2018
ALS FIRST RESPONDER AGREEMENT
AMR& CITY OF RIVERSIDE)
THIS ALS FIRST RESPONDER AGREEMENT hereby acknowledged, the Parties hereto agree as Agreement") is made between the American Medical follows:
Response Ambulance Service, Inc. (" AMR") and the
City of Riverside ( the " First Responder"). This 1. Provision of Services. First Responder will Agreement is effective as of the Commencement Date provide the ALS first responder services described as defined in Schedule" A" attached hereto. AMR and in Schedule" A" attached hereto ( the " Services") First Responder are sometimes individually referred to to patients who are responded to as part of the as " Party" and collectively as " Parties" in this County EMS System (as defined in the County Agreement. 911 Agreement)(" Patients") on the conditions, if any, described in Schedule " A" attached hereto
WHEREAS, First Responder contends that it is and in the Service Area. authorized to administer the delivery of ambulance
transport services within its boundaries pursuant to 2. Compliance with Laws. The Parties will comply Health and Safety Code Section 1797. 201 and in all material respects with all applicable federal Government Code Section 38794; and state laws and regulations, including the federal Anti- kickback statute. Each Party' s
WHEREAS, AMR is the emergency medical services vehicles will conform to applicable state provider in Riverside County, California ( the regulations and AMR' s vehicles will be duly County") and has entered in a Ground Advanced Life licensed for the transportation of Patients. All First Support Emergency Ambulance Services agreement Responderpersonnel staffing vehicles that provide with the County, effective July 1, 2015, with an initial the Services and all AMR personnel staffing term of five( 5) years and with the ability for up to three vehicles that provide AMR Emergency 3) additional" earned extensions" from( a) July 1, 2023 Ambulance Services will be licensed or certified through June 30, 2026; ( b) July 1, 2026 through June as required by applicable law. 30, 2028; and (c) July 1, 2028 through June 30, 2030
County 911 Agreement"): 3. Term. Unless earlier terminated as provided for in Section 4 below, the term of this Agreement shall
WHEREAS, the emergency ambulance services that commence on the Commencement Date set out in AMR is to provide in the County, including in the City Schedule" A" attached hereto, and shall continue of Riverside and First Responder' s service area, is in full force and effect through the term and any defined in the County 911 Agreement (" AMR earned extensions or other renewal terms of the Emergency Ambulance Services"); County 911 Agreement (" Term").
Notwithstanding the foregoing, in no event will
WHEREAS, the County 911 Agreement permits AMR the Term of this Agreement go beyond the term additional time to respond for a transport when it enters and any earned extensions or other renewal terms into public/ private partnerships with agencies which of the County 911 Agreement. can arrive on- scene and provide Advanced Life Support
ALS") services to patients first: 4. Termination. Either Party may terminate this Agreement:( a) at any time without cause and at its
WHEREAS, AMR receives a benefit in the form of sole discretion upon ninety ( 90) days written costs savings in an extended response time when an notice to the other Party; ( b) upon the material ALS first responder arrives before AMR and begins breach of this Agreement by the other Party, if caring for the patient: such breach is not cured within thirty( 30) days of written notice thereof to the other Party; or ( c)
WHEREAS, AMR wishes to retain First Responder to upon the implementation of a new first responder perform ALS first responder services within the service agreement directly with the County. area defined in Schedule" A" attached hereto(" Service Notwithstanding the foregoing, AMR may Area") in order for AMR to receive additional time to terminate this Agreement immediately upon: ( i) respond under the County 911 Agreement; and the failure of First Responder to meet the Response Time Standard provided in Schedule
WHEREAS, First Responder wishes to perform, and is A" attached hereto two ( 2) months in a row or capable of performing. ALS first responder services three( 3) months in any twelve( 12) month rolling within the Service Area pursuant to the terms of this period; or( ii) following First Responder's loss or Agreement. suspension of licensure necessary for the provision of the Services or reduction or loss of
NOW THEREFORE, in consideration of the First Responder' s insurance coverage below the foregoing and for other good and valuable minimum required under this Agreement. consideration, the receipt and sufficiency of which is
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5. Standards for Services. Each Party represents reconciliation amount owed to AMR due to late and warrants to the other Party that any and all response fees as outlined in Schedule A. services they provide shall be provided in
accordance with prevailing industry standards of 8. Restocking of Supplies. AMR shall restock First quality and care applicable to those services Responder in the field on a one- for- one basis for provided and the standards required by the disposable supplies and non- regulated County. All requirements of the County 911 medications usedfor treatment by First Responder Agreement and Riverside Municipal Code 5. 66 for patients that AMR transports. AMR shall pay applicable to the Services provided by First First Responder, $ 30,000 annually to reimburse Responder are incorporated herein. The Parties First Responder for equipment utilized in support represent that there are no terms within this of the restocking of supplies.
Agreement that are inconsistent with the
requirements of the County 911 Agreement 9. Dispatch and EMD. As long as the Firstapplicable to the Services provided by First Responder implements and maintains a Riverside Responder. In the event of any amendment to. or
County EMS Agency approved EMD program,interpretation of, the County 911 Agreement AMR shall pay $ 94,071. 15 annually First which would create an inconsistency between the Responder shall provide dispatch services for all requirements applicable to the Services provided
911 Emergency Medical Servicescalls originating
by First Responder and the terms of this in the Service Area for the duration of this Agreement, AMR shall immediately bring them to Agreement. AMR shall be required to provide a the attention of First Responder and the Parties link to the First Responder' s Computer Aided shall negotiate in good faith an amendment to this Dispatch (" CAD") system in its current or any Agreement to address the inconsistency. future configurations. Each AMR ambulance in the Service Area shall be capable of
6. No Billing by First Responder for Ambulance communicating with the First Responder' s Transport Services. First Responder shall not dispatch center and Fire units providing ALS first bill any Patient, third- party payer or any other responder services. source for any ambulance transport services. AMR
shall perform all billing for and Patient receiving 10. Record Retention. First Responder will retain First Responder services under the Agreement if books and records respecting Services rendered to the Patient is transported by AMR. AMR shall be Patients for the greater of ten( 10) years or the time solely and fully responsible for complying with
periods required under all applicable laws
applicable federal, state, and local laws -- including the requirements of the Secretary of including those relating to Medicare, Medi- Cal, Health and Human Services (" HHS")) and allow and the Affordable Care Act -- governing the
access to such books and records by duly
billing and collection of money for services
authorized agents of the Secretary of HHS. theprovided under this Agreement. Comptroller General and others to the extent required by law.
7. Compensation. As consideration for the Services
provided under this Agreement and the benefits 11. Audit Rights. Each Party shall, within areceived by AMR from the County ( as discussed reasonable amount of time after written notice in the recitals above), AMR shall pay to First from the other, provide representatives of the other Responder the sum of One hundred and twenty Party or the U. S. Government( as specified in thenine thousand nine hundred and ninety- seven notice), with access to all records, documents, dollars and twenty seven cents($ 129, 997. 27) per
fiscal and accounting data, and other informationmonth. ('` ALS First Responder Fee"). On each whether in paper form, microform, electronic
anniversary date of this Agreement, the First media or other form) that relate to this Agreement.
Responder shall be entitled to increase the ALS This obligation shall survive for a period of three First Responder Fee by a percentage equal to the
3) years following final payment under thisthen applicable annual percentage increase in the Agreement or until such later time as required Consumer Price Index ( CPI) annual change ( All under applicable law and regulation.
Urban Consumers for Riverside- San Bernardino-
Ontario). If CPI is discontinued or modified, a fair
12. Indemnity. To the fully extend permitted by law,substitute index or calculation to achieve the same each Party will defend. indemnify and holdresult as if not discontinued or modified will be harmlessthe other Party andits directors, officers,applied. First Responder shall submit its invoice employees, and agents from and against liabilityfor the ALS First Responder Fee to AMR monthly. claims resulting from or alleged to result from anyAny payment owed by either Party following the negligence, omissions, or willful or reckless
reconciliation shall be made within thirty ( 30)
misconduct of the indemnifying Party which arisedays; provided, however, the Parties may also agree to lower the payment to account for any
out of, relate to or result from the indemnifying
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Party' s performance or non- performance of this 15. Confidentiality. All information with respect to Agreement or the County 911 Agreement. the operations and business of a Party ( including but not limited to the rates charged hereunder) and
13. Insurance. The Parties currently maintain and any other information consideredto be andtreated will maintain during the Term of this Agreement as confidential by that Party gained during the liability insurance policies for claims that may negotiation or Term of this Agreement will be held arise out of the services provided under this in confidenceby the other Party and will not be Agreement or the County 911 Agreement. The divulged to any unauthorized person without prior Parties shall maintain comprehensive general and written consent of the other Party, except for automobile liability coverage with limits no less access required by law, such as the California than the amounts set forth in the County 911 Public Records Act, regulation and third party Agreement. The Parties shall maintain medical reimbursement agreements. The obligations under professional liability coverage with limits no less this section shall not apply to information which than the amounts set forth in the County 911 a) at the time of disclosure is in the public domain Agreement. The Parties shall maintain workers' or, after disclosure, enters the public domain other compensation insurance in the statutory required thanby breachof this Agreement;or( b) is already amounts. The Parties shall exchange, upon in the possession of the recipient at the time of execution of this Agreement, certificates of disclosure and is not acquired from the other Party; insurance evidencing coverage. Notwithstanding or( c) is later received on a non- confidential basis the foregoing, either Party may self- insure any or from a third party having the right to impart such all of the noted coverages, provided they are able information; or( d) is independently developed by to document sufficient reserves to cover exposures the recipient' s employees who did not have access in the amounts noted above. In the event of self- to such information in connection with this insured coverage, the Party shall provide a letter Agreement. evidencing such reserves to the other Party.
Coverage shall not be changed or modified 16. HIPAA Compliance. To the extent mandated by without using best efforts to at least thirty ( 30) law, each Party shall comply with the privacy days prior written notice to the other Party. provisions of the Health Insurance Portability and Accountability Act of 1996 and the regulations
14. Notices. Any notice required or permitted by this thereunder (" HIPAA"), and with such other Agreement shall be in writing and shall be requirements of HIPAA that may become delivered as follows, with notice deemed given as effective during the Term. All Patient medical indicated: ( a) by personal delivery, when records shall be treated as confidential so as to delivered personally; ( b) by overnight courier, comply with all state and federal laws. upon written verification of receipt; ( c) by
facsimile transmission, upon acknowledgment of 17. Relationship. In the performance of this receipt of electronic transmission; or ( d) by Agreement, eachParty shall be, asto the other, an certified or registered mail, return receipt independent contractor, and neither Party shall requested, upon verification of receipt. Notice have the right or authority, express or implied, to shall be sent to the following addresses: bind or otherwise legally obligate the other.
Nothing containedwithin this Agreementshall be
IF TO FIRST RESPONDER: construed to constitute either Party assuming or undertaking control or direction of the operations,
Fire Chief activities or medical care rendered by the other.
City of Riverside As to either Party' s employees, nothing contained 3401 University Ave herein shall be construed in such a manner as to Riverside, CA 92501 give effect to the notion that either Party shall in anyway assumeresponsibility for the oversight or
IF TO AMR: provision of the other Party' s employee benefits, including but not limited to the payment of wages,
Regional Director provision of health insurance, worker' s American Medical Response compensation, unemployment insurance. tax 879 Marlborough Avenue withholdings, or any and all other commonly Riverside, CA 92507 accepted benefits of employment.
With Mandatory Copy to: 18. Compliance Program and Code of Conduct.
AMR has made available to the First Responder a
Legal Department copy of its Code of Conduct, Anti- kickback American Medical Response, Inc. policies and other compliance policies, as may be 6363 South Fiddler' s Green Circle, Ste 1400 changed from time- to- time. at AMR' s web site, Greenwood Village, Colorado 80111 located at: www. amr. net, and the First Responder acknowledges receipt of such documents. AMR
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warrants that its personnel shall comply with Notwithstanding the foregoing, in no event shall AMR' s compliance policies, including training AMR or any other third party be entitled to any related to the Anti- kickback Statute. No funds information in, or report resulting from, such shall be used by the First Responder in a manner Background Investigations. that may violate 42 U.S.C. Section 1320a-7b, the
federal Anti- Kickback Statute. 21. Referrals. It is not the intent of either Party that any remuneration, benefit or privilege
19. Non- Exclusion. Each Party represents and provided for under this Agreement shall influence certifies that neither it nor any practitioner or or in any way be based on the referral or employee who orders or provides services on its recommended referral by either Party of Patients behalf hereunder, has been convicted of any to the other Party or its affiliated providers, if any, conduct that constitutes grounds for mandatory or the purchasing. leasing or ordering of any exclusion as identified in 42 U. S. C.§ 1320a- 7( a). services other than the specific services described Each Party further represents and certifies that it is in this Agreement. Any paymentsspecified herein not ineligible to participate in Federal health care are consistent with what the Parties reasonably programs or in any other state or federal believe to be a fair market value for the services government payment program. Each Party agrees provided. First Responder represents and warrants that if DHHS/ OIG excludes it. or any of its that the compensation it receives from AMR is less practitioners or employees who order or provide than or equal to the costs of the Services it services, from participation in Federal health care provides. programs, the Party must notify the other Party
within five( 5) days of knowledge of such fact, and 22. Equal Employment Opportunity. If the the other Party may immediately terminate this provisions of Executive Order 11. 246 are Agreement, unless the excluded practitioner or applicable to this Agreement, the Parties employee immediately discontinues ordering or incorporate the equal employment opportunity providing services hereunder. clause set forth in 41 C. F. R. part 60- 1. If the provisions of Executive Order 13, 496 are
20. Background Investigation. Each Party warrants applicable to this Agreement, the Parties and represents that it has performed a background incorporate the clause set forth in 29 C. F. R. part investigation on employees who provide Services 471, Appendix A to Subpart A. or drive vehicles as part of the Services
Background Investigation"). The Background 23. Benefits. This Agreement is entered into for the Investigation includes at least the following: benefit of the Parties to this Agreement only and shall confer no benefits, direct or implied, on any
Social Security Number Verification third personsor parties. The Servicesprovided by First Responder under this Agreement represent
Criminal Search ( 7 years or up to 5 criminal an extension and expansion of services the First searches) Responder owes to the public in general and by entering into this Agreement the First Responder
Employment Verification to include reason for does not intend to create a special relationship or separation and eligibility for re- employment for duty to the other Party or to the public served by each employer for 7 years either Party.
OIG List of Excluded Individuals/ Entities 24. Miscellaneous. This Agreement Sex Offender Registry including the whereas recital clauses above and Schedule " A" attached hereto, all of which are
GSA List of Parties Excluded from Federal expressly incorporated herein by reference): ( a) Programs constitutes the entire agreement between the
Parties with respect to the subject matter hereof,
Department of Motor Vehicle Driving History superseding all prior oral or written agreements with respectthereto; (b) may be amendedonly by
State and Local Licensure Verification written instrument executed by all Parties;( c) may not be assigned by any Party without the written
Drug Screen consent of the other Party, provided such consent not to be unreasonably withheld: ( d) shall be
First responder also warrants and represents that it binding on and inure to the benefit of the Parties shall perform a Background Investigation on hereto and their respective successors and future employees who will provide Services or permitted assigns; ( e) shall be interpreted and drive vehicles as part of the Services. Upon enforced in accordance with the laws of the State request and from time- to- time, First Responder of California. without regard to the conflict of laws shall provide AMR with a continuing certification provisions thereof; and the federal laws of the of such Background Investigations. United States applicable therein; ( f) may be CA\ DD\ 08000. 1 1503\ 10154974. 5
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executed in several counterparts ( including by executed by both Parties. In the event of a conflict facsimile or electronic transmission), each of between this Agreement and any Schedule which shall constitute an original and all of which, attached hereto, the terms of this Agreement shall when taken together, shall constitute one govern.
agreement; and ( g) shall not be effective until
SIGNATURES ON FOLLOWING PAGE]
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SIGNATURE PAGE FOR
2018
ALS FIRST RESPONDER AGREEMENT
AMR& CITY OF RIVERSIDE)
September 26, 2018
IN WITNESS WHEREOF, thePartieshaveheretoexecutedthis Agreementasof July 2. 2018.
AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE, INC.
By: s 03. 11.-—
Edward B. Van Home, CEO and President
By:
Timot , . Do O a CO
e2-14- -----
CITY OF RIVERSIDE
cociLea Deesing
By: AssistantCity Manager
litAttest: C
App • as to Form:
By: 0.10 ILA---
Neil D. Okazaki
Assistant City Attorney
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SCHEDULE" A"
1. Services:
First Respondershall provideadvancedlife support(asdefinedin theCounty911Agreement)first responseservicesto everyemergencycall dispatchedthrougha PublicSafetyAnsweringPointto a call locationwithin the ServiceArea definedbelow. FirstResponderpersonnelmayaccompanyAMR personnelduringtransportif thecareof thePatientand circumstanceswarrantbaseduponRiversideCountyprotocols.
IL Service Area:
Servicesshall be providedwithin the City of Riversideand its serviceareas (including thosein which it provides contracted services).
III. Commencement Date
8 The Commencement Date referred to in Section 3 of this Agreement shall be: November 1-, 2018.
IV. Response Times, Response Time Standards and Per Call Assessments For the Services,First Respondershall arrive on scenein nine( 9) minutes and fifty- nine( 59) secondsor lessat least ninety percent( 90%) of the time(" Response Time Standard"). First Responderis subject to the following per call assessments for late arrivals:
Zone Response Time Per Call Assessments for late arrival time Urban Zone 9 minutes 59 seconds Late. 01- 1.00 minute =$ 5. 00 Late 1.01- 2.00 minutes=$ 10. 00
Late 2. 01- 3.00 minutes=$ 20. 00
Late 3. 01- 4. 00 minutes=$ 50. 00
Late 4. 01- 5. 00 minutes=$ 70. 00
Late 5. 01- 6. 00 minutes=$ 180. 00
Late 6. 01- 7. 00 minutes=$ 220. 00
Late 7. 01- 8.00 minutes=$ 392. 00
Late 8.01- 9. 00 minutes=$ 448. 00
Late 9. 01- 10. 00 minutes=$ 504. 00
Late 10. 01- 15. 00 minutes=$ 800. 00
Late 15. 01- 20. 00 minutes=$ 1,000. 00
Late 20. 01- 30. 00 minutes=$ 1,200. 00
Late 30. 01- 60. 00 minutes=$ 2, 400. 00
Late more than 60. 00 minutes=$ 10,000. 00
For Clarification, AMR shall arrive on scenein eleven( 11) minutes and fifty- nine( 59) secondsor lessat least ninety percent( 90%) of the time(" Response Time Standard"), AMR is subject to the above per call assessmentsto the City of Riverside for late arrivals;
Responsetime for Services will be measuredfrom the time the dispatch is received by the First Responder with all informationnecessarytorespondtothecalluntilthetimetheFirstResponderarriveson-scene(orinthecaseof alocation otherthantheactualscene,thestagingareaornearestaccessiblepoint,e.g.,fence,apartmentcomplexparkinglot) orthe call is cancelled(" Response Time").
Inaccordancewith theCounty911Agreement,FirstResponderandAMRshallreportitsResponseTimesandResponse TimeStandardsfor Servicesquarterlyalongwith explanationsfor anydelayedresponsesin whichtheagencyrequests andexemption. ExemptionsoutlinedintheCounty911Agreement,suchasfor dispatcherrors,delaysin dispatchingfor calls and other non- First Responder errors, will be removed from First Responder Response Time Standards calculations, CA\ DD\ 08000. 11503\ 10t 54974.5
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as reasonably determined by AMR. Only those exemptionswhich are outlined in the County 911 Agreementare acceptable.
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