HomeMy WebLinkAboutSLO Ambulance - Agreement for Assignment of Billing Rights for 1st Responder 6.24.13AGREEMENT FOR ASSIGNMENT OF BILLING RIGHTS
FOR FIRST RESPONDER SERVICES
This Agreement for Assignment of Billing Rights for First Responder Services
("Agreement"), by and between the City of San Luis Obispo, a municipal corporation
("City") and San Luis Ambulance Service, fnc., a Califomia corporation ("SLAS") is
entered into on the date set forth below. Collectively, the parties to this agreement are
referred to as "the parties."
RECITALS
WHEREAS, SLAS is party to a May 24,2011 agreement with the County of San
Luis Obispo to provide ambulance services within the County of San Luis Obispo of which
a true and correct copy is attached hereto as Exhibit 1, and
WHEREAS, Article 4 of the May 24,2011 agreement with the County of San Luis
Obispo provides that SLAS shall make certain payments to the City in exchange for a
general assignment of the City's rights to bill persons for certain services provided by its fire
department in connection with emergency calls for medical assistance; and
WHEREAS, City's fire department meets minimum Advanced Life Support
Services requirements and./or EMT-D qualifications as set forth by the County of San Luis
Obispo's Emergency Medical Service Agency; and
WHEREAS, Article 3 of the lll4ay 24,2011 agreement with the County of San Luis
Obispo provides Performance standards utilizing City's First Responder Advanced Life
Support and/or EMT-D services in meeting SLAS deployment plan goals; and
WHEREAS, Article 4 of the }lay 24,2011 agreement with the County of San Luis
Obispo requires that the parties to this Agreement enter into a separate written agreement
providing for assignment of the City's rights to bill persons for these services.
NO'W, THEREFORE, IN CONSIDERATION OF THE PROVISIONS SET FORTH
BELOW, THE PARTIES AGREE AS FOLLOWS:
l. Definitions: The parties hereby incorporate by reference all definitions set
forth in Article I of the I|i4ay 24,20II agreement between SLAS and the County of San Luis
Obispo.
2. Assisnments: City hereby assigns its rights to SLAS to directly bill persons
for first-response emergency medical services provided by its fire department in connection
with emergency calls for medical assistance. First-response emergency medical services
provided by the City's fire department include, but are not limited to, providing initial
stabilization and trained on-scene assistance, and assistance en-route to medical facilities as
required, and extrication and rescue services.
3. Timing and Amount of First Responder Payment: The Contractor fust
responder payments for Fiscal Year 2010-ll are shown in County and SLAS Agreement,
Exhibit C. All first responder payments shall be made no later than the end of the second
month following the end of the quarter for which the payment accrued (for example,
payment for the period of April l't through June 30ü will be due on or before the following
August 30ft).
4. Annual Adjusünent to Payments: The quarterly payments to the first
responder agencies will be adjusted annually, on July 1, in propofion to the change in the
Los Angeles-Riverside-Orange County Consumer Price Index. However, in no event shall
the annual increase exceed five percent (5%). The indexes shall be for All Urban
Consumers as published by the Bureau of Labor Statistics.
5. Equipment Exchanqe and Replacement: SLAS shall establish a restocking
plan and replenish disposable medical supplies and equipment used by CITY in connection
with each patient transport.
6. Indemnification: SLAS shall defend, indemniff, save and hold harrnless the
City and its officers and employees from any and all claims, costs and liability (including
without limitation, attomeys' fees) 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
SLAS or its agents, servants, employees or subcontractors, save and except claims or
litigation arising from the sole negligence or sole willful misconduct of the City or its
officers or employees.
7. Term: The term of this Agreement shall be the same as set forth in Article 7
of the }/.ay 24,2011 agreement between the County and SLA. If the agreement between the
County and SLAS is extended, SLAS shall continue to make payments as set forth above,
and City shall continue to assign its rights to directly bill persons for emergency services
rendered by its fire department.
8. Early Termination: This Agreement may be terminated by either party, in its
sole discretion, upon one hundred eighty days' advance written notice to the other party.
This Agreement may be terminated immediately upon written mutual agreement of the
parties. Furthermore, City may terminate this Agreement immediately should the County of
San Luis Obispo terminate its March 26,1996 agreement with SLAS as provided in Section
7.3 of that agreement.
9. Modification: This Agreement may be modified or amended only by a
written document executed by the City and SLAS. This Agreement contains all the terms
and conditions agreed upon by the parties. Except as expressly provided for in this
Agreement, no other understanding or representation, oral or otherwise, regarding the
subject matter of this Agreement, shall bind or affect either of the parties.
The foregoing agreement was adopted this ay of 2013.
Mam
San Luis Obispo
ATTEST
City
APPROVED AS TO FORM:
Dietrick, CþAttomey
y-z >.//&
President and CEO Frank Kelton
San Luis Ambulance Service, Inc.
rhis agreement, enrere. 'Ï,:i:Hiii,iiTÏ:är between the counry orsan
Luis Oblspo (hereafter "County") and San Luis Ambulance Service, Inc., a California Corporation
(hereafter "Contractor"),
WITNESSETH
WHEREAS, the County regulates the operation of ambulance providers pursuant to the
provisions of Chapter 6.60 of the San Luis Obispo County Code (hereafter "Chapter 6.60"); and
WHEREAS, the Contractor has been a licensed provider of ambulance services Ín San Luis
Obispo County since 1945; and
WHEREAS, on March 26,t996,the County entered into a contract with the Contractor
designating the Contractor as the exclusive ambulance service provider in the Northern and Central
ambulance services areas of the County (hereafter "the 1996 Northernl0entral.Area,Contracü,);
and
WHEREAS, on May 6, L997,the County entered'into a contract with Five Cities Ambulance
Servlce, [nc; designating said cornpany as the exclusive ambulance service provÍder in the Southern
ambulance service area of the County (hereafter "r}re L997 Southern Area Corttract"); and
WHEREAS, by L999,Five Cities Ambulance Service, Inc. was experiencing financial and
operational problems that could only be cured by an infusion of,capital; and.
WHEREAS, the Contractor became the successor in interest of Five Cities Ambulance
Service, Inc. in L999, Subject to the approval of the County; and
WHERE^AS, on March I ,?OAÛ,the County gave its approval of the Contractor's stahls as the
successor in interest of Five Cities Ambulance Service, Inc., on May 23,2000, the County approved
amendments to both the 1996 Northern/Central Area Contrad and the 1997 Southern Area
Contract to èffectuate the transfer; and
WHEREAS, said amendments extended the duration of both contracts to make it feasible for
the Contractor to justify and recover the investments that would be necessary to upgrade the
operation of Five cities Ambulance service, Inc. to an acceptable level; and
WHEREAS, the 1996 Northern/Central Area Contract and the 1997 Southern Area Contract
contain somewhat varnng provisions that create ineffÌciencies aird inconsistencies; and
WHEREAS, to enhance. efficiency and consistency, the County desires to replace the two
existing'contracts with a single contract covering the North, Central and South emergency response
areas ofSan Luis Obispo County; and
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WHEREAS, the parties also desire to define an objective process for periodic review of the
maximum rates that may be charged by the Öontractor, as set forth below; and
WHEREAS, the parties desire to clarify the language of the former contracts and to make
certain other technical changes to the agreement as set forth below; and
WHEREAS, Chapter 6.60 defines the process for the development of ambulance provider
agreements and selection of provÍders whereby ambulance providers are designated by agreement
between County and the designated provider; and
WHEREAS, the Arnbulance Performance/0perations Committee (hereafter "APOC")
established pursuant to Chapter 6.60 has reviewed this agreement and recomnilended that County
enter into this agreement with the Contractor for the provision of ambulance services;
NOW, THEREFORE, irt,consideration'of the provisions set forth beloq the parties herebyagree as
follows:
ARTICIE 0.5 TRANSITIONAL PROVISIONS '
' Effectlve Date. This contract shall be effective upon the date (hereafter "Effective Date")
whlch is the latter of (1) the date that it is siecuted by,the Contractor and (2) the date of the Board
of Supervisors meeting at whlch it is approved; , : :
Rtghts and Obllgatlons with Respect to the Provlslon of Ambulance Servlces ffom and
after the Effectlve Date. This agreement governs the rights and obligations of the County and the
Contractor with respect to ambulance services provided on and after the Effective Date. Neither the
1996 Northern/Gentral Area Contract nor the 1997 Southern Arèa Contract shall have any effect on
said rights and obligations.
Rtghts and Obltgatlons with Respect to the Provlslon ofAmbulance Services before
the Effectlve Date, This agreement shall have no effect on the rights and obligations of the County
or the'Contractor with respect to ambulance services þrovided before the Effective Date. The 1996
Northern/Central Area Contract and the 1997 Southern Area Contract shall continue to define the
rights and obligations of the parties with respect to ambulance services provided before the
Effective Date.
'ARTICLE 1. DEFINITIONS :
, For the purpose of this agreement, all words and phrases that are defined in section
6.60.010 of the San Luis Obispo County Code shall have the meaning ascribed to them in said
sectíon of the County Code and are incorporated herein by reference. The following words and
phrases that are not defined in section 6.60.010 shall have the following meaning:
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1t
Advanced Llfe Support (A"t$): For ambulance services, means special services designed to
provide deffnitive prehospital emergenry medical care, including but not limited to,
cardiopulmonary resuscitation, cardiac monitoring cardlac defibrillation, advanced airway
managemenÇ intravenous therapy, administration of specified drugs and other mechanical
preparations, and other medicinal preparations, and other specified techniques and proceduies
administered by authorized personnel under the direct supervision of a Base Hospital as part of the
local EMS system at the scene of an emergency during transport to an acute care hospital and
during inter-facility transfer. :
Advanced Llfe Support (ALS) Provtder: A public or private provider authorlzed to
operate ALS units and provide ALS services in San Luis Obispo Cpunty.
Ambulance Performance/Operatlons Gommittee (APOC): The advisorybodycreated
pursuant to section 6.60,050 of Chapter 6.60.
Ambulance Servlce Area: For purposes of this contract, the North, Central and South
Emergency Response Areas as defined in Exhibit A, attached hereto and incorporated herein by this
reference.
Baslc Llfe Support (BtS): Ernergency first aid and cardiopulmonary resuscitation
procedures which as a minimum include recognizing respiratory and cardiac airest and starting the
proper application,of cardiopulmonary resuscitation to maintain life without invasive techniques
until the victim may be transported or until Advanced Life Support is available.
Chapter 6.60: Chapter 6.60 of the San Luis Obispo County Code ("Prehospital Emergency
Medical Care and Transport Services").
Contract Manager: The Coun!y's Health Agency Director, or designee, or successor in
responsibility. :
Emergenry: A condition or situation in which an individual has a need for immediate
medical attention or where the potential for such need is percelved by emergenry medical
personnel or a public safety agency.
EMS A'ct: California Health and Safety Code Sectio ns L797 et seq., or successor legislation
on the same subjecL
EMS rystem: A system of organizations, resources and individuals from whom some action
is required to ensure a timely and medicallyappropriate response to medical emergencies.
Flrst Responder Agency: Typically a public agency, such as a fire department, that
responds to emergency calls for medical assistance, providing initial stabilization and trained
assistance on-scene and when required en-foute to medical facilities; also refers to certain
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extrication and rescue services. In accordance with priority dispatch protocol, a first rêsponse unit
is routinely sent to all presumptively classified life-threatening calls within the Ambulance Service
Area.
Incident Command System: The combination of facilities, equipment personnel,
procedures, and communications operating within a common organizational structure, with
responsíbility for the management of assigned resources to effectively accomplish stated objectives
pertaining to an incident.
Life Threatenlng Emergencles: Those situations determined in accordance with local
medical dÍrection that are likely to result in the loss of life without fmmediate intervention,
Local EMS Planr The emergency.medical services plan adopted bythe local EMS Agenry
pursuant to the requirements of the EMS Act.
Medical control: The medical management of the emerg€ncy.medical services systern
pursuant to the provisions of Health & Safety Code chaptêr 5, sections 1978 et seq.
Paramedlc: An individual trained and licensed to perform ALS procedures under the
direction of a physician (also referred to as an EMT-P).
Paramedlc Ambulance: An ambulance staffed by a miriimum of one licensed Paramedic
and one certified EMT and equipped to provide ALS.
Transport: When a patient is transported by ambulance to a hospital or between medical
facilities where the medical capabilities of an ambulance are required or potentially required.
ARTICLE 2. DESIGNATION AS PROVIDER AND DESCRIPTION OF SERVICES TO BE PR.OVIDED
2.1 Servlces - In General. Pursuant to Chapter 6.60,the County hereby designates the
Contractor as the Ambulance Service Provider for the Ambulance Service Area. Within said,
Ambulance Service Areas, the Contractor shall provide emergency ambulance service witliout
interruption, 24 hours per da¡ every da¡ for the full term of this contract, in accordancewith all
provisions of this contract, The Contractor shall provide said emergenc¡r ambulance services ,''
without regard to the patient's race, color, national origin, religious affiliation, age, se& sexual
orientation, disability, and any other protected class under state or federal law, or abilþto pay.
2,2 Appllcable Standards and Involved Agencies. The Contractor shall provide Advanced
Life Support (ALS) emergency ambulance services under medical control as dispatched by MED-
COM. Such services shall be provided in accordancewith the requirementS of.the EMS Act, Chapter
6.60, the Local EMS Plan, this contract, and any other applicable statutes, ordinances and
regulations. In performing services hereunder, the Contractor shall work cooperatively with the
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local EMS agency. The Contractor shall also cooperate with the Ambulance Perform ance/
operations committee (APOC) with respect to matters within its purview.
2¡3 AlrAmbulance Transport. The County reserves the rightto enter into separate
transport agreements with air ambulance providers. Notwithstanding any other provision of this
agreement, the County may provide for air transport of patients when such transportation is
deemed bythe most senior medical personnel on the scene to be 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 àmbulance to
the most accessible emergency medical Facility equipped, staffe{ and prepared to administer care
appfopriate to the needs of the patient is the same or less than the estimated air transporttime.
2.4 Non-Proflt Transport Sen4ces. The County reserves the right to enter into separate
agreements-with non-profit agencies or districts whose purpose is to ¡educe the tnayel tirne for
patients residing in the more rural or inaccessible areas of the County. Such agreements will be
structured so as to ensure that the Contractor will be involved in meeüng non-profit transport
agencies at pre-determÍned transfer points for the transfer ofpatient care to the Contractor. Such
plans will be developed under the approval of the local EMS agency.
2;5 Requlrement for Non-Emergency Ambulance Sérvlces: It is the intent of the Local
EMS Plan and related ambulance provider agreements to establish Exclusive OperatingAreas
("EOAs") within which the designated ambulance seryice provider will retain the authority and
responsibility for the provision of all ambulance services in the EOA. When requests for non-
emergency ambulance transport service are made, the Contractor may tâke the tirne necessary to
mobilize resources beyond that on-duty at the time of the request However, at any time, the lead
medical þersonnel at the scene of the patient requiring transport (typically a hospital or hospital
emergency room) may upgrade the patient's status to one requiring emer$enry medical transport.
At that time, the designated Contractor in that EOA must respond immediately, as they would for
any emergency request.
2.6 Crltlcal Care Transports Contractor may operate a program of critical care transports,
which are nurse-staffed inter=facility transports for both emergency and non-emergency patient
conditions, in compliance with the policies and p¡ocedures developed bythe local EMS Agency.
Contractor may charge a critícal care transport base rate plus mileage for transportation. That rate
shall be subject to the rate review process as set forth in Article 6 herein.
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ARTICLE 3. PERFORMANCE STANDARDS
3.1 Deployment Plan. Throughout the term of this agreement, the Contractor shall comply
with the specific Deployment Plan requirements contained in Exhibit B, attached hereto and
incorporated herein by this reference, specifying all the ambulance stations (general locations) and
the number of vehicles to be deployed durÍng each hour of the da¡ and each day of the week for
each specific area or zone.
The general goal of the Deployment Flan is to provide an Advanced Life Support (ALS) uniÇ
either by the Contractor or by an ALS fire service agency, to at least 90% of all potentially life
threatening emergencyambulance requests originatingwithin eachAmbulanre Seruice Areawith a
maximum response time of 10 minutes in areas designated urban, and a maximum response time of
30 minutes in äreas designated as,rural, and a maximum response time of 60 minutes in areas
designated as remote; The-various areas ar€ set forth in Exhibit A;attached hereto and incorporated
herein by this reference;
Upon request, for purposes of contract administration, the Contractor shall provide
documentation regardingthe degree to which it has complied with the Deployment :
Plan, (Deployment Plan specifics for each zone are found in Exhibit B).
3.2 Staffing and Personnel. The Contractor shall send a Paramedic Ambulance staffed with
a minimum of two personnel;whose level of certification shall, as a minimum, be one Emergency
Medical Technician-l (EMT-I) and one Emergency Medical Technician-Pararnedic (EMT-P) to all life
threatening and potentially life threatening emergenc)¡ medical requests. Specific certification,
training supervision and preparedness requirements are outlined below.
A. Certlflcatlon. All ofthe Gontractorls ambulance personnel respondingto
emergenql¡ medical requests shall be currentl¡r certified and/or licensed by both the State of
California and the local EMS agency. ln addition, all of the Contractor's EMT-Ps shall be currently .
accredited by the local EMS agency-to practice in San Luis Obispo'County. The Contractor shall
retain on file at all tímes copies of the required current and valid licenses, certifications¡ and/or
accreditations of all emergency medical personnel perfor.ming services under thís agreemenL
B; Reasônable Work Schedules and Worklng Condtdons. As an independent
contractor, the Contractor shall be responsible for determining the méthods and techniques for
achieving compliance with the requirements of this contract; provided however, that the
Contractor shall utilize reasonable work schedules and work periods for its personnel so that they
are fresh enough to be able to perform safely and to provide adequate petientcare. The Contractor
shall ensure that any of its personnel, who work extended shifts, part-time jobs, voluntary overtime,
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or mandatory overtime, are not exhausted to such an extent that their judgment or motor sldlls
might be impaired. With the exception of extreme emergencies, the Contractor shall not knowingly
allow its personnel to work at any provider (public or private) in excess of seventy- two (72)
consecutive hours. The Contractor must provide each and every one of its ambulance personnel
with no less than twenty-four Q$ hours of off-dutytime, immediately following each work period.
C. Requlred Hazardous Materials Trafntng. The Contractor shall staff each
ambulance with Paramedics and EMTs who shall, within ninety (90) da¡rs of hire by Contractor,
each show sufficient evidence that they have successfully completed "Hazardous Materials - First
Responder Operational Course," or training that has been accepted as equivalent by the local EMS
agency and the County Fire Chiefs Haz-Mat Committee.
D. Orlentatlon and On-Gotng Preparedness. The Contractor shall properþ orient
all field personnel.before assigning them to respond to emergency medieal,requests. Such , :
orientation shall include at a minimum, ALS Provider policies and procedures; EMS system
overview;,EMS policies and procedures; radio communications with and behnteen the provider
agency, Base Hospital, protocolswith other'agencies (fire service, Sheriff/Coroner), receiving
hospitals, and MED'COM; map readi,ng skills including key landmarks,.routes to hospitals and other
major receiving facilities within the Countyand in surrounding areas; and ambulance and
equipment utilization and maintenance.
E. Fleld Supervislon. The Contractor shall provide at all times' and within.San Luis
Obispo County an individual autìòrized to act on behalf of the Contractor in all operational matters.
F. Preparatlon for Multl-Casualty Response..The Contractor,shall train all
annbulance pe,rsonnel and;supervisory staff in their respective roles and responsibilities unden the
County of San Luis Obispo Disaster Plans which are on file at the local EMS agency and prepare
them to, function,in the variety of roles that are required within the Incident Command System.
, G. Crttlcal Incldent Stress Debrleffng. The Contractor shall.make available to allr
Contractor employees the County Fire Chiefs Critical Incident Stress Debr.iefing Program. The
Contractor shall encourage program/team participation by the Contractor's employees. The
Contractor shall contribute up to $750 per zone per year to the Fire Chiefs Association, upon theÍr
request, to assist in funding the program/team. The Contractor shall not be required to contribute
such funds for any purpose other than ongoing training and support that is directþ linked to the
program/team's needs.
H. Tralnlng with Flre Agencles. The Contractor shall ensure that its ambulance
crews make themselves available to train with fire agencies located within all service areas covered
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by this contracÇ enga$ng in f oint training with each local fire department at least twice each
calendar ¡lear.
I. Communlcatlon with Flre Agencies. The Contractor shall ensure that its
Operations Manager makes himself or herself available to meetwith fire chiefs from public agencies
Iocated within each ambulance service area on a quarterly basis. The Contractor shall schedule
these meetings with reasonable notice to the fire chiefs.
3.3 Vehtcles and Equlpment.
A. Vehlcles. Ambulance vehicles shall at a minimum meet the standards of Title
XIII, California Code of Regulations. Vehicles shall display the n911" emergency telephone number
and state the level of service, 'Paramedic Unit," on both sides and the unit identification number/
radio designation in 4-inch letters. Ambulance vehieles shall be marked to identify the company
name, but shall not displa¡r any telephone number other than'91L or any'other advertisement, The ,
Contractor shall malntain its vehicles Ín a good working ordet consistent with the.manufach¡rer's
specifications. ln addÍtion¡ detailed records shall be maintained as to wofk performed costs related
to repairs¡ and operating and repair costs analyses where appropriate. Reports shall be
accomplished and systems shall be maintained so as to achieve at least the industry norms in
vehicle performance and reliability,
B. General Equipment. All of the Contractor's ambulances shall carry all
emergency supplies, and equipment identified in the County Ambulance Equipment and Supply
Policy on file atthe local EMS agency on each of the licensed units. The Contractor shall maintain its
vehicles, equipment,and supplies in a clean, sanitary and safemechanical condition at all times.
The Contractor agrees that equipment and supply requirements may.be changed with the,approval
ofthe Contract Manager due to changes in technology.
. C. Communlcadons BQulpment and Dlspatch.The Contractor shall equip all
Parârnedic arnbulances and supervisory vehicles used i¡,providingservice with a County MED-
CoM-capable radio. Each ambulance and+upeMsory vehicle shall also be equipped with a cellular
telephone. All ambulances for emexgency medical response under the terms of this agreement shall
operate only within San Luis Obispo County, or as directed by MED-COM; or in compliance with
policies and protocols established by the County. UHF:and VHF radio frequencies shall be
designatedbythe County. The Contractor shall operate the two-way radios in conformance with all s
applicable rules and regulatiôns of the Federal Communications Commission, artd in conformance
with all applicable state and/or County rules and operating procedures.
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D. Fallure to Meet Mlnlmum In-Servlce Equipment/Supply Requlrements. The
County may inspect the Contractor's ambulances during normal business hours, with prior notice.
Any ambulance that fails to meet the minimum in-service requirements contained in the County
Ambulance Equipment and Supply poliry, as determined bythe County, shall be immediately
removed from seMce until the deficiencyis corrected, and shall be replaced as necessaryto ensure
continued compliance with the deplo¡rment requirements contained in Exhibit ts.
E. Equlpment Exchange and ReplacemeRt. The Contractor shall irnplement and
maintain inventory control and equipment maintenance systems which keep the ambulance fleet
fully stocked with approved equipment in good worldng order at all times. The Contractor shall
establish a mechanism to replenish disposable medical supplies and equipmentused by a public
first responder agency in connection with each patiertt transport
F. Ambulance Restocklng Program. The Contractor shall continue its:restocking
plan for all first responders Ín its Ambulance Service Area. Said restocldng plan shall be approved
bythe Contract Manager and local EMS agency.
G' Dally Ambulance and Equlpment Inspec'tlon and Gheck-Out. Eabh da¡ each
arnbulance unit and the equipment contained therein shall be inspected and checked out. Each
ambulance unit shall be restocked following each response, êxcept in cases where back-to-back
responses donrt allow for restocking prior to initiating the second response. Equipment and
supplies shall be maintained at'levels that assure that back-to-back responses do not cause an
ambulance unit to respond to an emergenry medical call without sufficient equipment and supplies.
H. Ambulance ïlpe. The Contractor shall continue to maintain its entire fleet of
ambulances as Typp III, with the exception of four wheel drive ambulances used by Contractor for
off road access.
. 3.4 Dlsaster, Multl'casualty, Munral Atd Response and Standby, The Contractor will ,
deploy resources in accordance with'emergency.and or mutual aid plan or plans approved bythe ,
County. The Contractor shall render.ernergency assistance in multi-casualty or disaster situations
to any locatÍon as directed by MED-COM. At the scene of the multi-casualty incident or disaster, the '
Contractor's personnel shall perform in accordance with the County's Emergency Response plans
and the Incident Command System. When the Contractor is notified that multi-casualty/disaster
assistance is no longer required, the Contractor shall return all of its resources to the primary area
of responsibility and shall resume all operations in a timely manner. During the course of the multi-
casualty/disaster, the Contractor shall use its best effonts to provide local standard emergency
coverage by providing back up units.
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A. Tralnlng. The Contractor shall particlpate in disaster and multi-casualty training
and.exercises conductedb¡r the local EMS agency, the County and fire service agencies as requested.
B. Stand-By Servlce. The Contractor shall prpvide, at no charge to the County or
requesting agency, stand-by services at the scene of an emergenry incident within its ambulance
seruice area when directed by MED-COM.upon the request of a public safety agency. The Contractor
may charge for stand-by at an incident where a responsible party exists.
3.5 Move Up and Cover. The Contractor shall provide ambulance move-up and coverage
for service areas left uncovered due to other emergency responses, as directed by MED-COM.
Nothing shall preclude contractors in each service area from developing mutual coverage
agreements that may or mây not involve financial remuneration. When a contractor provides inter-
service area coverage at the request of MED-COM, contraútor shall be exempt from normal zone
coverage,requirements'
ARTICTE 4. FIRST RESPONDER SUPPORT.
.4.1 Uttllzatlon of Flre.Departnent Personnel. The County and the Contractor
acknowledge that fire service personnel play an integral part of the County's EMS system. They are
involved in scene managemenÇ patient care atboth ALS and BLS levels, auto extrication, heavy
rescue and cliff/wilderness rescue and assistance in patient transportation. The number and type
ofresources required ofContractor for each zone have been configured around the participation qf
tlre vanious fire service resources within the zone. If a public agency providing fire-based first
responder services executes a separate agreement with Contiactor generally assigning to
Contractor its right to bill patients for first,responder services¡ Contractor shall pay the first
responder agency for said assignment of billing rights in accordance with section 4.2 below. In
order to be eligible for support fees, ñre seMce agencies'must meet minimurn ALS requirements or
EMT-D qualifications as outlined by the local EMS agency: In the,event that there is a request by a
fire agency'for a change in its ALS Service or first responder fees, and to the extent that such
request may impact resource requirements and deplo¡rment as set out in Exhibit B, County, in
consultation with Count¡/s Ambulance Performance/Operations CommÍttee (AFOC), shall consider
the impact on Contractor of such change er request during the periodic rate rev.iew as set out in
Article 6. l
4.2 Ttmlng and Amount of Flrst Responder Payments. The Contractor shall make the
fìrst respondenpayments shown in Exhibit C, attached hereto, and incorporated herein by this
reference, to the agencies identiñed in Exhibit C, in the amounts shown in Exhibit C: All first
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responder payments shall be made no later than the end of the second month following the end of
the quarter for which the payment accrued (for example, payment for the period of April lst
through fune 30th will be due on or before the following August 30tÐ.' 4'SAnnual Adiustment to Payments. The quarterly payments to the first responder
agencies will be adjusted annually in proportion to the change in the Los Angeles-Riverside-Orange
County Consumer Price Index. However, in no event shall the annual increase exceed five percent
(50/o). The indexes shall be for All Urban Consumers as published bythe Bureau of Labor Statistics
using fuly as the base month.
4.4 Independent Agreements wtth Other Agencles. Nothing in this agreement shall
preclude Contractor from enteiing into other agreements with local fire service agencies to
improve the EMS system's overall efficiency. Any such agreement must be approved by the County's
Ambulanee Ferforrnance/Operations Committee (ApOC). i..
ARTICLE 5. RECORDS, REPORTING AND INSPECTIONS
5.1 EMS Run Report. The Contractor shall utilize the County's apþroved format for
documentation on all patient responses, including non-transports. The 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 the lscal EMS agency's policies and procedùres. The :
Contractor shall purchase aRy required forms. At the Contractor's option, the Contractor may print
its own supply of forms. All forms are subject to revision by the local EMS agency at any time. The
Contractor shall providethe Countywith copies of individual EMS rün rep.brß as requested bythe
local EMS agency' When so requested, reports shall be provided by the Contractor to the local EMS
agencywithinthree (3) business days of the request, The Countywilllimit srrch'requests to
circumstances that merit special handling.
5.2 Personnel Reports. The Contractctr shall provide the local EMS agencywith a list of
EMS personnel currently employed by the Contractor and Shall ü¡ldate that.list whenever there is a
change. The personnel list shall include, at a minimum, the name, address, telephone nurnber,
Paramedic, CPR and ACLS expiration dates, and California Driver's License number of each person
on the list.
5.3 Audlts and Inspecttons. The Contracbr shall maintain separate business and financial
records for services provided pursuant to this agreement in accordance with generally accepted
accounting principles. The County shall have the following rights of audit and inspection:
Poge 17 of20
A. Inspection and Copylng. Upon reasonable advance notifìcation, during normal
business hours, the County shall have the right to review any and all ofthe Contractor's business
and financial records pertaining to this agreement. All such records shall be made available to the
County at its San Luis Obispo Coünty office or other mutually agreeable location. The County 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 emplo¡rment agreements.
B. Flnanclal Statements. Annuall¡ the Contractor shall obtain and provide the
Coun$r with financial statements upon request. If the Contractor has audited financiaÌ statements in
its possession, Contractor shall make those available to the County. Otherwise, the.ñnancial
statements shall be prepared by a Certiffed Public Accountant and shall complywith generally
accepted standards for Reviewed Financial Staternents. The fìnancial statements shall cover the
Contractor's ambulance operations and/or any other businesses thæ- share overhead with the
Contractor's ambulance service operation.
C. Records of Bllllng; The Contractor shall provide the County upon request with
periodic repoft(s) in the format approved by the Contract Managerto demonstrate billing
compliance with approved/specifi ed rates.
, D, Budget Forecasts and Other Reports. The Gontract Manager may require the
Contractor to assist in future budget forecasting for planning purposes. The Contractor silall
provide the Counly with such assistance and other reports and records as may be reasonably
requiredbyContractManager. : '
' E. Obser'vatlon of Operatlons¡ Contractor shall allow Contract Manager or his/he,r
representatives, at a mutually agreed upon time, tO directly observe the Contractor's control center
operatlons, maintenance facilities, and,ambulance post locations, a¡d to ride as "thlrd person" to
observe the operation of any of the Contractor's ambulance units. The Contract manager or his/her
representative shall conduct themselves in a professional and courteous rnanner, shall not interfere
witþ the Contractorls emplo¡rees in the performance of their duties, and.shall at all times be
respectful of the Contractor. The Contractor shall submit to an annual performance evaluation in
acÇordance with procedures established by Contract Manager. It is also understood that at any time
the County may cause to be monitored the response time of any ambulance crew, so as to ascertain
compliance with standards that are established in Article 3 of this ag¡eement.
ARTICLE 6. PATIENT CHARGES
Pøge 12 of 2.0
6,1 Gharges for Services Provided. The Contractor's patient charges for servlces provlded
pursuant to this agreement shall not exceed the rates as established by the County.
. A. Consumer Prlce lndex AdfuSment tn Charges. Adjustments in patient charges
will beeffective at the conclusion of each annual rate review. If for some reason a rate review has
not been conducted within tlte preceding twelve (12) months, tlen a Consumer Price Index (CPI)
adjuòtment will be made to the current rates on October 1 of the subsequent year. The adjustment
w'ill be based upon the percentage of increase of the Los Angeles-Riverside-Orange County CPI.
However, in no event.shall the annualincrease exceed five percent (5%). The indexes used shall be
for "All Urban Customers" as published bythe Bureau of Labor Statistlcs.
B. Slgntflcant Changes ln Financial Condltlons. In the eventthat Contractor
experiences increases in operating costs or decreases in operating revenue to the extentthat
Contractor is no longer earning a'reasonable rate of return, as defined in.Article 6,5, the County will
consider ân increase,in ambulance charges. In this situation, theContract Managerrtayrequire
Contractorto provide Countywith financial statements and/or other pertinent information
necessaryto support any recommended supplemental inqrease in ambulance charges. In the event
that Contractor projects that profits will exceed the allowable proñt margiri at any time, as deñned
in Article 6,5, Contractor is obligated to immediately notify County so that the County may adjust
ambulance rates,
6;2 Perlodlc Rate Revlews - When Allowed¡ There shall be regular, perfodic reviews of
the maximum rates that the Contractor is allowed to,charge at the following times or under the
following circumstances: :
t '; ' A¡ Annual Review at:Optlon of Elther Party. Either party shall have the.right, Ín
its complete,and absolute discretion,.to require a rate review for the Contractor's prior year, and
every year thereafter; All rate reviews will cover either of the'following periods: (1) a nine-month
period of October 1 through fune 30, three consecutive quarters, annualized to September 30; or
(2) a twelve-month period of |uly 1 to fune 30. Should either parfy desire a rate review, it shall
serve the other party a written request for a rate review by f urie 30. Said review shall be completed
by Countywithin 60 days after receipt of all requested financial documents; and new trates, if any,
shall go into effect beginning October 1 of the following Contractor's fiscal year or thereafter.
B. Revlew Due To Slgnlflcant Change in Flnanclal Condttlons. If there is an
unexpected development that would have'a major impact on either the expensés or income of the
Contractor, either party rnay request a rate review within a reasonable time a.fter the impact of that
Page 13 of20
development becomes known. Additionall¡ if there is a level of service change which affects the
Contractor's response time and deployment capabilities, either party may request a rate review
within a reasonable time after becoming aware of such change. The party requesting the rate
review shall support its request with a narrative justification for tlie required change(s), including
reasons for the change(s), any measures taken to contain costs, and implications if the change(s)
is/are not approved. The party receiving'the request for rate review shall grant the request íf it
appears that itmaybe meritorious.
C. Relmbursernent to County. Contractor shall bear the full cost of any consultants
hired by County for the purpose ofconducting rate reviews, and that cost shall be treated as an
allowable expense in the subsequent rate review. However, Contractoris cost shall not exceed
$12,000.00 per rate review, ,
,
6¡3:PerlodRate'Revlews ' : :
A. Dlsclosure'of Records; When a rate review is initiated pursuant to Article 6.2,
Contractor shall provide any requested,business records and audited or,reviewed financial
statements on.an accrual basis to the County covering the period in question, said recqrds and
statements to be provided within 90 days of the receipt of the written request. , i,:
' B; Rate Revtew Guldellnes. The rate review process shall be guided and controlled
bythe "General Guidelines for.Ambulance Rate Revierd' (hereafter "Rate Review Guidelines") as
established by County and amended from time to time by County as reasonably necessary to
determine which expeRses shall be allowable and which expenses shall be disallowable forthe
performanca of this contract The Countymay disallow other expenses not identified in the Rate
Review Guidelines if it determines, in its discretion, that said expenses were not previously
identified in prior rate reviewsand are not reasohable necessaryto the perforrnance of this
contract. Furthermore, County may allow certain expenses not identified in the Rate Review
Guidelines if it determines, in its discretion, and based upon changed.circumstances subsÞntiated .
by Conffactor¡ that said expenses are reasonably necessary to the performance of this contract. The
County shall nst unreasonably modiff the Rate Review GuÍdelines and'shall discuss any'.
modifications-óf the Rate Review Guidelines with Contractor.
6.4 Perlodlc Rate Revlews - Findlngs by the Counry. The County shall review the records
and statements submitted by Contractor and veriffthe accuracy thereof. An Ambulance
Performance/Operations Gomrnittee (APOC) meeting may becalled if significant program or fiscal
issues arise. The Coungl may require submission of confirming and/or follow-up documentation.
Said conñrming and/or follow-up documentation shall be submitted to Count¡r within 1,5 days,of
Pwe ltl of 20
the request. At the conclusion of its review, the County shall ascertain the value of the following
terms, which shall have the meaning set forth below:
- A. Allowable Annual Expense. The total of expenses that were verified and that
the County found were reasonably necessaryto the performance of the contract,
B, Effectlve Annual Proñt. The amount of proñt found by the County, including
any items that Contractor reported as expenses but were disallowed by the County pursuant to the
preceding subparagraph.
C. Effectlve Proflt Margln. The Effective Annual Profit divided bythe Estimated
Net Revenue, expressed as a percentage.
6.5 Ferlodlc Rate Revlews - Settlng Fuhrre Maximum Rates. The County shall allow
Contractor a reasonable rate ofreturn and County agrees to consider all rate review appllcadons in
a timely manner. The County shall use the information developed in the rate review to predlct the
Effective Profìt Margin over the next,t2 months,(hereafter the "Predicted Future Effective Profit
Margin"); The prediction shall be made by assuming that rates are unchanged and estimatfng the
Effective Profit Margin over the next L2 months, considéring (1) the rate revÍew data which shall
be used as a baseline, (2) general historical trends that are likelyto affect revenue and expense, and
(3) specific, one-time factors that are likely to cause atypical changes in revenue andexpense. The
Predicted Future Effective Profit Margin shall be deemed to be reasonable if it falls withln the range
between 5% and 7o/o,which shall be referred to as the "Target Frofit Range."
A. Predlcted Future Effective Profit Margin Wlthln Target Profit Range. If the
Predicted Future EffecSive Profit Margin falls within the Target Profit Ranþe, no change in future
maximum rates shall be made as a result of the rate review, unless profits fell below 5o/oor
exceeded 7o/o inthe prior fiscal year: This is subject to Section 6.5C.
'8. Predlcted Fuh¡re Effectlve Profit Mar$n Outside the Target Proñt Range. If
the Predicted Future Effective Profit Marginis outside (above or:below).the Target Profit Range, the
future maximum rates shall be adjusted (upward or downward) by amounts sufficient to brlng the
Predicted F'uture Effective Profit MargÍn within the Target Proñt Range for the future. If the Target
Profit Range exceeds /o/s;.either due to the CPI increase or some other factor or lf the Target Profit
Range is,below 5ol0, the ftrture maximum rates will be adiusted so thatthe Predicted Future
Effective Profìt Margin will be 6%0. ThÍs is subject to Section 6;5C.
C. AdfusUnent for Profits Outslde the Target ProfltRange. Should Contractor's
profits earned fall belowthe 5% minimum, the rates shall be adjusted above the7Vomaximum until.
the Contractor's "loss," the dÍfference between ach¡al profits and the 570, is recovered. Conversel¡
Page 15 of20
Contractor shall "pay down" profits earned in excess of the 7% maximum allowed by having the
rates adjusted low enough, below the 570 minimum, until such time as excess profits are fully "paid
down."
D. Implementatlon of Maximum Rates Followtng a Rate Revlew. At the
conclusion of a rate review, lf the County determines that the maximum rates should be adjusted,
the Contract Manager shall provide written notifÌcation to the Contractor of the revised rates. No
further action by any party is necessary to implement said rates.
6.6 Bllling and Collectlons. The Contractor shall operate a billing and accounts receivable
system that is well documente{ easy to audit, and which minimizes the effort required of patients
to recover payment from thirdparty sources for which theymay be eligible. The Contractor Shall
make no attempts to ôollect its fees:at the time of service.
. AR,TICLE 7. TERM AND TERMINATION
T.l Inltlal Ter¡n. Unless terminated by either party pursuant to the provisions of this
agreement¡ this agreement shall remain in effect for the time pêriod (hereafter the "lnitial Term")
beginning on the Effective Date and ending on fune 30, 2016.
7.2 Automatic Extenslon of Term. The agreement shall remain in effectuntil fune 30,
2016, and may thereafterbe extended for an additional term, not to exceed 24 months, by mutual
written agreement of both partieS. Said mutual agreement must be reached prior to fune 30,.2016.
Prior to the expiration of'the contract, County shall begin evaluating its options with regard to the
extension f this. contract and, thereafter,,shall commence discussions with Contractor regarding
those options.
7.3 Termlnatlon by the County for Cause; County shall have the right to terminate this
agreement or to pursue âny:appropriate legal remedy in the €vent the Contractor materially
breaches this agreement a¡ld fails to correct such default within thirty (30) days following the
service of a ,written nodce by the County specif¡ring the default(s) and the effective date of intended
termination of this agreement, absent,cure. Conditions and circumstances which shall constitute a
material breach by the Contractor shall include but are not llmited to the following:
' A. Failure of the Contractor to operate the ambulance service system in a manner
that enables the County and the Contractor to remain in substantial Compliance with the
requlrements of the applicable,Federal, State, and Countylaws,'ruleS, andregulations. Minor
violations of such requirements shall not constitute a material breach except serious, willfrrl and/or
repeated violations shall constitute a material breach;
Pqge 16 ol20
B. Falsification of data supplied to the County including by way of example but not
by way of exclusion, dispatch data, patient reportdata, response time data, financial data, or
falsification of any other data required under this agreemen!
C. Failure to maintain equipment in accordance with good maintenance practices;
D. Deliberate and unauthorized scaling down of operations to the detriment of
performance;
E. Attempts bythe Contractorto intimidate or otherwise punish employees who
desire to sign contingent employment agreements with competing bidders during a subsequent bid
cycle;
F, Attempts bythe Contractor to intimidate or punish employees who participate in
protected concertèd acdvities, or who form or join any professional associations;
.G. Ghronic and persistent failure of the.Contractor:s employees.to conduct .
themselves in a professional and courteous manner, or to present a professional appearance;
H. Failure to complywith approved rate setting, billing, and collection procedures;
I. Repeated failures to meet response time requirements after reeeMng notice of
non-compliance from the Contract Manager; :
|. Fallure of the Contractor to provlde arrd malntaln the:requlred tnsurance and
performance security bond;
K. Failure of Contractor to provide patient care at a level and quality that meets
establishedstandards. , j :',
.ARTICIE
8. ASSIGNMENT OF BiLLING RIGHTS
WITH RESPECT TO COUNTY.PROVIDED FIRST RESPONDER SERVICES
S.l Asslgnment. The County hereby assigns to the Contractor its right to directl¡rbill
persons for county-provided fÌrst response emergency medical services. First response emergency
medical services provided by the Coungr may include,'but are not limited.to, providing initial
stabilization and trained on-scene assistance¡ and assistance en route to medical facilities as ,
required" and extrication and rescue services.
8.2 Payment for ^Asslgnment. In consideration of the assignment set forth in paragraph S.l
above, the Contractor shall pay to the County a "first responder support" pa¡ment in accordance
with Article 4 above.
ARTICLE 9. MISCETLANEOUS
Page 77 of20
9.1 Independent Contractor. The parties acknowledge and agree that the Contractor is an
independent contractor of the County and that nothing herèin shall be construed as creating any
. other type of relationship between the County and the Contractor.
9.2 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. tiability Insurance. The Contractor shall proVide comprehensive liability
insurance, including coverage for owned ahd non-owned automobÍles, wlth minimum combined
single limit coverage of $1,000,000 for all damages, including consequential damages, due to bodily
injury siclmess or disease; or death to anyperson or damage to or dedtruction of property,
including the loss of use thereof, arislng from each occurrence. Such insurance shall be endorsed to
include the County and its.officers and employees as additlonal,insureds as to all services
performed by the Contractor under this agreement. Said policies shall constihrte 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) shatl not be required
to contribute to any loss covered under the Contractor's insurance poliry.or poticies.
B. Workers' Compensation. The Contractor shall provide and malntain
throughout the term of this agreement workers' compensation insurance coverage for its
employees.
C. Cerdflcate of Insurance. The Contractor shall provide the Countywith
certiffcate(s) of insurance evidencing liability and worker's compensation insurance as required
herein no later than the Effective Date of this Contract. If the Çontractor. should renew the insurance
policy or policies, or acqulre either a new insurance policy or policies or amend the coverage
afforded through an endorsement to the policy at any time during the term of this Contract, then
the Contractor shall provide current certificate(s) ofinsurance.
D. Addltional Insurance Provlslons. The insurance policies provided by.the
Contractor shall include a provision for thirty (30) days wri.tten notice to the County before
cancellation or material changes of the above speciñed coverage, Fu.rther, said policy or policies
shall be from insurance companies admitted bythe California Department of Insurance to do
business in the State of California,
9.3 Indemnificatlon. The Contractor shall defend, indemniff, save, and hold harmless t}re
County and its officers and employees from any and all claims, costs and liability for any damages,
sickness, death, or injuryto person(s) or property, including without limitation all consequential
Page 18 of20
damages, from any cause whatsoever arising directly or indirectly from or connected with the
operations or services ofthe 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 iæ officers or employees. The Contractor shall reimburse the County
for any expenditures, including reasonable attorneys' fees that the County may make by reason of
the matters that are the subject of this indemnification.
9.4 Modlficatlons and Amendments.
A, General Amendments. This contract may only be modified or amended by a
written document exenrted by the Contractor and the San Luis Obispo County Board of Supervisors
or, after Board approval, by its designee, subjectto any required $tate or Federal approval.
B. Admlnlstratlve Amendments. To the extent required by changes in applicable
State or Federal laws or regulations, this agreement shall be automatically deemed amended to
conform.
9.5 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.
9.6 Notlces. Any notice required to be given pursuant to the terms and provisions hereof
shall be in writing and shall be sent by certified or registered mail to the parties at the following
addresses, as may be amended from time to tlme:
Tothe County:
HealthAgency Director
County of San Luis Obispo
P,O. Box 1489
San Luis Obispo, CA 93406
To the Contractor:
Frank Kelton, President and CEO
San Luis Ambulance Service,lnc.
3546 South Higuera Street
San Luis Obispo, CA 93401
With a copyto:
P. Terence Schubert, Esq.
Attorney at Law
1254 Marsh Street
San Luis Obispo, CA 93401
Pgge 19 of20
IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first set
forth above
SAN LUIS AMBULANCE SERVICE, INC.
A CalÍilornla Corporatlon
Frank Kelton
PresÍdent and CEO
ATTEST:.
(Signaure)
Name and Tltle of.Person Attestlng for
San Luis Ambulance Serlce, lnc
COUNTY OF SAN LUIS OBISPO
ny: ADAM HILL'
Chair of the Board of Supervisors
Authorized by Board Action on:
Wneu 24.2rvl
APPROVEDASTO FORM
AND TEGAL EFFECT
WARREN RIENSEN
COUNTYCOUNSEL
4
ATTEST:
IULIE RODEWALD, County Cierk and
Ex-Officio Clerkof the Board of Suþervlsors
Pdgq 20 o120.
EXHIBIT A: EMERGENCY RESPONSE AREAS OF SAN IUIS OBISPO COUNTY
EXHIBIT B: DEPLOYMBNT PLTN
EXHIBIT C: FIRST RESPONDER FEES
EXHIBIT D: SAN IUIS AMBULANCB SERVICE, INC. SERVICE RATES
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then'canoxty üt¡ough ûrqgs.gseya! {,.bctuectr ShÊU Bøsh sûd Squirs Canyun}" to üre
iutprscction ofÍIiphury W ànilPricc ftryan ed{d, rtËH ffdrjr¡* nryth o,f Oreutf &wl eird
ffffan¡: EËüqùt Rodd, tircn ngttrg$,r t¿ $í Mcnnts¡n F¡uk crs* nr¡d ùs sButttsm botrørdnry +f fito
Nqrth.T.ona
En*tr Shr¡sd bmúry t¡vith thc lrlorh Zorrc fron Ht M¡nm¿irr Fesk aüca" úsil ßpbersüy
sütfûËfiÉ tbtuugþ: Cdímt Pqk aaá to .the lfutri C$lrty ll.no ju*t totth of l.fislm¡ay ! 6S
(lttcluding a&of lügbwey ï6É Had thuporthrr afihc Ct¡yrme ¿ree in Sa$ Luìs Obispc,Cü¡nt''J,
Srrurh: T,.hc Ëqnra Ëüùnra;Çoqflfy:lha Êorrr the Pacific OsËan ûl KcËr kurrry Ìina
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E (hiblt "8"
DEPLOYMENT PLAN
The general goal of the Deployment Plan is to provÍde an Advanced Life Support (ALS) Unit, either
by Contractor or by an ALS fire service agency, to at least 90o/o of alpotentially life threatening
emergency ambulance requests originating within each Emergency Response Area with a
maximum response time of 10 minutes in areas designated urbary and with a maximum response
time of 30 mlnütes in areas designated as rural, and with a maxinrum response time of 60 minutes
in areas designated as remote.
The terms urban, rural, and remote are defined bythe California State Emergency Medical Services
Authority as follows:
Urban: All census placeswith a population of 2,500 to 500,000 and a population density of 100 to
999 persons per square mile; or census tracts and enumeration districts with census tracts which. -hav€,apopulat-iondensþof100to999-persons-persqua.nernile, .. . : .-.
Rural: All census places with a populatlon of less thair 2,500 and population density of 10 to 99
persons per square mile; or census tracts or enumeration districts without census tracts which
have a population denstty of 10 to 99 persons per square mile.
Remote: Census tracts or enumeration districts without census tracts which have a population
density of 5 to 9 persons per square mile.
If the State EMS Authori!y's definition of urban, rural, and remote is accepted locally, the cities and
unÍncorporated areas of San Luis Obispo Countywould be rated as follows based on California
State Department of Finance and San Luis Obispo County Planning Department figures:
Urban Aneas
City of Arroyo Grande
City of Atascadero
City of Grover Eeach
Cityof Morro Bay
City of Paso Robles
City of Pismo Beach
City of San Luis ObÍspo
Cambria
Cal Poly
Cayucos
Baywood Park/Los Osos
Nipomo
Oceano
Templeton
County Club (SLO)
Rural Areas
Adelaida
Avila Beach
Creston
Garden Farms
San Simeon
Whitley Gardens
Santa Margarita
San Miguel
Remote Areas
California Valley/
Simmler
Cholame
La Panza
Pozo
* Oak Shores
* Shandon
* Heritage Ranch
* Shando¡L Heritage Ranch and Oak Shores would normally be ln the rural category but are moved to the
remote category due to their slze, limÍted number of EMS responses and locatÍon with the county,
Exhtbft "B" (cont)
sPECt FIC RESOURCE REQUTREMENTS
1. Central Zone r3.3 ambulance units per day
12 public transport units for back-up/overload response (SLO City, Morro Bay)
iCurrent station locations acceptable - (Morro Ba¡r & San Luis Oblspo)
2 North Zone 13 ambulance units per day (half time unÍt allowed to float at Twin Cities
Community Hospital
rMove-up capability from central zone
lCurrent staüon locations aeceptable (Paso Robles and Atascadero)
3. South Zone 13 ambulance units per day
*Current$tation locations acceptable (Arroyo Grande & Nipomo)
Contractor shall at all tlmes rnaintainand-operate-sne (tr) fourwheel-drive ambulanee uniulhis
special requirement shall not increase the coverage requirement set forth above for the South Zone
as 3 ambulance units pe¡ day- .l:, ' i ,.
Bxhlblt "C"
FIRST RESPONDER PAYMENTS FISCAL YEAR 2O1O-11
First responder payments will be made nó later than the end of the Znd month followingthe
end of the quarter for which the payment accrued.
NORTH ZONE QUARTERI Y
City of Atascadero
CÍtyof Paso Robles
San Miguel Fire Dlstrict
County of San Luis Obispo
Templeton Community Service Dist;
Santa Margarita Fire
Total North Zone
CENTRAL ZONE
Avila Beach Co. Water District
Cayucos Fire Prevention District
City of Morro Bay
City of San Luis Obispo
County of San Luis Obispo
County SeMce Area 9, Zone B
(South Bay Fire)
Total Central Zone
SOUTH ZONE
Five Cities Fire Authority
City of Pismo Beach
County of San Luis ObÍspo -
Total South Zone
TOTAL Att ZONES
$25,650.28
$19,965.64
sL,0L6,79
sL3,2L7.99
$2,079.75
$924.35
ANNUAL
(7-L-LO Thru 6-30-11)
sL02,60L.L2
$79,862,56
s4,067.16
$52,87L.96
$8,319.00
$3,697.40
$62,854.80 szít,4L9.2O
$878.L2
$L,294.06
$19,965.64
$39,931.25
$7,209,83
$L5,667.46
$3,512.48
$5,L76,24
$79,862.56
$159,725.00
$28,839.32
562,669.84
$84,946.36 $339;785.44
$5,037.65
$1,894.89
$22,368.90
$20,150.60
$7,579.56
$89,475.60
$29,301.44 $r L7,2A5.76
ÛL77,L02.60 $708,410.40
Bxhlblt "D"
SAN LUISAMBULANCE SERVICE.INC. SERVICE RATES
Service
Advanced Life Support Base Rate
Critical Care Transport Base Rate
AncillaryCosts'
ALS Transport
Mileage (per mile)
Oxygen
Disposable/Supplies
Stand-by (per hour)
Rate ($)
L,947.66
2,466.33
664.00
L8.07
69.79
!7.47
L39.74
,/
BOARD OF SUPERVISORS, AGENDA FOR MAY 24,2OLL PAGE 3
A-1L Request by Supervisor Hill to reappoint Gerrit Vanderziel to the Airport Land Use Commission; All
Districts. (RECOMMEND APPROVAL.)
Health Agencv ltems:
A-Lz Request to approve a renewal agreement (Clerk's File) with San Luis Ambulance Service lnc. to
continue to provide ambulance services in the northern, central and southern ambulance service areas
through June 30, 20t6. (RECOMMEND APPROVAL AND INSTRUCT CHAIRPERSON TO SIGN.)
A-13 Request to approve an agreement (Clerk's File) with the Office of AIDS, California Department of Public
Health to receive funding in the amount 5508,083 to provide Housing Opportunities for Persons with
AIDS (HOPWA) for FY 20L0-13 and authorize the Health Agency Director to sign future amendments
that do not increase the level of General Fund support. (RECOMMEND APPROVAL AND INSTRUCT
CHATRPERSON TO StGN.)
General Services Aqencv ltems:
A-14 Request to approve a budget adjustment in the amount of 532,932 from Nuclear Power Plant revenues
to Fund Center 138 - Office of Emergency Center and Fund Center 200 - Maintenance Projects for the
completion of the Emergency Center lnterior Reconfiguration project at the County Operations Center;
2nd D¡strict. (RECOMMEND APPROVAL.)
A-15 Request to: 1) approve a Resolution of lntention to surplus and sell county owned real property
located at 549 1-0th Street in Paso Robles on behalf of the Superior Court; and 2) set August 2, 2OLL at
9:00 A.M. as the date the Board will act on the sale of the property; 1't District. (RECOMMEND
AppRovAL AND INSTRUCT CHAIRPERSON TO SIGN.)
A-16 Request at approve a Job Order Contract with The Gordian Group, Inc. for consulting services related
to construct¡on task/pricing and technical specifications for the Job Order Contract program.
(RECOMMEND APPROVAL AND INSTRUCT CHAIRPERSON TO SIGN.)
A-L7 Submittal of a bid opening report for Job Order Contract PJOCll (used by County Architectural Services
in completion of countywide projects); All Districts. (RECOMMEND APPROVAL AND INSTRUCT
CHAIRPERSON TO SIGN CONTRACT DOCUMENTS, CLERK,S FILED, WITH SEA PAC
ENGINEERING, INC.)
Other ltems:
A-18 Submittal of a resolution by the Sheriff-Coroner to permit the destruction of certain obsolete offìce
records, documents, instruments, books and papers where retention is no longer required.
(RECOMMEND APPROVAL AND INSTRUCT CHAIRPERSON TO slcN.)
Request by public Works to approve a map that has satisfied all the conditions of approval that were
established in the public hearing on its tentative map: Tract 2523, a proposed subdivision resulting in 7
lots by William R. Schaefer and Virginia Schaefer, Cyclone Street in Nipomo, act on the resolutions to
accept the offer of dedication for widening of Cyclone Street and accept the offers of dedication for
public pedestrian access on Cyclone Street and South Tejas Place, reject the offer of dedication for
drainage without prejudice to future acceptance; 4th Oistrict. (RECOMMEND APPROVAL AND
rNsTRUgr CHAIRPERSON TO SIGN.)
A-19