HomeMy WebLinkAbout2011/09/27 Item 13CITY COUNCIL
AGENDA STATEMENT
~`~~ CITY OF
CHULAVISTA
September 27, 2011 Item
ITEM TITLE: CONSIDERATION OF A REVISED AND RESTATED
AGREEMENT WITH AMERICAN MEDICAL RESPONSE
AMBULANCE SERVICE, INC.. FOR BASIC AND
ADVANCED LIFE SUPPORT SERVICE WITHIN THE
CHULA VISTA, IMPERIAL BEACH AND BONITA/
SUNNYSIDE FIRE PROTECTION DISTRICT EXCLUSIVE
OPERATING AREA
A. RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF CHULA VISTA APPROVING A REVISED AND
RESTATED AGREEMENT FOR BASIC AND ADVANCED
LIFE SUPPORT SERVICE WITH AMERICAN MEDICAL
RESPONSE AMBULANCE SERVICE, INC. FOR A THREE
YEAR TERM WITH A THREE YEAR EXTENSION OPTION
B. RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF CHULA VISTA APPROVING A REVISED AND
RESTATED AGREEMENT FOR BASIC AND ADVANCED
LIFE SUPPORT SERVICE WITH AMERICAN MEDICAL
RESPONSE AMBULANCE SERVICE, INC. FOR ATWO-
YEAR TERM WITH A SIX MONTH EXTENSION OPTION
SUBMITTED BY: FIRE CHIEF S~~
CITY ATTORNE~~2.C 6
REVIEWED BY: CITY MANAGER
4/STNS VOTE: YES ~ NO ~X
SUMMARY
This item presents for City Council consideration an Amended and Restated Agreement
for the provision of Basic and Advanced Life Support Services ("EOA Agreement") with
American Medical Response Ambulance Service, Inc. ("AMR"), and other options.
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Chula Vista, Imperial Beach and the Sunnyside/Bonita Fire District (collectively, the
"Participating Agencies") have been under contract with AMR, or its predecessors, since
1977. The most recent extension of this agreement was entered into back in December
2007. At that time the Council approved a 3 year extension of the EOA Agreement with
two additional 3 year options. In the interim, staff invested a substantial amount of time
developing a program and negotiating terms with AMR for the City to provide the
Advanced Life Support ("ALS") component of emergency medical response services
provided under the EOA Agreement. Negotiations with AMR and City fire staff were
nearing completion, but the initial term of the extended EOA was set to expire.
Accordingly, back in June of this year staff presented the City Council with an amended
and restated EOA Agreement that effectively implemented the extensions contemplated
in the previously approved 2007 extension, with sufficient time, in staffs estimate, to
implement the City program for providing ALS. At that time City Council directed staff
to bring back a 2 year extension alternative to the 3 plus 3 year agreement staff had
negotiated. Council also requested a report regarding City options for going out to bid as
an alternative to extending AMR's agreement.
The City Manager and the Fire Chief continue to recommend the 3 year plus 3 extension
version of the proposed agreement with AMR as the City's best option. This
recommendation is based upon a variety of factors including (1) AMR's quality of
service; {2) AMR's competitive pricing; (3) AMR's extensive and unique familiarity with
the EOA service area; (4) the Participating Agencies' desire to continue service with
AMR; (5) the City's desire to keep the option of not going out to bid periodically, saving
staff time and associated costs; and (6) the likelihood that City-provided ALS can be
implemented more expeditiously and effectively through an AMR contract extension.
The basis for staff's recommendation, and City Council options, are presented in more
detail below.
ENVIRONMENTAL REVIEW
The Director of Development Services has reviewed the proposed activity for compliance
with the California Environmental Quality Act (CEQA) and has determined that the
activity is not a "Project" as defined under Section 15378 of the State CEQA Guidelines
because the proposal consists of a governmental plan of action related to the City's
preparedness in the event of a natural or manmade disaster and which will not result
in direct or indirect significant physical impacts on the environment. Therefore, pursuant
to Section 15060 (c) (3) of the State CEQA Guidelines the activity is not subject to
CEQA. Thus, no environmental review is necessary.
BOARDS/COMMISSION RECOMMENDATION
Not Applicable.
RECOMMENDATION
That Council approves the resolution as written in Option 1, adopting the Revised and
Restated Agreement with AMR for Basic and Advanced Life Support Ambulance
Service, which includes a revised rate schedule for basic and advanced life support
ambulance transport rates, related service charges, and new agreement period of 3 years,
plus a 3 year extension option at the City Manager's discretion. In taking this action,
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staff also recommends that the City Council make the required findings to waive it's
competitive bid process in accordance with CVMC Section 2.56.070(3) and (4).
DISCUSSION
Factual Background
On December 11, 2007 the City Council approved the Revised and Restated Agreement
with American Medical Response (AMR) for Basic and Advanced Life Support Ambulance
Service (2007 Agreement). The 2007 Agreement became effective for the period of
December 11, 2007 through May 31, 2011. The 2007 Agreement contained a provision for
two additional three-year extensions for AMR to continue providing ambulance services
subject to the City's discretion. The 2007 Agreement also contained a provision for AMR to
request rate adjustments for ambulance services. The 2007 Agreement expired on May 31,
2011 and was temporarily extended for a period of thirty days and subsequently another
ninety days, with a pending expiration date of September 30, 2011.
The 2007 Agreement permits AMR to provide services to an Exclusive Operating Area
(EOA) that was adopted by the County of San Diego. This EOA consists of the City of
Chula Vista, Bonita/Sunnyside Fire Protection District, and the City of Imperial Beach. A
negotiation occurred between AMR and the Participating Agencies. The City of Imperial
Beach has requested alonger-term agreement, which includes a provision for five years with
an optional five-year extension. The other parties of AMR and Bonita/Sunnyside Fire
Protection District are in agreement with Chula Vista Staff's recommendation to extend the
agreement three years with an option to extend the agreement an additional three years.
Neither agency desires to go out to bid for emergency medical response services at this time.
On June 21, 2011, Council directed Staff to propose an agreement with the parties of an
extension of two years with an option to extend it another six months. This proposal was
made to the parties and agreed upon as an alternative, with the additional language that the
City of Chula Vista cannot send out a Request for Proposal (RFP) for the services provided
within the agreement for a period of two years or the length of the extended agreement.
AMR also requests removal of the "Termination for Convenience" clause if the agreement
is only extended two years.
Options Presented for Council Consideration
Staff is presenting Council two options for consideration in this resolution:
Option 1 is to approve the original approved extension of the agreement for a period of three
years with an option to extend another three years at the direction of the City Manager.
Option 2 is to approve extending the agreement two years with an option to extend another
six months at the direction of the City Manager. This option would also change the
agreement to reflect that the City of Chula Vista agrees not to go out to bid on the services
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provided within the agreement for a period of two years. This option would also remove the
"Termination for Convenience" clause in'the extended agreement.
The City Manager and the Fire Chief recommend Option 1. Chula Vista has enjoyed a long-
term relationship with AMR for the last 33 years. Staff has been working with AMR for the
past two years on a plan to enhance the level of Emergency Medical Services to the citizens
of Chula Vista. This plan includes asix-year phase-in of paramedic first responders within
the Chula Vista Fire Department. A significant benefit to the 2007 Agreement with AMR is
the stability that alonger-term agreement provides. Extending this agreement for three years
with the option of three additional years provides the stability needed as the fire department
transitions to providing the enhanced service level of paramedic advanced life support. By
maintaining the "Termination for Convenience" clause this option also provides the City
with maximum flexibility to pursue emergency medical service alternatives.
History and Background on the Legal Structure for the Provision of EMS Services
Before 1980, the responsibility for emergency medical services and disaster medical
preparedness was spread among a variety of state departments. It became clear that a more
unified approach to emergency and disaster medical services was needed. In order to
address this issue, the Emergency Medical Services System and Pre-hospital Emergency
Medical Care Personnel Act ("EMS Act") (California Health and Safety Code sections 1797
et seq.) was enacted in 1980.1 In a recent opinion, the EMS Act was described as follows:
"Through the EMS Act, the Legislature created essentially atwo-tiered
regulatory system `governing virtually every aspect of prehospital
emergency medical services.' [County of San Bernardino v. City of San
Bernardino (1997) 15 Ca1.4~' 909, 915.] The overarching purpose of this
statutory scheme was to `provide the state with a statewide system for
emergency medical services' and to `ensure the provision.. of effective and
efficient emergency medical care' to the people of California. [Cal. H&S
Code §§1797.1, 1797.6, subd.(a).]" 2
The first "tier" of governance under the EMS Act is occupied by the state, and
administered through the California Health and Human Services Agency. The second tier
is occupied by a "local EMS agency" which is responsible for implementing an
emergency medical services system; once that system is established, "all providers of
prehospital emergency medical services within its jurisdiction must operate within that
system." 3 One of the mandatory subjects of a local EMS plan is emergency medical
transportation.4 The EMS Act was amended in 1984 to authorize local EMS agencies to
establish Exclusive Operating Areas ("EOA"} and designate private providers to operate
in those areas.5
' Cal. H&S Code §§ 1797, et seq.
z County of Butte v. Emergency Medical Services Authority (2010) 187 Cal.App.4`h 1175, 1190.
3Id. at 1191; Cal. H&S Code §179.178.
a Cal. H&S Code §§ 1797.76, 1797.103, subd.(c), 1797.70, 1797.72.
s Cal. H&S Code §§ 1797.6, 1797.85, and 1797.224.
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The EMS Authority is charged with providing leadership in developing and implementing
EMS systems throughout California. In California, day-to-day EMS system management is
a local responsibility. Each county which is developing an EMS system must designate a
Local EMS Agency which can be the county health department, an agency established and
operated by the county, an entity with which the county contracts for the purposes of EMS
administration, or a joint powers agency. There are 31 single-county or multi-county Local
EMS Agencies. In our case, it is the County of San Diego Public Health Services.
Since the amendment of the EMS Act, the City and the other Participating Agencies have
utilized an EMS Act provision which allows the selection of an ambulance service
provider without a competitive bid process. California Health and Safety Code section
1797.224 ("Section 224") provides, in pertinent part:
"A local EMS agency may create one or more exclusive operating areas in
the development of a local plan, if a competitive process is utilized to
select the provider or providers of the services pursuant to the plan. No
competitive process is required if the local EMS agency develops or
implements a local plan that continues the use of existing providers
operating within a local EMS area in the manner and scope in which the
services have been provided without interruption since January 1, 1981."
For this exemption to be available, pre-hospital EMS services within local EMS area or
subarea must have been provided by one or more providers in an unchanged and
uninterrupted manner since January 1, 1981. Where those facts exist, a local EMS agency
may make a finding within the development of their emergency plan that those services
by existing providers shall continue. Chula Vista first entered into an agreement. with the
County in 1977 and its agreement with the AMR's corporate predecessor in 1977. Since
that time, services have been provided continuously in materially the same "manner and
scope." This gives the City the ability-but not the obligation--to be "grandfathered"
under section 1797.224 and continue operating with AMR without being obligated to
undertake a competitive process as long as the services provided remained the same. In
the attached letter to the City, the County Local Emergency Medical Service Agency
("LEMSA") has acknowledged the valid existence of a "grandfathered" agreement
between the City and AMR for services within the EOA, and that no competitive bid
process is currently required.
An alternative to "grandfathering" under section 224 would be a competitive
procurement process. The competitive process for creating EOAs is dictated by LEMSA.
The complete process is outlined in the attached document from the State, along with a
letter which advises that going out to a competitive process would result in the City being
subject to a new process from that point forward. It describes the process as follows:
"...Prehospital emergency medical services in the South Bay EOA have
continued, uninterrupted in the same manner and scope as described in the
agreement. However, shifting from a "grandfathered" status to a
competitively procured status would constitute a change to the manner and
scope of services and therefore the ambulance transportation service
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provided in the EOA would be subject to the following process now and at
periodic intervals into the future:
• CCV notifies County of San Diego EMS of their intent to change to a
competitive procurement process.
• County EMS notifies the California EMS Authority regarding the
recommended change(s) in the local EMS Plan.
• The EMS Plan is subject to EMSA approval
• CCV develops a Request for Proposal (RFP) which sufficiently sets
forth the requirements for service provision in accordance with any
and all applicable State and County laws, regulations, ordinances,
guidelines, policies and procedures.
• EMS reviews and approves the RFP to ensure it complies with the
State EMSA Guideline # 141 and to ensure a fair and competitive
process.
• EMSA has the authority to, and may choose to, review a proposed
competitive procurement process.
• CCV conducts the advertising and selection process for the RFP in
accordance with the State EMSA Guideline # 141 and applicable
laws. "
In short, pursuant to the EMS Act and the County letter, transitioning to a competitive
process for selection of the EOA ambulance provider would constitute a change in the
EMS Plan and would result in the following: (i) the City would have to develop an RFP
and selection process; (ii) the selection process would be subject to both county and state
approval; and (iii) the County would have to approve the RFP. In addition, if the City
wanted to be able to act independent of the other Participating Agencies, it would have to
request a new EOA. That change to the EMS Plan would also require state and county
approval.6
Analysis of Staff s Recommended Option
Staff continues to recommend the 3 year plus 3 extension version of the proposed
agreement with AMR as the City's best option. This recommendation is based upon a
variety of factors including (1) AMR's quality of service; (2) AMR's competitive pricing;
(3) AMR's extensive and unique familiarity with the EOA service area; (4) the
Participating Agencies' desire to continue service with AMR; (5) the City's desire to
keep the option of not going out to bid periodically, saving staff time and associated
costs; and (6) the likelihood that City-provided ALS can be implemented more
expeditiously and effectively through an AMR contract extension.
AMR's Ouality of Service:
Over the past 33 year contractual relationship the City has had with AMR, the customer
service provided to the citizens has been outstanding. The Fire Department has not had
~ County of Butte v. Emergency Medical Services Authority, 187 Cal.App.4~' 1175, 1197-1202; Cal. H&S
Code § 1797.224.
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any customer complaints on the care provided by AMR during the past- few years. AMR
continues to be active in City events and participates each year in the Fire Department
Open House and other civic venues. Bringing in a new, unknown vendor may result in a
change to this quality of service. It is in the best interest of the City to maintain this long
term relationship and excellent customer service to our citizens.
AMR's Competitive Pricing:
AMR's pricing continues to be very competitive in the San Diego area market. The chart
below illustrates the Ambulance Transport rates that AMR receives with each of their
contract agencies. Chula Vista is currently at the lowest rate and with this extended
agreement that caps cost increases will likely continue to maintain as the lowest transport
rate through the duration of the contract.
San Die o County Trans ort Rates with AMR
San National
$879.39 Bonita $1032.46 La Mesa $1,103.61 Miguel $1,116.59 City
FPD
Imperial
$881
07 Lemon
090.04
$1
$1,413.33 Alpine
$860.90 Chula
.
Beach ,
Grove Vista
$1,040.13 Count Avera e Trans ort Rate
AMR's Extensive and Unique Familiarity With The EOA Service Area:
AMR has been working within San Diego County for over 30 years. This extensive
understanding and familiarity of the South Bay EOA provides for a better preparedness
and response strategy when emergencies arise. With AMR's economy of scale,
providing for services in National City, San Miguel Fire District, La Mesa, Lemon
Grove, and Alpine, they can respond better to peak demands in Chula Vista. Their
knowledge of the system needs here in Chula Vista allows them to staff ambulances in
the most efficient manner based on the needs of the system. The staff of the City has
already established a strong operational working relationship with the staff of AMR; this
includes emergency responses with our supervisors and participation in the City's
Emergency Operations Center (EOC). The staffs of AMR and the Fire Department
participate in joint training monthly strengthening their response capabilities.
Participating Agencies' Desire to Continue Service With AMR:
The EOA consists of the City of Chula Vista, Bonita/Sunnyside Fire Protection District, and
the City of Imperial Beach. A negotiation occurred between AMR and the Participating
Agencies. The City of Imperial Beach has requested alonger-term agreement, which
includes a provision for five years with an optional five-year extension. The other parties of
AMR and Bonita/Sunnyside Fire Protection District are in agreement with Chula Vista
Staff's recommendation to extend the agreement three years with an option to extend the
agreement an additional three years. All three participating agencies have side-letter
agreements with AMR that provide for additional services. Bonita/Sunnyside Fire
Protection District and the City of Imperial Beach also provide Advanced Life Support First
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Responder services through these side-letters. Modifying the EOA agreement or engaging in
an RFP process will threaten their existing status of providing these services. Neither agency
desires to go out to bid for emergency medical response services at this time.
City's Desire to Maintain Low Cost Structure and Avoid The Financial Burden and
Impact on Staff Resources That Would Arise From Beim Obligated to Continually
Go Out To Bid:
Extending the agreement with AMR for another 3 years plus 3 extension allows the City
to maintain the grandfathered 224 rights afforded under the State law. Taking the EMS
program continually out to bid (depending on when the underlying contract expires) will
be a costly and time consuming endeavor. Staff time will need to be dedicated each time
the contract expires. The cost to hire a consultant to write the RFP and work through the
process ranges between $SOK and $150K.
Maintaining the grandfathered 224 rights gives the City the flexibility to decide in the
future if pursuing an RFP is in its best interest. Typically, there are three fundamental
reasons to seek a new contract. First would be if we were in negotiations with the vendor
and could not agree on important aspects of a new contract, creating an impasse situation.
Second would be if we felt our transport rate was too high and not in alignment with the
surrounding area. Third would be if the customer service being provided was not to the
level the City desired or there were complaints about the service. With this agreement,
AMR and the other participating agencies all agree none of these reasons exist.
Likelihood That Implementation of ALS Can Be Accomplished Sooner and More
Effectively Through AMR Contract Extension:
The Fire Department has been working with AMR on developing a First Responder ALS
program for the past two years. Providing along-term agreement creates the stability
needed to implement the City's plan for providing ALS. The acquisition of advanced
medical equipment along with training our current firefighters to the paramedic level will
take six years to complete. Extending this agreement for 3 years plus 3 allows the fire
department to continue to work with AMR on the implementation process. The ALS plan
has been fully developed and the City and bargaining group (Local 2180) continue to
negotiate on labor issues related to the program. Once negotiations are completed, this
agreement becomes the foundation for an additional agreement between the City of Chula
Vista and AMR providing for Paramedic First Response from the City and a change in
the maximum ambulance service rates collected by AMR to fully fund the ALS program.
The alternative to extending the EOA agreement is to go out to bid on the ambulance
services. The first step in this process is to seek agreement with the participating agencies
on the need to bid the services. If the other agencies do not agree then the City must ask
the County and State for approval to create our own EOA. This approval process is likely
to take several months and could be denied. The next step is to create a :new EMS plan
and the requirements of the system, which would take a few months to develop,
depending on if Chula Vista was alone in the EOA or with the other agencies. The
process for development, bid process, and final awarding of the contract is likely to take
an additional 18 to 24 months to complete.
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The First Responder ALS program is an enhancement to the current EOA agreement and
therefore not part of the RFP process, the entire program would need to be negotiated
after the new vendor was awarded the contract. Based on the approval processes needed,
and the RFP process itself, this negotiation would likely not start for at least two years. It
has taken two years at this point to develop the program with AMR, and it will likely take
at least a year to develop a new program with the new vendor. In essence, going out to
RFP could delay implementation of an ALS program for roughly 4 years. The Fire
Department has provided the Public Safety Sub-committee the plan for implementing the
program which includes a six year phased in approach. The Public Safety Sub-committee
has also requested that the Fire Department expedite the implementation of the ALS
program. Extending the agreement with AMR provides for the immediate
implementation of the ALS program and the enhanced service to our citizens.
Contract Summarv/Issues:
The EOA Agreement that is before Council has been substantially revised from the last
version that was approved in 2007. City staff met with AMR representatives and the Fire
Chiefs of Bonita and Imperial Beach over a period of some weeks to coordinate and draft
these changes.
Listed below are some of the additional terms that will enhance EMS service within the
City:
- Enhanced radio frequency inter-operability;
- AMR units assigned to emergency 911 incidents will comply with the Incident
Command System and report to the Incident Commander for assignment on the
assigned command and tactical frequencies;
- AMR will maintain one 800 Mhz portable radios per unit compatible with first
responder fire agency radio frequencies within the EOA;
- One AMR supervisor per vehicle will be dedicated to the South Bay EOA;
- AMR's paramedics agree to undergo additional emergency response training;
- Enhanced reporting of emergency responses and patient care;
- More joint training efforts between AMR and the agencies;
- Better biohazard disposal procedures and resources;
- Stricter limitations on the acceptable mileage lifetime of AMR's ambulances and
replacement schedule; and
- Enhanced monthly compliance reporting for AMR response times.
Request for Increase in the Maximum Basic and Advanced Life Support Ambulance
Transport Rates•
Pursuant to section 5.7 of the revised and restated agreement, AMR has the reserved right
to request a fee increase in the event of extraordinary cost increases occurring in any of
the contract years. Extraordinary costs are defined as an increase of 20% or more from
the previous contract year in any of the following categories:
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• Vehicle physical damage insurance
Professional liability insurance
• Worker's compensation insurance
• General Liability Insurance
• Gasoline, diesel, propane, oil and petroleum products
• Pharmaceuticals or medical supplies
Accordingly, the City Council reserves the right to approve or disapprove such a request.
As part of this revised and restated agreement, AMR is seeking a 911 rate adjustment.
This adjustment would bring the ALS Emergency Base Rate to $860.90. This rate
remains in the lower 30% of rates in Southern California and is the lowest in the County.
This Base rate is only the portion that AMR receives for transport and does not include
any jurisdictions additional pass through amount. The table below reflects all the
transport rates for AMR in the County.
San Die o Count Trans ort Rates with AMR
San National
$879.39 Bonita $1032.46 La Mesa $1,103.61 Miguel $1,116.59 City
FPD
Imperial
$881.07 Lemon
090.04
$1
$1,413.33 Alpine
$860.90 Chula
Beach ,
Grove Vista
$1,040.13 Count Avera e Trans ort Rate
Negotiated as part of this agreement, is an enhancement of services provided by AMR to
the City. This enhancement includes operational requirements that remove response
criteria exemptions from AMR during periods of high traffic, poor weather, and peak
usage. AMR is continuing to assist us with the development of the ALS First Responder
Program by providing staff time and other resources.
The justification for increasing the ALS emergency ambulance transport fee to $860.90
and allowing this rate to increase by 7% each year throughout the contract extension
period ending September 30, 2014 is attached and contained in an issue paper prepared
by AMR titled: "American Medical Response, Ambulance Rate Increase Justification,
June 2011 ". Currently, the City's rate with AMR is the lowest in the County and will
remain the lowest after this rate increase. Based on the financial justification and the
enhanced services provided by AMR, Staff recommends approval of the 7% rate
increase.
City of Chula Vista AMR Proposed ALS Rate Schedule:
Contract Year Base Rate Requested
Rate Year 1 Rate Increase Annual
Ad'ustment
Current $ 804.58 $ 860.90 $ 56.32 7%
Se t 2011/12 $ 860.90 $ 60.26 7%
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Se t 2012/13 $ 921.16 $ 64.48 7%
Sep t 2013/14 $ 985.65 $ .69.00 7%
Based on the above, staff believes that: (i) a competitive bid process would be
impractical; (ii) AMR is a sole source for ambulance service in the City based on its
unique performance capabilities and compatibility requirements; and (iii) the City's
interests would be materially better served by extending the AMR contract.
DECISION MAKER CONFLICT
Staff has reviewed the decision contemplated by this action and has determined that it is
not site specific and consequently the 500 foot rule found in California Code of
Regulations section 18704.2(a)(1) is not applicable to this decision.
CURRENT YEAR FISCAL IMPACT
There is no current year General Fund fiscal impact to the City associated with this
request. All fees associated are collected by AMR.
ONGOING FISCAL IMPACT
There is no current year General Fund fiscal impact to the City associated with this
request. All fees associated are collected by AMR.
ATTACHMENTS
Attachment 1) EOA Agreement
Attachment 2) Letter from County of SD
Attachment 3) 7% rate increase justification from AMR
Prepared by: Dave Hanneman, Fire Chief, Fire Department and Glen Googins, City
Attorney
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Attachment 1
REVISED AND RESTATED AGREEMENT FOR BASIC AND
ADVANCED LIFE SUPPORT AMBULANCE SERVICES
This REVISED AND RESTATED AGREEMENT FOR BASIC AND ADVANCED
LIFE SUPPORT AMBULANCE SERVICE ("Agreement") is entered into effective as of July 1,
2011 ("Effective Date"), by and between the CITY OF CHULA VISTA ("CITY"), a .municipal
corporation, together with Imperial Beach Fire Department and Bonita/Sunnyside Fire Protection
District (collectively "PARTICIPATING AGENCIES") and AMERICAN MEDICAL
RESPONSE AMBULANCE SERVICE, INC. F/K/A LAIDLAW MEDICAL
TRANSPORTATION, INC., a Delaware corporation, dba AMERICAN MEDICAL RESPONSE,
("AMR").
WITNESSETH
A. WHEREAS, within the City of Chula Vista, there is a public health and safety need
for effective and efficient basic and advanced life support emergency and non-
emergency ambulance services; and
B. WHEREAS, various studies and actual practical experience have clearly
demonstrated that communities of the approximate size and population of Chula
Vista are best assured of receiving the highest level of emergency and non-
emergency ambulance transportation services at the lowest cost to the consumer
where service calls are originated through the 911 ,system if said services are
delivered by a single, competent provider on an exclusive basis; and
C. WHEREAS, the CITY is authorized by Government Code Section 38794 and
Municipal Code Sections 5.10.310-5.10.340 to contract for ambulance services as
public convenience requires; and
D. WHEREAS, pursuant to California Health and Safety Code Section 1797.224, the
County of San Diego ("County") has adopted a plan, in which it has designated an
"exclusive operating area" ("EOA") defined as that part of San Diego County
generally known as the City of Chula Vista, Bonita/Sunnyside Fire Protection
District, and the City of Imperial Beach, for which EOA the CITY is empowered to
contract; and
E. WHEREAS, the City of Chula Vista Fire Department participates in the EOA's first
responder system responding to all emergencies originated in the 911 system; and
F. WHEREAS, on May 9, 1989, City and Med-Trans, dba Hartson Medical Services,
which has since been acquired by AMR, entered into an agreement for the provision
of basic and advanced life support and emergency and non-emergency service; such
agreement was amended on November 26, 1996 (as amended, the "Original
Agreement"); and
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G. WHEREAS, on June 1, 2002, CITY, AMR, and PARTICIPATING AGENCIES
entered into an Amended and Restated Agreement for Basic and Advanced Life Support
Ambulance Services with an option to extend the Agreement;
H. WHEREAS, on December 31, 2007, CITY, AMR, and PARTICIPATING AGENCIES
entered into a Revised and Restated Agreement for Basic and Advanced Life Support
Ambulance Services with an option to extend the Agreement;
I. WHEREAS, on May 31, 2011, CITY, AMR and PARTICIPATING AGENCIES
entered into an Amendment to the Agreement extending the Revised and Restated
Agreement for thirty (30) days; and
J. WHEREAS, on June 30, 2011, CITY, AMR and PARTICIPATING AGENCIES
entered into an Amendment to the Agreement extending the Revised and Restated
Agreement for ninety (90) days; and
K. WHEREAS, the parties' desire to extend the Agreement, with revised and restated terms
and conditions, as set forth in this REVISED AND RESTATED AGREEMENT FOR
BASIC AND ADVANCED LIFE SUPPORT AMBULANCE SERVICE.
NOW, THEREFORE, in consideration of the mutual promises herein contained and for
other good and valuable consideration, receipt of which is hereby acknowledged, the parties agree
as follows:
SERVICES
AMR shall, without cost to PARTICIPATING AGENCIES, perform the following services to the
satisfaction of PARTICIAPATING AGENCIES:
1.1 Provide pre-hospital Advanced Life Support ("ALS") and Basic Life Support
("BLS") emergency medical care and transport services in response to medical calls
for service received through 911 and/or public safety dispatch and communication
centers for calls within the EOA, twenty-four (24) hours each day, seven (7) days a
week without interruption, without regard to the patient's financial status.
1.2 AMR shall meet a maximum response time of ten (10) minutes for 90 percent of all
ALS emergency calls dispatched for each Service Area on a monthly basis.
1.3 AMR shall respond to all calls downgraded to BLS calls within twenty (20) minutes
for 90 percent of the calls dispatched for each Service Area on a monthly basis.
1.4 Response time shall be calculated from the time that a dispatch is received by AMR
for the first dispatched ambulance until the time that the first ambulance arrives on
the scene or at the designated staging area as designated by the incident commander.
If an ALS call is downgraded, the above maximum response time shall not apply;
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however, AMR shall be responsible for responding to such a downgraded call as is
required for a BLS response.
1.5 At a minimum AMR shall provide four (4), Type III ALS capable ambulances,
operating twenty-four (24) hours per day; and an additional Type III, ALS
ambulance operating twelve (12) hours per day, normally posted within the EOA.
1.6 Only ALS responses shall be rendered in direct response to calls for medical
emergencies originating from the 911 system or requests from public safety dispatch
and/or communications centers.
1.7 Participate in disaster preparedness training with EOA personnel. This training shall
be in accordance with San Diego County and EOA disaster plans and consist of two
(2} training sessions and participation in two (2) exercises per year in order to ensure
effective coordination between AMR and EOA employees during disaster
operations. AMR will provide a representative in Chula Vista's Emergency
Operations Center when reasonably required by local emergency.
1.8 Provide and maintain a minimum of one (1) 800 MHz mobile radio per ALS unit
with compatible with first responder fire agency radio frequencies within the EOA,
"Central Zone" and "Metro Zone".
Provide and maintain a minimum of one (1) 800 MHz portable radio per ALS unit
compatible with first responder fire agency radio frequencies within the EOA,
"Central Zone" and "Metro Zone."
AMR units assigned to emergency 911 incidents within the EOA will follow radio
procedures mutually agreed to between AMR and fire agencies. AMR will
participate in the RCIP project which includes AVL capabilities.
AMR units assigned to incidents will comply with the Incident Command System,
and report to the Incident Commander (IC) for assignment on the assigned
Command and Tactical radio frequencies.
All AMR dispatch data shall be captured electronically on a "real-time" basis with a
computer system capable of providing information to CITY with respect to address,
times of dispatch, response times, arrival times and unit identifier.
AMR will work with EOA members in developing area specific radio identifiers and
designators.
1.9 Participate in emergency medical services ("EMS") system activities including
development and operation of automatic and mutual aid agreements, disaster drills,
paramedic ride-alongs, paramedic intern training, and continuing education
programs. AMR also agrees to attend and participate in meetings called at
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reasonable frequencies by the CITY for the purpose of planning and coordinating
EMS service.
AMR field supervisory staff shall be trained at ICS 300 level within six (6) months
of implementation of this agreement. AMR ambulance crews shall be trained at ICS
100 & 200 within six (6) months of implementation of this agreement. AMR will
provide proof of this training.
Joint Training: '
AMR and CITY shall establish joint training .efforts for the sake of better patient
care and teamwork between both agencies.
AMR and CITY will establish a mutually agreed upon joint training curriculum and
corresponding training calendar for both BLS and ALS. Such training will take
place within the CITY, and can be attended by both AMR and CITY. crews. This
training will be open to other participating agencies.
Examples may include:
CPR Provider Course
EMT Defib / ETAD / AutoPulse Audit (3 times annually}
Infection Control practices & procedures (4 hours)
Protocol Updates
Skills Day (Spinal Immobilization, Helmet removal, Traction Splint, FAST Splint,
KED device, Splinting, OB, SOF T tourniquet, etc.)
MCI (START Triage, Triage Tags, Position roles and responsibilities, Treatment
areas, Co. MCA Trailers, etc.)
Documentation / CQI Issues
Using aero-medical resources
AMR and CITY will ensure adequate qualified instructors. AMR will provide
Instructor Training for CPR and First Aid for the department instructors of the other
partner agencies.
If staffing levels decrease due to training needs AMR agrees to staff a Medic Unit
for the duration of the training.
EOA Paramedic Knowledge/Skills/Proficiency Retention:
AMR shall accommodate to the best of their ability and provide interested EOA Fire
paramedics part-time employment subject to AMR's collective bargaining
agreements and their standards related to hiring and retention of employees. Such
accommodation is intended for retention of ALS knowledge and skills.
AMR and City will enter an agreement suitable to both agencies a paramedic
mentorship program. Such program is designed to allow current EOA paramedics
the opportunity to practice and function as paramedics while on-duty for the CITY,
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but under the direct supervision of an AMR paramedic. Such program will also
have to receive approval from the County Medical Director.
1.10 Provide a complaint procedure as outlined herein:
Whenever a complaint is received, regardless of whether from a health care agency,
public safety agency, a patient, or the general public, an Incident Report Form shall
be completed. The field supervisor shall conduct the initial investigation with
emphasis placed on identification of potential system failures and deficiencies,
recommendations for short and long range corrective actions, and the documentation
of facts for future review and reference.
Whenever possible, an immediate face-to-face response shall be made by a member
of AMR' s management team.
All documentation on complaints and criticisms shall be maintained for at least three
(3) years and a copy forwarded to appropriate PARTICIPATING AGENCY within
thirty (30) days of resolution or, in a case where no resolution is reached, the CITY
Manager ofthe-PARTICIPATING AGENCY or his or her designee shall be notified
within two (2) business days of determining that the matter is not resolvable.
1.11 AMR shall resupply the Fire Departments of PARTICIPATING AGENCIES with
medical supplies and related emergency medical equipment, including Personal
Protective Equipment and disposable semi-automatic defibrillator supplies contained
within the list of equipment and supplies described in Exhibit "A," up to a maximum
cost {"Maximum Resupply Obligation") per fiscal year (July through June).
a. For equipment and supplies not exchanged one-for-one at the scene, beginning
July 1, 2011, the Maximum Resupply Obligation shall be $16,500. AMR's
Maximum Resupply Obligation shall be increased each fiscal year thereafter by
10 percent per year, not to exceed $20,000 for any fiscal year during the term of
this Agreement or subsequent extensions. PARTICIPATING AGENCY will
document for AMR the equipment and supplies used but not exchanged at the
scene.
b. The ratio of the resupply amount shall correspond, on a pro rata basis, to the
percentage of calls for service for each PARTICIPATING AGENCY.
c. The cost of the items supplied by AMR shall be determined by the actual invoice
cost to AMR. CITY shall be provided with an appropriate statement on a
monthly basis from AMR detailing supplies PARTICIPATING AGENCIES
have received through this process and the cost assigned to the same.. In no event
shall AMR's obligation hereunder exceed the actual cost of PARTICIPATING
AGENCIES' resupply needs.
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d. AMR shall clearly label all items delivered to the PARTICIPATING
AGENCIES and to provide, with the initial order, "Material Safety Data Sheets"
for any new .items added to the PARTICIPATING AGENCIES' use or
inventory.
In the event that changes in federal, state or local regulations require additional
Personal Protective Equipment or other medical equipment or supplies in
support of EMS operations, and/or if AMR and CITY, by mutual consent, agree
to utilize new equipment in the field to enhance patient care, and the Maximum
Resupply Obligation by AMR is thereby caused to be exceeded for a given fiscal
year, the parties agree to negotiate in good faith to adjust the maximum limits of
AMR's contribution.
f. Establish an agreed, standardized-compliment of EMS disposable equipment for
fire stations. AMR agrees to deliver or have delivered these inventories to a
maximum of three (3) locations within the contract area and incorporate it into
their regular weekly rounds and may be changed subject to mutual consent of the
Parties.
g. Provide to CITY on a monthly basis a re-supply balance sheet. Information shall
identify all itemized transactions taken from the re-supply obligation in 1.11 (a)
of the Agreement.
h. Disposable medical supplies identified in the revised "Exhibit A" (1/16/09) that
are not typically replaced "one-for-one" on scene, or the specific make and
model are not supplied by AMR will be replaced by AMR in accordance with
the supply balance provisions of the contract.
1.12 Properly transport and dispose of all biological/medical waste generated by CITY
within the EOA while rendering services pursuant to this agreement. Includes
biological/medical waste storage sheds at Fire Station #52 and Fire Station #57 {new
location).
1.13 Provide all ambulances, as well as other vehicles and equipment, that are necessary
for the provision of services required under this Agreement (including all fuel,
lubricants, maintenance, insurance, and repairs/replacement).
1.14 Provide standby ambulance support to the Fire Departments of PARTICIPATING
AGENCIES at major emergencies as determined appropriate and necessary by
PARTICIPATING AGENCY'S incident commander. Exemptions shall be granted to
AMR for calls received within the response area for the unit assigned to such
incidents during the time that unit is committed. Additionally, calls that can be
shown to be exceptions because of the deployment of this resource may also be
granted exempt status from response time compliance.
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1.15 Participate in disaster preparedness planning and training activities carried out by
the AGENCIES within the EOA and the County of San Diego. AMR is not
responsible for providing medical supplies or equipment for such activities.
1.16 Comply with all training requirements established by the State of California, and all
applicable policies and provisions established by the San Diego County Emergency
Medical Services Division ("SDCEMSD").
1.17 AMR will submit Grooming/Tattoo policies to all participating jurisdictions for
review and input within 30 days of the effective date of this Agreement.
1.18 AMR will administer a program to make available influenza vaccine (seasonal and
pandemic} on an annual basis to all EOA suppression personnel during the term of
this Agreement the cost of the vaccines shall be the responsibility of the City.
1.19 AMR will administer a program to make available Tetanus, Diphtheria, and
Acellular Pertusis (Tdap) booster vaccine available to all EOA suppression
personnel as recommended by the California Department of Public Health during
the term of this agreement. The cost of the vaccines or serums shall be the
responsibility of the City.
1.20 AMR Uniforms: Shoulder Patch: A shoulder patch will be developed in
conjunction with EOA members and worn by all AMR personnel scheduled to work
the South Bay EOA to be agreed to by the EOA members and AMR. Work
Uniforms: 1) Rank /File 911 Paramedics: Uniform shirts and pants will be navy
blue in color, with black buttons; and 2) Administration: Uniform shirts and pants
will navy blue in color with black buttons. AMR will phase in the new uniforms
within the first year of this Agreement.
2. SYSTEM REQUIREMENTS
2.1 All ambulance units must be equipped and staffed at all times to meet all state and county
laws and regulations affecting service delivery. AMR shall operate and maintain all
ambulances and equipment in a manner that will not endanger life or property, and in
accordance with all existing and future federal, state, and local laws, ordinances, regulations,
resolutions, policies, procedures, and protocols applicable to AMR's performance pursuant
to this Agreement. AMR shall maintain Primary Type III Modular ALS units within the
EOA in accordance with practices in effect as of the Effective Date.
Preventable Mechanical Failure:
Ambulances dedicated to the Southbay EOA primarily assigned to 911 responses shall be
type III units equipped as described in the EOA contract and shall have a maximum service
life of 250,000 miles or five (5) years (whichever is less).
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Reserve or replacement ambulances shall be Type III units. Type III reserve units as well as
units that respond into the Southbay EOA from another area, will not be held to the mileage
or year requirements.
CITY shall have the ability to designate a reserve or replacement unit as in need of
evaluation if it meets the following criteria:
^ Any unit that has been out of service for more than one (1 } ,day (24 hours), four (4) or
more times in a calendar year; or
^ Any unit that has failed to respond because of a mechanical reason more than once in a
calendar year; and
^ Excepting that this definition does not include units out of service for regular scheduled
maintenance. Once a unit is repaired and placed back into service it shall be monitored
for a six (6) month period.
Under extreme circumstances, including but not limited to, a disaster, local emergency or
excessive fire activity, AMR shall be granted a variance to this requirement. Once the
extreme circumstance has passed, the above requirements will be reinstated.
2.2. Staffing. For all requests for service received through the 911 system and/or public safety
dispatch and communication centers for calls within the Service Area, AMR shall ensure
that, at a minimum, the staffing requirements of SDCEMSD or other appropriate successor
in interest with appropriate authority, will be met ~ at all times. In furtherance of this
requirement:
a. AMR shall guarantee minimum staffing levels on all units assigned to the EOA twenty-
four (24) hours per day, 365 days a year.
b. Such staffing levels shall be mandatory and employees needed for such staffing shall not
be released until such time as minimum staffing levels can be maintained.
c. AMR will provide one (1) AMR supervisor /vehicle which will be available to the South
Bay & National City EOA twenty-four (24) hours/day -seven (7) days/week. Typical
expectations include: overhead resource for incident operations, incident support (i.e.,
rehab and medical monitoring), and occasional field training.
2.3 AMR agrees to employ paramedics who meet and/or exceed all state and county licensing
and certification requirements. AMR will ensure that ail emergency personnel meet the
continuing education requirements specified by San Diego County.
2.4 AMR shall notify PARTICIPATING AGENCIES immediately whenever any condition
exists which adversely affects delivery of satisfactory emergency medical services to the
EOA. For purposes of this paragraph, notification of Heartland Fire Communications and
San Diego Fire Dispatch facilities shall be deemed appropriate notification.
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2.5 Other County-permitted providers' ambulances and personnel may be used for 911 pre-
hospital emergency medical care and transport only in accordance with County policy and
with approval of AMR.
2.6. When it becomes necessary to use other providers to assist in responding to 911 calls,
AMR shall include such incidents in the monthly report.
2.7 AMR is responsible for assuring that its ambulances are staffed and equipped in
accordance with County policy and the terms of this Agreement.
2.8 AMR shall participate in and cooperate with other EMS system entities in furthering
the development the system.
2.9 CITY acknowledges AMR's responsibility to inform each Agency it contracts with of the
requirements contained in the Health Insurance & Portability Act of 1996 regarding
confidentiality of patient records. The PARTICIPATING AGENCIES agree to uphold
the law with regard to the confidentiality of patient records and bear the costs of any
violation of patient confidentiality by their respective employees.
2.10 A minimum of semi-annual operations meetings for this EOA shall take place. Those
present shall include representatives from AMR and representatives from each
PARTICIPATING AGENCY. These meetings will take place to review monthly
response time reports, and to discuss any other issues involving this contract or
operations.
3. RESPONSE TIME PERFORMANCE
System response times are a key measurement of performance. This measurement is the
determining factor that drives the placement and redeployment of the system's resources throughout
the entire system.
3.1 Each incident will be counted as a single response regardless of the number of units that
respond.
3.2 AMR shall use its best efforts to minimize variations or fluctuations in response time
performance.
3.3 AMR shall not be held accountable for response time compliance for any request for
service outside the EOA. Responses to requests for service outside the EOA will not be
counted in the number of total calls used to determine response time compliance under
this Agreement.
3.4 Compliance Reporting. AMR shall file a report of response time compliance on the
following basis:
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a. For the City of Chula Vista, reports of response time compliance shall be .submitted
on a monthly basis.
b. For the City of Imperial Beach and the Bonita/Sunnyside Fire Protection District, a
report combining the City of Imperial Beach's and the Bonita/Sunnyside Fire
Protection District's response times shall be submitted on a monthly basis.
c. The form and format of such reporting shall approximate the form attached hereto as
Exhibit "B", which from time to time may be amended with agreement of the
parties, and shall be filed within ten {10) days of the. end of the previous month.
d. Monthly Compliance Reporting: AMR shall submit a monthly report of response
time compliance. The format of this report will be developed by AMR, and
approved by the CITY within thirty (30) days of signing the amended contract
agreement. This report shall. include:
i. Total number of responses
ii. Incident response times
iii. Raw compliance (without exceptions) percentage
iv. Number of responses receiving exceptions
v. Adjusted compliance total with exceptions (percentage)
vi. Number of 911 calls handled by other transport provider agencies.
3.5 Response Time Exemptions. It is understood that unusual circumstances beyond
AMR's reasonable control can induce response times that exceed the aforementioned
standards. "Declared Disasters": AMR may request an exception to response time
standards during times of declared emergencies as determined by the Fire Chief or their
designee, or calls to a scene related to an activation of "Annex D" of the San Diego
County Multi-Hazard Disaster Plan.
Equipment failure, traffic collisions not involving the responding ambulance, or lack of
a nearby ambulance shall not furnish grounds for release from general response time
standards. If AMR feels that any run or group of runs should be exempt from response
time standards due to unusual circumstances beyond AMR's reasonable control, AMR
may request that these runs be excluded from response time performance calculations.
Each PARTICIPATING AGENCY shall determine the granting of exemptions within
its service area. If the PARTICIPATING AGENCY concurs that the circumstances do
fit the contract's exemption criteria, it shall allow such exemptions in calculating
overall response time performance.
a. Each request for exemption will be accompanied by a completed "Exception Inquiry
Form" attached hereto as Exhibit "C," which from time-to-time may be amended
with the agreement of the parties, and shall be filed within ten (10) days of the end
of the previous month.
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b. The PARTICIPATING AGENCIES will have ten (10} days from the receipt of the
requested exemptions in which to notify AMR as to whether the requested
exemptions have been granted or denied.
3.6 Reassignment En Route. If a responding. ambulance is reassigned en route from a first
call to second call prior to arrival at the incident location, the response time clock will
not stop on the first call until the arrival of an appropriately staffed ambulance on the
scene of the first call.
a. Separate code classifications and response time measurements will be kept on each
call.
b. AMR is expected to meet the applicable response times for the calls, even when
diverted.
3.7 Notwithstanding any other provision within this Agreement, the ALS Ambulance may
be canceled en route or down graded by dispatch, or any on-duty paramedic, EMT, or
public safety officer at the scene consistent with San Diego County medical protocols.
3.8 Cancellation of Calls. Calls cancelled prior to the arrival of an ambulance on scene
shall not be included in determining monthly response time compliance, but will be
noted in the monthly report.
4. PENALTIES FOR RESPONSE TIME NON-COMPLIANCE
4.1 In the event AMR fails to meet the response time requirements in any service area,
AMR shall be accessed penalties as follows:
a. If AMR fails to meet the response time criteria, after exemptions (if any) have been
granted, AMR shall add an additional six (6) ALS Type III unit-hours per day to the
EOA. .
b. These additional unit-hours described in paragraph 4.1 shall remain in
place until such time and AMR has maintained response time
compliance for two (2) consecutive months.
c. Notwithstanding paragraph 4.1, in the event that AMR has nine {9) or more ALS
calls for service in one (1) calendar month with response times of twenty (20}
minutes or longer, the following penalty shall apply: AMR shall add an additional
eight (8) ALS Type III unit-hours per day to the EOA for two {2} months.
d. These additional unit-hours described in paragraphs 4.1 and 4.3 shall be
implemented within seven (7) days of the final determination of non-compliance.
5. FEE SCHEDULES
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AMR shall operate a billing and accounts receivable system that is humane, well-documented, easy
to audit, and which minimizes the effort required of patients to recover funds from third party
sources for which they may be eligible. AMR shall be able to provide quarterly and annual reports
as specified by CITY.
5.1 AMR is authorized to bill patients transported on calls originating as medical calls for
service through 911 and/or public safety dispatch and communication centers
according to AMR's fee structure attached as Exhibit "D," which maybe modified from
time to time as described in Subparagraphs below.
5.2 Rates charged for Base Rate, Oxygen, Mileage, Night Charges and Treatment only (No
Transport) ("Primary Rate Components") shall not be increased above those set forth on
Exhibit "D" for the period October 1, 2011 until September 30, 2012.
5.3 For each of the three (3) contract years October 1, 2011 to September 30, 2012 (year 1)
and October 1, 2012 to September 30, 2013 (Year 2); and October 1, 2013 to September
30, 2014 (Year 3), the Primary Rate Components may be increased at AMR's discretion
by an amount not to Exceed seven (7) percent per year. A justification of this rate
increase is also contained in Exhibit "D."
5 ;4 If the CITY exercises its option to extend the Agreement for an additional term of three
(3) years, AMR agrees to meet and confer with the CITY for the purpose of negotiating
limitations on maximum rate increases in those years.
5.5 The meet and confer process shall begin six (6) months prior to the expiration of Year 3
of the initial term.
5.6 All other non-Primary Rate Component charges, while not specifically assigned
maximum rates under this Agreement, shall not exceed industry standard rates charged
by AMR and other ALS/BLS service providers within the County of San Diego.
5.7 AMR reserves the right to submit a request to the Chula Vista City Council for a fee
increase, in addition to that allowed above, for extraordinary expenses in any of the
following categories:
• Vehicle physical damage insurance
• Professional liability insurance
• Workers Compensation insurance
• General liability insurance
• Gasoline, diesel, propane, oil and petroleum products
• Pharmaceuticals or medical supplies
Extraordinary expenses are defined as an increase in cost from the previous year of twenty
(20) percent or more for a specific contract year in any of the above-stated categories. The
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Chula Vista City Council reserves the right to approve or disapprove such a request in its
sole discretion.
5.8 Notwithstanding the above, AMR also reserves the right to submit a request for a fee
increase in the event of any extraordinary change in the payment or cost recovery
provisions in Medical, Medicare, or their successor programs.
5.9 The CITY shall notify AMR in writing of approval or disapproval of the increase
within thirty (30} calendar days of receipt of accurate and complete information
satisfactorily supporting any increase.
5.10 In the event that either Bonita/Sunnyside FPD or the City of Imperial Beach withdraws
from this Agreement, the minimum ambulance requirements of the above
subparagraph shall be waived, and new minimum ambulance requirements established
upon mutual Agreement between the parties. The withdrawing AGENCY must provide
no Iess than 180 days notice to all parties of its withdrawal.
6. INSURANCE
AMR shall obtain and maintain at all times a policy of insurance by an insurance carrier acceptable
to CITY against loss from public and automobile liability arising from any operation or activity of
AMR, its agents or employees. Types and amounts of such insurance to be maintained shall be as
defined in Exhibit "E" Insurance Requirements, which is hereby adopted by reference and hereby
made part of this Agreement.
7. HOLD HARMLESS & INDEMNIFICATION
AMR shall indemnify, protect, defend and hold harmless the CITY and PARTICIPATING
AGENCIES, its officers, agents, elected officials, volunteers and employees from and against all
claims demands, causes of action, costs, expenses, liability, loss, damage or injury, in law or equity,
to property or persons, including wrongful death, damages, losses and expenses, including
attorneys' fees and other costs of defense, arising out of or resulting from the performance by
AMR, its officials, officers, employees, agents, and contractors, of the services specified in this
Agreement caused, or alleged by third parties to have been caused, by any intentional or negligent
act or omission of AMR, any subcontractor of AMR or anyone directly or indirectly employed by
AMR or its subcontractors, except to the extent caused by the sole negligence or willful misconduct
of the CITY and PARTICIPATING AGENCIES, any subcontractor of the PARTICIPATING
AGENCIES, or anyone directly or indirectly employed by the PARTICIPATING AGENCIES or
its subcontractors.
Costs of Defense and Award. Included in the obligations in the Paragraph above, is the AMR's
obligation to defend, at AMR's own cost, expense and risk, any and all suits, actions or other legal
proceedings, that may be brought or instituted against CITY and PARTICIPATING AGENCIES,
its directors, officials, officers, employees, agents and/or volunteers, subject to the limitations
contained in the Paragraph above. AMR shall -pay and satisfy any judgment, award or decree that
may be rendered against CITY and PARTICIPATING AGENCIES or its directors, officials,
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officers, employees, agents and/or volunteers, for any and all related legal expenses and costs
incurred by each of them, subject to the limitations contained in the Paragraph above.
AMR's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by the
CITY and PARTICIPATING AGENCIES, its directors, officials, officers, employees, agents,
and/or volunteers. AMR agrees to pay any and all costs CITY AND PARTICIPATING
AGENCIES incur in enforcing the indemnity and defense provisions set forth above.
AMR's obligations under the above provisions shall survive the termination of this Agreement.
8. INDEPENDENT CONTRACTOR STATUS
1 Both parties hereto in the performance of this Agreement will be acting in an
independent capacity and not as agents, employees, partners or j oint ventures with one
another. AMR is not an employee of CITY and is not entitled to any of the rights,
benefits, or privileges of CITY employees, including, but not limited to medical,
unemployment, or workers' compensation insurance.
8.2 This Agreement contemplates the personal service of AMR and AMR's employees or
independent contractors, and it is recognized by the parties that a substantial inducement
to CITY for entering into this Agreement was, and is, the professional reputation and
competence of AMR.
8.3 Neither CITY nor its officers, agents or employees shall have any control over the
conduct of AMR or any of AMR's employees or independent contractors, except as
herein set forth, and AMR expressly agrees not to represent that AMR, or any of AMR's
agents, servants, employees or independent contractors, are in any manner agents,
servants or employees of CITY, it being understood that AMR, its agents, servants,
employees and independent contractors are as to CITY wholly independent contractors
and that AMR's obligations to CITY are solely such as prescribed by this Agreement.
9. ASSIGNMENT
AMR shall not assign any portion of this Agreement or the services to be rendered thereunder
without the written consent first obtained from CITY, which will not be unreasonably withheld.
10. PERMISSION TO SUBCONTRACT SERVICES
AMR may subcontract for ALS First Responder services with each PARTICIPATING AGENCY
within the service area. Each agency may enter into an agreement with AMR for the provision of
those services.
10.1 The parties agree that upon execution of such subcontracts for First Responder
services, response time performance standards may be modified and applicable
paragraphs of this Agreement modified in conformance with these new standards.
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11. RIGHT TO REQUIRE PERFORMANCE
The failure of CITY at any time to require performance by AMR of any provisions hereof, shall in
no way effect the right of CITY thereafter to enforce same. Nor shall waiver by CITY of any
breach of any of the provisions hereof be taken or held to be a waiver of any succeeding breach of
such provision or as a waiver of any provision itself.
12. SEVERABILITY
If any provision of this Agreement shall be declared to be illegal, void or unenforceable by a court
of competent jurisdiction, such provisions shall be deemed severable, and the other provisions shall
not be affected but shall remain in full force and effect.
13. AUDIT AND REPORTING PROCEDURES
AMR agrees to allow CITY officials complete access to all operational and financial records and
data (including computer generated reports) pertaining to the services provided pursuant to this
Agreement. All records and documents regarding this service shall be available in the County of
San Diego for a period of not. less than three (3) years. AMR further agrees to submit to CITY the
following reports:
13.1 San Diego County (pre-hospital patient records) EMS Report Forms (ALS and BLS)
on request.
13.2 Annual Financial Report that shows revenues billed and collected by payment source
for calls originating within the EOA which includes a list of all transports. (Note:
CITY reserves the right to conduct spot checks of patient billings.)
13.3 Monthly Response Time Analysis Report that shows percentage of calls arrived
within minute parameters and shows all late responses for all classifications.
13.4 Monthly Exception Report that lists all response performance exceptions requested.
AMR shall make every responsible effort to identify the cause of such extended
response time and shall document efforts to eliminate repetitions of that cause of poor
response time performance if requested by PARTICIPATING AGENCIES. (Note:
time in the system is counted in seconds, not in whole minutes.)
13.5 Annual Collection Percentage Report, which shows a breakdown of collection
performance.
14. NOTICES
All notices to AMR shall be mailed to:
General Manager
American Medical Response Ambulance Service, Inc.
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8808 Balboa Avenue
San Diego, California 92123
and
Legal Department
American Medical Response, Inc.
6200 South Syracuse Way, Suite 200
Greenwood Village, CO 80111
All notices to PARTICPATING AGENCIES shall be mailed to:
Fire Chief
City of Chula Vista
276 Fourth Avenue
Chula Vista, California 91910
and
City Manager
City of Chula Vista
276 Fourth Avenue
Chula Vista, California 91910
and
Fire Chief
City of Imperial Beach
865 Imperial Beach Boulevard
Imperial Beach, California 91932
Fire Chief
Bonita Sunnyside F.P.D.
4900 Bonita Road
Bonita, CA 91902
15. CONSIDERATION
Consideration provided to AMR for the comprehensive services to be provided by AMR is that
CITY shall grant to AMR the exclusive rights to provide emergency and non-emergency basic and
advanced life support service within the EOA originated through the 911 system.
16. CONTRACT ADMINISTRATION
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13-27
The CITY designates the City Manager, City of Chula Vista, 276 Fourth Avenue, Chula Vista,
California 91910, or his/her designated representative, to administer this Agreement on behalf of
the CITY. AMR designates Michael Murphy, General Manager, 8808 Balboa Avenue, Suite 150,
San Diego, California 92123, to administer this Agreement on behalf of AMR. All reports,
proposal, letters, notices and/or other correspondence shall be sent to the attention of the designated
representatives at their respective addresses.
17. TERM OF AGREEMENT AND RENEWAL PROVISIONS
This REVISED AND RESTATED AGREEMENT shall commence on October 1, 2011. The
Agreement shall terminate at midnight, September 30, 2014, unless extended as provided for herein.
This Agreement may be extended for one (1) additional period of three (3) years at CITY's option,
in its sole discretion. CITY shall exercise its option to extend by sending written notice to AMR of
its intent by no later than six (6) months prior to the expiration of the then current term. If CITY
fails to notify AMR of its intent as provided above, then AMR shall notify CITY in writing of its
desire to extend or not to extend the term, and CITY shall have an additional thirty (30) days from
its receipt of such notice to make its election. Factors that will be considered by the CITY include
AMR's response time performance, compliance with the terms and provisions of this Agreement,
AMR's responsiveness and cooperation in relationships with the CITY, County Emergency
Medical Services and the Base Hospitals, and any other factors considered of importance to the
CITY in its sale discretion.
18. RIGHT OF AMR TO TERMINATE AT BEGINNING OF YEAR 4.
18.1 Notwithstanding any other provisions of this Agreement, should the parties fail to
come to agreement on base rate charges at the beginning of the extension periods
AMR may terminate this Agreement by written notification to the
CITY providing notice of the effective date of such termination which shall not be less
than 365 days from the receipt of the notice. Service shall continue under the terms of
this Agreement for the time specified in the notice from AMR.
18..2 If after due diligence by the CITY, the CITY has not procured alternative ALS/BLS
services, the CITY shall be entitled to order an extension of service for an additional
period of up to 180 days after the termination by AMR. The CITY shall notify AMR in
writing at least sixty (60) days prior to the expiration of the one-year notice. Service
shall continue under the terms of this Agreement for the time specified in the notice
from CITY.
19. TERMINATION FOR CAUSE, LIQUIDATED DAMAGES
19.1 CITY may immediately terminate this Agreement if AMR's license to operate
ambulances by the state is revoked or suspended.
19.2 CITY may terminate this Agreement for material breach, if the material breach is not
cured within thirty (30) days after a written notice specifying the cause is delivered to
17
13-28
Michael Murphy, General Manager, American Medical Response Ambulance Service,
Inc., 8808 Balboa Avenue, San Diego, CA 92123 and Legal Department, American
Medical Response, Inc., 6200 South Syracuse Way, Suite 200, Greenwood Village, CO
80111 .
a. Material breach shall include, but not limited to:
(1) Failure to comply with the material terms and conditions of this Agreement,
after notice of the failure has been given to AMR;
(2) Gross misinterpretation or fraud;
(3}Failure to operate in compliance with the requirements of the applicable federal,
state and local laws, rules and regulations relating to the provision of ALS
paramedic and BLS ambulance service.
19.3 If, within the thirty (30) days after delivery of the written notice of termination for
Material breach, the material breach has not been cured to the reasonable satisfaction
of CITY's representative, then CITY may terminate this Agreement effective as of a
date specified in a written notice of termination delivered thereafter. During the thirty
(30) day cure period, if CITY determines that the public health and safety -would be
endangered by the continued provision of service by AMR, in consultation with the
County EMS Medical Director or designee, CITY may nevertheless, immediately
suspend further performance and give written notice of immediate termination of this
Agreement.
19.4 If, after termination of this Agreement for cause by CITY pursuant to 19.1 and 19.2, it
is ultimately determined by an arbitrator that CITY's termination was not justified (that
AMR had not committed a material breach of this Agreement), CITY and AMR agree
that the injury AMR may suffer as the result of such conduct by CITY is, impossible to
ascertain or estimate and that the sum of $50,000, shall be paid by CITY to AMR and
is a reasonable estimate of the potential injuries suffered. Said amount is agreed upon
as liquidated damages and not as a penalty.
19.5 Any waiver, acceptance of services, or failure to require compliance as it relates to the
Agreement shall not be deemed to be a waiver of any other breach of or change to the
terms of, or operate to stop CITY from enforcing the provisions of this Agreement. A
consent to one assignment by CITY shall not be deemed to waive the right to consent
to any future assignments.
20. TERMINATION FOR CONVENIENCE
Notwithstanding any provisions to the foregoing, CITY may terminate this Agreement at any time
and for any reason, by giving specific written notice to AMR of such termination and specifying
the effective date thereof, at least 180 days before the effective date of such termination. In the
18
13-29
event the Agreement is terminated by CITY as provided in this paragraph, AMR shall be entitled to
receive compensation for services rendered prior to the effective date of such termination. AMR
hereby expressly waives any and all claims for damage or compensation arising from termination
as provided for herein.
21. APPLICABILITY IN IMPERIAL BEACH
This Agreement shall apply throughout the EOA; provided, however, with regard to the provision
of services within the corporate limits of the City of Imperial Beach, the provisions of paragraph 3
(response time commitments) and Exhibit "D" (base rates) shall be superseded by the provisions, if
any, in any agreement in effect between AMR and the City of Imperial Beach.
If AMR and the City of Imperial Beach do not have an agreement in effect at any time during the
term of this Agreement, then response times and the Fee Schedule for the Imperial Beach portion of
the EOA shall be as provided herein.
22. AGREEMENT TO REOPEN NEGOTIATIONS
At any time during the term of the Agreement, either party .reserves the right to propose system
enhancement changes which will better meet the needs of the service area. The parties agree to
meet and confer and determine the appropriateness of any such change to the system and any
necessary or appropriate corresponding increase in AMR's rates. Any such change shall be by
mutual agreement with each parry acting in its sole discretion.
23. SIDE-LETTER AGREEMENTS
Under the authority of this Agreement, the CITY and PARTICIPATING AGENCIES are permitted
to enter into side-letter agreements with AMR specifying different levels of services, response time
commitments and rates provided to each of them. These side-letters will only be binding upon
AMR and the parties entering into them and the benefits therein will not accrue to any party not
entering into aside-letter agreement.
24. PERFORMANCE BOND
This Agreement also requires that AMR deposit with the CITY a performance bond in the amount
of $300,000.00 in favor of CITY and PARTICIPATING AGENCIES. A copy of said bond and
miscellaneous definitions are attached hereto as "Exhibit F." CITY shall only call the bond after the
following conditions precedent have been satisfied: (i) AMR materially breaches the Agreement;
(ii) CITY issues a written declaration of material breach; (iii) AMR fails to cure the material
breach; and (iv) the CITY terminates the Agreement.
25. COMPLIANCE.
The parties will comply in all material respects with all applicable federal and state laws and
regulations including, the Federal Anti-kickback statute. The funding set forth in this Agreement
(and/or any "side letter") shall be used only for the City services or system Enhancements set forth
19
13-30
herein. The CITY and each PARTICIPATING AGENCY warrants and represents that the
payments made by AMR shall be less than or equal to the CITY's ~ or PARTICIPATING
AGENCY'S actual costs to provide those services or system Enhancements. No funds shall be used
by the City or a PARTICIPATING AGENCY in a manner that may violate 42 U.S.C. Section
1320a-7b, the federal Anti-Kickback Statute.
26. COMPLIANCE PROGRAM AND CODE OF CONDUCT.
AMR has made available to each party a copy of its Code of Conduct, Anti-kickback policies and
other compliance policies, as may be changed from time-to-time, at AMR's web site, `located at:
www.amr.net, and each party acknowledges receipt of such documents. AMR warrants that its
personnel shall comply with AMR's compliance policies, including training related to the Anti-
kickback Statute.
27. NON-EXCLUSION.
Each party represents and certifies that neither it nor any practitioner who orders or provide
Services on its behalf hereunder has been convicted of any conduct that constitutes grounds for
mandatory exclusion as identified in 42 U.S.C.§ 1320a-7(a). Each party further represents and
certifies that it is not ineligible to participate in Federal health care programs or in any other state or
federal government payment program. Each party agrees that if DHHS/OIG excludes it, or any of
its practitioners or employees who order or provide Services, from participation in Federal health
care programs, the party must notify the other party within five (5) days of knowledge of such fact,
and the other party may immediately terminate the Agreement, unless the excluded party is a
practitioner or employee who immediately discontinues ordering or providing Services hereunder.
28. REFERRALS.
It is not the intent of either party that any remuneration, benefit or privilege provided for under the
Agreement shall influence or in any way be based on the referral or recommended referral by either
party of patients to the other party or its affiliated providers, if any, or the purchasing, leasing or
ordering of any' services other than the specific services described in this Agreement. Any
payments specified herein are consistent with what the parties reasonably believe to be a fair
market value for the services provided.
20
13-31
SIGNATURE PAGE TO AMENDED
AND RESTATED AGREEMENT FOR BASIC
AND ADVANCED LIFE SUPPORT AMBULANCE
SERVICE
THE CITY OF CHULA VISTA
AMERICAN MEDICAL RESPONSE
AMBULANCE SERVICE, INC.
a Delaware Corporation, dba
AMERICAN MEDICAL RESPONSE
Cheryl Cox
Mayor of the City of Chula Vista
ATTEST:
Approved as to form by:
Glen Googins
City Attorney
CITY OF IMPERIAL BEACH
Gary Brown
City Manager
Name:
21
13-32
Title:
BONITA/SUNNYSIDE FIRE
PROTECTION DISTRICT
Scott Walker
Fire Chief
~~ ~~~~~~
:-
~~~~~~~s
~C~u~ttp of ~~~ Diego
NICK MACCHIONE, FACHE HEALTH AND HUMAN SERVICES AGENCY
DIRECTOR PUBLIC HEALTH SERVICES
WILMA J. WOOTEIV, M.D., M.P.H. HEALTH SERVICES COMPLEX
PUBLIC HEALTH OFFICER 3551 ROSECRANS, SAN DIEGO, CALIFORNIA 92110
(619) 531-580D FAX (619} 542-4186
EMERGENCY MEDICAL SERVICES
6255 Mission Gorge Road
San Diego, CA 92120
(619) 285-6429 Fax: (619) 285-fi531
August 4, 2011
D. Hanneman, Fire Chief
City of Chula Vista Fire Department
460 Fourth Avenue
Chula Vista, CA 91910
Dear Chief Hanneman:
SOUTH BAY EXCLUSIVE OPERATING AREA
Attachment 2
Epidemiology & Immunization Servioes
Emergency & Disaster Medical Services
HIV, STD and Hepatitis
Maternal, Child and Family Health Services
Public Health Laboratory
PH Nursing
Border Health
TB Control & Refugee Health
Vital Records
At our meeting on August 1, 2011, you requested information on the required procurement process for
ambulance transportation services in the South Bay Exclusive Operating Area ("EOA") should the City of
Chula Vista (CCV) decide to pursue a competitive process. At that meeting, you indicated that this
information will be shared in a memo for the CCV City Council in response to questions raised at the
June 21, 2011 CCV City Council meeting.
You have advised the County that the CCV does not plan to make any changes in the geographic
boundaries of the South Bay EOA, which includes the CCV, the City of Imperial Beach .and the Bonita
Sunnyside Fire Protection District as defined by CCV's agreement with the County. As mentioned in
previous correspondence dated June 28, 2011, since the agreement took place prior to January 1, 1981,
the jurisdictions of the EOA are "grandfathered" under state statute. Prehospital emergency medical
services in the South Bay EOA have continued, uninteiTUpted in the same manner and scope as desct~ibed
in the agreement. However, shifting from a "grandfathered" status to a competitively procured status
would constitute a change to the manner and scope of services and therefore, the ambulance
transportation services provided in the EOA would be subject to the following process now and at
periodic intervals into the future:
• CCV notifies County of San Diego EMS of their intent to change to a competitive procurement
process.
• County EMS notifies the California EMS Authority regarding the recommended change(s) in the
local EMS Plan.
• The EMS Plan is subject to EMSA approval.
• CCV develops a Request for Proposal (RFP) which sufficiently sets forth the requirements for
service provision in accordance with any and all applicable State and County laws, regulations,
ordinances, guidelines, policies and procedures.
13-33
South Bay Exclusive Operating Area
August 4, 2011
Page 2
• EMS reviews and approves the RFP to ensure it complies with the State EMSA Guideline # 141
and to ensure a fair and competitive process.
• EMSA has the authority to, and may choose to, review a proposed competitive procurement
process.
• CCV conducts the advertising and selection process for the RFP in accordance the State EMSA
Guideline # 141 and applicable laws.
For a more detailed description of the competitive procurement process, please refer to the enclosed State
EMSA Guideline # 141 entitled "Competitive Process for Creating Exclusive Operating Areas."
It is our goal to ensure that any changes to the EOA affecting the jurisdictions and the provision of
emergency medical services in the South Bay EOA are discussed with all parties involved and an
agreement is reached prior to bringing recommendations to EMS.
If you have any questions, please contact me or Dr. Bruce Haynes, EMS Medical Director, at 619-285-
6429.
Sincerely,
Marcy Metz, Chief
Emergency Medical Services
MM:kc
Attachment
cc: Dr. Bruce Haynes, EMS Medical Director
Jim Sandoval, City of Chula Vista City Manager
Tom Clark, City of Imperial Beach Public Safety Director/Fire Chief
Scott Walker, Bonita Sunnyside Fire Protection District Fire Chief
Chuck Matthews, Public Health Administrator
13-34
STATE OF CALIFORNIA -HEALTH AND HUMAN SERVICES AGENCY ARNOLD SCHWARZENEGGER, Governor
EMERGENCY MEDICAL SERVICES AUTHORETY
1930 9"' STREET max;
SACRAMENTO, CA 958'44-7043 ''
(916)322-4336 FAX (916)324-2875
Competitive Process for Creating
Exclusive Operating Areas
February 1997
EMSA #141
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COMPETITIVE PROCESS FOR CREATING EXCLUSIVE OPERATING AREAS
Section 1797.224 of Division 2.5 of the Health and Safety Code requires that the EMS
Authority delineate a competitive process for awarding exclusive operating areas for
emergency response.
If the local EMS agency decides to create exclusive EMS operating areas, a Request
for Proposal (RFP) must be developed. An RFP is the awarding agency's description in
document form, of specific services to be provided in addition to other contractual
requirements. The competitive process for awarding the area must, at a minimum,
address the following:
1. Formal advertising of the opportunity to compete for areas.
2. A request for proposal which sufficiently states the requirements of the county
and requires adequate documentation of the respondents/ EMS capability and
fiscal status.
3. A responders' conference to provide a forum for answering questions.
4. Policies. for:
a. The submission of responses;
b. receiving responses;
c. response evaluation;
d. response rejection;
e. award notification;
f. protests and appeals; and
g. contract cancellation
When the local EMS agency policies and procedures have been developed, they should
be sent to the EMS Authority as part of the local EMS plan submittal. Approval of the
process may be secured prior to plan submittal provided it is later incorporated into the
plan.
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GUIDELINES FOR CREATING EXCLUSIVE EMERGENCY MEDICAL SERVICES
OPERATING SERVICE AREAS
I. INTRODUCTION
In the event a local emergency medical services (EMS) agency decides to create one or
more exclusive operating areas (EOA) in the development of a local plan, EMS
providers within those areas must be selected through a competitive process outlined in
Section 1797.224 of Division 2.5 of the Health and Safety Code unless one of the
statutory exceptions to that competitive process exists (Section 1797.224). A local EMS
agency creates an "exclusive operating area" whenever it restricts operations in an
EMS area or subarea defined by the Emergency Medical Services Plan to;
• one or more emergency ambulance services or
providers of limited advanced fife support (LALS) or
• advanced life support (ALS) (Section 1797.85)
The provisions of Section 1797.224 will apply in the majority of instances in the
development of a local plan since most local agencies restrict operations to one or more
emergency ambulance services or providers within the EMS area or subarea. This is
done in an effort to develop system-wide coordination and predictable EMS response
initiated from emergency calls received through a central dispatch facility. If the local
EMS agency restricts operations to one or more emergency ambulance services or
providers within an EMS area or subarea, exclusive operating areas are thereby
created.
A competitive process is not required if the local EMS agency implements a plan "that
continues-the use of existing providers operating within the local EMS area in the
manner and scope in which services have been provided without interruption since
January 1, 1981" (Section 1797.224). For this exemption to be available, prehospital
EMS services within local EMS area or subarea must have been provided by one or
more providers in an unchanged and uninterrupted manner since January 1, 1981.
Where those facts exist, a local EMS agency may make a finding within the
development of their plan that those services by existing providers shall continue.
If the local EMS agency decides to .create EOAs, a Request for Proposal (RFP) shall be
developed. An RFP is the awarding agency's description, in document form, of specific
services to be provided, in addition to other contractual requirements. An awarding
agency may be the county or any other county authorized agency.
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II. FORMAL ADVERTISING: INVITATIONS
An RFP should be prepared according to the following requirements. RFPs should
contain the applicable information enumerated below and any other information
necessary for proposal evaluation. The RFP should also include the eligibility and
evaluation criteria including the point system to be used in scoring proposals.
a. The serial number of the RFP
b. Name and address of the awarding agency.
c. Date of issuance
d. Time and place for submission of responses, including disposition of late
responses and potential reasons for rejecting all responses.
e. Time and place of response opening.
f. Period of time for which response is to remain in effect.
g. Guarantee, performance and payment bond requirements.
Responder's certification that all statements in the response are true. -This shall
constitute a warranty, the falsity of which shall entitle the awarding agency to
pursue any remedy authorized by law, which shall include the right, at the option
of the awarding agency, of declaring any contract made as a result thereof to be
void.
r. When needed for the proposal evaluation, pre-award surveys, or inspection, a
requirement that responders state the place(s), including the street address from
which the services will be furnished.
j. Description or specification of services to be furnished in sufficient detail to
permit open competition. The awarding agency shall obtain and distribute
information from current contractors necessary -for fair responses by all eligible
providers.
k. Time, place and method of service delivery.
I. Citation of, and required responder conformance to, all applicable provisions of
law and regulations.
m. Requirement for each responder to submit a detailed budget and budget
narrative wherein line items are identified as yearly or contract period costs.
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lil. RESPONDERS' CONFERENCE
The awarding agency should conduct a responders' conference at apre-designated
time during the early stage of the process. The date and time of the conference should
be stated in the RFP, or arrangements should be made for contacting RFP recipients.
The purpose of the responders' conference is to provide a forum for answering
questions. The conference should be the only time .that questions are answered
regarding the RFP. This will ensure that all prospective responders receive the same
information. Questions and answers need not be put in writing. If a written. response to a
question is provided then all prospective responders must receive a copy of the
question and the answer.
IV. PROPOSAL CONTENTS
1. The RFP should require responders to submit a statement of experience which shall
include but not limited to the following information:
a. Business name and legal business status (i.e., partnership, corporation,
etc.} of-the prospective contractor.
a. Number of years the prospective contractor has .been in business under
the present business name, as well as related prior business names.
b. Number of years of experience the prospective contractor has had in
providing the required services.
c. Contracts completed during last five (5) .years showing year, type of
services, dollar amount of services provided, location, and contracting
agency.
d. Details of any future or refusals to complete a contract.
e. Whether the responder holds a controlling interest in .any other
organization, or is owned or controlled by any other organization.
f. Financial interests in any other related business.
g. -Names of persons with whom the prospective contractor has been
associated in business as partners or business associates in the last five
(5) years.
h. Explanation of any litigation involving the prospective contractor or any
principal officers thereof, in connection with any contract for similar
services.
i. An explanation of experience in the service to be provided or similar
experience of principal individuals of the prospective con#ractor's present
organization.
j. A list of major equipment to be used for the direct provision of services.
k. The awarding agency should request financial information which will
disclose the true cost of the proposed operation and the intended source
13-39
of all funding related to the provision of services as specified in the RFP.
This may include current financial statements, letters of credit, and
guarantor letters from related entities, as well as other materials required
by the awarding agency.
I. A list of commitments, and potential commitments which may impact
assets, lines of credit, guarantor fetters, or otherwise affect the
responder's ability to perform the contract.
m. Business or professional licenses or certificates required by the nature of
the contract work to be performed and held by the responder.
n. An agreement to provide the awarding agency with any other information
the county determines is necessary for an accurate determination of the
prospective contractor's qualifications to perform services.
o. Agreement to right of the awarding agency to audit the prospective
contractor's financial and other records.
V. SUBMISSION OF PROPOSALS
1. Management of the proposal process should require that:
a. Proposals should be submitted so as to be received in the office
designated in the RFP document not later than the exact time set for
submission of responses.
a. Proposals, with required attachments, should be submitted in the format
specified by the awarding agency, and signed. The format should provide
for the desired sequence of the proposal's content and a model budget.
b. Proposals should be filled out, executed, and submitted in accordance
with the instructions which are contained in the RFP. If the proposal is not
submitted in the format specified, it may be considered only if the
responder meets and accepts all the terms and conditions of the RFP.
2. Any proposal received at the office designated in the RFP afterthe exact time
specified for receipt should not be considered unless it is received before award is
made and either:
a. The awarding agency has set forth an option, to be contained in the RFP
document, for acceptance of proposals by registered or certified mail, sent
prior to the date specified for the receipt of proposals.
b. It is determined that the late receipt was due solely to mishandling by the
awarding agency after receipt at the agency.
13-40
3. Acceptable evidence to establish whether a proposal is late or meets some of the
exceptions listed above may be:
a. The date of mailing of a proposal, proposal modification, or withdrawal sent
either by registered or certified mail is the U.S. Postal Service postmark on
the wrapper or on the receipt from the U.S. Postal Service. If neither
postmark shows a legible date, the proposal, modification, or withdrawal
should be deemed to have been mailed late:
b. The time of receipt at the awarding agency is the time-date stamp of such
agency on the proposal wrapper or other evidence of receipt.
4. Any modification or withdrawal of a proposal should be subject to the same
conditions cited above. A proposal may also be withdrawn in person by a responder
or an authorized representative, provided his/her identity is made known and he/she
signs a receipt for the proposal, but only if the withdrawal is made prior to the exact
time set for opening of proposals.
VI. RECEIPT AND EVALUATION OF PROPOSALS
1. Upon receipt, each proposal should be noted with a separately identifiable
proposal number, the date and time of receipt.
2. All proposals received prior to the time set for opening should be kept unopened
and secured in a locked receptacle.
3. An agency official should decide when the time set for submission has arrived
and should so declare to those present. Ail proposals received prior to the time
set for opening should be publicly opened and then following recorded and read
aloud to the persons present:
a. RFP number.
b. Submission date.
c. General description of service being procured.
d. Names of responders.
e. Amounts proposed.
f. Any other information the awarding agency determines in necessary.
4. if the number of proposals received is less than anticipated, the awarding agency
should examine the reasons for the small number of proposals received. The
purpose of this examination is to ascertain whether the small number of
responses is attributable to an absence of any of the prerequisites of formal
advertising.
5. Should administrative difficulties be encountered after proposal opening which
may delay contract award beyond the state deadline for contract award, the
responders should be notified before that date and the acceptance period
extended in order to avoid the need for re-advertisement.
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Vli. REJECTION OF PROPOSALS
1. Any proposal which fails to conform to the essential requirements of the RFP
documents, such as specifications or the delivery schedule should be rejected as
non-responsive. Proposals submitted which do not meet the requirements
regarding responsibility should also be rejected.
When rejecting a proposal, the awarding agency should notify each unsuccessful
responder that the proposal has been rejected.
2. A proposal should .not be rejected when it contains a minor irregularity or when a
defect or variation is immaterial or inconsequential.
A minor irregularity means a defect or variation which is merely a matter of form
and not of substance, such as:
a. Failure of the responder to return the required number of copies of signed
proposals.
b. Apparent clerical errors.
3. Immaterial or inconsequential means that the defect or variation is insignificant
as to price, quantity, quality, or delivery when contrasted with the total costs or
scope of the services being procured.
4. The awarding agency should give the responder an opportunity to cure any
deficiency resulting from a minor informality or irregularity in a proposa[ or waive
such deficiency, whichever is to the advantage of the awarding agency.
IX. CONTRACT PERIODS
1. The complete process (Requests for Proposals} must be repeated at periodic
intervals. The period between RFP requests should be established by local EMS
agency policy based upon population, initial investment in provision of service
and other relevant factors.
2. Contracts should be reviewed annually, at which time they could be renegotiated
if this option is included in the contract. A contract may be renewed without re-
bidding if this is stated in the RFP.
3. The rate of reimbursement for additional terms let under the contract should be
negotiated with the contractor .based on the following:
a. Actual expenditures by the contractor, as documented during the first contract
term and approved by the awarding agency.
b. Changes in state program requirements.
c. Other reasonable costs or increases in cost over which the contractor has no
control.
4. In negotiating costs, the awarding agency should assure that these costs
accurately reflect current contract performance and are not inflated to recover
13-42
costs which may have been understated by the contractor during the original
RFP process.
5. The awarding agency should assure, by audit if necessary, that all cost increases
are reasonable and necessary to the continuation of the contract.
X. PROTESTS
The awarding agency should consider any protest or objection regarding the award of a
contract, whether submitted before or after the award, provided it is filed within the time
period established in the RFP.
Written confirmation of all protests shall be requested from the protesting parties. The
protesting party should be notified in writing of the awarding agency's decision on the
protest. The notification should explain the basis for the decision.
The decision of the awarding agency regarding the protest may be appealed to higher
authority.
Xt. CANCELING THE PROCUREMENT PROCESS AFTER OPENING
1. The procurement process may be canceled after opening, but prior to award,
when the contracting officer determines in writing that cancellation is in the best
interest of the agency for reasons such as those listed below.
a. Inadequate, ambiguous, or otherwise deficient specifications were cited in
the RFP.
b. The services .are no longer required.
c. All otherwise acceptable proposals received are at unreasonable prices.
d. The proposals were not independently arrived at in open competition,
were collusive, or were submitted in bad faith.
e. The proposals received did not provide competitive adequate to ensure
reasonable prices in accordance with local resources or generally
accepted prices.
f. No proposal is received which meets the minimum requirements of the
RFP.
g. The awarding agency determines after analysis of the proposals that its
needs can be satisfied by a less expensive method.
2. All responders should be notified in writing of the specific reasons when
proposals are rejected.
13-43
Attachment 3
AMERICAN MEDICAL RE5PONSE
AMBULANCE RATE INCREASE JU5'f1PiCATlai~i
JUNE 21)11
As parr of this contract amendment, American Medical Response (AMR) is seeking a 911 Rate
adjustment. TMs ad}ustment wou{d bring the Al_5 Emergency Base Rate to $864.90. ThEs rate remains in
the lower 3095 of rates found in Southern Galifarnia and is substantially below the Average Base Rate
experienced in San Diego County, which is approximately $1,591.
The scale of the needed rate Increase occurs because of the unique economics of utilizing health
insurance {or health care reimbursement) as a vehicle for revenue generation, finlike mast fee-for-
service rates with which most municipal organizations are familiar -where one-dollar of rate Increase
closely approximates one-dollar of additional revenue, rates reliant primarily on health insurance are
much less responsive. For example, in the case of this rate request, each additional dollar attached to a
new rate increase will generate only about 16-cents In new revenue.
impact of Insurance payments an ability to collect revenue
The fundamental difference between traditional fee-for-service charges and charges reliant on
reimbursement of health insurance or government payers {l.e. Medicare) is the concept of "marginal
collection rate." Because of this impact, less than 16-cents of every additiianal dollar billed will
ultimately be collected within the Southbay system.
The reason for this is related to the realities of Medicare and the health insurance
industry. Revenue of any health care system Is divided into various methods of payment
represented by the various farms of payment far healthcare services. Typically these categories Include
the following;
1. Medicare
2. Medicaid {Medical)
3. Third Party Payers (Insurance Companies}
4. Private Pay
Each of these payers has a given "elasticity" of rate increases thaC they will recognize. Medicare
and Medicaid, for example, each set a given rate that they will pay for a service and will not pay above
that amount regardless of the amount charged. If 24% of the payer mix is paid by Medicare, then any
rare increase above the Medicare "profile" amount will go uncollected. The same is true for Medicaid
(Medical, except that the allowable rates #or Medicaid are even~vwer
(fi most instances) than Medicare.
The ability to recognize net revenue far each dollar of rate increase becomes more difficult as
the patient charge Increases. Therefore, it can be seen that many rate increases may seem large, bur the
actual ability of the health tare provider to see any net revenue can be as low as 596 on each additional
dollar added to a charge. This phenomenon partly explains the shocking reality of seemingly
unreasonable hospital bills received by patients.
13-44
When applied tv the rate request at hand, the fatiowing can provide a brief summary of the Issues and
impacts.
SUMMARY AND STATEM>rNT Oi=FACT
AMR has submitted a request for a base rate adjustment of7~ to $860.90
The $860.90rate proposed is sail beiow the average ALS Base Rates found in the current market and is,
in fact, in the lower 35% of rates In the County.
Based upon current marginal collection rati~s, the proposed rate increase represents an increase of
$56.32 per transport
Of this, AMR will net only $9.01 per transport. This represents a realized rate of Increase of only ~% of
base rates charged.
AMRs expenses are extra-ordinary in that Medical and Transportation CPi rates have averaged
4.29;; and 4.7% respectively over the past 3-years while consumer CPi has averaged 2.6%. AMR Is
particularly susceptible to increases in fuel which has brought the .annualized transportation inflation
factor to close to 129'o during several bf the past 8 quarters. The annualized rate oi: realized revenue to
AMR on an annual basis is ~.1%.
Additional expenses to be incurred by AMR in the new Southbay Contract include; requirements to paint
ambaiance fleet Red, purchase lUavy blue uniforms and the administration of Fire Department
Vaccination Program.
The table beiow illustrates that a 7% annual rate increase wail yield no mare that 1.19'a increase per year
over the term of the agreement. This results in between $9.01 and $x.1..06 of additional revenue realized
per transport.
Year
Rate 7% CQt.A
Increase
Hate Delta Marginal Collection
Rate Net Realized Effect per
Transport
Realized
2011 $ 804.58 $ 850.90 $ 55.32 16.0% $ 9.01 1.196
2012 $ 86D.90 $ 921.16 $ 60.2b 16.030 $ 9.64 1.1%
2013 $ 921.16 $ 985.65 $ 54.4$ 16.09b $ 10.32 1.19:
2D24 $ 9$5.65 $ 1,054.64 $ 69.00 15.0% $ 10.35 1.19'.
2015 $ 1,054.64 $ 1,128.47 $ 73.82 15.0% $ 11.07 i.l%
2016 $ 1,128.47 $ 1,207.45 $ 78.99 14.0% $ 17..06 1.Q%
13-45
RESOLUTION NO.2011-
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
CHULA VISTA APPROVING A REVISED AND
RESTATED AGREEMENT FOR BASIC AND ADVANCED
LIFE SUPPORT SERVICE WITH AMERICAN MEDICAL
RESPONSE AMBULANCE SERVICE, INC. FOR A THREE
YEAR TERM WITH A THREE YEAR EXTENSION
OPTION
WHEREAS, the City is authorized by California Government Code Section 38794 to
contract for ambulance services within its jurisdiction; and
WHEREAS, the City has had an ongoing relationship with Laidlaw Medical Transport
Inc., dba American Medical Response (AMR) and formerly known as Hartson Medical Services
since 1989 to provide basic and advanced life support ambulance services; and
WHEREAS, an agreement entered into with AMR on November 1, 1998 granted AMR
the authority to provide basic and • advanced life support ambulance services to the Exclusive
Operating Area (EOA) that was adopted by the County of San Diego. This EOA consists of the
City of Chula Vista, Bonita/Sunnyside Fire Protection District, and the City of Imperial Beach;
and
WHEREAS, this agreement was amended and was re-titled the Amended and Restated
Agreement and approved by Council on May 14, 2002; and
WHEREAS, the Amended and Restated Agreement commenced on June 1, 2002 and was
in effect for the three-year period ending May 31, 2005; and
WHEREAS, the Amended and Restated Agreement was extended by mutual option to
December 11, 2007; and
WHEREAS, additional updates to the Amended and Restated Agreement were submitted
to Council for approval on December 11, 2007; and
WHEREAS, Council approved the new Amended and Restated Agreement on December
11, 2007, set to expire on May 31, 2011; and
WHEREAS, the parties entered into a thirty (30) day extension on May 31, 2011; and
WHEREAS, the parties entered into a sixty (60) day extension on June 30, 2011; and
WHEREAS, the parties entered into a thirty (30) day extension on August 31, 2011; and
WHEREAS, the City wishes to continue the contractual relationship with AMR on the
13-46
Resolution No. _
Page 2
terms and conditions set forth in a Revised and Restated Agreement for a period of three (3)
years; and
WHEREAS, the Amended and Restated Agreement clarified and reinforced key
stipulations ensuring AMR's performance and service delivery throughout the EOA and thus
benefiting the members of the EOA; and
WHEREAS, pursuant to Section 17 of the Amended and Restated Agreement, the City
has the option to extend the Amended and Restated Agreement for one (1) additional three-year
period at the City Manager's option; and
WHEREAS, pursuant to Section 20 of the Amended and Restated Agreement, the City
has the option to terminate the Amended and Restated Agreement for convenience by providing
180 days written notice; and
WHEREAS, the authorized Primary Rate Components that AMR is permitted to charge
for services rendered in the EOA are stipulated and are stated in the Side-Letter Agreement; and
WHEREAS, pursuant to Section 5 of the Revised and Restated Agreement, AMR
reserves the right to submit a request for increases to the Primary Rate Components; and
WHEREAS, pursuant to Section 5 of the Revised and Restated Agreement, the City
Council has sole discretion to approve or disapprove increases to the Primary Rate Components
during the lifetime of the Agreement; and
WHEREAS, pursuant to Municipal Code 2.56.070(3), the City Council may waive any
competitive bidding requirements where the competitive bidding requirements as applied to the
contract are impractical, impossible, or the City interests would be materially better served by
applying a different purchasing process approved by the purchasing agent as being consistent
with good purchasing practices; and
WHEREAS, pursuant to Municipal Code 2.56.070(4), the City Council may waive any
competitive bidding requirements where a commodity or service is available from only one
known source as the result of unique performance capabilities, compatibility requirements or
market conditions; and
WHEREAS, AMR has demonstrated through its past performance the ability to fulfill
previous contract requirements, provide competitive pricing for its services, sustain its
interoperability with the Chula Vista Fire Department and other municipalities within the EOA
and deliver longstanding quality services to the community; and
WHEREAS, sending the EMS contract out to bid at this time is impractical and/or
impossible because the bid process could take longer than a year, it could disrupt service, it could
13-47
Resolution No.
Page 3
affect the quality of service currently provided to Chula Vista citizens, it could alter the structure
of the EOA, it would have to be approved by the County and State beforehand, it could be
rejected by the State, and there is no person currently on staff who has the expertise to prepare an
RFP with regard to EMS services; and
WHEREAS, the City's interests would be materially better served by continuing its long-
term contractual relationship with AMR because of AMR's unique performance capabilities, its
knowledge and expertise working within the EOA, its compatibility requirements, and market
conditions, including cost and existing service relationship and interoperability with all members
of the EOA and the extension of the contract has been determined to be a good purchasing
practice by the purchasing agent; and
WHEREAS, the City interests would be materially better served by continuing its long-
term contractual relationship with AMR because doing so would avoid any disruption in
emergency response service which could affect Chula Vista citizens seeking emergency medical
care; and
WHEREAS, the City's interests would be materially better served by moving- forward
with a contract extension because implementation of an Advanced Life Support training and
implementation process for the Fire Department would be achieved sooner through using the
existing EMS provider; and
WHEREAS, a sole source contract may be justified on an emergency basis if there is
insufficient time to conduct a competitive process. Taylor Bus Service v. San Diego Board of
Education (1987) 195 Cal. App. 3d 1331, 1345; and
WHEREAS, the EMS service currently provided by AMR is a commodity or service that
only it can provide because it has achieved unique performance compatibilities with the
emergency response services that Chula Vista, Bonita and Imperial Beach Fire Departments
provide as a result of working with these Departments on their emergency response systems for
years; and
WHEREAS, it is the intent and desire of the City Council to waive any competitive
bidding requirements based on the findings above and enter into the Revised and Restated
Agreement with AMR for the reasons set forth herein; and
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Chula
Vista waives any competitive bidding requirements and exercises its option to extend its
contractual relationship with AMR for the provision of basic and advanced life support
ambulance services.
BE IT FURTHER RESOLVED that the City Council of the City of Chula Vista does
hereby approve the Revised and Restated Agreement with AMR to be effective as of the date of
13-48
Resolution No.
Page 4
all parties signing the Agreement, for a period of three (3) years with an option to extend for one
(1) additional three-year term thereafter to be exercised under the City Manager's authority; and
BE IT FURTHER RESOLVED that the City Council of the City of Chula Vista does
hereby authorize the Mayor to execute the Revised and Restated Agreement in substantially the
form presented with such minor modifications or clarifications as may be authorized or required
by the City Attorney.
Presented by:
Dave Hanneman
Fire Chief
Approved as to form by:
~~ C/ ~~ ~.~~ y
Glen R. Googins ~2 ( ~
City Attorney
13-49
RESOLUTION NO. 2011-
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
CHULA VISTA APPROVING A REVISED AND
RESTATED AGREEMENT FOR BASIC AND ADVANCED
LIFE SUPPORT SERVICE WITH AMERICAN MEDICAL
RESPONSE AMBULANCE SERVICE, INC. FOR ATWO-
YEAR TERM WITH A SIX MONTH EXTENSION OPTION
WHEREAS, the City is authorized by California Government Code Section 38794 to
contract for ambulance services within its jurisdiction; and
WHEREAS, the City has had an ongoing relationship with Laidlaw Medical Transport
Inc., dba American Medical Response (AMR) and formerly known as Hartson Medical Services
since 1989 to provide basic and advanced life support ambulance services; and
WHEREAS, an agreement entered into with AMR on November 1, 1998 granted AMR
the authority to provide basic and advanced life support ambulance services to the Exclusive
Operating Area (EOA) that was adopted by the County of San Diego. This EOA consists of the
City of Chula Vista, Bonita/Sunnyside Fire Protection District, and the City of Imperial Beach;
and
WHEREAS, this agreement was amended and was re-titled the Amended and Restated
Agreement and approved by Council on May 14, 2002; and
WHEREAS, the Amended and Restated Agreement commenced on June 1, 2002 and was
in effect for the three-year period ending May 31, 2005; and
WHEREAS, the Amended and Restated Agreement was extended by mutual option to
December 11, 2007; and
WHEREAS, additional updates to the Amended and Restated Agreement were submitted
to Council for approval on December 1 1, 2007; and
WHEREAS, Council approved the new Amended and Restated Agreement on December
11, 2007, set to expire on May 31, 2011; and
WHEREAS, the parties entered into a thirty (30) day extension on May 31, 2011; and
WHEREAS, the parties entered into a sixty (60) day extension on June 30, 2011; and
WHEREAS, the parties entered into a thirty (30) day extension on August 31, 2011; and
WHEREAS, the City wishes to continue the contractual relationship with AMR on the
terms and conditions set forth in a Revised and Restated Agreement for a period of two (2) years;
13-50
Resolution No.
Page 2
and
WHEREAS, the Amended and Restated Agreement clarified and reinforced key
stipulations ensuring AMR's performance and service delivery throughout the EOA and thus
benefiting the members of the EOA; and
WHEREAS, pursuant to Section 17 of the Amended and Restated Agreement, the City
has the option to extend the Amended and Restated Agreement for one (1) additional six-month
period at the mutual agreement of the parties; and
WHEREAS, should this term of Agreement be approved, AMR will request deletion of
Section 20 that provided the City with the option to terminate the Amended and Restated
Agreement for convenience by providing 180 days written notice; and
WHEREAS, AMR has requested that if the two (2) year term is approved that the City
agrees not to send the EOA contract out to bid during this time (but staff can begin preparation of
a Request for Proposal); and
WHEREAS, the authorized Primary Rate Components that AMR is permitted to charge
for services rendered in the EOA are stipulated and are stated in the Side-Letter Agreement; and
WHEREAS, pursuant to Section 5 of the Revised and Restated Agreement, AMR
reserves the right to submit a request for increases to the Primary Rate Components; and
WHEREAS, pursuant to Section 5 of the Revised and Restated Agreement, the City
Council has sole discretion to approve or disapprove increases to the Primary Rate Components
during the lifetime of the Agreement; and
WHEREAS, pursuant to Municipal Code 2.56.070(3), the City Council may waive any
competitive bidding requirements where the competitive bidding requirements as applied to the
contract are impractical, impossible, or the City interests would be materially better served by
applying a different purchasing process approved by the purchasing agent as being consistent
with good purchasing practices; and
WHEREAS, pursuant to Municipal Code 2.56.070(4), the City Council may waive any
competitive bidding requirements where a commodity or service is available from only one
known source as the result of unique performance capabilities, compatibility requirements or
market conditions; and
WHEREAS, AMR has demonstrated through its past performance the ability to fulfill
previous contract requirements, provide competitive pricing for its services, sustain its
interoperability with the Chula Vista Fire Department and other municipalities within the EOA
and deliver longstanding quality services to the community; and
13-51
Resolution No.
Page 3
WHEREAS, sending the EMS contract out to bid at this time is impractical and/or
impossible because the bid process could take longer than a year, it could disrupt service, it could
affect the quality of service currently provided to Chula Vista citizens, it could alter the structure
of the EOA, it would have to be approved by the County and State beforehand, it could be
rejected by the State, and there is no person currently on staff who has the expertise to prepare an
RFP with regard to EMS services; and
WHEREAS, the City's interests would be materially better served by continuing its long-
term contractual relationship with AMR because of AMR's unique performance capabilities, its
knowledge and expertise working within the EOA, its compatibility requirements, and market
conditions, including cost and existing service relationship and interoperability with all members
of the EOA and the extension of the contract has been determined to be a good purchasing
practice by the purchasing agent; and
WHEREAS, the City interests would be materially better served by continuing its long-
term contractual relationship with AMR because doing so would avoid any disruption in
emergency response service which could affect Chula Vista citizens seeking emergency medical
care; and
WHEREAS, the City's interests would be materially better served by moving forward
with a contract extension because implementation of an Advanced Life Support training and
implementation process for the Fire Department would be achieved sooner through using the
existing EMS provider; and
WHEREAS, a sole source contract may be justified on an emergency basis if there is
insufficient time to conduct a competitive process. Taylor Bus Service v. San Diego Board of
Education (1987) 195 Cal. App. 3d 1331, 1345; and
WHEREAS, the EMS service currently provided by AMR is a commodity or service that
only it can provide because it has achieved unique performance compatibilities with the
emergency response services that Chula Vista, Bonita and Imperial Beach Fire Departments
provide as a result of working with these Departments on their emergency response systems for
years; and
WHEREAS, it is the intent and desire of the City Council to waive any competition
bidding requirements and enter into the Revised and Restated Agreement with AMR for the
reasons set forth herein; and
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Chula
Vista waives any competitive bidding requirements and exercises its option to extend its
contractual relationship with AMR for the provision of basic and advanced life support
ambulance services; and
BE IT FURTHER RESOLVED that the City Council of the City of Chula Vista does
13-52
Resolution No.
Page 4
hereby approve the Revised and Restated Agreement with AMR to be effective as of the date of
all parties signing the Agreement, for a period of two (2) years with an option to extend for one
(1) additional six-month term thereafter to be exercised under the City Manager's authority with
no termination for convenience clause contained therein; and
BE IT FURTHER RESOLVED that the City Council of the City of Chula Vista does
hereby authorize the Mayor to execute the Revised and Restated Agreement in substantially the
form presented with such minor modifications or clarifications as may be authorized or required
by the City Attorney.
Presented by:
Dave Hanneman
Fire Chief
Approved as to form by:
G~-~--o /rt At/'Z `/
Glen R. oogins ~o.Z 6 ~"
City Attorney
13-53