1 AGREEMENT FOR EXCLUSIVE EMERGENCY
AMBULANCE SERVICES
This AGREEMENT FOR EXCLUSIVE EMERGENCY AMBULANCE SERVICE (“Agreement”) is entered into effective as of July 1, 2026 ("Effective Date") by and betw een the CITY OF CHULA VISTA, a chartered municipal corporation (“City”), the CITY OF IMPERIAL BEACH, a municipal corporation, (“Imperial Beach”), and BONITA/SUNNYSIDE FIRE PROTECTION DISTRICT , an independent special district (“Bonita/Sunnyside”), each an “Agency” and collectively the “Agencies,” with referenced to the following facts:
RECITALS
A. Within Chula Vista, Bonita/Sunnyside, and Imperial Beach there is a public health and safety need for effective and efficient basic and advanced life support pre-hospital emergency medical care and ambulance transport services (“Emergency Ambulance Services”).
B. Various studies and actual practical experience have clearly demonstrated that communities of the approximate size and population of the Agencies are best assured of receiving the highest level of Emergency Ambulance Services at the lowest cost to the consumer where service calls are originated through the 911 system if said services are delivered by a single, competent provider on an exclusive basis.
C. Under state and local law, each Agency is authorized to provide or contract for exclusive Emergency Ambulance Services as public convenience requires and has been doing so since prior to June 1, 1980.
D. The County of San Diego Local Emergency Medical Services (“LEMSA”) has adopted a plan, in which it has designated an exclusive operating area (“EOA”) defined as that part of San Diego County generally known as Chula Vista, Bonita/Sunnyside, and Imperial Beach, for which Chula Vista has the authority to contract for Emergency Ambulance Services on behalf of the EOA.
E. The Agencies participate in the EOA's first responder system responding to all emergencies originated in the 911 system.
F. Since prior to June 1, 1980, the Agencies have contracted with American Medical Response Ambulance Service, Inc. (“AMR”), or its predecessors, for the provision of Emergency Ambulance Services within their respective jurisdictions and throughout the EOA (collectively, the “Service Area”). A map showing the existing Service Area, and each Agency’s subsection thereof, is attached hereto as Exhibit A.
G. The most recent agreement between the Agencies for AMR’s provision of E mergency Ambulance Services to the Service Area is that certain Amended and Restated Agreement for Basic and Advanced Life Support Ambulance Services dated effective October 1, 2018 (the “AMR Agreement”).
H. The Emergency Ambulance Transport Services Agreement is set to expire by its terms on June 30, 2026.
I. Since on or about October 1, 2018, Chula Vista has been evaluating the pros and cons various Emergency Ambulance Service delivery models for the Service Area. Options evaluated include (a) the continuation of service by AMR under existing or re -negotiated terms; (b) soliciting alternative proposals from AMR and other service providers through some form of competitive “Request for Proposals” process; and (c) the provision of service by Chula Vista through the Chula Vista Fire Department (“CVFD”).
J. After much analysis, including the engagement of A.P Triton to conduct a systems analysis and feasibility study, City staff concluded that the provision of Emergency Ambulance Services by the CVFD within Chula Vista and throughout the Service Areas could provide substantial benefits over 2 existing or alternative contracted services. Projected benefits included: (a) adding more ambulance units/hours dedicated primarily to the Service Area, (b) decreased the costs of transport bills, (c) reduced base rate cost fluctuation, (d) internal administrative control of the transport system, (e) unified dispatch and information technology between first responder and transport resources, and (f) more coordinated and consistent medical direction, and continuity of patient care.
K. On January 28, 2020, after hearing presentations from A.P. Triton and the CVFD, the Chula Vista City Council directed the CVFD and supporting City staff to proceed with next steps, including presenting a proposal for CVFD services to Bonita/Sunnyside and Imperial Beach, and negotiating terms for an agreement therewith.
L. Bonita/Sunnyside and Imperial Beach have each evaluated the CVFD proposal for the provision of Emergency Ambulance Services, and each concurs with the projected benefits of this service delivery model within their respective jurisdictions and throughout the Service Area. Each has negotiated with Chula Vista in good faith the terms and conditions for the provision by the CVFD of such services, as set forth in this agreement.
M. Chula Vista, through its CVFD, is authorized to provide exclusive Emergency Ambulance Services within the City of Chula Vista , pursuant to its authority under California Health and Safety Code Section 1797.201, pursuant to its general authority as a Charter City, and as specifically provided under Chula Vista Municipal Code Section 5.10.310. Chula Vista , through its CVFD, is also authorized to provide or contract for Emergency Ambulance Services within the Service Area in its capacity as a “grandfathered” provider of services under California Health and Safety Code Section 1797.224 for the LEMSA designated “EOA.”
N. Bonita/Sunnyside and Imperial Beach each also has the authority to provide Emergency Ambulance Services within their respective jurisdictions and/or to enter into a contract with Chula Vista for the provision of such services pursuant to their authority under California Health and Safety Code Section 1797.201 and/or 1797.224.
NOW, THEREFORE, in consideration of the mutual promises herein contained and for other good and valuable consideration, receipt of which is hereby acknowledged, the parties agree as follows:
AGREEMENT
1. SERVICES
1.1. Emergency Ambulance Services.
1.1.1. In General. In response to emergency medical calls for service originating from within the Service Area that are received through 911 or other public safety communication centers , Chula Vista, through the CVFD, shall provide Emergency Ambulance Services. Such services shall be available twenty-four (24) hours each day, seven (7) days each week, without interruption, and without regard to a patient's financial status. Such services shall be delivered in accordance with the response time requirements set forth in Section
1.2, below, and the system requirements and standards set forth in Section 2, below.
1.1.2. ALS Capable Units Required ; Exceptions. CVFD shall deploy ALS capable units in direct response to calls for medical emergencies originating from the 911 system or from other public safety dispatch or communications centers. Notwithstanding the foregoing, in each case consistent with San Diego County medical protocols: (a) CVFD may elect to deploy BLS Ambulance units to Level 3 calls; and (b) ALS Ambulance deployment may be canceled in route or down-graded to BLS by the CVFD designated dispatching agency, or any CVFD paramedic, EMT, or public safety officer with authority at the scene of an incident.
3 1.1.3. Standby Support for Other Emergency Calls. CVFD shall also provide standby ambulance support to the Fire Departments of each Agency for structural fires or other Service Area emergencies (“Other Emergency Calls”) as determined necessary and appropriate by each Agency’s incident commander.
Any ambulance unit so dispatched shall remain on site until released by the incident commander.
1.1.4. Special Events. CVFD shall also provide standby, Emergency Ambulance Services in the form of one, on- site Ambulance Unit, for up to two (2) special events within each sub-Service area, each calendar year. Additional special event ambulance support services may also be provided, subject to availability and additional service fees.
1.1.5. Other Call Types. Ambulance services to other call types may be also provided by CVFD as needed or appropriate, in its discretion, or subject to its approval of a corresponding operational plan.
1.1.6. Services Exclusive. Effective as of the “CVFD Services Commencement Dates” (as defined in initial section 5.1, below) e ach Agency, with respect to its own sub- Service Area: (a) designates CVFD as its exclusive provider of Emergency Ambulance Services under the terms of this Agreement; and (b) agrees not to designate or allow any third party to provide such services.
1.2. Response Time Requirements.
1.2.1. In General . As an integral part of its obligations under this Agreement, CVFD shall deliver the agreed upon Emergency Ambulance Services in a timely manner, consistent with the response time criteria set forth in this Section. In addition to overall response time compliance, CVFD agrees to use reasonable efforts to minimize variations or fluctuations in response time performance. Subject to applica ble exemptions, CVFD shall be expected to comply with applicable response time requirements even when initially dispatched ambulance units are diverted.
1.2.2. Specific Requirements.
a. Advanced Life Support. Respond in less than twelve (12) minutes to at least ninety percent (90%) of all ALS emergency and urgent calls (Levels 1 and 2) dispatched each month.
b. Basic Life Support . R espond in less than twenty (20) minutes to at least ninety percent (90%) of all BLS non-emergency calls (Level 3) dispatched each month.
c. Other Emergency Calls. Respond in less than twelve (12) minutes to at least ninety percent (90%) of all Other Emergency Calls dispatched each month.
1.2.3. Response Time Calculations.
a. In General. For emergency call Levels 1, 2, and 3, response time shall be calculated for each Agency’s sub-Service Area from the time that the 911 call is received by CVFD’s designated dispatching agency until the time that the first ambulance arrives on the scene or at the designated staging area as designated by the incident commander. If a responding. ambulance is reassigned in route from a first call to second call prior to arrival at the incident location, the response time clock will not stop on the first call until the arrival of an appropriately staffed ambulance on the scene of the first call. Each incident will be counted as a single response regardless of the number of units that respond.
b. Exemptions. It is understood that unusual circumstances beyond CVFD’s reasonable control can induce response times that exceed the response time standards set forth above.
Accordingly, in calculating response times for purposes of this Agreement, the following calls for service shall be considered “exempt” and not included in response time compliance calculations:
4 (1) Responses to requests for service outside the Service Area; (2) Responses to major emergencies or calls to a scene related to an activation of "Annex D" of the San Diego County Multi-Hazard Disaster Plan; (3) Calls cancelled prior to the arrival of an ambulance on scene; and (4) Such other appropriate exemptions as may be mutually agreed after consultations among the Agencies.
1.2.4. Reporting Requirements
a. Incident Reporting. CVFD shall use reasonable efforts to contact an affected Agency immediately upon the occurrence of a non-compliant “outlier” response time event. For purposes of this Agreement a non- compliant “outlier” response time event is a response time event exceeding 200% of the applicable response time threshold requirement. CVFD shall also notify each Agency immediately whenever any condition exists which materially, adversely affects delivery of compliant emergency medical services to that Agency.
b. Monthly Reporting. Each month CVFD shall provide each Agency a report of response time compliance within such Agency’s jurisdiction. Such reporting shall be filed within ten (10) days of the end of the previous month. The initial format of this report is attached hereto as Exhibit B. After consulting with all Agencies, CVFD may make modifications to the report format in its reasonable discretion. Reports shall be submitted in Excel or an equivalent format. For each month, and for each sub- Service Area, this report shall include:
(1) Total number of responses to calls
(2) Total number of transports
(3) Radio name for all transports
(4) Response time compliance
(5) Number of responses receiving exemptions.
(6) Number of 911 calls handled by other transport provider agencies (7) Transport Level (code 10-50)
(8) Number of “outliers”
1.2.5. Required Action in the event of Non-Compliance. In the event that CVFD fails to meet the response time requirements in any Agency’s service area for two (2) consecutive months or for three (3) total independent months within any twelve (12) month time period, CVFD shall be considered “non-compliant” under the terms of this Agreement with respect to that Agency . In such event, CVFD shall meet and confer with the affected Agency or Agencies to develop a plan for obtaining compliance at the earliest possible date, with initial actions to obtain compliance commencing within thirty days after the date non- compliance is determined.
Required compliance measures by CVFD may include, without limitation (a) strategic deployment of additional Ambulance Unit hours, and/or (b) alterations to operational response plans.
1.3. Ongoing Coordination. CVFD agrees to coordinate and participate in Agency meetings called from time to time by it, or any other Agency, for the purpose of planning and coordinating Emergency Ambulance Services within the Service Area, and to discuss any issues with response times or performance of CVFD responsibilities under the terms of this Agreement.
1.4. Complaint Procedures.
1.4.1. In General. Whenever a complaint is received regarding CVFD’s performance of its obligations under the terms of this Agreement, whether from a health care agency, public safety agency, a patient, or the general public, CVFD shall prepare a written “Incident Report” regarding such complaint. Incident Reports shall be prepared on a standard form reasonably approved by the Agencies. CVFD shall notify the affected Agency, or Agencies, promptly after the receipt of any such complaint, and a copy of the corresponding Incident Report, subject to any legally required or appropriate redactions, shall be available upon request. If deemed 5 necessary or appropriate by the CVFD, or upon request of the affected Agency, the CVFD shall direct and oversee an investigation of such complaint. In the course of such investigation, direct contact shall be made with the complaining party as necessary and appropriate.
1.4.2. Complaint Evaluation and Resolution. CVFD shall use best efforts to evaluate and resolve complaints within thirty (30) days of receipt thereof. In its evaluation of complaints, emphasis placed on identification of potential system failures and deficiencies, recommendations for short and long-range corrective actions, and the documentation of facts for future review and reference. Within thirty (30) days of complaint resolution or, in a case where no resolution is reached, within two (2) business days of determining that the matter is not resolvable, CVFD shall notify the Fire Chief or designee of the appropriate Agency.
1.4.3. Records of Complaints. All documentation on complaints shall be maintained by CVFD and made available for review by the affected Agency for a minimum of three (3) years. After three years, Agency complaint records for complaints that have been resolved, or that are reasonably determined to be unresolvable, may be destroyed, subject to compliance with Chula Vista document retention policies.
1.5. Local Agencies to Continue to Act as First Responders. Notwithstanding the Emergency Ambulance Services to be provided by CVFD hereunder, Imperial Beach and Bonita/Sunnyside shall continue to provide their own “first responder” emergency medical services within their respective jurisdictions (“First Responder Emergency Medical Services”) . Each Agency acknowledges and agrees that the First Responder Emergency Medical Services it provides under the terms of this Agreement are necessary to support and enhance the quality of the Emergency Ambulance Services being provided by CVFD hereunder. Such support and enhancement is provided through patient stabilization and treatment services delivered by a paramedic, with EMT support, arriving on average, prior to the arrival of an Ambulance Unit. First Responder Emergency Medical Services shall be provided at each Agency’s sole cost; provided, however, certain qualified First Responder Emergency Medical Services costs shall be reimbursable on the terms set forth in Section 4 hereof, below. In order to assure the continued value of such services, and their qualification for cost reimbursement hereunder, each Local Agency agrees that its First Responder Emergency Medical Services for all ALS urgent calls (Levels 1 and 2) shall be provided in less than seven (7) minutes to at least ninety percent (90%) of such calls dispatched each month.
2. SYSTEM REQUIREMENTS AND STANDARDS
2.1. Vehicles, Equipment and Supplies.
2.1.1. In General. CVFD will p rovide, maintain and operate all ambulances, other vehicles , equipment and supplies, necessary to provide the Emergency Ambulance Services required under the terms of this Agreement (collectively, the “Required Vehicles and Equipment”) . CVFD shall maintain and operate all Required Vehicles and Equipment in accordance with any and all federal, state, and local laws, ordinances, regulations, resolutions, policies, procedures, and protocols. Any piece of Required Vehicles and Equipment with any deficiency that compromises, or may reasonably compromise its function, shall be removed from service for repair or replacement.
2.1.2. Ambulance Specifications.
a. In General. Ambulances used in providing services under this Agreement shall be Type 1 ALS capable units that meet the standards of Title XIII, California Code of Regulations. At least one full- service ambulance unit shall be bariatric transport capable.
b. Useful Life. Service area frontline ambulances shall have a maximum service life of 200,000 miles or seven (7) years as a frontline ambulance. Service area reserve ambulances shall have a maximum service life of 275,000 miles or 10 years of total service.
c. Markings. Ambulances used in providing services under this Agreement shall bear the markings "CVFD Fire Department" in at least four (4) inch letters on both sides, below this shall be “Proudly 6 Serving the Communities of Bonita, Chula Vista and Imperial Beach.” The ambulances shall have a "Paramedic Unit," marking on both sides.
2.1.3. Biomedical Equipment. To provide continuity of care between first responder agency resources and transport system resources, a common set of cardiac monitors and automatic CPR devices will be utilized. For the duration of the term of this contract the selected equipment shall be the Zoll X Series Advanced monitors and Autopulse.
2.1.4. Communications.
a. In General. CVFD shall provide and maintain all communications systems and equipment necessary to provide support for the Emergency Ambulance Services described in this Agreement.
Communications system capacity shall include the ability to communicate with each Agency’s secondary PSAP, hospitals and other public safety agencies as required in a declared disaster situation. This obligation includes obtaining radio channels and all necessary FCC licenses and other permits as may be required for the operation of the communications system. A common ePCR platform shall also be established and maintained for use in documenting patient care.
b. Equipment Standards. In order to fulfill its obligations under this Section, CVFD shall provide the following c ommunications equipment: (1) each Ambulance Unit or supervisor unit shall be provided one (1) 800 MHz mobile radio compatible with first responder fire agency radio frequencies within the Service Area, “Central Zone" and "Metro Zone" ; (2) each crew member assigned to an Ambulance Unit or supervisor unit shall be provided one 800MHz portable radio and one cellular telephone; (3) all ambulances shall be equipped with Automatic Vehicle Location (AVL) devices and mobile data computers (MDC) or equivalent.
Communication equipment used by ambulance crews shall be capable of transmitting 12-lead ECGs to receiving facilities.
2.1.5. Other Support Vehicles. In order to support the provision of Emergency Ambulance Services throughout the Service Area, CVFD shall also provide and operate, as needed, the following system support vehicles: (a) one (1) EMS Supervisor Emergency Response Vehicle ; and (2) o ne (1) Supply Delivery Vehicle.
2.1.6. 2.1.6. Re-Supply. CVFD shall resupply the Fire Departments of each Agency with a standard compliment of first responder disposable medical supplies and related disposable emergency medical equipment, including personal protective equipment and semi-automatic defibrillator supplies. Supplies shall be provided on an “as-needed” basis in accordance with an agreed upon re -supply program. The parties shall meet and confer from time to time as necessary in order to evaluate and update such program to maximize efficiency.
2.2. System Operations.
2.2.1. Vehicle Deployment . The current CVFD operational program for deployment of Ambulance Units to serve the entire Service Area is as follows: (a) ten (10) fully equipped Ambulance Units operating on 24 hour shifts, 24 hours a day, 7 days a week; (b) two (2) fully equipped BLS Ambulance Units operating on 12 hour shifts, 7 days during peak call times; and (c) six (6) back-up Ambulance Units, two (2) of which shall be fully equipped. In addition, CVFD will deploy one (1) CVFD supervisor/ vehicle operating 24 hours a day, seven 7 days a week in order to provide system support, incident support and occasional field training.
Throughout the term of the Agreement, CVFD shall exercise best efforts to balance available system resources in order to maximize response time compliance within each Agency jurisdiction. As necessary and appropriate, CVFD may also utilize third party mutual aid support in order to meet response time requirements.
2.2.2. Ambulance Unit Allocations to Bonita/Sunnyside and Imperial Beach.
a. Deployment. CVFD shall stage within the sub- service areas of Bonita/Sunnyside and Imperial Beach, respectively, one Type I ALS capable ambulance, operating twenty-four (24) hours per day, 7 seven (7) days a week, 365 days per year (each a “Local Unit”). Local Units may be dispatched into other parts of the Service Area from time to time as system needs dictate; provided, however, CVFD shall exercise best efforts to minimize such diversions , to shift resources as necessary and appropriate to cover any vacated area, and to return diverted Local Units back to their designated Agency jurisdictions as soon as practicable.
b. Housing; Relations. Local Units will be based within a fire station operated by the Agency where the Agency is located (“Agency Base Station”). Housing for ambulance personnel at the Agency Base Station will be provided by the host Agency at no cost to CVFD or the system . Notwithstanding the foregoing, assigned Ambulance personnel will be responsible themselves, or through their bargaining groups, for payment of s tation dues and/or similar cost sharing arrangements among station personnel . Both CVFD ambulance personnel stationed at Agency Base Stations and Agency fire station personnel shall treat each other with professionalism and mutual respect. Any personnel conflicts involving CVFD ambulance personnel shall be reported to the on-duty CVFD EMS Supervisor as soon as possible. Imperial Beach and Bonita/Sunnyside have made no representations or warranties, expressed or implied, with respect to its respective Agency Base Station.
This section providing for the Agency Base Station is not a lease and City shall acquire no rights, e asements or licenses in or to the Agency Base Station by implication or otherwise except as expressly set forth in this Agreement. City understands that this is solely a temporary use allowance of the Agency Base Station and neither Imperial Beach nor Bonita/Sunnyside is granting any real property rights or interests in the Agency Base Station to City by entering into this Agreement. City agrees to immediately vacate the Agency Base Station upon the expiration or termination of the Agreement with respect to the applicable Agency. Additionally, City agrees to pay for any damage caused by City employees related to the housing of the Local Unit at the Agency Base Station during the term of this Agreement.
c. Bio-Waste Disposal. Each host Agency shall p rovide a site at each Agency Base Station for locating Bio- Hazardous Medical Waste collection equipment and services to be administered and funded by the CVFD as a system cost.
2.2.3. Communications Systems. As necessary and appropriate to support the delivery of Emergency Ambulance Services within each Agency, CVFD shall establish policies and procedures for the integration of radio and data communications with each Agency’s secondary PSAP, Base Hospital, and on-scene incident command. All CVFD dispatch data shall be captured electronically on a "real-time" basis with a computer system capable of providing information to all Agencies with respect to address, times of dispatch, response times, arrival times and unit identifier. Radio equipment used for ambulance -to-hospital communications shall be configured so that personnel providing patient care are able to directly communicate with the base or receiving hospital staff about the patient. CVFD will participate in the RCIP project which includes AVL capabilities for all Ambulance Units.
2.3. Staffing and Personnel Qualifications.
2.3.1. In General. All Ambulance Units responding to emergency calls within the Service Area under the terms of this Agreement shall be staffed, at all times, in full compliance with the staffing levels and qualifications set forth by the San Diego County Emergency Medical Services Division ( “SDCEMSD”), or any successor agency thereto with governing authority.
2.3.2. Staffing Levels . The current minimum staffing levels for Emergency Ambulance Services delivery and supervision, that are compliant with SDCEMSD standards, and are to be provided by the CVFD under the terms of this Agreement, are as follows:
a. CVFD ALS transport units assigned to the Service Area shall be staffed at all times with a minimum of one (1) Paramedic and one (1) EMT.
b. CVFD may send BLS Ambulance units staffed with two (2) EMT's to requests for multi-unit response and to any calls in which an EMD capable secondary PSAP determines that a BLS Ambulance response is appropriate according to emergency medical dispatch protocols and policies.
8 c. CVFD will provide one (1) emergency response supervisor for the Service Area twenty-four (24) hours a day, 365 days a year.
d. CVFD shall retain on staff at all times a California licensed physician to act as its Medical Director. The Medical Director will (i) provide direction and oversee each Agency’s prescriptive devices and controlled substance program; (ii) participate in each Agency’s training and quality improvement processes; and (iii) represent each Agency as needed with medical regulatory agencies.
e. CVFD shall employ and maintain a minimum of one (1) full-time EMS Educator, with experience in training and quality improvement to implement and oversee ongoing quality management programs. The educator shall be responsible for coordination of all clinical review activities, developing and supporting a comprehensive orientation academy for new employees, and managing CQI activities.
2.3.3. Personnel Qualifications and Training.
f. CVFD agrees to employ paramedics who meet and/or exceed all state and county licensing and certification requirements.
g. CVFD will ensure that al l emergency personnel for all Agencies are properly trained and, at a minimum, meet the continuing education requirements specified by the SDEMSD. CVFD will provide a minimum of 24 hours of continuing education annually via in service training, station based, or online resources. CVFD’s EMS Educator shall be licensed in California as a Paramedic or Registered Nurse. The EMS Educator will work cooperatively with each Agency to provide training based on quality improvement process identified areas for improvement. CVFD shall establish an EMS T raining Committee that will identify annual training needs and curriculum. Each Agency will provide a representative to participate in this committee.
2.4. Paramedic Coordination, Transport and Staffing. Whenever an Agency’s first responder paramedic initiates care to a patient, such paramedic shall make all clinical decisions with respect to such patient up until such time that the paramedic(s) staffing the CVFD Ambulance Unit arrives on the scene and elect(s) to assume medical control. Prior to assuming medical control, the CVFD Ambulance Unit paramedic shall first consult with the first responder paramedic. Upon assumption of medical control, the CVFD Ambulance Unit paramedic will be primarily responsible for decisions regarding treatment, transport destination, and whether the first responder paramedic needs to accompany the patient to the hospital. The paramedic(s) from the first responder unit and CVFD Ambulance Unit shall work together to provide patient care on scene and in route to the hospital , with a smooth transfer of medical control in the best interests of the patient. In the event of a dispute between the first responder paramedic and the CVFD Ambulance Unit paramedic regarding medical care, such dispute shall be resolved through medical direction from the base hospital. CVFD shall be responsible for providing transportation to any accompanying first responder paramedic from the hospital back to their home agency.
2.5. System Administration, Modifications and Enhancements.
2.5.1. CVFD shall administer the Emergency Ambulance Services system described herein on a day to day basis in its professional discretion, as it deems necessary and appropriate to comply with the standards set forth in this Agreement. In addition, provided that (a) all SDEMSD and legal standards continue to be met or exceeded, (b) overall response time compliance is maintained, and (c) Local Unit deployment requirements are maintained, CVFD shall also have the discretion and authority to modify the number and type of units deployed to serve the System Area , and other system standards and procedures. No such modification shall be enacted without first meeting and discussing such changes with the other Agencies.
2.5.2. CVFD shall form a Quality Improvement Committee. Each Agency will provide a representative to participate in this committee. The committee will meet regularly to identify and recommend areas for improvement to increase quality of care within the system.
2.5.3. At any time during the term of the Agreement, each Local Agency reserves the right to propose system enhancements intended to better meet the needs of the overall Service Area or one or more sub- 9 Service Areas. The parties agree to meet and confer and determine the appropriateness of any such change to the system and any necessary or appropriate corresponding increase in the Fee Schedule. Any such change proposed by a Local Agency will require the mutual agreement of all parties to this Agreement, with each party acting in its sole discretion.
3. SERVICE FEES AND COLLECTION
3.1. In General. CVFD will charge, and collect fees from, each patient to whom services were provided under the terms of this Agreement, including patients receiving medical treatment but n ot transported. All such fees shall be charged and collected uniformly throughout the Service Area.
3.2. Fee Schedule. CVFD shall charge fees for services provided to individuals in accordance with the schedule of fees attached hereto as Exhibit C (“Fee Schedule”). The Fee Schedule may be modified from time to time, but only on the terms set forth herein.
3.3. Fee Components. Authorized fees shall be comprised of the following components:
(a) “Base Fees” charged as a standard minimum fee to each patient transported, ALS and BLS alike; (b) “Service Fees” charged depending upon the services provided and the particular circumstances of the call; Service Fees may include, without limitation, fees for o xygen used, diagnostic tests administered, mileage travelled, specialty treatments, and night charges; (c) “Treatment and Release” fees for medical services rendered at the scene but without transport; and (d) “Miscellaneous Fees” for miscellaneous charges commonly charged by the industry. Fee components (b) through (d), above, shall be collectively referred to hereunder as “ Additional Fees.”
3.4. Base Fees.
3.4.1. Term of the contract. Base Fees may be subject to increase by CVFD, but only upon the reasonable demonstration by CVFD that its projected “Qualified Costs” to operate the Emergency Ambulance Services system for the Service Area over the upcoming twelve -month operating period (“Qualified Annual Operating Costs”) will increase over the previous twelve-month operating period. “Qualified Costs” for purposes of this Section are defined in Section 4.3. hereof, below.
3.4.2. Limits on Fee Increase s. The Base Fees increases allowed under this Section shall not exceed the amount projected as reasonably necessary to recover the projected increase in Qualified Annual Operating Costs for the upcoming year, factoring in reasonably projected collection rates. Except as provided in Section 3.5, below, in no event shall there be an annual increase in Base Fees implemented under this Section 3.4 in excess of four percent (4%) of the rate charged in the previous 12-month operating period.
3.4.3. Implementation Process. Prior to implementing any Base Fees increase pursuant to this Section 3.4, CVFD shall provide supporting data to and meet and confer with the other Agencies . Base Fees increases implemented under this Section shall go into effect on October 1 for the applicable fiscal year of operations.
3.5. Additional Fees. Additional Fees, shall be calculated and set by the City based upon (a) industry standard rates charged by other Emergency Ambulance Service providers within the County of San Diego, (b) information and advice received from its billing and collections provider, (c) input from the Local Agencies, and (d) other applicable legal and appropriate practical considerations relevant to the development of a service charges schedule that is fair and that maximize opportunities for insurance program reimbursement. City shall review and approve a schedule for Additional Fees at least annually.
3.6. Rate Adjustments to Respond to Extraordinary Cost Increases or Adverse Material Events. In addition to the fee increases allowed in Section 3.4, above, CVFD reserves the right to increase Base Fees in an amount that exceeds the 4% limitation imposed by Section 3.4.3, and/or prior to the next October 1 fee increase date if, and only if, it projects to incur over a twelve month period “E xtraordinary Expenses” in any of the 10 following expense categories:
• Vehicle physical damage insurance
• Professional liability insurance
• Workers Compensation insurance
• General liability insurance
• Gasoline, diesel, propane, oil and petroleum products • Pharmaceuticals or medical supplies not separately charged as line items
Extraordinary Expenses are defined as an increase in cost from the previous year of twenty percent (20%) or more for a specific contract year in any of the above- stated categories. In addition, CVFD also reserves the right to implement a fee increase in the event of any extraordinary change in the payment or cost recovery provisions in Medical, Medicare, or their successor programs, or any other materially adverse change in applicable law, projected to have a material adverse impact on E mergency Ambulance Services costs or revenues. Prior to implementing any Base Rate increase under this Section, City shall first meet and discuss with the other Agencies the basis and need for such an increase and shall consider Agency input regarding the need and appropriateness of same.
3.7. Collections. City intends to contract with a qualified third -party service provider to operate the billing and accounts receivable system required in connection with City’s provision of Emergency Ambulance Services hereunder. City’s contract for such services (“Billing and Collections Contract”) shall include provisions that require its contract to implement a billing and accounts system t hat is humane, well-documented, easy to audit, and which minimizes the effort required of patients to recover funds from third party sources for which they may be eligible , and is consistent with best industry practices. Each Agency shall have access to t he same information that City has access to under the terms of the Billing and Collections Contract.
4. FIRST RESPONDER COST REIMBURSEMENT
4.1. In General. On the terms set forth herein, e ach Agency shall be entitled to reimbursement out of revenues generated through the provision of Emergency Ambulance Services within their respective sub-Service Areas for certain costs it incurs in connection with its own provision of emergency medical first responder services (“First Responder Emergency Medical Services”) . Qualified reimbursements for First Responder Emergency Medical Services shall be for “ Qualified Base Cost Reimbursement” on the terms provided in Section 4.2, and “Qualified Contingent Cost Reimbursement” as provided in Section 4.3, herein, below
4.2. Qualified Base Cost Reimbursement. In consideration for each Agency’s commitment to continue to provide First Responder Emergency Medical Services in their respective sub-Service Areas, each Agency shall be entitled to reimbursement for the costs they incur, on an annual basis, in connection with the provision of such services in an amount equal to the amount they are currently receiving as reimbursement for such costs under their existing agreements with AMR (“Qualified Base Cost Reimbursement”). Each Agency’s annual Qualified Base Cost Reimbursement amount is set forth on Exhibit D attached hereto. City shall pay each Agency its annual Qualified Base Cost R eimbursement in quarterly installments . The first quarterly Qualified Base Cost Reimbursement payment shall be due and payable in arrears July 15 , 2026, for the period April 1, 2026 through June 30, 2026. Thereafter, each subsequent quarterly installment shall be due and payable, in arrears, on each July 15th October 15th, January 15th and April 15th thereafter, throughout the remaining term of this Agreement.
4.3. Qualified Contingent Cost Reimbursement. In addition to the Qualified Base Cost Reimbursement amount described in Section 4.2, above, each Agency may also be entitled to receive a “Qualified Contingent Cost Reimbursement” calculated as follows:
4.3.1. Annual Financial Statement. Each year, for th e twelve month operating period commencing July 1 and terminating June 30 (each a “Fiscal Year”), City shall calculate, memorialize and deliver to each Agency , by no later than the following December 31 st, a written financial statement summarizing the Qualified Costs incurred, fees charged and gross revenues generated (“Gross Revenues”) for its delivery of the 11 Emergency Ambulances Services throughout the Service Area, and within each Agency’s sub-Service Area (the “Annual Financial Statement”). An Annual Financial Statement issued with respect to any given Fiscal Year may include adjustments made by the City’s Finance Director in order to account for one-time occurrences, or a series of occurrences, that might otherwise cause misalignment of system costs and revenues for operations within that Fiscal Year. Any such adjustments shall be highlighted to facilitate Agency review and input.
4.3.2. Qualified Costs Defined . For purposes of this Agreement, “Qualified Costs” shall include any and all costs incurred by the CVFD in connection with its delivery of Emergency Ambulance Services within the Service Area , including, without limitation, costs incurred for labor (direct, indirect and overhead at City’s then applicable internal rates for “full cost recovery” ), equipment (including amortized capital costs and maintenance), supplies, contracted services (e.g., billing), funding of capital and operational reserves (with initial funding at 6 months of operations and a goal of funding up to 12 months , not to exceed then in effect best practices), and insurance. Qualified Costs shall also include any and all Qualified Base Cost Reimbursements paid to the Agencies as provided in Section 4.2, above. A current statement of projected annual Qualified Costs, including the various line -item categories thereof, is attached hereto as Exhibit E . Bonita/Sunnyside ’s and Imperial Beach’s allocable share of such costs shall be based upon staffing and support necessary for the operation of one (1) ALS capable Ambulance Unit, 24 hour a day, 7 days a week, 365 days per year within each of their respective sub-Service Areas (“Allocable Share of Costs”).
4.3.3. Local Agency Service Reimbursement Funds.
a. If for any Fiscal Year of operations under this Agreement, the revenues generated within a sub-Service Area for such year exceeds that sub-Service Area’s Allocable Share of Costs for that year, the amount of such excess (in each case, that Agency’s “Local Agency Service Reimbursement Funds”) shall be identified by CVFD on th at year’s Annual Financial Statement , and made available for reimbursement to the corresponding Agency under the terms and conditions set forth in this Section 4.3.3.
b. An Agency seeking reimbursement out of its amount of Local Agency Service Reimbursement Funds must first submit to CVFD a statement of its qualified costs incurred for its provision of First Responder Emergency Medical Services during the corresponding operational period. Such statement shall be prepared and submitted in a form approved by CVFD . A representative of each Agency, or its authorized consultant, shall certify such Agency’s statement to be accurate and not misleading in all material respects. Each statement submitted shall be subject to the review and reasonable approval of the City for consistency with industry standards. Any costs submitted that are not consistent with industry standards will not be qualified for reimbursement under the terms of this Agreement.
c. In any Fiscal Year, each Local Agency’s “Qualified Contingent Cost Reimbursement” shall be equal to the amount by which that Local Agency’s submitted and approved costs for its provision of First Responder Emergency Medical Services (“Approved First Responder Costs”) exceeds that Agency’s Qualified Base Cost Reimbursement, up to, but never in excess of, the amount of that Agency’s allocable share of Local Agency Service Reimbursement Funds. City shall endeavor to remit Qualified Contingent Cost Reimbursement amounts due and payable within 30 days of its calculation thereof, but in no event later than December 31st of each Fiscal Year.
d. To the extent Local Agency Service Reimbursement Funds exceed Approved First Responder Costs in any given Fiscal Year, CVFD , shall reinvest such amounts in the Emergency Ambulance Services system, either by building capital and/or operational reserves, investing in training or equipment, and/or other operational enhancements for the benefit of the system . CVFD shall consult with the other Agenc ies to receive their input prior to determining, in its discretion, the ultimate use of such funds To the extent an Agency’s Approved First Responder Costs exceed its Local Agency Service Reimbursement Funds, each Local Agency shall be solely responsible for such costs; no unreimbursed costs shall be carried forward to future years.
e. For example, if for Fiscal Year 21/22 Local Agency “A” has a Qualified Base Cost Reimbursement of $120,000, a Local Agency Service Reimbursement Funds allocation of $21,206, and an Approved First Responder Costs amount of $135,00 0, Agency A would be entitled to receive a Qualified 12 Contingent Cost Reimbursement of $15,000. The balance of the Local Agency Service Reimbursement Funds ($6,206) would be reinvested by the CVFD into the Emergency Ambulance Services system after consulting with the other Agencies.
5. TERM OF AGREEMENT
5.1. In General. The term of this Agreement shall commence on the Effective Date. Notwithstanding the foregoing, City’s obligations to provide Emergency Ambulance Services hereunder , and any of its related obligations, and to be capable itself of providing Emergency Ambulance Services to the Service Area, by on or about April 9, 2021 ( the “CVFD Services Commencement Date”) . Imperial Beach and Bonita/Sunnyside similarly agree to formally recognize the CVFD as their exclusive provider of Emergency Ambulance Services within their respective sub -Service Areas, by the CVFD Services Commencement Date. Unless earlier terminated as provided below, or otherwise extended by mutual agreement of the parties, t his Agreement shall continue in effect for the period of five (5) years following the CVFD Services Commencement Date.
5.2. Termination for Convenience. Commencing any time after the CVFD Services Commencement Dated, but no sooner, each party to this Agreement may terminate its obligations and participation under the terms of this Agreement for any reason, or no reason whatsoever (“Termination for Convenience”), by giving specific written notice to the other Agencies of such proposed termination and specifying the effective date thereof. Any proposed termination date must be at least 180 days after the date of the termination notice. In the event any party exercises its right of Termination for Convenience hereunder, all parties agree to cooperate with one another and to take any and all steps reasonably necessary and appropriate in order to effectuate such Termination for Convenience in a fair manner and to minimizes adverse impacts to the remaining Agencies.
6. AUDIT AND REPORTING PROCEDURES
Each Agency agrees to allow a designated representative from each other Agency complete access to all operational and financial records and data (including computer generated reports) pertaining to the services provided pursuant to this Agreement. All records and documents regarding this service shall be available at such Agency’s offices for a period of not less than three (3) years. To the extent any such reports contain proprietary or confidential information, each Agency accessing such information agrees to limit the distribution of such information within its organization to only those that are necessary to its process of review or evaluation, and not to disclose such information to any third party. Any Agency may require an Agency seeking access to its information, and/or its consultant(s), to enter into reasonable forms of confidentiality agreement(s) reflecting the terms of this Section.
7. INSURANCE
7.1. City shall obtain and maintain at all times a policy or policies of General Liability and automobile liability insurance covering any operation or activity of City, its agents or employees under the terms of this Agreement. Each Agency shall be named as an additional insured under any such policy or policies .
Notwithstanding the foregoing, City reserves the right to fulfill some or all its insurance obligations under this Section through a program of self-insurance.
7.2. Each other Agency shall obtain and maintain at all times a policy or policies of General Liability and Automobile Liability insurance covering any operation or activity of such Agency, its agents, or employers under the terms of this Agreement. Such policies shall be in forms and with coverage amounts that are consistent with industry standards and reasonably approved by the City’s Risk Manager. City shall be named as an additional insured under such policy or policies. Notwithstanding the foregoing, subject to the prior approval of the City’s Risk Manager, each Agency reserves the right to fulfill some or all of its insurance obligations under this Section through a program of self-insurance.
13 8. HOLD HARMLESS AND INDEMNIFICATION
City shall indemnify, protect, defend and hold harmless each Agency and their respective officers, agents, elected officials, volunteers and employees from and against all claims demands, causes of action, costs, expenses, liability, loss, damage or injury, in law or equity, to property or persons, including wrongful death, damages, losses and expenses, including attorneys' fees and other costs of defense, arising out of or resulting from the performance by City, its officials, officers, employees, agents, and contractors, of the services specified in this Agreement caused, or alleged by third parties to have been caused, by any intentional or negligent act or omission by City, any subcontractor of City or anyone directly employed by City or its subcontractors, except to the extent caused by the willful misconduct or sole negligence of any Agency, or any subcontractor thereof or anyone directly employed thereby. Included in the obligations in this Section is City’s obligation to defend, at City’s own cost, expense and risk, any and all suits, actions or other legal proceedings, that may be brought or instituted against any of the other Agencies, or their respective directors, officials, officers, employees, or agents, subject to the limitations contained in this Section, above.
9. INDEPENDENT CONTRACTOR STATUS
All parties hereto in the performance of this Agreement will be acting in an independent capacity and not as agents, employees, partners, or joint ventures with one another. City is not an employee of the other Agencies and is not entitled to any of the rights, benefits, or privileges of the Agencies’ employees, including, but not limited to medical, unemployment, or workers' compensation insurance. None of the other Agencies nor their respective officers, agents or employees shall have any control over the conduct of City or any of City’s employees or independent contractors, except as herein set forth, and City expressly agrees not to represent that City, or any of City's agents, servants, employees or independent contractors, are in any manner agents, servants or employees of the other Agencies, it being understood that City, its agents, servants, employees and independent contractors are as to the other Agencies wholly independent contractors and that City’s obligations to the other Agencies are solely such as prescribed by this Agreement.
10. CONTRACT ADMINISTRATION; NOTICE
City designates the City Manager, or his/her designated representative, to administer this Agreement on its behalf. Bonita/Sunnyside designates its Fire Chief to administer this Agreement on its behalf. Imperial Beach designates its Fire Chief to administer this Agreement on its behalf. All reports, proposal, letters, notices and/or other correspondence shall be sent to the attention of the designated representatives at their respective addresses as follows:
City of Chula Vista
Fire Chief
City of Chula Vista
276 Fourth Avenue
Chula Vista, California 91910
and
City Manager and City Attorney
City of Chula Vista
276 Fourth Avenue
Chula Vista, California 91910
City of Imperial Beach
City Manager, Fire Chief and City Attorney
City of Imperial Beach
865 Imperial Beach Boulevard
Imperial Beach, California 91932
14 Bonita/Sunnyside Fire Protection District
Fire Chief
Bonita Sunnyside FDP
4900 Bonita Road
Bonita, CA 91902
11. COMPLIANCE WITH LAWS
11.1. In General. Any and all Emergency Ambulance Services or First Responder Services provided hereunder shall be provided in strict accordance with all applicable federal, state, and local laws and regulations, including any and all applicable medical standards imposed by the SDEMSD.
11.2. Specific Legal Requirements.
11.2.1. Patient Confidentiality. Each Agency, respectively, is responsible for complying with laws regarding the confidentiality of patient records and shall bear the costs of any violation of patient confidentiality laws committed by their respective employees.
11.2.2. Anti-Kickback Requirements. Each Agency on its own behalf agrees that it will comply in all material respects with all applicable federal and state laws and regulations including, the Federal Anti - kickback statute. The system revenues generated under the terms of this Agreement shall be used only for costs related to the provision of Emergency Ambulance Services or qualified First Responder Support Services as set forth herein. Such qualified costs may include and all necessary and appropriate costs related to the funding of reserves, training, labor (direct and overhead), equipment, supplies, and contractual services (including, without limitation, billing and collections services), all as more particularly set forth herein. Each Agency warrants and represents on its own behalf that any requests it makes for reimbursements for costs shall be less than or equal to such Agency’s actual costs incurred for such items. No funds shall be used by any Agency in a manner that may violate 42 UC.S. Section 1320a-7b, the federal Anti-Kickback Statute. It is not the intent of either party that any remuneration, benefit or privilege provided for under the Agreement shall influence or in any way be based on the referral or recommended referral by either party of patients to the other party or its affiliated providers, if any, or the purchasing, leasing or ordering of any services other than the specific services described in this Agreement.
Any payments specified herein are consistent with what the parties reasonably believe to be fair market value for the services provided.
11.2.3. No Mandatory Exclusion. Each party represents and certifies that neither it nor any practitioner who orders or provide Services on its behalf hereunder has been convicted of any conduct that constitutes grounds for mandatory exclusion as identified in 42 U.S.C.S 1320a-7(a).
11.2.4. Federal Health Care Program Requirements. Each party further represents and certifies that it is not ineligible to participate in Federal health care programs or in any other state or federal government payment program. Each party agrees that if DHHS/OIG excludes it, or any of its practitioners or employees who order or provide services, from participation in Federal health care programs, the party must notify the other party within five (5) days of knowledge of such fact, and the other party may immediately terminate the Agreement, unless the excluded party is a practitioner or employee who immediately discontinues ordering or providing services hereunder.
12. GENERAL PROVISIONS
12.1. Assignment and Subcontracting. City shall not assign its obligations under this Agreement without the prior written of Bonita/Sunnyside and Imperial Beach, each acting in their sole discretion. Any City proposed subcontract for any other component of the Emergency Ambulance Services shall be subject to the prior written approval of the other Agencies in their reasonable discretion. Notwithstanding the foregoing, City shall have the
15 right to subcontract for the following services without the other Agenc ies’ approval: billing and collection services.
12.2. Authority. By signing below, each Agency represents and warrants to the others that it is legally authorized by its governing body to enter into this Agreement and to perform the obligations as set forth herein, and that the parties executing this Agreement on behalf of such party are duly authorized agents with authority to do so.
12.3. No Third-Party Beneficiaries. There are no other parties to this Agreement, express or implied, direct or indirect. Each party acknowledges that it is not their intent to create any third-party beneficiaries to this Agreement.
12.4. Severability. If any provision of this Agreement shall be declared to be illegal, void or unenforceable by a court of competent jurisdiction, such provisions shall be deemed severable, and the other provisions shall not be affected but shall remain in full force and effect.
12.5. Consideration. City’s Exclusive Right to Provide Emergency Ambulance Services. The consideration provided by the Agencies to City in exchange for the Emergency Ambulance Services to be provided by City under the terms of this Agreement is that the Agencies shall grant to City the exclusive rights to provide emergency and non-emergency basic and advanced life support ambulance transport services originated through the 911 or equivalent system within the Service Area.
12.6. Exhibits. All Exhibits referenced herein shall be attached hereto and are incorporated herein by reference.
12.7. Defaults; Remedies.
12.7.1. Failure of Performance; Opportunity to Cure. In the event that any party fails to perform its obligations under the terms of this Agreement, such party shall be in default under this Agreement if (a) upon receipt of written notice from a non- defaulting party (or parties) identifying the failure of performance, and (b) after being given a reasonable opportunity to cure such fai lure, (c) such party fails to cure such failure of performance.
12.7.2. Dispute Resolution . In the event of a ny dispute regarding the interpretation of this Agreement, or regarding whether or not a party is in compliance with the terms hereof, the parties agree to meet and confer for a period of up to thirty ( 30) days in order to attempt to amicably resolve such dispute. I f after meeting and conferring the dispute cannot be amicably resolved, the parties may elect to refer the matter over to some form of mutually agreeable arbitration.
12.7.3. Administrative Claims Requirements and Procedures. No suit shall be brought arising out of this Agreement against City unless a claim has first been presented in writing and filed with City and acted upon by City in accordance with the procedures set forth in Chapter 1.34 of the Chula Vista Municipal Code, and such policies and procedures used by City in the implementation of same, as in effect at the time.
12.7.4. Attorneys’ Fees. The prevailing party in any lawsuit filed by a party to this Agreement with respect to this Agreement shall be entitled to receive reimbursement of its reasonable attorneys ’ fees and court costs incurred in connection with such lawsuit.
12.8. Entire Agreement; Amendment. This Agreement , together will all other agreements referenced herein, constitutes the entire agreement between the parties with respect to the subject matter contained herein .
All other prior or contemporaneous agreements, understandings, representations, warranties and statements, oral or written are hereby superseded. The Agreement may be amended, but only in writing signed by all parties hereto.
12.9. Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be 16 deemed an original, but all of which shall constitute one Agreement after each party has signed such a counterpart.
12.10. Further Assurances. The parties agree to perform such further acts and to execute and deliver such additional documents and instruments as may be reasonably required in order to carry out the provisions of this Agreement and the intentions of the parties.
12.11. Construction of Agreement
12.11.1. Recitals. The recitals set forth above are adopted as a part of the Agreement of the parties, and the facts set forth therein are acknowledged and agreed to be true, accurate and complete.
12.11.2. Exercise of Authority. The parties acknowledge and agree that this Agreement is the product of their mutual exercise of authority over the provision, administration, and governance of Emergency Ambulance Services and emergency medical services pursuant to their statutory, charter, and/or police powers including, without limitation, Health and Safety Code Sections 1797.201 and 1797.224. Nothing in this Agreement shall be construed as a relinquishment, abandonment, or waiver of each Agency’s rights, obligations, or authority under Health and Safety Code section 1797.201.
12.11.3. Ambiguities. The parties acknowledge and agree that each of them has participated in the drafting of this Agreement and that any rule of construction to the effect that ambiguities are to be resolved against the drafting party shall not apply.
[SIGNATURE PAGE TO FOLLOW]
17 SIGNATURE PAGE TO AGREEMENT FOR EXCLUSIVE
EMERGENCY AMBULANCE SERVICES
IN WITNESS THEREOF, the parties hereto have caused this Agreement to be executed, so as to be effective and binding as of the Effective Date.
THE CITY OF CHULA VISTA
Tiffany Allen
City Manager
Approved as to form by:
Marco A. Verdugo
City Attorney
CITY OF IMPERIAL BEACH
________________________________
Tyler Foltz
City Manager
Approved as to form by:
Jennifer Lyon
City Attorney
BONITA/SUNNYSIDE FIRE PROTECTION DISTRICT
____________________________
Mike Smith
Fire Chief
EXHIBIT A
SERVICE AREA MAP
EXHIBIT B
RESPONSE TIME REPORT TEMPLATE
Master_Incident_NumberAddress Problem Fixed_Time_PhonePickUpFixed_Time_CallEnteredQueueRadio_NameTime_Assigned Time_ArrivedAtSceneTime_Call_ClearedTime_Enroute Time_ContactTime_Depart_SceneTime_Arrive_DestinationResponse Time Unit Response Time Transport_Mode Exemption ReasonJurisdiction NC20004855 SWEETWATER RD & PLAZA BONITA CENTER WAUnc/Fainting (Non Trauma)(L 7/12/2020 14:56 7/12/2020 14:58AM415 ############# 7/ 12/2020 15:10 7/12/2020 15:10 #############NULL NULL NULL 0:13:42 0:11:46 NULL Bonita FS20097937 STATE ROUTE 54 EB OFF RAMP & BRIARWOOD RBreathing Problems (L1) 7/11/2020 12:34 7/11/2020 12:34M2 #############N ULL 7/11/2020 12:37#############NULL NULL NULL #VALUE! #VALUE! NULL Bonita FS20097937 STATE ROUTE 54 EB OFF RAMP & BRIARWOOD RBreathing Problems (L1) 7/11/2020 12:34 7/11/2020 12:34M1 0 ############# 7/11/2020 12:48 7/11/2020 13:46 #############NULL 7/11/2020 13:04 7/11/2020 13:16 0:14:34 0:13:29 50-Non Emergency Bonita FMSC202019 5901 STEEPLECHASE RD Falls / Back Inj (Trauma) (L1) NULL 7/31/2020 12:16AM419 ############# 7/31/2020 12:22 7/31/2020 13:19 #############NULL 7/31/2020 12:34 7/31/2020 12:52 #VALUE! 0:05:49 MUTUAL AID TRANSPORT Bonita FMSC201954 3359 BONITA WOODS DR Falls / Back Inj (Trauma) (L1) NULL 7/23/2020 18:47AM416 ############# 7/23/2020 18:56 7/23/2020 20:08 #############NULL 7/23/2020 19:11 7/23/2020 19:28 #VALUE! 0:09:20 MUTUAL AID TRANSPORT Bonita FMEC200080 192 MURRAY ST Assault/Rape (L1) 7/17/2020 22:19 7/17/2020 22:20AM412 ############# 7/17/2020 22:28 7/17/2020 22:53 #############NULL NULL NULL 0:08:59 0:06:26 NULL Chula Vista CV20015216 1316 Pershing Rd Convulsions / Seizures (L1) 7/31/2020 23:25 7/31/2020 23:25AM419 ############# 7/31/2020 23:36 8/1/2020 0:26 #############NULL 7/31/2020 23:50 8/1/2020 0:03 0:11:27 0:10:43 MUTUAL AID TRANSPORT Chula Vista CV20015213 Telegraph Canyon Rd & Oleander Ave Traffic Accident (L1) 7/31/2020 22:54 7/31/2020 22:54AM415 ############# 7/31/2020 23:00 7/31/2020 23:47 #############NULL 7/31/2020 23:13 7/31/2020 23:18 0:06:08 0:05:29 MUTUAL AID TRANSPORT Chula Vista CV20015212 363 Roosevelt St Assault/Rape (L1) 7/31/2020 22:27 7/31/2020 22:27AM414 ############# 7/31/2020 22:36 7/31/2020 22:43 #############NULL NULL NULL 0:09:49 0:06:38 NULL Chula Vista CV20015211 1258 Cuyamaca Ave Psych / Suicide Attempt (L1) 7/31/2020 22:07 7/31/2020 22:07M8 ############# 7/31/2020 22:19 7/31/2020 23:13 #############NULL 7/31/2020 22:34 7/31/2020 22:42 0:11:51 0:11:02 40-BLS Status Transport Chula Vista IB20001654 1012 Fern Ave Breathing Problems (L1) 7/31/2020 22:57 7/31/2020 22:57AM413 ############# 7/31/2020 23:03 7/31/2020 23:24 #############NULL NULL NULL 0:06:18 0:05:06 NULL Imperial Beac IB20001653 838 Georgia St Chest Pain (L1) 7/31/2020 18:26 7/31/2020 18:27AM419 ############# 7/31/2020 18:33 7/31/2020 18:55 #############NULL 7/31/2020 18:42NULL 0:06:39 0:05:24 MUTUAL AID TRANSPORT Imperial Beac IB20001652 1490 Hemlock Ave Assault/Rape (L1) 7/31/2020 9:22 7/31/2020 9:22AM413 7/31/2020 9:22 7/31/2020 9:27 7/31/2020 9:28 7/31/2020 9:23 NULL NULL NULL 0:05:29 0:04:42 NULL Imperial Beac IB20001651 1158 Palm Ave Unc/Fainting (Non Trauma)(L 7/31/2020 8:06 7/31/2020 8:07AM413 7/ 31/2020 8:07 7/31/2020 8:11 7/31/2020 9:06 7/31/2020 8:09 NULL 7/31/2020 8:22 7/31/2020 8:30 0:04:45 0:03:50 MUTUAL AID TRANSPORT Imperial Beac IB20001650 674 Palm Ave Chest Pain (L1) 7/31/2020 0:41 7/31/2020 0:42AM417 7/31/2020 0:48NULL 7/31/2020 0:48NULL NULL NULL NULL #VALUE! #VALUE! NULL Imperial Beac
EXHIBIT C
FEE SCHEDULE
Transport Fees
ALS2/ALS1/BLS $2800.00
Service Fees
Mileage (Per transport mile) $41.73
Oxygen $104.70
EKG $0.00
Night Charge $76.60
EXHIBIT D
QUALIFIED BASE COST REIMBURSEMENT AMOUNTS
Qualified Base Cost Reimbursement
Imperial Beach
$109,256
Bonita Sunnyside Fire Protection District
$26,775
Approved First Responder Costs
Paramedic Pay
Paramedic Training Costs
Zoll Monitor Repair and Replacement
Zoll Autopulse System
Agency Specific Medical Supplies
EMS PPE
Paramedic Renewal Fees
Designated EMS Project Funds
EMS Related Dispatch Fees
EMS Related Activity Response Apparatus Fuel and Maintenance Expenses
` EXHIBIT E
LOCAL AGENCY COST ALLOCATION
Full Burden Cost
Paramedic FTE (3)
EMT FTE (3)
Apportioned Cost
Cost of support activities for one ambulance. Equivalent to 8,760 unit hours of coverage.
Currently 1/10th of total cost based on initial number of units.
Supervision
Medical Director
Supply Delivery
Training Support
Medical Supplies
Capital Equipment-Monitors and Autopulses, Ambulances, Gurney Systems, Communications Fuel
EMS Staff
EMS Educator
Insurance/Risk Management
Billing Services
City Overhead
Pass Thru
Capital and Operational Reserve