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HomeMy WebLinkAboutAgenda - 08-17-1993 - III-E 1 ORANGE COUNTY BOARD OF COMMISSIONERS Action Agenda Item No ' -E ACTION AGENDA ITEM ABSTRACT Meeting Date: August 17, 1993 SUBJECT: UNC Hospitals - EMS Contracts Renewal DEPARTMENT Emergency Management PUBLIC HEARING YES NO X ATTACHMENT(S) INFORMATION CONTACT Contracts Nick Waters, ext 3030 7/23/93 Letter from UNC Hospitals TELEPHONE NUMBER Resolution Hillsborough 732-8181 Chapel Hill 968-4501 Mebane 227-2031 Durham 688-7331 PURPOSE: To consider extending the duration of existing contracts with the UNC Hospitals. BACKGROUND: For several years, the County has provided personnel and equipment support to the UNC Hospitals, under contract, for the Hospitals ' air ambulance and ground transportation programs. Flight paramedics and ambulance drivers are currently County employees, with the County fully reimbursed for their salaries, benefits, and associated costs, plus some overhead expenses. It is the Hospitals ' intent to have these employees become Hospitals employees no later than October 31, 1993. The Hospitals propose that the existing contracts for these two programs be extended for four months, to terminate on October 31 . The terms of the contract for the period July 1 - October 31, 1993 would be identical to the terms that have been in effect from July 1, 1992 - June 30, 1993. The letter from UNC Hospitals proposes the creation of additional contracts in the future to provide ambulance maintenance and backup ground transportation. Staff will evaluate the viability of this proposal before asking the Board to consider any future commitments by the County. RECOMMENDATION: The Manager recommends that the Board adopt the attached resolution approving the four month contract extensions and authorizing the Chair to sign the UNC Hospitals letter extending the contracts. - • 4 STATE OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT BETWEEN THE UNIVERSITY OF NORTH CAROLINA HOSPITALS AND ORANGE COUNTY, NORTH CAROLINA THIS AGREEMENT, made effective the 1st day of July, 1992 by and between The University of North Carolina Hospitals, hereinafter referred to as "The Hospital" and Orange County, North Carolina, hereinafter referred to as "Orange County" for its office of Emergency Medical Services. WITNESSETH: WHEREAS, The Hospital desires to implement a hospital-based air ambulance program; and WHEREAS, The Hospital desires the services of Emergency Medical Technician- Paramedics ("Paramedics") for on-flight coverage; and WHEREAS, Orange County desires to assist The Hospital in implementing its air ambulance program by supplying the services of paramedics; and WHEREAS, The Hospital desires to reimburse Orange County for such paramedic services: NOW, THEREFORE, in consideration of the premises and the following mutual promises, convenants and conditions, the Hospital and Orange County agree as follows: 1. Orange County agrees to make available to The Hospital the services of seven full-time paramedics, and one part-time paramedic who shall not exceed 312 hours annually unless approved by the Program Director. 2. Both Orange County and The Hospital agree that for all purposes such paramedics shall be considered employees of Orange County. Orange County agrees to consult with The Hospital prior to assigning such paramedics to The Hospital air ambulance program. 3. Orange County agrees that the paramedics whose services are provided pursuant to this Agreement shall maintain North Carolina certifications as Emergency Medical Technicians-Paramedics and shall have at least two years of Advanced Life Support experience. 4. Both Orange County and The Hospital understand and agree that The Hospital will have administrative and professional supervision of such paramedics while they are rendering services to The Hospital under this Agreement. Professional activities and services rendered pursuant to this Agreement shall be in compliance with policies and protocols developed and agreed upon by designated representatives of The Hospital. 5 5. Both Orange County and The Hospital agree and understand that if at any time The Hospital determines that a paramedic's performance or professional interactions are inadequate or inappropriate for flight duty, The Hospital may request termination of the paramedic, The Hospital shall provide sufficient documentation to Orange County detailing the reasons for the Hospital's request for termination. Such documentation shall be in a form that is in compliance with the Orange County Personnel Ordinance regarding disciplinary action. Orange County will recruit for a replacement paramedic with final hiring to be approved by the Hospital. 6. The Hospital agrees to provide a training experience for one part-time and seven full-time paramedics. Such training shall be in conjunction with the training of the Hospital's flight nurses to the extent feasible. The Hospital further agrees that, to the extent feasible, flight teams shall consist of both a nurse and a paramedic. Training shall include any travel or educational outreach approved by the Program Director or designee. The amount shall not exceed $2,500 annually. 7. Both Orange County and The Hospital understand and agree that Orange County may designate an in-Hospital liaison accountable to Orange County Office of Emergency Medical Services for paramedic personnel functions such as discipline, scheduling, holidays, sick leave. 8. In return for the services of paramedics, as identified herein, The Hospital agrees to reimburse Orange County for the cost of salaries and applicable fringe benefits of one part-time and seven full-time paramedics. The Hospital further agrees to reimburse Orange County for the cost of salaries and applicable fringe benefits of the above paramedics and alternates during the training period references in paragraph 6 above. "Fringe benefits," as used herein, shall include Orange County's contributions to the local government employee's retirement system, health insurance, life insurance/accidental death and dismemberment and workers' compensation for the paramedics covered by this Agreement. At its option, The Hospital shall either reimburse Orange County for the cost of or provide coverage for professional liability insurance for the paramedics whose services are provided pursuant to this Agreement. The Hospital agrees to provide life insurance and disability insurance for the paramedics covered by this Agreement. In addition, Orange County will ensure that life and disability insurance provided by the Orange County benefits package will cover work in the air medical environment for the flight paramedics. Pursuant to these agreements, The Hospital shall reimburse Orange County at the rate of $22,500 per month, subject to such modification of this monthly amount as is necessary following specific agreement between the parties of the actual cost of authorized and approved salaries and fringe benefits. The monthly amount will be agreed upon and modified annually to reflect as nearly as possible the actual cost of the contract. The new monthly rate will begin on July 1, 1992 and thereafter will coincide with the Hospital's fiscal year, beginning July 1. Any overtime must be approved by The Hospital through the Carolina Air Care Program Director or his/her designee. Annual salary increases shall be negotiated with The Hospital due to budget impact. This agreement shall terminate automatically if the parties do not agree to the amount of salary increases requested by Orange County, not withstanding the terms of paragraph 12 below. Orange County shall provide monthly statements of actual cost along with their monthly bill. Orange County shall bill The Hospital by the 15th of the month. The Hospital agrees to reimburse Orange County $6,000 annually for administrative overhead associated with the Paramedic contract, upon submission of documentation to justify the overhead. This amount covers administrative time for the 6 personnel department, finance department, and the Orange County Manager. This amount will be invoiced monthly with corresponding documentation of associated cost. 9. Both Orange County and The Hospital understand and agree that nothing in this Agreement shall be construed to create an exclusive arrangement between the parties. Orange County is free to provide services of any kind or nature to any other air and land ambulance service or program. 10. The Hospital agrees to notify Orange County When The Hospital's air ambulance is responding within the geographic area covered by Orange County Office of Emergency Medical Services. 11. This Agreement shall run for a period of 1 year from the 1st day of July, 1992 to the 30th day of June 1993 and shall be renewable thereafter upon written notice executed by both parties. 12. This 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 180 days prior to termination. In the event of such termination any payment due shall be prorated to the date of termination. 13. In compliance with 42 U.S.C. 1395x (V) (1) (I) and implementing regulations, Orange County agrees, until the expiration of four years after the service are furnished under this contract, to allow the Secretary of the Department of Health and Human Services and the Comptroller General access to this contract and to the books, documents and records of Orange County necessary to verify the nature and extent of the costs of this contract, subject to and consistent with the policies and procedures contained din OMB Circular A-102, Attachment P. Orange County further agrees that if any of the duties of this contract are carried out by a subcontractor of Orange County such subcontract shall contain a clause to the effect that, until the expiration of four years after the services are furnished under such subcontract, the Secretary of the Department of Health and Human Services and the Comptroller General shall have access to such subcontract to the books, document and records of the subcontract necessary to verify the nature and extent of the costs of such subcontract, subject to and consistent with the policies and procedures contained in OMB Circular A-102, Attachment P. 14. 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 he duty authorized officials of both parties. 15. The laws of North Carolina shall govern the validity and interpretation of the provisions, terms and conditions of the Agreement. - 7 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: • FOR AND ON BEHALF OF: THE UNIVE- .ITY OF NO: H ORANGE COUNTY, CAROLIN'OSPI L NORTH CAROLINA 1114 / Eric B. Munson ' :irman, Executive Director Orange County Board of Commissioners Date: 6/4'' Date: 4- - 9 - y 2- • 8 STATE OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT BETWEEN THE UNIVERSITY OF NORTH CAROLINA HOSPITALS AND ORANGE COUNTY, NORTH CAROLINA THIS AGREEMENT, made and entered into the 1st day of July 1992 and by and between the University of North Carolina Hospitals, hereinafter referred to as "THE HOSPITAL" and Orange County, North Carolina, hereinafter referred to as "THE COUNTY", for its Office of Emergency Management Services. WITNESSETH: WHEREAS, THE HOSPITAL desires ground transportation services consisting of: 1. One ambulance and qualified, rested driver available 24-hours a day, 365 days a year who can arrive at THE HOSPITAL within 30 minutes of a request from Carolina Air Care. 2. A second ambulance and qualified, rested driver available eight hours a day during peak hours, Monday through Friday who can arrive at THE HOSPITAL within 30 minutes of a request from Carolina Air Care. Peak hours will be specified by the Hospital at a later date. 3. Carolina Air Care reserves the privilege to define transport needs and level of transport acuity. The transports include, but are not limited to, patient transports, organ transports, equipment returns, transport of HOSPITAL specialty teams, patient transport to and from THE HOSPITAL or its MRI facility, to and from the Ambulatory Care Center and transport of Carolina Air Care personnel. All transports are to be at the direction of Carolina Air Care administrative staff. WHEREAS, THE COUNTY desires to provide these services to THE HOSPITAL. WHEREAS, THE HOSPITAL desires to reimburse THE COUNTY for such services; NOW, THEREFORE, in consideration of the- premises and of the following mutual promises, covenants and conditions, THE HOSPITAL and THE COUNTY agree as follows: COUNTY RESPONSIBILITIES 1. To schedule drivers for ambulances. To provide three full-time drivers and any part-time staff needed to accomodate the Hospital based on the mission requirements stated above. 9 2. To provide replacement ambulances in case either of the vehicles are out of service due to maintenance or repairs, subject to availability of County units at the time of request. 3. To perform daily. check-out of each unit and all non-medical equipment aboard the ambulance at the beginning of each shift. Repair or replace any items that require same and ensure a sufficient supply of air and oxygen. 5. To properly maintain the vehicles in good working order and to maintain the equipment on board the ambulance in accordance with the North Carolina Emergency Medical Services Act of 1973, as amended, and implementing regulations. 6. To provide liability and property insurance on any ambulances purchased by the Hospital designated for the Carolina Air Care program and to provide proof of insurance to THE HOSPITAL upon request. 7. To ensure THE COUNTY's staff is attired in the uniform provided by Carolina Air Care for each Carolina Air Care transport or function. 8. The drivers will ensure that necessary communications regarding their status during Carolina Air Care missions are made on a regular basis with the Carolina Air Care Communications Center. 9. Upon request, the drivers will provide assistance to the medical crew to load/unload equipment and patients. 10. After each transport, restock equipment and make repairs as necessary to ensure the proper operations of all equipment. Leave vehicles fully stocked and full of gas, 02, and air for the on-call driver(s) at night and on weekends. 11. Provide quarterly expense reports. (Salary, maintenance, fuel, and other associated operating costs.) HOSPITAL RESPONSIBILITIES 1. To provide two ambulances. a. One vehicle shall be a 1990 Type Ill Modular truck and shall be equipped with radio and medical equipment to meet all State requirements. In addition, the vehicle shall be equipped with oxygen and compressed gas cylinders of at least H size. The vehicles will be equipped with suction, 110 volt source, a fixture to hold the ventilator used in the helicopter, a fixture to hold the Life Pak V, and high-intensity directional lighting in the patient care area. The vehicles will be fitted with a device to secure the "pediatric stretcher." There will also be fittings to secure two neonatal transport isolettes of the variety currently used by THE HOSPITAL. The vehicle will be identified with a logo and paint scheme similar to the one on THE HOSPITAL helicopter. This vehicle is to be used exclusively for Carolina Air Care purposes. b. The second and any subsequent vehicles shall be equipped with radio and medical equipment to meet all State requirements. They also will be equipped with identical additional equipment as specified in Section 1 (a). These ambulances will be identified with a logo and paint scheme similar to the one on THE HOSPITAL helicopter. 10 2. Carolina Air Care will provide an ambulance for MRI transports, with the attendant being provided by the Hospital. In the event that all Carolina Air. Care ambulances are unavailable, Orange County will provide an ambulance and a driver for MRI transports. • 3. The new Ambulatory Care Center located on Mason Farm Road will be operational by November 1992. Patients at this facility requiring non-emergency transport and due to physicial limitations are unable to use the Hospital shuttle will be transported by the Carolina Air Care ground ambulance. It is anticipated that the weekly total will range from 2 - 5 transports. The Hospital will provide an attendant to accompany the patient to the Hospital from the Ambulatory Care Center (these are likely to be Day-Op patients needing further assessment or stretcher patients not able to ride on the shuttle). Orange County will provide an ambulance and a driver if the Carolina Air Care ground ambulance is not available. Any emergency transports will be called in by 911 and are not subject to the provisions of this contract. 4. THE HOSPITAL retains full authority and responsibility for the care and treatment of its patients and will have administrative and professional supervision of any Orange County EMS employee while said employees are rendering services to THE HOSPITAL under this agreement. During a transport THE HOSPITAL, its employees and members of the Medical Staff will be in charge of the medical aspects of the transports, including the authority to prescribe to the driver the degree of urgency of the transport, and the authority to order the vehicle to stop and remain parked while medical procedures are being performed. The driver will operate within Orange County EMS policies concerning the safe movement of the vehicle. 5. THE HOSPITAL will reimburse THE COUNTY for the services provided at the rate of$12,000 per month. TERM OF AGREEMENT This Agreement shall run from the 1st day of July, 1992 to the 30th day of June, 1993. TERMINATION OF AGREEMENT This Agreement or its renewals 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 ninety (90) days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination. The parties agree and understand that the Director of Orange County Emergency Services may temporarily suspend services under this Agreement in the event of a county-wide disaster. ACCESS OF RECORDS In compliance with 42 U.S.C. 1395x (V) (1) (I) and implementing regulations, Orange County agrees, until the expiration of four (4) years after the services are furnished under this Agreement, to allow the Secretary of the Department of Health and Human Services and the Comptroller General access to this contract and to the books, Ge acta e documents and records of Orange County necessary to verify the nature and extent of the costs of this contract. If Orange County chooses to subcontract this service, such subcontract shall contain a clause to the effect that, until the expiration of four (4) years after the services are furnished under such subcontract, the Secretary of the Department of Health and Human Services and the Comptroller General stall have access to such subcontract and to the books, documents, and records of the 11 subcontractor necessary to verify the nature and extent of the costs of such subcontract. ENTIRE AGREEMENT This 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 duly authorized officials of both parties. GOVERNING LAW 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 0 BEHALF OF: THE UNIV '� ITY I "AROLINA HOSPITALS ,P ? DATE: /7/,-1--'// ERIC B. MUNSON EXECUTIVE DIRECTOR FOR AND ON BEHALF OF: ORANGE COUNTY, NORTH CAROLINA eAma,ddi DATE: -a9-9. MOSES CAREY, J CHAIR OF THE BOARD OF /MMISSIONERS ATTEST: B VERL iv. BL "�' CLERK T• THE BOARD K,51 UNIVERSITY Fla r thtf DATE,NORTH CAROLINA NA HOSPITALS /7 93 Hospitals ITEM.404, lir 101 Manning Drive . • Chapel Hill,North Carolina 27514 July 23, 1993 Nick Waters, Director Orange County Emergency Management P.O. Box 8181 Hillsborough, NC 27278 The attached contracts are submitted for renewal through October 31, 1993. The contracts are exact duplicates of the existing contracts between UNC Hospitals and Orange County Emergency Management. Per our earlier conversation regarding both the paramedic and ground ambulance contracts I appreciate your willingness to extend this to the above period. The paramedics and drivers will become hospital employees by the end of October. Upon termination we will need to execute another contract for maintenance services for our three ambulances; which, will include providing 911 and backup service to the hospital and ambulatory care center. We appreciate your help in providing this important service and look to continued strong collaborative efforts to maximize patient satisfaction. Please obtain the required signature for renewal of these contracts. Sincerely, Bruce B. Chappell Jr., Program Director Dept. of Emergency Medicine FOR AND ON BEHALF OF : FOR AND ON BEHALF OF THE UNIVERSITY OF NORTH ORANGE COUNTY, NORTH CAROLINA CAROL A HOSPITALS / ,1 Eric B. Munson osey Carey Jr, Executive Director Chair of the Board o.' • issioners North Carolina Memorial Hospital • North Carolina Children's Hospital • North • na Neuropsychiatric Hospital North Carolina Jaycee Burn Center • North Carolina Clinical Cancer Center • ►•rth Carolina Women's Center UNC Ambulatory Care Center • Carolina Consultation Center 2 ORANGE COUNTY COMMISSIONERS RESOLUTION EXTENDING EMS CONTRACTS WITH UNC HOSPITALS WHEREAS, UNC Hospitals and Orange County have for a number of years entered into agreements whereby the County provides personnel and equipment support to the Hospitals for the operation of Air Ambulance and Ground Transportation programs, and WHEREAS, it is the desire of the Hospitals that the existing agreement for these services be extended through October 31, 1993, and WHEREAS, the County is willing and able to continue to provide these services during this period under the terms of the existing agreement, NOW, THEREFORE, BE IT RESOLVED that the Orange County Board of Commissioners does hereby approve the extension of existing contracts between the County and UNC Hospitals through October 31, 1993, and FURTHERMORE, BE IT RESOLVED that the Board directs County staff to evaluate the advantages and disadvantages of any request that may be forthcoming from the Hospitals for future contracts pertaining to ambulance maintenance or backup service, prior to the County making any commitments to provide such services. This, the 17th day of August, 1993.