ADDENDUM TO AGREEMENT BETWEEN THE CITY OF RIVERSIDE AND AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE, INC.
This Addendum ("Addendum") is entered into by and between the City of Riverside ("City") and American Medical Response Ambulance Service, Inc. ("AMR"), and amends that certain Agreement for ALS First Responder and Ambulance Services dated July 16, 2024 ("Agreement").
In the event of any direct conflict or inconsistency between the terms of this Addendum and the terms of the Agreement (including Section 2 and Exhibit A), the terms of this Addendum shall control. Except as expressly modified herein, all terms and conditions of the Agreement remain in full force and effect.
1. Exemptions
The following circumstances may qualify for an exemption from response time penalties under Exhibit A of the Agreement, when the event was beyond AMR's reasonable control, directly caused the delayed response, and could not reasonably have been anticipated or avoided through appropriate deployment or routing.
1.1 Railroad Crossing Delay: A delay caused by an ambulance being stopped at an active railroad crossing. AMR must provide Automatic Vehicle Location / Computer- Aided Dispatch ("AVL/CAD") data identifying the unit's location, the railroad crossing, and the approximate duration of the delay.
1.2 Extraordinary Traffic Delay: A delay caused by an unusual and significant traffic condition resulting from an unforeseen collision, emergency incident, law- enforcement activity, or similar event. Normal or recurring traffic congestion, including customary peak-hour traffic, shall not qualify for an exemption.
1.3 Unanticipated Road Closure or Construction Delay: A delay caused by an unanticipated road closure, detour, or construction condition that materially prevented the responding unit from using its reasonably available route.
1.4 Severe Weather Conditions: A delay caused by an unusual or severe weather event that materially affected roadway safety, visibility, or the responding unit's ability to travel using a reasonably available route. AMR must provide CAD/AVL data and supporting documentation identifying the weather condition, its location, and its approximate impact on the response.
1.5 Additional Unit Requested by Riverside Fire Department ("RFD"): When RFD requests an additional ambulance after the initial ambulance response has been initiated, the response time for the additional unit shall begin when AMR receives the request for that specific additional unit. This provision does not apply when AMR substitutes or reassigns a unit because of an internal operational, staffing, mechanical, deployment, or availability issue.
1.6 The City may, in its discretion, consider written exemption requests based on unusual circumstances not specifically identified in this Agreement. Exemption requests shall be reviewed on the FirstWatch Online Compliance Utility ("OCU") on an ongoing basis but will occur at least monthly, AMR will submit a written explanation in the FirstWatch OCU for the City's review. The City's approval or denial of an exemption request shall be final and non-reviewable. In no event shall an Ambulance Patient Offload Delay (APOD) qualify as an unusual circumstance or serve as grounds for an exemption.
2. RFD may approve or deny an exemption request based on the documentation provided and the requirements of this Addendum. The burden of demonstrating eligibility for an exemption rests with AMR. Failure to provide timely or sufficient documentation shall be grounds for denial.
3. Submission Timeline: AMR shall submit all exemption requests, along with required supporting CAD/ AVL data and documentation, within fifteen (15) calendar days following the end of the month in which the incident occurred. Failure to submit within this timeframe shall constitute a waiver of the exemption request for that incident.
3.1 Response-Time Corrections
AMR shall maintain sufficient resources and appropriate operational procedures to meet all obligations under this Agreement, including the accurate recording and communication of required response-time intervals.
3.2 When a required timestamp is missing or demonstrably inaccurate, AMR may request a correction through the FirstWatch OCU. Each requested correction must be supported by objective and independently verifiable evidence, such as CAD/AVL records, or other documentation acceptable to RFD. When CAD or AVL data is unavailable, the patient care record shall be considered an acceptable form of supporting documentation. A correction shall not be based solely upon the recollection or written statement of personnel.
3.3 AMR shall submit all requested timestamp corrections and supporting documentation to the City within fifteen (15) calendar days following the end of the month in which the incident occurred. Approved corrections and exemptions shall be applied to the quarterly response-time reconciliation and penalty billing provided under Exhibit A of the Agreement. RFD may approve or deny each requested correction based on the evidence provided. The burden of establishing the accuracy of a corrected timestamp rests with AMR.
3.4 A timestamp correction shall be used only to establish the accurate response-time interval. It shall not constitute an exemption from a response-time penalty when the corrected response time exceeds the applicable standard.
3.5 For a time correction to be approved, AMR must provide objective evidence establishing the unit's actual arrival time. Approval of the corrected timestamp does not automatically exempt the incident from any fee or penalty assessment under Exhibit A.
4. Response Time Metric Calculation
For purposes of calculating response-time compliance, the City shall use the applicable clock-start and clock-stop timestamps recorded in CAD. Effective upon execution of this Addendum, the City shall discontinue application of the fifteen (15) second pager queue time allowance and the sixty (60) second full CAD outage pager queue times. No adjustment, deduction, or credit for pager queue time shall be applied to the recorded response-time interval.
4.1 Notwithstanding any current or future standard, policy, procedure, methodology, or directive adopted or modified by the County Emergency Medical Services ("EMS") Agency, the response-time standards and calculation established by the Agreement and Exhibit A shall remain controlling unless expressly amended by the Riverside City Council in its sole discretion. No change by the County EMS Agency shall automatically modify, supersede, or otherwise affect the response-time requirements or calculation established under this Agreement.
[SIGNATURES ON THE FOLLOWING PAGE]
IN WITNESS WHEREOF, the parties hereto have caused this First Amendment to the ALS FIRST RESPONDER AND AMBULANCE SERVICES AGREEMENT to be executed the day and year first above written.
CITY OF RIVERSIDE, a California charter AMERICAN MEDICAL RESPONSE, city and municipal corporation AMBULANCE SERVICE, INC., Sean Russell
By:_ - By: Sean Russell (Oct 6, 2026 08:27:58 PDT)
City Manager Name: Sean Russell
Title: Region President
APPROVED AS TO CONTENT: seremey shumaker
V: Jeremey Shumaker (Oct 5, 2026 14:54:32 PDT
Name: Jeremy Shumaker
. Steve Mckinster
By: Title: Region Director
Fire Chief
ATTEST:
By: -
City Clerk
CERTIFIED AS TO AVAILABILITY OF
FUNDS:
By:
Chief Financial Officer
APPROVED AS TO FORM:
Jack Liu
By: Jack liu (Oct 6. 2026 10:13:21 PDT
Assistant City Attorney
315464 JCL 9/15/26