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HomeMy WebLinkAboutMINUTES - 03122019 - Fire Protection DistrictCALENDAR FOR THE BOARD OF DIRECTORS CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT BOARD CHAMBERS ROOM 107, ADMINISTRATION BUILDING, 651 PINE STREET MARTINEZ, CALIFORNIA 94553-1229 JOHN GIOIA, CHAIR CANDACE ANDERSEN, VICE CHAIR DIANE BURGIS KAREN MITCHOFF 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 12, 2019   Present: John Gioia, Director; Candace Andersen, Director; Karen Mitchoff, Director; Federal D. Glover, Director Absent: Diane Burgis, Director Staff Present:David Twa, County Administrator Jeff Carman, Fire Chief                  1:00 P.M. Convene and call to order.   CONSIDER CONSENT ITEMS (Items listed as C.1 through C.4 on the following agenda) – Items are subject to removal from Consent Calendar by request of any Director or on request for discussion by a member of the public. Items removed from the Consent Calendar will be considered with the Discussion Items.   PRESENTATIONS   PR.1 PRESENTATION of Carnegie Heroes Award to Samantha Olive Barnhouse. (Jeff    March 12, 2019 Contra Costa Fire Protection District Minutes 1 PR.1 PRESENTATION of Carnegie Heroes Award to Samantha Olive Barnhouse. (Jeff Carman, Fire Chief and Vic Massenkoff, Retired Fire Investigator)       AYE: Director John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover Other: Director Diane Burgis (ABSENT) DISCUSSION ITEMS   D. 1 CONSIDER Consent Items previously removed.    There were no 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. 2019-08, revising the fee for first-responder emergency medical services provided by the Contra Costa County Fire Protection District. (Jeff Carman, Fire Chief)       AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover D. 4 HEARING to consider adopting Ordinance No. 2019-06, 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 Karen Mitchoff, Director Federal D. Glover Other: Director Diane Burgis (ABSENT) D. 5 CONSIDER accepting a report from the Fire Chief regarding a new proposed program between the Contra Costa County Fire Protection District and REACH Air Medical Services, LLC to provide fire and air ambulance services, and APPROVE and AUTHORIZE the Fire Chief, or his designee, to execute an Air Ambulance Agreement with REACH Air Medical Services, LLC, for a five-year term, to provide fire and air ambulance services within Contra Costa County. (Jeff Carman, Fire Chief)       AYE: Director John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover Other: Director Diane Burgis (ABSENT) D. 6 DETERMINE that the San Pablo Fire Station 70 project is feasible, and AWARD    March 12, 2019 Contra Costa Fire Protection District Minutes 2 D. 6 DETERMINE that the San Pablo Fire Station 70 project is feasible, and AWARD and AUTHORIZE the Fire Chief, or designee, to execute a construction contract in the amount of $9,778,000 with Alten Construction, Inc., and related actions for the construction of the new Fire Station 70 at 1800 23rd Street, San Pablo. (Aaron McAlister, Assistant Fire Chief)       AYE: Director John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover Other: Director Diane Burgis (ABSENT) D. 7 CONSIDER approving and authorizing the Fire Chief, or designee, to execute a contract amendment with American Medical Response West, effective April 1, 2019, to revise the payment provisions and update Exhibit D (Ambulance Unit Hour Rates) in the Service Plan with no change to original term or payment limit, for emergency ambulance services. (Jeff Carman, Fire Chief)       AYE: Director John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover Other: Director Diane Burgis (ABSENT) D. 8 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 Karen Mitchoff, Director Federal D. Glover Other: Director Diane Burgis (ABSENT) D. 9 CONSIDER accepting a report from the Fire Chief providing a summary of Contra Costa County Fire Protection District accomplishments over the last five years. (Jeff Carman, Fire Chief)       AYE: Director John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover Other: Director Diane Burgis (ABSENT) D.10 CONSIDER adopting Resolution No. 2019/63, which supersedes Resolution No. 2017/392, regarding compensation and benefits for unrepresented fire safety management classifications in the Contra Costa County Fire Protection District, as recommended by the County Administrator. (David Twa, County Administrator)       AYE: Director John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover Other: Director Diane Burgis (ABSENT) D.11 CONSIDER appointing Lewis T. Broschard III to the position of Fire Chief, Contra Costa County Fire Protection District at Step 5 of the salary range effective April 1, 2019, all other benefits as provided in the Fire Management Resolution applicable to the position of Fire Chief. (David Twa, County Administrator)    March 12, 2019 Contra Costa Fire Protection District Minutes 3    AYE: Director John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover Other: Director Diane Burgis (ABSENT) CONSENT ITEMS   C.1 ADOPT Position Adjustment Resolution No. 22432 to add three Fire Captain-56 Hour positions and cancel three vacant Firefighter-56 Hour positions in the Contra Costa County Fire Protection District. (Budgeted; 100% Special District Revenue)       AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover C.2 ADOPT Position Adjustment Resolution No. 22433 to add one Fire Inspector II (represented) position and cancel one vacant Fire Inspector I (represented) position in the Contra Costa County Fire Protection District. (Budgeted; 100% Special District Revenue)       AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover C.3 APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a contract with Life Extension Clinics, Inc., doing business as Life Scan Wellness Centers, in an amount not to exceed $1,500,000, to provide annual medical evaluations for Contra Costa County Fire Protection District personnel for the term April 1, 2019, through March 31, 2023. (100% CCCFPD General Operating Fund)       AYE: Director John Gioia, Director Candace Andersen, Director Diane Burgis, Director Karen Mitchoff, Director Federal D. Glover C.4 ACCEPT the 2018 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   ADVISORY COMMISSION The Contra Costa County Fire Protection District Advisory Fire Commission is scheduled to meet next on Monday, April 8, 2019 at 7:00 p.m. at the District Training Center, 2945 Treat Blvd., Concord, CA 94518. March 12, 2019 Contra Costa Fire Protection District Minutes 4 RECOMMENDATION(S): PRESENTATION of Carnegie Heroes Award to Antioch Citizen Samantha Olive Barnhouse. FISCAL IMPACT: No fiscal impact. BACKGROUND: The Carnegie Heroes Award is presented to civilians who risk their lives to an extraordinary degree while saving or attempting to save the lives of others. In 2018, eighteen people were named Carnegie Heroes and three lost their lives attempting to save others. Samantha Olive Barnhouse, 37, saved 78 year-old Lobis Burton from a burning house on February 17, 2018, in Antioch, California. Alerted to the fire, Ms. Barnhouse, who lived across the street from Mr. Burton's apartment building, entered his apartment. She moved past the burning kitchen to reach Mr.Burton who was sitting in a bedroom in a wheeled desk chair and unable to move due to an injured hip. As flames and smoke intensified, Ms. Barnhouse pulled the desk chair through the bedroom past the kitchen and to the front door. The APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover, Director ABSENT:Diane Burgis, 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: PR.1 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 12, 2019 Contra Costa County Subject:Presentation of Carnegie Heroes Award to Antioch Citizen Samantha Olive Barnhouse March 12, 2019 Contra Costa Fire Protection District Minutes 5 BACKGROUND: (CONT'D) chair became stuck and Ms. Barnhouse pulled it free causing herself and and Mr. Burton to fall outside beneath flames issuing overhead through the doorway. Within a minute, the apartment's windows shattered due to the heat. Mr. Burton was hospitalized for smoke inhalation and a broken hip, but he was not burned. Ms. Barnhouse was treated at the hospital for smoke inhalation and subsequently recovered. The Fire District is honored to present Samantha Olive Barnhouse with the Carnegie Medal for risking her life while rescuing Lobis Burton from his burning apartment. March 12, 2019 Contra Costa Fire Protection District Minutes 6 RECOMMENDATION(S): A. OPEN the public hearing on Ordinance No. 2019-08, receive testimony, and CLOSE the public hearing. B. ADOPT the attached ordinance, Ordinance No. 2019-08, which authorizes the District to revise its emergency medical first-responder fees to recover its actual costs for providing emergency medical first-responder services, as set forth in the ordinance. FISCAL IMPACT: The ordinance allows the Contra Costa County Fire Protection District to recover the costs of responding to, and providing services for, emergency medical incidents. BACKGROUND: The Contra Costa County Fire Protection District (District) strives to provide timely and efficient first responder emergency medical services (EMS) to residents and businesses located within the District, and to persons that visit, do business in, or travel through the District's jurisdiction. The spectrum of EMS responses encompasses an emergency response to a single APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: , 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 12, 2019 Contra Costa County Subject:Cost Recovery for Emergency Medical First Responder Services March 12, 2019 Contra Costa Fire Protection District Minutes 7 BACKGROUND: (CONT'D) family home for a person suffering from a medical condition, a vehicle accident requiring patient extrication, a complex technical rescue of a person on a remote hillside, a mass casualty incident involving many patients needing immediate care, and more. To successfully carry out our EMS mission, the District must provide and maintain modern equipment, apparatus, and sufficiently trained and licensed personnel. These are necessary components for the protection of the public health, safety, and the welfare of District residents, businesses, and visitors. The District responds to a high volume of EMS incidents which cause a significant impact on the finances and operations of the District. The District finances its emergency, rescue, and fire response services with general purpose revenues. The District's receives general purpose revenue from a portion of ad valorem property taxes. The District has experienced reductions and significant fluctuations in funding along with increased costs and increased demands for services. The District's general purpose revenues are inadequate to meet the costs of providing fire protection services, emergency medical and rescue services, and hazardous materials emergency response services. On December 9, 2014, the District's Board of Directors adopted Ordinance No. 2014-19 to establish a fee to recover the costs of providing EMS responses as authorized by the California Health & Safety Code. These costs include the District's actual personnel, equipment, and apparatus costs, as well as the cost of supplies, administration, and emergency medical dispatch. Since the ordinace was adopted, the District's costs to provide emergency medical fire-responder services have increased. Ordinance No. 2019-08 will increase the District's fee to ensure the District is recovering the actual costs of providing emergency response services. Exhibit A to the ordinance depicts how the District calculated its costs for responding to an emergency medical incident. The fee for each emergency will be calculated based on the actual hourly and per-unit costs that the District incurs to respond to the emergency. The administrative rate used is based on California's reimbursement for emergency incident response. District staff have determined that our actual costs exceed this 10% rate. CONSEQUENCE OF NEGATIVE ACTION: Without adoption of Ordinance 2019-08, the Fire District will not be able to recover the increased costs of responding to, and providing services for, emergency medical incidents. CHILDREN'S IMPACT STATEMENT: Approximately 10% of emergency medical service responses involve children under the age of 15. AGENDA ATTACHMENTS Ordinance 2019-08 MINUTES ATTACHMENTS Signed Ordinance No. 2019-08 March 12, 2019 Contra Costa Fire Protection District Minutes 8 ORDINANCE NO. 2019-08 (Uncodified) (Cost Recovery for Emergency Medical First-Responder 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 1. Authority. This ordinance is enacted pursuant to Health and Safety Code sections 13910 through 13919. SECTION 2. Purpose and Recitals. (a) The Contra Costa County Fire Protection District (“District”) provides timely and efficient emergency, rescue, fire protection, and other services to residents and businesses located in the District, and to persons who visit, do business in, or travel through the District. (b) The District responds to a high volume of calls for emergency medical services, by deploying District personnel to incidents and providing first-responder emergency medical assessment and treatment to persons at those incidents. (c) On December 9, 2014, the District’s Board of Directors adopted Ordinance No. 2014-19 to establish a fee for providing emergency medical first-responder services. Since the ordinance was adopted, the District’s costs to provide emergency medical first-responder services have increased. The purpose of this ordinance is to increase the District’s fee for emergency medical first-responder services to ensure the District is recovering its costs to provide those services. (d) The District has reasonably calculated its costs of providing emergency medical first- responder services to a person at an incident. These costs include the District’s actual personnel and apparatus costs, the cost of supplies, and the cost of equipment to provide emergency medical first-responder services to each person. The emergency medical first- responder fee established by this ordinance is calculated based on the District’s actual costs of providing emergency medical first-responder services to each person at an incident. SECTION 3. Definitions. For purposes of this ordinance, the following terms have the following meanings: (a) “Advanced life support emergency medical services” means advanced life-saving procedures that include, but are not limited to, intravenous fluid therapy, intubation, administration of drugs, and electro-cardio conversion. March 12, 2019 Contra Costa Fire Protection District Minutes 9 (b) “Basic life support emergency medical services” means basic-level care that includes, but is not limited to, oxygen therapy, injury and wound management, patient packaging, and operation of an automated external defibrillator. (c) “Emergency medical first-responder services” means advanced life support emergency medical services and basic life support emergency medical services provided by District personnel who are licensed healthcare practitioners, other than ambulance-based personnel, to a person at an incident. Emergency medical first-responder services do not include any of the following: services provided by ambulance-based personnel of the District or any other entity; medical transportation services provided by the District or any other entity; or emergency medical first-responder services provided by any person or entity other than the District. SECTION 4. Emergency Medical First-Responder Fee. (a) An emergency medical first-responder fee to recover the District’s actual costs of providing emergency medical first-responder services to each person is established in the amount specified in Exhibit A attached hereto and incorporated herein. (b) The emergency medical first-responder fee shall be charged to each person who receives District emergency medical first-responder services during a single incident. (c) The District Board of Directors (“Board”), may adjust the amount of the emergency medical first-responder fee established by this ordinance pursuant to Health and Safety Code section 13916. SECTION 5. Fee Collection. (a) If the District provides emergency medical first-responder services to a person, the Fire Chief, or designee, will send an invoice seeking payment of the emergency medical first- responder fee 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 the insurer to which the invoice should be sent. (b) The Fire Chief, or designee, shall invoice, bill, receive payments, and discharge from accountability uncollectable emergency medical first-responder fees charged under this Ordinance, all in accordance with applicable District policies and procedures, as may be updated from time to time. Any future updates to those District policies and procedures will include a process to discharge from accountability accounts that are not collectible. SECTION 6. No Effect on Emergency Medical First-Responder Services. This ordinance neither expands nor limits emergency medical first-responder services. Nothing in this ordinance relieves the District from providing emergency medical first-responder services. Emergency medical first-responder 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 medical first-responder fee. March 12, 2019 Contra Costa Fire Protection District Minutes 10 SECTION 7. No Waiver of Other Means of Cost Recovery. This ordinance does not preclude the District from recovering its emergency response costs in any other manner authorized by law, including, but not limited to, Government Code sections 53150 through 53158 and Health and Safety Code sections 13009, 13009.1, and 13009.6. SECTION 8. Repeal of Ordinance 2014-19. Except as specified in Section 9 of this Ordinance, Ordinance No. 2014-19 is hereby repealed and superseded by this Ordinance, as of the effective date of this Ordinance. SECTION 9. Severability. Notwithstanding any other provision of this Ordinance to the contrary, if a court of competent jurisdiction determines any fee set forth in this Ordinance is invalid or unenforceable, the fee adopted by Ordinance No. 2014-19 shall be deemed not to have been repealed and shall remain in effect and subject to the remaining provisions of this ordinance. Notwithstanding any other provision of this Ordinance to the contrary, if a court of competent jurisdiction determines this Ordinance is invalid or unenforceable, Ordinance No. 2014-19 shall be deemed not to have been repealed and shall remain in full force and effect. SECTION 10. 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 East Bay Times, a newspaper published in this County. PASSED ON _________________________________ by the following vote: AYES: NOES: ABSENT: ABSTAIN: ATTEST: DAVID J. TWA, ____________________________ Clerk of the Board of Supervisors Board Chair and County Administrator By: ________________________ [SEAL] Deputy SMS H:\Client Matters\CCCFPD\Ordinance 2019-08 Final (First Responder Fee).docx March 12, 2019 Contra Costa Fire Protection District Minutes 11 Exhibit A First-Responder Fee Calculation (Cost Per Incident) Apparatus Costs Type I Engine, Quint, or Squad $125.00 Personnel Costs Firefighter/Paramedic $79.94 Engineer $86.81 Fire Captain $96.82 Administrative Costs Emergency Medical Dispatch $72.00 Administrative Rate 10%* Fire Emergency Medical First-Responder Fee $506.63 *Administrative rate based on State of California Office of Emergency Services approved administrative rate for local government reimbursement for emergency incident response. March 12, 2019 Contra Costa Fire Protection District Minutes 12 March 12, 2019 Contra Costa Fire Protection District Minutes 13 March 12, 2019 Contra Costa Fire Protection District Minutes 14 March 12, 2019 Contra Costa Fire Protection District Minutes 15 March 12, 2019 Contra Costa Fire Protection District Minutes 16 RECOMMENDATION(S): A. OPEN the public hearing on the following ordinance: 1. Ordinance No. 2019-06, an ordinance authorizing the Contra Costa County Fire Protection District to revise its emergency ambulance service fees beginning April 12, 2019. B. RECEIVE testimony and CLOSE the public hearing. C. ADOPT Ordinance No. 2019-06, which becomes effective on April 12, 2019. 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 12, 2019. 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, APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover, Director ABSENT:Diane Burgis, 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: D. 4 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 12, 2019 Contra Costa County Subject:Emergency Ambulance Service Rate Schedule Revision March 12, 2019 Contra Costa Fire Protection District Minutes 17 March 12, 2019 Contra Costa Fire Protection District Minutes 18 BACKGROUND: (CONT'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 $ 2,245.40 Mileage Rate (for each mile traveled with a loaded patient)$ 53.56 Oxygen Administration Charge $ 187.46 Treat and Refused Transport $ 481.00 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 13, 2018. 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, 2018. 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 2018 was 2.0%. The “collection realization percentage” is the percentage of patient billings actually collected by the District. The District’s collection realization percentage for calendar year 2017 is 23.26%. 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 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. March 12, 2019 Contra Costa Fire Protection District Minutes 19 Emergency Ambulance Response Base Rate $ 2,312.76 Mileage Rate (for each mile traveled with a loaded patient)$ 55.17 Oxygen Administration Charge $ 193.08 Treat and Refused Transport $ 495.43 If approved by the District Board of Directors, these rates will go into effect on April 12, 2019. CONSEQUENCE OF NEGATIVE ACTION: If Ordinance No. 2019-06 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 CCCEMA-District Contract CCCFPD-AMR Contract CCCFPD Ambulance Ordinance 2019-06 MINUTES ATTACHMENTS Signed Ordinance 2019-06 March 12, 2019 Contra Costa Fire Protection District Minutes 20 March 12, 2019 Contra Costa Fire Protection District Minutes 21 March 12, 2019 Contra Costa Fire Protection District Minutes 22 March 12, 2019 Contra Costa Fire Protection District Minutes 23 March 12, 2019 Contra Costa Fire Protection District Minutes 24 March 12, 2019 Contra Costa Fire Protection District Minutes 25 March 12, 2019 Contra Costa Fire Protection District Minutes 26 March 12, 2019 Contra Costa Fire Protection District Minutes 27 March 12, 2019 Contra Costa Fire Protection District Minutes 28 March 12, 2019 Contra Costa Fire Protection District Minutes 29 March 12, 2019 Contra Costa Fire Protection District Minutes 30 March 12, 2019 Contra Costa Fire Protection District Minutes 31 March 12, 2019 Contra Costa Fire Protection District Minutes 32 March 12, 2019 Contra 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District Minutes 95 March 12, 2019 Contra Costa Fire Protection District Minutes 96 March 12, 2019 Contra Costa Fire Protection District Minutes 97 March 12, 2019 Contra Costa Fire Protection District Minutes 98 March 12, 2019 Contra Costa Fire Protection District Minutes 99 March 12, 2019 Contra Costa Fire Protection District Minutes 100 March 12, 2019 Contra Costa Fire Protection District Minutes 101 March 12, 2019 Contra Costa Fire Protection District Minutes 102 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 12, 2019 Contra Costa Fire Protection District Minutes 103 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 12, 2019 Contra Costa Fire Protection District Minutes 104 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 12, 2019 Contra Costa Fire Protection District Minutes 105 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 12, 2019 Contra Costa Fire Protection District Minutes 106 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 12, 2019 Contra Costa Fire Protection District Minutes 107 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 12, 2019 Contra Costa Fire Protection District Minutes 108 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 12, 2019 Contra Costa Fire Protection District Minutes 109 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 12, 2019 Contra Costa Fire Protection District Minutes 110 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 12, 2019 Contra Costa Fire Protection District Minutes 111 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 12, 2019 Contra Costa Fire Protection District Minutes 112 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 12, 2019 Contra Costa Fire Protection District Minutes 113 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 12, 2019 Contra Costa Fire Protection District Minutes 114 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 12, 2019 Contra Costa Fire Protection District Minutes 115 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 12, 2019 Contra Costa Fire Protection District Minutes 116 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 12, 2019 Contra Costa Fire Protection District Minutes 117 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 12, 2019 Contra Costa Fire Protection District Minutes 118 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 12, 2019 Contra Costa Fire Protection District Minutes 119 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 12, 2019 Contra Costa Fire Protection District Minutes 120 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 12, 2019 Contra Costa Fire Protection District Minutes 121 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 12, 2019 Contra Costa Fire Protection District Minutes 122 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 12, 2019 Contra Costa Fire Protection District Minutes 123 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 12, 2019 Contra Costa Fire Protection District Minutes 124 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 12, 2019 Contra Costa Fire Protection District Minutes 125 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 12, 2019 Contra Costa Fire Protection District Minutes 126 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 12, 2019 Contra Costa Fire Protection District Minutes 127 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 12, 2019 Contra Costa Fire Protection District Minutes 128 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 12, 2019 Contra Costa Fire Protection District Minutes 129 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 12, 2019 Contra Costa Fire Protection District Minutes 130 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 12, 2019 Contra Costa Fire Protection District Minutes 131 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 12, 2019 Contra Costa Fire Protection District Minutes 132 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 12, 2019 Contra Costa Fire Protection District Minutes 133 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 12, 2019 Contra Costa Fire Protection District Minutes 134 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 12, 2019 Contra Costa Fire Protection District Minutes 135 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 12, 2019 Contra Costa Fire Protection District Minutes 136 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 12, 2019 Contra Costa Fire Protection District Minutes 137 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 12, 2019 Contra Costa Fire Protection District Minutes 138 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 12, 2019 Contra Costa Fire Protection District Minutes 139 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 12, 2019 Contra Costa Fire Protection District Minutes 140 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 12, 2019 Contra Costa Fire Protection District Minutes 141 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 12, 2019 Contra Costa Fire Protection District Minutes 142 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 12, 2019 Contra Costa Fire Protection District Minutes 143 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 12, 2019 Contra Costa Fire Protection District Minutes 144 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 12, 2019 Contra Costa Fire Protection District Minutes 145 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 12, 2019 Contra Costa Fire Protection District Minutes 146 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 12, 2019 Contra Costa Fire Protection District Minutes 147 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 12, 2019 Contra Costa Fire Protection District Minutes 148 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 12, 2019 Contra Costa Fire Protection District Minutes 149 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 12, 2019 Contra Costa Fire Protection District Minutes 150 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 12, 2019 Contra Costa Fire Protection District Minutes 151 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 12, 2019 Contra Costa Fire Protection District Minutes 152 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 12, 2019 Contra Costa Fire Protection District Minutes 153 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 12, 2019 Contra Costa Fire Protection District Minutes 154 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 12, 2019 Contra Costa Fire Protection District Minutes 155 • , 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 12, 2019 Contra Costa Fire Protection District Minutes 156 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 12, 2019 Contra Costa Fire Protection District Minutes 157 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 12, 2019 Contra Costa Fire Protection District Minutes 158 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 12, 2019 Contra Costa Fire Protection District Minutes 159 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 12, 2019 Contra Costa Fire Protection District Minutes 160 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 12, 2019 Contra Costa Fire Protection District Minutes 161 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 12, 2019 Contra Costa Fire Protection District Minutes 162 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 12, 2019 Contra Costa Fire Protection District Minutes 163 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 12, 2019 Contra Costa Fire Protection District Minutes 164 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 12, 2019 Contra Costa Fire Protection District Minutes 165 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 12, 2019 Contra Costa Fire Protection District Minutes 166 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 12, 2019 Contra Costa Fire Protection District Minutes 167 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 12, 2019 Contra Costa Fire Protection District Minutes 168 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 12, 2019 Contra Costa Fire Protection District Minutes 169 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 12, 2019 Contra Costa Fire Protection District Minutes 170 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 12, 2019 Contra Costa Fire Protection District Minutes 171 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 12, 2019 Contra Costa Fire Protection District Minutes 172 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 12, 2019 Contra Costa Fire Protection District Minutes 173 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 12, 2019 Contra Costa Fire Protection District Minutes 174 ORDINANCE NO. 2019-06 ORDINANCE NO. 2019-06 (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 $2,245.40; (2) a mileage rate (for each mile traveled with a loaded patient) of $53.56 per mile ; (3) an oxygen administration charge of $187.46; and (4) a treat and refused transport charge (in some cases) of $481.00. 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 2018 was 2.0%. March 12, 2019 Contra Costa Fire Protection District Minutes 175 ORDINANCE NO. 2019-06 2 G. The Ambulance Subcontract requires the hourly rates paid by the District to the Ambulance Services Subcontractor to increase annually by the percentage equal to the product of the District’s 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 Ambula nce 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. 2018-10. 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 12, 2019 Contra Costa Fire Protection District Minutes 176 ORDINANCE NO. 2019-06 3 SECTION IV. Emergency Ambulance Services Fees. (a) The Emergency Ambulance Services fees to recover the District’s actual costs of providing Emergency Ambulance Services to each patient are established in the amount specified in Exhibit A attached hereto and incorporated herein. (b) The Emergency Ambulance Services fees shall be charged to each person who receives District Emergency Ambulance Services during a single incident. (c) The District Board of Directors (the “Board”) may adjust the amount of the Emergency Ambulance Services fees established by this ordinance pursuant to Health and Safety Code section 13916. SECTION V. Fee Collection. (a) If the District provides Emergency Ambulance Services to a person through its Ambulance Services Subcontractor, the Fire Chief, or designee, including the District’s Emergency Ambulance Services billing subcontractor, will send an invoice seeking payment of the Emergency Ambulance Services fees to the person, and to the insurance company that provides medical insurance coverage for the person (the “Insurer”) if the person or his or her representative has identified to the District or to its Ambulance Services Subcontractor the Insurer to which the invoice should be sent. (b) The Fire Chief, or designee, has approved and adopted policies and procedures for invoicing, billing, and receiving payments for each Emergency Ambulance Services fee charged under this ordinance. The policies and procedures include a process to discharge from accountability accounts that are not collectible. SECTION VI. No Effect on Emergency Ambulance Services. This ordinance neither expands nor limits Emergency Ambulance Services. Nothing in this ordinance relieves the District from providing Emergency Ambulance Services. Emergency Ambulance Services will continue to be provided without regard to whether a person is insured by an Insurer, and without regard to whether a person has the ability to pay the Emergency Ambulance Services fees. SECTION VII. No Waiver of Other Means of Cost Recovery. This ordinance does not preclude the District from recovering its Emergency Ambulance Services costs in any other manner authorized by law. SECTION VIII. Severability. If any fee or provision of this ordinance is held invalid or unenforceable by a court of competent jurisdiction, that holding shall not affect the validity or enforceability of the remaining fees or provisions, and the Board declares that it would have adopted each remaining part of this ordinance irrespective of any such invalidity. SECTION IX. Effective Date . This ordinance becomes effective 30 days after its passage. Within 15 days after its passage, this ordinance shall be published once with the names of the directors voting for and against it in the East Bay Times, a newspaper published in this County. March 12, 2019 Contra Costa Fire Protection District Minutes 177 ORDINANCE NO. 2019-06 4 PASSED ON _________________________________ by the following vote: AYES: NOES: ABSENT: ABSTAIN: ATTEST: DAVID J. TWA, ____________________________ Clerk of the Board of Supervisors Board Chair and County Administrator By: ________________________ [SEAL] Deputy ESG: Cccfpd Ambulance Services Fee Ord 2019-06 March 12, 2019 Contra Costa Fire Protection District Minutes 178 ORDINANCE NO. 2019-06 5 Exhibit A Emergency Ambulance Services Fee Calculation For each Emergency Ambulance Service call, District shall charge the patient the Emergency Ambulance Response Base Rate, plus mileage costs at the Mileage Rate. If oxygen is administered to a patient, District shall charge the patient the Oxygen Administration Charge, whether transported or not. If a patient is treated and refuses transport, District shall charge the Treat and Refused Transport rate. 1. Emergency Ambulance Response Base Rate ................................................. $2,312.76 2. Mileage Rate (for each mile traveled with a loaded patient)............................... $55.17 3. Oxygen Administration Charge......................................................................... $193.08 4. Treat and Refused Transport ............................................................................. $495.43 March 12, 2019 Contra Costa Fire Protection District Minutes 179 March 12, 2019 Contra Costa Fire Protection District Minutes 180 March 12, 2019 Contra Costa Fire Protection District Minutes 181 March 12, 2019 Contra Costa Fire Protection District Minutes 182 March 12, 2019 Contra Costa Fire Protection District Minutes 183 March 12, 2019 Contra Costa Fire Protection District Minutes 184 March 12, 2019 Contra Costa Fire Protection District Minutes 185 RECOMMENDATION(S): 1. ACCEPT a report from the Fire Chief regarding a new proposed program between the Contra Costa County Fire Protection District and REACH Air Medical Services, LLC to provide fire and air ambulance services within Contra Costa County. 2. APPROVE and AUTHORIZE the Fire Chief, or his designee, to execute an Air Ambulance Agreement with REACH Air Medical Services, LLC, for a five-year term, to provide fire and air ambulance services within Contra Costa County. FISCAL IMPACT: Pursuant to terms of the Air Ambulance Agreement (Agreement) and except as otherwise stated in the Agreement, costs for the program will be borne by REACH. REACH shall seek payment for all services relating to the program by directly billing and collecting from air transport patients and other persons for whose benefit such services are provided. The Contra Costa County Fire Protection District (District) has no responsibility to REACH or otherwise for the non-payment of bills by individuals or other responsible parties for the patient care and transportation services rendered by REACH. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover, Director ABSENT:Diane Burgis, 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 12, 2019 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 12, 2019 Contra Costa County Subject:Air Ambulance Agreement with REACH Air Medical Services, LLC March 12, 2019 Contra Costa Fire Protection District Minutes 186 BACKGROUND: The Contra Costa County Fire Protection District (District) currently participates in a cooperative program with the Contra Costa County Office of the Sheriff to provide an aerial reconnaissance platform and rescue from remote areas. Unfortunately, this program does not provide for the transport of patients to a hospital. The program also has a limited number of days and hours during which it is available. In a new proposed program between the District and REACH Air Medical Services (REACH), REACH would provide flight services, including emergency and inter-facility air medical transportation, 24 hours per day. This is an opportunity to improve service delivery, patient access, and customer service through this collaborative provision of services. REACH is classified by the Contra Costa County Emergency Medical Services Agency as an air ambulance and rescue aircraft and is accredited and compliant with the Federal Aviation Administration and California Emergency Medical Services Authority laws and regulations for the provision of air medical transportation services. Pursuant to terms of the Agreement, REACH will provide flight services that are available to the District 24 hours per day and 365 days per year, except for maintenance and repair activities. The District will provide REACH with three captain/paramedics - one per shift - to help staff the helicopter. The captain/paramedics will be full-time employees of the District and will operate out of Buchanan Field. As part of the proposed agreement, the District will be able to utilize the REACH helicopter as an aerial reconnaissance platform for major incidents, aerial firefighting, and for rescues from remote areas. REACH will reimburse the District (wages and benefits) for the cost of three captain/paramedic positions, currently estimated at $76,988 per month. REACH will provide the hangar space for its aircraft storage and maintenance events. REACH is responsible for all fuel, maintenance, and associated costs of operating the aircraft. The term of the Agreement is effective for a period of five (5) years, commencing on effective date, and terminating on the fifth anniversary of the effective date. The District may extend the initial term for two (2) successive three (3) year periods. The Agreement may be terminated by either party at will and without cause with ninety (90) days prior written notice to the other party. CONSEQUENCE OF NEGATIVE ACTION: The existing program will continue with limited scope and availability. ATTACHMENTS REACH Project PPT March 12, 2019 Contra Costa Fire Protection District Minutes 187 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS CONFIRE / REACH AIR AMBULANCE SERVICE AGREEMENT PUBLIC-PRIVATE COOPERATIVE PROJECT Service •Leadership •Teamwork •Safety and Preparedness •Professionalism •Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 188 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS THE BACKSTORY •ConFire’s partnership with the Sheriff’s helicopter program has proven to be extremely valuable to ConFire and all County fire agencies. •Aerial command and reconnaissance •Aerial firefighting •Rescue from remote areas •Expedited delivery of advanced life support •More opportunities would exist with extended flight times. •REACH is interested in expanding their scope of work outside of simple air transport. Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 189 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS THE INITIAL DISCUSSION •REACH would reimburse ConFire for the cost of a captain/paramedic to staff an air ambulance at Buchanan Field. •Flight crew will consist of a pilot, a captain/paramedic, and a registered nurse. Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 190 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS EXPANDED MISSION •REACH will reimburse ConFire for the cost of providing a captain/paramedic. •REACH has purchased three (3) larger helicopters capable of patient transport AND rescue/fire missions. Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 191 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS KEY POINTS •No cost to ConFire •Longer flight hours (24/7) •Countywide asset •Enhanced capability •Increased capacity •Winch equipped Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 192 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity Questions? Jeff Carman, Fire Chief (925) 941-3300 jcarm@cccfpd.org 6 March 12, 2019 Contra Costa Fire Protection District Minutes 193 RECOMMENDATION(S): 1. DETERMINE that the Fire Station 70 project is feasible pursuant to the Memorandum of Understanding between the City of San Pablo and the District (the "MOU") based upon the lowest construction bid of $9,778,000, and the City of San Pablo contributing 40% of the project cost, not to exceed $4.5 million. 2. APPROVE and AUTHORIZE the Fire Chief, or designee, to execute the Memorandum of Agreement, and the Right of First Offer according to the terms of the MOU, and ACCEPT the Grant Deed from the City for the property located at 1800 23rd Street and identified as Assessor’s Parcel Number 411-100-029. 3. APPROVE plans, specifications, and design for the Contra Costa County Fire Protection District Fire Station 70 (San Pablo) Project (WH704B). 4. DETERMINE that the bid submitted by Alten Construction, Inc. (Alten) complies with the requirements of the Project specifications, and the District Board WAIVES any irregularities in Alten Construction, Inc.’s compliance with the requirements of the County's Outreach Program; and FURTHER DETERMINE that Alten has submitted the lowest responsive and responsible bid for the project. 5. AWARD the construction contract for APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover, Director ABSENT:Diane Burgis, Director Contact: Aaron McAlister, Assistant Fire Chief 925-941-3300 x1103 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: D. 6 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 12, 2019 Contra Costa County Subject:Construction Contract for the New Fire Station 70 at 1800 23rd Street, San Pablo March 12, 2019 Contra Costa Fire Protection District Minutes 194 RECOMMENDATION(S): (CONT'D) the above project to Alten Construction, Inc. (Contractor), in the listed amount ($9,778,000), and the unit prices submitted in the bid, and DIRECT the Fire Chief, or designee, to prepare the contract. 6. DIRECT that Alten Construction, Inc. shall submit two good and sufficient surety bonds (performance and payment bonds) in the amount of $9,778,000 each. 7. ORDER that, after the Contractor has signed the contract and returned it, together with the bonds, certificate 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 to sign the contract for this Board. 8. ORDER that, in accordance with the project specifications and upon signature of the contract by the Fire Chief, or designee, any bid bonds posted by the bidders are to be exonerated and any checks or cash submitted for bid security shall be returned. 9. ORDER that the Fire Chief, or designee, sign any escrow agreements prepared for this Project to permit the direct payment of retention into escrow or the substitution of securities for moneys withheld by the District to ensure performance under the contract, pursuant to Public Contract Code Section 22300. 10. AUTHORIZE the Fire Chief, or designee, to order changes or additions to the work pursuant to Public Contract Code Section 20142. 11. 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. 12. DELEGATE, pursuant to Labor Code Section 6705, to the Fire Chief or to any registered civil or structural engineer employed by the District, the authority to accept detailed plans showing the design of shoring, bracing, sloping, or other provisions to be made for worker protection during trench excavation covered by that section. 13. DECLARE that, should the award of the contract to Alten be invalidated for any reason, the Board would not in any event have awarded the contract to any other bidder, but instead would have exercised its discretion to reject all of the other bids received. Nothing in this Board Order shall prevent the Board from re-awarding the contract to another bidder in cases where the successful bidder establishes a mistake, refuses to sign the contract, or fails to furnish required bonds or insurance (see Public Contract Code Sections 5100-5107). FISCAL IMPACT: The total project budget including architectural services, construction management services, capital projects fees, construction and contingency is $13 million. The Contra Costa County Fire Protection District and the City of San Pablo will enter into a Memorandum of Understanding wherein the City of San Pablo contributes $4.5 million in funding for the construction of Fire Station 70 and the District contributes $8.5 million in funding. Development impact fees have been exhausted in the District's capital outlay fund; therefore, this construction project will initially be funded through use of unrestricted general fund reserves. The District will return to the Board with a general fund budget adjustment prior to the end of the current fiscal year. As part of the District's 2019-20 Recommended Budget submission, the District requested the establishment of a capital construction fund for current and future major construction projects, to include March 12, 2019 Contra Costa Fire Protection District Minutes 195 Fire Station 70. Included in that request is the earmarking of unrestricted reserves for this project. The District has a 10% General Fund Reserve Policy. Currently, reserves far exceed 10% of budgeted expenditures. At this time reserves can be used to fund this project without having to consider financing. Delays in the project could result in increased construction costs. 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 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. On November 8, 2016, the District contracted with LCA Architects to develop plans and specifications for a fire station at this new location. On September 12, 2017, the Board found the project to be exempt from the California Environmental Quality Act (CEQA) under CEQA Guidelines section 15332 as infill development. Per Section 4. A. and B. of the Memorandum of Understanding, the City and District agreed to take specified actions for the purpose of determining the feasibility of the Project, and if the Project was found to be feasible, but before Project construction commenced, the City would convey to the District fee title to the new Station 70 Property. The new station will house two full three-person crews for potential expansion of services in the future and will comply with seismic standards as well as being able to meet ADA requirements. The station will provide fire protection for the community over the next fifty years and allow for the facility to provide personnel with the components, systems, and features found in modern fire stations. The new Fire Station 70 will be a two-story structure including, but not limited to, three (3) apparatus bays, kitchen, dorm rooms, offices, restrooms, training, exercise, decontamination, storage, day and dining rooms, along with all associated heating and cooling, electrical, civil site work, and landscaping. The new station will include a two-stop elevator, emergency generator, and fuel tank. The project will also include a photovoltaic roof system and designed to meet LEED Silver equivalency per the County’s standard for public buildings. On November 13, 2018, this Board approved the design and bid documents for the construction of the Project and the bid Notice to Contractors was duly published in accordance with Public Contract Code Section 22037 and emailed, faxed or sent by U.S mail to construction trade journals as specified in Public Contract Code Section 22036. Bids were received and opened by the Public Works Department on January 17, 2019, and the bid results are as follows: BIDDER: Alten Construction, Inc., Richmond CA. BASE BID: $9,778,000. BIDDER: D.L. Falk Construction, Inc., Hayward BASE BID: $10,044,000. BIDDER: W.A. Thomas Co., Inc., Martinez BASE BID: $10,420,000. The average prevailing wage rates are on file with the Clerk of the Board of Directors and will be the minimum rates paid on this project. Construction is estimated to begin in April 2019 and will take approximately seventeen months to complete. The City will fund $4,500,000 of the station construction. The District will fund the balance of the project with unrestricted general fund reserves. Public Works Department staff has determined that Alten 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 Alten Construction Inc. in the amount of $9,778,000. Pursuant to the County's Project Labor Agreement (PLA) policy, a PLA is required on this Project. Alten 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 March 12, 2019 Contra Costa Fire Protection District Minutes 196 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 increasing cost due to escalation. AGENDA ATTACHMENTS MINUTES ATTACHMENTS Letter of Support San Pablo March 12, 2019 Contra Costa Fire Protection District Minutes 197 Z0 F- F- Z E: < Z March 11, 2019 CITY.;SAN PABLO City agnew I)irections E-TRANSMITTAUREGULAR MAIL The Honorable John Gioia, Chair Contra Costa County Board of Supervisors / Contra Costa County Fire Protection District Board of Directors 651 Pine Street. Room 107 Martinez, CA 94553 RE LETTER OF SUPPORT FOR COUNTY BOS/CONFIRE DISTRICT BOARD OF DIRECTORS AGENDAITEM D.6 - CONSTRUCTION CONTRACT FOR THE NEW FIRE STATION 70 AT 1800 23RD STREET, SAN PABLO Dear County BOS/CCCFPD Board of Directors On behalf of the City of San Pablo City Council, lurge your fullsunoort on agenda item D.6 scheduled for your review and approval at your next regular CCCFPD Board of Directors meeting scheduled on Tuesday, March 12, 2019. BACKGROUND First, lwould like to commend CCCFPD (District) Fire Chief Jeff Carmen. and his project management team, in working collaboratively with City of San Pablo officials to bring this critically-needed public safety essentialfacility improvement to the City of San Pablo. As you know. this project is long overduelsince 1993, the District has provided criticalfire protection and basic/advanced life support (BLS/ALS) medical services in an aging, temporary FS #70 facility, consisting of outdated, and non-compliant modular structures for over 25 years. Therefore. it was imperative that this new FS#70 project be constructed to permanently replace this aging/temporary facility with a new, essential public safety facility for District lire personnelto meet increased service demands and delivery of tire protection and BLA/ALS medicalsupport services in San Pablo, and the surrounding West County Service Area. With the demise of the former Doctor's MedicalCenter in 2015, FS #70 continues to play a criticaland vitalrole in providing these criticalemergency response services throughout the West County region. CITY COUNCIL APPROVAL AND FUNDING ALLOCATED On January 20, 2015, the San Pablo City Councilunanimously adopted Resolution No. #2015-016 to direct the City Manager to execute a 5-year agreement with the District to establish a new EMS Squad Unit at County Fire Station #70 in San Pablo. This 5-year agreement provides a totalof $6.6M in City funds over a 5-year period toward sustaining these criticaIBLS/ALS medicalservices in San Pablo, funded in perpetuity by localvoters through the City's Measure K Sales Tax Measure adopted in June 2012, along with an 13831 San Pablo Avenue, Building I e San Pablo, CA 94806 Main: 5 10-215-3000 e Fax: 5 10-620-0204 www.SanPabloCA.govMarch 12, 2019 Contra Costa Fire Protection District Minutes 198 Contra Costa County Board of Supervisors/ CCCFPD Board of Directors March 11. 2019 Re: County BOS/CCCFPD BOD Agenda Item D.6 Page 2 annualcontribution from the City's adopted 4-year QuadrenniaIGeneraIFund Operating Budget. Additionally, following execution of the 5-year EMS agreement, the City Council also adopted a Memorandum of Understanding (MOU) on June 19. 2017 via Resolution #No. 2017-129 which formalized the City's funding commitment on the proposed construction of a new and permanent FS#70 facility on City--owned land located at 1800 23rd St.,in San Pablo. On Monday. March 4, 2019, the City Councilreceived a finalproject presentation of the FS#70 project from District Staff, and officially appropriated a maximum totalof $4.5M (or 40% of the project cost) in one-time capitalfunds toward the FS#70 project is accordance with the adopted MOU as part of the City Council's Feasibility Review Action which was unanimously approved by the San Pablo City Council via Resolution #2019-030 (See Attachment). Based on our recent history of City funding and support of FS#70 in San Pablo, we urge your immediate approvalof this proposed construction contract for this project. In closing, the City is very fortunate for the inter-agency collaboration and partnership between the City of San Pablo and the County/District in bringing this project to fruition. Moreover. we appreciate County Supervisor John Gioia for his continued support of this project in San Pablo. located within District #l boundaries. Following your favorable review. the City urges your approvalof the recommended lowest and responsive construction bid of $9,778,000 to construct the new FS#70 project with Aren Construction, Inc. as recommended by District staff under Agenda Item D.6 per the posted March 12, 2019 County BOS/District Board agenda. Any questions regarding this matter. Rodriguez at (510) 215-3016, or email: please contact San Pablo City Manager Matt attrGD$ [1pgbloca:gov. Thank you for your time and consideration Sincerely Rich Kinneyl '0 City of San Pablo Attachment:City of San Pablo City CounciIResolution #2019-030 cc County Supervisor BOS Offices David Twa, Contra Costa County CAO San Pablo Councilmembers San Pablo City Manager Matt Rodriguez San Pablo City Attorney Lynn Tracy Nerland Jim Parrott, City Fire Services consultant March 12, 2019 Contra Costa Fire Protection District Minutes 199 RESOLUTION 2019-030 RESOLUTION OF THE CI'lY COUNCIL OF THE CITY OF SAN PABLO DETERMINING THE FIRE STATION 70 CONSTRUCTION PROJECT FEASIBLE UNDER THE MEMORANDUM OF UNDERSTANDING DATED JUNE 19. 2017 BY AND BETWEEN THE CONTRA COSTA COUN'fY FIRE PROTECTION DISTRICT AND THE CITY OF SAN PABLO AND APPROPRIATING $4.5 MILLION FROM GENERAL FUND DESIGNATED RESERVES - FIRE/EMS SERVICES FS#70 TO ACCOUNT CODE IOO-111044000 WHEREAS, the City has long partnered with the Contra Costa County Fire Protection District (the "District") to provide fire and emergency medical services ('EMS') for the City; WHEREAS, Fire Station 70 crews had been operating out of a "temporary" modular building for many years, and with the addition of an EMS Squad. they no longer have adequate living spaced WHEREAS, both the City and the District desire to construct a new Fire Station 70 ("New Station 70") in the City with sufficient capacity to house the EMS Squad and other District personneland apparatusl WHEREAS, on June 19. 2017, the City entered into a Memorandum of Understating ("MOU") with the District for the funding and construction of the New Station 70 on City-owned land located at 1800 23'd St. ("1800 23rd Street")I WHEREAS. the City willacquire the current Fire Station 70 located at 13928 San Pablo Avenue ("Existing Station 70 Property") from the District in exchange for 1800 23rd Street where the District willconstruct the New Fire Station 70; WHEREAS, the City will contribute forty percent (40%) of the District's cost of constructing the New Station 70 ("New Station 70"), up to a maximum of $4.5 million; WHEREAS, if the District no longer provides fire or emergency medicalservices within the boundaries of the City, or decides to sellthe New Station 70, the City will have the right of first offer to purchase the New Station 70 for 40% of the fair market value determined by an independent appraised WHEREAS, the District willbe responsible for the design and construction of the New Station 70. Moreover, the District is also tasked to determine the feasibility of the project including CEQA compliance, environmental review, title review, project specifications, project budget, verification of bids and overallproject feasibilityl Resolution 2019-030 Page 1 March 12, 2019 Contra Costa Fire Protection District Minutes 200 WHEREAS. on February 12, 2019 determining the Project to be feasible; the City received a letter from the District WHEREAS, the District has completed its due diligence on its lowest bidder and intends to award the construction contract at the County Board of Supervisors ('BOS") meeting on March 12, 20191 WHEREAS, at the same meeting determination required under the MOU; the BOS willalso make its feasibility WHEREAS. the total Project cost is $13,000.000 and the contribution willbe$4,500,0001 City's financial WHEREAS, the proposed resolution will find the Project feasible and authorize the City Manager to execute necessary documents and carry out the City's obligations under the MOU; and WHEREAS. the proposed resolution also appropriates $4.5 million from General Fund Designated Resewes - Fire/EMS Services FS#70 to the Special Department Expenses account in the City Councilbudget (100-1110-44000). NOW, THEREFORE, the City Councilof the City of San Pablo does hereby resolve as follows: Section 1. Recitals. The Recitals set forth above are true and correct and incorporated herein. Sec11e112. Determining the New Fire StatiQILZO Construction Proiect.to be Feasible. The City Council hereby determines the New Fire Station 70 Project to be feasible in accordance with the terms set forth in the MOU and confirms the contribution of $4.5 million to the project. SsQ11Qn.3. Citv Manager Authorization. The City Council hereby authorizes the City Manager to execute documents and take such other actions as are necessary to carry out and implement the obligations of the City under the MOU, and. with the consent of the City Attorney, to approve minor. non-monetary amendments to the documents. Section 4. Appropriation of Funds. The City Council hereby authorizes the appropriation of $4.5 million from General Fund Designated Reserves - Fire/EMS Services FS #70 (100-0000-00000) to account code 100-1110-44000 in the City Council budget to fund the City's obligations under the MOU. Resolution 2019-030 Page 2 March 12, 2019 Contra Costa Fire Protection District Minutes 201 PASSED AND ADOPTED this 4th day of March, 2019 by the following vote AYES: COUNCILMEMBERS: Pineda. Xavier. Pabon-Alvarado. Cruz and KinneyNOES: COUNCILMEMBERS: None ABSENT: COUNCILMEMBERS: None ABSTAIN: COUNCILMEMBERS: None ATTEST: APPROVED: Patricia Ponce, City Clerk Rich Kinn ayo Resolution 2019-030 Page 3 March 12, 2019 Contra Costa Fire Protection District Minutes 202 RECOMMENDATION(S): APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a contract amendment with American Medical Response West (AMR), effective April 1, 2019, to revise the payment provisions and update Exhibit D (Ambulance Unit Hour Rates) in the Service Plan with no change to original term or payment limit, for emergency ambulance services. FISCAL IMPACT: The contractual unit hour rate increase is theoretically cost neutral. The District's ambulance service rates will increase by 3.0%, but only a fraction of amounts billed are actually collected by the District. That fraction (the collection realization rate) is multiplied by the 3.0% CPI increase to determine AMR's ambulance unit hour rate increase. AMR then collects 100% of ambulance unit hours invoiced to the District. Factors that impact future transport collections include transport volume, services provide (e.g., mileage and oxygen), payer mix, payment caps, and potential changes to the Affordable Care Act and other relevant legislation. The increase is 100% funded out of the CCCFPD EMS Transport Fund. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover, Director ABSENT:Diane Burgis, Director Contact: Terence Carey, Assistant Chief - EMS (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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: D. 7 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 12, 2019 Contra Costa County Subject:Contract Amendment with American Medical Response West (AMR) March 12, 2019 Contra Costa Fire Protection District Minutes 203 BACKGROUND: Effective January 1, 2016, the Contra Costa County Fire Protection District (District) became the exclusive operator of emergency ambulance service within Exclusive Operating Areas 1, 2, and 5 in Contra Costa County. The District contracts with American Medical Response West (AMR) for actual ambulance unit hours. The ambulance unit hour rates are specified in Exhibit D to the Service Plan of the Contract between the District and AMR. The modifications to the AMR contract are as follows: Exhibit D (Ambulance Unit Hour Rates) is replaced with a new Exhibit D reflecting new Ambulance Unit Hour Rates effective April 1, 2019. This is a contractual unit hour rate increase pursuant to Service Plan Section P.2. (Ambulance Unit Hourly Rate Adjustments). The Contract between the District and the Contra Costa County Emergency Medical Services Agency (CCCEMSA) allows the District to request an ambulance service rate increase after the first twelve (12) month of service. The District's increase is based on changes in the Consumer Price Index, All Urban Consumers for Medical Care (U.S. city average) (1982-4=100) ("CPI"). The District's annual rate increase is the greater of three percent (3%) or the increase in the CPI for the subject calendar year. The CPI for calendar year 2018 was 2.0%; therefore, the District has requested a 3.0% increase in its Ambulance Services Rate Schedule to be effective April 12, 2019. To determine AMR's contractual unit hour rate increase, 0.030 (or 3.0%) is multiplied by the collection realization percentage for calendar year 2017. The District's 2017 collection realization percentage is 0.2326 (or 23.26%). This results in a unit hour rate increase for AMR of 0.006978 (or .6978%). CONSEQUENCE OF NEGATIVE ACTION: AMR is contractually entitled to a CPI-related unit hour rate increase on April 1, 2019. ATTACHMENTS Unit Hour Rate Worksheet Exhibit D Ambulance Unit Hours Rates March 12, 2019 Contra Costa Fire Protection District Minutes 204 Ambulance Unit Hours per Week AMR Unit Hour Rates Eff 4-1-18 CPI Factor Contractual Unit Hour Rates Eff 4-1-19 4,501 - 4,668 147.70 1.006978 148.73 4,669 - 4,836 144.22 1.006978 145.23 4,837 - 5,004 140.96 1.006978 141.94 5,005 - 5,172 137.94 1.006978 138.90 5,173 - 5,340 135.11 1.006978 136.05 5,341 - 5,508 134.06 1.006978 135.00 5,509 - 5,676 133.07 1.006978 134.00 5,677 - 5,844 132.14 1.006978 133.06 5,845 and over 131.26 1.006978 132.18 Note: CPI Factor = 1 + (0.03 x .2326) = 1.006978 Rate Increase Worksheet March 12, 2019 Contra Costa Fire Protection District Minutes 205 Initials: Contractor District Form L-3 (Page 55 of 55) SERVICE PLAN (Purchase of Services - Long Form) Exhibit D Ambulance Unit Hours Rates Ambulance Unit Hours Per Week Ambulance Unit Hour Rate 4,501 - 4,668 $ 148.73 4,669 - 4,836 $ 145.23 4,837 - 5,004 $ 141.94 5,005 - 5,172 $ 138.90 5,173 - 5,340 $ 136.05 5,341 - 5,508 $ 135.00 5,509 - 5,676 $ 134.00 5,677 - 5,844 $ 133.06 5,845 and over $ 132.18 March 12, 2019 Contra Costa Fire Protection District Minutes 206 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: 03/12/2019 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover, Director ABSENT:Diane Burgis, 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 12, 2019 , County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: D. 8 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 12, 2019 Contra Costa County Subject:Fire Chief's Report - March 12, 2019 March 12, 2019 Contra Costa Fire Protection District Minutes 207 ATTACHMENTS Fire Chief's March Report March 12, 2019 Contra Costa Fire Protection District Minutes 208 March 12, 2019 TO: Board of Directors FROM: Jeff Carman, Fire Chief RE: Fire Chief’s Report ______________________________________________________________________  Fire Station 16 (Lafayette): Interior finishes will begin pending final framing inspection. All windows have been installed. The exterior finishes are also underway with stucco and stone veneer. The emergency generator has been delivered and placed on the pad. As soon as weather permits, the concrete and asphalt will be laid in the driveway. We are on track for an April completion. Final utility tie ins (water, sewer, gas and electric) are either complete or scheduled. We will plan a ribbon cutting ceremony as the final completion date becomes clear.  Fire Station 70 (San Pablo): The San Pablo City Council will consider an item to approve the feasibility and commitment of $4.5 million to the project on March 5. The March 12 Fire Board agenda includes an item to award the construction bid. The District will potentially issue a notice to proceed with construction in April. Pending completion of construction contracts, we will have a kick off meeting with the project team. There will be a highly visible groundbreaking ceremony in the coming months.  Fire Station 9 (Pacheco): We continue to meet with airport staff on the potential site layout. We are early in the CEQA process, and our goal is to have CEQA completed and architectural drawings approved by the end of 2019. We are working with Capital Projects to pre-qualify bidders in spring of 2019.  Fire Station 86 (Bay Point): The site layout is complete and the CEQA process is in progress. The District has been meeting with neighboring property owners and sharing the site plans. We will be presenting to the Bay Point Municipal Advisory Council in May 2019. Our goal is to have CEQA complete and architectural drawings approved by the end of 2019. We are working with Capital Projects to prequalify bidders in spring of 2019  Academy 52 graduated on February 14 which added 24 new firefighters to the District. These recruits will fill existing vacancies and allow us to place Engine 16 into service in Lafayette. Academy 53 began on February 19 with 20 recruits and will graduate in late spring/early summer 2019. The District saw the need to hold back- to-back academies this year in order to keep vacancies to a minimum as we head into another wildland fire season. The District is striving for a minimal number of March 12, 2019 Contra Costa Fire Protection District Minutes 209 vacancies as we enter the 2019 wildland fire season. We are also planning for Academy 54 which will begin on or about October 1, 2019.  As we presented at our last Board meeting, the District met last week with a team from East Contra Costa Fire to discuss ways to reduce their dependency on ConFire and try to reduce the disparity between the aid we provide and the aid we receive. There were a number of recommendations discussed, and each team is studying the proposals to determine their value and any potential consequences. A more comprehensive report on these changes will be presented to our Board at the next meeting.  The Fire District has been working for several years to try and reinvigorate our Reserve Program. Many years ago, our reserve program was strong, and many of our reserves graduated from the program to become firefighters with ConFire. A number of those firefighters promoted through the ranks and have retired. We hope to re-strengthen the program to provide career development opportunities for those who want to become firefighters and provide an added level of service to the Briones community.  Congratulations to Captain and Local 1230 President Vince Wells for being sworn in as the 4th District Vice President of the California Professional Firefighters (CPF). This accomplishment follows his award as Labor Representative of the Year in 2018. Captain Wells also has the distinction of being the first African-American person to be elected to the CPF executive board. March 12, 2019 Contra Costa Fire Protection District Minutes 210 RECOMMENDATION(S): ACCEPT a report from the Fire Chief providing a summary of Contra Costa County Fire Protection District accomplishments over the last five years. FISCAL IMPACT: No fiscal impact. BACKGROUND: On the occasion of his retirement, after five-and-a-half years of service as Fire Chief of Contra Costa County Fire Protection District, Chief Carman will review the District's accomplishments over the course of the last five years. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover, Director ABSENT:Diane Burgis, 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: D. 9 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 12, 2019 Contra Costa County Subject:Fire Chief's Look Back on Five Years of District Accomplishments March 12, 2019 Contra Costa Fire Protection District Minutes 211 ATTACHMENTS Look Back Over Five Years March 12, 2019 Contra Costa Fire Protection District Minutes 212 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS LOOK BACK ON FIVE YEARS OF DISTRICT ACCOMPLISHMENTS FIRE CHIEF JEFF CARMAN Service •Leadership •Teamwork •Safety and Preparedness •Professionalism •Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 213 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS Contra Costa Fire Officials Prepare For Station Closures 2013 --A DISTRICT CHALLENGED BY FIVE YEARS OF RECESSION Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity CONFIRE Issues Service Reduction and Fire Station Closure Plan CONFIRE Set to Discuss Station 87 Closure with Public CONFIRE to Host Community Meetings for Station Shut-Downs CONFIRE Issues Service Reduction and Fire Station Closure Plan Cash-Strapped CoCo County Fire Departments Weigh Ballot Options, Station Closures March 12, 2019 Contra Costa Fire Protection District Minutes 214 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 215 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 216 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 217 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity Structure Fires 696 Vegetation Fires 354 Other 1,859 Medical Calls 33,507 Vehicle Accidents 2,028 Rescues 704 Medical Alarm… Fire Alarms 2,922 Other 4,659 2018 Fire and EMS Incidents by Type 2018 Alliance Stats Total EMS Incidents (Fire & Ambulance 76,387 Total Ambulance-Only Incidents 42,296 Total Ambulances Dispatched 94,836 Total Ambulance Transports 74,704 0 50000 100000 150000 2016 2017 2018 Growing Demand for Fire, EMS and Ambulance Services Total Fire & EMS Ambulance-Only Incidents Total Incidents Responded Comm center calls March 12, 2019 Contra Costa Fire Protection District Minutes 218 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 219 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS Service • Leadership • Teamwork • Safety and Preparedness • Professionalism • Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 220 CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT FIRE • RESCUE • EMS LOOK BACK ON FIVE YEARS OF DISTRICT ACCOMPLISHMENT FIRE CHIEF JEFF CARMAN Service •Leadership •Teamwork •Safety and Preparedness •Professionalism •Integrity March 12, 2019 Contra Costa Fire Protection District Minutes 221 RECOMMENDATION(S): ADOPT Resolution No. 2019/63, which supersedes Resolution No. 2017/392, regarding compensation and benefits for unrepresented fire safety management classifications in the Contra Costa County Fire Protection District. FISCAL IMPACT: The fiscal impact is dependent upon the specific educational background of the Fire Chief. The maximum pre-pension cost of the benefits is under $1,500 per month. This will not be an increased cost, as most employees (including the newly appointed Fire Chief) will have received these benefits prior to promoting into the Fire Chief position. BACKGROUND: Effective April 1, 2019, the Management Resolution for the Contra Costa County Fire Protection District has been modified in the following ways: 1. Modify Section 20. Fire Management Educational Allowance Program. Modified the section to add the classification of Fire Chief-Contra Costa (RPA1) to those eligible for the differentials, modified the language pertaining to eligibility for allowances for the Fire Chief will be approved by the APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover, Director ABSENT:Diane Burgis, Director Contact: Lisa Driscoll, County Finance Director, (925) 335-1023 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: Dianne Dinsmore, Human Resources Director, Robert Campbell, Auditor-Controller D.10 To:Contra Costa County Fire Protection District Board of Directors From:David Twa, County Administrator Date:March 12, 2019 Contra Costa County Subject:Contra Costa County Fire Management Resolution No. 2019/63, which Supercedes Resolution No. 2017/392 March 12, 2019 Contra Costa Fire Protection District Minutes 222 BACKGROUND: (CONT'D) > County Administrator’s Office. The affect will be that the Fire Chief may be eligible for educational differentials listed in Section 20, if approved by the County Administrator’s Office. 2. Eliminate Section 28. Modified Personal Holiday Credit Maximum. Previous to this change the Fire Chief was allowed a maximum accrual of twenty-four hours (24 hours). This change makes the Fire Chief eligible for the same accruals as all other management employees (40 hours). CONSEQUENCE OF NEGATIVE ACTION: Benefits for the District Fire Chief will be significantly different than for other unrepresented management employees', potentially making it more difficult to attract and retain candidates for promotion. AGENDA ATTACHMENTS Resolution 2019/63 Body of Resolution 2019-63 MINUTES ATTACHMENTS Signed Resolution No. 2019/63 March 12, 2019 Contra Costa Fire Protection District Minutes 223 THE BOARD OF DIRECTORS OF THE CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT Adopted this Resolution on 03/12/2019 by the following vote: AYE:4 John Gioia Candace Andersen Karen Mitchoff Federal D. Glover NO: ABSENT:1 Diane Burgis ABSTAIN: RECUSE: Resolution No. 2019/63 In the Matter Of: Compensation and Benefits for Contra Costa County Fire Protection District Unrepresented Fire Safety Management Employees The Contra Costa County Board of Supervisors acting solely in its capacity as the governing board of the Contra Costa County Fire Protection District RESOLVES THAT: Effective April 1, 2019 and continuing, and until further Order of the Board, the Board adopts the attached program of compensation and benefits for Contra Costa County Fire Protection District Unrepresented Safety Management employees in the classifications listed below. Except for Section 3 of Resolution No. 2002/615, this Resolution supersedes all previous resolutions providing compensation and benefits for the employees in classifications listed below, including but not limited to Resolution No. 2017/392. Assistant Fire Chief-Exempt (RPB1) Assistant Fire Chief-Group 1 (RPBA) Deputy Fire Chief-Exempt (RPB2) Fire Marshal (RJGA) Fire Chief-Contra Costa (RPA1) Supervising Fire Inspector (RJHC) Unless expressly provided otherwise, this Resolution is subject to the provisions of appropriate Administrative and Personnel Bulletins, the 1937 County Employees Retirement Act, the County Salary Regulations, and the County Personnel Management Regulations. Unrepresented safety management employees include employees in classified, exempt, and project classifications. This Resolution is organized in two parts to distinguish those general Fire District benefits provided to unrepresented safety management employees (Part I) and those benefits provided exclusively to the Fire Chief (Part II). Unless otherwise expressly provided, compensation and benefits under this Resolution are authorized only for permanent and project employees who work full time or part time, no less than twenty (20) hours per week. The full text of this Resolution is attached. Contact: Lisa Driscoll, County Finance Director, (925) 335-1023 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: Dianne Dinsmore, Human Resources Director, Robert Campbell, Auditor-Controller March 12, 2019 Contra Costa Fire Protection District Minutes 224 March 12, 2019 Contra Costa Fire Protection District Minutes 225 i RESOLUTION NO. 2019/63 TABLE OF CONTENTS Resolution No. 2019/63 I. BENEFITS FOR UNREPRESENTED SAFETY MANAGEMENT EMPLOYEES 1. Leaves With and Without Pay 1.10 Holidays (list of holidays observed by the District) 1.11 Definitions 1.12 Holidays 1.13 Holidays - Flexible Work Schedules 1.14 Holidays - Part-Time Employees 1.15 No Overtime Pay, Holiday Pay, or Comp Time 1.16 Personal Holiday Credit 1.17 Vacation 1.18 Sick Leave 1.19 Part-Time Employees 1.20 Family Care Leave 1.21 Leave Without Pay-Use of Accruals 2. Health and Dental Benefits 2.A. Health Plans 2.10 Health Plan Coverages 2.11 Contra Costa Health Plan (CCHP) 2.12 Health Plan Monthly Premium Subsidy 2.13 Retirement Coverage 2.14 Premium Payments 2.B. Dental and Life Insurance Plans 2.15 Dental Program 2.16 Dental Plan Premium Subsidy 2.17 Retirement Coverage 2.18 Life Insurance Benefit Under Health and Dental Plans 2.19 Supplemental Life Insurance 2.20 Premium Payments 2.21 Family Member Eligibility Criteria March 12, 2019 Contra Costa Fire Protection District Minutes 226 ii RESOLUTION NO. 2019/63 2.C. General Provisions 2.22 Extended Coverage 2.23 Rate Information 2.24 Dual Coverage 2.25 Catastrophic Leave Program 2.26 Health Care Spending Account 2.27 PERS Long-Term Care 2.28 Dependent Care Assistance Program 2.29 Premium Conversion Plan 2.30 Prevailing Section 2.31 Voluntary Vision Plan 3. Transportation Expense 3.10 Mileage Reimbursement 3.11 Commuter Benefit Program 4. Retirement Benefits 4.10 Contribution 4.11 Safety Employees Retirement- Tier A- Employees who Became Safety Members of CCCERA before January 1, 2013 4.12 Employees with More Than 30 Years of Continuous Service as Safety Members 4.13 Safety Employees Retirement- Safety PEPRA Tier- Employees who Become Safety Members of CCCERA on or after January 1, 2013 5. 415H2 Participation 6. Training 6.10 Career Development Training Reimbursement 6.11 Management Development Policy 7. Bilingual Pay Differential 8. Higher Pay for Work in a Higher Classification 9. Other Terms and Conditions of Employment 9.10 Overtime Exempt Exclusion 9.11 Overtime 9.12 Length of Service Credits March 12, 2019 Contra Costa Fire Protection District Minutes 227 iii RESOLUTION NO. 2019/63 9.13 Mirror Classifications 9.14 Deep Classes 9.15 Administrative Provisions 10. Management Longevity Pay 11. Deferred Compensation 12. Annual Management Administrative Leave 13. Management Life Insurance 14. Vacation Buy Back 15. Professional Development Reimbursement 16. Sick Leave Incentive Plan 17. Video Display Terminal (VDT) Users Eye Examination 18. Long-Term Disability Insurance 19. Uniform Allowance 20. Fire Management Educational Allowance Program 21. Fire Services Emergency Recall and Standby Differential 22. Executive Professional Development Reimbursement II. BENEFITS FOR FIRE CHIEF 23. Automobile 24. Executive Life Insurance 25. Fire Management Educational Reimbursement 26. No Fire Services Emergency Recall and Standby Differential 27. No Vacation Buy Back March 12, 2019 Contra Costa Fire Protection District Minutes 228 1 of 22 RESOLUTION NO. 2019/63 I. BENEFITS FOR UNREPRESENTED SAFETY MANAGEMENT EMPLOYEES IN THE CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT 1. Leaves With and Without Pay 1.10 Holidays: The District will observe the following holidays during the term covered by this Resolution: New Year’s Day Labor Day Martin Luther King Jr. Day Veteran’s Day Washington’s Birthday Thanksgiving Day Memorial Day Day after Thanksgiving Independence Day Christmas Day Such other days as the Board of Supervisors may designate by Resolution as holidays. Any holiday observed by the District that falls on a Saturday is observed on the preceding Friday and any holiday that falls on a Sunday is observed on the following Monday. 1.11 Definitions: Regular Work Schedule: The regular work schedule is eight (8) hours per day, Monday through Friday, inclusive, for a total of forty (40) hours per week. Flexible Work Schedule: A flexible work schedule is any schedule that is not a regular, alternate, 9/80, or 4/10 work schedule and where the employee is not scheduled to work more than 40 hours in a “workweek” as defined below. Workweek for Employees on Regular and Flexible Work Schedules: For employees on regular and flexible work schedules, the workweek begins at 12:01a.m. on Monday and ends at twelve midnight on Sunday. 1.12 Holidays Observed: Employees on regular and flexible work schedules are entitled to observe a holiday (day off work), without a reduction in pay, whenever a holiday is observed by the District. 1.13 Holidays – Flexible Work Schedules: When a holiday falls on the regularly scheduled day off of any employee who is on a flexible work schedule, the employee is entitled to take the day off, without a reduction in pay, in recognition of the holiday. These employees are entitled to request another day off within the same work week in recognition of their regularly March 12, 2019 Contra Costa Fire Protection District Minutes 229 2 of 22 RESOLUTION NO. 2019/63 scheduled day off. The requested day off must be within the same work week as the holiday and it must be pre-approved by the employee’s supervisor. If the day off is not approved by the supervisor, it is lost. If the approved day off is a nine (9) hour workday, the employee must use one (1) hour of non-sick-leave accruals. If the approved day off is a ten (10) hour workday, the employee must use two (2) hours of non-sick-leave accruals. If the employee does not have any non-sick-leave accrual balances, leave without pay (AWOP) will be authorized. 1.14 Holidays – Part-Time Employees: Permanent, part-time employees are entitled to observe a holiday (day off work) in the same ratio as the number of hours in the part-time employee’s schedule bears to forty (40) hours. 1.15 No Overtime Pay, Holiday Pay, or Comp Time: Employees are not entitled to receive overtime pay, holiday pay, overtime compensatory time, or holiday compensatory time. Employees who are unable or not permitted to observe a holiday (take the day off), are authorized to receive overtime pay ONLY IF the employee is on the Overtime Exempt Exclusion List (see Section 9.10). 1.16 Personal Holiday Credit: Employees are entitled to accrue two (2) hours of personal holiday credit each month. This time is prorated for part-time employees. No employee may accrue more than forty (40) hours of personal holiday credit. On separation from District service, employees are paid for any unused personal holiday credits at the employee’s then current rate of pay, up to a maximum of forty (40) hours. 1.17 Vacation: Employees are entitled to accrue paid vacation credit not to exceed the maximum cumulative hours as follows: Monthly Maximum Accrual Cumulative Length of Service Hours Hours Under 11 years 10 240 11 years 10-2/3 256 12 years 11-1/3 272 13 years 12 288 14 years 12-2/3 304 15 through 19 years 13-1/3 320 20 through 24 years 16-2/3 400 25 through 29 years 20 480 30 years and up 23-1/3 560 March 12, 2019 Contra Costa Fire Protection District Minutes 230 3 of 22 RESOLUTION NO. 2019/63 Each employee is eligible to accrue increased vacation hours on the first day of the month following the employee’s Service Award Date. An employee’s Service Award Date is the first day of his/her temporary, provisional, or permanent appointment to a position in the County. If an employee is first appointed to a temporary or provisional position and then later appointed to a permanent position, the Service Award Date for that employee is the date of the first day of the temporary or provisional appointment. 1.18 Sick Leave: Employees are entitled to accrue paid sick leave credit in accordance with the provisions of the County Salary Regulations and District Personnel Bulletin No. 21 (Sick Leave Policy) adopted on August 10, 1995, as periodically amended. 1.19 Part-Time Employees: Part-time employees are entitled to accrue paid vacation and sick leave credit on a pro-rata basis. 1.20 Family Care Leave: The provisions of Section 1006.3 of the Contra Costa County Personnel Management Regulations and Resolution No. 94/416, as amended, relating to Leaves of Absence and Family Care Medical Leave apply to all employees covered by this Resolution. 1.21 Leave Without Pay - Use of Accruals: The provisions of Section 1006.6 of the Contra Costa County Personnel Management Regulations, as amended, relating to use of accruals while on leave without pay, apply to all employees covered by this Resolution. 2. Health, Dental and Related Benefits 2.A. Health Plans 2.10 Health Plan Coverages: Group health benefits through the California Public Employees’ Retirement System (CalPERS) are provided for all permanent full-time employees. The CalPERS health care program, as regulated by the Public Employees’ Medical and Hospital Care Act (PEMHCA), regulations issued pursuant to PEMHCA and the administration of PEMHCA by CalPERS, controls on all health plan issues, including but not limited to eligibility, benefit levels, benefit plans, minimum premium subsidies, and costs. 2.11 Contra Costa Health Plan (CCHP): Because CCHP has met the minimum standards required under PEMHCA and is approved as an alternative CalPERS plan option, employees and COBRA counterparts may elect to March 12, 2019 Contra Costa Fire Protection District Minutes 231 4 of 22 RESOLUTION NO. 2019/63 enroll in CCHP under the CalPERS plan rules and regulations. 2.12 Health Plan Monthly Premium Subsidy: The District’s subsidies to the CalPERS monthly health plan premiums are as provided below. The employee must pay any Health Plan premium costs that are greater than the District’s subsidies identified below. a. Health Plan Premium Subsidy: 1. District Premium Subsidy through November 30, 2015. Beginning on January 1, 2010, and through November 30, 2015, the amount of the District premium subsidy that is paid for employees and eligible family members is a set dollar amount and is not a percentage of the premium charged by the plan. The District will pay the CalPERS statutory minimum employer monthly health plan premium subsidy or the following monthly health plan premium subsidy, whichever is greater: Employee/Retiree/Survivor Only $478.69 Employee/Retiree/Survivor & One Dependent $957.38 Employee/Retiree/Survivor & Two or more Dependents $1228.67 2. District Premium Subsidy through November 30, 2016. For the plan year that begins on January 1, 2016, the District will contribute up to an amount equivalent to eighty percent (80%) of the 2016 CalPERS Kaiser premium at each level (employee only, employee + 1, employee + 2 or more) towards the covered employee’s CalPERS or CalPERS Alternative Plan (CCHP) premium. 3. District Premium Subsidy On and After December 1, 2016. For the plan year that begins on January 1, 2017, the District will pay a monthly premium subsidy for each health plan that is equal to the actual dollar monthly premium subsidy that is paid by the District for that plan as of November 30, 2016. In addition, if there is an increase in the monthly premium charged by a health plan for 2017, the District and the employee will each pay fifty percent (50%) of that increase. For each plan year thereafter, and for each plan, the District and the employee will each pay fifty percent (50%) of the monthly premium increase above the 2016 plan premiums. b. In the event that the District premium subsidy amounts are greater than one hundred percent (100%) of the applicable premium of any health or dental plan, for any plan year, the District’s subsidy will not exceed one hundred percent (100%) of the applicable plan premium. 2.13 Retirement Coverage: Government Code section 22892 applies to all employees covered by this Resolution. March 12, 2019 Contra Costa Fire Protection District Minutes 232 5 of 22 RESOLUTION NO. 2019/63 2.14 Premium Payments: Employee participation in any health plan is contingent upon the employee authorizing payroll deduction by the District of the employee’s share of the premium cost. If an employee’s compensation in any month (including during a leave of absence) is not sufficient to pay the employee share of the premium, the employee must pay the difference to the Auditor-Controller. The responsibility for this payment rests solely with the employee. 2.B. Dental and Life Insurance Plans 2.15 Dental Program: Every permanent employee may participate in any available County Group Dental Plan. The District may change dental plan providers at any time during the term of this resolution. 2.16 Dental Plan Premium Subsidy: The dental plan premium subsidies set forth below are provided only for permanent full-time employees and permanent part-time employees regularly scheduled to work at least twenty (20) hours per week. The employee will pay any dental plan costs that are greater than the District’s premium subsidies set forth below. a. Beginning on January 1, 2010, and for each calendar year thereafter, the amount of the District premium subsidy that is paid for employees and eligible family members is a set dollar amount and is not a percentage of the premium charged by the dental plan. The District will pay the following monthly dental plan premium subsidies: Delta Dental with CCHP A or B: Single: $41.17 Family: $93.00 Delta Dental with any CalPERS health plan Single: $34.02 Family: $76.77 Delta Dental without a health plan Single: $43.35 Family: $97.81 DeltaCare (PMI) with CCHP A or B Single: $25.41 Family: $54.91 DeltaCare (PMI) with any CalPERS health plan Single: $21.31 March 12, 2019 Contra Costa Fire Protection District Minutes 233 6 of 22 RESOLUTION NO. 2019/63 Family: $46.05 DeltaCare (PMI) without a health plan Single: $27.31 Family: $59.03 b. If the District contracts with another dental plan, the District will determine the monthly dollar premium subsidy that it will pay to that dental plan for employees and their eligible family members. c. In the event that the District premium subsidy amounts are greater than one hundred percent (100%) of the applicable premium of any dental plan, for any plan year, the District’s contribution will not exceed one hundred percent (100%) of the applicable plan premium. 2.17 Retirement Coverage: a. Upon Retirement: 1. Upon retirement and for the term of this resolution, employees and their eligible family members may remain in their District dental plan, but without District-paid life insurance coverage, if immediately before their proposed retirement the employees and dependents are either active subscribers to one of the District contracted dental plans, or if while on authorized leave of absence without pay, they have retained continuous coverage during the leave period. The District will pay the dental plan monthly premium subsidies set forth in Section 2.16, subsection a., for eligible retirees and their eligible family members. 2. For employees hired on or after January 1, 2009 and their eligible family members, no monthly premium subsidy will be paid by the District for any dental plan after they separate from District employment. Upon completion of fifteen (15) years of service as an employee of the District, an employee who retires under the Contra Costa County Employees’ Retirement Association (“CCCERA”) may retain continuous coverage of any District dental plan, provided that (I) he or she begins to receive a monthly retirement allowance from CCCERA within 120 days of separation from District employment and (ii) he or she pays the full premium cost under the chosen dental plan without any District premium subsidy. For purposes of retiree dental eligibility, one year of service is defined as one thousand (1,000) hours worked within one District anniversary year. 3. For purposes of this section 2.17 only, “eligible family members” does not include Survivors of employees or retirees. March 12, 2019 Contra Costa Fire Protection District Minutes 234 7 of 22 RESOLUTION NO. 2019/63 2.18 Life Insurance Benefit Under Health and Dental Plans: For employees who are enrolled in a District sponsored health or dental plan as either the primary insured or a dependent, term life insurance in the amount of ten thousand dollars ($10,000) will be provided by the District. 2.19 Supplemental Life Insurance: In addition to the life insurance benefits provided by this resolution, employees may subscribe voluntarily and at their own expense for supplemental life insurance. Employees may subscribe for an amount not to exceed five hundred thousand dollars ($500,000), of which one hundred thousand dollars ($100,000) is a guaranteed issue, provided the election is made within the required enrollment periods. 2.20 Premium Payments: Employee participation in any dental or life insurance plan is contingent upon the employee authorizing payroll deduction by the District of the employee’s share of the premium cost. The District’s subsidy to the dental and life insurance premium is payable monthly. If an employee’s compensation in any month (including during a leave of absence) is not sufficient to pay the employee share of the premium, the employee must pay the difference to the Auditor-Controller. The responsibility for this payment rests solely with the employee. 2.21 Family Member Eligibility Criteria: The following persons may be enrolled as the eligible Family Members of a dental plan Subscriber: 1. Eligible Dependents: a. Employee’s legal spouse b. Employee’s qualified domestic partner c. Employee’s unmarried child who is: (1) under age 19; or (2) Age 19 or above, but under age 24; and who I. Resides with the employee for more than 50% of the year, excluding time living at school; and, ii. Receives at least 50% of support from employee; and iii. Is enrolled and attends school on a full-time basis, as defined by the school. d. Employee’s disabled child who is over age 19, unmarried, and incapable of sustaining employment due to a physical or mental disability that existed prior to the child’s attainment of age 19. March 12, 2019 Contra Costa Fire Protection District Minutes 235 8 of 22 RESOLUTION NO. 2019/63 2. “Employee’s child” includes natural child, step-child, adopted child, child of a qualified domestic partner, and a child specified in a Qualified Medical Child Support Order (QMCSO) or similar court order. 2.C. General Provisions 2.22 Extended Coverage: a. An employee on approved leave without pay for more than thirty (30) days may continue his/her health/dental/life insurance coverage provided that the employee pays his/her share of the monthly premium during said leave. b. An employee who separates from District employment is covered by his/her District health and/or dental plan through the last day of the month in which he/she separates. Employees who separate from District employment may continue Group health and/or dental plan coverage to the extent provided by the COBRA laws and regulations. 2.23 Rate Information: The County-Benefits Service Unit will make dental plan rate information and, to the extent possible, CalPERS health plan rate information available to employees and departments, upon request. In addition, the County Benefits Service Unit will publish and distribute to employees and departments information about rate changes as they occur during the year. 2.24 Dual Coverage: a. Each employee and retiree may be covered only by a single District health (or dental) plan, including a CalPERS plan. For example, a District employee may be covered under a single District health and/or dental plan as either the primary insured or the dependent of another District employee or retiree, but not as both the primary insured and the dependent of another District employee or retiree. b. All dependents may be covered by the health and/or dental plan of only one spouse or one domestic partner. For example, when both husband and wife are District employees, all of their eligible children may be covered as dependents of either the husband or the wife, but not both. c. For purposes of Section 2.24, only, “District” includes the County of Contra Costa, the Contra Costa County Fire Protection District, and all other special districts governed by the Board of Supervisors. March 12, 2019 Contra Costa Fire Protection District Minutes 236 9 of 22 RESOLUTION NO. 2019/63 2.25 Catastrophic Leave Program: All employees are included in the District’s Program and may designate a portion of their accrued vacation, administrative leave or personal holiday credit to be deducted from existing balances and credited to a specific eligible employee. To utilize this program, all recipient requests must be submitted to the Fire Chief for review and recommendation to the County Administrator. The County Administrator will make final decision as to approval or denial of the request to use accruals in the Catastrophic Leave Bank. 2.26 Health Care Spending Account: After six (6) months of permanent employment, employees may elect to participate in a Health Care Spending Account (HCSA) Program designated to qualify for tax savings under Section 125 of the Internal Revenue Code, but such savings are not guaranteed. The HCSA Program allows employees to set aside a pre- determined amount of money from their pay, before taxes, for health care expenses not reimbursed by any other health benefit plan. HCSA dollars can be expended on any eligible medical expenses allowed by Internal Revenue Code Section 125. Any unused balance is forfeited and cannot be recovered by the employee. 2.27 PERS Long-Term Care: The District will deduct and remit monthly premiums to the PERS Long-Term Care Administrator for employees who are eligible and voluntarily elect to purchase long-term care at their personal expense through the PERS Long-Term Care Program. 2.28 Dependent Care Assistance Program: The District will continue to offer the option of enrolling in a Dependent Care Assistance Program (DCAP) designed to qualify for tax savings under Section 129 of the Internal Revenue Code, but tax savings are not guaranteed. The program allows employees to set aside up to five thousand dollars ($5,000) of annual salary (before taxes) per calendar year to pay for eligible dependent care (child and elder care) expenses. Any unused balance is forfeited and cannot be recovered by the employee. 2.29 Premium Conversion Plan: The District will continue to offer a Premium Conversion Plan (PCP) designed to qualify for tax savings under Section 125 of the Internal Revenue Code, but tax savings are not guaranteed. The program allows employees to use pre-tax dollars to pay health and dental premiums. 2.30 Prevailing Section: To the extent that any provision of this Section (Section 2. Health, Dental and Related Benefits) is inconsistent with any provision of any other District or County enactment or policy, including Administrative Bulletins, County Salary Regulations, and County Personnel Management Regulations, or any other resolution or order of March 12, 2019 Contra Costa Fire Protection District Minutes 237 10 of 22 RESOLUTION NO. 2019/63 the Board of Supervisors, acting in any of its various capacities including as the Governing Board of the Contra Costa County Fire Protection District, the provisions of this Section (Section 2. Health, Dental and Related Benefits) will prevail. 2.31 Voluntary Vision Plan: Beginning no earlier than the 2018 plan year, active permanent full-time and active permanent part-time employees will be offered the opportunity to enroll in a voluntary vision plan. Employees will pay the full premium costs of the plan. The District will contract with a provider for a voluntary vision plan with no co-pays. The vision plan is not available to temporary or permanent intermittent employees. 3. Transportation Expense 3.10 Mileage Reimbursement: The District will pay a mileage allowance for the use of personal vehicles on District business at the rate allowed by the Internal Revenue Service (IRS) as a tax deductible expense, adjusted to reflect changes in this rate on the date it becomes effective or the first of the month following announcement of the changed rate by the IRS, whichever is later. 3.11 Commuter Benefit Program: The District will offer employees the option of enrolling in an employee-funded qualified transportation (commuter) benefit program designed to qualify for tax savings under section 132 (f) of the Internal Revenue Code, but such savings are not guaranteed. The Commuter Benefit Program will allow employees to set aside pre-tax dollars for qualified transportation expenses to the extent and amount allowed by the Internal Revenue Service. 4. Retirement Benefits 4.10 Contribution. Employees are responsible for the payment of one hundred percent (100%) of the employees’ basic retirement benefit contribution determined annually by the Board of Retirement of the Contra Costa County Employees’ Retirement Association, without the District paying any part of the employees’ share. Employees are also responsible for payment of the employees’ contribution for the retirement cost-of-living program as determined annually by the Board of Retirement, without the District paying any part of the employees’ contribution. 4.11 Safety Employees Retirement- Tier A- Employees Who Became Safety Members of CCCERA Before January 1, 2013. The retirement formula of “3 percent at 50" applies to all employees who became Safety members of the Contra Costa County Employees Retirement Association (CCCERA) on or before December 31, 2012. The cost-of-living adjustment (COLA) to March 12, 2019 Contra Costa Fire Protection District Minutes 238 11 of 22 RESOLUTION NO. 2019/63 the retirement allowances of these employees will not exceed three percent (3%) per year. The final compensation of these employees will be based on a twelve (12) consecutive month salary average. This retirement benefit will be known as Safety Tier A. a. Until December 1, 2017, each employee will pay nine percent (9%) of his/her retirement base to pay part of the employer’s contribution for the cost of Safety Tier A retirement benefits. b. For the period of December 1, 2017, through and including June 30, 2018, each employee in Tier A will pay six percent (6%) of his/her retirement base to pay part of the employer’s contribution for the cost of Safety Tier A retirement benefits. c. For the period of July 1, 2018, through and including June 30, 2019, each employee will pay three percent (3%) of his/her retirement base to pay part of the employer’s contribution for the cost of Safety Tier A retirement benefits. d. Effective on July 1, 2019, each employee’s payment of three percent (3%) of his/her retirement base to pay part of the employer’s contribution for the cost of Safety Tier A retirement benefits will cease. e. “Retirement base” means base salary and other payments, such as salary differential and flat rate pay allowances, used to compute retirement deductions. 4.12 Employees with More Than 30 Years of Continuous Service as Safety Members- Tier A. Beginning on January 1, 2008 and pursuant to Government Code section 31664.1, current and future employees in classifications that are governed by this Resolution and designated by the Contra Costa County Employees’ Retirement Association as safety members with credit for more than thirty (30) years of continuous service as safety members, will not make payments from their retirement base to pay part of the employer’s contribution towards the cost of Safety Tier A. 4.13 Safety Employees Retirement- Safety PEPRA Tier- Employees Who Become Safety Members of CCCERA on or after January 1, 2013. a. For employees who become Safety members of the Contra Costa County Employees Retirement Association (CCCERA) on or after January 1, 2013, retirement benefits are governed by the California Public Employees Pension Reform Act of 2013 (PEPRA) (Chapters 296 and 297, Statutes of 2012) and PEPRA Safety Option Plan Two (2.7% @ 57) applies. To the extent that this resolution conflicts with any provision of PEPRA, PEPRA governs. March 12, 2019 Contra Costa Fire Protection District Minutes 239 12 of 22 RESOLUTION NO. 2019/63 b. For employees who, under PEPRA, become Safety New members of CCCERA on or after January 1, 2016, the cost of living adjustment to the retirement allowance will not exceed two percent (2%) per year, and the cost of living adjustment will be banked. c. Sections 4.11 and 4.12, above, apply to employees who, under PEPRA, become reciprocal Safety Members of CCCERA in Tier A, as determined by CCCERA. 5. 414H2 Participation The District will continue to implement Section 414(h) (2) of the Internal Revenue Code which allows the Auditor-Controller to reduce the gross monthly pay of employees by an amount equal to the employee’s total contribution to the County Retirement System before Federal and State income taxes are withheld, and forward that amount to the Retirement System. This program of deferred retirement contribution is universal and non-voluntary. 6. Training 6.10 Career Development Training Reimbursement: All full-time employees are eligible for career development training reimbursement not to exceed seven hundred fifty dollars ($750) per fiscal year. The reimbursement of training expenses includes books and is governed by any Administrative Bulletins on Travel or Training. 6.11 Management Development Policy: Employees are authorized to attend professional training programs, seminars, and workshops, during normal work hours at the discretion of their Fire Chief, for the purpose of developing knowledge, skills, and abilities, in the areas of supervision, management, and County/District policies and procedures. Up to thirty (30) hours of such training time is recommended annually. a. The District is encouraged to provide for professional development training exceeding thirty (30) hours annually for people newly promoted to positions of direct supervision. b. Priority is given to professional training programs offered through the County Training Institute. Other related and appropriate training/education resources approved by the District are also allowable. c. To encourage personal and professional growth, the District provides reimbursement for certain expenses incurred by employees for job-related training (required training and career development training/education). Provision for eligibility and reimbursement identified in Administrative March 12, 2019 Contra Costa Fire Protection District Minutes 240 13 of 22 RESOLUTION NO. 2019/63 Bulletin 112.9. d. The Fire Chief is responsible for authorization of individual professional development reimbursement requests. Reimbursement is through the regular demand process with demands being accompanied by proof of payment (copy of invoice or canceled check). 7. Bilingual Pay Differential: A monthly salary differential will be paid to incumbents of positions requiring bilingual proficiency as designated by the Fire Chief and the Contra Costa County Director of Human Resources. The differential will be prorated for employees working less than full time and/or on an unpaid leave of absence during any given month. The differential is one hundred dollars ($100.00) per month. The designation of positions for which bilingual proficiency is required is the sole prerogative of the District/County, and such designations may be amended or deleted at any time. 8. Higher Pay for Work in a Higher Classification: The County Salary Regulations notwithstanding, when an employee is required to work in a higher paid classification, the employee will receive the higher compensation for such work, pursuant to the County Salary Regulations, plus any differentials and incentives the employee would have received in his/her regular position. Unless the Board has by Resolution otherwise specified, the higher pay entitlement will begin on the 41st consecutive hour in the assignment. 9. Other Terms and Conditions of Employment: 9.10 Overtime Exempt Exclusion: Employees in unrepresented classifications are overtime exempt and are not eligible for overtime pay, holiday pay, overtime compensatory time, or holiday compensatory time. Instead, these employees are awarded Annual Management Administrative Leave in recognition of the extra burden their job responsibilities may sometimes place on their work schedules. However, unrepresented employees may be made eligible for overtime pay if their names are placed on the Overtime Exempt Exclusion List by the County Administrator’s Office. Employees on the Overtime Exempt Exclusion List are authorized to receive overtime pay only. These employees are NOT eligible for holiday pay, overtime compensatory time, or holiday compensatory time. Employees on the Overtime Exempt Exclusion List are also NOT eligible for Annual Management Administrative Leave for the quarter they are on the Overtime Exempt Exclusion List. The policies and procedures for the March 12, 2019 Contra Costa Fire Protection District Minutes 241 14 of 22 RESOLUTION NO. 2019/63 Overtime Exempt Exclusion List are set forth in the County Administrator’s memo of November 6, 2002. 9.11 Overtime: Employees on the Overtime Exempt Exclusion List will be compensated at one and one-half (1.5) times their base rate of pay (excluding differentials) for authorized work exceeding eight (8) hours in a day or forty (40) hours in a week. 9.12 Length of Service Credits: Length of service credit will date from the beginning of the last period of continuous County/District employment, including temporary, provisional and permanent status and absences on an approved leave of absence; except that when an employee separates from a permanent position in good standing and is subsequently re- employed in a permanent County/District position within two (2) years from date of separation, the period of separation will be bridged. Under these circumstances, the service credits will include all credits accumulated at time of separation but will not include the period of separation. The service credits of an employee are determined from employee status records maintained by the Human Resources Department. 9.13 Mirror Classifications: As determined by the Director of Human Resources, employees in unrepresented job classifications that mirror management, represented or unrepresented job classifications may receive the salary and fringe benefits that are received by employees in the comparable mirror classifications. 9.14 Deep Classes: No provision of this Resolution regarding terms and conditions of employment supersedes any provision in any Deep Class Resolution. 9.15 Administrative Provisions: The County Administrator may establish guidelines, bulletins or directives as necessary to further define or implement the provisions of this resolution. 10. Management Longevity Pay 10.10 Ten Years of Service: Employees who have completed ten (10) years of service for the District are eligible to receive a two and one-half percent (2.5%) longevity differential effective on the first day of the month following the month in which the employee qualifies for the ten (10) year service award. 10.11 Fifteen Years of Service: Employees who have completed fifteen (15) years of service for the District are eligible to receive an additional two and one-half percent (2.5%) longevity differential effective on the first day of March 12, 2019 Contra Costa Fire Protection District Minutes 242 15 of 22 RESOLUTION NO. 2019/63 the month following the month in which the employee qualifies for the fifteen (15) year service award. For employees who completed fifteen (15) years of service on or before January 1, 2008, this longevity differential will be paid prospectively only from January 1, 2008. 11. Deferred Compensation A. Deferred Compensation Incentive. The District will contribute eighty-five dollars ($85) per month to each employee who participates in the County’s Deferred Compensation Plan. To be eligible for this incentive, the employee must contribute to the deferred compensation plan as indicated below: Monthly Contribution Employees with Qualifying Base Required to Maintain Current Monthly Contribution Incentive Program Salary of: Amount Eligibility $2,500 and below $250 $50 $2,501 - 3,334 $500 $50 $3,335 - 4,167 $750 $50 $4,168 - 5,000 $1,000 $50 $5,001 - 5,834 $1,500 $100 $5,835 - 6,667 $2,000 $100 $6,668 and above $2,500 $100 Employees who discontinue contributions or who contribute less than the required amount per month for a period of one (1) month or more will no longer be eligible for the eighty five dollar ($85) District supplement. To reestablish eligibility, employees must again make a Base Contribution Amount as set forth above based on current monthly salary. Employees with a break in deferred compensation contributions either because of an approved medical leave or an approved financial hardship withdrawal will not be required to reestablish eligibility. Further, employees who lose eligibility due to displacement by layoff, but maintain contributions at the required level and are later employed in an eligible position, will not be required to reestablish eligibility. B. Eligibility for Loan Program. All employees are eligible to apply for loans from the Contra Costa County Deferred Compensation Plan loan program established by the Board of Supervisors on June 26, 2012, by Resolution No. 2012/298. 12. Annual Management Administrative Leave March 12, 2019 Contra Costa Fire Protection District Minutes 243 16 of 22 RESOLUTION NO. 2019/63 a. On January 1st of each year, full-time employees will be credited with ninety four (94) hours of paid Management Administrative Leave. This time is non-accruable and all balances will be zeroed out on December 31 of each year. b. Permanent part-time employees are eligible for Management Administrative Leave on a prorated basis, based upon their position hours. Permanent-intermittent employees are not eligible for Management Administrative Leave. c. Employees appointed (hired or promoted) to unrepresented management positions are eligible for Management Administrative Leave on the first day of the month following their appointment date and will receive Management Administrative Leave on a prorated basis for that first year. d. Employees on the Overtime Exempt Exclusion List are authorized to receive overtime pay; therefore, their Management Administrative Leave will be reduced by twenty-five percent (25%) each time the employee is on the List. The twenty-five percent (25%) reduction will be deducted from the employee’s current leave balance, but if there is no balance, it will be deducted from future awarded Annual Management Administrative Leave. 13. Management Life Insurance Employees are covered at District expense by term life insurance in the amount of fifty seven thousand dollars ($57,000) in addition to the insurance provided under Section 2.18. 14. Vacation Buy Back A. For Employees Hired Before October 1, 2011: Until close of business on September 30, 2011, employees hired before October 1, 2011, may elect payment of up to one-third (1/3) of their annual vacation accrual, subject to the following conditions: (1) the choice can be made only once in each calendar year; (2) payment is based on an hourly rate determined by dividing the employee’s monthly salary by 173.33; and (3) the maximum number of vacation hours that may be paid in any calendar year is one-third (1/3) of the annual accrual. On and after October 1, 2011, employees hired before October 1, 2011, may elect payment of up to one-third (1/3) of their annual vacation accrual, subject to the following conditions: (1) the choice can be made only once every thirteen (13) months and there must be at least 12 full months between each election; (2) payment is based on an hourly rate determined by dividing the March 12, 2019 Contra Costa Fire Protection District Minutes 244 17 of 22 RESOLUTION NO. 2019/63 employee’s monthly salary by 173.33; and (3) the maximum number of vacation hours that may be paid in any one sale is one-third (1/3) of the annual accrual. Where a lump-sum payment is made to employees as a retroactive general salary adjustment for a portion of a calendar year that is subsequent to the exercise by an employee of the vacation buy-back provision herein, that employee’s vacation buy-back will be adjusted to reflect the percentage difference in base pay rates upon which the lump-sum payment was computed, provided that the period covered by the lump-sum payment includes the effective date of the vacation buy-back. B. For Employees Hired On and After October 1, 2011: Employees hired on and after October 1, 2011, may not elect payment of their vacation accruals, unless the employee was eligible for a Vacation Buy Back benefit before being promoted into any classification covered by this Resolution. 15. Professional Development Reimbursement With the exceptions of the Fire Chief, Assistant Chief(s), and Deputy Fire Chief, employees are eligible for reimbursement of up to six hundred twenty- five dollars ($625) for calendar year 2008 and for each two (2) year period thereafter, for memberships in professional organizations, subscriptions to professional publications, attendance fees at job-related professional development activities, and purchase of job-related computer hardware and software (excludes automation connectivity, support, or subscription fees) from a standardized County-approved list or with Fire Chief approval, provided each employee complies with the provisions of the County’s Computer Use and Security Policy adopted by the Board of Supervisors and manuals. In order to receive reimbursement, the employee must have been in an eligible classification when the expense was incurred. Individual professional development reimbursement requests must be approved by the Fire Chief. Reimbursement will occur through the regular demand process with demands being accompanied by proof of payment (copy of invoice or canceled check). 16. Sick Leave Incentive Plan Employees may be eligible for a payoff of a part of unused sick leave accruals at separation. This program is an incentive for employees to safeguard sick leave accruals as protection against wage loss due to time lost for injury or illness. Payoff must be approved by the Director of Human Resources, and is March 12, 2019 Contra Costa Fire Protection District Minutes 245 18 of 22 RESOLUTION NO. 2019/63 subject to the following conditions: a. The employee must have resigned in good standing. b. Payout is not available if the employee is eligible to retire. c. The balance of sick leave at resignation must be at least seventy percent (70%) of accruals earned in the preceding continuous period of employment, excluding any sick leave use covered by the Family and Medical Leave Act, the California Family Rights Act, or the California Pregnancy Disability Act. d. Payout is by the following schedule: Years of Payment Continuous Service Payment of Unused Sick Leave Payable 3 – 5 years 30% 5 – 7 years 40% 7 plus years 50% e. No payoff will be made pursuant to this section unless the Contra Costa County Employees’ Retirement Association has certified that an employee requesting a sick leave payoff has terminated membership in, and has withdrawn his or her contributions from, the Retirement Association. f. It is the intent of the Board of Supervisors that payments pursuant to this section preclude County retirement benefits resulting from employment by this County/District governed by the Board. 17. Video Display Terminal (VDT) Users Eye Examination Employees are eligible to receive an annual eye examination on District time and at District expense provided that the employee regularly uses a video display terminal at least an average of two (2) hours per day as certified by the Fire District. Employees certified for examination under this program must make their request through the Benefits Service Unit of the County Human Resources Department. Should prescription VDT eyeglasses be prescribed for the employee following the examination, the District agrees to provide, at no cost, basic VDT eyewear consisting of a fifty dollar ($50) frame and single, bifocal or trifocal lenses. Employees may, through individual arrangement between the employee and the employee’s doctor and solely at the employee’s expense, include blended lenses and other care, services or materials not covered by the Plan. March 12, 2019 Contra Costa Fire Protection District Minutes 246 19 of 22 RESOLUTION NO. 2019/63 18. Long-Term Disability Insurance The County will continue in force the Long-Term Disability Insurance program with a replacement limit of eighty-five (85%) of total monthly base earnings reduced by any deductible benefits. 19. Uniform Allowance Effective October 1, 2015, the monthly uniform allowance for all employees in classes for which a uniform is required shall be fifty-four dollars and fifty cents ($54.50) per month. 20. Fire Management Educational Allowance Program Employees in the specified Fire District management classifications who possess the certificates or educational degrees set forth below and/or meet the continuing educational requirements set forth below, are eligible for professional development educational allowances under the conditions set forth below. This program is intended to encourage the professional development of eligible Fire District Management personnel. Only the following classifications are eligible to participate in this educational allowance program: Fire Chief- Contra Costa (RPA1) Assistant Fire Chief–Exempt (RPB1) Deputy Fire Chief- Exempt (RPB2) Fire Marshal (RJGA) Supervising Fire Inspector (RJHC) Only the following job-related certificates and degrees are eligible for this program: a. A Certificate of Achievement in Fire Technology, Business Administration, Management and Supervision, or a related field from an accredited college. b. An Associated of Arts or Science Degree from an accredited college with a major in Fire Technology, Business Administration, Management and Supervision, or a related field. c. A Chief Officer Certificate issued by the Office of the State Fire Marshal. d. A Baccalaureate Degree from an accredited college or university with a major in Business, Public Administration, or a related field. March 12, 2019 Contra Costa Fire Protection District Minutes 247 20 of 22 RESOLUTION NO. 2019/63 All allowances will be designated as either temporary or permanent and will be awarded in increments of two and one-half percent (2.5%) times the employee’s base rate of pay. The combined temporary and permanent educational allowances awarded to any employee may not exceed seven and one-half percent (7.5%) times the employee’s base rate of pay. The following conditions must be satisfied in order to earn the designated allowance: Temporary Allowance A temporary allowance of two and one-half percent (2.5%) times the employee’s base rate of pay may be awarded for annually completing at least forty (40) hours of pre-approved education or training or at least three (3) pre- approved college semester units (or equivalent quarter units), or a pre- approved combination thereof, in pursuit of any one of the certificates or degrees set forth in options (a) through (d) above or as pre-approved by the Fire Chief. A temporary allowance is effective for a period of only twelve (12) months, commencing on the first day of the month after proof of completion of course work is received and approved by the Fire Chief or designee. Temporary allowances automatically terminate at the end of month twelve (12). A temporary allowance of two and one-half percent (2.5%) times the employee’s base rate of payment may be awarded to the Fire Chief for annually completing the above conditions, except that verification of eligibility must be approved by the County Administrator or designee. Permanent Allowances A permanent allowance of two and one-half percent (2.5%) times the employee’s base rate of pay may be awarded for possession of one (1) of the certificates or degrees set forth in options (a) through (d) above. Only one (1) two and one-half percent (2.5%) permanent allowance is available within this category. In the alternative, a permanent allowance of five percent (5%) may be awarded for possession of those certificates or degrees in the following combinations only: (1) options (b) and (c) or (2) options (a) and (d). An employee receiving the five percent (5%) permanent allowance may not also receive the two and one-half percent (2.5%) permanent allowance. This program is subject to appropriate administrative guidelines and controls promulgated by the Fire Chief and approved by the Director of Human March 12, 2019 Contra Costa Fire Protection District Minutes 248 21 of 22 RESOLUTION NO. 2019/63 Resources to ensure that the standards set forth herein are met. Verification of an employee’s eligibility must be by the Fire Chief or designee. A permanent allowance of two and one-half percent (2.5%) times the employee’s base rate of pay or the alternative five percent (5%) times the employee’s base rate of pay may be awarded to the Fire Chief subject to the same conditions described above for a permanent allowance, except that the Fire Chief’s eligibility must be approved by the County Administrator or designee. Payment of any of the allowances set forth herein begins on the first day of the month following the month in which: a) the Fire Chief verifies the employee’s eligibility for that allowance, or b) the County Administrator or designee verifies the Fire Chief’s eligibility for that allowance. 21. Fire Services Emergency Recall and Standby Differential Effective through December 31, 2017, each employee assigned to standby and emergency recall duty for a minimum of two (2) weeks each month is eligible for a salary differential in the amount of five percent (5%) times the employee’s base rate of pay. Each employee assigned to standby and emergency recall duty for one (1) week in each four (4) consecutive week period is eligible to receive a differential in the amount of two and one-half percent (2.5%) times the employee’s base rate of pay. Effective January 1, 2018, each employee assigned to standby and emergency recall duty for a minimum of ten (10) days each month is eligible for a salary differential of five percent (5%) times the employee’s base rate of pay. 22. Executive Professional Development Reimbursement In lieu of the benefits provided in Section 15, the Fire Chief, Assistant Chief(s), and Deputy Fire Chief are eligible for reimbursement of up to nine hundred twenty-five dollars ($925) for calendar year 2008 and for each two (2) year period thereafter, for memberships in professional organizations, subscriptions to professional organizations, subscriptions to professional publications, attendance fees at job-related professional development activities, and purchase of job-related computer hardware and software (excludes automation connectivity, support, or subscription fees) from a standardized County-approved list or with Fire Chief approval, provided each employee complies with the provisions of the County’s Computer Use and Security Policy adopted by the Board of Supervisors and manuals. In order to receive reimbursement, the employee must have been in an eligible classification when the expense was incurred. March 12, 2019 Contra Costa Fire Protection District Minutes 249 22 of 22 RESOLUTION NO. 2019/63 Individual professional development reimbursement requests must be approved by the Fire Chief. Reimbursement will occur through the regular demand process with demands being accompanied by proof of payment (copy of invoice or cancelled check). Certifications regarding compliance with County’s Computer Use and Security Policy may be required. II. BENEFITS FOR FIRE CHIEF As the Chief Officer of the Fire District and an Appointed Department Head, the Fire Chief receives the benefits provided under Part I, except as modified below: 23. Automobile The District will provide the Fire Chief with an appropriate vehicle. The Fire Chief is not eligible for an Automobile Allowance. 24. Executive Life Insurance In lieu of the insurance provided in Part I, Section 13, the Fire Chief is covered, at District expense, by term life insurance in the amount of sixty thousand dollars ($60,000), additional to the insurance provided under Section 2.18. 25. Fire Management Educational Reimbursement The Fire Chief is entitled to be reimbursed by the District for all Fire Management educational expenses (tuition, fees, books, and the like) incurred by the Fire Chief during his tenure as Fire Chief. 26. No Fire Services Emergency Recall and Standby Differential The Fire Chief is not eligible for the Fire Services Emergency Recall and Standby Differential set forth in Part I, Section 21 of this Resolution. 27. No Vacation Buy Back The Fire Chief is not eligible for the Vacation Buy Back plan set forth in Part I, Section 14 of this Resolution. [end] March 12, 2019 Contra Costa Fire Protection District Minutes 250 RECOMMENDATION(S): APPOINT Lewis T. Broschard III to the position of Fire Chief, Contra Costa County Fire Protection District at Step 5 of the salary range effective April 1, 2019, all other benefits as provided in the Fire Management Resolution (currently Resolution No. 2019/63) applicable to the position of Fire Chief. FISCAL IMPACT: No fiscal impact. The Fire Management Resolution (Resolution No. 2019/63) allows the Fire Chief classification to qualify for specific education differentials effective April 1, 2019. The fiscal impact is dependent upon the specific educational background of the Fire Chief. The maximum pre-pension cost of the benefits is under $1,500 per month. This will not be an increased cost, as most employees (including the proposed candidate for Fire Chief) will have received these benefits prior to promoting into the Fire Chief position. BACKGROUND: Earlier this year, Fire Chief Jeff Carmen announed his retirement effective March 2019. To ensure a seamless transition, the County Administrator is recommending the appointment of Deputy Fire Chief Lewis Broschard III as Fire Chief effective April 1, 2019. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, Director Candace Andersen, Director Karen Mitchoff, Director Federal D. Glover, Director ABSENT:Diane Burgis, Director Contact: Timothy Ewell - (925) 335-1036 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: Dianne Dinsmore, Human Resources Director, Robert Campbell, Auditor-Controller D.11 To:Contra Costa County Fire Protection District Board of Directors From:David Twa, County Administrator Date:March 12, 2019 Contra Costa County Subject:APPOINTMENT OF FIRE CHIEF, CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT - LEWIS BROSCHARD III March 12, 2019 Contra Costa Fire Protection District Minutes 251 BACKGROUND: (CONT'D) Chief Broschard has a fire service career spanning over 25 years working in small and large fire service organizations. His experience includes positions and responsibilities in emergency operations, fire prevention, and executive leadership. He joined Contra Costa County Fire in 2007 as a Fire Inspector and then promoted to Fire Prevention Captain in 2009. In 2010 he was promoted to Fire Marshal; during his tenure the Fire Prevention Bureau created and implemented its strategic plan, was successful in the first Fire Code amendment ordinance to be adopted by all cities served by the District without exceptions, and implemented a cost recovery program that enabled the District to expand fire prevention services and add personnel within the Fire Prevention Bureau during one of the most severe economic downturns. He was promoted to Assistant Fire Chief in 2014 where he was responsible for the Contra Costa Regional Fire Communications Center, Fire Prevention Bureau, Apparatus and Fleet, Information Systems, and Facilities. During this time the District transformed the methods used for procuring fire apparatus and light vehicles in order to create a vehicle replacement program, initiated the Fire Station 16 and Fire Station 70 replacement projects and the District’s solar energy installation project. In late 2015 he was appointed to the newly created Deputy Fire Chief position where he was an integral part of the implementation of the ambulance services contract with Contra Costa County. As the Deputy Fire Chief he is responsible for overseeing the chief officers responsible for Emergency Operations, Fire Prevention, Communications, Emergency Medical Systems, and Support Services. From 2011 to 2013, Chief Broschard served as the President of the Contra Costa County Fire Chiefs Association and he is currently the California OES Fire/Rescue Operational Area Coordinator for Contra Costa County. Chief Broschard holds a BS in Managerial Economics from UC Davis, an MBA from John F. Kennedy University, and he is a CSAC Credentialed County Executive. He has also been certified by the Office of the State Fire Marshal as a Fire Prevention Officer; Fire Officer; and Chief Officer. I am recommending Lewis T. Broschard III be appointed Fire Chief of the Contra Costa County Fire Protection District at Step 5 of the salary range effective April 1, 2019. CONSEQUENCE OF NEGATIVE ACTION: The Fire Chief position will be vacant upon the retirement of the current incumbent. March 12, 2019 Contra Costa Fire Protection District Minutes 252 RECOMMENDATION(S): ADOPT Position Adjustment Resolution No. 22432 to add three (3) Fire Captain-56 Hour (RPTA) (represented) positions at salary plan and grade 4N6 1814 ($7,934-$10,633) and cancel three (3) vacant Firefighter-56 Hour (RPWA) (represented) positions (17674, 17675, and 17676) at salary plan and grade 4N6 1595 ($6,388 - $8,560) in the Contra Costa County Fire Protection District. FISCAL IMPACT: Approval of this action will result in an annual cost increase of approximately $179,316, an estimated $85,210 of which is attributable to increased pension costs. BACKGROUND: The Contra Costa County Fire Protection District (District) added nine (9) Firefighter Recruit positions to its 2018-19 recommended and adopted budget. The eventual purpose of these positions was to staff newly constructed Fire Station 16 in the City of Lafayette. Construction on Fire Station 16 was scheduled to be completed in the fourth quarter of 2018-19. Since the APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 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: Holly Trieu (925) 941-3300 ext. 1301 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: Holly Trieu C.1 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 12, 2019 Contra Costa County Subject:Add Three Fire Captain Positions and Cancel Three Firefighter Positions March 12, 2019 Contra Costa Fire Protection District Minutes 253 BACKGROUND: (CONT'D) District hires new suppression employees in groups (i.e., academies) and fills rank and file positions through promotional assessments, it was necessary to establish the positions as Recruits. The District (and County) has delegated authority (called "flexible staffing") to move positions within certain classifications up and down between ranks without having to do a P300 each time. The District has flexible staffing authority to move positions from Recruit to Firefighter (and Firefighter Paramedic) to Fire Engineer (and the reverse). The District does not, however, have the authority to move a position to the rank of Fire Captain without a P300 (i.e., Board approval). A three-person engine or truck company is staffed very specifically with one Firefighter (or Firefighter Paramedic), one Fire Engineer, and one Fire Captain. Now that the Recruits have finished the fire academy and have moved into Firefighter (or Firefighter Paramedic) positions, the District can fill the vacant Fire Engineer and Fire Captain positions necessary to staff Fire Station 16. This action adds the three Fire Captain positions. Fire Station 16 construction is on schedule and is set to officially open with full engine company staffing in April or May 2019. CONSEQUENCE OF NEGATIVE ACTION: A three-person fire company consists of a Firefighter, a Fire Engineer, and a Fire Captain. They have distinct roles and job duties. If this action is not approved, the District will be unable to staff newly constructed Fire Station 16 in the City of Lafayette. CHILDREN'S IMPACT STATEMENT: Not applicable. AGENDA ATTACHMENTS AIR 36841_P300 22432 Add 3 Capts & Cancel 3 FFs BOS 3.12.19 MINUTES ATTACHMENTS Signed P300 22432 March 12, 2019 Contra Costa Fire Protection District Minutes 254 POSITION ADJUSTMENT REQUEST NO. 22432 DATE 2/4/2019 Department No./ Department CCC Fire Protection District Budget Unit No. 7300 Org No. 7300 Agency No. 70 Action Requested: Add three (3) Fire Captain (RPTA) (represented) positions and cancel three (3) vacant Firefighter (RPWA) (represented) positions (# 17674, #17675, and #17676) in the Contra Costa County Fire Protection District. Proposed Effective Date: 3/13/2019 Classification Questionnaire attached: Yes No / Cost is within Department’s budget: Yes No Total One-Time Costs (non-salary) associated with request: $0.00 Estimated total cost adjustment (salary / benefits / one time): Total annual cost $179,316.00 Net County Cost $0.00 Total this FY $44,829.00 N.C.C. this FY $0.00 SOURCE OF FUNDING TO OFFSET ADJUSTMENT Budgeted; 100% CCCFPD General Operations Fund Department must initiate necessary adjustment and submit to CAO. Use additional sheet for further explanations or comments. Jackie Lorrekovich, Chief, Admin Svcs ______________________________________ (for) Department Head REVIEWED BY CAO AND RELEASED TO HUMAN RESOURCES DEPARTMENT Paul Reyes 2/28/2019 ___________________________________ ________________ Deputy County Administrator Date HUMAN RESOURCES DEPARTMENT RECOMMENDATIONS DATE 2/28/2019 Add three (3) Fire Captain (RPTA) (represented) positions at salary plan and grade 4N6 1814 ($7,934-$10,633) and cancel three (3) vacant Firefighter (RPWA) (represented) positions (17674, 17675, and 17676) at salary plan and grade 4N6 1595 ($6,388 - $8,560) in the Contra Costa County Fire Protection District. Amend Resolution 71/17 establishing positions and resolutions allocating classes to the Basic / Exempt salary schedule. Effective: Day following Board Action. (Date) Amanda Monson 2/28/2019 ___________________________________ ________________ (for) Director of Human Resources Date COUNTY ADMINISTRATOR RECOMMENDATION: DATE Approve Recommendation of Director of Human Resources Disapprove Recommendation of Director of Human Resources Other: ____________________________________________ ___________________________________ (for) County Administrator BOARD OF SUPERVISORS ACTION: David J. Twa, Clerk of the Board of Supervisors Adjustment is APPROVED DISAPPROVED and County Administrator DATE BY APPROVAL OF THIS ADJUSTMENT CONSTITUTES A PERSONNEL / SALARY RESOLUTION AMENDMENT POSITION ADJUSTMENT ACTION TO BE COMPLETED BY HUMAN RESOURCES DEPARTMENT FOLLOWING BOARD ACTION Adjust class(es) / position(s) as follows: P300 (M347) Rev 3/15/01 March 12, 2019 Contra Costa Fire Protection District Minutes 255 REQUEST FOR PROJECT POSITIONS Department Date 2/28/2019 No. xxxxxx 1. Project Positions Requested: 2. Explain Specific Duties of Position(s) 3. Name / Purpose of Project and Funding Source (do not use acronyms i.e. SB40 Project or SDSS Funds) 4. Duration of the Project: Start Date End Date Is funding for a specified period of time (i.e. 2 years) or on a year-to-year basis? Please explain. 5. Project Annual Cost a. Salary & Benefits Costs: b. Support Costs: (services, supplies, equipment, etc.) c . Less revenue or expenditure: d. Net cost to General or other fund: 6. Briefly explain the consequences of not filling the project position(s) in terms of: a. potential future costs d. political implications b. legal implications e. organizational implications c. financial implications 7. Briefly describe the alternative approaches to delivering the services which you have considered. Indicate why these alternatives were not chosen. 8. Departments requesting new project positions must submit an updated cost benefit analysis of each project position at the halfway point of the project duration. This report is to be submitted to the Human Resources Department, which will forward the report to the Board of Supervisors. Indicate the date that your cost / benefit analysis will be submitted 9. How will the project position(s) be filled? a. Competitive examination(s) b. Existing employment list(s) Which one(s)? c. Direct appointment of: 1. Merit System employee who will be placed on leave from current job 2. Non-County employee Provide a justification if filling position(s) by C1 or C2 USE ADDITIONAL PAPER IF NECESSARY March 12, 2019 Contra Costa Fire Protection District Minutes 256 March 12, 2019 Contra Costa Fire Protection District Minutes 257 RECOMMENDATION(S): ADOPT Position Adjustment Resolution No. 22433 to add one (1) Fire Inspector II (RJVB) (represented) position at salary plan and grade 4N5 1793 ($7,771-$10,414) and cancel one (1) vacant Fire Inspector I (RJWJ) (represented) position number 15888 at salary plan and grade 4N5 1528 ($5,975-$8,007) in the Contra Costa County Fire Protection District. FISCAL IMPACT: Approval of this action will result in an annual cost increase of approximately $66,796, an estimated $40,284 of which is attributable to employer pension costs. BACKGROUND: The classification of Fire Inspector II is the safety classification in the Fire Inspector classification series pursuant to the establishment of the general classification of Fire Inspector I. Fire Inspector I was established as an entry level position to perform non-safety related code enforcement, plan review, inspections of non-hazardous occupancies, APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 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: Holly Trieu (925) 941-3300 ext. 1301 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 12, 2019 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: Holly Trieu C.2 To:Contra Costa County Fire Protection District Board of Directors From:Jeff Carman, Chief, Contra Costa County Fire Protection District Date:March 12, 2019 Contra Costa County Subject:Add One Fire Inspector II Position and Cancel One Fire Inspector I Position March 12, 2019 Contra Costa Fire Protection District Minutes 258 BACKGROUND: (CONT'D) public education, and other related duties. Fire Inspector II incumbents perform journey level complex inspection work and enforce fire laws, ordinances and regulations in Group H and other hazardous related occupancies, participate in fire investigation work, and support emergency incident activities. This request is to rebalance the number of Fire Inspector I and Fire Inspector II positions back to eight at each level. Position Adjustment Resolution No. 22335 to cancel a vacant Fire Inspector II position and add a Fire Inspector I position was approved to accommodate a specific and time sensitive recruitment and internal employee reassignment issue. The need for that switch has been resolved and this request is to rebalance the number of Fire Inspector I and Fire Inspector II positions back to the original organizational structure to best serve the needs of the Fire Prevention Bureau in meeting its mandates for required occupancy inspections, completing specific technical work at the Fire Inspector II level, and supporting Fire District operations. Fire Inspector position costs are offset by fees charged for the services they provide. CONSEQUENCE OF NEGATIVE ACTION: If this action is not approved, the District will not have the requisite number of Fire Inspector II positions available to hire journey level experienced individuals into the Fire Prevention Bureau. Certain activities and inspections performed by the Fire Inspector II classification will not be completed. CHILDREN'S IMPACT STATEMENT: Not applicable. AGENDA ATTACHMENTS AIR 36897_P300 22433 Add Inspector II-Cancel Inspector I - BOS 3.12.19 MINUTES ATTACHMENTS Signed P300 22433 March 12, 2019 Contra Costa Fire Protection District Minutes 259 POSITION ADJUSTMENT REQUEST NO. 22433 DATE 2/7/2019 Department No./ Department CCC Fire Protection District Budget Unit No. 7300 Org No. 7300 Agency No. 70 Action Requested: Add one (1) Fire Inspector II (RJVB) (represented) position and cancel one (1) vacant Fire Inspector I (RJWJ) (represented) position 15888 in the Contra Costa County Fire Protection District. Proposed Effective Date: 3/13/2019 Cl assification Questionnaire attached: Yes No / Cost is within Department’s budget: Yes No Total One-Time Costs (non-salary) associated with request: $0.00 Estimated total cost adjustment (salary / benefits / one time): Total annual cost $66,796.00 Net County Cost $0.00 Total this FY $16,699.00 N.C.C. this FY $0.00 SOURCE OF FUNDING TO OFFSET ADJUSTMENT Budgeted; 100% General Operating Fund Revenue Department must initiate necessary adjustment and submit to CAO. Use additional sheet for further explanations or comments. Jackie Lorrekovich, Chief, Admin Svcs ______________________________________ (for) Department Head REVIEWED BY CAO AND RELEASED TO HUMAN RESOURCES DEPARTMENT Paul Reyes 2/28/2019 ___________________________________ ________________ Deputy County Administrator Date HUMAN RESOURCES DEPARTMENT RECOMMENDATIONS DATE 2/28/2019 Add one (1) Fire Inspector II (RJVB) (represented) position at salary plan and grade 4N5 1793 ($7,771-$10,414) and Cancel one (1) vacant Fire Inspector I (RJWJ) (represented) position number 15888 at salary plan and grade 4N5 1528 ($5,975- $8,007) in the Contra Costa County Fire Protection District. Amend Resolution 71/17 establishing positions and resolutions allocating classes to the Basic / Exempt salary schedule. Effective: Day following Board Action. (Date) Amanda Monson 2/28/2019 ___________________________________ ________________ (for) Director of Human Resources Date COUNTY ADMINISTRATOR RECOMMENDATION: DATE Approve Recommendation of Director of Human Resources Disapprove Recommendation of Director of Human Resources Other: ____________________________________________ ___________________________________ (for) County Administrator BOARD OF SUPERVISORS ACTION: David J. Twa, Clerk of the Board of Supervisors Adjustment is APPROVED DISAPPROVED and County Administrator DATE BY APPROVAL OF THIS ADJUSTMENT CONSTITUTES A PERSONNEL / SALARY RESOLUTION AMENDMENT POSITION ADJUSTMENT ACTION TO BE COMPLETED BY HUMAN RESOURCES DEPARTMENT FOLLOWING BOARD ACTION Adjust class(es) / position(s) as follows: P300 (M347) Rev 3/15/01 March 12, 2019 Contra Costa Fire Protection District Minutes 260 REQUEST FOR PROJECT POSITIONS Department Date 2/28/2019 No. xxxxxx 1. Project Positions Requested: 2. Explain Specific Duties of Position(s) 3. Name / Purpose of Project and Funding Source (do not use acronyms i.e. SB40 Project or SDSS Funds) 4. Duration of the Project: Start Date End Date Is funding for a specified period of time (i.e. 2 years) or on a year-to-year basis? Please explain. 5. Project Annual Cost a. Salary & Benefits Costs: b. Support Costs: (services, supplies, equipment, etc.) c . Less revenue or expenditure: d. Net cost to General or other fund: 6. Briefly explain the consequences of not filling the project position(s) in terms of: a. potential future costs d. political implications b. legal implications e. organizational implications c. financial implications 7. Briefly describe the alternative approaches to delivering the services which you have considered. Indicate why these alternatives were not chosen. 8. Departments requesting new project positions must submit an updated cost benefit analysis of each project position at the halfway point of the project duration. This report is to be submitted to the Human Resources Department, which will forward the report to the Board of Supervisors. Indicate the date that your cost / benefit analysis will be submitted 9. How will the project position(s) be filled? a. Competitive examination(s) b. Existing employment list(s) Which one(s)? c. Direct appointment of: 1. Merit System employee who will be placed on leave from current job 2. Non-County employee Provide a justification if filling position(s) by C1 or C2 USE ADDITIONAL PAPER IF NECESSARY March 12, 2019 Contra Costa Fire Protection District Minutes 261 March 12, 2019 Contra Costa Fire Protection District Minutes 262 RECOMMENDATION(S): APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a contract with Life Extension Clinics, Inc., doing business as Life Scan Wellness Centers, in an amount not to exceed $1,500,000, to provide annual medical evaluations for Contra Costa County Fire Protection District personnel for the term April 1, 2019, through March 31, 2023. FISCAL IMPACT: Budgeted; 100% CCCFPD General Operating Fund BACKGROUND: The Contra Costa County Fire Protection District (District) has provided annual medical evaluations for firefighters to ensure that they are medically fit for duty for nearly 20 years. During the past two decades, the assault on North American firefighters’ health and wellness has evolved dramatically. As we, the District, continued our research into how to best protect our most important asset, the firefighters, we found that we needed to take a more proactive approach. The key to reducing the mortality rate of firefighters is continual health and wellness education and providing resources for early detection of disease processes that kill our nations’ first responders at double the rate of the normal population. One of the most effective indicators of the health and wellness of the Districts’ firefighters can be found during a comprehensive medical evaluation. These evaluations include a health risk assessment, a medical history review to determine any health conditions that would prevent, or could be aggravated by, performing the duties of the position, including but not limited to, the ability to carry equipment, wear protective equipment/clothing, APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 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: Robert Lutzow, Safety 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 12, 2019 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 12, 2019 Contra Costa County Subject:Contract for Employee Physical Examinations March 12, 2019 Contra Costa Fire Protection District Minutes 263 and meet the physical and psychological demands of the firefighter position. Firefighters are often the first to arrive at the scene of some of the most disturbing and devastating events that occur in our county. Contra Costa County Fire Protection District is an all hazards emergency response organization and thus, the firefighters we employ can be subjected to a wide range of working conditions on a daily basis. These events can range from responding to incidents involving the death of a child, to homicide, suicide, rape, child abuse, family violence, fatal car accidents and even acts of terrorism. Also, firefighters often enter structurally compromised buildings under hot and smoky conditions while wearing heavy and restrictive clothing and carrying awkward equipment. In recent years, these fires have become more dangerous as they burn at higher temperatures and produce a toxic atmosphere similar to that of a Hazardous Materials incident. Benzene, formaldehyde and hydrogen cyanide are just a few of the chemicals firefighters are exposed to while fighting fire on a daily basis. As more and more toxic materials are used to create the items we have in our homes, the toxic soup firefighters work in will only become more dangerous. These high levels of stress, physical demands and long-term exposure to chemicals and infectious disease can take a toll on the health of firefighters and especially to their cardiovascular system. These intense work environments of high heat, low oxygen, high carbon monoxide and other combustible products often produces a maximum heart response. These and other risks are what account for nearly 50% of fire ground deaths being heart-related,” ( March 12, 2019 Contra Costa Fire Protection District Minutes 264 BACKGROUND: (CONT'D) New England Journal of Medicine, March 07). Cardiovascular, respiratory and thermoregulatory strain on firefighters is profound, increasing the odds of heart attack from 12-126 times while firefighting. Occupational cancer is yet another increasing risk of the job, an analysis of 32 studies published in the Journal of Emergency Medicine in 2006 showed that many cancers were significantly associated with firefighting. These included testicular (highest risk), multiple myeloma (53%), malignant melanoma, non-Hodgkin’s lymphoma (51%), prostate (28%), skin (39%), brain (32%), rectum, pharynx, stomach (22%), colon (21%), and leukemia. The University of Cincinnati conducted a study in 2009 where further research revealed that firefighters developed 10 types of cancers more frequently than any other occupation; the most virulent of these was testicular cancer. Firefighters also face a 53% greater risk of a deadly cancer that attacks bone marrow: multiple myeloma, a cancer that occurs when a firefighter sweats due to the open pores on the skin allowing numerous carcinogens to enter the bloodstream at an alarming rate. In fact, according to the Firefighter Cancer Support Network (FFCSN) Fact Sheet, 61% of firefighter line of duty deaths between 2002 and 2016 were attributed to cancer. Due to the physical nature of their work, firefighters are also at a significant risk for musculoskeletal injury with back injury being the highest reported, followed by upper and lower extremities. In a given year, the IAFF Death and Injury Survey indicates that one out of every five firefighters will die or be injured in the line of duty, thus showing that proper prevention and rehabilitation are essential. That is why the International Associations of Fire Chiefs and International Association of Fire Fighters recommend that a “Fire Service Occupational Physician” monitor their patients long term effects of the working environment, including exposure to chemical and biological agents and disease patterns that may indicate work-related health concerns. Therefore, it would be of the utmost importance for the Contra Costa County Fire Protection District to have this comprehensive NFPA 1582 yearly Medical Exam in conjunction with a Behavioral Health Evaluation, as firefighters are exposed to scenes and situations that are beyond the complexities of reasoning. These exams will be performed by a company that specializes in and has vast knowledge of NFPA 1582 physicals that include the following procedures: Head to toe physical exam (per NFPA 1582), vital signs, skin cancer screening, visual acuity test, hearing exam, breast exam, personal consultation with a review of testing results at physical appointment, recommendations for medical intervention and behavioral modification changes, cardiac assessment to include: echocardiogram, resting EKG, cardiac treadmill stress test, with V02 max calculation, carotid arteries ultrasound, aortic aneurysm ultrasound. Cancer and disease assessment to include: thyroid ultrasound, liver, pancreas, gall bladder, spleen, kidney and bladder ultrasound, pelvic ultrasound for women (external), testicular ultrasound for men. Laboratory blood tests to include: thyroid panel, occult blood screen, PSA for men (prostate cancer marker), CA-125 for women (ovarian cancer marker), lipid panel, diabetes test, pulmonary function test, urinalysis with chem strip, complete blood count (hemoglobin with diff), comprehensive metabolic panel (CMP). OSHA respirator medical clearance, fitness program (NFPA 1582 Guidelines) to include: fitness and agility evaluation, body composition analysis, stretching/flexibility/endurance analysis, nutrition and diet recommendations personal fitness recommendations. Medical clearances to include: OSHA respirator medical clearance, Hep B antibody clearance screening, Hep B Antigen (titer), Hep C screening, and TB test (interferon). While comparing our previous annual physical and a Lifescan physical, it was determined that a Lifescan physical can be performed in a more efficient and comprehensive manner, with an eventual cost savings to the District by reducing long term health care costs. Lifescan will come to a District worksite and perform a comprehensive NFPA 1582 physical and Behavioral Health Evaluation at a rate of nine firefighters a day, allowing firefighter physicals to be completed in a two-month time period rather than the 8-9 month timeline we currently have. Lifescan will deliver the most competent exams available. March 12, 2019 Contra Costa Fire Protection District Minutes 265 CONSEQUENCE OF NEGATIVE ACTION: The District will not be able to increase the efficiency and quality of firefighter annual physical examinations. March 12, 2019 Contra Costa Fire Protection District Minutes 266 RECOMMENDATION(S): ACCEPT the 2018 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 2018 Annual Report of the Advisory Fire Commission. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/12/2019 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 12, 2019 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 12, 2019 Contra Costa County Subject:Advisory Fire Commission 2018 Annual Report to the Board of Directors March 12, 2019 Contra Costa Fire Protection District Minutes 267 ATTACHMENTS 2018 AFC Annual Report March 12, 2019 Contra Costa Fire Protection District Minutes 268 2018 ANNUAL REPORT  CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT ADVISORY FIRE COMMISSION Erel Betser, District I (February – December) Matthew Guichard, District II Edward Haynes, District III, (January – March) Debra Galey, District IV (Vice-Chair) Nat Rojanasathira, District V (Chair) Mike Egan, At Large #1 Richard T. Chapman, At Large #2 (Liaison to the Board of Supervisors) Latonia Ellingberg, Staff Alternates Lisa Bartley (District I / April – September; At-Large / October – December) Walter Fields (District V / June – September; At-Large / October – December) Darran Mazaika (District IV / June – September; At-Large / October – December) March 12, 2019 Contra Costa Fire Protection District Minutes 269 2018 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: 4005 Port Chicago Highway, Concord at 7:00 p.m. Chair: Nat Rojanasathira Staff: Latonia Ellingberg Reporting Period: January through December 2018 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 the 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 Line of Duty Death Memorial Service  Attended Fire Academy #51 Graduation Ceremony  Attended various city council, town hall, and other fire board meetings II. ACCOMPLISHMENTS  Reviewed and provided feedback on the Draft FY 2018/19 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 12, 2019 Contra Costa Fire Protection District Minutes 270  Successfully amended the Bylaws to allow for three At-Large alternate commissioners, any one of whom may replace any seated member regardless of supervisorial district  Attended walkthrough of Fire District’s new administrative offices III. ATTENDANCE/REPRESENTATION  Vacancies: District III  Diversity: Commission consists of a variety of retired and active business professionals/owners including Engineer; Attorney; Management Analyst – City of Brentwood; Administrative Services Director – Town of Danville; retired Security Advisor, former Police Detective, and volunteer Firefighter/EMT with the Graeagle Volunteer Fire Department; retired Fire Captain; Claims Analyst; Paramedic; and Criminal Investigator.  Level of Participation: Regular Mtgs. Betser 3 of 5 Chapman 6 of 6 Egan 5 of 6 Galey 5 of 6 Guichard 6 of 6 Haynes 0 of 1 Rojanasathira 5 of 6 Bartley (Alternate) 4 of 5 Fields (Alternate) 3 of 4 Mazaika (Alternate) 4 of 4  Quorum Frequency: No meetings cancelled due to lack of a quorum. IV. TRAINING/CERTIFICATION  Commissioners Bartley, Betser and Mazaika completed “The Brown Act and Better Government Ordinance – What You Need to Know as a Commission, Board, or Committee Member” and “Ethics Orientation for County Officials.” V. PROPOSED WORK PLAN/OBJECTIVES FOR NEXT YEAR  Continue to work with the Fire Chief on budgetary issues.  Contribute to the development of a weed abatement appeal process.  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. March 12, 2019 Contra Costa Fire Protection District Minutes 271