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Contract No. T7- '02%7
CARDIAC CARE PROGRAM EQUIPMENT AGREEMENT
T
THIS A EEMENT is made and entered into this day
of 2006,
by and between
and
COUNTY OF LOS ANGELES
(hereafter "County "),
ARCADIA FIRE DEPARTMENT
(hereafter "Provider ")
WHEREAS, pursuant to the authority granted under the
Emergency Medical Services System and the Prehospital Emergency
Medical Care Personnel Act (Health and Safety Code, sections
1797, et. seg.), ( "Act ") County has established and maintains an
Advanced Life Support ( "ALS ") system providing services
utilizing Emergency Medical Technicians - Paramedics (hereafter
"paramedics ") for the delivery of emergency medical care to the
sick and injured at the scene of an emergency, during transport
to a general acute care hospital, during interfacility transfer,
while in the emergency department of a general hospital, until
care responsibility is assumed by the regular staff of that
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hospital, and during training within the facilities of a
participating general acute care hospital; and
WHEREAS, under the Act County has designated its Department
of Health Services (hereafter "DHS ") as the local Emergency
Medical Services Agency (hereafter "EMS Agency "); and
WHEREAS, the EMS Agency approves paramedic provider
agencies, to render through licensed and accredited paramedic
personnel, ALS level patient care in accordance with policies
and procedures established by the EMS Agency and the State
Emergency Medical Services Authority; and
WHEREAS, the Arcadia Fire Department (hereafter "Provider ")
is an approved primary provider of prehospital emergency medical
services with the City of Arcadia, and is staffed with certified
Emergency Medical Technician -Is ( "EMT ") and licensed and
accredited paramedics; and
WHEREAS, under Title 22, California Code of Regulations
sections 100144 and 100169, the Medical Director of the local
EMS Agency ( "Medical Director ") may approve policies and
procedures allowing a paramedic to initiate a 12 -Lead
electrocardiogram (12 -Lead EKG) on a patient experiencing chest
pain in the prehospital setting, provided that continuous
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quality improvement ( "CQI ") measures are in place as specified
in section 100167 of such regulations; and
WHEREAS, the EMS Agency has established a systemwide CQI
program as defined and required under Title 22, California Code
of Regulations sections 100136 and 100172; and
WHEREAS, the Medical Director, in consultation with the
Cardiac Technical Advisory Group, has approved and recommended
Countywide implementation of 12 -Lead EKGs for prehospital
emergency medical care, and the addition of 12 -Lead EKG
equipment to the ALS Unit Inventory; and
WHEREAS, Provider desires to utilize 12 -Lead EKG equipment
for Provider ALS units in accordance with prehospital emergency
medical care policies and procedures established by the local
EMS Agency; and
WHEREAS, the EMS Agency agrees to reimburse Provider for
the cost of the initial purchase of 12 -Lead EKG equipment and
the initial training associated with the equipment's use, unless
previously funded by other grant funds; and
WHEREAS, the parties agree to cooperate with each other and
with paramedic base hospitals within the County for the
development and implementation of approved ST Elevation
Myocardial Infarction (STEMI) Receiving Centers which will serve
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as a destination for 9 -1 -1 patients who are experiencing a STEMI
as determined by a 12 -Lead EKG administered in the field by an
ALS Unit; and
WHEREAS, County's authority for this Agreement is found in
Health and Safety Code section 1797.252, Title 22, California
Code of Regulations section 100169, and Government Code section
26227; and
WHEREAS, the parties agree that Provider does not waive its
"grandfather" status, if applicable, under California Health and
Safety Code section 1797.201, and that this agreement is solely
for the purpose of establishing terms and conditions of
reimbursement by County to Provider for the 'initial purchase of
12 -Lead EKG equipment and associated training, and does not
impact any of Provider's present or future rights under Health
and Safety Code section 1797.201.
NOW, THEREFORE, the parties agree as follows:
1. BASIS AND PURPOSE: The basis of this Agreement is the
desire and intention of the EMS Agency to cooperate in the
operations of each party's component of the emergency medical
care delivery system, consistent with each party's other health
services activities and fiscal requirements and the duties and
responsibilities of the County and its EMS Agency. The
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Agreement's purpose is to establish, in a manner reflective of
such cooperative basis, the designated rules, duties and
responsibilities of the parties with respect to the matters
addressed herein.
2. TERM: The term of this Agreement shall commence upon
Board approval and shall continue in full force and effect to
and including June 30, 2007.
In any event, this Agreement may be canceled at any time by
either party by the giving of at least one - hundred - eighty (180)
calendar days advance written notice thereof to the other party.
3. ADMINISTRATION: The Director of DHS or designee shall
have the authority to administer this Agreement and subsequent
amendments, if any, on behalf of County. The Provider's Fire
Chief or designee is authorized to administer this Agreement and
subsequent amendments, if any, on behalf of Provider.
4. RESPONSIBILITIES OF THE COUNTY RELATING TO THE
PURCHASE OF 12 -LEAD EKG EQUIPMENT AND TRAINING:
A. County agrees to reimburse Provider for the
initial purchase of 12 -Lead EKG equipment and for the
initial training of paramedic and EMT personnel in the use
of 12 -Lead EKG equipment, at the rates and per terms
specified in Subparagraphs B and C, hereinbelow.
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B. REIMBURSEMENT FOR 12 -Lead EKG PURCHASE:
Reimbursement shall be made by County to Provider within
ninety (90) days of receipt of a complete and correct
invoice from Provider for the initial purchase of 12 -Lead
EKG equipment in accordance with the rate of reimbursement
specified hereunder. Reimbursement by County to Provider
shall be limited to the purchase of one (1) 12 -Lead EKG
machine per approved ALS Unit, to be purchased by Provider
no later than December 31, 2006. County's reimbursement to
Provider shall not exceed a total maximum amount of
Seventeen Thousand Dollars ($17,000) per 12 -Lead EKG
machine, excluding any vendor credit for exchange of
existing EKG equipment. All vendor credit for exchange of
existing equipment for new 12 -Lead EKG equipment shall be
applied to the purchase cost prior to County's
reimbursement to Provider. Notwithstanding the foregoing,
the County shall not reimburse Provider for the purchase of
a 12 -Lead EKG machine if Provider has already received
funding from a grant or any other third party source to
offset the cost of such machine.
C. REIMBURSEMENT FOR INITIAL TRAINING:
Reimbursement shall be made by County to Provider within
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ninety (90) days of receipt of a complete and correct
invoice from Provider for initial training of Provider's
paramedic and EMT personnel in the use of 12 -Lead EKG
equipment. Such invoice must include rosters from initial
training that identify each attendee, each attendee's
classification (paramedic or EMT), date of training, and
total hours of initial training. Reimbursement by County
to Provider shall be limited to the initial training
completed no later than June 30, 2007, and as described
herein. County's reimbursement to Provider shall not
exceed a total maximum amount of Forty -Five Dollars
($45.00) per hour of initial training per attendee, limited
to one category of training per attendee, for the following
maximum hours:
TRAINING CATEGORY
ATTENDEE
MAXIMUM HOURS
ACLS Paramedic 16
(includes 12 -Lead EKG training)
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12 -Lead EKG Paramedic 6
12 -Lead EKG EMT 2
D. Reimbursement by County to Provider shall be made
in the order that invoices are received from all Providers
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under this Agreement (first -come, first- served basis).
Providers that have not received previous grant funding for
reimbursement of expenditures described in Section 4,
Subparagraph A of this Agreement, shall have priority for
reimbursement. Reimbursement shall be made by County to
Provider for 12 -Lead EKG equipment purchased by Provider no
later than December 31, 2006, and for initial training of
Provider's paramedic and EMT personnel on the use of such
equipment that is completed no later than June 30, 2007.
5. RESPONSIBILITIES OF PROVIDER RELATING TO THE PURCHASE
OF 12 -LEAD EKG EQUIPMENT AND TRAINING:
A. Provider shall be responsible for the selection
of a vendor and the initial procurement of 12 -Lead EKG
equipment under the terms of the group purchase plans
developed by the Los Angeles Chapter of the California Fire
Chiefs Association. Provider agrees to equip each approved
ALS Unit within its agency with each 12 -Lead EKG machine
purchased under terms of this Agreement. Purchase of said
equipment must be made by Provider no later than December
31, 2006, to qualify for reimbursement by County.
B. Provider shall coordinate and arrange for the
initial training of paramedic and EMT personnel in the use
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of 12 -Lead EKG equipment
Such training must be completed
no later than June 30, 2007, to qualify for reimbursement
by County.
C. Provider shall submit an invoice to County that
clearly reflects and provides reasonable details for said
purchase of 12 -Lead EKG equipment. Reimbursement by County
will be subject to the terms as set forth in Section 4,
Subparagraphs B, C, and D of this Agreement. Invoice(s)
shall be forwarded by Provider to the EMS Agency, 5555
Ferguson Drive, Suite 220, Commerce, California 90022. All
invoices shall be submitted by Provider to County within
thirty (30) days after purchase of said EKG equipment, with
respect to the purchase deadline as set forth in Section 5,
Subparagraph A of this Agreement.
D. Provider shall submit an invoice to County that
clearly reflects and provides reasonable details of the
initial training of paramedics and EMT personnel on the use
of 12 -Lead EKG equipment. Reimbursement by County will be
subject to the terms set forth in Section 4, Subparagraphs
C and D of this Agreement. Invoice(s) shall include
roster(s) from initial training that identify each
attendee, each attendee's classification (paramedic or
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EMT), date of training, and total hours of initial training
per attendee. Invoices) shall be forwarded by Provider to
the EMS Agency, 5555 Ferguson Drive, Suite 220, Commerce,
California 90022. Invoice(s) shall be submitted by
Provider to County within thirty (30) days after training
is completed, with respect to the training deadline as set
forth in Section 5, Subparagraph B of this Agreement.
E. Provider shall submit upon request by the EMS
Agency, accurate and complete data pertaining to
prehospital emergency medical care of STEMI patients.
F. Provider shall be responsible for: (1) all
maintenance of 12 -Lead EKG equipment purchased under terms
of this Agreement and beyond, (2) expenditure for purchase
of all replacement 12 -Lead EKG equipment, (3) expenditure
for additional and /or future 12 -Lead EKG equipment
purchased after December 31, 2006, and (4) expenditure for
training on the use of 12 -Lead EKG equipment that occurs
after June 30, 2007.
G. Provider agrees to utilize any 12 -Lead EKG
equipment subject to this Agreement in a manner consistent
with standards, policies, and procedures of the EMS Agency.
Provider agrees that in such utilization it shall provide
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prehospital care as needed without regard to a person's
ability to pay.
6. INDEPENDENT CONTRACTOR STATUS: This Agreement is by
and between County and Provider and is not intended, and shall
not be construed, to create the relationship of agent, servant,
employee, partnership, joint venture, or association, between
County and Provider. Provider understands and agrees that all
the Provider employees performing services on behalf of Provider
under this Agreement are, for the purposes of worker's
compensation liability, employees solely of Provider and not of
County.
7. INDEMNIFICATION: Each party (Indemnifying Party)
shall indemnify, defend, and hold harmless the other, and the
other's Special Districts, elected and appointed officers,
employees, and agents from and against any and all liability,
including but not limited to demands, claims, fees, actions,
costs and expenses (including attorney and expert witness fees)
arising from or connected with the Indemnifying Party's acts
and /or omissions arising from and /or relating to this Agreement.
8. MAXIMUM COUNTY OBLIGATION: County has allocated a
maximum total amount of Four Million Dollars ($9,000,000.00) for
reimbursement of allowable costs incurred by all Providers under
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terms of this Agreement. The parties acknowledge that this
funding is comprised by revenue generated by Measure B,
Preservation of Trauma Centers and Emergency Medical Services
annual special tax as allocated by the County Board of
Supervisors (Measure B Trauma Property Assessment [TPA] Funds).
The parties further acknowledge that, following all due payment
by County to all Providers under terms of this Agreement, any
Measure B TPA funds unused at the termination of this Agreement
shall remain in the Measure B Special Fund, pending additional
use subject to approval by the County Board of Supervisors.
9. MERGER PROVISION: The body of this Agreement, and any
exhibits attached hereto, fully express all understandings of
the parties concerning all matters covered and shall constitute
the total Agreement. No addition to or alteration of the terms
of this Agreement, whether by written or verbal understanding of
the parties, their officers, agents, or employees, shall be
valid unless made in the form of a written amendment. to this
Agreement which is formally approved and executed by the
parties.
10. COMPLIANCE WITH HEALTH INSURANCE PORTABILITY AND
ACCOUNTABILITY ACT OF 1996: The parties acknowledge the
existence of the Health Insurance Portability and Accountability
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Act of 1996 and its implementing regulations ( "HIPAA ").
Provider understands and agrees that as a provider of medical
treatment services, it is a "covered entity" under HIPAA and, as
such, has obligations with respect to the confidentiality,
privacy and security of patients' medical information, and must
take certain steps to preserve the confidentiality of this
information, both internally and externally, including the
training of its staff and the establishment of proper procedures
for the release of such information, and the use of appropriate
consents and authorizations specified under HIPAA.
The parties acknowledge their separate and independent
obligations with respect to HIPAA, and that such obligations
relate to transactions and code sets, privacy, and security.
Provider understands and agrees that it is separately and
independently responsible for compliance with HIPAA in all these
areas and that County has not undertaken any responsibility for
compliance on Provider's behalf. Provider has not relied, and
will not in any way rely, on County for legal advice or other
representations with respect to Provider's obligations under
HIPAA, but will independently seek its own counsel and take the
necessary measures to comply with the law and its implementing
regulations.
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Provider and County understand and agree that each is
independently responsible for HIPAA compliance and agree to take
all necessary and reasonable actions to comply with the
requirements of the HIPAA law and implementing regulations
related to transactions and code set, privacy, and security.
Each party further agrees to indemnify and hold harmless the
other party (including their officers, employees, and agents),
for its failure to comply with HIPAA.
11. NOTICES: Any and all notices required, permitted, or
desired to be given hereunder by one party to the other shall be
in writing and shall be delivered to the other party personally
or by United States mail, certified or registered, postage
prepaid, return receipt requested, to the parties at the
following addresses and to the attention of the person named.
The Medical Director shall have the authority to issue all
notices which are required or permitted by County hereunder.
Addresses and persons to be notified may be changed by one party
by giving at least ten (10) calendar days prior written notice
thereof to the other.
A. Notices to County shall be addressed as follows:
1. Department of Health Services
Emergency Medical Services Agency
5555 Ferguson Drive, Suite 220
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Commerce, California 90022
Attention: Director
2. Department of Health Services
Contracts and Grants Division
313 North Figueroa Street, 6 L Floor East
Los Angeles, California 90012
Attention: Division Chief
3. Auditor - Controller
Kenneth Hahn Hall of Administration
500 West Temple Street, Room 525
Los Angeles, California 90012
Attention: Director
B. Notices to Provider shall be addressed as
follows:
Arcadia Fire Department
630 South Baldwin Avenue
Arcadia, California 91007
Attention: Kurt Norwood, Battalion Chief
IN WITNESS WHEREOF, The Board of Supervisors of the County of
Los Angeles has caused this Agreement to be subscribed by its
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Director of Health Services and Provider on its behalf by its duly
authorized officer, the day, month, and year first above written.
ARCADIA FIRE DEPARTMENT
By U6&f
William R. Kelly
City Manager
COUNTY OF EOS AN EL
By L
Bruce A Ch n'of,
Directo and Chie
Officer
APPROVED AS TO PROGRAM:
By Department of Health Services
Da id R. Lu r. %
Fire Chief //
By
Carol Meyer, Dir for
Emergency Medical Services Agency
APPROVED AS TO FORM:,
Stephen Deitsch
City Attorney
APPROVED AS PO FORM
BY THTE OF THE COUNTY COUNSEL
Deputy
APPROVED AS TO CONTRACT
ADMINISTRATION:
Department of Health Services
�
By Cam- 6? ( ���,(/"
Cara O'Neill, Chief
Contracts and Grants Division