MEDICAL DIRECTOR AGREEMENT
This Medical Director Agreement ("Agreement") is entered into as of the 29" day of JUly 2020, by and between The Regents of the University of California, a corporation described in California Constitution Art. IX, Sec. 9, on behalf of its UCSF School of Medicine, Department of Emergency Medicine ("UCSF"), and the City of Alameda,
RECITALS
A. The Alameda Fire Department ("Fire Department") is a department of the City.
Within the Fire Department Emergency Medical Services
Division ("EMSD");
B. Fire Department's services provided through EMSD include providing first responder and emergency medical treatment and transport for patients of Alameda City and Alameda County as part of the 911-response system for Alameda County EMS;
UCSF operates a School of Medicine which includes a Department of Emergency Medicine and employs or contracts with physicians ("UCSI Physicians") who are licensed to practice medicine in the State of California; D. City desires that UCSF provide medical director services for Fire Department; E. UCSF Physicians are qualified to provide those services and UCSF desires to make those services available through its UCSF Physicians.
NOW, THEREFORE, in consideration of the forgoing, which are incorporated herein by reference, and the mutual covenants and agreements contained in this Agreement, the parties hereby agree as follows:
ARTICLE 1
RESPONSIBILITIES OF USE
1.1 Services.
(a) Medical Director. UCSF will provide a UCSF Physician to serve as the director of Alameda City's Fire Department Division of Emergency Medical Services ("Medical Director") to perform the services identified in Exhibit 1.la of this Agreement. The UCSF Physician shall be identified in Exhibit 1.la by mutual agreement of the parties Medical Director shall keep monthly time logs submitted to Fire Department and shall provide a minimum of one (1) hour per week or four (4) hours per month in Medical Director services.
1.2 Qualifications. During the term of this Agreement, each UCSF Physician providing services pursuant to this Agreement shall be experienced in rendering such services and shall maintain on an unrestricted basis:
(a) California Licensure as a physician/or surgeon;
(b) Federal Drug Enforcement Administration certification; (c) Fire Department Medical Staff membership and appropriate clinical privileges at Fire Department;
(d) Board eligible or board certified in Emergency Medicine; (e) Faculty appointment at UCSF; and
(1) Professional liability coverage as set forth in this Agreement.
1.3 UCSF's Obligations to Personnel. UCSF shall be solely responsible for satisfying any and all obligations for any UCS Physician providing services under this Agreement. Such obligations shall include, but not be limited to, paying all federal and state withholding taxes applicable to employees, complying with federal and state wage-hour obligations (including overtime), workers compensation obligations, unemployment insurance obligations, and other applicable taxes and contributions to government mandated employment related insurance and similar programs.
1.4 Standard of Care. To the extent permitted by law, UCSF and each UCSF Physician shall, at all times, perform services in accordance with and comply with the following:
All applicable laws, regulations, and policies of all government authorities relating to City and the Fire Department, including all applicable Fire Department and professional licensure anc reimbursement laws, regulations, and policies;
(b) The Joint Commission standards and recommendations; (c) Fire Department policies and rules;
(d) Fire Department's Medical Staff bylaws, rules and policies; and (e) The terms of this Agreement.
ARTICLE 2
RESPONSIBILITIES OF FIRE DEPARTMENT
2.1 Space, Equipment and Supplies. Fire Department shall furnish UCSF and Physicians with such space, equipment, staff, supplies and support services as reasonably necessary for UCSF to fulfill its responsibilities hereunder. Fire Department agrees to keep and maintain said premises in good and sanitary - 2-
2.2 Environmental Laws. Fire Department shall be solely responsible for complying with all federal, state and local environmental and health and safety laws, regulations and ordinances ("Environmental Laws"), and all environmental health and safety permits, licenses, and authorizations ("Environmental Permits"), and for otherwise operating its premises (including that which it provides to the UCSF Physicians) in a manner which is protective of human health and the environment. The responsibilities of Fire Department include, but are not limited to: (a) obtaining and maintaining all necessary Environmental Permits, (b) being the designated generator of wastes and otherwise arranging for the lawful treatment, storage, disposal, transport and other management of medical and hazardous materials, chemicals and wastes associated with the activities conducted by UCSF Physicians hereunder, (c) providing any reports, warnings or other notifications that may be required of Fire Department or physicians providing care at Fire Department under any Environmental Laws or Environmental Permits, (d) identifying, investigating and remediating any threatened or actual releases of medical or hazardous materials, chemicals or wastes to the environment, whether or not caused by a UCSF Physician, and (e) using reasonable best efforts to provide for the safety and wellbeing of persons who enter its premises, including but not limited to, the exposure of persons to medical and hazardous materials, chemicals, wastes building materials, and environmental media or other conditions at and in the vicinity of such premises. Fire Department on its own behalf and on behalf of any persons entering the premises provided to UCSF Physicians expressly waives and releases any claims against each UCSF Physician, UCSF and their respective successors, members, officers, directors, employees and agents (collectively, the "UCSF Parties") in connection with the environmental matters addressed herein this Section 2.2, except to the extent any such environmental matters are exacerbated by or caused by the negligence or intentional misconduct of any of the UCSF Parties.
2.3 Fire Department Staff.
(a) Fire Department shall employ or otherwise retain all non-physician personnel required for providing the services in this Agreement. Such personnel shall be appropriately licensed or certified as required under California law. Fire Department shall make all decisions regarding shail fist aimp and onsin with such personnel, but Fire Department (b) Fire Department shall be solely responsible for satisfying any and all bligations for personnel that Fire Department retains, employs, o ontracts with in order to assist it in performing this Agreement. Suc obligations shall include, but not be limited to, paying all federal and state withholding taxes applicable to employees, complying with employment related insurance and similar programs.
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ARTICLE 3
INDEPENDENT CONTRACTOR
3.1 Independent Contractor Status. In performing all work, duties, and obligations nder this Agreement, it is mutually understood and agreed that UCSF an ICSF Physicians are at all times acting and performing as independer contractors in relation to the Fire Department herein. Nothing in this Agreement is intended to, nor shall be, construed to create between Fire Department and UCSF or between Fire Department and any of UCSP ARTICLE 4
COMPENSATION
4.1 Compensation. Fire Department shall pay UCSF monthly for services performed under this Agreement as described below:
For services provided through June 30, 2020: Fire Department shall pay UCSF $265.34 per hour, and a $317 per month administration fee.
Services not to exceed 10 hours a month or $2,970.40 per month including the administrative fee.
2020 - December 31, 2021: Fir
Services not to exceed 12 hours a month or $3,676.32 per month including the administrative fee.
Total compensation shall not exceed $67,818.24.
These payments shall be made by the 10th of each month for the preceding month's services by check made payable to The Regents of the University of California delivered to:
UCSF Department of Emergency Medicine at ZSFG
Attn: Leesa Cantero
1001 Potrero Avenue
Building 5, Suite 6A
San Francisco, CA 94110
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4.2 Compliance with Laws. Fire Department represents that it maintains a compliance program designed to promote adherence to applicable federal and state laws, regulations, and interpretations. Fire Department shall use commercially reasonable best efforts to ensure that all claims relating to the services satisfy all applicable payor rules, regulations, and instructions.
Without limiting the scope of the indemnification provided in Section 7.2 below, Fire Department shall indemnify, defend and hold harmless UCS and UCSF Physicians from any liability, loss, damage, claim, fine, or expense, including costs and reasonable attorneys' fees, arising from any actual or alleged billing errors, false claims, or insurance fraud relating to claims for any service, except to the extent caused by the negligence or intentional misconduct of any of the UCSF Parties.
ARTICLE 5
TERM AND TERMINATION
5.1 Term of Agreement. This Agreement shall be retroactively effective as of January I, 2020 and shall continue for a period of two (2) years unless terminated earlier as set forth hereunder.
5.2 Termination. Notwithstanding any other provision in this Agreement, this Agreement may be terminated as follows:
(a) Either party may terminate this Agreement without cause at any time by giving at least ninety (90) days' prior written notice to the other party; provided that the parties shall not enter into another agreement for the same services during the course of one year following the termination date.
(b) Either party may terminate this Agreement upon the material breach of this Agreement by the other party by giving the other party thirty (30) days' prior written notice. The party claiming the right to terminate hereunder shall set forth in the required notice of intended terminatior the facts underlying its claim that the other party has breach this Agreement. If such breach is remedied within twenty (20) days of the receipt of such notice, this Agreement shall remain in effect for the remainder of its term. If the breach is not cured, this Agreement shall terminate at the end of the thirty (30)-day notice period. (c) Either party may terminate this Agreement immediately on written notice to the other party if, in the reasonable opinion of the notifying - 5-
5.3 Effects of Expiration or Termination. Upon expiration or termination of this \greement, neither party shall have any further obligation hereunder except for (i) obligations due and owing which arose prior to the date of termination and (ii) obligations, promises, or covenants contained herein which expressly extend beyond the term of this Agreement.
ARTICLE 6
INSURANCE
Insurance. Each party shall maintain the insurance coverage set forth in Exhibit
6.1. ARTICLE 7
INDEMNIFICATION
7.1 Indemnification of Fire Department by USE. USE and/or its UCSF Physicians shall defend (with counsel acceptable to City), indemnify, and hold City and Fire Department, City Council, City commissions, council and commission members, officers, employees, and agents harmless from and against any and all liability, loss, expense (including reasonable attorneys fees), or claims for injury or damages arising out of the performance of this Agreement, but only in proportion to and to the extent that such liability, loss, expense, attorneys' fees, or claims for injury or damages are caused by or result from the negligent or intentional acts or omissions of any of the US! Parties. 7,2 Indemnification of UCSF by Fire Department. Fire Department shall defend (with counsel acceptable to UCSF), indemnify and hold UCSF and/or its UCSF Physicians, its officers, employees, and agents harmless from and against any and all liability, loss, expense (including reasonable attorneys' fees), or claim:
for injury or damages arising out of Fire Department's performance of this ARTICLE 8
GENERAL PROVISIONS
8.1 Patient Records. Any and all patient records and charts created at Fire - 6-
permitted and conducted in accordance with applicable legal requirements and pursuant to commonly accepted standards of patient confidentiality and at the location in the City selected by Fire Department. Each party shall be responsible for maintaining patient confidentiality of all patient records created hereunder in accordance with applicable laws and regulations.
Each party agrees to notify the other party's privacy office of the unauthorized access, use, or disclosure of any personally identifiable information, or protected health information known or suspected by such party within two (2) days of learning of the same in order to ensure that the reporting of such unauthorized access, use or disclosure of this information is reported within five (5) days of detection to the California Department of Public Health (CDPH) and as appropriate, to the Office of Civil Rights and Centers for Medicare and Medicaid Services. Each party's privacy office will oversee the required notification to CDPH
Each party agrees that if they fail to adhere to any of the privacy, confidentiality, and/or data security provisions set forth herein and, as a result, personally identifiable information or protected health information is unlawfully accessed, used or disclosed, that they agree to pay, upon written demand of the other party, all costs associated with any notification to affected individuals required by law or deemed appropriate, and that they also agree to pay for any and all fines and/or administrative penalties imposed for such unauthorized, access, use or disclosure of personally identifiable information or protected health information or for delayed reporting.
8.2 Cooperation in Disposition of Claims. City/Fire Department and UCSF agree to cooperate with each other in the timely investigation and disposition of certain audits, disciplinary actions and third-party liability claims arising out of any Services provided under this Agreement. To the extent allowed by law, City/Fire Department and UCSF shall have reasonable and timely access to the medical records, charts, and/or de-identified quality assurance data of the other party relating to any claim or investigation related to Services provided pursuant to this Agreement. Provided, however, that nothing shall require either City/Fire Department or UCSF to disclose any peer review documents, records or communications which are privileged under Section 1157 of the California Evidence Code, under the Attorney-Client Privilege or under the Attorney Work-Product Privilege. UCSF shall be responsible for discipline of UCSF Physicians in accordance with UCSF's applicable policies and procedures.
To the extent allowed by law and in accordance with the applicable institution policies, the parties shall notify one another as soon as possible of any adverse event which may result in liability to the other party. The failure to provide notice shall not be deemed a breach of the Agreement, and such failure to do so shall not relieve the indemnifying party of its indemnity obligations if such delay does not prejudice the defense thereof.
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It is the intention of the parties to fully cooperate in the disposition of all such audits, actions or claims. Such cooperation may include, but is not limited to, timely notice, joint investigation, defense, disposition of claims of third parties arising from Services performed under this Agreement, and making witnesses available; provided, however only to the extent consistent with UCSF or City policies and only so long as any personnel assistance by UCSF or City does not materially interfere with any UCSF or City employee's performance of his or her UCSF or City employment responsibilities.
8.3 No Requirement to Refer. Nothing in this Agreement, or any other written or oral agreement, or any consideration in connection with this Agreement contemplates or requires the admission or referral of any patient to the Fire Department or UCS. This Agreement is not intended to influence any Physicians' judgment in choosing the medical facility appropriate for the proper care and treatment of their patients.
8,4 Non-Discrimination. The parties agree that they shall not discriminate against patients on the basis of race, ethnicity, religion, national origin, citizenship, age, sex, preexisting medical condition, physical or mental handicap, insurance status, economic status, or ability to pay for medical services, except to the extent that a circumstance such as age, sex, preexisting medical condition, or physical or mental handicap is medically significant to the provision of appropriate medical care to the patient in accordance with applicable laws and regulations.
8.5 Access to Books and Records.
(a) UCSF agrees to cooperate fully with Fire Department by, among other things, generating, maintaining, and making available all necessary records, in order to assure that Fire Department will be able to meet all requirements for participation and payment associated with public or private third party payment programs.
(b) Until the expiration of four years after the expiration or termination of this Agreement, UCSF shall make available, upon written request of the Secretary of the United States Department of Health and Human Services ("Secretary") or the Comptroller General of the United States General Accounting Office ("Comptroller"), or any of their duly authorized representatives, a copy of this Agreement and such books, documents and records of UCSF as are necessary to certify the nature and extent of costs of the services UCSF provided under this Agreement. UCSF further agrees that if it carries out any of its duties under this Agreement through a subcontract with a value or cost of $10,000 or more over a twelve (12) month period with a related organization, that such subcontract shall contain a clause to the effect that until the expiration of four years after the furnishing of such - 8-
books, documents, and records of such organization that are necessary to verify the nature and extent of such costs.
Assignment and Delegation. Neither this Agreement nor any of the rights or uties under this Agreement may be assigned or delegated by either part xcept as expressly authorized in writing by both parties
8.7 Binding on unesers in irsele end prand bo biod he Agreementrand the benefit of the heirs, executors, administrators, assigns, and successors of each of the parties hereto.
8.8 Notice. Any written notification required hereunder shall be personally served or mailed by certified mail, return receipt requested, to the following:
f to UCSF: Christine Montgomery
Chief Administrative Officer
UCSF Department of Emergency Medicine
533 Parnassus Avenue, Suite U575
San Francisco, CA 94143
Senior Associate Director, Contracts/Awards
Office of Sponsored Research
University of California, San Francisco
3333 California Street, Suite 315
San Francisco, CA 94143-0962 (94118 for express
If to City: City of Alameda
City Manager
2263 Santa Clara Avenue
Alameda, CA 94501
With a copy to: City of Alameda
City Attorney
2263 Santa Clara Avenue
Alameda, CA 94501
8.9 Use of Name. City and Fire Department agrees that any use of the "UCSF" or California in accordance with the provisions of applicable law, including but not limited to California Education Code Section 92000. City and Fire - 9-
Department shall not advertise or market any of the UCSF Physicians' names in any marketing materials without the consent of UCSF.
8.10 Construction of Agreement. The validity, interpretation, and performance of this Agreement shall be governed by and construed in accordance with the internal laws of the State of California. The parties agree that the terms and provisions of this Agreement embody their mutual intent and agreement and that they are not to be construed more liberally in favor of, nor more strictly against, any party hereto.
8.11 Severability. The provisions of this Agreement shall be deemed severable and if any portion shall be held invalid, illegal, or unenforceable for any reason, the remainder of this Agreement shall be effective and binding upon the parties.
8.12 Captions. Any captions to or headings of the articles, sections, subsections, paragraphs, or subparagraphs of this Agreement are solely for the convenience of the parties, are not a part of this Agreement, and shall not be used for the interpretation or determination of the validity of this Agreement or any provision hereof.
8.13 Waiver of Provisions. Any waiver of any terms and conditions hereby must be in writing and signed by the parties hereto. A waiver of any of the terms and conditions hereof shall not be construed as a waiver of any other terms and conditions hereof.
8.14 Force Majeure. Neither party shall be liable nor deemed to be in default for any delay or failure in performance under the Agreement or other interruption of service or employment deemed resulting, directly or indirectly, from Acts of God, civil or military authority, acts of public enemy, war, accidents, fires, explosions, earthquakes, floods, failure of transportation, machinery or supplies, vandalism, strikes or other work interruptions by City's or Fire Department's employees, or any similar or dissimilar cause beyond the reasonable control of either party. However, both parties shall make good faith efforts to perform under this Agreement in the event of any such circumstance.
8.15 Change in Law. In the event that a change in state or federal law, statute, regulation or enforcement, or same materially affects this Agreement, the
8.16 Third-Party Beneficiaries. This Agreement is not intended and shall not be construed to create any rights for any third party.
8.17 Amendments. This Agreement may be amended or modified only in a written document signed by both Fire Department and UCSF.
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8.18 Exhibits. All Exhibits referred to herein are hereby incorporated herein. In the event any provision of this Agreement conflicts with any Exhibit to this Agreement, the Exhibit shall control with respect to the subject matter of such Exhibit.
8.19 Counterparts; Electronic Copies. This Agreement may be executed in any number or counterparts, each of which shall be deemed an original, but all such counterparts together shall constitute but one and the same instrument. Delivery of an executed counterpart of this Agreement by facsimile, electronic signature, • pdf data file or other scanned executed counterpart by email shall be equally as each shall fully bind each party who has executed it. The parties to this document agree that a digital signature or copy of the original signature may be used for any and all purposes for which the original signature may have been used. The parties agree they will have no rights to challenge the use or authenticity of this document based solely on the absence of an original signature.
8.20 Ability to Enter Agreement. City and UCSF each represents and warrants that it is free to enter into this Agreement and to perform each of the terms and conditions of the Agreement.
8.21 No Exclusion. Each party represents and warrants to the other party that it and its representatives are not:
(a) currently excluded, debarred, or otherwise ineligible to participate in the Federal health care programs as defined in 42 U.S.C. Section 1320a-7b- (f) (the "Federal health care programs") and/or present on the exclusion database of the Office of the Inspector General ("OIG") or the Government Services Administration ("GSA");
(b) convicted of a criminal offense related to the provision of health care items or services but have not yet been excluded, debarred, or otherwise andard ineligible to participate in the Federal health care programs; (c) debarred, suspended, excluded or disqualified by any federal overnmental agency or department or otherwise declared ineligibl rom receiving federal contracts or federally approved subcontracts o from receiving federal financial and nonfinancial assistance and benefits.
This shall be an ongoing representation and warranty during the term of this right to terminate this Agreement immediately for cause. - 11 -
8.22 Governing Law. This Agreement shall be governed by and construed and enforced in accordance with and subject to the laws of the State of California without regard to its conflict of law provision.
8.23 Singular and Plural. Words used herein in the singular, where the context so permits shall be deemed to include the plural and vice versa.
Entire Agreement. This Agreement including its Exhibits contains a full and umped apprecion or the tights an obiral, pres of the maries and i had ith respect to the subiect matter herei
Signatures on following page
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IN WITNESS WHEREOF, the parties have executed this Agreement on the day and year set forth below.
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, CITY OF ALAMEDA on behalf of UCSF, Department of Emergency a municipal corporation Medicine ("UCSF")
Talmedy 2. King
By:
Talmadge E. King, Jr., MD
Its: Dean, UCSF School of Medicine Its: City Manager
Date: July 17, 2020 Date: July 29, 2020
Read and Acknowledged: Approved as to form: City Attorney Seen lovel
Peter Sokolove, MD
Its: Chair of the Department of Assistant City Attomey
Emergency Medicine
Date: 7/22/2020
Recommended for Approval
taly signod by Mary Mime
Mary Merced on collay Mence, a du Alameda Fire Department Di: 20073116 ONCUS
By:
Mary Mercer, MD
By
7/21/20
Date: Name JAMES COLBURO
Title DEPUTy CHIEF
EXHIBIT 1.1a
Medical Director Services
Alameda Fire Department Emergency Medical Services Division UCSF Physician providing Services: Mary Mercer, MD
MEDICAL DIRECTOR JOB STATEMENT
I.
Provides quality assurance, education to and clinical direction of the field providers (EMTs and paramedics), as well as oversight of the controlled Cly Fire Department Divin of rent edic series after required meetings; does related work as required. Services will be provided approximately 1-2 hours/week or 4 - 8 hours/month.
II. CRITICAL ELEMENTS OF PERFORMANCE
Provides overall clinical direction for the Service's emergency medical technician (EMT) and emergency medical technician - paramedic (EMT-P) through the fire department chain of command in order to maintain control of patient care in accordance with the local EMS Agency and state rules and regulations; provides instruction to members of the department through continuing education, academy classes, and recertification courses; establishes standards for basic and advanced training, remediation, and continuing education programs for all AFD EMS personnel to provide uniformity in patient care provision; participates in Alameda County EMS Agency committees and meetings as required by Alameda County regulation and agreements to establish appropriate clinical oversight, feedback, and input into protocol development, equipment selection, and quality assurance matters in cooperation with the other EMS medical directors and the Alameda County EMS Agency; regularly attends state level conferences, EMDAC and EMSAAC; provides quality assurance review for the department to maintain the standard of care in Alameda; reviews of EMS calls in consort with the EMS Coordinator to verify appropriate medical care provision; promotes and encourages the continued growth and perpetuation of the fire department as a provider of emergency medical services; published author (preferred).
Ill. PERFORMANCE STANDARDS
Effectively establishes working relationships with the Chief of the Department, his staff, the officer in charge of EMS, the EMS Coordinator, and the Alameda County EMS Agency Medical Director; effectively formulates sound medical policies and protocols; works with the EMS Coordinator to competently set EMS training and retraining standards for Alameda Fire Department EMS providers; effectively provides advice to the Chief or his designee in matters pertaining to the selection, correction, and supervision of medical care providers; assists with the Alameda Fire Department Quality Program; provides instruction to members of the Alameda Fire Department.
IV. KNOWLEDGE-SKILL-ABILITY REQUIRED TO PERFORM
SATISFACTORILY
A. Knowledge
1. Knowledge in the general practice of emergency medicine.
2. Knowledge of the operations of the emergency medical services system.
3. Knowledge of the laws and ordinances pertaining to emergency medical services.
4. Knowledge of educational principles and techniques.
5. Knowledge of practices and techniques of report review and analysis.
6. Knowledge of current and emerging trends and delivery methods in EMS in the State of California
B. Skill
1. Skill to perform the duties of an emergency care physician.
2. Skill in the formulation of medical procedures.
3. Skill in communicating highly technical medical information.
4. Skill in performing case reviews.
C. Ability
Ability to establish effective working relationships among individuals and organizations.
Ability to work well with volunteers.
Ability to perform medical procedures.
MINIMUM QUALIFICATIONS
Graduation from accredited school of medicine with a medical doctor (MD) degree; experience in emergency care medicine; possession of a current license to practice medicine in the State of California; completion of a fellowship or practicum in emergency medical services (preferred); currently practicing emergency medicine, in a Fire Department, at a minimum in the State of California, preferably in Alameda County.
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EXHIBIT 6.1
Insurance
I. Insurance to be Maintained by Fire Department. Fire Department, at its sole cost and expense, shall procure and maintain professional liability insurance and shall insure its activities in connection with this Agreement during the term of this Agreement with a carrier and in a form acceptable to UCSF as follows:
(a) Professional Medical and Hospital Liability Insurance with financially sound and reputable companies with limits of five million dollars ($5,000,000) per date prior to coinciding with the effective date of this Agreement and a deductible of no more than five hundred thousand dollars ($500,000). In the event that a claims-made policy is canceled or non-renewed, then Fire Department shall obtain extended reporting (tail) coverage for the remainder of the five (5)-year period
(b) Comprehensive or Commercial Form General Liability Insurance (contractual liability included) with a limit of one million dollars ($1,000,000) per occurrence and a general aggregate of five million dollars ($5,000,000). If such insurance is written on a claims-made form, it shall continue for five (5) years following termination of this Agreement. The insurance shall have a retroactive date prior to or coinciding with the effective date of this Agreement. (c) Workers' Compensation Insurance in a form and amount covering Fire Department's full liability as required by law under the Workers' Compensation Insurance and Safety Act of the State of California as amended from time to time.
(d) Such other insurance in such amounts that from time to time may be reasonably required by the mutual consent of the parties against other insurable risks relating to performance.
It should be expressly understood, however, that the coverages required under this Exhibit shall not in any way limit the liability of Fire Department.
Fire Department, upon execution of this Agreement, shall furnish UCSF with Certificates of Insurance evidencing compliance with all requirements. Certificates shall further provide for thirty (30) day advance written notice to UCSF of any modification, change or cancellation of any of the above insurance coverages. - 16 -
IL. Insurance to be Maintained by the USE. UCSF shall maintain insurance or self-insure its activities in connection with this Agreement by maintaining programs of self- insurance as follows:
(a) Professional Medical and Hospital Liability self-insurance with limits of five million dollars ($5,000,000) per occurrence, with a general aggregate of ten million dollars ($10,000,000). If such insurance is written on a claims-made form, it shall continue for five (5) years ollowing termination of this Agreement. The insurance shall have etroactive date prior to or coinciding with the effective date of thi Agreement and a deductible of no more than five hundred thousand dollars ($500,000). In the event that a claims-made policy is canceled or non-renewed, then University shall obtain extended reporting (tail) coverage for the remainder of the five (5) year period. (b) General Liability Self-Insurance Program with a general aggregate limit of two and a half million dollars ($2,500,000). If such insurance is written on a claims-made form, it shall continue for five (5) years following termination of this Agreement. The insurance shall have a retroactive date prior to or coinciding with the effective date of this Agreement.
(c) Workers' Compensation Self-Insurance Program covering the UCSF's full liability as required by law under the Workers' Compensation Insurance and Safety Act of the State of California as amended from time to time.
(d) Such other insurance in such amounts which from time to time may be reasonably required by the mutual consent of the parties against other insurable risks relating to performance.
It should be expressly understood, however, that the coverages required under this Exhibit 6.1 shall not in any way limit the liability of the UCSF or its Physicians.
UCSF, upon execution of this Agreement, shall furnish Fire Department with Certificates of Insurance evidencing compliance with all requirements: Certificates shall further provide for thirty (30) day advance written notice to Fire Department of any modification, change or cancellation of any of the above insurance coverages. - 17 -
CERTIFICATE OF
Date: June 23, 2020
SELF-INSURANCE COVERAGE
PRODUCERANSURED
The Regents of the University of California This Certificate is issued as a matter of information only to authorized viewers for Office of the President their internal use only and confers no rights upon any viewer of this Certificate Office of Risk Services The Certificate does not amend, extend or alter the coverage described below. 1111 Franklin St., 10%h Floor This Certificate may only be copied, printed and distributed by an authorized Oakland, CA 94607-5200 viewer for its internal use. Any other use, duplication or distribution of the 510-987-9832 Certificate without the written consent of the Regents of the University of California is prohibited
ENTITIES AFFORDING COVERAGE
PARTICIPATION
COMPANY LETTER A The Regents of the University of California 100 %
COVERAGES
THIS IS TO CERTIFY THAT THE REGENTS OF THE UNIVERSITY OF CALIFORNIA IS A GOVERNMENTAL ENTITY THAT HAS A SELF-FUNDED
RETENTION FOR LIABILITIES DESCRIBED BELOW, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY WRITTEN CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY PERTAIN. THIS SELF-FUNDED PROGRAM IS
SUBJECT TO ALL PROVISIONS OF THE BYLAWS AND STANDING ORDERS OF THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, WHICH
DOES NOT PERMIT ANY ASSUMPTION OF LIABILITY WHICH DOES NOT RESULT FROM THE NEGLIGENT ACTS OR OMISSIONS OF ITS OFFICERS, AGENTS OR EMPLOYEES. THE REGENTS' SELF FUNDED RETENTION IS AT LEAST THE LIMITS LISTED BELOW.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMITS LTR
GENERAL LIABILITY GENERAL AGGREGATE Not applicable
COMMERCIAL GENERAL LIABILITY PRODUCTS COMPIOP AGG 5,000,000 | CLAIMS MADE X OCCURRENCE Self-Insured July 1, 2020 July 1, 2021 PERSONAL & ADV INJURY 5,000,000 CONTRACTUAL LIABILITY 5,000,000
PROFESSIONAL LIABILITY 5,000,000
EACH OCCURRENCE 5,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Not applicable
TANY AUTO
& ALTONED BODILY INJURY s 2,500,000
(PER PERSON
SCHEDULED Self-Insured July 1,2020 July 1, 2021
AUTOS
X HIRED AUTOS CODILY INJURY 2,500,000
(PER ACCIDENT
ANOWNED
AUTOS
*GARAGE LIABILITY PROPERTY DAMAGE $ 2,500,000
PROPERTY EACH OCCURRENCE 7,500,000
X FIRE & EXTENDED PERILS Self-Insured July 1,2020 July 1,2021 AGGREGATE S Not applicable
STATUTORY LINITS
- ORLOTER LABELIA TON AND Self-Insured July 1, 2020 July 1, 2021 EACH ACCIDENT DISEASE - POLICY LIMIT As required by
California Law
DISEASE - EACH EMPLOYEES As required by
California Law
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/SPECIALITEMS
ADDITIONAL COVERED PARTY- AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH RESPECT TO GENERAL LIABILITY
AND AUTOMOBILE LIABILITY
LOSS PAYEE - AS REQUIRED BY WRITIEN CONTRACT OR AGREEMENT WITH RESPECT TO PROPERTY COVERAGE
CERTIFICATE HOLDER CANCELLATION
APPLICABLE PARTY AS REQUIRED BY WRITTEN CONTRACT SHOULD THE REGENTS ELECT TO DISCONTINUE SELF-INSURING ITS
OR AGREEMENT LIABILITIES, THE REGENTS WILL UPDATE PROOF OF SELF-INSURANCE ON ITS WEBSITE. THE REGENTS SHALL NOT BE OBLIGATED TO PROVIDE INDIVIDUAL
NOTICE TO VENDORS OR OTHERS
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Approved as to Form: CHERYL A. LLOYD, AVP & CHIEF RISK OFFICER
CITY ATTORNEY
By: M.H 7.23.20
Deputy City Attorney
UNIVERSITY OF CALIFORNIA
PROOF OF SELF-INSURANCE COVERAGE
The Regents of the University of California are often requested by outside parties to provide evidence • Using an off-campus location to host an event, ceremony, athletic event, theatre production, practice space, job fair, educational outreach event, etc • Leasing or renting equipment, motor vehicle(s), or real estate • Research grant sub-awards
• Affiliation (non-healthcare/medical related) and Professional Services Agreements The University of California self-funds its liability exposures, so does not issue individual certificates of insurance. The UC Office of Risk Services has developed a Certificate of Self-Insurance Coverage document (COC) to illustrate the self-funded retention levels maintained for each liability program.
The COC is available on-Jine for use by entities conducting business with the university as evidence of the self-funded retention levels, coverage terms, and limits routinely requested. The self-insurance limits accepted in each specific written agreement or contract shall be the limits that apply should a loss arise, regardless of the limits provided in the on-line Certificate of Self-Insurance Coverage document.
The UC COC Site is solely for the use and benefit of the vendors and organizations which contract with the University of California and not for resale or other transfer to or use by or for the benefit of any other person or entity. You may print copies for use within your organization, provided that you do not modify the COC in any way, nor distribute any copies outside your organization. You may not use any of the University of California's names or marks in any manner that creates the impression such names or marks belong to or are associated with you or imply any endorsement by the University of California, and you acknowledge that you have no ownership rights in and to any of these names or marks. You will not use the Site, the information contained therein or any of the University's names or marks in unsolicited mailings or spam material. You may not link directly to the COC ("deep link") or bring up or present the COC or other content of this site within another web site ("frame").
Official Correspondence must be sent via postal mail to:
Chief Risk Officer
Office of Risk Services
Office of the President
University of California
1111 Franklin St., 10th Floor
Oakland, CA 94607-5200
510-987-9832
[email protected]
Please contact the local Risk Manager at the specific University of California location where you are contracting if you have insurance coverage questions:
Campus Risk Managers Directory
• Hospital Risk Managers Directory
No: 2134358680 Return Address
This Certificate is provided to: UC San Francisco
350 Parnassus, Suite 507
San Francisco, CA 94143-0207
UNIVERSITY OF CALIFORNIA
EVIDENCE OF SELF-INSURANCE
PROFESSIONAL LIABILITY & HOSPITAL LIABILITY
Type of Coverage Self-Insured Limits
1. PROFESSIONAL MEDICAL AND HOSPITAL LIABILITY: 5,000,000 Each Occurrence 10,000,000 Aggregate
II. SPECIAL TERMS & CONDITIONS:
1. This certificate is issued in connection with work performed by:
Alameda Fire Department_UCSF Emergency Medicine_Medical Director Agreement This certificate is only valid for work performed within the course and scope of his/her employment within:
Department of Emergency Medicine at University of California, San Francisco Medical Center Effective: 07/23/2020 - 07/01/2021
University employees are provided a University funded defense and indemnification for alleged negligence acts or omissions rising out of the course and scope of the University employment except where they act or fail to act because of actual fraud, corruption, or actual malice. (California Tort Claims Act. Government Code Section 810).
2. The self-insurance evidenced herein follows the provisions of the Bylaws and Standing Orders of the Regents of the University of California and self-insurance programs as administered by the University of California, Office of the President, Office of Risk Services, which do not permit any assumption of liability which does not result from and is not caused by the negligent acts or omissions of its officers, agents, or employees. Any indemnification or hold harmless clause with broader provisions than required under such Bylaws and Standing Orders shall invalidate this certificate.
This certificate is in effect until the expiration date indicated below or termination of applicable contract, affiliation agreement or termination of University employment, whichever comes first.
Should any of the above described program of self-insurance be materially modified or cancelled before the expiration date shown below, The Regents of the University of California will give 30 days written notice to the certificate holder.
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Effective Date: 07/01/2020 7/28/20 Susan Penney
UC San Francisco Risk Managemen
S50 Francisco CA 94143-0207
Expiration Date: 07/01/2021 Approval Date: 7/27/2020
This Certificate is issued as a matter of information only and confers no rights upon the certificate holder. The Cerificale does not amend, extend or alter the coverage described above. This certificate does not constitute a contract between the holder and the University of California.
Form: PL Individual 0914