part, for religious worship.
18. Indemnification. Contractor will defend, indemnify, save, and hold hannless County and its officers and employees
from any and all claims, demands, losses, costs, expenses, and liabilities for any damages, fines, sickness, death, or
injury to person(s) or property, including any and all administrative fines, penalties or costs imposed as a result of an
administrative or quasi-judicial proceeding, arising directly or indirectly from or connected with the services provided
hereunder that are caused, or claimed or alleged to be caused, in whole or in part, by the negligence or willful
misconduct of Contractor, its officers, employees, agents, contractors, subcontractors, or any persons under its
direction or control. If requested by County, Contractor will defend any such suits at its sole cost and expense. If
County elects to provide its own defense, Contractor will reimburse County for any expenditures, including
reasonable attorney's fees and costs. Contractor's obligations under this section exist regardless of concurrent
negligence or willfuJ misconduct on the part of the County or any other person; provided, however, that Contractor is
not required to indemnify County for the proportion of liability a court determines is attributable to the sole
negligence or willful misconduct of the County, its officers and employees. This provision will survive the expiration
or tennination of this Contract.
19. Insurance. During the entire tenn of this Contract and any extension or modification thereof, Contractor shall keep
in effect insurance policies meeting the following insurance requirements· unless otherwise expressed in the Special
Conditions:
a . Commercial General Liabilitv Insurance. For all contracts where the total payment limit of the contract is
$500,000 or less, Contractor will provide commercial general liability insurance, including coverage for business
losses and for owned and non-owned· automobiles, with a minimum combined single limit coverage of $500,000
for all damages, including consequential damages, .due to bodily injury, sickness or disease, or death to any person
or damage to or destruction of property, including the loss of use thereof, arising from each occurrence. Such
insurance must be endorsed to include County and its officers and employees as additional insureds as to all
services perfonned by Colllraclor under this Contract Said policies must •r~•ry ins~ as to
Contractor ~
Form L-5 (Page 4 of7) April 18, 2017 CCCFPD Minutes 215
Contra Costa County
Standard Form L-5
Revised 2014
GENERAL CONDITIONS
(Purchase of Services -Long Form)
County, the state and federal governments, and their officers, agents, and employees, so that other insurance
policies held by them or their self-insurance program(s) will not be required to contnlmte to any loss covered
under Contractor's insurance policy or policies. Contractor must provide County with a copy of the endorsement
making the County an additional insured on all commercial general liability policies as required herein no later
than the effective date of this Contract. For all contracts where the total payment limit is greater than $500,000,
the aforementioned insurance coverage to be provided by Contractor must have a minimum combined single limit
coverage of$1,000,000.
b. Workers' Compensation. Contractor must provide workers' compensation insurance coverage for its employees.
c. Certificate of lnsu.-ance .. The Contractor must provide County with (a) certificate(s) of insurance evidencing
liability and worker's compensation insurance as required herein no later than the effective date of this Contract.
If Contractor should renew the insurance policy(ies) or acquire either a new insurance policy(ies) or amend the
coverage afforded thulugh an endorsement to the policy at any time during the term of this Contract, then
Contractor must provide (a) current certificate(s) of insurance.
d. Adcytional Insurance Prorisjons. No later than five days after Contractor's receipt of: (i) a notice e;f
cancellation, a notice of an in~tion to cancel, or a notice of a lapse in any of Contractor's insurance covetfl!:e
required by this Contract; or (ii)'·a notice ofa material change to Contractor's insurance coverage required by this
Contract, Contractor will provide Department a copy of such notice of cancellation. notice of intention to cancel,
notice of lapse of coverage, or notice of material change. Contractor's failure to provide Department the notice as
required by the preceding sentence is a default under this Contract
20. Notices. All notices provided for by this Contract must be in writing and may be delivered by deposit in the United
States mail, postage prepaid. Notices 10 County must be addressed to the head of the county department for which
this Contract is made. Notices to Contractor must be addressed to the Contractor1s address designated herein. The
effective date of notice is the date of deposit in the mails or of other delivery, except that the effective date of notice to
County is the date of receipt by the head of the county department for which this Contract is made.
21. Primacy of General Conditions . In the event of a conflict between the General Conditions and the Special
Conditions, the General Conditions govern unless the Special Conditions or Service Plan expressly provide otherwise.
22. Nonrenewal. Contractor understands and agrees that there is no representation, implication, or understanding that the
services provided by Contractor under this Contract will be purchased by County under a new contract following
expiration or termination of this Contract, and Contractor waives all rights or claims to notice or hearing respecting
any failure to continue purchasing all or any such services from Contractor.
23. Possessorv Inteust. If this Contract results in Contractor having possession of, claim or right to the possession of
land or improvements, but does not vest ownership of the land or improvements in the same person, or if this Contract
results in the placement of taxable improvements on tax exempt land (Revenue & Taxation Code Section 107), such
interest or improvements may represent a possessory interest subject to property'tax, and Contractor may b~ subject to
the payment of property taxes levied on such interest. Contractor agrees that this provision compli with the notice
~/
County Dept.
Fonn L-5 (Page 5 of7)
April 18, 2017 CCCFPD Minutes 216
Contra Costa Cmmty
Standard Fonn L-5
Revised 2014
GENERAL CONDITIONS
(Purchase of Services -Long Form)
requirements of Revenue & Taxation Code Section 107 .6, and waives all rights to further notice or to damages under
that or any comparable statute.
24. No Third-Party Beneficiaries. Nothing in this Contract may be construed to create, and the parties do not intend to
create, any rights in third parti_es.
25. Copyrights, Rights in Data, and Works Made for Hire. Contractor will not publish or transfer any materials
produced or resulting from activities supported by this Contract without the express written consent of the County
Administrator. All reports, original drawings, graphics, plans, studies and other data and documents, in whatever
for:m or format, assembled or prepared by Contactor or Contractor's subcontractors, consultants, and other agents in
connection with this Contract arc ''works made for hire" (as defined in the Copyright Act, 17 U.S.C . Section 101 et
seq., as am.ended) for County, and Contractor unconditionally and irrevocably transfers and assigns to Agency all
right, title, and interest, including all copyrights and other intellectual property rights, in or to the works made for hire .
Unless required by law, Contractor shall not publish, transfer, discuss, or disclose any of the above-described works
made for hire or any infonnation gathered, discovered, or generated in any way through this Agreement, without
County's prior express written consent. If any of the works made for hire is subject to copyright protection, County
reserves the right to copyright such works and Contractor agrees not to copyright such works. If any works made for
hire are copyrighted, County reserves a royalty-free, irrevocable license to reproduce, publish, and use the works
made for hire, in whole or in part, without restriction or limitation, and to authorize others to do so.
26 . Endorsements. In its capacity as a contractor with Contra Costa County, Contractor will not publicly endorse or
oppose the use of any particular brand name or commercial product without the prior written approval of the Board of
Supervisors. In its County-contractor capacity, Contractor will not publicly attribute qualities or lack of qualities to a
particular brand name or commercial product in the absence of a well~established and widely accepted scientific basis
for such claims or without the prior written approval of the Board of Supervisors . In its County-contractor capacity,
Contractor will not participate or appear in any commercially produced advertisements designed to promote a
particular brand name or commercial product, even if Contractor is not publicly endorsing a product, as long as the
Contractor's presence in the advertisement can reasonably be interpreted as an endorsement of the product by or on
behalf of Contra Costa County. Notwithstanding the foregoing, Contractor may express its views on products to other
contractors, f:he Board of Supervisors, County officers, or others who may be authorized by the Board of Supervisors
or by law to receive such views.
27. Required Audit. (A) If Contractor is funded by $500,000 or more in federal grant funds in any fiscal year from any
source, Contractor must provide to County, at Contractor's expense, an audit confonning to the reqtiirements set forth
in the most current version of Office of Management and Budget Circular A-133 . (B) If Contractor is funded by Jess
than $500,000 in federal grant funds in any fiscal year from any source, but such grant imposes specific audit
requirements, Contractor must provide County with an audit conforming to those requirements. (C) If Contractor is
funded by less than $500,000 in federal grant funds in any fiscal year from any source, Contractor is exempt from
federal audit requirements for that year; however, Contractor's records must be available for and an audit may be
required by, appropriate officials of the federal awarding agency, the General Accounting Office (GAO), the pass-
through entity and/or the County. If any such audit is required, Contractor must provide County with such audit.
With respect to the audits specified in (A), (B) and (C) above, Contractor is solely responsible for arranging for the
oonduct of the audit. and for itS cost. County may withhold the estimated cost of l F"O percep\ of the
~)
ontractor County Dept.
Form L-5 (Page 6 of7) April 18, 2017 CCCFPD Minutes 217
Contra Costa County
Standard Form L-5
Revised 2014
GENERAi, CONDITIONS
(Purcl1ase of Services -Long Form)
contract amount, whichever is greater, or the fmal payment, from Contractor until County receives the audit from
Contractor.
28. Authorization. Contractor, or the reprcsentative(s) signing this Contract on behalf of Contractor, represents and
warrants that it has full power and authority to enter into this Contract and to perform the obligations set forth herein.
29. No Implied Waiver. The waiver by County of any breach of any term or provision of this Contract will not be
deemed to be a waiver of such term or provision or of any subsequent breach of the same or any other term or
provision contained herein.
Form L-5 (Page 7 of 7)
April 18, 2017 CCCFPD Minutes 218
RECOMMENDATION(S):
ACCEPT a report from the Fire Chief providing a status summary for ongoing Fire District activities and initiatives.
FISCAL IMPACT:
No fiscal impact.
BACKGROUND:
At the request of the Contra Costa County Fire Board of Directors, the Fire Chief is providing a report on the status
and progress of the various District initiatives.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/18/2017 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover,
Director
ABSENT:Candace Andersen,
Director
Contact: Jeff Carman, Fire Chief
925-941-3500
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of
the Board of Supervisors on the date shown.
ATTESTED: April 18, 2017
, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
D.5
To:Contra Costa County Fire Protection District Board of Directors
From:Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:April 18, 2017
Contra
Costa
County
Subject:Fire Chief's Report - April 18, 2017
April 18, 2017 CCCFPD Minutes 219
ATTACHMENTS
Fire Chief's Report _April 18,
2017
April 18, 2017 CCCFPD Minutes 220
April 18, 2017
TO: Board of Directors
FROM: Jeff Carman, Fire Chief
RE: Fire Chief’s Report
______________________________________________________________________
▪ Fire Station 16 plans continue to move forward. Construction drawings are currently
being developed as we prepare our submission for building permits. Additionally,
contractors are being prequalified in anticipation of going to bid in early summer.
▪ Fire Station 70 elevations and design plans are being developed in preparation for
submission to the City of San Pablo after the CEQA process is completed
(tentatively scheduled for July). The funding agreement continues to move forward,
and District staff, City of San Pablo staff, and County Counsel are working together
to finalize the agreement language.
▪ The Fire District just completed the first phase of a new firefighter recruitment
examination. As the Board is aware, a recruitment committee was implemented last
year, and the members are focused on District efforts to attract and maintain
diversity within our ranks. Thus far, committee members have represented the Fire
District at several job fairs and other venues. Although the committee is still in its
infancy, we hope to see increased diversity in the applicant pool for Academy 51
which will begin in October 2017.
▪ The Contra Costa Regional Fire Communications Center has always been and
continues to be a challenging and demanding environment. Last year, we
processed just under 148,000 incidents of which 80% were EMS related. Despite
the high volume, we are experiencing an overall reduction of 51 seconds in
ambulance dispatch time. Our EMD quality has improved by 32% (from 58% to
90%). We continue to focus on our EMD quality improvement plan as we work
toward securing certification from the International Academies of Emergency
Dispatch (IAED). In July, we will begin dispatching both fire and EMS calls for El
Cerrito and Kensington which will increase our incident volume by approximately
3,500 per year.
▪ Dispatcher Appreciation Week was April 9 through April 15. On April 19, the County
will host a dispatcher appreciation luncheon. This is an opportunity for all public
safety agencies to come together to recognize their dispatchers, often the unsung
heroes, for their hard work. In the last month, one of our dispatchers, Janin
April 18, 2017 CCCFPD Minutes 221
Campbell, guided an anxious father through delivering his baby in a car on the
freeway. In fact, Janin has assisted in the delivery of four babies during her time as
a dispatcher. This is but one example of the amazing efforts of our dispatchers. It is
also one of the rare incidents that culminated as a happy occasion rather than a
tragic event. (Audio tape)
▪ Three years ago, Fitch and Associates presented us with their report on the Fire
District. While we addressed many of the issues they identified, the one
recommendation from which we deviated was that of replacing two of our engine
companies with three new squads. Based on the then current fire-related incident
data, I requested and received your support to forgo this particular recommendation.
Today, I wish to extend my thanks to you for your support and to reaffirm that we
made the right decision.
As standard procedure in our extremely busy Fire District, our men and women
respond to a high volume of incidents, many of them significant and complex. In the
last month alone, the District responded to 23 working structure fires, several of
which went to multiple alarms; six motor vehicle accidents which required
disentanglement to remove the patients; several multi-casualty incidents, including a
shooting incident with five victims; a car in the delta which required our rescue
swimmers to be deployed; a complex and technical recovery effort to secure a man
who had been electrocuted from the top of a 100+ foot crane.
In the midnight hours of the first of April, while working an incident on Highway 4 in
Pittsburg, one of our new ladder trucks (acting as our blocking apparatus) was struck
at a high rate of speed resulting in the death of the driver and minor injury to our
firefighters who were on board at the time.
In the three years that I have been with the Fire District, our firefighters have fallen
through burned out floors and had roofs and roof debris fall on them; our apparatus
have been struck twice on the freeway in the last 12 months; and one of our
firefighters fell from a two-story roof and, fortunately, landed on a second-story
balcony. Several firefighters have medically retired due to on-the-job injuries which
could not be repaired. Upon the retirement of our more experienced personnel, our
risk for injury increases as we fill the vacancies with younger, inexperienced
firefighters. While this is not an action item, it is important to maintain that
awareness.
I want you to know that, at all times, I am concerned about the welfare of our
firefighting personnel. As we approach the 10th anniversary of the day that Fire
Captain Matt Burton and Fire Engineer Scott Desmond died while attempting a
rescue during firefighting operations in West County, I think it is important to note
that, statistically, we have been very fortunate to have such a low rate of major injury
and death among our firefighters. As an organization, the Fire District strives to
provide the safest working environment we can, but it is important to always keep in
mind that it is still a dangerous job, and there are facets of the job which we simply
cannot control.
April 18, 2017 CCCFPD Minutes 222
RECOMMENDATION(S):
APPROVE and AUTHORIZE the Purchasing Agent on behalf of the Fire Chief, or designee, to execute a purchase
order with All Star Fire Equipment, Inc., in an amount not to exceed $350,000, for the purchase of self-contained
breathing apparatus (SCBA) equipment in the Contra Costa County Fire Protection District.
FISCAL IMPACT:
Budgeted; 100% Special District General Operating Fund
BACKGROUND:
The Contra Costa County Fire Protection District (District) uses self-contained breathing apparatus (SCBA) to
provide breathing air for firefighters during firefighting activities and other emergency response activities, including
hazardous materials responses, activities involving exposure to heat and toxins, and/or otherwise unhealthy and
hazardous environments. SCBA is a required and standard piece of firefighter personal protective equipment.
SCBA consists of several components, including the harness and straps, air cylinder, regulator, face piece, and voice
amplifier. Spare air cylinders are
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/18/2017 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover,
Director
ABSENT:Candace Andersen,
Director
Contact: Lewis Broschard, Deputy Fire
Chief (925) 941-3501
I hereby certify that this is a true and correct copy of an action taken and entered on the
minutes of the Board of Supervisors on the date shown.
ATTESTED: April 18, 2017
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C.1
To:Contra Costa County Fire Protection District Board of Directors
From:Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:April 18, 2017
Contra
Costa
County
Subject:Purchase Order for SCBA Equipment
April 18, 2017 CCCFPD Minutes 223
BACKGROUND: (CONT'D)
also required for extended operations and to provide ample supply of full cylinders for immediate use.
The District was fortunate to receive significant grants through FEMA in prior years to provide updated SCBA
equipment. SCBA equipment has a useful life limit, based on manufacturer specification and recommendations, and
150 air cylinders have reached the end of their permitted use period.
The District needs to purchase 25 new sets of SCBA along with various associated equipment to maintain currency
with NFPA standards and OSHA regulations, as well as the SCBA manufacturer specifications and
recommendations. A large amount of air cylinders purchased many years ago have reached the end of their useful life
and must be replaced.
CONSEQUENCE OF NEGATIVE ACTION:
If this purchase is not approved, the District will remove approximately 150 air cylinders from service in April,
without having a cache of replacements, because the current air cylinders have reached the end of their useful life.
With the retirement of older SCBA equipment and the re-opening of fire stations, there is not a sufficient supply of
SCBA equipment for all personnel and fire stations unless this purchase is approved.
CHILDREN'S IMPACT STATEMENT:
No impact.
April 18, 2017 CCCFPD Minutes 224
RECOMMENDATION(S):
APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a contract amendment with American Medical
Response West (AMR), effective April 1, 2017, to revise the payment provisions and update Exhibit D (Ambulance
Unit Hour Rates) in the Service Plan with no change to original term or payment limit, for emergency ambulance
services.
FISCAL IMPACT:
The AMR ambulance unit hour rate increase is intended to be cost neutral. The District's ambulance service rates will
increase by 3.8%, but only a fraction of amounts billed are actually collected. That fraction is applied to the 3.8% CPI
increase to determine AMR's ambulance unit hour rate increase. AMR collects 100% of ambulance unit hours
invoiced to the District.
Other factors impact District transport revenue, so in fact this action is theoretically cost neutral. Factors that impact
future transport collections include transport volume, services provide (e.g., mileage and oxygen), payer mix,
payment caps, and potential changes to the Affordable Care Act and other relevant legislation.
Based on the formula included in the Service Plan, after Dispatch and SSM costs are removed, the Ambulance Unit
Hour Rates will increase by an amount not to exceed 1.0108%.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/18/2017 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover,
Director
ABSENT:Candace Andersen,
Director
Contact: Lewis Broschard, Deputy Fire
Chief (925) 941-3501
I hereby certify that this is a true and correct copy of an action taken and entered on the
minutes of the Board of Supervisors on the date shown.
ATTESTED: April 18, 2017
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C.2
To:Contra Costa County Fire Protection District Board of Directors
From:Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:April 18, 2017
Contra
Costa
County
Subject:Contract Amendment with American Medical Response West (AMR)
April 18, 2017 CCCFPD Minutes 225
BACKGROUND:
Effective January 1, 2016, the Contra Costa County Fire Protection District (District) became the exclusive
operator of emergency ambulance service within Exclusive Operating Areas 1, 2, and 5 in Contra Costa County.
The District contracts with American Medical Response West (AMR) for actual ambulance unit hours.
The modifications to the AMR contract are as follows:
Service Plan Section P.1. is amended to remove AMR Dispatch and System Status Management (SSM)
costs from the Ambulance Unit Hour Rate. Effective April 1, 2017, actual costs incurred by AMR for
Dispatch and SSM will be invoiced to the District separately from Ambulance Unit Hours.
Service Plan Section P.2. is amended to clarify the time period used for determining the collections rate for
use in calculating Ambulance Unit Hour Rate adjustments.
Exhibit D (Ambulance Unit Hour Rates) is replaced with a new Exhibit D reflecting new Ambulance Unit
Hour Rates effective April 1, 2017. These new rates include 1) a decrease due to the elimination of
Dispatch and SSM costs as a component of Ambulance Unit Hour Rates; and 2) an increase pursuant to
Service Plan Section P.2. (Ambulance Unit Hourly Rate Adjustments).
Service Plan Section P.2. of the Contract between the District and AMR provides as follows:
Ambulance Unit Hourly Rate Adjustments. Beginning on April 1, 2017, and on each April 1 thereafter, the
Per Unit Hour Rate will increase by the percentage equal to the product of (a) District's collection
realization percentage (i.e., the percentage of patient billings actually collected) for the preceding year,
times (b) the increase in the rates that the District changes for services under the CCCEMSA Contract that
is based on the charges in the Consumer Price Index.
The ambulance unit hour rates are specified in Exhibit D to the Service Plan of the Contract between the District
and AMR.
Under the District's Contract with the Contra Costa County Emergency Medical Services Agency (CCCEMSA),
the District is also entitled to regular rate increases after the first twelve (12) month of service. The District's
increase is based on changes in the Consumer Price Index, All Urban Consumers for Medical Care (U.S. city
average) (1982-4=100) ("CPI"). The District's annual rate increase is the greater of three (3) percent or the
increase in the CPI for the subject calendar year.
The CPI for calendar year 2016 is 3.8%; therefore, the District is requesting a 3.8% increase in its Ambulance
Services Rate Schedule effective April 1, 2017.
To determine AMR's increase, 0.038 (or 3.8%) will be multiplied by the collection realization percentage for
calendar year 2015. Calendar year 2015 collection data (provided by AMR) is being used for this calculation
because calendar year 2016 collections are not mature (i.e., the percentage of patient billings actually collected,
particularly in the last quarter of the year, will not reflect long term actual collections). Likewise, the April 1,
2018, increase for ambulance unit hour rates will be determined using the District's collection realization
percentage for calendar year 2016.
Additionally, Dispatch and SSM costs are being removed from the Ambulance Services Rate Schedule effective
April 1, 2017. A year of experience indicates the ambulance resource dispatching system may operate more
flexibly and with a more appropriate staffing level if these costs are removed as a static component of the
Ambulance Unit Hour Rate.
CONSEQUENCE OF NEGATIVE ACTION:
AMR is contractually entitled to a unit hour rate increase on April 1, 2017. The District will not have an accurate
ambulance unit hour rate schedule embedded in the service contract without approval of this action.
ATTACHMENTS
April 18, 2017 CCCFPD Minutes 226
Exhibit D Redline Eff 4-1-17
Exhibit D Final Eff 4-1-17
April 18, 2017 CCCFPD Minutes 227
Initials:
Contractor District
Form L-3 (Page 55 of 55)
SERVICE PLAN
(Purchase of Services - Long Form)
Exhibit D
Ambulance Unit Hours Rates
Ambulance Unit Hours Per Week Ambulance Unit Hour Rate
4,501 ‐ 4,668 $ 139.64139.17
4,669 ‐ 4,836 $ 138.21137.80
4,837 ‐ 5,004 $ 136.88136.52
5,005 ‐ 5,172 $ 135.64135.32
5,173 ‐ 5,340 $ 134.48134.20
5,341 ‐ 5,508 $ 133.40133.16
5,509 ‐ 5,676 $ 132.38132.18
5,677 ‐ 5,844 $ 131.42131.25
5,845 and over $ 130.51130.38
April 18, 2017 CCCFPD Minutes 228
Initials:
Contractor District
Form L-3 (Page 55 of 55)
SERVICE PLAN
(Purchase of Services - Long Form)
Exhibit D
Ambulance Unit Hours Rates
Ambulance Unit Hours Per Week Ambulance Unit Hour Rate
4,501 ‐ 4,668 $ 139.17
4,669 ‐ 4,836 $ 137.80
4,837 ‐ 5,004 $ 136.52
5,005 ‐ 5,172 $ 135.32
5,173 ‐ 5,340 $ 134.20
5,341 ‐ 5,508 $ 133.16
5,509 ‐ 5,676 $ 132.18
5,677 ‐ 5,844 $ 131.25
5,845 and over $ 130.38
April 18, 2017 CCCFPD Minutes 229
RECOMMENDATION(S):
APPROVE and AUTHORIZE the Fire Chief, or his designee, to execute an agreement with the City of El Cerrito
Fire Department for the provision of fire and emergency medical dispatch services for the term July 1, 2017, through
June 30, 2020.
FISCAL IMPACT:
The anticipated revenue, on an annual basis, is expected to be approximately $122,000 in the first full year of
operations. Payments may be increased, per the agreement, to cover costs of providing the dispatch services. The
payments from the City of El Cerrito are intended to offset the Contra Costa County Fire Protection District's cost of
providing the service.
BACKGROUND:
The El Cerrito Fire Department currently contracts with the City of Richmond for the provision of fire and
emergency medical dispatch services. The most recent agreement between these parties expired on June 30, 2014,
however the City of Richmond continues to provide these services to the El Cerrito Fire Department.
In July 2016, representatives from the City of Richmond and the Richmond Police Department
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/18/2017 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover,
Director
ABSENT:Candace Andersen,
Director
Contact: Lewis Broschard, Deputy Fire
Chief (925) 941-3501
I hereby certify that this is a true and correct copy of an action taken and entered on the
minutes of the Board of Supervisors on the date shown.
ATTESTED: April 18, 2017
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C.3
To:Contra Costa County Fire Protection District Board of Directors
From:Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:April 18, 2017
Contra
Costa
County
Subject:Fire and Emergency Medical Dispatch Services for El Cerrito and Kensington
April 18, 2017 CCCFPD Minutes 230
BACKGROUND: (CONT'D)
held a meeting to inform the partner agencies in the West County Consortium that the City of Richmond was
withdrawing from the consortium created to support fire dispatch services. The City of Richmond expressed an
interest in continuing to provide dispatch services under a different cost and contract structure. The City of
Richmond informed the City of El Cerrito that it intended to increase the cost of dispatch services for the police
department and to begin charging a fee for fire dispatch services.
The City of Richmond notified the City of El Cerrito that it intends to stop providing dispatch services on July 1,
2017, unless the City of El Cerrito signs a new dispatch agreement at a significantly higher cost. Following that
meeting, city staff explored dispatch options with other emergency dispatch centers in the region. City staff also
evaluated the costs associated with switching dispatch software and records management software.
On December 20, 2016, the City Council approved a resolution to allow the City Manager to enter into
negotiations with the Contra Costa County Fire Protection District (District) for the provision of dispatch services.
In January 2017, the City of El Cerrito began negotiating with the District.
In February 2017, the District presented an proposal to the City of El Cerrito for the provision of fire and
emergency medical dispatching services. This proposal mirrors existing and long-standing agreements wherein
the District already provides these services to the East Contra Costa Fire Protection District, Moraga-Orinda Fire
Protection District, Crockett-Carquinez Fire Protection District, Rodeo-Hercules Fire Protection District, and the
City of Pinole Fire Department.
The El Cerrito City Council approved the proposal at their March 21, 2017, meeting.
El Cerrito will be charged a proportionate rate for the District to provide dispatch services that is representative of
the workload created by the El Cerrito Fire Department. It is anticipated that the El Cerrito Fire Department will
generate an additional 3,000 emergency incidents, along with a commensurate amount of increased incoming 911
phone calls received in the center. This represents an approximate 3.5% increase in call volume and a
corresponding annual charge of approximately $122,000 to the City of El Cerrito to cover the costs of providing
services under the current rate structure.
The addition of the El Cerrito Fire Department to the list of agencies within the County who are dispatched by the
District will enhance communications within the West County area and create efficiencies in ambulance
dispatching to El Cerrito with the elimination of the Richmond PD dispatch center. 911 calls will be routed
directly from the primary safety access point (police dispatch center) to the District’s Communication Center,
which will be responsible for both the fire and ambulance dispatching to El Cerrito and Kensington.
The District anticipates providing full fire and emergency medical dispatching to the El Cerrito Fire Department,
which includes the Kensington Fire Protection District under contract with the El Cerrito Fire Department, by July
1, 2017.
CONSEQUENCE OF NEGATIVE ACTION:
The City of El Cerrito Fire Department and Kensington Fire Protection District will be forced to seek alternative
fire and emergency medical dispatch services and efficiencies in fire and ambulance dispatching will not be
realized.
ATTACHMENTS
El Cerrito Staff Report
April 18, 2017 CCCFPD Minutes 231
Date: March 21, 2017
To: El Cerrito City Council
From: Paul Keith, Chief of Police
Lance Maples, Fire Chief
Subject: Public Safety Dispatch Services
ACTION REQUESTED
Adopt a resolution authorizing the City Manager or his designee to enter into
agreements with the Office of the Sheriff of Contra Costa County and the Contra Costa
County Fire Protection District for the provision of public safety dispatch services from
July 1, 2017 to June 30, 2022 for police dispatch and June 1, 2017 to December 31,
2019 for fire dispatch.
BACKGROUND
The El Cerrito Police Department and El Cerrito Fire Department currently contract with
the City of Richmond for the provision of dispatch and records management services.
The most recent agreement expired on June 30, 2014. Since June 30, 2014, the City of
Richmond continues to provide dispatch and records management services as outlined
in the Consolidated Communications Agreement and the Consortium Records
Management Agreement.
In July 2016, representatives from the City of Richmond and the Richmond Police
Department held a meeting to inform the partner agencies in the West County
Consortium that the City of Richmond was withdrawing from the consortium. The City of
Richmond expressed an interest in continuing to provide dispatch services under a
different cost and contract structure. The City of Richmond also informed the City of El
Cerrito that it intended to stop providing after-hours records support and police data
hosting. The City of Richmond informed the City of El Cerrito that it intended to increase
the cost of dispatch services for the police department and begin charging for fire
dispatch services.
The City of Richmond notified the City of El Cerrito that it intends to stop providing
dispatch services on July 1, 2017, unless the City of El Cerrito signs a new dispatch
agreement at a significantly higher cost.
Following that meeting, staff explored dispatch options with other emergency dispatch
centers in the region. Staff also evaluated the costs associated with switching dispatch
software and records management software.
On December 20, 2016, the City Council approved a resolution to allow the City
Manager to enter into negotiations with the Office of the Sheriff, Contra Costa County
April 18, 2017 CCCFPD Minutes 232
Fire Protection District, and the County of Contra Costa for the provision of dispatch
services. In January 2017, the City of El Cerrito began negotiating with these entities.
In January 2017, the City of Richmond informed the City of El Cerrito that they will
agree to provide interim dispatch services after July 1, 2017 at a 10% premium over the
already increased cost if the City of El Cerrito has not yet transferred dispatch services
to another agency.
The City of Richmond provided cost information to the City of El Cerrito to continue
providing public safety dispatch services. The cost for a new dispatch contract for police
dispatch with the City of Richmond is $803,257 annually and the cost for a new contract
for fire dispatch is $481,954 annually. The combined cost for police and fire dispatch,
provided by the City of Richmond, would be $1,285,211 annually.
In February 2017, the Office of the Sheriff and the Contra Costa County Fire Protection
District presented agreements to the City of El Cerrito for the provision of public safety
dispatch services. These agreements are the result of negotiations between the City of
El Cerrito and these entities.
The Contra Costa County Sheriff’s Department will present an agreement to the Board
of Supervisors of the County of Contra Costa to allow them to provide public safety
dispatch services to be offered to the City of El Cerrito.
ANALYSIS
Staff has identified the Office of the Sheriff of Contra Costa County and the Contra
Costa County Fire Protection District as the providers that best meet the needs of the El
Cerrito Police and Fire Departments. The Office of the Sheriff currently manages
emergency police dispatch for the unincorporated communities of Contra Costa County
as well as the cities of Pittsburg, Oakley, Moraga, Orinda, Lafayette, and Danville.
Contra Costa County Fire Protection District manages the fire dispatch services for their
service area, the unincorporated communities of Contra Costa, as well as Pinole,
Hercules, Moraga, Orinda, Oakley and Brentwood. Should the City decide to enter into
an agreement with these County entities for dispatch services, staff anticipates that the
change will not be noticeable to users of the 911 emergency systems.
STRATEGIC PLAN CONSIDERATIONS
Approving the attached resolution will allow the City Manager to enter into an
agreement with the Office of the Sheriff of Contra Costa County and an agreement with
the Contra Costa County Fire Protection District for dispatch services. These
agreements will create a long term solution to public safety dispatching in El Cerrito.
This will help the City in its goal to achieve long term financial sustainability by allowing
staff to reduce dispatch related costs over a multiple year contract. In addition, staff will
continue to ensure the public’s health and safety by preventing a lapse in dispatch
services.
April 18, 2017 CCCFPD Minutes 233
Agenda Item No. 7(C)
FINANCIAL CONSIDERATIONS
Approval of this resolution will authorize the City Manager to enter into agreements for
public safety dispatch services. Staff has identified the Office of the Sheriff of Contra
Costa County and the Contra Costa County Fire Protection District as the preferred
solution for dispatch services. The funding required for these agreements is already
authorized in the FY 2016/2018 budget.
The Office of the Sheriff identified the cost for El Cerrito Police Dispatch services as
being no greater than $439,012.40 for fiscal year 2017/2018. The Contra Costa County
Fire Protection District identified the cost for El Cerrito Fire Dispatch services as being
no greater than $123,832 for FY 2017/2018. The total anticipated cost of Public Safety
Dispatch Services for FY 2017/2018 is therefore projected to be no greater than
$562,844.40.
The budgeted amount for dispatch services in FY 2017/18 is $636,000. The agreements .
offered by the Office of the Sheriff of Contra Costa County and the Contra Costa County
Fire Protection District will result in an estimated overall financial savings of $81,452 .60
over the budgeted amount in FY 2017/18. The agreement for police dispatch is for a
period of 5 years ending June 30, 2022 and may be terminated by either party without
cause, with 90 days written notice. The agreement for fire dispatch is for a period of 2
and one half years and may be terminated by either party without cause, with 90 days
written notice.
LEGAL CONSIDERATIONS
The City Attorney has reviewed the attached agreements and has approved them as to
form .
Reviewed by:
Scott Hanin
City Manager
Attachments:
1. Resolution
2. Contra Costa County Fire Protection District Agreement
3. Contra Costa County Sheriff's Department Agreement
Pa ge 3
April 18, 2017 CCCFPD Minutes 234
RESOLUTION NO. 2017-XX
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF EL CERRITO AUTHORIZING THE
CITY MANAGER TO ENTER INTO AGREEMENTS WITH THE OFFICE OF THE SHERIFF
OF CONTRA COSTA COUNTY AND THE CONTRA COSTA FIRE PROTECTION DISTRICT
FOR THE PROVISION OF PUBLIC SAFETY DISPATCH SERVICES FOR THE PERIOD
JULY 1, 2017 TO JUNE 30, 2022, FOR POLICE DISPATCH AND FOR THE PERIOD OF
JULY 1, 2017 TO DECEMBER 31, 2019, FOR FIRE DISPATCH
WHEREAS, the City of Richmond has communicated its intent not to renew the
Consolidated Communication Agreement, under which it provided public safety and fire
dispatch services to the City of El Cerrito; and
WHEREAS, the Office of the Sheriff of Contra Costa County and the Contra Costa
County Fire Protection District have demonstrated their interest in providing public safety
dispatch services to the City of El Cerrito; and
WHEREAS, Staff has identified the Sheriff of Contra Costa and the Contra Costa
County Fire Protection District as the preferred public safety dispatch service; and
WHEREAS, an agreement with the Office of the Sheriff of Contra Costa County and the
Contra Costa County Fire Protection District will ensure continuity of emergency 911 services;
and,
WHEREAS, the agreements offered by the Office of the Sheriff of Contra Costa County
and the Contra Costa County Fire Protection District offer an overall financial savings over the
current dispatch services agreement.
NOW THEREFORE, BE IT RESOLVED by the City Council of the City of El Cerrito that
it hereby authorizes the City Manager to enter into agreements with the Office of the Sheriff of
Contra Costa County and the Contra Costa County Fire Protection District for the provision of
public safety dispatch services, in substantially the form presented, allowing for minor changes
requested by the Board of Supervisors, if any, with approval of the City Attorney.
I CERTIFY that at a regular meeting on March X, 2017 the City Council of the City of El
Cerrito passed this Resolution by the following vote:
AYES: COUNCILMEMBERS:
NOES: COUNCILMEMBERS:
ABSTAIN: COUNCILMEMBERS:
ABSENT: COUNCILMEMBERS:
April 18, 2017 CCCFPD Minutes 235
RECOMMENDATION(S):
APPROVE and AUTHORIZE the Purchasing Agent to execute, on behalf of the Fire Chief, a purchase order to
American Medical Response West in an amount not to exceed $435,030 for ambulance dispatching and system status
management services provided from February 1, 2016, through March 31, 2017.
FISCAL IMPACT:
AMR's cost to provide these services to the District (over and above what is included in the Emergency Ambulance
Service Contract) is $435,030 for the term February 1, 2016, through March 31, 2017. $435,030 will be charged to
the CCCFPD EMS Transport Fund.
BACKGROUND:
In February 2016, the Contra Costa County Fire Protection District (District) began dispatching all American Medical
Response West (AMR) ambulances with Contra Costa County EOAs 1, 2, and 5 as part of the new Emergency
Ambulance Service Contract. The original staffing plan for the system status management and dispatching of
ambulances was developed in late 2015 in collaboration with AMR. This plan called for two (2) AMR employees to
staff the District's Communications
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/18/2017 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover,
Director
ABSENT:Candace Andersen,
Director
Contact: Lewis Broschard, Deputy Fire
Chief (925) 941-3501
I hereby certify that this is a true and correct copy of an action taken and entered on the
minutes of the Board of Supervisors on the date shown.
ATTESTED: April 18, 2017
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C.4
To:Contra Costa County Fire Protection District Board of Directors
From:Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:April 18, 2017
Contra
Costa
County
Subject:Authorize Payment to AMR for Dispatch and System Status Management Costs
April 18, 2017 CCCFPD Minutes 236
BACKGROUND: (CONT'D)
Center at all times to provide the system status management and dispatching capacity needed to support the operation.
The cost of these AMR employees was included in the contracted ambulance unit hour rate paid by the District to
AMR.
During the first few months of the program, it was determined that additional AMR dispatchers were needed, at least
on a temporary basis, and a third dispatcher position was filled. Due to the technical complexity of taking on the City
of Richmond ambulance dispatching and CAD interfaces, implementation of the East Bay Regional Communication
System (EBRCS) for AMR, and our goal to improve response time compliance and overall system performance
during the first year of operations, we also added an AMR Dispatch Supervisor to manage, lead, and direct the
ambulance dispatch personnel and assist with the integration and implementation of new work flows within the
District’s Communication Center. This temporary staffing model has remained in place to support the District
through the first year of operations. Currently, steps are being taken to reduce this staffing based on the successful
implementation of certain technologies, efficiencies, and work flow changes and the realization of experience
received during the first year of emergency ambulance operations.
The additional dispatcher position and the supervisor position were not included in the original staffing plan
modeling and were added as we learned what was necessary during the initial startup phase of this operation. The
changes, and accompanying costs, were necessary to ensure a consistent service delivery and compliance with the
Emergency Ambulance Service contract performance measures during the first year of operations.
Since these extra costs were not anticipated during the original contract negotiations in late 2015, they were not
included in the original service contract and the District did have a mechanism by which to pay AMR. A contract
amendment during the first period of operations would have been problematic and speculative as to the long-term
needs of this new system. The experience of the last 12 months running the emergency ambulance system,
accompanied by the series of staffing and workflow changes in the Communications Center needed to establish a
suitable model and staffing plan moving forward, has given us the opportunity to make amendments to the contract
now that will meet our needs into the future.
This Board order requests approval to pay AMR for those unanticipated costs related to the dispatch and system
status management of ambulances from February 2016 through March 2017. The cost of providing the additional
dispatcher position on a 24/7 basis, along with the cost for the supervisor position, total $435,030 for the period
February 2016 through March 2017. The original contract between the District and AMR is being amended effective
April 1, 2017, to include new payment provisions for dispatch and system status management costs.
CONSEQUENCE OF NEGATIVE ACTION:
The District will not be able to compensate AMR for services they provided in the startup phase of dispatch
integration for the emergency ambulance transport system.
April 18, 2017 CCCFPD Minutes 237
RECOMMENDATION(S):
APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a contract with Peter Benson, M.D., for the
period May 1, 2017, through April 30, 2020, with a payment limit not to exceed $360,000, for physician oversight of
emergency ambulance and fire-based emergency medical first responder services.
FISCAL IMPACT:
$120,000 annually or $360,000 over a three-year period. Funds are budgeted in the EMS Transport Fund (fund
204000) in the current fiscal year and in the recommended budget for fiscal year 2017-18.
BACKGROUND:
The terms and conditions of the Emergency Ambulance Services Contract between the Contra Costa County
Emergency Medical Services Agency (CCCEMSA) and the Contra Costa County Fire Protection District (District)
require that the Contractor (District) retain a California licensed physician as its chief medical adviser to enforce
internal standards of excellence in medical care and serve as a liaison between the District, CCCEMSA, and AMR.
The District has been working with Peter Benson, M.D. since May
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/18/2017 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover,
Director
ABSENT:Candace Andersen,
Director
Contact: Terry Carey, EMS Assistant
Chief 925-941-3504
I hereby certify that this is a true and correct copy of an action taken and entered on the
minutes of the Board of Supervisors on the date shown.
ATTESTED: April 18, 2017
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C.5
To:Contra Costa County Fire Protection District Board of Directors
From:Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:April 18, 2017
Contra
Costa
County
Subject:Contract for Ambulance and Emergency Medical Service (EMS) Physician Oversight
April 18, 2017 CCCFPD Minutes 238
BACKGROUND: (CONT'D)
2014, to provide physician oversight for the District's fire-based emergency medical services (EMS) program and to
provide critical input into the development of a proposal to become the County's successful bidder for emergency
ambulance services in Emergency Response Areas 1, 2, and 5.
The District has now been providing emergency ambulance services within Contra Costa County since January 1,
2016. Dr. Benson's current contract expires on April 30, 2017.
CONSEQUENCE OF NEGATIVE ACTION:
The terms and conditions of the Emergency Ambulance Services Contract between CCCEMSA and the District
require that the Contractor (District) retain a California licensed physician as its chief medical adviser.
CHILDREN'S IMPACT STATEMENT:
Approximately 10% of emergency medical service responses involve children under the age of 15.
April 18, 2017 CCCFPD Minutes 239