HomeMy WebLinkAboutAgenda - 09-17-1996 - 8b •
4
1
Orange County
Board of Commissioners
Action Agenda Item Abstract
Date: September 17, 1996
Action Agenda
Item No JLL
Subject: EMS Transportation Agreement
Department: Emergency Management Public Hearing Yes No XX
Attachment(s): Information Contact: Nick Waters
Transportation Agreement Extension Number: 3030
Telephone Number:
Hillsborough 732-8181
Chapel Hill 968-4501
Mebane 227-2031
Durham 688-7331
Purpose: To consider approving an agreement between Orange County and South
Orange EMS and Rescue Squad, Inc. (SOEMSRS) in regard to transportation by
SOEMSRS.
Background: Beginning October 1, 1996,the way emergency medical services (EMS)
in Orange County is delivered will change. The "new"way of doing business in Orange
County includes changes in how responses occur as well as how EMS is financed.
County paramedic staff(supplemented by some volunteers)will be providing initial
response to all calls. Based on the nature of the call, an ambulance may or may not be
dispatched simultaneously with a paramedic. All paramedics will have advanced
assessment training and will carry most all of the equipment which is currently stocked
on ambulances. The paramedic will arrive on the scene and will either: assess and release
the patient; assess, treat, and/or refer the patient; or, if ambulance transport is necessary,
will assess and treat the patient while an ambulance is dispatched. This will help to
assure the availability of an ambulance when it is needed and will also assure that each
patient will be assessed by a paramedic.
Under this new EMS delivery system, all emergency ambulance transportation will be
provided under the terms of an agreement between Orange County and SOEMSRS. The
attached agreement addresses the transportation component of this delivery system and
lays out the responsibility of each party with regard to ambulance transportation. Details
J
2
of purchase, reimbursement, etc. are covered in the agreement and have been approved by
the purchasing director and the director of finance for the county. As approved in the
1996-97 operating budget, all necessary day-to-day EMS expenses of SOEMSRS will be
covered by Orange County in return for the Squad's provision of volunteers and
temporary paid staff to provide all required emergency ambulance coverage. A
substantial portion of the additional cost of covering Squad expenses will be recouped
through billing of patients, and third party carriers such as insurance companies,
Medicare, and Medicaid, for services rendered.. The charges, as approved in the 1996-97
Orange County fee schedule, will be: $100 for paramedic treatment; $250 for Basic Life
Support(BLS)treatment and transport; and $350 for Advanced Life Support(ALS)
treatment and transport. There is no charge for paramedic assessment and release at the
scene unless treatment is requested or required. It is important to note that Orange
County EMS will continue to operate under the principle that no one will be denied
emergency medical care based on an inability to pay.
Recommendation: The Manager recommends that the Board approve the agreement
and authorize the Chair to sign.
3
STATE OF NORTH CAROLINA
COUNTY OF ORANGE
AGREEMENT BETWEEN
SOUTH ORANGE EMS AND RESCUE SQUAD, INC.
AND
ORANGE COUNTY, NORTH CAROLINA
THIS AGREEMENT, made and entered into the day of September, 1996, by
and between South Orange EMS and Rescue Squad, Inc., hereinafter referred to as 'THE
SQUAD" and Orange County, North Carolina, hereinafter referred to as '"THE
COUNTY", for and on behalf of its Office of Emergency Management Services.
WITNESSETH:
WHEREAS, THE COUNTY pursuant to the authority contained in N.C.G.S.
§153A-250(b), wishes to have a private non-profit organization provide transportation
services as part of its emergency medical system using personnel other than County Staff
and to compensate said agency for those services; and
WHEREAS, THE SQUAD desires to provide this service to THE COUNTY.
NOW, THEREFORE, in consideration of the premises and of the following mutual
promises, covenants and conditions, THE COUNTY and THE SQUAD agree as follows:
I. SQUAD RESPONSIBILITIES
A. To name a single point of contact that has the right and authority to
conduct business on behalf of THE SQUAD. The name of this individual shall be
provided to THE COUNTY upon the signing of this agreement. THE SQUAD shall
provide THE COUNTY with notice of any change in the contact person 5 working days
prior to the effective date of the change.
B. To provide staffing of ambulances 24 hours per day, 7 days per week at
staffing levels established by agreement of the parties provided, however, that in no event
shall THE SQUAD permit the staffing of ambulances used to provide services under this
1
4 j
agreement by individuals certified below the level of Emergency Medical Technician.
C. To ensure that all personnel are trained, certified and current in all
continuing education requirements pursuant to standards set by THE COUNTY,
and other licensing/certification boards as may be appropriate. Evidence of certification
required by N.C.G.S. §131E-159 shall be provided to THE COUNTY. THE SQUAD
shall ensure that these records are kept current.
D. To purchase items used by THE SQUAD in accordance with Orange County
purchasing policies and procedures, and any relevant statutes, and to submit requests for
payment for these items by the method and on forms specified by THE COUNTY and
within budgeted appropriations.
E. To maintain and provide documentation and requests for payroll
reimbursements by the method and on forms as specified by THE COUNTY.
F. To ensure that at all times when on duty, THE SQUAD's staff is attired in
the uniform approved and/or provided by THE COUNTY.
G. To perform daily checkouts of each unit, all supplies and equipment at the
beginning of each shift, and report any deficiencies to THE COUNTY in a manner
approved by THE COUNTY. THE SQUAD shall not allow the supplies and equipment
on each unit to fall below the standards established by the North Carolina Medical Care
Commission.
H. To properly maintain the vehicles provided by THE COUNTY in good
working order and have necessary maintenance and repairs completed in the method
approved by THE COUNTY. THE SQUAD shall keep and maintain records of the
maintenance and operation of the vehicles in accordance with N.C.G.S. §131E-156.
Copies of these records shall be furnished to THE COUNTY. Further, it shall be the
responsibility of THE SQUAD to notify THE COUNTY when to obtain or renew the
ambulance permit required by N.C.G.S. §131E-156.
I. THE SQUAD shall provide and maintain evidence of a current Ambulance
Providers License, issued pursuant to N.C.G.S. §131E-155.1, to THE COUNTY.
J. To provide a monthly expense report (salary, maintenance, supplies, fuel,
and other associated operational costs) to THE COUNTY.
IC THE SQUAD may enter into contracts or agreements with third parties to
provide services under this Agreement. Any such arrangements shall provide that THE
COUNTY will retain ultimate control and responsibility and that the third party will be
bound by this Agreement. In any case, where THE SQUAD enters into an arrangement
with third parties, and when such contracts are not contrary to law, THE COUNTY shall
2
a
5
not be obligated or liable for any breach of contract or other action in law to any party
other than THE SQUAD.
L. THE SQUAD understands and agrees that the financial officer or designee
of THE COUN'T'Y shall have the right to inspect all books and records of THE SQUAD,
and will be given full and complete access.
H. COUNTY RESPONSIBILITIES
A. To provide ambulances sufficient enough to support the required
staffing levels of THE SQUAD. However, any ambulances provided by THE COUNTY
are and shall remain the property of THE COUNTY and upon termination of this
agreement are to be returned to THE COUNTY in good working condition, reasonable
wear and tear accepted.
B. To make purchases of items used by THE SQUAD in accordance with
Orange County purchasing policies and procedures and to make payment for items
purchased by THE SQUAD with the approval of THE COUNTY within a time frame
(not to exceed 30 days of receipt of a request for reimbursement) agreed on by THE
COUNTY and THE SQUAD.
C. To provide a process for reimbursement of SQUAD salary costs within a
time frame (not to exceed 30 days of receipt of a request for reimbursement) agreed on
by THE COUNTY and THE SQUAD.
D. To provide a standard of uniforms for SQUAD personnel providing services
pursuant to this Agreement.
E. To provide necessary supplies, equipment, fuel, and other medical essentials
for the staffing of units to the level'specified by THE COUNTY, and to provide a method
of re-stocking units after each use.
F. To provide reimbursement for the general preventive maintenance and
vehicle repair for the ambulances used by THE SQUAD to provide services pursuant to
this Agreement. This includes vehicles owned by THE SQUAD, but used to provide
services under this Agreement.
G. To retain full authority and responsibility for the care and treatment of all
patients that use the EMS system; and to ensure that professional supervision is given
during transportation by THE SQUAD. THE COUNTY'S medical director will supervise
and provide medical care direction to THE SQUAD.
H. To provide all required health and safety standards including vaccinations
3
6
I
for the members of THE SQUAD providing services under this Agreement.
I. To establish training and continuing education requirements on a schedule
set by the Medical Director which will assure adequate opportunity for maintenance of
personnel certification.
III. INSURANCE
A. THE SQUAD will be responsible for the negligence of its employees and
agents. Further, THE COUNTY shall define the amounts and levels of insurance which
THE SQUAD shall maintain for the activities performed pursuant to this Agreement as
well as the buildings and equipment used to provide services under this Agreement. It
shall be at THE COUNTY'S option to either provide the coverage through a policy
purchased by THE COUNTY or to reimburse THE SQUAD for insurance policies
purchased by them. Any policies of insurance purchased directly by THE SQUAD shall
be through an insurance company acceptable to THE COUNTY.
IV. - TERM
A. This agreement shall run from October 1, 1996 through June 30, 1997, and
shall be renewable thereafter upon written agreements executed by both parties.
V. TERMINATION
A. The Agreement or its renewal may be terminated at any time without
penalty by either party provided that written notice of such termination is furnished to the
other party at least 60 days prior to termination. In the event of such termination any
payment due shall be prorated to the date of termination.
VI. MUTUAL UNDERSTANDING
A. THE SQUAD and THE COUNTY understand and agree that nothing in
this agreement shall be construed to create an exclusive arrangement between the parties,
and THE COUNTY is free to provide services by other means.
VII. ENTIRE UNDERSTANDING
A. The Agreement contains the entire understanding of the parties and shall
not be altered, amended or modified, except by an agreement in writing executed by the
4
J
7
1
duly authorized officials of both parties.
VIII. SITUS
A. The laws of North Carolina shall govern the validity and interpretation of
the provisions, terms and conditions of this agreement.
IN WITNESS WHEREOF, the parties have hereunto signed this Agreement in their
official capacities of the day and year listed below.
FOR AND ON BEHALF OF:
SOUTH ORANGE EMS AND RESCUE, SQUAD, INC.
DATE:
RAY deFRIESS
CHAIR OF THE BOARD OF DIRECTORS
FOR AN ON BEHALF OF:
ORANGE COUNTY, NORTH CAROLINA
DATE:
MOSES CAREY, JR.
CHAIR OF THE BOARD OF COMMISSIONERS
ATTEST:
BEVERLY A. BLYTHE
CLERK TO THE BOARD
5