Resolution Automatic Aid and Mutual Aid Agreement With AMR 08-06-13

8/22/2019 Resolution Automatic Aid and Mutual Aid Agreement With AMR 08-06-13

1/11

City CouncilAgenda Item Summary

Meeting Date: August 6, 2013Prepared by: Michael Calhoun

Name: Consideration of a Resolution authorizing the City of Carmel by-the-Sea to enter intoan automatic aid and mutual aid agreement with American Medical Response(AMR) to provide ambulance and emergency medical services outside each agency'srespective designated response areas.

Description:American Medical Response (AMR) is the contract emergency medical serviceprovider for Monterey County and responsible for providing Advance Life Support(ALS) ambulance services in their operational boundaries within the County ofMonterey as authorized by the Emergency Medical Services (EMS) Agency.Since September of 2008, AMR, Carmel Fire & Ambulance (CF A) and MontereyCounty Regional Fire District (MCRFD) have integrated emergency medicalservices through the implementation of an automatic aid and mutual aid agreementbased on the closest or most appropriate resource. This new agreement modifies theclosest ambulance response to a contract compliance agreement to respond torequests for service in adjoining response areas when identified as the closest ormost appropriate resource. The closest or most appropriate ambulance will continueto respond to life threatening incidents such as a heart attack or difficulty breathing.The most appropriate resource will be determined by the EMS dispatcher, automaticvehicle locator (AVL) and known response barriers for priority one (code three)medical service calls as determined by the EMS dispatcher.Entry into this agreement does not waive any rights maintained by Carmel FireAmbulance pursuant to Health and Safety Code Section 1797.201, including theright to provide emergency medical services and medical transportation serviceswithin the boundaries of the City of Carmel -by-the-Sea.The Automatic Aid and Mutual Aid Agreements were reviewed by the CityAttorney.


2/11

Important Considerations: N/A

Decision Record: N/A

Reviewed by:I

J a s o n ~ City Administrator

Meeting Date: August 6, 2013Prepared by: Michael Ca lhoun


3/11

CITY OF CARMEL-BY-THE-SEACITY COUNCIL

RESOLUTION 2013-A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CARMEL-BY-THE-SEA

AUTHORIZING THE CITY OF CARMEL TO ENTER INTO AN AUTOMATIC AID ANDMUTUAL AID AGREEMENT WITH AMERICAN MEDICAL RESPONSE (AMR) TO

PROVIDE AMBULANCE AND EMERGENCY MEDICAL SERVICES WITHIN EACHAGENCY'S RESPECTIVE DESIGNATED RESPONSE AREA.

WHEREAS, The City ofCarmel-by-the-Sea and American Medical Response (AMR) aregeographically located in close proximity of each other within the County ofMonterey; and.WHEREAS, this agreement is for the provision ofAutomatic Aid and Mutual Aid only, anddoes not grant exclusive operating privileges to Carmel Fire & Ambulance and AMR outside of

their current designated districts; andWHEREAS, automatic aid is rendered to for emergency medical services/events

constituting so called day-to-day automatic aid arising out of Carmel Fire & Ambulance and AMRambulance units being the closest available or most appropriate emergency medical servicesresource to specific emergent ambulance requests; andWHEREAS, this agreement is reciprocal in that for Carmel Fire & Ambulance and AMRproviding automatic aid within their specified response areas, the County shall allow Carmel Fire

& Ambulance and AMR to retain its own agency's structured billing schedule.NOW, THEREFORE, BE IT RESOLVED THAT THE CITY COUNCIL OF THE CITYOF CARMEL-BY-THE-SEA DOES:

1. Authorize the City ofCarmel-by-the-Sea to enter into a automatic aid agreement with AMRto provide emergency medical services outside their designated areas and as identified asresponse zones as shown on Exhibit "A" within the vvritten agreement.

2. Authorize the City Administrator to sign the agreement subject to any required languagemodifications.


4/11

PASSED AND ADOPTED BY THE CITY COUNCIL OF THE CITY OF CARMEL-BY-THESEA this 6th day ofAugust, 2013 by the following roll call vote:A YES: COUNCIL MEMBERS:NOES: COUNCIL MEMBERS:ABSENT: COUNCIL MEMBERS:ABSENT: COUNCIL MEMBERS:

SIGNED:

Jason Burnett, MAYORATTEST:

Heidi Burch, City Clerk


5/11

Automatic Aid and Mutual Aid Agreement 7-5-13

Automatic Aid and Mutual Aid AgreementWith and Between

American Medical Response WestAnd the

City of Carmel-by-the-Sea

IntroductionIn an effort to provide an integration of ambulance service and to facilitate and respond the mostappropriate paramedic ambulance unit to emergency calls within each agency's respective designatedresponse area. American Medical Response West (AMR) and the City of Carmel-by-the-Sea (Carmel)have committed to the implementation of an Automatic Aid and Mutua l Aid Agreement. ThisAgreement provides an integration of services to facilitate and respond with the closest and mostappropriate paramedic ambulance unit to emergency calls within their designated response districts .

Witnesseth:WHEREAS, the named parties of this Agreement are geographically located in close proximity to

each other within the County of Monterey, and;WHEREAS, this Agreement is for the provision of Automatic Aid and Mutual Aid only, and does

not grant Exclusive Operating Area privileges to AMR or Carmel outside of thei r current designatedresponse areas, and;

WHEREAS, Automatic Aid and Mutual Aid is rendered fo r Emergency Medical Services (EMS)events constituting so-called day-to-day Automatic Aid arising out of AMR and Carmel ambulance unitsbeing the closest available or most appropriate EMS resource to specific emergent ambulance requests,and;

WHEREAS, this Agreement is reciprocal in that fo r AMR and Carmel providing Automatic Aidand Mutual Aid within their specified response areas, the County shall allow AMR and Carmel to retainits own agency's structured billing schedule, and;

NOW THEREFORE, in consideration of geographical and physical locations of available EMSresources, i.e., emergency ambulances in the Monterey County EMS response zones 08CH, 12CH, 08R IO,


6/11


the closest or most appropriate resource. Most appropriate resource will be determined by thecommunications center utilizing current EMS resource status (resource must be staffed and ready torespond), automatic vehicle locator (AVL) systems and known response barriers. Requests for serviceshall apply to those requests that are determined to meet priority one (code three) response asdetermined by the dispatcher.The areas referred to on the attached Ambulance Response Zone map that may receive mutual aid areidentified as response zones 08CH, 12CH, 08RIO, 12CV, 08CN, 12PB66, and CR66. The writtendescription incorporated herein, outlines in detail the geographical areas of Automatic/Mutual Aidprovided under the current response zones outlined under the January 30, 2010 AMR AGREEMENT TOPROVIDE ADVANCED LIFE SUPPORT AMBULANCE SERVICE FOR THE COUNTY OF MONTEREY.This Agreement allows AMR to request an ambulance unit from Carmel fo r Emergency Medical Servicesfo r MUTUAL AID response to an area outside the Carmel Response Zone, but within the CountyFranchise Response Zones outlined under the AMR AGREEMENT TO PROVIDE ADVANCED LIFE SUPPORTAMBULANCE SERVICES FOR THE COUNTY OF MONTEREY when the system status of availableambulances deems necessary and appropriate in the best interest of patient care. This Agreementallows Carmel to request an ambulance unit from AMR fo r Emergency Medical Services fo r MUTUAL AIDresponse to an area outside the County Franchise Response Zones, but within the Carmel ResponseZone when the system status of available ambulances deems necessary and appropriate and in the bestinterest of patient care.

2. Ambulance Availability fo r Automat ic Aid and Mutual AidWhen a call for service occurs, the call taker enters the information into the Monterey County CADSystem, where it is then simultaneously and automatically routed to the appropriate Monterey CountyEmergency Dispatcher (Fire Comm.) and AMR Dispatcher, based on the geographic location of the call.Ambulance resources shall be dispatched immediately without delay based on each parties CADprogramming fo r all calls within the automatic and mutual aid zone described herein.This shall occur forall calls fo r service in the Automatic Aid and Mutual Aid area that are determined to be a priority one(code three) level of response by the communications dispatcher.The dispatcher shall determine themost appropriate EMS resource to send by utilizing theAVL system and taking into account the unit'sstatus as well as any known response barriers.

3. AVL Administrative View


7/11


vehicles operated in the Mutual aid area. All data captured in the AVL system is proprietary andconfidential and may not be shared in any form outside of the parties in this agreement. All inquiriesrelated to the function/use of the AVL system shall be directed to the Monterey County EMS Agency forresolution .

4. ReportsThe responding ambulance crew in the Automatic and Mutual Aid area shall complete and file allrequired reports and Patient Care Records, including but not limited to, reports mandated by theMonterey County EMS agency, county and state governments.

5. CompensationAll services provided in theAutomatic and Mutual Aid area shall be performed without monetarycompensation from one party of this Agreement to the other. The parties have the right to bill thepatient or any third party billing for services as rendered and as allowed fo r by all applicable laws.

6. InsuranceEach party represents that it has and will maintain comprehensive automobile insurance,comprehensive general liability insurance and professional liability insurance all in minimum amountsthat are usual and customary within the emergency medical services industry and workerscompensation insurance in the statutory required amounts.

7. IndemnificationEach party will indemnify and hold the other party harmless from and against liability claims resultingfrom or alleged to result from any negligent or willful misconduct of the indemnifying party related tothe performance of this agreement.

8. Agreement Not For Benefit of Third PartiesThis agreement shall not be construed as, or deemed to be, an agreement for the benefit of any thirdparty or parties, and no third party or parties shall have any right of action hereunder fo r any causewhatsoever. Any services performed or expenditures made in connection with this Agreement by eitherparty hereto shall be deemed conclusively to be for the direct protection and benefit of the inhabitantsof the EMS response areas identi fied herein.


8/11


b. This writing represents the entire Agreement and understanding between the parties. Norepresentation, warranty, condition or agreement of any kind or nature whatsoever shallbe binding upon the parties hereto unless incorporated in the Agreement. This Agreementmay only be modified in writing, signed by all parties hereto .

c. This Agreement shall be governed by and interpreted under the laws of the State ofCalifornia.

10. Term of Agreement/TerminationThis Agreement shall become effective upon execution by all parties and shall remain in full force andeffect unless terminated as provided herein.This Agreement may be terminated without cause by either party upon thirty {30) days written notice oftermination given to the other parties. Prior to termination of this agreement not ification shall be madewith the Monterey County EMS Agency.

11. Othera. Referrals-It is not the intent of either party that any remuneration, benefit or privilege

provided for under this Agreement sha ll influence or in any way be based on the referral orrecommended referral by either party of patients fo r the other party or its affiliatedprovider, if any, or the purchasing, leasing or ordering of any services other than thespecific services described in the Agreement. Any payments specified herein are consistentwith what the parties reasonably believe to be a fair market value for the servicesprovided.b. Compliance - The parties will comply in all material respects with all applicable federal,state and local laws and regulations, including the federal Anti-kickback Statute. Eachparty's ambulances will conform to applicable state and local regulations for medicalequipment fo r ambulances and be duly licensed for the transportation of patients. Allpersonnel staffing vehicles that provide the services will be licensed or certified as requireby applicable law.

c. Compliance program and Code of Conduct- AMR has made available to the other parties acopy of its Code of Conduct, Anti-kickback policies and other compliance policies as may bechanged from time-to-time, at AMR's web site, located at: www.amr.net, and the otherparties acknowledge receipt of such documents. AMR warrants that its personnel shallcomply with AMR's compliance policies, including training related to the Anti-kickback


9/11


agrees that if DHHS/OIG excludes it, or any of its practitioners or employees who order orprovide services, from participation in Federal health care programs, the party must notifythe other parties within five (5) days of the knowledge of such fact, and the other partiesmay immediately terminate this Agreement, unless the excluded party is a practitioner oremployee who immediately discontinues ordering or providing services hereunder.

e. Relationship - in performance of this agreement, each party hereto shall be, as to theother, an independent contractor and neither party shall have the right or authority,expressed or implied, to bind or otherwise legally obligate the other. Nothing contained inthis agreement shall be construed to constitute either party assuming or undertakingcontrol or direction of the operations, activities or medical care rendered by the other. Theparties' administrative staff shall meet on a regular basis to address issues of mutualconcern related to the provisions of aid and the parties' respective rights and obligationshereunder. It is agreed that the parties shall not be liable fo r payment of any salaries,wages or other forms of compensation for any of the other party's personnel performingservices under this agreement.

12. MiscellaneousThis agreement constitutes the entire agreement between the parties with respect to thesubject matter hereof, superseding all prior oral and written agreement and may be amendedonly by written instrument executed by all parties. Furthermore, this agreement shall not beeffective until executed by all parties.

13. NoticesAny notice required or permitted by this Agreement shall be in writing and shall be delivered asfollows, with notice deemed given as indicated: (a) by personal deliver, when deliveredpersonally; (b) by overnight courier, upon written verification of receipt; (c) by facsimiletransmission, upon acknowledgement of receipt of electronic transmission; or (d) by certified orregistered mail, return receipt requested, upon verification of receipt. Notices shall be sent tothe following addresses:General ManagerAmerican Medical ResponsePO Box 1953


10/11

Automatic Aid and Mutual Aid Agreement

City AdministratorCity of Carmel by the SeaPO Box CCCarmel by the Sea, Ca 93921EMS DirectorCounty of Monterey1270 Natividad Rd (second floor)Salinas, Ca 93906

IN WITNESS WHEREOF, the parties have hereto executed this Agreement.American Medical ResponseBy:.____________Title:_____________City of Carmel by the SeaBy:._______________________Title:._____________Approved as to form (Monterey County EMS Agency)By:_______________________Title:____________

7-5-13


11/11

59

I

EXHIBI T "A "

.....( .......\ . ~

\ - r. .,. ) .- ~'......

Documents

Resolution Automatic Aid and Mutual Aid Agreement With AMR 08-06-13