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Home My WebLink AboutMINUTES - 03132018 -CALENDAR FOR THE BOARD OF DIRECTORS CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT BOARD CHAMBERS ROOM 107, ADMINISTRATION BUILDING, 651 PINE STREET MARTINEZ, CALIFORNIA 94553-1229 KAREN MITCHOFF, CHAIR JOHN GIOIA, VICE CHAIR CANDACE ANDERSEN DIANE BURGIS FEDERAL D. GLOVER 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 & MINUTES March 13, 2018 Present: Director John Gioia; Director Candace Andersen; Director Diane Burgis; Director Karen Mitchoff; Director Federal D. Glover Staff Present:David Twa, County Administrator Jeff Carman, Fire Chief 1:30 P.M. Convene and call to order. Adjourned today's meeting at 2:03 p.m. CONSIDER CONSENT ITEMS (Items listed as C.1 through C.8 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. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 1 DISCUSSION ITEMS D. 1 CONSIDER Consent Items previously removed. There were no consent items removed for discussion. D. 2 PUBLIC COMMENT (2 Minutes/Speaker) There were no requests to speak at Public Comment. D.3 HEARING to consider adopting Ordinance No. 2018-10, 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) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover D.4 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 Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover D.5 CONSIDER awarding and authorizing the Fire Chief, or designee, to execute a construction contract in the amount of $3,429,000, with D.L. Falk Construction, Inc. for new Fire Station 16 located at 477007 Los Arabis Drive in Lafayette and approve related actions. (Lewis Brochard, Deputy Fire Chief) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover CONSENT ITEMS C.1 APPROVE and AUTHORIZE the purchasing agent on behalf of the Fire Chief, to execute a purchase order with HME Incorporated in an amount not to exceed $690,000 for the purchase of two (2) Type III Model 34 wildland firefighting engines for emergency response. (100% Pittsburg Capital Fund) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover C.2 ACCEPT the 2017 Annual Report of the Advisory Fire Commission, as recommended by the Fire Chief. (No fiscal impact) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 2 C.3 APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the U. S. Department of Homeland Security, California Governor's Office of Emergency Services, State Homeland Security Grant Program (SHSGP), in an amount not to exceed $375,000, for the purchase of a water tender vehicle. (75% Federal, 25% District match) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover C.4 APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the U. S. Department of Homeland Security, California Governor's Office of Emergency Services, State Homeland Security Grant Program (SHSGP), in an amount not to exceed $245,000, for the purchase of swift water rescue vehicles. (75% Federal, 25% District match) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover C.5 APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the U. S. Department of Homeland Security, California Governor's Office of Emergency Services, State Homeland Security Grant Program (SHSGP), in an amount not to exceed $80,000, for the purchase of thermal imager cameras. (75% Federal, 25% District match) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover C.6 APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the Federal Highway Safety Program, California State Transportation Agency Office of Traffic Safety in an amount not to exceed $130,000, for the purchase of rescue equipment. (100% Federal) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover C.7 APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the U.S. Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA), Grant Programs Directorate (GPD), Assistance to Firefighters Grant (AFG), in an amount not to exceed $375,000, for the purchase of a water tender unit. (90% Federal, 10% District match) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover C.8 APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 3 C.8 APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a Consulting Services Agreement with Kitchell CEM, in an amount not to exceed $670,000, subject to approval by the County Administrator and approval as to form by County Counsel, for construction management services for the new Fire Station 70 project at 1800 23 rd Street in the City of San Pablo. (100% Special District Restricted Capital Funds) AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 4 ADVISORY COMMISSION The Contra Costa County Fire Protection District Advisory Fire Commission is scheduled to meet next on Monday, April 16, 2018 at 7:00 p.m. at the District Training Center, 2945 Treat Blvd., Concord, CA 94518. 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 5 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 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 6 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 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 7 RECOMMENDATION(S): A. OPEN the public hearing on the following ordinance: 1. Ordinance No. 2018-10, an ordinance authorizing the Contra Costa County Fire Protection District to revise its emergency ambulance service fees beginning April 13, 2018. B. RECEIVE testimony and CLOSE the public hearing. C. ADOPT Ordinance No. 2018-10, which becomes effective on April 13, 2018. FISCAL IMPACT: This ordinance 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 13, 2018. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Jeff Carman, Fire Chief (925) 941-3300 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: March 13, 2018 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: D.3 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 13, 2018 Contra Costa County Subject:Emergency Ambulance Service Rate Schedule Revision March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 8 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 $ 2,180.00 Mileage Rate (for each mile traveled with a loaded patient)$ 52.00 Oxygen Administration Charge $ 182.00 Treat and Refused Transport $ 467.00 The District is not authorized to charge more or less than the rates specified in the District-CCCEMSA contract. The current rates became effective April 18, 2017. The original 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, and were amended effective April 1, 2017. The hourly rates are specified in Exhibit D of the District-AMR contract. The contract and its amendment are 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 District’s collection realization percentage for the year preceding the calendar year just ended 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 2017 was 2.5%. The “collection realization percentage” is the percentage of patient billings actually collected by the District. The District’s collection realization percentage for calendar year 2016 is 22.45%. 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 80% of 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 9 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 requires CCCEMSA to approve annual increases, based on changes in the CPI, to the Service Rate Schedule when requested by the District. Applying a 3.0% increase to the Service Rate Schedule results in the modified rates shown below. Emergency Ambulance Response Base Rate $ 2,245.40 Mileage Rate (for each mile traveled with a loaded patient)$ 53.56 Oxygen Administration Charge $ 187.46 Treat and Refused Transport $ 481.00 If approved by the District Board of Directors, these rates will go into effect on April 13, 2018. CONSEQUENCE OF NEGATIVE ACTION: If Ordinance No. 2018-10 is 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. AGENDA ATTACHMENTS CCCFPD Ambulance Services Fee Ordinance 2018 CCCEMSA-District Contract District-AMR Contract Proof of Publication MINUTES ATTACHMENTS Signed Ordinance 2018-10 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 10 ORDINANCE NO. 2018-10 (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. The District currently charges Emergency Ambulance Services patients the following amounts: (1) an Emergency Ambulance Response base rate of $2,180; (2) a mileage rate (for each mile traveled with a loaded patient) of $52.00 per mile; (3) an oxygen administration charge of $182.00; and (4) a treat and refused transport charge (in some cases) of $467.00. 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 2017 was 2.5%. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 11 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 collection realization percentage for the year preceding the calendar year that just ended, 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 3.0% increase in the rates established by District Ordinance No. 2017-09. 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. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 12 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. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 13 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: Cccfpd Ambulance Services Fee Ord 2018-10 - County Counsel 3-6-18 Comments (Redline) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 14 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 ................................................. $2,245.40 2. Mileage Rate (for each mile traveled with a loaded patient) .............................. $53.56 3. Oxygen Administration Charge ........................................................................ $187.46 4. Treat and Refused Transport ............................................................................. $481.00 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 15 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 16 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 17 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 18 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 19 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 20 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 21 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 22 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 23 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 24 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 25 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 26 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 27 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 28 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 29 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 30 March 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DISTRICT MINUTES 103 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 104 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 105 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 106 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 107 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 108 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; Form L-3 (Page 2 of 55) Initials: <ff Contractor March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 109 SERVICE PLAN (Purchase of Services • Long Form) 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. Form L-3 (Page 3 of 55) Initials : u..t_ Contractor March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 110 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46 . 47. 48 . 49. 50. 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 . Form L-3 (Page 4 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 111 SERVICE PLAN (Purchase of Services • Long Form) 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 Initials: (\. ' ~ Form L-3 (Page 5 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 112 SERVICE PLAN (Purchase of Services~ Long Form) 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 Initials: ~ TtJ Contractor ~ Form L-3 (Page 6 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 113 SERVICE PLAN (Purchase of Services· Long Form) 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_.> Form L-3 (Page 7 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 114 SERVICE PLAN (Purchase of Services • Long Form) 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 . Form L-3 (Page 8 of 55} March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 115 SERVICE PLAN (Purchase of Services -Long Form) 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 Form L-3 (Page 9 of 55) Initials: f....Jf_ Contractor March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 116 SERVICE PLAN (Purchase of Services -Long Form) 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 Form L-3 (Page 10 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 117 SERVICE PLAN (Purchase of Services· Long Form) 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. Initials:~ C\ Contractor ~ Form L-3 (Page 11 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 118 SERVICE PLAN (Purchase of Services -Long Fonn) 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) Initials: t("~ (U e ~ Counfy" Form L-3 (Page 12 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 119 SERVICE PLAN (Purchase of Services • Long Form) 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., Form L-3 (Page 13 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 120 SERVICE PLAN (Purchase of Services-Long Form) 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 on tractor ~ Form L-3 (Page 14 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 121 SERVICE PLAN (Purchase of Services • Long Form) 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/ Form L·3 (Page 15 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 122 SERVICE PLAN (Purchase of Services .. Long Form) 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 . Fonn L-3 (Page 16 of 55) Initials;~ Contractor March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 123 SERVICE PLAN (Purchase of Services a Long Form) 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); Form L-3 (Page 17 of 55) lnHlafs: (J;!!_ Contractor March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 124 SERVICE PLAN (Purchase of Services -Long Form} 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? Fonn L·3 (Page 18 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 125 SERVICE PLAN (Purchase of Services • Long Form) 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 Form L-3 (Page 19 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 126 SERVICE PLAN (Purchase of Services -Long Form) 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 ~ Form L-3 (Page 20 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 127 SERVICE PLAN (Purchase of Services -Long Form) 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. Form L-3 (Page 21 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 128 SERVICE PLAN (Purchase of Services· Long Form) 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 ~ Form L-3 (Page 22 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 129 SERVICE PLAN {Purchase of Services-Long Form) 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. Form L-3 (Page 23 of 55) Initials: (, /Jll/Co ()1 ~r ~ March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 130 SERVICE PLAN (Purchase of Services -Long Form) 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 Initials: {(' ~ ~orr actor Co Q~ Form L-3 {Page 24 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 131 SERVICE PLAN (Purchase of Services -Long Fonn) 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 Initials Cou ~ Form L-3 (Page 25 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 132 SERVICE PLAN (Purchase of Services • long Form) 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. ~ Initials: (d Co ractor ~ Form L-3 (Page 26 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 133 SERVICE PLAN (Purchase of Services .. Long Form) 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 Initials: ____ :;;.__ c ~ Form L-3 {Page 27 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 134 SERVICE PLAN (Purchase of Services· Long Form) 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 Initials: _-ff.-___ v Cou Form L-3 (Page 28 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 135 SERVICE PLAN (Purchase of Services .. long Form) 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 Initials: .4"V ~ JL County Form L-3 (Page 29 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 136 SERVICE PLAN (Purchase of Services -Long Form) 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; ~ ~ Initials. on tractor Coun Form L-3 (Page 30 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 137 SERVICE PLAN {Purchase of Services • Long Form) 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. Form L-3 (Page 31 of 55) Initials: /. f'flt/ ~ IJm!l/tor ~ March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 138 SERVICE PLAN (Purchase of Services -Long Fonn) 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. Form L-3 (Page 32 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 139 SERVICE PLAN (Purchase of Services -Long Form) 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; lnmai.({k Co§l _, Form L-3 (Page 33 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 140 SERVICE PLAN (Purchase of Services -Long Form) 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 . Form L-3 (Page 34 of 55) lnWals:/( tyfj/ ~ \l£r £-- March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 141 SERVICE PLAN (Purchase of Services • Long Form) 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. Form L-3 (Page 35 of 55) Initials.(/"~ nJ Vc/l!ctm coW- March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 142 SERVICE PLAN (Purchase of Services -Long Form) 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. Initials : /,bl}/ C) ~r ~ Form L-3 (Page 36 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 143 SERVICE PLAN (Purchase of Services • Long Form) 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 Initials: l1--¥1,..._- Co t ~ Fonn L-3 (Page 37 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 144 SERVICE PLAN (Purchase of Services .. Long Form) 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 : Form L-3 (Page 38 of 55) lnltmls: <( fo./ Q ~~ March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 145 SERVICE PLAN (Purchase of Services R Long Form) 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. Form L-3 (Page 39 of 55) ln~ialso lt Contractor March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 146 SERVICE PLAN (Purchase of Services -Long Form) 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. Form L-3 (Page 40 of 55) Initials: /. hJ/ (\) ~~ March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 147 SERVICE PLAN (Purchase of Services-Long Form) 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. Fonn L-3 (Page 41 of 55) lnltlals: ~ Contractor March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 148 SERVICE PLAN (Purchase of Services -Long Form) 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 :[ Form L-3 (Page 42 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 149 SERVICE PLAN (Purchase of Services -Long Fonn) 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 ~ Form L-3 (Page 43 of 55) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 150 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 151 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 152 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 153 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 154 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 155 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 156 • , 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 157 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 158 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 ~ March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 159 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 160 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 161 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 162 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. 1 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 163 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 164 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 165 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 166 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 167 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 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 168 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?) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 169 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 170 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 171 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 172 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 173 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 174 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) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 175 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 176 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: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Jeff Carman, Fire Chief 925-941-3300 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: March 13, 2018 , County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: latonia ellingberg D.4 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 13, 2018 Contra Costa County Subject:Fire Chief's Report - March 13, 2018 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 177 ATTACHMENTS FC Report March 2018 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 178 Contra Costa County Fire Protection District 4005 Port Chicago Highway, Suite 250, Concord, CA 94520 ● (925) 941-3300 ● www.cccfpd.org March 13, 2018 TO: Board of Directors FROM: Jeff Carman, Fire Chief RE: Fire Chief’s Report ______________________________________________________________________ ▪ Fire Station 16 (Lafayette): District staff has been meeting with the immediately adjacent neighbors to keep them informed of our construction timelines. Bids were opened on Thursday, February 22. There is a Board agenda item on today’s agenda to award a contract to the successful bidder. Contract documents will be finalized in the coming weeks, and a kickoff meeting will be scheduled with the contractor, County Capital Projects, the Fire District, and our construction manager. ▪ Fire Station 70 (San Pablo): The architect is drafting the full construction drawings. We expect to have a pre-submittal meeting with the City of San Pablo this month when our plans are 80-90% complete. We remain on track to submit for a building permit in spring 2018 and will go to bid in summer 2018. ▪ Fire Station 9 (Pacheco) and Fire Station 86 (Bay Point): District staff has been meeting regularly with County Capital Projects and the architect. We are very early in the design phase. Following conceptual development, we will initiate the CEQA review process. ▪ The graduation ceremony for Fire Academy #51 was held on February 23, 2018, at El Campanil Theatre in Antioch. The event was well attended by families, friends, District personnel, various city and county officials, and other dignitaries. Many thanks to those of you who were able to join us on this special occasion. ▪ The Fire District’s administrative offices relocated over the February 16-18 weekend. Our offices were closed on Friday, February 16, and we reopened at our new location, 4005 Port Chicago Highway, on February 20, 2018. ▪ 2018 has already been a particularly busy year for fires. This not only impacts our suppression crews, but it also has a significant impact on our Fire Investigation Unit. Since January 1, our investigators have investigated almost 85 fires, 60% of which are considered suspicious in nature, and they have been successful in making several arson arrests. Although it is difficult to quantify, I am certain that the efforts of March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 179 Board of Directors March 13, 2018 Page 2 our investigators have succeeded in reducing the number of fires that could have otherwise occurred. ▪ The Fire District was recently awarded another grant from the Department of Homeland Security for a water tender, a replacement water rescue boat and tow vehicle, and several thermal imaging cameras. Our grant program has been very successful, and we currently have $1.8 million in grants awarded and in process. ▪ District personnel recently finished their final week of Hazardous Materials Specialist training. The six-week certificate program will allow our personnel to staff the hazardous materials response vehicle that was awarded to us by the California Office of Emergency Services. Our plan is to have the team fully functional in March. ▪ The most recent fires in Napa and Ventura counties were unique in many ways. The fires spread faster and grew larger than other fires in the State’s history, destroyed 11,000 homes, and killed 60+ residents. These fires have demonstrated that the Statewide Mutual Aid System, created in 1950, needs updating to deploy resources faster and alert the population in advance of the emergency. For the last two years, local fire agencies have asked the Governor for $100 million in on-going funding to update the aging mutual-aid system. To date, the Governor has provided $50 million in one-time funding from the Greenhouse Gas Revenue Fund to assist this work. Local agencies continue to lobby our elected officials as well as the gubernatorial candidates to help them fully understand why the funds are needed. We are hopeful that we can get the necessary support at the State level to better respond to climate driven events. ▪ Over the last several years firefighters have become more involved in emergency incidents involving violence and have also become targets of violent acts while performing their duties. Law enforcement agencies across the nation are working more closely with firefighters and EMS providers to provide immediate care at crime scenes before the scenes are deemed secure; as a result, our jobs are becoming more dangerous. In order to better protect our firefighters in these situations, we are in the process of evaluating ballistic body armor and helmets to be worn at incidents most prone to firefighter injury. Once the evaluation is complete, we will use the information gained to purchase this protective equipment for our personnel. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 180 RECOMMENDATION(S): 1. APPROVE the plans, specifications, and design for the Contra Costa County Fire Protection District Fire Station 16 (Project WH795B). 2. DETERMINE that the bid submitted by D.L. Falk Construction Inc., complies with the requirements of the project specifications, and the Board WAIVES any irregularities in D.L. Falk Construction Inc.’s compliance with the requirements of the County's Outreach Program for this project contained in the project specifications, and FURTHER DETERMINE that D.L. Falk Construction Inc., submitted the only responsive and responsible bid for this project. 3. AWARD the construction contract for the above project to D.L. Falk Construction Inc., in the amount of $3,429,000, and DIRECT that the Fire Chief, or designee, prepare the contract. 4. DIRECT that D.L. Falk Construction Inc., shall submit two good and sufficient security bonds (performance and payment bonds) in the amount of $3,429,000 each. 5. ORDER that, after the contractor has signed the contract and returned it, together with the bonds, evidence of insurance, and other required documents, and the Fire Chief has reviewed and found them to be sufficient, the Fire Chief, or designee, is authorized APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Lewis T. Broschard, Deputy Fire Chief (925) 941-3300 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: March 13, 2018 David J. Twa, 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:March 13, 2018 Contra Costa County Subject:Construction Contract for the New Fire Station 16 at 4007 Los Arabis Drive in Lafayette March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 181 RECOMMENDATION(S): (CONT'D) to sign the contract for this Board. 6. ORDER that, in accordanceRECOMMENDATION(S): (CONT'D) with the project specifications and upon signature of the contract by the Fire Chief, or designee, any bid bonds posted by the bidders are exonerated and any checks or cash submitted for bid security shall be returned. 7. AUTHORIZE the Fire Chief, or designee, to sign any escrow agreements prepared for this project to permit the direct payment of retentions into escrow or the substitution of securities for moneys withheld by the County to ensure performance under the contract, pursuant to Public Contract Code Section 22300. 8. AUTHORIZE the Fire Chief, or designee, to order changes or additions to the work pursuant to Public Contract Code Section 20142. 9. DELEGATE, pursuant to Public Contract Code Section 4114, to the Fire Chief, or designee, the Board's functions under Public Contract Code Sections 4107 and 4110. FISCAL IMPACT: This project is budgeted in the CCCFPD Capital Outlay Fund (203100). BACKGROUND: The purpose of this project is to build a new Fire Station (FS) 16. In late 2011 the Fire District initiated the process for the design of a replacement facility for Fire Station 16 in Lafayette at the present location on Los Arabis Drive. At that time, the station was comprised of a small residential style fire station built in the 1950s that was abandoned shortly after the Loma Prieta Earthquake. The construction cost estimate is $3,500,000, and the general prevailing wage rates will be the minimum rates paid on this project. Bids were received and opened by the Public Works Department on February 22, 2018, and the bid results are as follows: BIDDER: D.L. Falk Construction Inc., Hayward CA. BASE BID: $3,429,000. Public Works Department staff has determined that D.L. Falk Construction Inc.'s bid is responsive and that the bidder has documented an adequate good faith effort to comply with the requirements of the County's Outreach Program, as provided in the project specifications. Staff recommends that the bid be awarded to D.L. Falk Construction Inc. in the amount of $3,429,000. Pursuant to the County's Project Labor Agreement (PLA) policy, a PLA is required on this project. D.L. Falk Construction has signed a PLA. The general prevailing rates of wages, which shall be the minimum rates paid on this project, are on file with the Clerk of the Board and copies are available to any parties upon request. CONSEQUENCE OF NEGATIVE ACTION: If the project is not approved, a new fire station will not be constructed impacting future emergency response in the area. Alternatively, if the District is directed to proceed under a different course of action, delays would be added to the construction timeline. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 182 RECOMMENDATION(S): APPROVE and AUTHORIZE the purchasing agent on behalf of the Fire Chief, to execute a purchase order with HME Incorporated in an amount not to exceed $690,000 for the purchase of two (2) Type III Model 34 wildland firefighting engines for emergency response. FISCAL IMPACT: Not to exceed $690,000. 100% Pittsburg Special Fund (203800). BACKGROUND: The Contra Costa County Fire Protection District (District) is charged with fighting wildland fires as part of its primary mission of providing fire protection. The apparatus used for fighting wildland fires is specialized and requires a configuration and specifications not common to the typical municipal fire department pumper. The apparatus used for fighting wildland fires require four-wheel drive, a short wheel base, the ability to carry a supply of specialized wildland firefighting equipment, and interior seating capacity for up to four firefighters. The most common type of apparatus used throughout the State of California by agencies like the District is referred to as a Type III Engine. The District currently operates a fleet of twelve (12) Type III Engines and five (5) Type II engines that have been reconfigured for wildland firefighting. With this purchase we are targeting a portion of our oldest wildland engines manufactured in 2000 for replacement. These vehicles have a hydrostatic pump system that is no longer utilized by the district and poses training challenges. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Aaron McAlister, Assistant Fire Chief 925-941-3300 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: March 13, 2018 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:March 13, 2018 Contra Costa County Subject:Purchase of Type III Wildland Firefighting Engines March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 183 The National Fire Protection Association (NFPA) recommends a maximum of 15 years for front-line service for these types of apparatus. The California Department of Forestry and Fire Protection (Cal Fire) has developed specifications for their Type III Engines that are suitable for the needs of our agency in carrying out the control and suppression of wildland fires. We selected a Cal Fire designed Type III Engine and recommend purchasing two of these units as part of the HGAC Cooperative Purchasing program. This system allows local government agencies to procure goods and services already competitively bid and awarded. The District has a threat of wildland urban interface fires similar to the conditions found in last year’s North Bay fires in Napa, Sonoma, and Solano County. The acquisition of two engines will have a positive impact on District operations and public safety. Investing in our wildland fleet will allow the District to have modern, more reliable equipment available for fires that occur in the wildland urban interface areas. The District already owns two of these vehicle built by HME and has been satisfied with the performance. The consistency will provide for streamlined maintenance. There are hundreds of these style units in service in California, and replacement parts are readily available. This price is extremely competitive when compared to other custom built wildland firefighting vehicles. The per unit cost of the engines is approximately $311,000 plus tax and the total project with tax will not exceed will not exceed $690,000, including sales tax. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 184 March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 185 BACKGROUND: (CONT'D) CONSEQUENCE OF NEGATIVE ACTION: The District would be unable to invest in its wildland firefighting fleet. The District would continue to maintain engines that have been in service as front line engines for over 18 years. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 186 RECOMMENDATION(S): ACCEPT the 2017 Annual Report of the Advisory Fire Commission. FISCAL IMPACT: No fiscal impact. BACKGROUND: At the request of the Contra Costa County Fire Protection District Board of Directors, the Fire Chief is submitting the 2017 Annual Report of the Advisory Fire Commission. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Jeff Carman, Fire Chief 925-941-3300 x1100 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: March 13, 2018 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:March 13, 2018 Contra Costa County Subject:Advisory Fire Commission 2017 Annual Report to the Board of Directors March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 187 ATTACHMENTS AFC 2017 Annual Report March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 188 2017 ANNUAL REPORT  CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT ADVISORY FIRE COMMISSION Bill Granados, District II, Liaison to the Board of Supervisors (January – June) Matthew Guichard, District II (July – December) Edward Haynes, District III, (Vice Chair, January – August) Debra Galey, District IV (Vice Chair, September – December) Nat Rojanasathira, District V (Chair, September – December) Mike Egan, At Large #1 Richard T. Chapman, At Large #2 (Chair, January – August; Liaison to the Board of Supervisors, September – December) Latonia Ellingberg, Staff Alternates Walter Fields, District V (January – June) Erling Horn, District II (January – June) March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 189 2017 ANNUAL REPORT Contra Costa County Fire Protection District Advisory Fire Commission Meetings: Bi-monthly meetings were held: February, April, June, August, October, and December Location/Time: 2945 Treat Blvd., Concord at 7:00 p.m. Chair: Richard “Tom” Chapman (January – August) Nat Rojanasathira (September – December) Staff: Latonia Ellingberg Reporting Period: January through December 2017 I. ACTIVITIES  Conducted regular business of the Commission  Conducted regular business of the Commission as well as the following Committees:  Apparatus & Equipment*  Budget*  Personnel*  Property and Annexation* (*All above committee business conducted during course of regular meetings.)  Attended Contra Costa County Fire Commissioners Association Meetings  Attended Board of Supervisors Meetings  Attended Contra Costa County Fire Protection District Board of Directors meetings  Attended the Fallen Firefighters Memorial Service  Attended Fire Academy #49 Graduation Ceremony  Attended various city council, town hall, and other fire board meetings II. ACCOMPLISHMENTS  Reviewed and provided feedback on the Draft FY 2017/18 Budget  Conducted public hearings to resolve public complaints regarding weed abatement charges  Approved adjustments to weed abatement charges  Provided feedback on fire prevention activities, suppression leave, incident summary reports and response times  Provided feedback on levels of service in communities with closed stations or reduced service March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 190  Proposed that Fire Station 70 be dedicated to the memory of Fire Captain Matt Burton and Fire Engineer Scott Desmond who gave their lives in the Line of Duty on July 21, 2007.  Proposed that the Bylaws be amended to allow for two At-Large alternate commissioners, either of whom could replace any seated member regardless of supervisorial district. III. ATTENDANCE/REPRESENTATION  Vacancies: District 1; District 1 Alternate; District 3 Alternate; District 4 Alternate; District 5 Alternate  Diversity: Commission consists of a variety of retired and active business professionals/owners; retired Fire Captain; computer programmer; retired security advisor, former police officer, volunteer Firefighter/EMT with the Gray Eagle Volunteer Fire Department; Administrative Services Director – Town of Danville; and Management Analyst – City of Brentwood.  Level of Participation: Regular Mtgs. Chapman 6 of 6 Egan 5 of 6 Galey 5 of 6 Granados 3 of 3 Haynes 6 of 6 Rojanasathira 5 of 6 Fields (Alt.) 1 of 3 Horn (Alt.) 2 of 3  Quorum Frequency: No meetings cancelled due to lack of a quorum. IV. TRAINING/CERTIFICATION  Commissioner Egan renewed his Emergency Medical Technician (EMT) certification. V. PROPOSED WORK PLAN/OBJECTIVES FOR NEXT YEAR  Continue to work with the Fire Chief on budgetary issues.  Attend meetings relative to fire service issues.  Provide input to the Board of Directors.  Continue to monitor citizen complaints stemming from the District’s weed abatement program.  Continue to approve adjustments to weed abatement charges.  Continue to exercise oversight of the approval process for the disposal of surplus property.  Continue to explore alternate funding sources.  Follow up on proposed Bylaws amendment. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 191 RECOMMENDATION(S): APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the U. S. Department of Homeland Security, California Governor's Office of Emergency Services, State Homeland Security Grant Program (SHSGP), in an amount not to exceed $375,000, for the purchase of a water tender vehicle. FISCAL IMPACT: There may be a 25% local agency match requirement. The fiscal requirements will be determined after awards have been made. BACKGROUND: The Contra Costa County Fire Protection District received approval to apply for and accept funding from the State Homeland Security Grant Program (SHSGP) for three separate items on the January 16, 2018 meeting, agenda item C1. The SHSGP program requires a separate board approval for each item. This request is for the first item: 1) One water tender. Currently the District uses an aging water tender to transport water from a water source to a fire scene. A new apparatus will be more reliable and will not require costly repairs. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Lewis Broschard, Deputy Chief 925-941-3300 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: March 13, 2018 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:March 13, 2018 Contra Costa County Subject:2018 State Homeland Security Grant - Water Tender March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 192 BACKGROUND: (CONT'D) CONSEQUENCE OF NEGATIVE ACTION: The District would not be able to take advantage of this funding opportunity. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 193 RECOMMENDATION(S): APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the U. S. Department of Homeland Security, California Governor's Office of Emergency Services, State Homeland Security Grant Program (SHSGP), in an amount not to exceed $245,000, for the purchase of swift water rescue vehicles. FISCAL IMPACT: There may be a 25% local agency match requirement. The fiscal requirements will be determined after awards have been made. BACKGROUND: The Contra Costa County Fire Protection District received approval to apply for and accept funding from the State Homeland Security Grant Program (SHSGP) for three separate items on the January 16, 2018 meeting, agenda item C1. The SHSGP program requires a separate board approval for each item. This request is for the second item: 2) A swift water rescue inflatable boat, a trailer with motor, and a response tow vehicle. Currently the District has a smaller inflatable boat. The funding of the inflatable boat would double our water rescue capabilities. The tow vehicles will allow the District to safely transport the boats to an emergency scene. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Lewis Broschard, Deputy Chief 925-941-3300 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: March 13, 2018 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:March 13, 2018 Contra Costa County Subject:2018 State Homeland Security Grant - Swift Water Rescue Equipment March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 194 CONSEQUENCE OF NEGATIVE ACTION: The District would not be able to take advantage of this funding opportunity. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 195 RECOMMENDATION(S): APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the U. S. Department of Homeland Security, California Governor's Office of Emergency Services, State Homeland Security Grant Program (SHSGP), in an amount not to exceed $80,000, for the purchase of thermal imager cameras. FISCAL IMPACT: There may be a 25% local agency match requirement. The fiscal requirements will be determined after awards have been made. BACKGROUND: The Contra Costa County Fire Protection District received approval to apply for and accept funding from the State Homeland Security Grant Program (SHSGP) for three separate items on the January 16, 2018 meeting, agenda item C1. The SHSGP program requires a separate board approval for each item. This request is for the third item: 3) Eight thermal imager cameras. If awarded, these devises would be used to replace older thermal imager cameras on primary rescue and fire response apparatus. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Lewis Broschard, Deputy 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: March 13, 2018 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:March 13, 2018 Contra Costa County Subject:2018 State Homeland Security Grant - Thermal Imagers March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 196 CONSEQUENCE OF NEGATIVE ACTION: The District would not be able to take advantage of this funding opportunity. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 197 RECOMMENDATION(S): APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the Federal Highway Safety Program, California State Transportation Agency Office of Traffic Safety in an amount not to exceed $130,000, for the purchase of rescue equipment. FISCAL IMPACT: 100% Federal grant funds BACKGROUND: The California Office of Traffic and Safety (OTS) is tasked with developing and implementing a highway safety program that addresses the behavioral factors that impact safety on the road. The goal of the annual program is to prevent serious injury and death resulting from motor vehicle crashes so that all roadway users arrive at their destination safely. Using Federal Highway Safety Program funds, the OTS partners with political subdivisions of the state to address California’s highway safety needs at the state, county and local level. The Contra Costa County Fire Protection District received approval to apply for and accept funding from the OTS on the January 16, 2018 meeting, APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Lewis Broschard, Deputy Chief 925-941-3300 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: March 13, 2018 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: C.6 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 13, 2018 Contra Costa County Subject:2018 California Office of Traffic and Safety Grant March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 198 BACKGROUND: (CONT'D) agenda item C.2. The original request was for one set of eDraulics vehicle extrication equipment for Fire Engine 69 in El Sobrante. The District would like to amend the request to increase the request to include three additional sets for a total of four sets for $130,000. The additional equipment would be provided to equip the East Contra Costa Fire Protection District. CONSEQUENCE OF NEGATIVE ACTION: The District will not be able to apply for and accept this grant funding for new rescue equipment. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 199 RECOMMENDATION(S): APPROVE and AUTHORIZE the Fire Chief, or designee, to apply for and execute a grant agreement with the U.S. Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA), Grant Programs Directorate (GPD), Assistance to Firefighters Grant (AFG), in an amount not to exceed $375,000, for the purchase of a water tender unit. FISCAL IMPACT: 90% Federal; 10% local agency match requirement. BACKGROUND: The purpose of the Assistance to Firefighters Program is to enhance the safety of the public and firefighters with respect to fire and fire-related hazards. The funds provide critically needed resources that equip and train emergency personnel to recognized standards, enhance operational efficiencies, foster interoperability, and support community resilience. AFG has three activities: Operations and Safety, Vehicle Acquisition, and Regional Projects. Each activity has its own eligibility requirements. The Contra Costa County Fire Protection District (District) received approval to apply for projects under both Operations and Safety and Regional Projects from the Board of Directors at the January APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Lewis Broschard, Deputy Chief 925-941-3300 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: March 13, 2018 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: C.7 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 13, 2018 Contra Costa County Subject:2017 Assistance to Firefighters Grant March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 200 BACKGROUND: (CONT'D) 16, 2018, meeting. The District would also like to apply for funding under Vehicle Acquisition to purchase a water tender. The District uses water tenders to transport water from a remote water source to the fire scene. An additional tender will increase the District's fire suppression capabilities. CONSEQUENCE OF NEGATIVE ACTION: The District will not be able to take advantage of this funding opportunity. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 201 RECOMMENDATION(S): APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2018 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover, Director Contact: Lewis T. Broschard, Deputy Fire Chief 925-941-3300 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: March 13, 2018 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: C.8 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 13, 2018 Contra Costa County Subject:Fire Station 70 (San Pablo) Construction Management Agreement March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 202 RECOMMENDATION(S): (CONT'D) APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a Consulting Services Agreement with Kitchell CEM, in an amount not to exceed $670,000, subject to approval by the County Administrator and approval as to form by County Counsel, for construction management services for the new Fire Station 70 project at 1800 23 rd Street in the City of San Pablo. FISCAL IMPACT: Currently this projected in budgeted in the CCCFPD Capital Outlay Fund. BACKGROUND: In late 2015 the Contra Costa County Fire Protection District (District) initiated the process for the design of a replacement facility for Fire Station 70 (FS 70) in San Pablo, currently located at 13928 San Pablo Avenue. The current station is comprised of modular buildings installed in 1992 subsequent to the permanent station facility being abandoned due to damage sustained from the Loma Prieta earthquake. The current station was designed for a crew of three personnel and is now housing a crew of five personnel with the addition of Squad 70. In early discussions with the City of San Pablo, an alternate site at 1800 23rd Street was made available to relocate the station. Since those discussions, preliminary site plans have been developed and the project appears feasible for the new location. The District has been working with LCA Architects to develop construction drawings for the fire station. As we prepare for the bidding process, the District desires to bring on a construction management firm to assist with construction feasibility, the bidding process and ultimately construction management. The City of San Pablo has pledged funds to assist in the construction and relocation of the station. The new station would be built to house two full three-person crews for potential expansion of services in the future and will include modern seismic standards as well as being able to meet ADA requirements. The station would be built to provide protection for the community over the next fifty years and would allow for the facility to provide personnel with the components, systems, and features found in a modern fire station. The County Public Works Department requested Statements of Qualifications ("SOQs") for services for some specific and Countywide capital projects. The Public Works Department received eight SOQs from interested firms and four firms were shortlisted. A selection committee of County staff conducted interviews and ranked Kitchell CEM as one of the top ranking firms. It is recommended that Kitchell be awarded the agreement for the subject project. The Public Works Department will administer the agreement and facilitate project management for the District. CONSEQUENCE OF NEGATIVE ACTION: If the agreement is not approved, construction management services will not be provided and the quality of delivery and management of the project could be negatively impacted. March 13, 2018 CCC FIRE PROTECTION DISTRICT MINUTES 203