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HomeMy WebLinkAboutORD-2010-026 South Orange Rescue Squad, Inc. Franchise OrdinanceD ~t.,o - t o !o - o ~ to ,~ - i G - ~o is ou grange escue qua Inc: Franclu-"se~r~ic finance An Ordinance granting anon-exclusive Franchise ("hereafter Franchise") to South Orange Rescue Squad, Inc.., a North Carolina Non-Profit Corporation ("the Grantee") to operate Emergency Medical Services and Rescue Services in Orange County, North Carolina. WHEREAS, Orange County ("the Grantor"), desires to assure the availability of Emergency Medical Services and Rescue Services within the County; WHEREAS, the Grantor has, following reasonable notice, and after consideration, analysis and deliberation conducted public proceedings, during which proceedings the technical ability, financial condition, legal qualifications and general character of the Grantee were determined to be acceptable to receive a Franchise to conduct its Emergency Medical and Rescue Services; WHEREAS, the Grantor has determined that Grantee is entitled to have a non- exclusive Franchise granted, that a need exists for the Emergency Medical and Rescue Services contemplated herein to improve the level of services available to residents of Orange County, helping to assure the provisions of adequate and continuing services which preserves, protects, and promotes the public health safety and welfare, and that granting a Franchise to the Grantee is a cost effective and reasonable manner of meeting the need; WHEREAS, the Grantee desires to operate Emergency Medical and Rescue Services within the Grantor's jurisdiction; WHEREAS, the proposed Emergency Medical and Rescue Services will fit within the existing services provided by the Orange County Emergency Services System so as not to adversely affect the level of services or operations of other Franchisees to render service; and WHEREAS, the procedures of N.C. Gen. Stat. § 153A-250, § 153A-45, and § 153A-46 have been complied with. NOW THEREFORE, the parties agree as follows: Section 1. Nature and Term of Grant a. The Grantor hereby grants the Grantee anon-exclusive Franchise to operate and maintain Emergency Medical and Rescue Services (be an EMS and Rescue Services provider) in the Franchise District upon the terms and conditions set forth herein. b. The Franchise granted herein is for a term of five (5) years from the effective date of the Franchise, which shall begin on the first day following the date of Page 1 of 23 acceptance by e antee of-~ rF ancFuse terms an con itions set o herein. Section 2. Definitions The following words, terms and phrases, when used in this Franchise, shall have the meanings ascribed to them in this Section, except where the context clearly indicates a different meaning: a. Ambulance. The term "ambulance" means any privately or publicly owned motor vehicle, aircraft, or vessel that is specifically designed, constructed, or modified and equipped and is intended to be used for and is maintained or operated for the transportation on the streets or highways, waterways, or airways of this State of persons who are sick, injured, wounded, or otherwise incapacitated or helpless. b. Ambulance Provider. The term "ambulance provider" means an individual, firm, corporation, or association who engages or professes to engage in the business or services of transporting patients in an ambulance. c. Approved. The term "approved" shall mean approved by the North Carolina. Medical Care Commission pursuant to the latter's rules and regulations promulgated under N. C. Gen. Stat. §143B-165. d. Advisory Committee or Committee. The term "Advisory Committee" or "Committee" shall mean the Orange County Emergency Medical Services Committee which is the technical advisory committee designated by the Board of County Commissioners with respect to emergency medical services in Orange County. e. Contract. The term "contract" shall mean the instrument by which both parties agree to the terms of operation of the service to be provided. f. Convalescent Transportation Services. The term "convalescent transportation service" shall mean the operation of an ambulance for any purpose other than transporting emergency or emergent patients. g. County. The term "County" shall mean Orange County and its Board of Commissioners or their designated representative(s). h. Emergency. The term "emergency" or "emergency transportation services" shall mean the use of a service, its equipment and personnel to provide medical care, rescue, and/or transportation of a patient who is in need of immediate rescue or medical treatment in order to prevent loss of Page 2 of 23 li a or er aggravation o physio ogical or psychological illness or injury. i. Emergency Services System or ESS. Emergency Services System or "ESS" shall mean a coordinated arrangement of local resources under the authority of the Emergency Services Director (including all agencies, personnel, equipment, and facilities) organized to respond to medical emergencies and integrated with other health care providers and networks including public health, community health monitoring activities, and special needs populations. j. Emergency Medical Dispatcher or Telecommunicator. The term "emergency medical dispatcher" of "telecommunicator" shall mean an emergency telecommunicator who has completed educational requirements and been credentialed by the Department of Health and Human Services as an emergency medical dispatcher and who is available to receive requests for emergency services, to dispatch emergency services, and to advise local law enforcement agencies, fire departments, rescue squads, first or medical responder units and emergency medical services and facilities of any existing or threatened emergency. k. Emergency Medical Services. "Emergency Medical Services" or "EMS" means services rendered by emergency medical services personnel in responding to improve the health and wellness of the community and to address the individual's need for emergency medical care within the scope of practice as defined by the North Carolina Medical Board, in accordance with G.S. 143-514, and the Orange County Medical Director in order to prevent loss of life or further aggravation of physiological or psychological illness or injury. 1. Emergency Medical Services Instructor. "Emergency Medical Services Instructor" means an individual who has completed educational requirements approved by the Department of Health and Human Services and has been credentialed by that Department as an emergency medical services instructor. m. Emergency Medical Services Peer Review Committee. Emergency Medical Service Peer Review Committee means a panel composed of EMS program representatives responsible for analyzing patient care data and outcome measures to evaluate the ongoing quality of patient care, system performance, and medical direction within the EMS system. The committee may include physicians, nurses, EMS personnel, medical facility personnel and county government staff as determined by the Emergency Services Director in consultation with the County Medical Director. Page 3 of 23 n. mergency a is ec clan MT . The term "emergency medical technician" means an individual who has completed a training program in emergency medical caze that has been approved for legal recognition by the North Cazolina Department of Health and Human Services, in accordance with rules promulgated by the Medical Care Commission, has been certified as an EMT by the State of North Cazolina Office of Emergency Medical Services, and approved by the County Medical Director to perform services as an EMT in the Orange County EMS system. o. Emergency Medical Technician -Intermediate (EMT-I). The term "emergency medical technician -intermediate" means an individual who has completed a training program in emergency medical care at the intermediate level that has been approved for legal recognition by the North Cazolina Department of Health and Human Services, in accordance with rules promulgated by the Medical Caze Commission, has been certified as an EMT -Intermediate by the State of North Carolina Office of Emergency Medical Services, and approved by the County Medical Director to perform services at the EMT-Intermediate level in the Orange County EMS system. p. Emergency Medical Technician - Pazamedic (EMT-P). The term "emergency medical technician -paramedic" means an individual who has completed a training program in emergency medical care at the pazamedic level that has been approved for legal recognition by the North Cazolina Department of Health and Human Services, in accordance with rules promulgated by the Medical Caze Commission, has been certified as an EMT-Paramedic by the State of North Cazolina Office of Emergency Medical Services, and approved by the County Medical Director to perform services as anEMT-Paramedic in the Orange County EMS system. q. Emergency Services Director. The term shall mean the person designated by the Orange County Board of Commissioners to manage the overall Emergency Services System in Orange County. r. First Responder. The term "first responder" shall mean an organization with personnel trained in emergency medical care that is dispatched to the scene of a medical emergency for the primary purpose of providing emergency medical assistance to a patient until the ambulance and additional medical aid arrives. s. Franchise. The term "franchise" shall mean a permit issued by the County to a person for the operation of am ambulance service, rescue squad or first responder unit. Page 4 of 23 t. Franchisee. The term "franchisee" shall mean any person having been issued a franchise by the County for the operation of an ambulance. service, rescue squad or first responder unit. u. Inspection. Inspection shall mean the physical .review of buildings and facilities, vehicles, equipment, supplies, storage, repair and maintenance areas, records and any related materials. v. License. The term "license" shall mean any driver's license or permit to operate a motor vehicle issued under or granted by the laws of the State of North Carolina. w. Medical Responder. "Medical Responder" shall mean an individual who has completed an educational program in emergency medical care and first aid approved and credentialed by the Department of Health and Human Services as a medical responder and the Orange County Medical Director to operate in Orange County EMS. x. Medical Director. "Medical Director" shall mean the physician appointed, either directly or by written delegation, by the County and have the responsibilities as provide by l0A NCAC 13P .0403 and l0A NCAC 13P .0404. The County may, in addition, appoint an assistant medical director. The medical director and the assistant medical director shall meet the criteria defined in the "North Carolina College of Emergency Physicians: Standards of Medical Oversight and Data Collection," which is incorporated by reference in accordance with N.C. Gen. Stat. § 150B-21.6, including subsequent amendments and editions. y. Non-Emergency Transportation Services. The term "non-emergency transportation service" shall mean the operation of an ambulance for any purpose other than transporting emergency or emergent patients. z. Operation Protocols. "Operation Protocols" shall mean the administrative policies and procedures of EMS that provides guidance for the day-to-day operations of the system. aa. Operator. The term "operator" shall mean a person in actual physical control of an ambulance or rescue service vehicle which is in motion or which has-the engine running. bb. Owner. The term "owner" shall man any person or entity who owns an ambulance or provides a service covered by this Ordinance. cc. Patient. The term "patient" shall mean an individual who is sick, injured, wounded, or otherwise incapacitated or helpless such that the need for Page 5 of 23 some medical assistance might be anticipated while being transported to or from a medical facility. dd. Person. The term "person" shall mean any individual, firm, partnership, association, corporation, company, group of individuals acting together for a common purpose, or organization of any kind, including any governmental agency other than the United States. ee. Practical Examination. "Practical Examination means a test where an applicant for credentialing as an emergency medical technician, or medical responder, emergency medical technician -intermediate, or emergency medical. technician -paramedic demonstrates the ability to perform specified emergency medical care skills. ff. Rescue. The term "rescue" shall mean the removal of individuals facing external, non-medical, and non-patient related peril to areas of relative safety. gg. Rescue Squad or Rescue Unit. The term "rescue squad" or "rescue unit" shall mean a group of individuals who are not necessarily trained in emergency medical services, fire fighting, or law enforcement, but who expose themselves to an external, non-medical, and non-patient related peril to effect the removal of individuals facing the same type of peril to areas of relative safety. hh. Secondary Ambulance Provider. The term "secondary ambulance provider" shall mean the system of personnel and equipment meeting the same criteria as a primary ambulance provider, but not normally dispatched on first call response. ii. Service. The term "service" shall mean the same as owner. jj. Treatment Protocols. "Treatment Protocols" shall mean a document approved by the medical director and the Office of Emergency Medical Service specifying the diagnostic procedures, treatment procedures, medication administration, and patient-care-related policies that shall be completed by emergency service personnel based upon the assessment of the patient. kk. Victim. The term "victim" shall mean any patient or potential patient that is entrapped, entangled pinned, fallen, suspended, or otherwise in need of rescue services. Section 4. General Responsibilities Page 6 of 23 a. Grantee is authorized under this Franchise to operate the following types of service(s), the combination of which shall constitute Grantee's "EMS Services for the purposes of this Franchise, and subcategories under which they can operate shall be identified in the "Operation Agreement" to be entered into by the Franchisee and the County within 90 days after acceptance of the Franchise permit. i. Emergency Services ii. Rescue Services c. Grantee shall comply at all times with the requirements of "An Ordinance Regulating Ambulance, Emergency Medical, First Responder And Rescue Service And Granting Of Franchise And Contracts To The Operator In The County Of Orange ("EMS Franchise Oz~dinance"), this Franchise Agreements, the Operations Agreement, and all applicable laws relating to health, sanitation, safety, equipment, ambulance design or other EMS Services vehicle design and all legal requirements related to a Model EMS System and all other laws and ordinance; a. Grantee shall maintain in good standing its state and local Drivers and Privilege license (s) to operate its ambulance or other EMS Services as provided for by Law. b. Establish and maintain appropriate and effective professional working relationships with all public health, public safety, and emergency services organization and personnel. c. Professional working relationships shall be cooperative and collaborative in nature. d. Maintain neat, clean, and professional appearance of personnel, equipment and facilities. Section 5. Scope of Service and Service Area a. Grantee shall operate its EMS Services, 24 hours per each and every day of the calendar year, within the Franchise District specified in Exhibit A, except when a different or additional service area is provided for herein. b. Grantor may from time to time alter, and at its sole discretion, amend Exhibit A and the service area of the County that constitute (s) the Franchise District. c. Grantor shall at all times during the terms of the Franchise provide the highest level of care to all residents within the service area of the Franchise District. Page 7 of 23 Section 6. The Orange County Emergency Services System ("ESS") Plan a. Grantee shall comply with the Grantor's official written ESS System Plan for the management and deployment of EMS Services Vehicles within the Franchise District and, additionally, within other service areas pursuant to the EMS System Mutual Aid Plan and any cooperative agreement to continue services in service -areas where Franchisees' EMS System franchises has been suspended. b. Grantee shall keep at its place a business at all times the most current copy of the ESS System Plan. Section 7. Staffing and Performance Requirements a. Grantee shall comply with the scope of practice rules promulgated by the North Carolina Medical Board pursuant to law regarding the medical skills and .medication that may be used by credentialed emergency medical services personnel at each level of patient care. b. Grantee shall comply with standard for drivers and attendants developed by the North Carolina Medical Care Commission as requirements for certification of emergency medical technicians pursuant to law, rules and regulations promulgated by the Board of Medical Examiners for advanced life support technicians, which is incorporated in this subsection by reference. c. No staff of Grantee shall drive an ambulance vehicle, attend a patient, or permit an ambulance to be operated when transporting a patient within the County unless the driver holds a currently valid North Carolina Drivers license and currently valid credentials as an EMT, EMT-I or EMT-P issued by the North Carolina Department of Health and Human Services, Office of Emergency Medical Services. Notwithstanding the foregoing, in an exceptional circumstance when an EMT, EMT-I, or EMT-P is not available, for the purpose of driving only or when providing Non- Transport Service an approved firefighter, First or Medical Responder, Rescue Services Provider or law enforcement officer with a currently valid North Carolina drivers license may drive an ambulance, provided such driver does not attend a patient or victim or does not otherwise provide medical services to a patient or victim. d. Grantee shall comply with the Grantor's official written EMS System Plan for the use of credentialed EMS personnel for all of the authorized Practice Settings. Any agreement between Grantee and a third party to provide special events coverage is subject to .pre-approval in writing by the Grantor, which approval shall not be reasonable withheld. Page 8 of 23 e. Grantee's staff that operate EMS Service Vehicles shall actively participate in any emergency vehicle operations training provided by the Grantor as directed by the Emergency Services Director. f. Grantee's staff shall comply with Grantor's official written EMS System continuing education plan for EMS personnel under the direction of the Orange County Continuing Education Coordinator. g. Grantee staff shall also participate in all clinical and field internship educational components of Grantor's continuing education plan. h. Grantee shall comply with all education program requirements for qualified credentialed EMS personnel as provided by law. i. Grantee shall assign credentialed staff to assist, upon request, with any orientation provided by Grantor to local area hospitals that routinely receive patients from Grantee. Section 8. Vehicle and Equipment Requirements a. Grantee shall comply with all vehicle and equipment standards as developed by the North Carolina Medical Care Commission pursuant to law, including without limitation, those applicable to the EMS Services. b. Grantee shall maintain for each ambulance and other EMS Services Vehicle a permit as provided for by law. c. Grantee shall comply with the state EMS Non-Transporting Vehicle Permit requirements. d. Grantee shall have available the following minimum number of ambulances and other EMS Services Vehicles in excellent working order to provide coverage to the service area of the Franchise District 24 hours per day. One (1).Type 1 Ambulance, One (1) In Service Rescue Vehicles and other EMS Services Vehicles and equipment as necessary to provide the high quality of services provided for in this Franchise. e. Grantee shall comply with the Grantor's operational protocols for the management of equipment, supplies and medications to assure that each ambulance and other EMS Services Vehicle contains the required equipment and supplies on each response; for cleaning and maintaining the equipment and vehicles; and to assure that supplies and medications Page 9 of 23 are not used beyond the expiration date and stored in a temperature controlled atmosphere according to manufacturer's specifications. f. Grantee shall comply with the Orange County's written infection control policy including the cleansing and disinfecting of ambulances and other EMS Services Vehicles and equipment that are used to treat or transport patients. g. Grantor may, upon reasonable notice, inspect all equipment, ambulances and other EMS Service Vehicles used by Grantee. Section 9. Communications Requirement a. Grantee shall equip each ambulance and other EMS Services Vehicle with the following: i. An operational two-way radio capable of establishing good quality voice communications from with the geographical confines of Orange County to each hospital emergency department in the County in which the service is based; ii. Two-way radio communication capabilities for communication with all hospital emergency departments to which transportation of patients is made on a regular or routine basis anywhere within the State of North Carolina; and iii. An operational two-way radio capable of establishing communications from within the geographic confines of Orange County to the Orange County Emergency Communications Center, which is the dispatching agency within the County. b. This subsection shall not apply to privately owned vehicles of Grantee's staff. c. Grantee shall maintain current authorization or Federal Communication Commission licenses for all frequencies and radio transmitters operated by Grantee. Grantee shall display at Grantee's headquarters and make available for inspection per Federal Communication Commission's rules and regulations copies of all authorization and licenses. d. Grantee's base of operations shall have at least one open telephone 24 hours per each and every day of the calendar year. Grantee's telephone numbers shall be registered with Orange County Emergency Communication Center, and changes to Grantee's telephone numbers shall be transmitted to the Emergency Communication Center within 24 hours of such change. Page 10 of 23 e. Grantee's EMS Services shall be dispatched from the Orange County Emergency Communications Center. Section 10. Data Collection and Performance Report a. Grantee shall maintain the following records: i. Records of dispatch which shall show time call was received, time dispatched, time arrived on scene, time arrived at destination, time in service, and time returned to base. ii. Trip Records stating all information required in subsection (i) of this Section in addition to information on a form approved by the County. The trip record shall be so designed as to provide the patient with a copy containing all required information. iii. Personnel Checklist and Inspection Report listing contents and description for each vehicle, signed by the individual verifying vehicle operations and equipment. iv. A detailed record of complaints received from the public, other enforcing agencies and services regarding Franchise infractions. v. Any other records required by state law, rules or regulations or deemed by the Department of Emergency Service as relevant to the effective and efficient operations of the Emergency Management System as provided in the "Operations Agreement" and necessary for a fair determination of the capability of the Grantee to continue to provide Emergency Medical Services and Rescue Services in Orange County in accordance with the requirement of law and the provision of this Franchise. b. All of the records identified in subsection (a) above shall be maintained for a minimum three (3) year period unless a longer retention period is otherwise required by law or other retention periods. c. Grantee shall establish and maintain a system to record data that used the Model Data set and data dictionary as specified in "North Carolina College of Emergency Physicians: Standards for Medical Oversight and Data Collection." d. Grantees shall maintain confidentiality of patient records as provided by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, N.C. Gen. Stat. 143-518 and all other state and federal law. Page 11 of 23 e. Grantee shall submit a written monthly report to the Emergency Services Director, or their designee, providing the number of calls and runs during the month. The report shall contain the number of emergency calls, the number- of convalescent calls, the total number of calls and the total number of patients transported. f. Grantee may inspect Grantee's records at any time in order to ensure compliance with the EMS Franchise Ordinance and this Franchise Agreement; however, Grantor's shall inspect the Grantee's records at least once a year to ensure compliance with the EMS Franchise Ordinance and this Franchise Agreement. Section 11. Medical Oversight a. Grantee shall designate a representative of Grantee to attend and participate in regular meetings of the Orange County EMS Peer Review Committee. b. Grantee shall monitor and comply with any online medical direction for operating within EMT-P systems. c. Grantee shall comply with the Grantor's plan for Medical Oversight and Written Treatment Protocols. d. Grantee shall comply with the Grantor's written plan to address the management of the EMS System including: i. the triage of patients to appropriate facilities; ii. transport of patients to facilities outside of the system; iii. Arrangement for transporting patients to appropriate facilities when diversion or bypass plans are activated; iv. A mechanism for reporting, monitoring and establishing standards for system response times; v. A special events staffing plan; vi. A disaster plan; and vii. Mass gathering plan. e. Grantee shall comply with the Medical Director's written guidance regarding decision about the equipment, medical supplies, and Page 12 of 23 medications that will be carried on any ambulance or other EMS Services Vehicle. f. The Medical Director may suspend temporarily, pending due process review by the EMS Peer Review Committee, any of Grantee's EMS personnel from further participation in the EMS system when the Medical Director determines that the activities or medical care rendered by such personnel may be detrimental to the care of the patient, constitute unprofessional behavior or results in non-compliance with credentialing requirements. Section I2. Rates and Adjustments a. Grantee shall submit a schedule of rates to the Grantor for approval and shall not charge more nor less than the authorized rates without specific authorization from the Grantor. b. Grantee shall not attempt to collect rates on emergency call until the patient has reached the point of destination, has received medical attention and is in a condition deemed by the physician fit to consult with the service; but Grantee may attempt to collect rates with family or guardian of the patient once the patient is in the process of receiving medical attention. c. On Special Event coverage and convalescent calls, Grantee may attempt to collect payment before the ambulance or other EMS Services Vehicle begins its trip. Section 13. Insurance a. Within thirty (30) calendar days after the effective date of issuance of the Franchise, the Grantee shall provide proof of the required insurance. Grantee shall at all times during the Franchise term maintain in force and effect insurance coverage, issued by an insurance company licensed to do business in North Carolina, covering the following: i. Every ambulance or other EMS Services Vehicle owned and/or operated by or for the Grantee proving for the following payment of injury and damages: (a) In the minimum sum of $1,000,000 for injury to or death of individuals in accidents resulting from any cause for which. the owner of the vehicle would be liable on account of liability imposed on him by law, regardless of whether the vehicle was being driven by the owner of his agent; and Page 13 of 23 (b) In the minimum sum of $1,000,000 for the loss of or damage to the property of another, including personal property, or under like circumstances in sums as may be required by the State of North Carolina or as authorized by the Grantor. (c) The insurance coverage minimum limits required in subsection (a) and (b) above shall be evaluated annually by the Orange County Department of Emergency Services in consultation with the Orange County Risk Manager and the County Attorney's Office and may be revised by the Grantor as Grantor deems appropriate, and at Grantor's sole discretion. In directing a change in insurance coverage, the Department of Emergency Services shall consider the risk needs protected by this insurance coverage and the availability in the marketplace of the coverage amounts to be required. ii. Grantee shall at all times during the Franchise term maintain in force and effect insurance coverage, issued by an insurance company licensed to do business in North Carolina for Worker's Compensation coverage for all employees with statutory limits in compliance with applicable law. b. Insurance coverage necessary to comply with this Section shall be approved by the Grantor, and copies of such insurance policies (or certificates of insurance) shall be provided to the Grantor.' c. The Grantor shall be named as an additional insured as its interests may appear. Section 14. Transfer of Ownership or Control and Changes in Level of Services a. Prior approval of the Grantor shall be required where ownership or control of more than ten percent of the right or control of the Grantee is acquired by a person or group of persons acting in convert, not of whom own or control ten percent or more of such rights of control, singularly or collectively, at the date of the grant of the Franchise. By its acceptance of the Franchise, the Grantee specifically agrees that any such acquisition occurring without prior approval of the Grantor shall constitute a violation of the Franchise by the grantee and shall be cause for termination at the option of the Grantor. b. Any change in ownership of Grantee without the approval of the Grantor shall terminate the Franchise and shall require a new application and a new Franchise in conformance with all the requirements of the EMS Franchise Ordinance, as amended and in effect at the time of franchising. Page 14 of 23 Any change in the level of services offered by a Grantee's EMS Services unit without the approval of the Grantor shall terminate the Franchise and shall require a new application and a new franchise in conformance with all the requirements of the EMS Franchise Ordinance, as amended and in effect at the time of franchising. d. Grantee may not sell, assign, mortgage or otherwise the transfer the Franchise without the approval of the Grantor; if the Grantor sells, assigns, mortgages or otherwise transfer the Franchise without Grantor's approval this shall terminate the Franchise and require a new application and a new Franchise in conformance with all the requirements of the EMS Franchise Ordinance, as amended and in effect at the time of franchising. Section 15. Miscellaneous Provisions a. Grantor may, upon reasonable notice, inspect the premises, vehicles, equipment and personnel of Grantee to ensure compliance with this Franchise and perform any other inspections that may be required. b. Grarrtee shall make available for inspection by the State of North Carolina, the Grantor, or their designated representatives, Grantee's EMS Services, its equipment and the premises designated in the application and all records relating to its maintenance and operations as such. c. Grantee shall cooperate with the Grantor to educate the public concerning injury prevention and community health. d. Grantee's staff shall not wear or carry aboard any ambulance of other EMS Services Vehicles firearms or weapons as defined by law, which does not include tools that aid in providing services. The foregoing restriction shall not be construed to apply to equipment used by Grantee to provide EMS Services. e. Grantee shall post its Franchise Certificate, issued to it by the Grantor, in a readily visible location at the Grantee's base of operations for the EMS Service. f. Grantee shall not allow its Franchise Certificate to be defaced, removed, or obliterated. g. Grantee shall comply with all applicable law and Grantor's policies and procedures related to confidentiality of medical information, including without limitation the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Page 15 of 23 Section 16. Termination Provisions a. Grantee may terminate this Franchise with 60 days written notice to Grantor and the Grantor may revoke the Franchise in the event of noncompliance with the provisions of the EMS Ordinance or this Franchise Agreement. After a notice of services termination is given, the Grantee may reapply for a franchise if a continued service is desired. b. Upon suspension, revocation, termination or a stay by the Emergency Services Director of this Franchise, Grantee shall immediately cease all operations authorized by this Franchise. c. Upon suspension, revocation, termination of a driver's license such person shall cease to dive an ambulance or other EMS Service Vehicle. Upon suspension, revocation or termination of an attendant's certificate (i.e., Medical Responder, EMT, EMT-I or EMT-P) by the Office of Emergency Medical Services or by the Medical Director, such person shall cease to attend patients or otherwise provide medical care. Grantee shall not permit the foregoing person to drive an ambulance or their EMS Service Vehicle or provide medical care in conjunction with EMS Services, if Grantee is found to have notice of or should have had notice of such suspension, revocation or termination at the sole discretion of the Grantor this shall terminate the Franchise and shall require a new application and a new Franchise in conformance with all the requirements of the EMS Franchise Ordinance, as amended and in effect at the time of franchising. d. In the event that Grantee shall at any time during the Franchise desire to sell any of the real or personal property identified in Exhibit B (hereinafter "Asset" or "Assets"), which is hereby incorporated by reference, pursuant to a bona fide offer to a bona fide offer which it shall have received, it shall offer to sell any such Asset or Assets (hereafter "Asset or Assets for Sale) to Grantor at the same process as that contained in such bona fide offer. The offer to Grantor to sell an Asset shall be in writing and shall include a copy of the bona fide offer. The offer to Grantor to ell an Asset shall be in writing and shall include a copy of the bona fide offer for the Asset received by the Grantee. Grantor shall have 60 days from and after receipt thereof to decide whether or not to purchase the Asset or Assets for Sale at such prove. If Grantor shall give notice of intent not to purchase or shall give no notice within the time herein limited, Grantee may accept such offer and proceed with the sale thereunder. If Grantor notifies Grantee that it elects to purchase the Asset or Assets for Sale at such prove, the parties shall enter into a contract of purchase and sale forthwith. Such contract shall provide, among other things, for the conveyance of good and marketable title b warranty deed. Upon dissolution of the Grantee pursuant to N.C. Gen. Stat. § SSA-14-1, et seq., the Assets shall be either: (a) distributed to one or more appropriately receiving successor Page 16 of 23 Franchisee (s) that will carry on, In Orange County, the functions of ambulance, first or medical responder, rescue or other related emergency services meeting one or more exempt purposes within the meaning of 501(c)(3) of the Internal Revenue code (or the corresponding section of any future federal tax code) or (b) distributed to the grantor for the foregoing public purposes. This subsection 16(d) of this EMS Service Franchise survives the termination of the Franchise. Section 17. Forum for Litigation Any litigation between the Grantor and Grantee arising under or regarding the Franchise shall occur, if in the North Carolina courts, in Orange County Superior Court or District Court having jurisdiction thereof, or if in the federal courts, in the United States District Court for the Middle District of North Carolina. Section 18. Notice Any notice provided for under the Franchise shall be sufficient if in writing and delivered personally to the following address or deposited in the United States Mail, postage prepaid, certified mail, return receipt requested, addressed as follows, or to such other address as the receiving party hereafter shall specify in writing: If to the Grantor: Orange County Emergency Services Post Office Box 8181 Hillsborough, North Carolina 27278 Attn: Emergency Services Director (919) 245-6100 If to the Grantee: Chair, Board of Directors South Orange Rescue Squad, Inc. Post Office Box 128 Carrboro, North Carolina 27510-0128 (919) 967-1515 Section 19. Severability If any Section, subsection, sentence. Clause, phrase, or other portion of this Franchise is, for any reason, declared invalid, in whole or in part, by any court, agency, commission, legislative body, or other authority of competent jurisdiction, such portion shall be deemed a separate, distinct and independent portion. Such declaration shall not affect the validity of the remaining portions hereof, which other portions shall continue in full force and effect. Page 17 of 23 Section 20. Reservation of Rights Notwithstanding any other provision of the Franchise, Grantor and Grantee reserve all rights that they may possess under the law unless expressly waived herein. Nothing herein shall constitute a waiver of rights of either party, provided, however, that both parties warrant and represent that, as of the effective date of the Franchise, they are not aware of any provision in the Franchise that is contrary to applicable law. Section 21. Penalties and Remedies a. A violation of any provision of this Franchise Ordinance or other failure of the Grantee to abide by the provisions of this Franchise shall subject the Grantee to a civil penalty of five hundred ($500) dollars. If Grantee fails to pay this penalty within ten (10) days after being cited for a violation, the Grantor may seek to recover the penalty by filing a civil action in the nature of a debt. b. A violation of any provision of this Franchise Ordinance by the Grantee shall constitute a misdemeanor, punishable as provided in N.C. Gen. Stat. § 14-4. c. The Grantor may seek to enforce this Franchise Ordinance through any appropriate equitable action. d. Each day that a violation continues of this .Franchise Ordinance after the Grantee has been notified of the violation shall constitute a separate offense. e. The Grantor may seek to enforce this Franchise Ordinance by using any one or any combination of the foregoing remedies. Section 22. Non-discrimination The Grantee shall not discriminate in any manner on the basis or factors prohibited by law. Section 23. Acceptance by Grantee This Franchise and all of its terms and provisions shall be accepted by Grantee in writing in the form hereinafter set forth within thirty (30) days of the grant of this Franchise by the Grantor and when accepted shall be filed with Grantor's Clerk who shall record the same in the Book of Ordinances. Such written acceptance may be upon or at the end of a copy of this Franchise Ordinance and it shall state and express the acceptance of said Franchise and its terms, conditions Page 18 of 23 and provisions; and Grantee shall agree in said written acceptance to abide by, to observe and to perform the same according to all of its terms and provisions, subject to applicable state and federal law and shall declare that statements and recitals contained on said Franchise are correct and that it has made an es make the agreements and statements set forth in this Franchise. Acceptanec_e herein re ed to shall be in the following form: The undersi ed, ``~*~ ~ • n his/her capacity as Cbw.~r ~ `~ .o:a, of the South Orange Re, cu d, Inc., Inc. and on behalf of that agency, does hereby accept and approve the fo in and attached Franchise and all of its terms and conditions; and in consideration of the benefits and privileges granted to it does hereby agree to abide by, carry out, observe and perform all of the obligations and things provided to be carried out and performed by it in said Franchise approved by the Grantor Commissioners, subject to applicable state and federal law. This. the~~ day of ~Yva~• , 2010 FOR GRANTEE: Printed Name and Title ~- STATE OF NORTH CAROLINA COUNTY OF ORANGE ) On the ~~day of , 2010 before me Not pub 'c for and State aforesaid, Pers ally appeared before me on behalf of said agency, acknowledges the signing and execution of th foregoing instrument. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed by notarial seal on the day and year above written. _ ~~NH~t~yp' t Notary Public ~ '~ ~'' ~' •. ~. • ~ ~ r ~ ~~~~ ~ ~ ~ ~ ~ « My Commission Expires: ~- Q (S i A ' ""' "sn : 11p4tG:ti ',, '••..y.....• ~ ~~. '~yq~ couN~;,~, IN WITNESS WHEREOF, this South Orange Rescue Squad, Inc. ~21i'se Ordinance passed on First Reading on the ~ day of March 2010 and was passed and adopted on Second Reading this the ~ day of , 2010. Page 19 of 23 .: ,.~;e ~3 e ' ~ ~. .d ~ ~,~ . 17~ __ 'Valerie P. Fous~iee~lair Orange County Board of Commissioners ATTEST: ~onfiaB~r, Clerk to the Orange County Board of Commissioners APPROVED AS FO ~~ ette M. oore, Staff Attorney Orange County Attorney's Office Page 20 of 23 ACCEPTANCE BY GRANTEE: This Franchise and all of its terms and provisions shall be accepted by Grantee in writing in the form hereinafter set forth within thirty (30) days of the grant of this Franchise by the Grantor and when accepted shall be filed with Grantor's Clerk who shall record the same in the Book of Ordinances. Such written acceptance may be upon or at the end of a copy of this Franchise Ordinance and it shall state and express the acceptance of said Franchise and its terms, conditions and provisions; and Grantee shall agree in said written acceptance to abide by, to observe and to perform the same according to all of its terms and provisions, subject to applicable state and federal law and shall declare that statements and recitals contained on said Franchise are correct and that it has made and does make the agreements and statements set forth in this Franchise. Acceptance herein~eferrecJ~to shall be in the following form: The undersigned, ~~ his/her capacity as C.ysa~ ~'~.e'~ . of t e South Orange Resc a d, Inc., Inc. and on behalf of that agency, does hereby accept and approve the for and attached Franchise and all of its terms and conditions; and in consideration of e benefits and privileges granted to it does hereby agree to abide by, carry out, observe and perform all of the obligations and things provided to be carried out and performed by it in said Franchise approved by the Grantor Commissioners, subject to applicable state and federal law. This the ~ day of JJ~~ , 2010 FOR GRANTEE: Printed Name and Title STATE OF NORTH CAROLINA COUNTY OF ORANGE ) On the ~ day of , 2010 before me N~ Publi f r County and State aforesaid, Personally geared before me on behalf of said agency, acknowledges the signing and execution of the foregoing ins ent. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed by notarial seal on the day and year above written. Notary Public , My Commission Expires: Page 21 of 23 ~,~p~tsa~~~t~h~i ~~ V ~ • `•• ~ ~i .. • •• ~~ OTA~.: = - -•-- ~ r ~~i~ •'•.w••.••• • a`~ EXHIBIT A TO EMS SERVICES FRANCHISE FOR TECHNICAL RESCUE SERVICES, INC., A NORTH CAROLINA NON-PROFIT CORPORATION FRANCHISE DISTRICT Geographic Location: All of the County of Orange Page 22 of 23 EXHIBIT B TO EMS SERVICES FRANCHISE FOR TECHNICAL RESCUE SERVICES, INC., A NORTH CAROLINA NON-PROFIT CORPORATION ASSETS 1. Real Estate and Improvements Address 2 202 Roberson Street, Chapel Hill Personal Property Tune 1261 Ambulance [fully outfitted] 1262 Ambulance [fully outfitted] Clampett [Rescue Truck, fully outfitted] Other Rescue Truck [pickup] Rescue Van/TRT Mobile Command Post [w/ equipment] Gator Trailer and Gator Boats and Motors Confined Space Trailer and Equipment Miscellaneous Other Equipment [radios, repeater, licenses, CPR equipment, etc.] Estimated Property Value $ 900K [estimated market value of property only; value of building structure is undetermined] *Estimated Replacement Value (as of January 1, 2010 $95,000 $135,000 $80,000 $40,000 $100,000 $40,000 $20,000 $50,000 $250,000 Page 23 of 23 .• p p ~~ ~ p p ~ Sem f~er Altus Muneris - Volunteers Since 1971 Date: January I9, 2010 To: Col. Frank Montes de Oca, Director, Orange County Emergency Seiwices; Valerie Foushee, Chair, Orange County Board of Commissioners; Bernadette Pelissier, Vice-Chair; Alice Gordon; Pam Hemminger; Barry Jacobs; Mike Nelson; Steve Yuhasz. Greetings: By this letter, The South Orange Rescue Squad formally applies for an operational franchise to provide ambulance and rescue services to the citizen's of Orange County tluough the Orange County Department of Emergency Services and the Orange County Board of Commissioners. Specifically, South Orange Rescue Squad is applying for a franchise to provide: Technical Rescue Response [High Angle rescue, Swiftwater rescue, Confined Space Rescue] Special Event EMS and Ambulance Service Regularly-Scheduled EMS and Ambulance Service "Surge" EMS/Ambulance Service These services will be dispatched through Orange County 911 Communications and will be integrated into and will augment and support emergency services provided by Orange County Emergency Services [OCES] to help meet county-wide response needs. The South Orange Rescue Squad [SOBS] has been providing all-volunteer emergency EMS and rescue services to the citizens of Orange County since 1971. Until June 2009, SOBS had provided regularly scheduled, 3-day, 12 hour per day EMS and Ambulance service to The University of North Carolina and the surrounding Chapel Hill, CaiTboro, and southern Orange County area to augment the Orange County EMS System. SOBS currently provides "Surge" EMS and Ambulance service to OCES during times of overload to the County's resources. SOBS currently provides EMS and Ambulance service for f re or other large incident "Rehab and Support" whenever requested by OCES or any fire department or law enforcement agency within Orange County. PO Box l Z8, Carrbaro, NC 27510-D 128 ~ 919.967.1 S I S ~ www.soresecue.org 27 ~ _._ Semper Aptus Muneris -Volunteers Since 1971 ~~ SORS currently loans its ambulances and equipment to the County during times when County vehicles are out-of-service or otherwise "off-line". SORS currently provides Technical Rescue services for county-wide response whenever requested through OCES 9I 1. SORS currently provides Technical Rescue Services by contract to the University of North Carolina Department of Energy Services. SORS currently provides Technical Rescue Services by contract with the Orange Water and Sewer Authority. SORS currently provides Special Event EMS and Ambulance Service by contract to The University of North Carolina Department of Athletics [UNC home football games, basketball games, track events, NCAA Championship events and NCHSAA High School Football and Basketball Championship events]. SORS currently provides Special Event EMS and Ambulance Service to the Town of Chapel Hill [Annual Halloween coverage, Street Fairs, Festivals, spontaneous UNC Basketball street celebrations, road races, bike races and triathlons]. SOBS currently provides Special Event EMS and Ambulance Services for coverage of Chapel Hill / Carrboro City School System High School Football games. SORS currently provides CPR and AED training and certification to citizens and groups in Orange County at no charge. As an all-volunteer, 501-(C}-3 Non-Profit organization, SORS owns it's own fleet of Ambulance and Rescue vehicles. We train all of our volunteers to the applicable local, state, or national standard [or higher]. We maintain our awn insurance for our volunteers. South Orange Rescue Squad has been meeting and working closely with the Director of OCES, Col. Frank Montes de Oca, to examine ways that the volunteers and i~esout~ces of the South Orange Rescue Squad can be positioned and utilized within the larger goal of EMS and Rescue service to all of the citizen's of Orange County. Due to its all-volunteer nature, SORS akeady provides a tremendous benefit to the citizens of Orange County, since it does not receive any tax-supported revenue., SORS is extremely interested in providing cooperative and integrated EMS and Rescue Services along side OCES, while still retaining it's integrity and identity as a locally based, a11-volunteer organization. PO Box 128, Carrboro, NC 2 75 ! 0-0128 ~ 9 ! 9.967.1 S 1 S ~ www.soresecue. org 28 ,• p p ~~~' ~ ' Semler Altus Muneris -Volunteers Since 1971 ~~ There is, demonstrably, a significant County-wide need for the services, resources, and capabilities of a volunteer EMS and Rescue Squad. The South Orange Rescue Squad is ready, willing and able to meet that need. We understand that the initial review of this application will be through the Department of Emergency Services and we look forward. to continuing our conversations with the appropriate individuals to refine the details of our working agreement. We are in the process of putting together the paperwork that is required to support this application and anticipate having it to the Depat~tment in the very near future. We are anxious to move ahead with the process and get started in implementing the operational details required to allow South Orange Rescue Squad the opportunity to provide these vital services to the citizens of Orange County. Respectfully Submitted, Fred Stipe, Chairman atthew Mauzy, Chief SORS Board of Directors SORS cc: Annette Moore SORS Board of Directors FO Box 128, Carrbaro, NC 27510-128 ~ 919.967.1515 f www.soresecue.org 29 ~`€` ~ Semler Aptus Muneris -Volunteers Since 1971 February 22, 2010 Dear Col. Montes de Oca: The South Orange Rescue Squad is extremely excited at the prospect of continuing to move forward in partnership with Orange County Emergency Services and we hope that the issuance of Ambulance and Rescue franchises will be relatively straightforward and expeditious. SOBS is willing and committed to develop a practical working agreement with OCES that spells out the operational details that will allow us to continue to provide the high level of service and response that we have to date. Our immediate goal is to develop a reasonable and achievable framework of services that will benefit the citizens of the entire county and provide SORS with the flexibility and opportunity to grow and expand our operational capabilities over time. SORS looks forward to working with OCES to continue to provide: • Supplemental "Surge" EMS and ambulance transport whenever requested by OCES, throughout the entirety of Orange County. SORS will continue to support OCES with both equipment and personnel during times of need. EMS and ambulance coverage for Special Events. SOBS has been the long-term provider for the iJNC Department of Athletics and also provides coverage of other local events such as high school football games, road races, triathlons, and track meets. SORS has also provided many years of supplemental EMS and ambulance coverage for Town of Chapel Hill events such as Halloween, Fourth of July Fireworks, street fairs and "spontaneous" [usually basketball-related] celebrations on Franklin Street. Fire and large incident rehabilitation and support for volunteer and municipal fire depar4ments whenever requested by OCES, throughout the entirety of Orange County. Providing hydration and physical checks can be crucial elements of firefighter safety and support. • Technical Rescue Services in the areas of High-Angle, Swiftwater, and Confined-Space rescue. SORS has been along-term provider of technical rescue awazeness, training and rescue support for the Orange Water & Sewer Authority and the i1NC Department of Energy Services. SORS also provides state wide and regional technical rescue assistance whenever it is needed. • Regularly scheduled EMS and ambulance coverage to augment OCES resources county wide. SORS has historically provided scheduled EMS. and ambulance support in PO Box 128, Carrboro, NC 27510-0128 ~ 919.967.1515 ~ www.sorescue.org 30 `~F~~` Semler Altus Muneris -Volunteers Srnce f 97f the University of North Cazolina/Chapel HilUCarrboro regions of southern Orange County. SORS strongly desires to continue to provide this locally based service in its core volunteer area, but also desires to expand EMS and ambulance support to serve the citizens of the entire county. A locally based program helps with recruiting and training and an expanded coverage area provides a greater exposure of emergency response needs and experience for our volunteers. The South Orange Rescue Squad is dedicated to the provision of the highest levels of emergency service and response. We train our volunteers to meet or exceed all applicable standards across all areas of service. SOBS is [and has always been] financially sound and well managed. We own all of our equipment and have an absolute minimum of outstanding debt. We own the property and the building that serves as our stationhouse and it is debt-free. Over the years, we have developed a remazkable inventory of physical assets and trained volunteers that can be brought to beaz when situations warrant. As an all-volunteer organization, SORS strongly desires to grow and expand our organization as well as our services and personnel resources. As we grow and develop, we hope to then be able to expand our functional capabilities, which in turn makes us an even greater resource to the citizens of Orange County. The ability to provide our volunteers a wider range of service opportunities will only serve to strengthen our organization. The first steps in this process have already been taken. SORS and OCES personnel are working together to craft an operational working agreement that is mutually beneficial. It is hoped that this operational agreement will be flexible and realistic in its goals. Frequent and regular review of this agreement should allow for refinement and expansion of the services provided as we move forward. With careful and thoughtful planning and development, the South Orange Rescue Squad will continue to grow and provide an ever-increasing scope and range of emergency services to the citizens of Orange County. We look forward to continuing a productive and cooperative partnership with OCES as we work together to achieve our mutual goal of excellence in community service. Best Regards, Fred Stipe, Chair SORS Board of Directors PO Box 128, Carrboro, NC 275{0-0128 ~ 919.967. ~5I5 ~ www.sorescue.org 31 32 ~'~ Semler Altus Muneris -Volunteers Since 1971 _ ~~`` , CC: Orange County Board Of Commissioners Orange County Manager Annette Moore SOBS Board of Directors PO Box 128, Carrboro, NC 27510-0128 ~ 9!9.467.1515 ~ www.sorescue.org 5 acceptance by the Grantee of the Franchise terms and conditions set forth herein. Section 2. Definitions The following words, terms and phrases, when used in this Franchise, shall have the meanings ascribed to them in this Section, except where the context clearly indicates a different meaning: a. Ambulance. The term "ambulance" means any privately or publicly owned motor vehicle, aircraft, or vessel that is specifically designed, constructed, or modified and equipped and is intended to be used for and is maintained or operated for the transportation on the streets or highways, waterways, or airways of this State of persons who are sick, injured, wounded, or otherwise incapacitated or helpless. b. Ambulance Provider. The term "ambulance provider" means an individual, firm, corporation, or association who engages or professes to engage in the business or services of transporting patients in an ambulance. c. Approved. The term "approved" shall mean approved by the North Carolina Medical Caze Commission pursuant to the latter's rules and regulations promulgated under N. C. Gen. Stat. § 143B-165. d. Advisory Committee or Committee. The term "Advisory Committee" or "Committee" shall mean the Orange County Emergency Medical Services Committee which is the technical advisory committee designated by the Boazd of County Commissioners with respect to emergency medical services in Orange County. e. Contract. The term "contract" shall mean the instrument by which both parties agree to the terms of operation of the service to be provided. f. Convalescent Transportation Services. The term "convalescent transportation service" shall mean the operation of an ambulance for any purpose other than transporting emergency or emergent patients. g. County. The term "County" .shall mean Orange County and its Board of Commissioners or their designated representative(s). h. Emergency. The term "emergency" or "emergency transportation services" shall mean the use of a service, its equipment and personnel to provide medical caze, rescue, and/or transportation of a patient who is in need of immediate rescue or medical treatment in order to prevent loss of Page 2 of 23 6 life or further aggravation of physiological or psychological illness or injury. i. Emergency Services System or ESS. Emergency Services System or "ESS" shall mean a coordinated arrangement of local resources under the authority of the Emergency Services Director (including all agencies, personnel, equipment, and facilities) organized to respond to medical emergencies and integrated with other health care providers and networks including public health, community health monitoring activities, and special needs populations. j. Emergency Medical Dispatcher or Telecommunicator. The term "emergency medical dispatcher" of "telecommunicator" shall mean an emergency telecommunicator who has completed educational requirements and been credentialed by the Department of Health and Human Services as an emergency medical dispatcher and who is available to receive requests for emergency .services, to dispatch emergency services, and to advise local law enforcement. agencies, fire departments, rescue squads, first or medical responder units and emergency medical services and facilities of any existing or threatened emergency. k. Emergency Medical Services. "Emergency Medical Services" or "EMS" means services rendered by emergency medical services personnel in responding to improve the health and wellness of the community and to address the individual's need for emergency medical care within the scope of practice as defined by the North Carolina Medical Board, in accordance with G.S. 143-514, and the Orange County Medical Duector in order to prevent loss of life or further aggravation of physiological or psychological illness or injury. 1. Emergency Medical Services Instructor. "Emergency Medical Services Instructor" means an individual who has completed educational requirements approved by the Department of Health and Human Services and has been credentialed by that Department as an emergency medical services instructor. m. Emergency Medical Services Peer Review Committee. Emergency Medical Service Peer Review Committee means a panel composed of EMS program representatives responsible for analyzing patient care data and outcome measures to evaluate .the ongoing quality of patient care, system performance, and medical direction within the EMS system. The committee may include physicians, nurses, EMS personnel, medical facility personnel and county government staff as determined by the Emergency Services Director in consultation with the County Medical Director. Page 3 of 23 7 n. Emergency Medical Technician (EMT). The term "emergency medical technician" means an individual who has completed a training program in emergency medical care that has been approved for legal recognition by the North Cazolina Department of Health and Human Services, in accordance with rules promulgated by the Medical Care Commission, has been certified as an EMT by the State of North Carolina Office of Emergency Medical Services, and approved by the County Medical Director to perform services as an EMT in the Orange County EMS system. o. Emergency Medical Technician -Intermediate (EMT-I). The term "emergency medical technician -intermediate" means an individual who has completed a training program in emergency medical care at the .intermediate. level that has been approved for legal recognition by the North Carolina Department of Health and Human Services, in accordance with rules promulgated by the Medical Caze Commission, has been certified as anEMT -Intermediate by the State of North Cazolina Office of Emergency Medical Services, and approved by the County Medical Director to perform services at the EMT-Intermediate level in the Orange County EMS system. p. Emergency Medical Technician - Pazamedic (EMT-P). The term "emergency medical technician -paramedic" means an individual who has completed a training program in emergency medical care at the paramedic level that has been approved for Legal recognition by the North Carolina Department of Health and Human Services, in accordance with roles promulgated by the Medical Care Commission, has been certified as an EMT-Paramedic by the State of North Cazolina. Office of Emergency Medical Services, and approved by the County Medical Director to perform services as anEMT-Paramedic in the Orange County EMS system. q, Emergency Services Director. The term shall mean the person designated by the Orange County Board of Commissioners to manage the overall Emergency Services System in Orange County. r. First Responder. The term "first responder" shall mean an organization with personnel trained in emergency medical care that is dispatched to the scene of a medical emergency for the primary purpose of providing emergency medical assistance to a patient until the ambulance and additional medical aid arrives. s. Franchise. The term "franchise" shall mean a permit issued by the County to a person for the operation of am ambulance service, rescue squad or first responder unit. Page 4 of 23 8 t. Franchisee. The term "franchisee" shall mean any person having been issued a franchise by the County for the operation of an ambulance service, rescue squad or first responder unit. u. Inspection. Inspection shall mean the physical review of buildings and facilities, vehicles, equipment, supplies, storage, repair and maintenance areas, records and any related materials. v. License. The term "license" shall mean any driver's license or permit to operate a motor vehicle issued under or granted by the laws of the State of North Cazolina. w. Medical Responder. "Medical Responder" shall mean an individual who has completed an educational program in emergency medical care and first aid approved and credentialed by the Department of Health and Human Services as a medical responder and the Orange County Medical Director to operate in Orange County EMS. x. Medical Director. "Medical Director" shall mean the physician appointed, either directly or by written delegation, by the County and have the responsibilities asprovide by lOA NCAC 13P .0403 and lOA NCAC 13P .0404. The County may, in addition, appoint an assistant medical director. The medical director and the assistant medical director shall meet the criteria defined in the "North Carolina College of Emergency Physicians: Standards of Medical Oversight and Data Collection," which is incorporated by reference in accordance with N.C. Gen. Stat. § 150B-21.6, including subsequent amendments and editions. y. Non-Emergency Transportation Services. The term "non-emergency transportation service" shall mean the operation of an ambulance for any purpose other than transporting emergency or emergent patients. z. Operation Protocols. "Operation Protocols" shall mean the administrative policies and procedures of EMS that provides guidance for the day-to-day operations of the system. aa. Operator. The term "operator" shall mean a person in actual physical control of an ambulance or rescue service vehicle which is in motion or which has the engine n~nning. bb. Owner. The term "owner" shall man any person or entity who owns an ambulance or provides a service covered by this Ordinance. cc. Patient. The term "patient" shall mean an individual who is sick, injured, wounded, or otherwise incapacitated or helpless such that the need for Page 5 of 23 9 some medical assistance might be anticipated while being transported to or from a medical facility. dd. Person. The term "person" shall mean any individual, firm, partnership, association, corporation, company, group of individuals acting together for a common purpose, or ,organization of any kind, including any governmental agency other than the United States. ee. Practical Examination. "Practical Examination means a test where an applicant for credentialing as an emergency medical technician, or medical responder, emergency medical technician -intermediate, or emergency medical technician -paramedic demonstrates the ability to perform specified emergency medical care skills. ff. Rescue. The term "rescue" .shall mean the removal of individuals facing external, non-medical, and non-patient related peril to areas of relative safety. gg. Rescue Squad or Rescue Unit. The term "rescue squad" or "rescue unit" shall mean a group of individuals who are not necessarily trained in emergency medical services, fire fighting, or law enforcement, but who expose themselves to an external, non-medical, and non-patient related peril to effect the removal of individuals facing the same type of peril to areas of relative safety. hh. Secondary Ambulance Provider. The term "secondary ambulance provider" shall -mean the system of personnel and equipment meeting the same criteria as a primary ambulance provider, but not normally dispatched on first call response. ii. Service. The term "service" shall mean the same as owner. jj. Treatment Protocols. "Treatment Protocols" shall mean a document approved by the medical director and the Office of Emergency Medical Service specifying the diagnostic procedures, treatment procedures, medication administration, and patient-care-related policies that shall be completed by emergency service personnel based upon the assessment of the patient. kk. Victim. The term "victim" shall mean any patient or potential patient that is entrapped, entangled pinned, fallen, suspended, or otherwise in need of rescue services. Section 4. General Responsibilities Page 6 of 23 10 a. Grantee is authorized under this Franchise to operate the following types of service(s), the combination of which shall constitute Grantee's "EMS Services for the purposes of this Franchise, and subcategories under which they can operate shall be identified in the "Operation Agreement" to be entered into by the Franchisee and the County within 90 days after acceptance of the Franchise permit. i. Emergency Services ii. Rescue Services c. Grantee shall comply at all times with the requirements of "An Ordinance Regulating Ambulance, Emergency Medical, First Responder And Rescue Service And Granting Of Franchise And Contracts To The Operator In The County Of Orange ("EMS Franchise Ordinance"), this Franchise Agreements, the Operations Agreement, and all applicable laws relating to health, sanitation, safety, equipment, ambulance design or other EMS Services vehicle design and all legal requirements related to a Model EMS System and all other laws and ordinance; a. Grantee shall maintain in good standing its state and local Drivers and Privilege license (s) to operate its ambulance or other EMS Services as provided for by Law. b. Establish and maintain appropriate and effective professional working relationships with all public health, public safety, and emergency services organization and personnel c. Professional working relationships shall be cooperative and collaborative in nature. d. Maintain neat, clean, and professional appearance of personnel, equipment and facilities. Section 5. Scope of Service and Service Area a. Grantee shall operate its EMS Services, 24 hours per each and every day of the calendaz yeaz, within the Franchise District specified in Exhibit A, except when a different or additional service area is provided for herein. b. Grantor may from time to time alter, and at its sole discretion, amend Exhibit A and the service area of the County that constitute (s) the Franchise District_ c. Grantor shall at all times during the terms of the Franchise provide the highest level of care to all residents within the service area of the Franchise District. Page 7 of 23 11 Section 6. The Orange County Emergency Services System ("ESS") Plan a. Grantee shall comply with the Grantor's official written ESS System Plan for the management and deployment of EMS Services Vehicles within the Franchise District and, additionally, within other service areas pursuant to the EMS System Mutual Aid Plan and any cooperative agreement to continue services in service areas where Franchisees' EMS System franchises has been suspended. b. Grantee shall keep at its place a business at all times the most current copy of the ESS System Plan. Section 7. Staffing and Performance Requirements a. Grantee shall comply with the scope of practice rules promulgated by the North Carolina Medical Boazd pursuant to law regarding the medical skills and medication that may be used by credentialed emergency medical services personnel at each level of patient care. b. Grantee shall comply with standard for drivers and attendants developed by the North Carolina Medical Care Commission as requirements for certification of emergency medical technicians pursuant to Iaw, rules and regulations promulgated by the Boazd of Medical Examiners for advanced life support technicians, which is incorporated in this subsection by reference. c. No staff of Grantee shall drive an ambulance vehicle, attend a patient, or permit an ambulance to be operated when transporting a patient within the County unless the driver holds a currently valid North Cazolina Drivers license and currently valid credentials as an EMT, EMT-I or EMT-P issued by the North Carolina Department of Health and Human Services, Office ~of Emergency Medical Services. Notwithstanding the foregoing, in an exceptional circumstance when an EMT, EMT-I, or EMT-P is not available, for the purpose of driving only or when providing Non- Transport Service an approved firefighter, First or Medical Responder, Rescue Services Provider or law enforcement officer with a currently valid North Carolina drivers license may drive an ambulance, provided such driver does not attend a patient or victim or does not otherwise provide medical services to a patient or victim. d. Grantee shall comply with the Grantor's off cial written EMS System Plan for the use of credentialed EMS personnel for all of the authorized Practice Settings. Any agreement between Grantee and a third party to provide special events coverage is subject to pre-approval in writing by the Grantor, which approval shall not be reasonable withheld. Page 8 of 23 12 e. Grantee's staff that operate EMS Service Vehicles shall actively participate in any emergency vehicle operations training provided by the Grantor as directed by the Emergency Services Director. f. Grantee's staff shall comply with Grantor's official written EMS System continuing education plan for EMS personnel under the direction of the Orange County Continuing Education Coordinator. g. Grantee staff shall also participate in all clinical and field internship educational components of Grantor's continuing education plan. h. Grantee shall comply with all education program requirements for qualified credentialed EMS personnel as provided by law. i. Grantee shall assign credentialed staff to assist, upon .request, with any orientation provided by Grantor to local area hospitals that routinely receive patients from Grantee. Section 8. Vehicle and Equipment Requirements a. Grantee shall comply with all vehicle and equipment standards as developed by the North Carolina Medical Care Commission pursuant to law, including without limitation, those applicable to the EMS Services. b. Grantee shall maintain for each ambulance and other EMS Services Vehicle a permit as provided for by law. c. Grantee shall comply with the state EMS Non-Transporting Vehicle Permit requirements. d. Grantee shall have available the following minimum_ _number of ambulances and other EMS Services Vehicles in excellent working order to provide coverage to the service area of the Franchise District 24 hours per day. One (1) Type 1 Ambulance, One (1) In Service Rescue Vehicles and other EMS Services Vehicles and equipment as necessary to provide the high quality of services provided for in this Franchise. e. Grantee shall comply with the Grantor's operational protocols for the management of equipment, supplies and medications to assure that each ambulance and other EMS Services Vehicle contains the required equipment and supplies on each response; for cleaning and maintaining the equipment and vehicles; and to assure that supplies and medications Page 9 of 23 13 are not used beyond the expiration date and stored in a temperature controlled atmosphere according to manufacturer's specifications. f. Grantee shall comply with the Orange County's written infection control policy including the cleansing and disinfecting of ambulances and other EMS Services Vehicles and equipment that are used to treat or transport patients. g. Grantor may, upon reasonable notice, inspect all equipment, ambulances and other EMS Service Vehicles used by Grantee. Section 9. Communications Requirement a. Grantee shall equip each ambulance and other EMS Services Vehicle with the following: i. An operational two-way radio capable of establishing good quality voice communications from with the geographical confines of Orange County to each hospital emergency department in the County in which the service is based; ii. Two-way radio communication capabilities for communication with all hospital emergency departments to which transportation of patients is made on a regular or routine basis anywhere within the State of North Cazolina; and iii. An operational .two-way radio capable of establishing communications from within the geographic confines of Orange County to the Orange County Emergency Communications Center, which is the dispatching agency within the County. b. This subsection shall not apply to privately owned vehicles of Grantee's . staff. c. Grantee shall maintain current authorization or Federal Commuzucation Commission licenses for all frequencies and radio transmitters operated by Grantee. Grantee shall display at Grantee's headquarters and make available for inspection per Federal Communication Commission's rules and regulations copies of all authorization and licenses. d. Grantee's base of operations shall have at least one open telephone 24 .hours per each and every day of the calendar year. Grantee's telephone numbers shall be registered with Orange County Emergency Communication Center, and changes to Grantee's telephone numbers shall be transmitted to the Emergency Communication Center within 24 hours of such change. Page 10 of 23 14 e. Grantee's EMS Services shall be dispatched from the Orange County Emergency Communications Center. Section 10. Data Collection and Performance Report a. Grantee shall maintain the following records: i. Records of dispatch which shall show time call was received, time dispatched, time arrived on scene, time arrived at destination, time in service, and time returned to base. ii. Trip Records stating all information required in subsection (i) of this Section in addition to information on a form approved by the County. The trip record shall be so designed as to provide the patient with a copy containing all required information. iii. Personnel Checklist and Inspection Report listing contents and description for each vehicle, signed by the individual verifying vehicle operations and equipment. iv. A detailed record of complaints received from the public, other enforcing agencies and services regarding Franchise infractions. v. Any other records required by state law, rules or regulations or J deemed by the Department of Emergency Service as relevant to the effective and efficient operations of the Emergency Management System as provided in the "Operations Agreement" and necessary for a fair determination of the capability of the Grantee to continue to provide Emergency Medical Services and Rescue Services in Orange County in accordance with the requirement of law and the provision of this Franchise. b. All of the records identified in subsection (a) above shall be maintained for a minimum three (3) year period unless a longer retention period is otherwise required by law or other retention periods. Grantee shall establish and maintain a system to record data that used the Model Data set and data. dictionary as specified in "North Carolina College of Emergency Physicians: Standards for Medical Oversight and Data Collection." d. Grantees shall maintain confidentiality of patient records as provided by the Health Insurance Portability and Accountability -Act of 1996 (HIPAA), Public Law 104-191, N.C. Gen. Stat. 143-518 and all other state and federal law. Page 11 of 23 15 e. Grantee shall submit a written monthly report to the Emergency Services Director, or their designee, providing the number of calls and runs during the month. The report shall contain the number of emergency calls, the number of convalescent calls, the total number of calls and the total number of patients transported. f. Grantee may inspect Grantee's records at any time in order to ensure compliance with the EMS Franchise Ordinance and this Franchise Agreement; however, Grantor's shall inspect the Grantee's records at least once a year to ensure compliance with the EMS Franchise Ordinance and this Franchise Agreement. Section 11. Medical Oversight a. Grantee shall designate a representative of Grantee to attend and participate in regular meetings of the Orange County EMS Peer Review Committee. b. Grantee shall monitor and comply with any online medical direction for operating within EMT-P systems. c. Grantee shall comply with the Grantor's plan for Medical Oversight and Written Treatment Protocols. d. Grantee shall comply with the Grantor's written plan to address the management of the EMS System including: i. the triage of patients to appropriate facilities; ii. transport of patients to facilities outside of the system; iii. Arrangement for transporting patients to appropriate facilities when diversion or bypass plans are activated; iv. A mechanism for reporting, monitoring and establishing standards for system response times; v. A special events staffing plan; vi. A disaster plan; and vii. Mass gathering plan. e. Grantee shall comply with the Medical Director's written guidance regarding decision about the equipment, medical supplies, and Page 12 of 23 16 medications that will be carried on any ambulance or other EMS Services Vehicle. f. The Medical Director may suspend temporarily, pending due process review by the EMS Peer Review Committee, any of Grantee's EMS personnel from further participation in the EMS system when the Medical Director determines that the activities or medical care rendered by such personnel may be detrimental to the care of the patient, constitute unprofessional behavior or results in non-compliance with credentialing requirements. Section 12. Rates and Adjustments a. Grantee shall submit a schedule of rates to the Grantor for approval and shall not chazge more nor less than the authorized rates without specific authorization from the Grantor. b. Grantee shall not attempt to collect rates on emergency call until the patient has reached the point of destination, has received medical attention and is in a condition deemed by the physician fit to consult with the service; but Grantee may attempt to collect rates with family or guardian of the patient once the patient is in the process of receiving medical attention. c. On Special Event coverage and convalescent calls, Grantee may attempt to collect payment before the ambulance or other EMS Services Vehicle begins its trip. Section 13. Insurance a. Within thirty. (30) calendaz days after the effective date of issuance of the Franchise, the Grantee shall provide proof of the required insurance. Grantee shall at all times during the Franchise term maintain in force and effect insurance coverage, issued by an insurance company licensed to do business in North Cazolina, covering the following: i. Every ambulance or other EMS Services Vehicle owned and/or operated by or for the Grantee proving for the following payment of injury and damages: (a) In the minimum sum of $1,000,000 for injury to or death of individuals in accidents resulting from any cause for which the owner of the vehicle would be liable on account of liability imposed on him by law, regardless of whether the vehicle was being driven by the owner of his agent; and Page 13 of 23 17 (b) In the minimum sum of $1,000,000 for the loss of or damage to the property of another, including personal property, or under like circumstances in sums as may be required by the State of North Carolina or as authorized by the Grantor. (c) The insurance coverage minimum limits required in subsection (a) and (b) above shall be evaluated annually by the Orange County Department of Emergency Services in consultation with the Orange County Risk Manager and the County Attorney's Office and may be revised by the Grantor as Grantor deems appropriate, and at Grantor's sole discretion. In directing a change in insurance coverage, the Department of Emergency Services shall consider the risk needs protected by this insurance coverage and the availability in the marketplace of the coverage amounts to be required. ii. Grantee shall at all times during the Franchise term maintain in force and effect insurance coverage, issued by an insurance company licensed to do business in North Carolina for Worker's Compensation coverage for all employees with statutory limits in compliance with applicable law. b. Insurance coverage necessary to comply with this Section shall be approved by the Grantor, and copies of such insurance policies (or certificates of insurance) shall be provided to the Grantor. c. The Grantor shall be named as an additional insured as its interests may appear. Section 14. Transfer of Ownership or Control and Changes in Level of Services a. Prior approval of the Grantor shall be required where ownership or control of more than ten percent of the right or control of the Grantee is acquired by a person or group of persons acting in convert, not of whom own or control ten percent or more of such rights of control, singularly or collectively, at the date of the grant of the Franchise. By its acceptance of the Franchise, the Grantee specifically. agrees that any such acquisition occurring without prior. approval of the Grantor shall constitute a violation of the Franchise by the grantee and shall be cause for termination at the option of-the Grantor. b. Any change in ownership of Grantee without the approval of the Grantor shall terminate the Franchise and shall require a new application and a new Franchise in conformance with all the requirements of the EMS Franchise Ordinance, as amended and in effect at the time of franchising. Page 14 of 23 18 c. Any change in the level of services offered by a Grantee's EMS Services unit without the approval of the Grantor shall terminate the Franchise and shall require a new application and a new franchise in conformance with all the requirements of the EMS Franchise Ordinance, as amended and in effect at the time of franchising. d. Grantee may not sell, assign, mortgage or otherwise the transfer the Franchise without the approval of the Grantor; if the Grantor sells, assigns, mortgages or otherwise transfer the Franchise without Grantor's approval this shall terminate the Franchise and require a new application and a new Franchise' in conformance with all the requirements of the EMS Franchise Ordinance, as amended and in effect at the time of franchising. Section 15. Miscellaneous Provisions a. Grantor may, upon reasonable notice, inspect the premises, vehicles, equipment and personnel of Grantee to ensure compliance with this Franchise and perform any other inspections that may be required. b. Grantee shall make available for inspection by the State of North Carolina, the Grantor, or their designated representatives, Grantee's EMS Services, its equipment and the premises designated in the application and all records relating to its maintenance and operations as such. c. Grantee shall cooperate with the Grantor to educate the public concerning injury prevention and community health. d. Grantee's staff shall not wear or carry aboard any ambulance of other EMS Services Vehicles firearms or weapons as defined by law, which does not include tools that aid in providing services. The foregoing restriction shall not be construed to apply to equipment used by Grantee to provide EMS Services. e. Grantee shall post its Franchise Certificate, issued to it by the Grantor, in a readily visible location at the Grantee's base of operations for the EMS Service. f. Grantee shall not allow its Franchise Certificate to be defaced, removed, or obliterated. g. Grantee .shall comply with all applicable law and Grantor's policies and procedures related to confidentiality of medical information, including without limitation the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Page 15 of 23 19 Section 16. Termination Provisions a. Grantee may terminate this Franchise with 60 days written notice to Grantor and the Grantor may revoke the Franchise in the event of noncompliance with the provisions of the EMS Ordinance or this Franchise Agreement. After a notice of services termination is given, the Grantee may reapply for a franchise if a continued service is desired. b. Upon suspension, revocation, termination or a stay by the Emergency Services Director of this Franchise, Grantee shall immediately cease all operations authorized by this Franchise. c. Upon suspension, revocation, termination of a driver's license such person shall cease to dive an ambulance or other EMS Service Vehicle. Upon suspension, revocation or termination of an attendant's certificate (i.e., Medical Responder, EMT, EMT-I or EMT-P) by the Office of Emergency Medical Services or by the Medical Director, such person shall cease to attend patients or otherwise provide medical care. Grantee shall not permit the foregoing person to drive an ambulance or their EMS Service Vehicle or provide medical care in conjunction with EMS Services, if Grantee is found to have notice of or should have had notice of such suspension, revocation or termination at the sole discretion of the Grantor this shall terminate the Franchise and shall require a new application and a new Franchise in conformance with all the requirements of the EMS Franchise Ordinance, as amended and in effect at the time of franchising. d. In the event that Grantee shall at any time during the Franchise desire to sell any of the real or personal property identified in Exhibit B (hereinafter "Asset" or "Assets"), which is hereby incorporated by reference, pursuant to a bona fide offer to a bona fide offer which it shall have received, it shall offer to sell any such Asset or Assets (hereafter "Asset or Assets for Sale) to Grantor at the same process as that contained in such bona fide offer. The offer to Grantor to sell an Asset shall be in writing and shall include a copy of the bona fide offer. The offer to Grantor to ell an Asset shall be in writing and .shall include a copy of the bona fide offer for the Asset received by the Grantee. Grantor shall have 60 days from and after receipt. thereof to decide whether or not to purchase the Asset or Assets for Sale at such prove. If Grantor shall give notice of intent not to purchase or shall give no notice within the time herein limited, Grantee may .accept such offer and proceed with the sale thereunder. If Grantor notif es Grantee that it elects to purchase the Asset or Assets for Sale at such prove, the parties shall enter into a contract of purchase and sale forthwith. Such contract shall provide, among other things, for the conveyance of good and marketable title b warranty deed. Upon dissolution of the Grantee pursuant to N.C. Gen. Stat. § SSA-14-1, et seq., the Assets shall be either: (a) distributed to one or more appropriately receiving successor Page 16 of 23 20 Franchisee (s) that will carry on, In Orange County, the functions of ambulance, first or medical responder, rescue or other related emergency services meeting one or more- exempt purposes within the meaning of 501(c)(3) of the Internal Revenue code (or the corresponding section of any future federal tax code) or (b) distributed to the grantor for the foregoing public purposes. This subsection 16(d) of this EMS Service Franchise survives the termination of the Franchise. Section 17. Forum for Litigation Any litigation between the Grantor and Grantee azising under or regarding the Franchise shall occur, if in the North Carolina courts, in Orange County Superior Court or District Court having jurisdiction thereof, or if in the federal courts, in the United States District Court for the Middle District of North Carolina. Section 18. Notice Any notice provided for under the Franchise shall be sufficient if in writing and delivered personally to the following address or deposited in the United States Mail, postage, prepaid, certified mail, return receipt requested, addressed as follows, or to such other address as the receiving party hereafter shall specify in writing: If to the Grantor: Orange County Emergency Services Post Office Box 8181 Hillsborough, North Carolina 27278 Attn: Emergency Services Director (919) 245-6100 If to the Grantee: Chair, Board of Directors South Orange Rescue Squad, Inc. Post Office Box 128 Carrboro, North Carolina 27510-0128 (919) 967-1515 Section 19. Severability If any Section, subsection, sentence. Clause, phrase, or :other portion of this Franchise is, for any reason, declared invalid, in whole or in part, by any court, agency, commission, legislative body, or other authority of competent jurisdiction, such portion shall be deemed a sepazate, distinct and independent portion. Such declaration shall not affect the validity of the remaining portions hereof, which other portions shall continue in full force and effect. Page 17 of 23 21 Section 20. Reservation of Rights Notwithstanding any other provision of the Franchise, Grantor and Grantee reserve all rights that they may possess under the law unless expressly waived herein. Nothing herein shall constitute a waiver of rights of either parry, provided, however, that both parties warrant and represent that, as of the effective date of the Franchise, they are not aware of any provision in the Franchise that is contrary to applicable law. Section 21. Penalties and Remedies a. A violation of any provision of this Franchise Ordinance or other failure of the Grantee to abide by~ the provisions of this Franchise shall subject the Grantee to a civil penalty of five hundred ($500) dollars. If Grantee fails to pay this penalty within ten (10) days after being cited for a violation, the Grantor may seek to recover the penalty by filing a civil action in the nature of a debt. b. A violation of any provision of this Franchise Ordinance by the Grantee shall constitute a misdemeanor, punishable as provided in N.C. Gen. Stat. § 14-4. c. The Grantor may seek to enforce this Franchise Ordinance through any appropriate equitable action. d. Each day that a violation continues of this Franchise Ordinance after the Grantee has been notified of the violation shall constitute a separate offense. e. The Grantor may seek to enforce this Franchise Ordinance by using any one or any combination of the foregoing remedies. Section 22. Non-discrimination The Grantee shall not discriminate in any manner on the basis or factors prohibited by law. Section 23. Acceptance by Grantee This Franchise and all of its terms and provisions shall be accepted by Grantee in writing in the form hereinafter set forth within thirty (30) days of the grant of this Franchise by the Grantor and when accepted shall be filed with Grantor's Clerk who shall record the same in the Book of Ordinances. Such written acceptance may be upon or at the end of a copy of this Franchise Ordinance and it shall state and express the acceptance of said Franchise and its terms, conditions Page 18 of 23 22 and provisions; and Grantee shall agree in said written acceptance to abide by, to observe and to perform the same according to all of its terms and provisions, subject to applicable state and federal law and shall declare that statements and recitals contained on said Franchise are correct and that it has made and does make the agreements and statements set forth in this Franchise. Acceptance herein referred to shall be in the following form: The undersigned, in his/her capacity as of the South Orange Rescue Squad, Inc., Inc. and on behalf of that agency, does hereby accept and approve the. foregoing and attached Franchise and all of its terms and conditions; and in consideration of the benefits and privileges granted to it does hereby agree to abide by, carry out, observe and perform all of the obligations and things provided to be carried out and performed by it in said Franchise approved by the Grantor Commissioners, subject to applicable state and federal law. This the day of , 2010 FOR GRANTEE: Printed Name and Title STATE OF NORTH CAROLINA COUNTY OF ORANGE On the _ day of , 2010 before me a Notary State aforesaid, Personally appeared before me behalf of said agency, acknowledges the signing and execution of the foregoing instrument. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed by notarial seal ~ori the day and year above written. Notary Public My Commission Expires: IN WITNESS WHEREOF, this South Orange Rescue Squad, Inc. Franchise Ordinance passed on First Reading on the day of March 2010 and was passed and adopted on Second Reading this the _ day of , 2010. Public for the County and on Page 19 of 23 23 Valerie P. Foushee, Chair Orange County Board of Commissioners ATTEST: Donna Baker, Clerk to the Orange County Board of Commissioners APPROVED AS TO FORM: Annette M. Moore, Staff Attorney Orange County Attorney's Office Page 20 of 23 24 ACCEPTANCE BY GRANTEE: This Franchise and all of its terms and provisions shall be accepted by Grantee in writing in the form hereinafter set forth within thirty (30) days of the grant of this Franchise by the Grantor and when accepted shall be filed with Grantor's Clerk who shall record the same in the Book of Ordinances. Such written acceptance may be upon or at the end of a copy of this Franchise Ordinance and it shall state and express the acceptance of said Franchise and its terms, conditions and provisions; and Grantee shall agree in said written acceptance to abide by, to observe and to perform the same according to all of its terms and provisions, subject to applicable state and federal law and shall declare that statements and recitals contained on said Franchise are correct and that it has made and does make the agreements and statements set forth in this Franchise. Acceptance herein referred to shall be in the following form: The undersigned, in _ his/her capacity as of the South Orange Rescue Squad, Inc., Inc. and on behalf of that agency, does hereby accept and approve the foregoing and attached Franchise and all of its terms and conditions; and in consideration of the benefits and privileges granted to it does hereby agree to abide by, carry out, observe and perform all of the obligations and things provided to be carried out and performed by it in said Franchise approved by the Grantor Commissioners, subject to applicable state and federal law. This the day of , 2010 FOR GRANTEE: Printed Name and Title STATE OF NORTH CAROLIlVA COUNTY OF ORANGE On the _ day of , 2010 before me a Notary Public for the County and State aforesaid, Personally appeazed before me on behalf of said agency, acknowledges the signing and execution of the foregoing instrument. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed by notarial seal on the day and year above written. Notary Public My Commission Expires: Page 21 of 23 25 EXHIBIT A TO EMS SERVICES FRANCHISE FOR TECHNICAL RESCUE SERVICES, INC., A NORTH CAROLINA NON-PROFIT CORPORATION FRANCHISE DISTRICT Geographic Location: All of the County of Orange Page 22 of 23 26 EXHIBTT B TO EMS SERVICES FRANCHISE FOR TECHNICAL RESCUE SERVICES, INC., A NORTH CAROLINA NON-PROFIT CORPORATION ASSETS Real Estate and Improvements Address 202 Roberson Street, Chapel Hill 2. Personal Property Tune 1261 Ambulance [fully outfitted] 1262 Ambulance [fully outfitted] Clampett [Rescue Truck, fully outfitted] Other Rescue Truck [pickup] Rescue Van/TRT Mobile Command Post [w/ equipment) Gator Trailer and Gator Boats and Motors Confined Space Trailer and Equipment Miscellaneous Other Equipment [radios, repeater, licenses, CPR equipment, etc.] Estimated Property Value $ 900K [estimated market value of property only; value of building structure is undetermined] *Estimated Replacement Value (as of January 1, 2010) $95,000 $135,000 $80,000 $40,000 $100,000 $40,000 $20,000 $50,000 $250,000 Page 23 of 23 27 '''~ Semler A~itus Muneris - Volunteers Since 1971 ~~ Date; January 19, 2010 To: Col. Frank Montes de Oca, Director, Orange County Emergency Seiwices; Valerie Foushee, Chair, Orange County Board of Commissioners; Bernadette Pelissier, Vice-Chair; Alice Gordan; Pam Hemminger; Ba,~ry Jacobs; Mike Nelson; Steve Yuhasz. Greetings: By this letter, The South Orange Rescue Squad formally applies for an operational franchise to provide ambulance and rescue services to the citizen's of Orange County through the Orange County Deparhnent of Emergency Services and the Orange County Board of Commissioners. Specifically, South Orange Rescue Squad is applying for a franchise to provide: Technical Rescue Response [High Angle rescue, Swiftwater rescue, Confined Space Rescue] Special Event EMS and Ambulance Service Regularly-Scheduled EMS and Ambulance Service "Surge" EMS/Ambulance Service These services will be dispatched through Orange County 911 Communications and will be integrated into and will augment and support emergency services provided by Orange County Emergency Services [OCES] to help meet county-wide response needs. The South Orange Rescue Squad [SOBS] has been providing all-volunteer emergency EMS and rescue services to the citizens of Orange County since 1971. Until June 2009, SOBS had provided regularly scheduled, 3-day, 12 hour per day EMS and Ambulance service to The University of North Carolina and the surrounding Chapel Hill, Caxrboro, and southern Orange County area to augment the Orange County EMS System. SOBS currently provides "Surge" EMS and Ambulance service to OCES during times of overload to the County's resources. SOBS currently provides EMS and Ambulance service for fire or other Iarge incident "Rehab and Support" whenever requested by OCES or any fire depaztment or law enforcement agency . within Orange County. PO Box 128, Carrboro, NC 27510-0128 (919.967.1515 ~ www.saresecue.org 28 ~` .~ Semper Aptus Muneris -Volunteers Since !97! ~~ SORS currently loans its ambulances and equipment to the County during times when County vehicles are out-of-service or otherwise "off-line". SORS currently provides Technical Rescue services for county-wide response whenever requested through OCES 9I 1. SORS currently provides Technical Rescue Services by contract to the University of North Carolina Department of Energy Services. SORS currently provides Technical Rescue Services by contract with the Orange Water and Sewer Authority. SORS currently provides Special Event EMS and Ambulance Service by contract to The University of North Carolina Department of Athletics [UNC home football games, basketball games, track events, NCAA Championship events and NCHSAA High School Football and Basketball Championship events]. SORS currently provides Special Event EMS and Ambulance Service to the Town of Chapel Hill [Annual Halloween coverage, Sheet Fairs, Festivals, spontaneous UNC Basketball street celebrations, road races, bike races and triathlons]. SOBS currently provides Special Event EMS and Ambulance Services for coverage of Chapel Hill / Carrboro City School System High School Football games. SORS currently provides CPR and AED training and certification to citizens and groups in Orange County at no charge. As an all-volunteer, 501-(C)-3 Non-Profit organization, SORS owns it's own fleet of Ambulance and Rescue vehicles. We train all of our volunteers to the applicable local,. state, or national standard [or higher]. We maintain our own insurance for our volunteers. South Orange Rescue Squad has been meeting and working closely with the Director of OCES, Col. Frank Montes de Oca, to examine ways that the volunteers and resources of the South Orange Rescue Squad can be positioned and utilized within the Larger goal of EMS and Rescue service to all of the citizen's of Orange County. Due to its all-volunteer nature, SORS already provides a tremendous benefrt to the citizens of Orange County, since it does not receive any tax-supported revenue.. SORS is extremely interested in providing cooperative and integrated EMS and Rescue Services along side OCES, while still retaining it's integrity and identity as a locally based, all-volunteer organization. PO Box 128, Carrboro, NC 2751.0-0128 ~ 919.967.1515 ~ www.soresecue.org 29 ~1` , . •'• N~©~J 11 U tl Sem er Aptus Muneris -Volunteers Since 1971 There is, demonstrably, a significant County-wide need for the services, resources, and capabilities of a volunteer EMS and Rescue Squad. The South Orange Rescue Squad is ready, willing and able to meet that need. We understand that the initial review of this application will he through the Department of Emergency Services and we look forward to continuing our conversations with the appropriate individuals to refine the details of our working agreement. We are in the process of putting together the paperwork that is required to support this application and anticipate having it to the Department in the very near future. We are anxious to move ahead with the process and get started in implementing the operational details required to allow South Orange Rescue Squad the opportunity to provide these vital services to the citizens of Orange County. Respectfully Submitted, Fred Stipe, Chairman atthew Mauzy, Chief SORS Board of Directors SORS cc: Annette Moore SORS Board of Directors ®p ~ ll V~~ ~~~~~JL~ ~~LJII~~ PO Box 128, Carr6oro, NC 27510-0128 ~ 919.967.1515 ~ www.soresecue.org 30 __._ ~. ~~F Semler Altus Muneris -Volunteers Since 1971 February 22, 2010 Dear Col. Montes de Oca: The.South Orange Rescue Squad is extremely excited at the prospect of continuing to move forward in partnership with Orange County Emergency Services and we hope that the issuance of Ambulance and Rescue franchises will be relatively straightforward and expeditious. SORS is willing and committed to develop a practical working agreement with OCES that spells out the operational details that will allow us to continue to provide the high level of service and response that we have to date. Our immediate goal is to develop a reasonable and achievable framework of services that will benefit the citizens of the entire county and provide SORS with the flexibility and opportunity to grow and expand our operational capabilities over time. SORS looks forward to working with OCES to continue to provide: • Supplemental "Surge" EMS and ambulance transport whenever requested by OCES, throughout the entirety of Orange County. SORS will continue to support OCES with both equipment and personnel during times of need. EMS and ambulance coverage for Special Events. SORS has been the long-term provider for the LTNC Department of Athletics and also provides coverage of other local events such as high school football games, road races, triathlons, and track meets. SOR5 has also provided many years of supplemental EMS and ambulance coverage for Town of Chapel Hill events such as Halloween, Fourth of July Fireworks, street fairs and "spontaneous" [usually basketball-related] celebrations on Franklin Street. Fire and large incident rehabilitation and support for volunteer and municipal fire departments whenever requested by OCES, throughout the entirety of Orange County. Providing hydration and physical checks can be crucial elements of firefighter safety and support. • Technical Rescue Services in the areas of High-Angle, Swiftwater, and Confined-Space rescue. SORS has been along-term provider of technical rescue awareness, training and rescue support for the Orange Water & Sewer Authority and the UNC Department of Energy Services. SOBS also provides state wide and regional technical rescue assistance whenever it is needed. • Regularly scheduled EMS and ambulance coverage to augment OCES resources county wide. SORS has historically provided scheduled EMS and ambulance support in PO Box 128, Carr6oro, NC 27510-0128 ~ 919.967.1515 ~ www.sorescue.org 31 ,... ~... "~ ~Y` ~ Semler Altus Muneris -Volunteers Since 1971 the University of North Cazolina/Chapel Hi1UCarrboro regions of southern Orange County. SORS strongly desires to continue to provide this locally based service in its core volunteer area, but also desires to expand EMS and ambulance support to serve the citizens of the entire county. A locally based program helps with recruiting and training and an expanded coverage area provides a greater exposure of emergency response needs and experience for our volunteers. The South Orange Rescue Squad is dedicated to the provision of the highest levels of emergency service and response. We train our volunteers to meet or exceed all applicable standards across all azeas of service. SORS is [and has always been] financially sound and well managed. We own all of our equipment and have an absolute minimum of outstanding debt. We own the property and the building that serves as our stationhouse and it is debt-free. Over the years, we have developed a remarkable inventory of physical assets and trained volunteers that can be brought to bear when situations warrant. As anall-volunteer organization, SORS strongly desires to grow and expand our organization as well as our services and personnel resources. As we grow and develop, we hope to then be able to expand our functional capabilities, which in turn makes us an even greater resource to the citizens of Orange County. The ability to provide our volunteers a wider range of service opportunities will only serve to strengthen our organization. The first steps in this process have akeady been taken. SORS and OCES personnel are working together to craft an operational working agreement that is mutually beneficial. It is hoped that this operational agreement will be flexible and realistic in its goals. Frequent and regulaz review of this agreement should allow for refinement and expansion of the services provided as we move forward. With careful and thoughtful planning and development, the South Orange Rescue Squad will continue to grow and provide anever-increasing scope and range of emergency services to the citizens of Orange County. We look forward to continuing a productive and cooperative partnership with OCES as we work together to achieve our mutual goal of excellence in community service. Best Regards, Fred Stipe, Chair SORS Board of Directors PO Box 128, Carrboro, NC 2751 Q-0128 ~ 919.967.1515 ~ www sorescue.org 32 . . '~~ ~ Semper Aptus Muneris -Volunteers Since 1971 CC: Orange County Board Of Commissioners Orange County Manager Annette Moore SOBS Board of Directors PO Box 128, Carrboro, IVC 27510-0128 ~ 9!9.967.1515 ~ www.sorescue.org rJw~ 7. Regular Agenda a. First Reading: South Orange Rescue Squad Inc. Emeraency Services Franchise Ordinance The Board considered approving the First Reading of a Franchise Ordinance to grant a permit to South Orange Rescue Squad, Inc. for Emergency Medical and Rescue Services. Emergency Services Director Frank Montes de Oca summarized this item. Staff Attorney Annette Moore said that in order to adopt and grant a permit for ambulance services, the County must hold a public hearing. In order to grant a franchise, it must be by ordinance and it may not be adopted until it has passed at two regular meetings. On February 2"d, a public hearing was held on the need for ambulance service and the Board did find the need to adopt such an ordinance. At the February 2"d meeting, the Board asked that the staff work further with South Orange Rescue Squad and it has done so. South Orange Rescue Squad has submitted all documents outlining its capabilities. Emergency Services has conducted a review of the documents and worked with the applicant to complete all necessary documentation. Frank Montes de Oca said that the recommendation is that the Board grant on first reading a franchise for five-year terms to South Orange Rescue Squad, Inc., for Emergency Medical Services and Rescue Services. PUBLIC COMMENT: Ray de Friess has been a member of SORS since 1971. He said that SORS has always had a good working relationship with the .County and the goal is to provide good service. He said that this service is needed in Orange County. Matthew Mauzy is the Chief of SORS. He gave some of his history with the rescue squad. He said that SORS has trained hundreds of swift water rescuers from across the state. He said that the leadership opportunities have allowed him to face numerous challenges in his professional career. He said that he looks forward to the opportunity to partner on an expanded basis with Orange County Emergency Services. Ally Edmundson is the Assistant Chief of the Technical Rescue Team with SORS. She gave her history with the squad. She does rescue and technical rescue. She said that South Orange is different in that they provide both EMS and highly specialized rescue services to the community and the state. She said that SORS also employs the same number of women as men. She is a swift water rescue instructor as well. Through her service with SORS, she decided to obtain a Master's in Nursing and now works as a nurse practitioner at Wake Med. She continues to volunteer with SORS because she loves it. Bill Waddell is a lifetime resident of Orange County. He joined SORS in 1993. He said that he and his wife serve on .the squad. He takes enormous pride in serving the people of Orange County. He has seen many people come through SORS and become doctors, nurses, police officers, PAs, soldiers, etc. He thinks that Orange County should be extremely proud of SORS and the contributions that it has made to the County for 40 years. Fred Stipe is a lifelong resident of Orange County. He has worked with the squad since the late 1980's. He is a member of the Board of Directors and has been the Chair for the last 4 years. He extended thanks to Annette Moore for her legal. guidance through this process. He also thanked Frank Montes de Oca, Frank Clifton, and the Board of County Commissioners. A motion was made by Commissioner Nelson, seconded by Commissioner Pelissier to: - Approve the First Reading of a Franchise Ordinance to grant on first reading a franchise for five-year terms to South Orange Rescue Squad, Inc. for Emergency Medical Services and Rescue Services; s7 - Direct staff to discuss and enter into an Operations Agreement with South Orange Rescue Squad within 90 days that identifies the subcategories under which SORS will be permitted to operate based on the needs of the County and the capacity and capabilities of SORS and to provide for the daily operational functions of SORS as it works within the Orange County Emergency Services System; and - Authorize the Emergency Services Director to negotiate the Agreement with SORS and the County Manager to sign the Agreement subject to review by the County Attorney or other legal staff. Franchise Ordinance approval is conditional upon successful completion of the operational agreement within 90 days of acceptance of the Franchise Ordinance by the SORS. VOTE: UNANIMOUS 8. Reports a. Acceptance of the County Master Aaing Annual Report for 2009 and 2010 Priorities The Board considered accepting the Orange County Master Aging Plan Annual Progress Report for 2009 and approving the priorities for 2010. Steve Lackey, Chair of the Advisory Board on Aging, presented this progress report. Commissioner Hemminger asked about the concept plan for expanding the wellness program and Steve Lackey said that the advisory board is proposing to develop a concept plan to see what an expansion would be like. He said that the Seymour Center Wellness Center is not adequate for their needs. The goal is to see how much it would cost to expand, and if all like it, then they would move forward with the plan. Commissioner Gordon said that in the recommendations the advisory board was looking at options that did not cost the County money. Commissioner Jacobs asked about when the Unified Development Ordinance is being developed and if some of these aging in place standards would be addressed. Craig Benedict said that where there are easy fixes, they will be able to address them. If there are more complex fixes, a placeholder will be put in the UDO. Commissioner Jacobs said that a lot of the same standards would apply to physically- disabled people. He hopes that this community will be involved as well. He made reference to page 21 and the legislative forum and advocacy issues. He said that it would be useful to have a one paragraph explanation of the penalty on married couples. Commissioner Jacobs said that, in reading through the whole document, it would be nice to get a report on how the senior centers are performing based on what was projected. Regarding the discussion on page 8 about planning the East/West public route from Mebane to Durham that would intersect the 420 route, Commissioner Jacobs said that he would like to ask the Chair/Vice-Chair/Manager to have a joint meeting with the Mebane City Council because there are so many issues in common. A motion was made by Commissioner Jacobs, seconded by Commissioner Yuhasz to ask the Chair, Vice-Chair, and the Manager to work on meeting with the Mebane City Council on common issues. VOTE: UNANMOUS Commissioner Pelissier made reference to page 21 and exploring the potential for collaboration of the Department on Aging and Department of Social Services. She is very pleased to see this and she hopes that this can be done elsewhere. She would like to know the outcome of this. 4~/7 /V /°~/O'~ ~~ ~~Q~`G'~P~ ~~ _fla °- 1 ~ ` ~~ or in an amount which would be modified in direct proportion to the amount actually received, and authorized the Manager to sign the agreement. e. Lease Renewal -High Rock Solid Waste Convenience Center The Board approved the lease renewal for the period of July 27, 2010 through July 26, 2015 at a monthly cost based on the escalator clause of the initial lease and authorized the Chair to sign the renewal agreement on behalf of the Board. f. NC State Firemen's and Rescue Sauad Annual Certification Roster The Board approved the certification requirements fro the life safety branch manager and staff to participate in the North Carolina State Firemen's Association for the year 2010 and authorized the Chair to sign. ~ Second Reading: South Orange Rescue Squad Inc Emergency Services Franchise Ordinance The Board granted on Second Reading a franchise by ordinance for five year terms to South Orange Rescue Squad, In. for Emergency Medical Basic Life Support and Rescue Services; authorized the Chair to sign the Franchise Ordinance; directed staff to discuss and enter into an Operations Agreement with South Orange Rescue Squad within 90 days that identifies the subcategories under which SORS will be permitted to operate the Emergency Medical Basic Life Support and Rescue Services Franchise based on the needs of the County and the capacity and capabilities of SORS as well as to provide for the Daily operational functions of SORS as it works within the Orange County Emergency Services System; and after the Emergency Services Director negotiates the Operations Agreement with SORS, authorize the County Manager to sign the Agreement subject to review by the County Attorney or his staff. The granting of the Franchise Ordinance is conditional upon successful completion of the Operations Agreement within 90 days of acceptance of the Franchise Ordinance by the SORS. h. Fiscal Year 2009-10 Budget Amendment #8 The Board approved budget and capital project ordinance amendments for fiscal year 2009-10 for Department of Social Services, Library Services, Conservation Easements Capital Project Ordinance, and Technical Amendment. i. Retirement Incentive Proqram The. Board approved the offering of an additional Retirement Incentive Program for FY 09-10 to reduce the number of positions in the County prior to July 1, 2010 for employees who have been employed by Orange County for 10 or more years and are eligible to retire under the NC Local Governmental Employees Retirement System. L Boards/Commissions/Task Forces to be Dissolved The Board approved the dissolved list of boards, commissions, and task forces which are no longer active because their charge has been completed. VOTE ON CONSENT AGENDA: UNANIMOUS 5. Items Removed From Consent Agenda -NONE 6. Public Hearings a. North Carolina Community Transportation Proqram (CTP) Administrative and Capital Grant Application for FY 2010/2011 The Board conducted an annual public hearing on the North Carolina Community Transportation Program grant application by Orange Public Transportation for FY 2010-2011, and considered approving the grant application that includes adopting a resolution authorizing the applicant to enter into an agreement with North Carolina Department of Transportation, and authorizing the County Attorney to complete the necessary certifications and assurances and authorizing the Chair to sign.