Attachment A
Proposed Agreement for
Public-Based Ambulance
Services with CONFIRE
AGREEMENT
BY AND BETWEEN
CONSOLIDATED FIRE AGENCIES
AND
THE CITY OF VICTORVILLE
on behalf of its Fire Department
for
AMBULANCE SERVICES
This Agreement, dated for reference purposes only, is made and entered into by and between the Consolidated Fire Agencies, a Joint Powers Authority, duly authorized and existing under Government Code § 6500 et seq. (hereinafter referred to as "CONFIRE") and the City of Victorville, on behalf of its Fire Department (hereinafter referred to as "Agency" or "City").
CONFIRE and Agency or City may be referred to hereinafter individually as a "Party" or collectively as the "Parties."
RECITALS
WHEREAS, CONFIRE submitted a Proposal in response to RFP # ICEMA23-ICEMA-4811, Advanced Life Support and Basic Life Support Ground Ambulance Services, Interfacility and Critical Care Transport Services for Exclusive Operating Areas in San Bernardino ("Proposal"); and WHEREAS, CONFIRE was selected as the successful bidder for RFP # ICEMA23-ICEMA-4811 and entered into Contract Number 23-1282 with San Bernardino County ("County Contract"), a copy of which is attached hereto as Exhibit A and incorporated herein by this reference; and WHEREAS, Agency will provide certain Transport Services using Agency personnel and ambulance apparatus and equipment owned by Agency, Priority Ambulance, LLC ("Priority"), or a combination thereof, as specified in this Agreement; and WHEREAS, the Parties desire to enter into this Agreement to memorialize the terms and conditions under which Agency will provide Transport Services.
WHEREAS, it is the intent of the Parties that Agency provide the Transport Services described herein in accordance with this Agreement and the County Contract.
TERMS
NOW, THEREFORE, in consideration of the above recitals and the mutual covenants hereinafter contained and for good and valuable consideration, the receipt of which is hereby acknowledged, the Parties agree as follows:
Incorporation of Recitals. The recitals above are true and correct and are hereby incorporated into this Agreement by this reference.
2. SCOPE OF WORK:
A. Authorized Deployment: Agency is authorized to provide Transport Services in one or more of the following operational capacities, as identified in the Agency Deployment Schedule attached hereto as Exhibit B and the then-current CONFIRE deployment plan:
1. Surge Deployment: Ambulance resources placed into service on a temporary, episodic, or as-needed basis upon activation or authorization by CONFIRE to address peak demand, system imbalance, reduced unit availability, emergencies, special events, mutual aid, disaster operations, or other operational needs.
2. Reserve or Backup Deployment: Ambulance resources used to replace, supplement, or support an unavailable surge resource.
B. Baseline Deployment Commitment: Agency shall provide the baseline Transport Services identified in the Agency Deployment Schedule. The Agency Deployment Schedule shall identify, as applicable:
1. The number of authorized surge, reserve, or backup ambulance resources;
2. The scheduled hours or periods of availability for each resource;
3. Whether each resource will use Agency-owned or Priority-owned ambulance apparatus or equipment, VCV agrees to the following terms and conditions:; and i. Such Services shall be provided in accordance with the terms and conditions of Contract Number 12-1282.
4. Any other agency-specific deployment requirements agreed upon by the Parties.
C. Additional or Alternative Deployment: In addition to its baseline deployment commitment, Agency, upon written agreement of the Parties, may provide additional or alternative Transport Services when requested or activated by CONFIRE and when Agency personnel and resources are available. Such deployment may include additional surge coverage, system relief, mutual aid, emergency response, or temporary replacement of another ambulance resource.
D. CONFIRE Authorization: Agency shall not deploy or submit an invoice for any resource under this Agreement unless the resource is:
1. Included in the Agency Deployment Schedule or the then-current CONFIRE deployment plan; or
2. Expressly requested or authorized by CONFIRE through its designated representative or communications center.
E. Deployment Adjustments: The operational status, posting location, hours, apparatus assignment, or deployment role of an Agency resource may be adjusted from time to time through the CONFIRE deployment plan or by written operational direction from CONFIRE, provided the adjustment does not materially increase Agency's minimum baseline commitment, change the applicable compensation, or otherwise materially alter the Parties' contractual obligations.
1. Changes that materially increase Agency's minimum baseline commitment, modify compensation, or alter the allocation of responsibility between the Parties shall require a written amendment to this Agreement.
Performance Requirements: Agency shall provide all Transport Services in accordance with this Agreement, the County Contract, the then-current CONFIRE deployment plan, applicable ICEMA requirements, and all applicable laws, regulations, policies, protocols, and operational standards.
G. Agency Qualifications: Agency represents and warrants that it has and will maintain the personnel, infrastructure, training, licenses, certifications, resources, and operational capability necessary to provide the Transport Services assigned to it under this Agreement.
3. PAYMENT:
CONFIRE shall compensate Agency for the Services provided as set forth below:
Unit Hour Cost for Services provided using Agency-owned ambulance apparatus and equipment will be reimbursed at a rate of One Hundred Eighty-One Dollars and Seventy-Three Cents ($181.73). The Unit Hour Cost is reflective of the cost of providing the Services.
B. For each completed transport performed using Agency-owned ambulance apparatus and equipment, CONFIRE will reimburse Agency Forty Dollars and Forty- Three Cents ($40.43) for medical restock and supplies.
C. Payment shall be made to Agency on a quarterly basis based upon invoices prepared from CAD data, reflective of the in-service hours and completed transports for Agency.
CONFIRE shall evaluate the reimbursement rates annually on or before March 1 of each year in accordance with Administrative Committee Policy 3.016, attached hereto as Exhibit C. Any updated reimbursement rates shall be set upon approval of a resolution by the CONFIRE Administrative Committee in accordance with Exhibit B and shall take effect on the date specified in the resolution without further amendment to this AgreementTERM OF AGREEMENT:
A. Effective Date: This Agreement shall become effective on the date it is fully executed by representatives of both Parties ("Effective Date").
B. Term: This Agreement shall remain in full force and effect from the Effective Date for a term coterminous with the County Contract, unless terminated in accordance with this Agreement. If the County Contract is extended, the Parties may mutually agree in writing to extend this Agreement for the corresponding extension of Contract Number 23-1282.
C. Agency-Initiated Termination: Agency may request termination of this Agreement by written notice to CONFIRE. Upon receipt of written notice, the Parties shall then meet and confer in good faith to identify and attempt to resolve the issues giving rise to the request and, if the issues are not resolved, to address an orderly service transition. If the parties cannot resolve the issues giving rise to the request within thirty (30) days, the Parties shall mutually agree on the termination date; in no event shall the termination date be less than 180 days after Agency's initial notice. Nothing in this subsection limits CONFIRE's rights under Section 20.
MODIFICATIONS TO AGREEMENT: A review of the Agreement terms may be initiated at any time by either Party upon written notice to the other. The Parties agree to negotiate in good faith and deal fairly with respect to performance under this Agreement and any proposed modifications. Except for reimbursement rate updates approved under Section 3(E), this Agreement may be modified only in writing and with the approval of both Agency and CONFIRE through each entity's governing body.
6. EMPLOYEE STATUS/WORKERS' COMPENSATION: It is expressly understood that in the performance of the Services herein provided for, Agency shall be, and is, an independent contractor and is not an agent or employee of CONFIRE. Agency has and shall retain the right to exercise full control and supervision of the Services and full control over the employment, direction, assignment, compensation, and discharge of all persons employed by Agency and assisting in the performance of Services hereunder. Agency shall be solely responsible for all matters relating to the payment of its employees, including compliance with social security, workers' compensation, withholding, and all regulations governing such matters.
7. INDEMNIFICATION:
Agency agrees to indemnify, defend (with counsel reasonably approved by CONFIRE) and hold harmless CONFIRE and its authorized officers, employees, agents and volunteers from any and all claims, actions, losses, damages, and/or liability arising out of the performance of this Agreement by Agency, and/or its officers, employees, agents, contractors or volunteers, including the acts, errors, or omissions of Agency and for any costs or expenses incurred by CONFIRE on account of any claim except where such indemnification is prohibited by law. Agency's indemnification obligation shall not apply to CONFIRE's negligence or "willful" misconduct within the meaning of Civil Code Section 2782.
INSURANCE REQUIREMENTS FOR PROFESSIONAL SERVICES
Except as otherwise provided in accordance with the self-insurance provisions described in subparagraph J hereunder, Agency shall procure and maintain for the duration of the Agreement he following levels of insurance against claims for injuries to persons or damages to propert hich may arise from or in connection with the performance of the work hereunder by thi Agency, its agents, representatives, or employees.
A. Minimum Scope and Limit of Insurance
Coverage shall be at least as broad as:
1.- Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $3,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit.
2. Automobile Liability: Insurance Services Office Form Number CA 0001 covering Code 1 (any auto), or if Agency has no owned autos, Code 8 (hired) and 9 (non- owned), with limit no less than $3,000,000 per accident for bodily injury and property damage.
3. Workers' Compensation insurance as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease.
Professional Liability (Errors and Omissions) Insurance appropriate to the Agency's profession, with limit no less than $3,000,000 per occurrence or claim, $3,000,000 aggregate. The Retroactive Date must be shown and must be before the date of the contract or the beginning of contract work. Insurance must be maintained, and evidence of insurance must be provided for at least five (5) years after completion of the contract of work. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a Retroactive Date prior to the contract effective date, the Agency must purchase "extended reporting" coverage for a minimum of five (5) years after completion of contract work. A copy of the claims reporting requirements must be submitted to CONFIRE for review.
B. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following provisions:
CONFIRE, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CL policy with respect to liability arising out of work or operations performed by or on behalf of the Agency including materials, parts, or equipment furnished in connection with such work or operations.
General liability coverage can be provided in the form of an endorsement to the Agency's insurance at least as broad as one of the following ISO ongoing operations Forms: CG 20 10 or CG 20 26 or CG 20 33 (not allowed from subcontractors), or CG 20 38; and one of the following ISO completed operations Forms: CG 20 37, CG 20 39 (not allowed from subcontractors), or CG 20 40.
C. Primary Coverage
For any claims related to this contract, the Agency's insurance coverage shall be primary insurance coverage at least as broad as ISO CG 20 01 04 13 as respects CONFIRE, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by CONFIRE, its officers, officials, employees, or volunteers shall be excess of the Agency's insurance and shall not contribute with it.
D. Notice of Cancellation
Agency shall provide immediate written notice if (1) any of the required insurance policies is terminated; (2) the limits of any of the required policies are reduced; or (3) the deductible or self-insured retention is increased. In the event of any cancellation or reduction in coverage or limits of any insurance, Agency shall forthwith obtain and submit proof of substitute insurance.
E. Waiver of Subrogation
Agency hereby grants to CONFIRE a waiver of any right to subrogation which any insurer of said Agency may acquire against CONFIRE by virtue of the payment of any loss under such insurance. Agency agrees to obtain any endorsement that may be necessary to effect this waiver of subrogation, but this provision applies regardless of whether or not CONFIRE has received a waiver of subrogation endorsement from the insurer. However, the Workers' Compensation policy shall be endorsed with a waiver of subrogation in favor of CONFIRE for all work performed by the Agency, its employees, agents and subcontractors.
Acceptability of Insurers
Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than A: VII, unless otherwise acceptable to CONFIRE.
G. Verification of Coverage
Agency shall furnish CONFIRE with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to CONFIRE before work begins.
However, failure to obtain the required documents prior to the work beginning shall not waive the Agency's obligation to provide them. CONFIRE reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time.
H. Subcontractors
Agency shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Agency shall ensure that CONFIRE is an additional insured on insurance required from subcontractors.
1. Special Risks or Circumstances
CONFIRE reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances.
Self-Insured Retentions
In lieu of the forgoing insurance requirements CONFIRE may approve the use of the City's self-insurance described herein below.
City is an authorized self-insured or partially self-insured public entity for purposes of Professional Liability, General Liability, Automobile Liability, and Workers' Compensation and warrants that through its programs of self-insurance and insurance, it has adequate coverage or resources to protect against liabilities arising out of performance of the terms, conditions, or obligations of this Agreement.
9. AGENCY RECORDS:
Agency shall maintain all records and books pertaining to the delivery of Services under this Contract and demonstrate accountability for Agreement performance as set forth in Contract Number 23-1282.
All records shall be complete and current and comply with all Agreement requirements.
Such records include but are not limited to patient care reports. Failure to maintain acceptable records shall be considered grounds for withholding of payments for invoices submitted and/or termination of the Agreement.
All records relating to Agency's personnel, consultants, subcontractors, Services/Scope of Work, and expenses pertaining to this Agreement shall be kept in a generally acceptable accounting format. Records should include primary source documents. Fiscal records shall be kept in accordance with Generally Accepted Accounting Principles and must account for all funds, tangible assets, revenue, and expenditures. Fiscal records must comply with the appropriate Office of Management and Budget (OMB) Circulars, which state the administrative requirements, cost principles, and other standards for accountancy.
CONFIRE, State and Federal government shall have absolute right to review and audit all records, books, papers, documents, corporate minutes, and other pertinent items as requested, and shall have absolute right to monitor the performance of Agency in the delivery of Services provided under this Contract. Agency shall cooperate fully in any auditing or monitoring conducted. Agency shall cooperate with CONFIRE in implementing, monitoring, and evaluating this Contract and comply with any and all reporting requirements established by CONFIRE. Agency shall not disclose any protected health information or any other record or information protected by state and/or federal law to CONFIRE, State, and Federal government under this section of the Agreement.
All records pertaining to Services delivered and all fiscal, statistical, and management books and records shall be available for examination and audit by CONFIRE representatives for a period of three years after final payment under this Contract or until all pending CONFIRE, State, and Federal audits are completed, whichever is later.
10. WAIVER: No waiver of a breach of any provision of this Agreement will constitute a waiver of any other breach or of such provision. Failure of either Party to enforce at any time, or from time to time, any provision of this Agreement will not be construed as a waiver thereof.
The remedies herein reserved will be cumulative and additional to any other remedies in law or equity.
11. PARTIAL INVALIDITY: Should any part, term, portion, or provision of this Agreement be finally decided to be in conflict with any law of the United States or the State of California or otherwise be unenforceable or ineffectual, the validity of the remaining parts, terms, portions, or provisions will be deemed severable and will not be affected thereby, provided such remaining portions or provisions can be construed in substance to constitute the agreement which the parties intended to enter into in the first instance.
12. NOTICES: All notices required or permitted to be given pursuant to this Agreement may be personally served on the other party by the party giving such notice or may be served by certified mail, return receipt requested, to the following addresses:
City of Victorville Consolidated Fire Agencies
Fire Department Joint Powers Authority
Attn: Bobby Clemmer Attn: Nathan Cooke
14343 Civic Dr 1743 Miro Way
Victorville, CA 92392 Rialto, CA 92376
13. APPLICABLE LAW: At all times during the term of this Agreement, CONFIRE and Agency shall comply with all applicable laws, ordinances, rules, and regulations of the United States of America, the State of California, including all agencies and subdivisions thereof, and the Inland Counties Emergency Medical Agency.
14. VENUE: The venue of any action or claim brought by any party to the Agreement will be the Superior Court of San Bernardino County. Each party hereby waives any law or rule of the court that would allow them to request or demand a change of venue. If any action or claim concerning the Agreement is brought by any third party and filed in another venue, the parties hereto agree to use their best efforts to obtain a change of venue to San Bernardino County.
15. ATTORNEYS' FEES AND COSTS: If any legal action is instituted to enforce any party's rights hereunder, each party shall bear its own costs and attorney fees, regardless of who the prevailing party is. This paragraph shall not apply to those costs and attorney fees directly arising from a third-party legal action against a party hereto and payable under Indemnification and Insurance Requirements.
16. CONTRACT ASSIGNABILITY: Without the prior written consent of CONFIRE, Agency may not assign or subcontract its obligations under this Agreement either in whole or in part.
17. CONFIDENTIALITY:
Pursuant to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and the Health Information Technology for Economic and Clinical Health ("HITECH") Act, regulations have been promulgated governing the privacy of individually identifiable health information.
Agency acknowledges that it is a covered entity and subject to the requirements of HIPAA and HITECH, and their implementing regulations. Agency agrees to comply fully with the terms of HIPAA and HITECH and the regulations promulgated thereunder and to ensure any subcontractors utilized to fulfill Services pursuant to this Contract comply with said provisions.
Agency further agrees to comply with the requirements of all other applicable federal and state laws/regulations that pertain to the protection of health information.
18. RELEASE OF INFORMATION: No news releases, advertisements, public announcements, or photographs arising out of the Agreement or Agency's relationship with CONFIRE may be made or used without prior written approval of CONFIRE.
19. TIME OF THE ESSENCE: Time is of the essence in the performance of this Agreement and of each of its provisions.
20. CORRECTION OF PERFORMANCE DEFICIENCIES:
A. Failure by Agency to comply with any of the provisions, covenants, requirements, or conditions of this Contract shall be a material breach of this Agreement.
In the event of a non-cured breach, CONFIRE may, at its sole discretion and in addition to any other remedies available at law, in equity, or otherwise specified in this Agreement:
A. Afford Agency a time period thereafter within which to cure the breach, which period shall be established at the sole discretion of CONFIRE; and/or B. Terminate this Agreement immediately and be relieved of the payment of any consideration to Agency. In the event of such termination, CONFIRE may proceed with the work in any manner deemed proper by CONFIRE.
The cost to CONFIRE shall be deducted from any sum due to Agency under this Agreement, and the balance, if any, shall be paid by Agency upon demand.
21. LEGALITY AND SEVERABILITY: The parties' actions under the Contract shall comply with all applicable laws, rules, regulations, court orders, and governmental agency orders. The provisions of this Contract are specifically made severable. If a provision of the Contract is terminated or held to be invalid, illegal, or unenforceable, the validity, legality, and enforceability of the remaining provisions shall remain in full effect.
22. EMPLOYMENT DISCRIMINATION: During the term of the Contract, Agency shall not discriminate against any employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, sexual orientation, age, or military and veteran status. Agency shall comply with Executive Orders 11246, 11375, 11625, 12138, 12432, 12250, 13672, Title VI and Title VII of the Civil Rights Act of 1964, the California Fair Employment and Housing Act, and other applicable Federal, State, and County laws and regulations and policies relating to equal employment and contracting opportunities, including laws and regulations hereafter enacted.
23. DEBARMENT AND SUSPENSION: Agency certifies that neither it nor its principals or employees are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. (See the following United States General Services Administration's System for Award Management website: https://www.sam.gov). Agency further certifies that if it or any of its subcontractors are business entities that must be registered with the California Secretary of State, they are registered and in good standing with the Secretary of State.
24. ENTIRE AGREEMENT: This Agreement, including all Exhibits and other attachments, which are attached hereto and incorporated by reference, and other documents incorporated herein, represents the final, complete, and exclusive agreement between the parties hereto. Any prior agreement, promises, negotiations, or representations relating to the subject matter of this Agreement not expressly set forth herein are of no force or effect.
This Agreement is executed without reliance upon any promise, warranty, or representation by any party or any representative of any party other than those expressly contained herein.
Each party has carefully read this Agreement and signs the same of its own free will. This Agreement may be executed in any number of counterparts, each of which so executed shall be deemed to be an original, and such counterparts shall together constitute one and the same Agreement. The parties shall be entitled to sign and transmit an electronic signature of this Agreement (whether by facsimile, PDF or other email transmission), which signature shall be binding on the party whose name is contained therein. Each Party providing an electronic signature agrees to promptly execute and deliver to the other party an original signed Agreement upon request.
25. MISCELLANEOUS: Agency shall ensure all personnel providing Services under this Agreementhave all required licenses and certifications required by the State of California and the Inland Counties Emergency Medical Agency, and as specifically set forth in Contract Number 23-1282.
26. DISPUTES: In the event of a dispute, the parties shall use their best efforts to settle the dispute through negotiation with each other in good faith.
IN WITNESS WHEREOF, Agency and CONFIRE have caused this Agreement to be executed by their authorized representatives. The Parties have executed this Agreement on the dates indicated below.
CONSOLIDATED FIRE AGENCIES - CITY OF VICTORVILLE
CONFIRE
Date: _ 20_
Date: 30/09/2026 ,20_ By: _
By: vistian Conce
Print Name: Keith Metzler
Print Name: Nathan Cooke Its: City Manager
Its: Executive Director
APPROVED AS TO FORM:
By:
Andre de Bortnowsky, City Attorney
CITY OF VICTORVILLE RISK MANAGEMENT:
By:
Sandra Bostick, Risk Manager
P: /APPSIWPDATAIVCA10005 - FIRE DEPTICONFIRE AMBULANCE1100.3-CONFIRE_PUBLIC_BASED_AMBULANCE_AGREEMENT_VCV_2026.08.10 REDLINE TLT 08.20.26.DOCX Exhibit A
to
Agreement for Transport Services
EXHIBIT B
AGREEMENT FOR TRANSPORT SERVICES
AGENCY DEPLOYMENT SCHEDULE
This Exhibit B identifies the Agency baseline authorized deployment of ambulance resources under the Agreement. The baseline deployment does not limit CONFIRE's authority to activate additional resources or make operational deployment adjustments as provided below and in the Agreement.
Deployment Authorized Baseline Availability Ambulance Apparatus Category Resources and Equipment
Front-Line None Not Applicable Not Applicable
Deployment
AGENCY-owned o
One (1) fully Upon request or activation by CONFIRE Priority-owned ambulana Surge or Additional equipped emergency Land subject to the availability of AGENCY apparatus and equipment, Deployment as expressly authorized by
ground ambulance. personnel and resources
CONFIRE
One (1) fully AGENCY-owned or
Priority-owned ambulance
Reserve or Backup equipped reserve apparatus and equipment, Deployment emergency ground resource previously activated by as expressly authorized by ambulance CONFIRE, and subject to the availability CONFIRE of Agency personnel and resources
1. Authorized Deployment. AGENCY may deploy and receive compensation for a resource only when the resource is identified in this Exhibit, included in the then-current CONFIRE deployment plan, or expressly requested or authorized by CONFIRE through its designated representative or
2. Deployment Adjustments. CONFIRE may adjust the posting location, schedule, hours, apparatus assignment, or operational role of an AGENCY resource through the then-current CONFIRE deployment plan or written operational direction. An adjustment that materially increases AGENCY's minimum baseline commitment, changes the applicable compensation, or materially alters the allocation of responsibility between the Parties requires a written amendment to the Agreement.
3. Additional Resources. Upon request or activation by CONFIRE and subject to the availability of personnel and resources, AGENCY may provide additional emergency ground ambulances for surge coverage, system relief, emergency response, mutual aid, disaster operations, special events, or other authorized operational needs.
4. Performance Requirements. AGENCY shall provide all Transport Services in accordance with the Agreement, Contract Number 23-1282, the then-current CONFIRE deployment plan, applicable ICEMA requirements, and all applicable laws, regulations, policies, protocols, and operational standards.
EXHIBIT C
to
AGREEMENT FOR TRANSPORT SERVICES
CONFIRE ADMINISTRATIVE COMMITTEE POLICY 3.016
REIMBURSEMENT RATE ADJUSTMENT POLICY
The current Administrative Committee Policy 3.016 is attached hereto and incorporated into the Agreement solely for purposes of determining reimbursement-rate adjustments pursuant to Section
3.E. AGENCY DEPLOYMENT SCHEDULE
NOTE: DRAFT Approved at
Administrative Committee Meeting
August 25, 2026
3.016 Public-Based Ambulance Unit
Hour Cost and Medical Supply Restock
Reimbursement Rates
Document
Number 3.016 Issue Date To Be Determined
Public-Based Ambulance Unit
Title Hour Cost and Medical Supply Review Date To Be Determined Restock Reimbursement Rates
Section Series 3000: Administration Revision Date To Be Determined Policy Owner Executive Administration Approved By Administrative Committee CONFIRE and Participating Agencies providing or staffing Public-Based Ambulances Applicability under agreement with CONFIRE
Required
Reviews Legal; Finance; EMS and Transport; affected Public-Based Ambulance agencies.
Joint Powers Agreement; San Bernardino County Contract No. 23-1282, as amended; Related applicable Public-Based Ambulance Agreements; Administrative Committee Policies Authority 1.001, 1.002, 1.004, 5.002, 5.003, and 6.002; then-current California Fire Assistance / Standards Agreement and Cal OES salary survey instructions.
Supersedes New Policy
1. Purpose
This policy establishes a transparent, repeatable, and cost-based process for calculating na approving reimbursement rates for public agencies that provide or staff ambulance n support of San Bernardino County Contract No. 23-1282, as amended (Count Contract). It memorializes the basis for each rate, supports consistent annual review, prevents duplicate reimbursement, and permits each annual calculation to be reconstructed from retained source records.
2. Authority and Order of Control
The Administrative Committee adopts this policy under the authority delegated by the Joint Powers Agreement, applicable Board policies, and the Administrative Committee Policies.
Rates approved under this policy shall be consistent with the County Contract, applicable Public-Based Ambulance Agreements, the adopted CONFIRE budget, and applicable law.
If this policy conflicts with the County Contract, Board action, the Joint Powers Agreement, or applicable law (Controlling Authority), the Controlling Authority governs An Administrative Committee rate resolution adopted under this policy establishes only the reimbursement rates authorized by the applicable Public-Based Ambulance Agreement and does not independently amend any other agreement term or authorize an expenditure beyond available appropriations or delegated authority.
When a Public-Based Ambulance Agreement expressly incorporates the annual Administrative Committee rate resolution, the resolution updates the reimbursement schedule on its effective date without a separate agreement amendment. If an agreement does not contain that incorporation, the rate shall not change until the parties complete an amendment or other approval required by that agreement.
3. Applicability
This policy applies to CONFIRE and each Participating Agency that provides or staffs a Public-Based Ambulance for service within the exclusive operating areas covered by the County Contract. It governs the standardized reimbursement rates paid under the applicable Public-Based Ambulance Agreements. The approved standardized rate is not a representation or guarantee that it will equal the actual cost incurred by every Participating Agency.
4. Definitions
Agency-Owned Ambulance. A Public-Based Ambulance owned or leased by a Participating Agency and equipped, maintained, and restocked at the Participating Agency's or CONFIRE's cost.
Authorized Adjustment Rate. A contractually authorized or Administrative Committee-approved percentage adjustment applied for a Rate Year. The annual resolution shall identify the source of the adjustment, the percentage used, and the rate components to which it applies.
Baseline Agency. A Participating Agency included in the annual cost-profile analysis because it provides a front-line Agency-Owned Public-Based Ambulance service and has sufficient verified data for the applicable Rate Year. A Baseline Agency need not be Benchmark-Eligible.
Benchmark-Eligible Agency. A Baseline Agency for which sufficient verified rate data are available to calculate the Standard Benchmark Personnel Profile for the applicable Rate Year.
CFAA Blended Base Hourly Rate. The blended straight-time hourly classification rate reflected in, or used to prepare, the agency's then-current California Fire Assistance Agreement salary survey or equivalent verified payroll calculation, excluding any burden component separately added under this policy.
Completed Transport. A patient transport completed by a Public-Based Ambulance and recognized as a transport under the County Contract and the applicable Public-Based Ambulance Agreement.
County Contract. San Bernardino County Contract No. 23-1282, as amended, and any successor contract governing the same ambulance service program.
Participating Agency. A public agency that is a party to a Public-Based Ambulance Agreement with CONFIRE and is authorized to provide or staff one or more Public- Based Ambulances in support of the County Contract, including front-line, surge, additional, reserve, or backup resources, whether or not the agency is included as a Baseline Agency or Benchmark-Eligible Agency for a particular Rate Year.
Priority-Owned Ambulance. An ambulance owned, equipped, maintained, and restocked by Priority Ambulance, or its successor under the County Contract, that is staffed by a Participating Agency for front-line, surge, or other approved service.
Public-Based Ambulance. An ambulance resource staffed by personnel of a Participating Agency under a Public-Based Ambulance Agreement with CONFIRE to perform services required by the County Contract, whether the ambulance is Agency-Owned or Priority-Owned.
Public-Based Ambulance Agreement. An agreement between CONFIRE and a Participating Agency governing the provision or staffing of Public-Based Ambulance resources in support of the County Contract, regardless of the agreement title used by the parties.
Rate Year. The period for which reimbursement rates are approved by Administrative Committee resolution.
Standard Benchmark Personnel Profile. A standardized two-person personnel cost profile consisting of one Firefighter/Paramedic and one Firefighter/EMT. The profile is used solely for benchmark rate calculation and does not establish or represent the actual staffing or deployment model of a Participating Agency.
Unit Hour. One hour during which an approved ambulance resource is in service and available for assignment, as determined under the applicable Public-Based Ambulance Agreement and CONFIRE CAD records.
Unit Hour Cost or UHC. The standardized hourly reimbursement rate calculated under this policy.
5. Governing Rate Principles
1. Rates shall be based on reasonable, allocable, documented costs and shall not include additional revenue beyond the approved cost-based reimbursement methodology.
2. A cost may be recovered only once. Costs included in the UHC may not also be included in the medical supply restock add-on or another reimbursement category.
3. The same lookback period and calculation rules shall be used for all Baseline Agencies to the extent practicable.
4. Personnel calculations shall use blended classification data and shall not disclose or depend on the salary of a specifically named employee.
5. Final rates shall be rounded to the nearest cent. Intermediate calculations shall retain at least four decimal places.
6. Approved rates apply prospectively from the effective date stated in the resolution and remain in effect until superseded by subsequent Administrative Committee action. There is no automatic retroactive true-up unless expressly authorized by the applicable agreement and approved by the Administrative Committee.
6. Roles and Responsibilities
Executive Director
The Executive Director or designee administers this policy, issues annual data requests, resolves routine data questions, and presents the recommended rates and supporting analysis.
Finance and EMS Staff
CONFIRE Finance and EMS staff shall validate source records, prepare the calculation workbook, identify assumptions or exclusions, calculate the rates, and prepare the staff report and proposed Administrative Committee resolution.
Participating Agencies
Each Participating Agency shall timely provide requested rate and cost information certified by an authorized finance, human resources, or executive representative.
Supporting records shall be sufficient to verify each material input.
EMS Division Subsidiary Committee
Staff should present the annual calculation to the EMS Division Subsidiary Committee for review and recommendation when meeting schedules permit. The absence of an EMS Division Subsidiary Committee recommendation does not delay or limit the Administrative Committee's authority to act.
Administrative Committee
The Administrative Committee shall approve the reimbursement rates by resolution at a publicly noticed meeting. A majority vote is required unless a Controlling Authority requires a different vote.
7. Annual Rate-Setting and Approval Process
The annual review shall begin no later than December 1, or at least 90 days before the intended effective date if the Administrative Committee establishes a different schedule.
Staff shall schedule the proposed annual rate resolution for the last regular Administrative Committee meeting before March 1 unless a different date is established by the Administrative Committee or required by a Controlling Authority. The resolution shall identify its effective date.
The annual review shall include, but not be limited to:
1. Issue a written data request identifying the Rate Year, lookback period, required source documents, and submission deadline.
2. Validate the completeness, consistency, and non-duplication of personnel, capital, maintenance and operations, transport, and restock inputs.
3. Calculate a cost profile for each Baseline Agency and calculate the systemwide capital and maintenance and operations components.
4. Calculate the Agency-Owned Ambulance UHC, Priority-Owned Ambulance UHC, and medical supply restock add-on in accordance with Section 8.
5. Prepare a staff report stating the methodology, data periods, material assumptions, Benchmark-Eligible Agencies, excluded profiles or data, fiscal impact, and any proposed deviation from the default methodology.
6. Present the proposed rates in a formally adopted Administrative Committee resolution. Upon approval and completion of any additional action required by a Controlling Authority, provide the resolution to each affected Participating Agency and implement the rates on the stated effective date.
8. Rate Calculation Methodology
For benchmark selection, staff shall calculate the personnel component for each Benchmark-Eligible Agency using the fully burdened hourly cost of one Firefighter/Paramedic and one Firefighter/EMT. The benchmark personnel calculation is standardized for rate-comparison purposes and does not depend on the agency's actual ambulance staffing configuration.
For each benchmark position, the fully burdened hourly cost shall be calculated from the CFAA Blended Base Hourly Rate and the agency-specific burden rates in effect for the Rate Year. If a submitted CFAA rate already includes a burden component, that component shall be excluded from the separate add-on to prevent duplicate recovery.
Benchmark Personnel Profile
For each Baseline Agency, staff shall calculate the Standard Benchmark Personnel Profile using the agency's verified rates for one Firefighter/Paramedic and one Firefighter/EMT, regardless of the agency's actual ambulance staffing or deployment model. A Baseline Agency is Benchmark-Eligible when sufficient verified rate data are available for both classifications. If an agency does not maintain one of the required classifications, or sufficient verified rate data are unavailable, the agency shall not be included in benchmark selection.
Agency Personnel Cost
For each Benchmark-Eligible Agency, the Agency Personnel Cost shall equal the sum of the fully burdened hourly cost of one Firefighter/Paramedic and one Firefighter/EMT.
Each position shall be calculated using the CFAA Blended Base Hourly Rate and the agency-specific burden rates in effect for the Rate Year. If a submitted CFAA rate already includes a burden component, that component shall be excluded from the separate add-on to prevent duplicate recovery.
Fully Burdened Hourly Cost: CFAA Base Rate x (1 + WC/UI/Medicare Rate + Retirement Employer Rate + Fringe Rate)
WC/UI/Medicare means the combined workers' compensation, unemployment insurance, and Medicare burden used in the approved annual workbook.
Agency Personnel Cost: Sum of the fully burdened hourly costs for all required crew positions
Ambulance and Equipment Capital Cost
The capital component annualizes the current replacement cost of an Agency-Owned Ambulance and the standard durable equipment required to place it in service. The calculation uses straight-line cost allocation as a reimbursement methodology and is not financial-statement depreciation. No salvage value is assumed unless the Administrative Committee approves a different treatment by resolution.
A default 33 percent reserve allocation is applied to recognize approximately one shared reserve unit for every three front-line units. The annual workbook shall update current replacement costs using recent actual acquisitions, cooperative purchasing schedules, or documented vendor quotations. Asset categories, quantities, useful lives, and the reserve
allocation are listed in Appendix A. Any change shall be disclosed in the annual staff report and resolution.
Hourly Capital Cost: Sum of [(Replacement Cost × Quantity x (1 + Reserve Allocation))
/ Useful Life in Years] / 8,760
Expendable medical supply inventory and supply-exchange costs are excluded because Maintenance and Operations Cost
The maintenance and operations component shall use actual costs for the most recent complete 12-month period available. The calculation shall use the actual costs of all Agency-Owned Ambulances serving the County Contract exclusive operating areas.
Eligible costs may include fuel, oil and fluids, scheduled maintenance, repairs, tires, parts, towing, required inspections, registration, directly allocable fleet-service charges, and other ordinary fleet operating costs. The calculation shall be net of rebates, credits, insurance recoveries, warranty recoveries, and amounts paid by another party. It shall exclude capital replacement costs, medical supplies, personnel costs included in the personnel component, administrative overhead not directly allocable to fleet operations, fines, penalties, and duplicative subtotals. A cost category may not be counted both as a total and as one of its component parts.
Ambulance Unit-Years shall equal the sum of the months each included ambulance was available to support the County Contract during the lookback period, divided by 12. This permits partial-year units to be included without treating them as full-year units.
Hourly M&O Cost: Eligible Actual Annual M&O Cost / Ambulance Unit-Years / Authorized Contract or Inflation Adjustment
An Authorized Adjustment Rate may be applied only when authorized by the Administrative Committee or a Controlling Authority. The annual staff report and resolution shall separately identify the source of the adjustment, the percentage used, the data period to which it relates, the components to which it applies, and the basis for concluding that the adjustment does not duplicate cost escalation already reflected in current-cost inputs. The adjustment may not be embedded within another component.
Adjusted Agency UHC Profile
Unless the annual resolution expressly approves a different component-specific treatment, the Authorized Adjustment Rate shall be applied to the Baseline Agency subtotal after personnel, capital, and maintenance and operations costs are calculated.
Adjusted Agency UHC Profile: (Agency Personnel Cost + Hourly Capital Cost + Hourly M&O Cost) x (1 + Authorized Adjustment Rate) Benchmark Eligibility and Selection
Only Baseline Agencies for which the Standard Benchmark Personnel Profile can be calculated using sufficient verified Firefighter/Paramedic and Firefighter/EMT rate data shall be included in benchmark selection. Staff shall rank the Benchmark-Eligible Adjusted Agency UHC Profiles from lowest to highest. The default benchmark is the highest Benchmark-Eligible profile.
The Administrative Committee may select a different benchmark only by resolution stating the material facts and reasons for the deviation.
Agency-Owned Ambulance UHC
Agency-Owned Ambulance UHC: Highest Adjusted Agency UHC Profile among the Benchmark-Eligible Agencies, unless the Administrative Committee approves a documented deviation by resolution.
Priority-Owned Ambulance UHC
When a Participating Agency staffs a Priority-Owned Ambulance, the Participating Agency does not bear the ambulance capital, fleet maintenance and operations, or medical restock cost. The Priority-Owned Ambulance UHC therefore removes the systemwide capital and maintenance and operations components from the approved Agency-Owned Ambulance UHC. The rate remains subject to the Authorized Adjustment Rate embedded in the approved Agency-Owned Ambulance UHC unless the annual resolution expressly approves a different treatment.
Priority-Owned Ambulance UHC: Agency-Owned Ambulance UHC - Hourly Capital Cost - Hourly M&O Cost
Medical Supply Restock Add-On
The medical supply restock add-on reimburses the cost of consumable medical supplies and medications replenished for Agency-Owned Public-Based Ambulances. It is paid per Completed Transport because the Public-Based Ambulance Agreements use a transport-based payment mechanism. The numerator shall include eligible supplies used and restocked following all Public-Based Ambulance responses, including responses that do not result in transport, because the restock obligation is triggered by use rather than by transport.
Eligible restock cost shall be based on actual acquisition cost, net of returns, rebates, credits, manufacturer replacements, hospital replacements, and amounts paid by another party. It shall exclude durable equipment, capital items, training stock, administrative overhead, and any cost included in the UHC or another reimbursement category.
Medical Supply Restock Add-On: Eligible Actual Restock Cost for all Public- Based Ambulance responses / Completed Transports by those ambulances during the same period
The add-on is payable only for a Completed Transport by an Agency-Owned Ambulance when the public-based program bears the applicable restock cost. It is not payable when a
Participating Agency uses a Priority-Owned Ambulance because Priority owns and restocks that ambulance. It is also not payable when the same supply cost is otherwise reimbursed.
Beginning with the first annual review supported by a complete County Contract operating period, the rate shall use the actual costs and Completed Transports of all Public-Based Ambulances serving the County Contract exclusive operating areas.
9. Data Sufficiency, Exclusions, Deviations, and Corrections Substitution for Incomplete Data
If a Participating Agency does not provide complete data, staff may use the agency's most recent verified data, adjusted for known changes, and shall disclose the substitution in the staff report.
Minimum Data Sufficiency
If fewer than three Benchmark-Eligible Agency profiles are available, staff shall recommend a rate based on the best available verified data, and the Administrative Committee resolution shall state the basis and findings supporting the selected benchmark.
Exclusions
Staff may exclude unsupported, duplicative, non-allocable, extraordinary, or non- recurring amounts. Each material exclusion shall be identified in the staff report.
Off-Cycle Rate Action
The Administrative Committee may. approve an off-cycle rate resolution when a material contract amendment, staffing change, cost shift, calculation error, or other documented circumstance makes the existing rate unreasonable or inconsistent with this policy.
Corrections
A correction based on a calculation error shall be prospective unless the applicable Public-Based Ambulance Agreement and law authorize a retroactive correction and the resolution expressly approves it.
10. Required Contents of the Annual Resolution
The annual resolution, together with the supporting staff report when incorporated by reference, shall identify the following:
1. The Rate Year and effective date.
2. The Agency-Owned Ambulance UHC.
3. The Priority-Owned Ambulance UHC.
4. The medical supply restock add-on.
5. The lookback periods and Baseline Agencies used.
6. Each Baseline Agency profile considered, its Benchmark-Eligible status, and the reason for any benchmark exclusion.
7. The personnel, capital, maintenance and operations, and Authorized Adjustment Rate components, including the source and application of the Authorized Adjustment Rate.
8. The benchmark-selection result and any deviation from the default methodology.
9. Any substituted or prior-year data and any material exclusion from the annual calculation.
10. Any change to the Appendix A standard capital asset schedule, useful lives, or reserve allocation.
11. The estimated fiscal impact and confirmation that implementation is within delegated authority and available appropriations, or identification of additional action required by a Controlling Authority.
12. The version date or other identifier of the approved annual calculation workbook and a statement that the resolution supersedes the prior annual rate resolution on its effective date.
11. Records, Audit, and Confidentiality
CONFIRE shall retain the annual calculation workbook, source documents, agency audit or legal-hold requirement. Participating Agencies shall provide supporting records upon reasonable request as required by their Public-Based Ambulance Agreements.
The public staff report and resolution shall use aggregated or blended data. Individual employee salary information and other confidential records shall be handled in accordance with applicable law and CONFIRE policy. Nothing in this section limits lawful audit, litigation, or regulatory access.
12. Related Authority and Records
• Third Amended and Restated Joint Powers Agreement for Consolidated Fire Agencies, as amended.
• San Bernardino County Contract No. 23-1282, as amended. • Applicable Public-Based Ambulance Agreements.
• Administrative Committee Policy 1.001, Administrative Committee Policy Establishment and Numbering.
• Administrative Committee Policy 1.002, Adoption/Amendment of Policies. • Administrative Committee Policy 1.004, Record Retention. • Administrative Committee Policy 5.002, Administrative Committee Meeting Agenda. • Administrative Committee Policy 5.003, Minutes of Administrative Committee Meetings.
• Administrative Committee Policy 6.002, EMS Division Subsidiary Committee. • Then-current California Fire Assistance Agreement and Cal OES salary survey instructions.
• Annual Administrative Committee Public-Based Ambulance rate resolution and supporting calculation workbook.
APPENDIX A
STANDARD CAPITAL ASSET SCHEDULE
The annual workbook shall update the replacement cost for each included asset. The quantities, useful lives, and reserve allocation below reflect the initial standard. Any change requires disclosure in the annual staff report and resolution. The 33 percent reserve allocation represents approximately one shared reserve unit for every three front- line units.
Useful Life Reserve
Asset Category Qty. Allocation UHC Treatment
Type | ambulance 7 years 33% Included
Cardiac monitor 7 years 33% Included
Power-load system 7 years 33% Included
Powered cot 7 years 33% included
Stair chair 7 years 33% included
Automated CPR device 7 years 33% Included
ePCR tablet 3 years 33% Included
800 MHz dual-head mobile radio 1 7 years 33% Included
Tri-band portable radio and accessories 2 7 years 33% Included Cellular telephone 1 3 years 33% Included
Tactical vest and helmet 2 7 years 33% Included
As
Ambulance supply-exchange - Not Not applicable
applicable Exclude ron tracg
inventory restock add-or
Capital Formula Application
For each included asset, annualized cost equals current replacement cost multiplied by quantity and by 1.33, divided by the useful life. The hourly capital component is the sum of all annualized asset costs divided by 8,760. The annual workbook shall preserve the source for each replacement cost.
APPENDIX B
INITIAL 2026 METHODOLOGY BASIS AND RATE RECONSTRUCTION
HISTORICAL RECORD - CURRENT RATES ARE ESTABLISHED BY RESOLUTION This appendix preserves the basis of the initial 2026 rate calculation as a historical ecora. It does not establish current reimbursement rates or replace a rate adopted b dministrative Committee resolution. Future rates shall be established under this polic using the then-current annual workbook and source records.
B.1 Source Basis
1. Personnel: 2026 blended CFAA base rates and agency-specific District, Onlar ire Department, Rancho ducamonga Fire Prote Vion istrict, and San Bernardino County Fire Protection District. County Fire used Ambulance Operator rates.
2. Capital: current replacement-cost schedule in the 2026 rate-development workbook, using the Appendix A quantities, useful lives, and 33 percent reserve allocation. The resulting hourly capital component was $10.50.
3. Maintenance and Operations: San Bernardino County Fire vehicle- management actuals for the ambulance fleet for June 1, 2025 through June 1, 2026. The workbook calculated $172.11 per ambulance-day and $7.17 per ambulance-hour. •
4. Adjustment: 3.00 percent RFP inflation index applied to each agency subtotal.
5. Restock: comparable Priority Arizona operations because County Contract Public-Based Ambulance actuals were not yet available.
B.2 Agency UHC Profiles
Agency Proflle Personnel Capital M&O Subtotal 3% Adj. Adjusted TUHC
Chino Valley $168.72 $10.50 $7.17 $186.39 $5.59 $191.98 Ontario $158.77 $10.50 $7.17 $176.44 $5.29 $181.73
Rancho Cucamonga $129.11 $10.50 $7.17 $146.78 $4.40 $151.18 County Fire $123.49 $10.50 $7.17 $141.16 $4.23 $145.39
The 2026 comparative analysis initially included agency personnel profiles reflecting the available source data. For benchmark selection under this policy, personnel costs are standardized using one Firefighter/Paramedic and one Firefighter/EMT regardless of an agency's actual ambulance staffing or deployment model. Benchmark eligibility therefore depends on the availability of sufficient verified rate data for those classifications. The annual benchmark calculation shall use the standardized personnel profile rather than an agency's actual ambulance staffing configuration.
B.3 Priority-Owned Ambulance Rate
Initial Priority-Owned Ambulance UHC: $181.73 - $10.50 - $7.17 = $164.06 B.4 Initial Medical Supply Restock Add-On
Priority Arizona Operation Observed Cost per
Transport
Chandler $33.77
Glendale $40.43
Goodyear $39.73
Scottsdale $36.25
The initial add-on used the highest observed amount, $40.43 per Completed Transport. This conservative transitional benchmark recognized that the comparable operations restocked fire-based agencies after all calls, including responses that did not result in transport. Once a complete County Contract operating period is available, the add-on will be replaced by the actual County Contract formula in Section 8.10.
B.5 Initial Rate Schedule for Separate Resolution
Rate Initial Amount
Agency-Owned Ambulance UHC $181.73 per Unit Hour
Priority-Owned Ambulance UHC $164.06 per Unit Hour
Medical Supply Restock Add-On 40.43 per Completed Transport; Agency Owned Ambulances onl
These amounts are included solely to reconstruct the initial methodology. The controlling rates are those stated in the then-current Administrative Committee resolution and applicable Public-Based Am
CONFIRE^ Victorville - Public Agency
Ambulance Agreement^09.29.2026
Final Audit Report . 2026-09-30
Created: 2026-09-30
By: Joe Barna ([email protected])
Status: Signed
Transaction ID: CBJCHBCAABAAIrpX4r1lj6/Wwf6VpA7U2Dg63tSbl6et "CONFIRE^Victorville - Public Agency Ambulance Agreement^0
9.29.2026" History
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