HomeMy WebLinkAboutMINUTES - 02021993 - 1.25 TO: BOARD OF SUPERVISORS
T O R S
dAk± Contra
FROM: Mark Finucane; Health Services Director
By: Elizabeth A. Spooner, Contracts Administrat Costa
DATE: January 21, 1993 County
SUBJECT: Approve Ambulance Service (Novation) Agreement #23-055-9 with ��
San Ramon Valley Fire Protection District
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
Approve and authorize the Chair, Board of Supervisors, to execute on
behalf of the County, Ambulance Service (Novation) Agreement #23-055-9
with the San Ramon Fire Protection District for the period from 12: 01.
a.m. on January 3 , 1993 through 12 : 00 midnight on January 2, 1994, for
provision of emergency ambulance Services in County's Emergency
Response Area 4. This document includes provision for a four-month
automatic extension through May 2, 1994.
II. FINANCIAL IMPACT:
This is a non-financial agreement. There is no County General Fund
impact.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On June 25, 1991, the Board of Supervisors approved Ambulance Service
Agreement #23-055-8 with San Ramon Valley Fire Protection District to
provide emergency ambulance services in County Emergency Response Area
4 for the period from January 3, 1991 through January 2 , 1993 .
Novation Agreement #23-055-9 replaces the four-month automatic
extension which was included in the prior Agreement and will provide
for continuance of San Ramon Valley Fire Protection District's
emergency ambulance services through January 2, 1994 .
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMZJ A ION OF BOARD CO Mi TEE
APPROVE OTHER C
SIGNATURE(S)
ACTION OF BOARD ON _ _ APPROVED AS RECOMMENDED OTIfER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) 1 HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVIS7 ON THE DATE SHOWN.
Contact: Art Lathrop (646-4690)
CC: Health Services (Contracts) ATTESTED �1
Risk Management Phil Batchelor,Clem of the$ and of
Auditor-Controller Supervisors and County Administrator
Contractor /J
M362/7-83 BY __ DEPUTY
AMBULANCE SERVICE AGREEMENT
(County Dispatched Calls)
(Novation) Number 23-055-9
1. Contract Identification.
Department: Health Services (Office of the Director)
Subject: Emergency Ambulance Services (Emergency Response Area(s) 4 )
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: SAN RAMON VALLEY FIRE PROTECTION DISTRICT
Capacity: County Governmental District
Address: 800 San Ramon Valley Boulevard
Danville, California 94526
Mailing Address: 1500 Bollinger Canyon Road, San Ramon, California . 94583
3. Term. The effective date of this Contract is 12:01 a.m. on January 3. 1993 and it
terminates 12:00 midnight on January 2. 1994, unless sooner terminated as provided herein.
4. County's Obligations. County shall refer to the Contractor those calls for emergency
ambulance service it receives for Emergency Response Area(s) 4 subject to all terms and
conditions contained or incorporated herein.
5. Contractor's Obligations. Contractor shall provide the emergency ambulance 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
and subject to Contractor's proposal for contract, dated July, 1990, on file with County's
Emergency Medical Services Agency and incorporated herein by reference, except that in the
case of any conflicting provisions, the provisions contained in this Service Plan, Special
Conditions, General Conditions, and Exhibits shall prevail.
6. Conditions. This Contract is subject to the General Conditions and Special Conditions
(if any) attached hereto, which are incorporated herein by reference.
7. Pro eet. This Contract implements in part the County's Local Emergency Medical
Services Plan in that it provides for emergency ambulance service.
8. Legal Authority. This Contract is entered into under and subject to the following
legal authorities: Health and Safety Code Sections 1797 et seq. , Government Code Sections
26227 and 31000, County Ordinance Code, Division 48..
9. Signatures. These signatures attest the parties' agreement hereto:
COUNTY OF CONTRA COSTA, CALIFORNIA
ATTEST: Phil Batchelor,- Clerk of the Board
BOARD OF SUPERVISORS of Supervisors and County Administrator
By / By
Chairman/Designee Deputy
CONTRACTOR/CONSULTANT
By1 _ ByXX� �
FIRE CHIEF X
(Official business Capacity) (Official Business Capacity)
Note to Contractor: For corporations (profit or nonprofit), the contract must be signed by two officers. Signature A mast be
that of the president or vice-president and Signature 3 must be that of the secretary or assistant secretary (Civil Code Section
1190 and Corporations Code Section 313). All signatures mist be acknowledged as set forth on page 2.
.Contra Costa County Standard Form 1/87 '
APPROVALS/ACKNOWLEDGEMENT
Number 23-055-9
APPROVALS
RECOMMENDED BY DEPARTMENT FORM APPROVED
By 1 By
Designee
APPROVED: COUNTY ADMINISTRATOR
By
_ a-o�
ACKNOWLEDGEMENT
State of California ACKNOWLEDGEMENT (By Corporation,
Partnership, or Individual)
County of CONTRA COSTA
The person(s) signing above for Contractor, personally known to me in the
individual or business capacity(ies) stated, or proved to me on the basis of
satisfactory evidence to be the stated individual or the representatives) of the
partnership or corporation named above in the capacity(ies) stated, personally
appeared before me today and acknowledged that he/she/they executed it, and
acknowledged to me that the partnership named above executed it or acknowledged
to me that the corporation named above executed it pursuant to its bylaws or a
resolution of its board of directors.
Dated: JANUARY 18, 1993
[Notarial Seal]
;y:.r•. OFFICIAL SEAL
1UDTTHKAY tANIER Nota Public/Deputy outs Clerk
NOTARY PUBLIC CALIFORNIA
CONTRA COSTA COUNTY
MY COMM.EXPIRES DEC.16,1994
K
-2-
-
SERVICE PLAN
Number 23-055-9
I. SERVICE ACTIVITIES.
A. Scope of Service. Contractor shall provide emergency ambulance services, as
requested by the Sheriff's Communications Center or other designated public safety dispatch
center(s) , in County-specified Emergency Response Area(s) 4 , delineated in the current
copy of the map entitled "Emergency Response Areas of. Contra County" , as amended, which is
on file in the office of the Sheriff-Coroner and Clerk of the Board of Supervisors. Such
services shall be provided in accordance with the requirements of Health and Safety Code
Section 1797 et seq. , Division 48 of the Contra Costa County Ordinance Code, and all
regulations promulgated thereunder, which are incorporated herein by reference, and in
accordance with any amendments or revisions thereof. In performing services hereunder,
Contractor shall work cooperatively with County's Health Services Director or his designee,
Art Lathrop (also referred to herein as "Contract Manager") .
B. Services. In consideration of the County's referral to Contractor of Emergency
Ambulance Service requests originating in Emergency Response Area(s) 4 , Contractor shall
perform the following services to the complete satisfaction of the County:
1. Contractor shall provide said emergency ambulance services, without
interruption, 24 hours per day, 7 days per week, 52 weeks per year, for the full term of this
Contract.
2. Contractor shall provide said emergency ambulance services support without
regard to the patient's race, color, national origin, religious affiliation, age, sex, or
ability to pay.
3. The Proposal submitted by Contractor in response to the County Request for
Proposal for Emergency Response Area(s) 4 is on file with :County's Emergency Medical
Services Agency and is incorporated herein by this reference and made a part of this
Contract, except that in the case of any conflicting provisions, the provisions contained in
this Ambulance Service Agreement shall prevail.
II. Performance Standards.
A. Response Time Performance Standards. Contractor's response time on requests for
emergency medical service originating from within the service area shall meet the following
performance standards:
1. Potentially Life Threatening Emergency Response (Code 3) . Each and every
month, Contractor shall respond to ,at least 95% of all potentially life threatening emergency
ambulance requests originating within Emergency Response Area(s) 4 with a maximum response
time of ten (10) minutes in sub-areas designated urban/suburban, and with a maximum response
time of twenty (20) minutes in sub-areas designated as rural as set forth in Exhibit A,
attached hereto and incorporated herein by this reference. A detailed map delineating
urban/suburban -and rural sub-areas and a detailed map description are on file at the
Emergency Medical Services Agency office at 50 Glacier Drive, Martinez, CA. , which documents
are incorporated herein by this reference.
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SERVICE PLAN
Number 23-055-9
2. Non-Life Threatening Emergency Response (Code 21.
Contractor shall respond to all non-life threatening Code 2 emergency ambulance requests
received from a public safety agency with a maximum response time of fifteen (15) minutes in
designated urban/suburban areas and a maximum response time of thirty (30) minutes in
designated rural areas, or shall immediately notify the County dispatch agency if the
response time will exceed the maximums set forth herein.
3. Resgonse Time Calculation. Contractor's response times shall be
calculated on a monthly basis to determine compliance with the 95% standard set forth in
Section II.A.1. , above. Response times are calculated from the time the ambulance unit
receives the request (disconnect time) until the ambulance unit arrives at the nearest public
road access to the scene.
4. Response Time Exceptions. In the monthly calculation of Contractor's
performance in regard to emergency response time standards, every emergency request
originating from within Contractor's assigned Emergency Response Area (ERA[s] ) , shall be
.included except as follows:
a. Upgrades/Downgrades. Emergency responses which have been upgraded,
(i.e. from response Code 2 to response Code 3) or downgraded (i.e. from response Code 3 to
response Code 2) prior to the arrival of the responding ambulance.
b. Standby. When one or more of Contractor's Advanced Life Support
(ALS) ambulance units have been placed on stand-by status not including the first one hour
of stand-by, provided, however, that Contractor gave prior notice to County that said stand-
by might limit Contractor's ability to meet response time standards.
C. 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 paramedic ambulance shall be counted.
d. Multicasualty Disaster. The response time requirements shall be
suspended during a declared multicasualty incident, medical advisory, or disaster in Contra
Costa County, or during a declared disaster in a neighboring jurisdiction which has requested
assistance from the County.
e. Good Cause. The Contract Manager may allow exceptions to the
response time requirements for good cause as determined in his sole discretion. At a
minimum, the asserted ground(s) for exception 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 cause for an exception may include, but is not
limited to, incorrect or inaccurate dispatch information received from County Communications
Center; disrupted voice or data radio transmission; mobile data terminal failure; material
change in dispatch location; Computer Aided Dispatch (CAD) failure; 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 road construction or inclement weather, e.g. , fog;
unavoidable delays caused by trains; when units are providing County authorized mutual aid;
when hospital(s) are on emergency department diversion or trauma center bypass when said
diversion or bypass can be shown to affect response times; and off-road .locations.
3
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SERVICE PIAN
Number 23-055-9
f. Unusual System Overload. The Contract Manager may allow exceptions to
the contract response time standards for responses during periods of unusual system overload.
Such exceptions shall be allowed at the sole discretion of the Contract Manager.
Furthermore, this provision shall apply only if an "unusual system overload" plan has been
submitted by the Contractor and approved by the Contract Manager prior to any request for
exception. The Contract Manager may, at his sole discretion and at any time, revoke approval
of an "unusual system overload" plan by providing written notice to Contractor. Contractor
may submit a new plan for approval. If a new plan is not submitted and approved, the
"unusual system overload" plan exception to response time calculations. and penalties shall
not apply until an approved new plan is in place. Contract Manager shall not unreasonably
withhold approval of any plan.
5. Apvlication for Exception. Itis the Contractor's responsibility to apply
to Contract Manager for an exception to a required response time.
6. Exception Request Procedure. For each actual response time which the
Contractor believes to be an exception to a required response time, the Contractor shall
submit, in writing, to the Contract Manager a detailed explanation of the incident in
question. Exception requests shall be submitted with the monthly performance reports
required in Section R.2.a. , herein, The Contract Manager shall grant or deny exceptions to
performance standards and shall so advise the Contractor.
7. Documentation of Response Times. Contractor shall document all times
necessary to determine the total ambulance response time, including but not limited to total
on-scene time; total time to transport to hospital; time call received by Contractor; time
ambulance crew assigned; time enroute to scene; arrival at scene time; time enroute to
hospital; and arrival at hospital time. All times shall be recorded on the County Patient
Care Report Form (PCR) , described in Section II. R.1. of the Service Plan (Patient Care
Report Forms) , herein, and as part of Contractor's dispatch system.
B. Performance Report. Within ten (10) working days following the end of
each month, Contractor shall document and report to Contract Manager in writing, in .a manner
required by the Contract Manager, information as specified in Paragraph R.2. (Performance
Reports) of the Service Plan. Contractor shall identify the causes of failures of
performance, and shall document efforts to eliminate these problems.
9. Penalty for Failure to Provide Data to Determine Compliance.
a. Each and every time an emergency ambulance is dispatched and the
ambulance crew fails ,to report and document on-scene time shall be considered a failure ,to
report data to determine compliance. The Contractor, in order to rectify the failure to
report an on-scene time may demonstrate to the satisfaction of the Contract Manager an
accurate on-scene time.
b. Where an on-scene time cannot be provided for a particular emergency
call, the response time for that call shall be deemed to have exceeded the required response
time for purposes of determining response time compliance.
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SERVICE PLAN
Number 23-055-9
B. Deployment Plan.
1. Contractor shall provide Contractor Manager with a current deployment plan
specifying all ambulance stations and number of vehicles to be deployed during each hour of
the day, and each day of the week, upon request of Contract Manager for contract monitoring
purposes.
2. Contractor shall submit proposed changes in the deployment plan in writing
to the Contract Manager thirty (30) days before implementation. The thirty (30) day notice
may be waived by the Contract Manager if the Contract Manager determines that an emergency
adjustment to the plan is needed to correct an acute performance problem.
3. Contractor acknowledges and agrees with the goal of the EMS system to
achieve the response time standards specified herein and to achieve timely responses in each
community served.
a. Contractor shall therefore endeavor to deploy ambulance resources in
a manner consistent with this goal.
b. If, as a result of local zoning or use restrictions, Contractor is
unable to obtain adequate ambulance station locations, Contractor may request exclusion of
designated areas from the response time standard. The Contract Manager shall take into
account Contractor's diligence in seeking station locations and any necessary permits in
granting or denying an exclusion.
C. Ambulance Staffing/Personnel Preparation.
1. Ambulance Staffing. Contractor shall send an Advanced Life Support (ALS)
ambulance staffed with two paramedics (Emergency Medical Technicians-Paramedics) [EMT-P] to
all life threatening and potentially life threatening emergency medical requests. Contractor
may send Basic Life Support (BLS) units staffed with two (2) EMT-Is to requests for BLS
interfacility transfers, multi-unit response and any calls in which the County designated
medical dispatch center determines BLS response is appropriate.
2. Work and Services. Contractor shall comply with all applicable State and
local laws and regulations, and County EMS policies, procedures and protocols.
3. Second Patient Attendant During Long Transports. Contractor shall develop
and implement a procedure, which has been approved by the Contract Manager, to provide a
second patient attendant (in addition to the driver) trained at least to the EMT-I level for
transport of critical trauma patients when transport time is expected to exceed 15 minutes.
4. Certification. All of Contractor's ambulance personnel responding to
emergency medical requests shall be currently certified, and, in addition, all paramedic
personnel shall be currently accredited by the EMS Agency to practice in Contra Costa County.
Contractor shall retain on file at all times, copies of the current and valid licenses,
certifications, and/or accreditations of all emergency medical personnel performing services
under this Agreement.
5. Advanced Cardiac Life Support (ACLS) Certification. All paramedics
responding to potentially life threatening emergency medical requests shall be currently
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4 Contractor County Dept.
SERVICE PIAN
Number 23-055-9
certified in ACLS by the American Health Association. Contractor shall retain on file at all
times., copies of the current and valid certifications of all paramedics performing services
under this Agreement.
6. Required Trauma Training.
a. Contractor shall staff each ALS ambulance with a minimum of one
paramedic certified in Prehospital Trauma Life Support (PHTLS) or Basic Trauma Life Support
(BTLS) . Contractor shall retain on file at all times, copies of the current and valid
certifications of all PHTLS or BTLS qualified paramedics performing services under this
agreement.
b. All paramedics shall be required by Contractor to obtain
certification in PHTLS or BTLS within six (6) months of hire.
D. Company Orientation and On-Going Preparedness. Contractor shall proply orient
all field personnel before assigning them to respond to emergency medical requests. Such
orientation shall include at a minimum, provider agency policies and procedures; EMS system
overview; EMS policies and procedures; radio communications with and between the provider
agency; base hospital, receiving hospitals, and county communications centers; map reading
skills including key landmarks, routes to hospitals and other major receiving facilities
within the county and in surrounding areas; and ambulance and equipment utilization and
maintenance.
E. Field Supervision. Contractor shall provide at all times and within Contra
Costa County an on-duty employee or officer, authorized to act on behalf of the Contractor
in all operational matters.
F. Preparation for Multicasualti Response. Contractor shall train all ambulance
personnel and supervisory staff in their respective roles and responsibilities under the
County Multicasualty Incident Plan (MCIP) which is on file at the County EMS Agency, and
prepare them to function as the medical portion of the Incident Command System.
G. Driver Training. Contractor shall maintain an on-going driver training program
for ambulance personnel. The program, the number of instruction hours, and the system for
integration into the Contractor's operations (e.g. , accident review boards, impact of
accidents on employee performance reviews and compensation, etc.) will be reviewed and is
subject to approval by County initially and on an annual basis. Map reading shall be an
integral part of driver training.
H. Assaultive Behavior Management Training. Contractor shall provide ambulance
personnel with the training, knowledge, understanding, and skills to effectively manage
patients with psychiatric, drug/alcohol or other behavioral or stress related problems, as
well as difficult or potentially difficult scenes on an on-going basis. Emphasis shall be
on techniques for establishing a climate conducive to effective field management, and for
preventing the escalation of potentially volatile situations.
I. Infection Control. Contractor shall develop and strictly enforce policies for
infection control and contaminated materials disposal to decrease the chance of communicable
disease exposure.
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SERVICE PLAN
Number 23-055-9
J. Quality Assurance (OA) Program.
1. Contractor shall maintain a comprehensive Quality Assurance Program
designed to interface with the EMS Quality Assurance Program, which is on file at the EMS
Agency.
2. Contractor shall provide a physician or a Registered Nurse to implement and
oversee this on-going QA program. This individual shall be responsible for the medical
quality assurance evaluation of all services provided pursuant to this Agreement.
3. The goal of Contractor's QA program shall be to evaluate patient care
services provided pursuant to this Agreement.
4. Contractor shall submit for approval an annual quality assurance plan.
This quality assurance plan shall meet the objectives identified in the Ambulance Quality
Assurance (QA) Program, on file at the Emergency Medical Services Agency.
K. Preventative Health Care. Contractor shall provide currently recommended
immunizations and health screening for its high risk personnel.
L. Critical. Incident Stress Debriefing. Contractor shall establish a critical
incident stress debriefing program and an ongoing stress reduction program for its employees.
These programs shall be submitted to the Contract Manager for approval.
M. Ambulance Vehicles and Equipment.
1. Vehicles. Ambulance vehicles shall meet the .standards of Title XIII,
California Code of Regulations.
2. Vehicle Marking.
a. Ambulance vehicles used in providing contract services shall bear the
markings "Contra Costa County Emergency Medical Services" on both sides. Such vehicles shall
display the "911" emergency telephone number and state the level of service, "Paramedic
Unit", on both sides.
b. Ambulance vehicles shall be marked to identify the company name, but
shall not display any telephone number other than 911 or any other advertisement.
C. Overall design, color, and lettering are subject to the approval of
the Contract Manager.
3. Vehicle Maintenance. Contractor shall maintain its vehicles in good
working order, consistent with manufacturer's specifications. In addition, detailed records
shall be maintained as to work performed, costs related to repairs, and operating and repair
costs analyses where appropriate. Such repairs shall be accomplished and systems shall be
maintained so as to achieve at least the industry norms in vehicle performance and
reliability.
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SERVICE PIAN
Number 23-055-9
4. General Equipment.
a. All of Contractor's ambulances shall carry all emergency supplies and
equipment identified in the County Ambulance Equipment and Supply list on file at the EMS
Agency.
b. Contractor shall maintain its vehicles, equipment, and supplies in
a clean, sanitary, and safe mechanical condition at all times.
C. Contractor agrees that equipment and supply requirements may be
changed with the approval of the Contract Manager due to changes in technology.
5. Failure To Meet Minimum In-Service Equipment/Supply Requirements. County
may inspect Contractor's ambulances at any time, without prior notice. Any ambulances that
fail to meet the minimum in-service requirements contained in the County Ambulance Equipment
and Supply list as determined by County shall be immediately removed from service until the
deficiency is corrected.
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.
County may adopt protocols governing provisional dispatch of ambulances not in compliance
with minimum in-service requirements and shall comply with these protocols.
N. Eguipment Exchange and Replacement.
1. Contractor shall implement and maintain inventory control .and equipment
maintenance systems which will allow the ambulance fleet fully stocked with quality equipment
in good working order at all times.
2. Contractor's plan for replacement of expendable equipment and supplies
shall be self-sufficient and shall not rely on receiving hospital stock or billing services
unless expressly agreed to in writing by receiving hospitals.
3. - Contractor shall establish a mechanism to exchange non-expendable medical
supplies and equipment supplied by a fire first responder agency in connection with patient
transport, in those situations where said supplies and equipment are interchangeable.
0. Communications Equipment and Dispatch.
1. Dispatch Center. Contractor shall operate a dispatch center and maintain
all equipment (fixed, mobile, linkages) necessary to receive requests for emergency ambulance
services via data or voice, made at the County designated public safety dispatch centers, and
capable of dispatching all ambulance units used in providing services pursuant to this
Agreement.
a. Contractor shall pay for all interfaces to its computer equipment,
the total mileage costs, if any, and for hardware at its facility.
b. The County shall be responsible for hardware at its site(s) .
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7 Contractor County Dept.
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SERVICE PIAN
Number 23-055-9
C. New dispatch system costs shall not be imposed upon Contractor
without due regard to increased costs. Contractor reserves the right to petition the County
for recoupment of significant cost increases.
2. Dispatcher Preyaredness. Contractor shall adequately train and prepare
emergency ambulance dispatchers to process emergency medical requests for service. Said
dispatchers shall be given a company orientation as well as a thorough orientation to the
County EMS system before being assigned to operate as part of Contractor's ambulance dispatch
system.
3. Dispatch Evaluation. Contractor shall implement an on-going program for
the evaluation of dispatch operations, education and training of dispatchers, and problem
identification and resolution.
4. Ambulance Communication Eguipment. Contractor shall equip all paramedic
ambulances and supervisory vehicles used in providing service to the County with 4-channel
radios for communication- on County's MEDARS radio system and with cellular telephones for
ambulance to base hospital communications. County will lease to Contractor, or Contractor
may supply in accordance with County specifications, two way vehicular or portable radio
equipment under the following terms:
a. All ambulances for emergency medical response under the terms of this
Agreement shall operate only within Contra Costa County, or as directed by a County
communications center, or in compliance with policies or protocols established by County.
b. Radio frequencies shall be designated by County for the purpose of
communications with a County designated communications center and for ambulance-to-hospital
communications.
C. Approved radio equipment must be installed in conformance with
existing County policies prior to assignment of a vehicle to an emergency response area.
Installations and removals will be at Contractor's expense.
d. Contractor shall obtain a certificate of inspection of approved radio
equipment by County following installation, and on an annual basis thereafter and shall make
vehicles available for inspection of County owned radios upon reasonable request of County.
Alternate procedures may be adopted by Contract Manager and County Communications Division.
e. Specific radio equipment purchased by County at County expense for
private Contractor shall remain the property of and under control of the County at all times.
f. County owned radios damaged due to accidents, malicious mischief, and
acts of God, shall be repaired or replaced at County's option by County, for which Contractor
shall pay County's actual cost of repair or replacement. Equipment shall remain the property
of the County.
g. Contractor shall operate the two-way radios in conformance with all
applicable rules and regulations of the Federal Communication Commission, and in conformance
with all applicable County rules and operating procedures. All operators of the two-way
radios shall at all times be subject to the exclusive control of County:
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Number 23-055-9
h. All radio equipment other than Contractor's internal company system
shall be approved by the County Communications Director.
P. Disaster, Multicasualty, Mutual Aid Response, Standby.
1. Disaster Response. Contractor shall render emergency assistance in
multicasualty or disaster situations to any location as directed by a county communications
center or by Contract Manager.
a. During multicasualty or disaster periods, Contractor will be exempt
from all responsibilities for response time performance until notified by the County.
b. At the scene of the multicasualty/disaster, Contractor's personnel
shall perform in accordance with the County Multicasualty Plan.
C. When Contractor is notified that multicasualty/disaster assistance
is no longer required, Contractor shall return all of its resources to the primary area of
responsibility and shall resume all operations in a timely manner.
d. During the course of the multicasualty/disaster, the Contractor shall
use best efforts to provide local standard emergency coverage.
2. Disaster Response Vehicle. Contractor shall provide one vehicle as a
disaster response vehicle. This vehicle should be kept in" good working order and available
for emergency response to the scene. The vehicle should not be a routine ambulance used in
day-to-day operations. The following equipment shall be stored in the disaster vehicle:
a. Backboard and straps
b. Cervical collars
C. Head immobilization sets and foam wedges
d. Splints for legs and arms
e. Oxygen equipment
f. Dressings and bandages
g. Advanced life support equipment, e.g. , IV bags/start equipment
3. Disaster/Multicasualty Training. Contractor shall participate in disaster
and multicasualty training and exercises. conducted by the EMS Agency.
4. Mutual Aid. Contractor shall respond in a mutual aid capacity to other
service areas within and outside of Contra Costa County when directed by the Contract
Manager.
5. Stand-By Service. Contractor shall provide, at no charge to County or
requesting agency, stand-by services at the scene of an emergency incident within its
emergency response area when directed by a County communications center upon the request of
a public safety agency. A unit placed on stand-by shall be dedicated to the incident for
which it has been placed on stand-by. Stand-by periods exceeding eight (8) hours must be
approved by the Contract Manager.
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Number 23-055-9
6. Ambulance Service Assistance. Contractor, to the best of its ability,
shall assist in servicing any other emergency response areas where the County agreement for
that response area has been suspended or terminated.
Q. Public Education and Information. Contractor shall sponsor and/or participate
in classes to educate the general public to emergency medical services. Contractor shall
work with existing community groups, service organizations, and Chambers of Commerce to
support the local community efforts for educating the public regarding emergency response,
care, and transportation, including where citizen training can be obtained including CPR.
R. Records, Reports, Audits, Inspections.
1. Patient Care Report Forms. Contractor shall utilize the County's "Patient
Care Report Form" (PCR) for patient documentation on all patient responses including non-
transports. Contractor shall complete this form accurately and include all information
listed in Section 100169 of the California Code of Regulations, and distribute it according
to established EMS Policies and Procedures.
a. County shall provide the required PCR forms to Contractor at County's
cost. At Contractor's option, Contractor may print its own supply of forms. The form is
subject to revision by the Contract Manager at any time.
b. At the end of each and every month, Contractor shall provide County
with copies of the dispatch record and PCR form for each and every emergency response in that
month, no later than ten (10) working days following the last day of the month; or, when
requested by County in connection with an incident investigation, within 72 hours of request.
Contractor shall identify and provide separately, copies of PCRs for trauma transports
(patients meeting trauma triage criteria) on a monthly basis.
C. Contractor shall provide County with copies of any individual Patient
Care Report Form on request within three (3) working days of request.
2. Performance Reports. Within ten (10) working days following the last day
of each month, Contractor shall document and report to Contract Manager in writing in a form
required by the Contract Manager:
a. a list of each and every emergency call dispatched for which
Contractor did not meet the response time standard.
b. a list of each and every emergency call where an ALS ambulance was
not dispatched.
C. a list, of each and every call, sorted by area of the County, i.e. ,
West, Central, and East, where there was a failure to properly record all times necessary to
determine the response time, and for patients meeting trauma criteria, on-scene time and/or
transport to hospital time.
d. a list of trauma transports by city and by hospital including all
times necessary to calculate each and every response time, on-scene time, and transport to
hospital time.
Initials
10 Contractor County Dept.
SERVICE PIAN
Number 23-055-9
3. Statistical Data. Within 20 working days following the last day of each
month, the Contractor shall provide records in computer readable format and suitable for
statistical analysis for all ambulance responses. Records shall include the following data
elements:
a. unit identifier
b. service level (paramedic or EMT-I)
C. location of call- address, city
d. location of call - Thomas Brother's map coordinates
e. nature of call (dispatch info)
f. code to scene
g- time call received
h. time call dispatched
i. time unit enroute
j . time unit on-scene
k. time unit enroute to hospital
1. time unit at hospital
M. time unit clear and available for nest call
n. outcome (dry run, transport)
o. receiving hospital
P. code to hospital
q. major trauma (MTV,. non-MTV)
4. Personnel Reports.
a. Contractor shall provide County with a list of paramedics currently
employed by Contractor and shall update that list whenever there is a change.
b. The personnel list shall include at a minimum, name, address,
telephone number, ACLS expiration date, and California Driver's License number.
5. Other Reports. Contractor_ shall provide such other reports and records
as may be reasonably required by Contract Manager.
6. Observation of Operations. County representatives may, at any time and
without notification, directly observe Contractor's control center operations, maintenance
facilities, and ambulance post locations, and may ride as "third person" to observe the
operation of any of Contractor's ambulance units. The County's representatives shall conduct
themselves in a professional, and courteous manner, shall not interfere with Contractor's
employees in the performance of their duties, and shall at all times be respectful of
Contractor's employer/employee relationship.
7. Annual Performance Evaluation. Contractor shall participate in annual
performance evaluations in accordance with procedures established by Contract Manager.
S. Compensation Related Provisions.
1. Contractor's patient charges for services provided pursuant to this
agreement shall not exceed the rates set forth in Exhibit B, which is attached hereto and
incorporated herein by this reference, except as approved in writing by Contract Manager.
Initial � '"y
11 Contractor County Dept.
I
SERVICE PLAN
Number 23-055-9
2. Contract Manager may approve annual increases in patient charges identified
in Exhibit B, based on the changes in the Consumer Price Index for All Urban Consumers, San
Francisco-Oakland. Any rate increase under this provision shall not take effect until 15
days following written approval by Contract Manager.
3. In the event that Contractor experiences a cost increase in any consumable
supplies exceeding twenty percent (20%) , Contractor may request and Contract Manager may
approve increase(s) in charges to patients for said consumable supplies. Additionally,
Contractor may apply for adjustments in rates for disposable non-reusable supplies upon
demonstration to the satisfaction of Contract Manager that the rates charged are insufficient
to cover the Contractor's cost for the purchase and distribution of such supplies, plus ten
percent (10%) for overhead expenses.
4. Contract Manager may approve charges for expendable supplies not listed in
Exhibit B, when newly required under EMS prehospital protocols adopted during contract
period.
T. Billing/Collection Services.
1. Contractor shall maintain a business office within Contra Costa County.
2. Contractor shall operate a billing and accounts receivable system that is
well documented, easy to audit, and which minimizes the effort required of patients to
recover from third party sources for which they may be eligible. The billing system shall:
a. automatically generate Medicare and Medicaid statements.
b. itemize all procedures and supplies employed on patient bills; and
C. be capable of responding to patient and third party payer inquiries
regarding submission of insurance claims, dates and types of payments made, itemized charges,
and other inquiries.
3. Contractor shall make no attempts to collect its fees at the time of
service.
U. Payment Provisions. No payments shall be made by County to Contractor for
emergency ambulance service provided pursuant to this agreement.
V. Cooperation With Evolvine System. Contractor agrees to participate and assist
in the development of system changes subject to negotiated costs, if any.
W. County Approved Base Station Hospitals. County, through its Ambulance Permit
Officer, shall notify Contractor in writing, upon execution of this Contract, of all County
approved Base Station Hospitals. Further, County shall notify Contractor in writing of
changes. or additions to .such approved hospitals, as such changes or additions occur.
Z
Initials-
12
'
12 Contractor County Dept.
SPECIAL CONDITIONS
Number 23-055-9
1. Novation. The parties having entered into a prior Ambulance Services Agreement
#23-055-8 for the period January 3, 1991 through January 2, 1993 (which contained provision
for an automatic four-month contract extension for the period from January 3, 1993 through
May 2, 1993) , County and Contractor hereby agree to substitute this Agreement #23-055-9 for
the aforesaid four-month automatic contract extension. Effective January 3, 1993, all
contract rights and obligations of the parties will be governed by this Agreement #23-055-9.
2. Automatic Contract Extension. Notwithstanding Paragraph 3. (Term) of this
Contract, unless this Contract is terminated by either party pursuant to Paragraph 5.
(Termination) of the General Conditions prior to January 2, 1994, the term of this Contract
shall be automatically extended from January 2, 1994 through May 2, 1994. During its
extended term, this Contract is nevertheless subject to all the terms and conditions
applicable during its initial term, including but not limited to General Conditions Paragraph
5. (Termination) . The purpose of this automatic contract extension is to allow for
continuation of services to patients during which time County may complete its Competitive
Request for Proposal process and finalize its negotiations as the result of the competitive
bidding process for the next contract period. If this Contract is automatically extended,
Contractor shall continue to provide services as set forth in the Service Plan, subject to
any amendments thereto, while all other conditions of the Contract shall remain in effect.
3. Renewal Provisions. Paragraph 22 (Nonrenewal) of the General Conditions is
hereby modified to read as follows:
"a. This contract may be renewed or extended by mutual agreement of County and
Contractor expressed in writing, for a maximum of two periods of one year each, provided the
Contractor has satisfactorily performed the services set forth herein.
b. Notwithstanding Subsection a. of this section, 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 waives all rights or, claims to
notice or hearing respecting any failure to continue purchase of all or any such services
from Contractor."
4. Response Area Exclusivity. Except for the provision of backup services, or the
suspension or termination of this Agreement, County shall not enter into any agreement with
any other provider for ground response to emergency ambulance requests from the County
Communications Center or other designated public safety dispatch center within Contractor's
Emergency Response Area(s) during the term of this Agreement.
5. Air Ambulance Transport. County reserves the right to enter into separate
transport agreements with air ambulance providers. Notwithstanding any other provisions of
this Agreement, County may provide for air transport of patients when such transportation is
deemed to be medically in the best interest of the patient(s) . However, no such agreement
shall provide for air transport of non-critical patients or of critical patients when a
ground ambulance is on-scene and transport time by ground ambulance to the most accessible
emergency medical facility equipped, staffed, and prepared to administer care appropriate to
the needs of the patient is the same or less than estimated air transport time.
Initials: �,r{
1 Contractor Cdunty Dept.
SPECIAL CONDITIONS
Number 23-055-9
6. No Advertising. Contractor shall not, in the course of providing service under
this Agreement, advertise, promote, or endorse any other service or product provided by
Contractor or any other firm.
7. Private Work. Nothing in the Agreement shall prevent Contractor from conducting
private work that does not interfere with the requirements of this Agreement.
8. Breach of Contract.
a. Notice of Default. County shall have the right to terminate or cancel
this Agreement or to pursue any appropriate legal remedy in the event Contractor materially
breaches this Agreement and fails to correct such default within seven (7) days following the
service of a written notice. by County specifying the default(s) and the effective date of
intended termination of this Agreement, absent cure.
b. Definitions of Breach. Conditions and circumstances which shall
constitute a material breach by the Contractor shall include but are not limited to the
following:
1) Failure of the Contractor to operate the ambulance service system in
a manner which enables the County and the Contractor to remain in substantial compliance with
the requirements of the applicable Federal, State, and County laws, rules, and regulations.
Minor violations of such requirements shall not constitute a material breach except wilful
and repeated violations shall constitute a material breach;
2) Falsification of data supplied to the County including by way of
example but not by way of exclusion, dispatch data, patient report data, response time data,
financial data, or falsification of any other data required under this Agreement;
3) Failure to maintain equipment in accordance with good maintenance
practices;
4) Deliberate and unauthorized scaling down of operations to the
detriment of performance during a "lame duck" period;
5) Attempts by the Contractor to intimidate or otherwise punish
employees who desire to sign contingent employment agreements with competing bidders during
a subsequent bid cycle;
6) Attempts by the Contractor to intimidate or punish employees who
participate in protected concerted activities, or who form or join any professional
associations;
7) Chronic and persistent failure of Contractor's employees. to conduct
themselves in a professional and courteous manner, or to present a professional appearance;
8) Failure to comply with approved rate setting, billing, and collection
procedures;
Initials--_~'`��.
2 Contractor County Dept.
SPECIAL CONDITIONS
Number 23-055-9
9) Repeated failures to meet response time requirements after receiving
notice of non-compliance from the Contract Manager;
10) Repeated failures to respond to 95% of all potentially life
threatening emergency medical requests with paramedic units;
11) Failure of the Contractor to provide and maintain the required
insurance; or
12) Failure to comply with or exceed the minimum employee wage/salary
benefit package specified in Contractor's Proposal.
9.. End Term Provisions. Contractor agrees to return to County all County issued
equipment in good working order, normal wear and tear excepted, at the termination of this
Agreement. For- any County equipment not so returned, County shall repair or replace said
equipment at Contractor's expense and deduct the cost thereof from any payments owed to
Contractor. In the event the Contractor is not owed any payments under this Agreement,
Contractor shall reimburse County for the actual cost of repairs or replacement.
10. Transition Planning.
a. Competitive Bid Required. Contractor acknowledges that County intends
to complete a competitive procurement process for the provision of emergency ambulance
services within Contractor's Emergency Response Area(s) following termination of this
Agreement. Contractor acknowledges and agrees that County may select a different ambulance
service provider to provide exclusive emergency ambulance services within all or some of the
Emergency Response Area(s) specified herein following said competitive procurement process.
b. Future Bid Cycles. Contractor acknowledges and agrees that supervisory
personnel, EMTs, paramedics, and control center personnel working in the EMS system have a
reasonable expectation of long-term employment in this system, even though contractors may
change from time to time. Accordingly, Contractor shall not penalize or bring personal
hardship to bear upon any of its employees who applies 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.
11. Retention of Records. Paragraph 3. (Records) , Subparagraph a. (Retention of
Records) of the General Conditions is hereby modified to read as follows:
"a. Retention of Records. The Contractor shall retain all documents pertaining
to this Contract for five (5) years from the end of the fiscal year following the date of
service; 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, and
except as otherwise restricted by law, Contractor shall make these records available to
authorized representatives of the County, the State of California, and the United States
Government. "
Initials
3 Contractor County Dept.
SPECIAL CONDITIONS
Number 23-055-9
12. Termination. General Conditions Paragraph 5. (Termination) , Subparagraph a.
(Written Notice) is hereby modified to read as follows:
"a. Written Notice. This Contract may be canceled immediately by written
mutual consent."
13. Insurance. Paragraph 19. (Insurance) is hereby deleted and replaced in its
entirety by the following paragraph:
"19. Insurance. During the entire term of this Contract and any extension or
modification thereof, the Contractor shall keep .in effect insurance policies meeting the
following insurance requirements unless otherwise expressed in these Conditions:
a. Liability Insurance. The Contractor shall provide malpractice insurance
and comprehensive liability insurance, including coverage for owned and non-owned vehicles,
each with a minimum combined single limit coverage of $1,000,000 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
act, omission, or occurrence. Such insurance shall be endorsed to include the County of
Contra Costa and their respective officers and employees as additional named insured as to
all services performed by Contractor under this agreement.
b. Workers' Compensation. The Contractor shall provide workers' compensation
insurance coverage for its employees.
C. Certificate of Insurance. The Contractor shall provide the County with
a certificate(s) of insurance evidencing liability, medical malpractice and workers'
compensation insurance as required herein no later than the effective date of this Contract.
If the Contractor should renew the insurance.policy(ies) or acquire either a new insurance
policy(ies) or amend the coverage afforded through an endorsement to the policy(ies) at any
time during the term of this _Contract, then Contractor shall provide (a) current
certificate(s) of insurance.
d. Additional Insurance Provisions. The insurance policies provided by the
Contractor shall include a provision for thirty (30) days written notice to County before
cancellation or material change of the above specified coverage. Said policies shall
constitute primary insurance as to the 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) shall not be required to contribute to any loss covered under the
Contractor's insurance policy or policies."
Initials:
4 Contractor County Dept.
Contra Costa County Standard Form 1/87
GENERAL CONDITIONS
(Purchase of Services)
1. Compliance with Law. Contractor shall be subject to and comply with all Federal,
State and local laws and regulations applicable with respect to its performance under this
Contract, in 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 shall 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. Retention of Records. The Contractor shall 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 shall 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) (1) of the Social Security Act, and any regulations promulgated thereunder,
Contractor shall, upon written request and until the expiration of four years after the
furnishing of services pursuant to this Contract, make available to the Secretary of Health
and Human Services or to the Comptroller General, or any of their duly authorized
representatives, this Contract and books, documents, and records of Contractor that are
necessary to certify the nature and extent of all costs and charges hereunder.
Further, if Contractor carries out any of the duties of this Contract through a subcontract
with a value or cost of $10,000 or more over a twelve-month period, such subcontract shall
contain a clause to the effect. that upon written request and until the expiration of four
years after the furnishing of services pursuant to such subcontract, the subcontractor shall
make available, to the County, to the Secretary or to the Comptroller General, or any of
their duly authorized representatives, the subcontract and books, documents, and records of
the subcontractor that are necessary to verify the nature and extent of all costs and charges
thereunder.
This special condition is in addition to any and all other terms regarding the maintenance
or retention of records under this Contract and is binding on the heirs, successors, assigns
and representatives of Contractor.
4. Reporting Requirements. Pursuant to Government Code Section 7550, Contractor
shall include in all documents or 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 shall apply only if the payment limit under this Contract exceeds
$5,000.
1
1
Contra Costa County Standard Form 1/87
GENERAL CONDITIONS
(Purchase of Services)
5. Termination.
a. Written Notice. This Contract may be terminated by either party, at their
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. The County, upon written notice to Contractor, may
immediately terminate this Contract should the Contractor fail to perform properly any of
its obligations hereunder. In the event of such termination, the County may proceed with
the work in any reasonable manner it chooses. The cost to the County of completing
Contractor's performance shall be deducted from any sum due the Contractor under this
Contract, without prejudice to the County's rights otherwise to recover its damages.
C. Cessation of Funding. Notwithstanding Paragraph 5.a. above, in the event
that Federal, State, or other non-County funding for this Contract ceases, this Contract is
terminated without notice.
6. Entire Agreement. This Contract contains all the terms and conditions agreed upon
by the parties. Except as expressly provided herein, no other understanding, oral or
otherwise, regarding the subject matter of this Contract shall be deemed to exist or to bind
any of the parties hereto.
7. Further Specifications for Overating Procedures. 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 developed and set
forth in a written Informal Agreement between the Contractor and the County. Such Informal
Agreements shall be designated as such and shall not be amendments to this Contract except
to the extent that they further.detail or clarify that which is already required hereunder.
Such Informal Agreements may not enlarge in any manner the scope of this Contract, including
any sums of money to be paid the Contractor as provided herein. Informal Agreements may be
approved and signed by the head of the County Department for which this Contract is made or
his designee.
8. Modifications and Amendments.
a. General Amendments. This Contract may be modified or amended by a written
document executed by the 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. Administrative Amendments. Subject to the Payment Limit, the Payment
Provisions and the Service Plan may be amended by a written administrative amendment executed
by the Contractor and the County Administrator or his designee, subject to any required State
or Federal approval, provided that such administrative amendments may not materially change
the Payment Provisions or the Service Plan.
9. Disputes. Disagreements between the County and Contractor concerning the meaning,
requirements, or performance of this Contract shall be subject to final determination in
writing 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 Federal
Government.
2
Contra Costa County Standard Form 1/87
• GENERAL CONDITIONS
(Purchase of Services)
10. Choice of Law and Personal Jurisdiction.
a. This Contract is made in Contra Costa County and shall be governed and
construed in accordance with the laws of the State of California.
b. Any action relating to this Contract shall be instituted and prosecuted in
the courts of Contra Costa County, State of California.
11. Conformance with Federal 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 shall 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 the
County indicating the 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, shall not relieve the Contractor's
obligation to fulfill this Contract as prescribed; nor -shall the County be thereby estopped
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. The Contractor shall not enter into subcontracts for any
work contemplated under this Contract and shall not assign this Contract or monies due or
to become due, without the prior written consent of the County Administrator or his designee,
subject to any required State or Federal approval.
14. Independent Contractor Status. This Contract is by and between two independent
contractors and is not intended to and shall not be construed to create the relationship
between the parties of agent, servant, employee, partnership, joint venture or association.
15. Conflicts of Interest. Contractor, its officers, partners, associates, agents,
and employees, shall not make, participate in making, or in any way attempt to use the
position afforded them by this Contract to influence any governmental decision in which he
or she knows or has reason to know that he or she has a financial interest under California
Government Code Sections 87100, et seq. , or otherwise.
16. Confidentiality. 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: _
a. All applications and records concerning any individual made or kept by
Contractor or any public officer or agency in connection with the administration of or
relating to services provided under this Contract will be confidential, and will not be open
to examination for any purpose not directly connected with the administration of such
service.
3
Contra Costa County Standard Form 1/87
GENERAL CONDITIONS
(Purchase of Services)
b. 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 information other than as authorized by law may be guilty of a misdemeanor.
17. Nondiscriminatogy Services. Contractor agrees that all goods and services under
this Contract shall be available to all qualified persons regardless of age, sex, race,
religion, color, national origin, or ethnic background, or handicap, and, that none shall be
used, in whole or in part, for religious worship or instruction.
18. Indemnification. The Contractor shall defend, indemnify, save, and hold harmless
the County and its officers and employees from any and all claims, costs and liability for
any damages, sickness, death, or injury to person(s) or property, including without
limitation all consequential damages, from any cause whatsoever arising directly or
indirectly from or connected with the operations or services of the Contractor or its agents,
servants, employees or subcontractors hereunder, save and except claims or litigation arising
through the sole negligence or sole willful misconduct of the County or its officers or
employees. Contractor will reimburse the County for any expenditures, including reasonable
attorneys' fees, the County may make by reason of the matters that are the subject of this
indemnification, and if requested by the County will defend any claims or litigation to
which this indemnification provision applies at the sole cost and expense of the Contractor.
19. Insurance. During the entire term of this Contract and any extension or
modification thereof, the Contractor shall keep in effect insurance policies meeting the
following insurance requirements unless otherwise expressed in the Special Conditions:
a. Liability Insurance. The Contractor shall provide comprehensive liability
insurance, including coverage 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
shall be endorsed to include the County and its officers and employees as additional insureds
as to all services performed by Contractor under this agreement. . Said policies shall
constitute primary insurance as to the 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) shall not be required to contribute to any loss covered under the
Contractor's insurance policy or policies.
b. Workers' Compensation. The Contractor shall provide workers' compensation
insurance coverage for its employees.
C. Certificate of Insurance. The Contractor shall provide the 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 the Contractor should
renew the insurance policy(ies) or acquire either a new insurance policy(ies) or amend the
coverage afforded through an endorsement to the policy at any time during the term of this
Contract, then Contractor shall provide (a) current certificate(s) of insurance.
d. Additional Insurance Provisions. The insurance policies provided by the
Contractor shall include a provision for thirty (30) days written notice to County before
cancellation or material changes of the above specified coverage.
4
contra Costa County Standard Form 1/87
GENERAL CONDITIONS
(Purchase of Services)
20. Notices. All notices provided for by this Contract shall be in writing and may
be delivered by deposit in the United States mail, postage prepaid. Notices to the County
shall be addressed to the head of the County Department for which this Contract is made.
Notices to the Contractor shall be addressed to the Contractor's address designated herein.
The effective date of notice shall be the date of deposit in the mails or of other delivery,
except that the effective date of notice to the County shall be the date of receipt by the
head of the County Department for which this Contract is made.
21. Primacy of General Conditions. Except for Special Conditions which expressly
supersede General Conditions, the Special Conditions (if any) and Service Plan do not limit
any term of the General Conditions.
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 waives all rights or claims to notice or hearing respecting any failure to
continue purchase of all or any such services from Contractor.
23. Possessory Interest. If this Contract results in the Contractor having possession
of, claim to 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 be subject to the payment of property taxes levied on such interest.
Contractor agrees that this provision complies with the notice 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. Notwithstanding mutual recognition that services
under this Contract may provide some aid or assistance to members of the County's population,
it is not the intention of either the County or Contractor that such individuals occupy the
position of intended third-party beneficiaries of the obligations assumed by either party
to this Contract.
25. Copyrights and Rights in Data. Contractor shall not publish or transfer any
materials produced or resulting from activities supported by this agreement without the
express written consent of the County Administrator. If any material is subject to
copyright, the County reserves the right to copyright such and the Contractor agrees not to
copyright such material. If the material is copyrighted, the County reserves a royalty-
free, nonexclusive, and irrevocable license to reproduce, publish, and use such materials,
in whole or in part, and to authorize others to do so.
5
EXHIBIT A
AMBULANCE RESPONSE TIMES
Areas Designated As Rural
Thomas Brothers Map Coordinates
The areas identified below by Thomas Brothers map area number
and map coordinates are considered rural, therefore response
times of .up to 20 minutes (Code 3 response) or 30 minutes (Code
2 response) will be the maximum acceptable response times. All
areas not identified below are considered urban/suburban, and
are therefore subject to the urban/suburban response time
standards.
04 All 29 ALL 51 D1 D1-4 96 D1-5
06 A7 30 ALL E1 E1-4 E1-6
B1-7 31 ALL 52 ALL 69 A1-5 97 A1-6
C1-7 32 ALL 53 A4-7 B1-7 B1-6
D1-7 33 ALL B4-7 70 B1 C1-6
E1-7 34 A2 C4-7 73 A3-7 D1-7
07 A2-7 B1-2 D5-7 B5-7 E5-7
B5-7 C1-2 E1 C6-7 98 A5-6
C7 D1-2 E6-7 - 74 D4-7 B5-7
D7 E1-2 54 A3 E4-7 101 B1
08 D6-7 35 Al-7 Bl-7 76 D5-7 Cl.
E6-7 B1 C1-7 E1-7 D1-2
09 Al-7 36 C5 D1-7 77 A4-7 E1-3
B1-7 D5-7 E1-7 B5-7 102 D2-6
C1-2 E5-7 55 Al-7 C6-7 E3-7
'C5-7 38 D5 B3-7 D7 103 A3-7
D7 E1-2 C4-7 78 E1 B3-7
E7 39 A6-7 D4-7 79 ALL C3-7
11 .ALL B7 E4-7 80 ALL D3-7
12 Al-7 C2-7 56 A4-7 81 Al E1-7
B1-7 D1-7 B5-7 B1-4 104 ALL
C1-7 E1-7 C5-7 C1-4 105 ALL
D1-7 40 ALL D6-7 D1-4 106 ALL
E3 41 Al-44 E6-7 E1-6 107 ALL
E7 B1-5 57 ALL 82 ALL 108 ALL
14 C1 C1-7 58 ALL 83 ALL 109 ALL
D1 D1-7 59 A6-7 84 ALL 110 ALL
E1-3 E1-7 B6-7 85 ALL 111 ALL
17 A2-7 42 A1-7 C6-7 86 ALL 112 ALL
B2-7 B1-7 61 A1-7 87 ALL 113 ALL
C4-7 C1-7 B1-7 88 A6-7 114 Al
D4-7 D1-4 C1-2 B6-7 116 B1-3
E6-7 E1-4 C4 C6-7 C1-4
18 A6-7 43 ALL C6-7 D6-7 D1-5
19 ALL 44 A5-7 63 Al-2 E6-7 E2-5
23 ALL B6-7 B1-3 X89 ALL 117 E1
24 A1-5 45 Al-5 C1-7 90 ALL 118 Al
B1-5 B1-5 D1-7 91 A7 B1-5
C1-6 C1-6 E1-7 B7 C1-5
D1-5 D1-6 64 ALL C1-7 D1-4
E1-6 El-6 65 C1-7 D1-7 E1-4
25 ALL 46 Al-7 D1-7 E1-7 119 ALL
26 ALL B1-2 E1-7 92 ALL
27 ALL 50 D2-7 66 ALL 93 ALL
28 ALL E2-7 68 C1-2 94 ALL
1
EXHIBIT B
PATIENT CHARGES
Advanced Life Support Service $500.00
Basic Life Support Service $275.00
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