HomeMy WebLinkAboutReso 1981-10708
RESOLUTION NO.
10708
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CHULA
VISTA APPROVING FIRST AMENDED AGREEMENT WITH HARTSON'S
AMBULANCE SERVICE TO PROVIDE PARAMEDIC SERVICES TO THE
CITY OF CHULA VISTA AND SPECIFIED ADJACENT AREAS, AND
AUTHORIZING THE CITY MANAGER TO EXECUTE SAID AGREEMENT
FOR AND ON BEHALF OF THE CITY OF CHULA VISTA
The City Council of the City of Chula Vista does hereby
resolve as follows:
NOW, THEREFORE, BE IT RESOLVED by the City Council of the
City of Chula Vista that that certain First Amended Agreement
between THE CITY OF CHULA VISTA, a municipal corporation, and
HARTSON'S AMBULANCE SERVICE, INC. to provide paramedic services to
the City of Chula Vista and specified adjacent areas, dated the 8th
day of December, 1981, a copy of which is attached hereto and
incorporated herein, the same as though fully set forth herein be,
and the same is hereby approved.
BE IT FURTHER
of Chula Vista be, and
execute said agreement
Vista.
RESOLVED that the City Manager of the City
he is hereby authorized and directed to
for and on behalf of the City of Chula
Presented by
Approved as to form by
~?etr
Lane F. Cole, City Manager
~
.
, -
George D. Lindberg, City Attorney
ADOPTED AND APPROVED
CHULA VISTA, CALIFORNIA, this
198 1 , by the following vote,
by the CITY
8th day of
to-wit:
COUNCIL of the CITY OF
December
AYES: Councilmen
McCandliss, Scott, Cox, Gi11ow, Campbell
NAYES: Councilmen
None
ABSENT: Councilmen
None
City of Chula Vista
STATE OF CAL IFORNIA)
COUNTY OF SAN DIEGO) ss.
CITY OF CHULA VISTA)
I, , City Clerk of the
City of Chula Vista, California, DO HEREBY CERTIFY that the above
is a full, true and correct copy of Resolution No. , and
that the same has not been amended or repealed. DATED
City Clerk
FIRST AMENDED AGREEMENT TO PROVIDE
PARAMEDIC SERVICES TO THE CITY OF CHULA
VISTA AND SPECIFIED ADJACENT AREAS
THIS FIRST AMENDED AGREEMENT, is made and entered into
this 8th day of December ,1981, by and between THE CITY OF
CHULA VISTA, a municipal corporation, hereinafter called
"City/Contractor" and HARTSON'S AMBULANCE SERVICE, INC., dba Bay
Cities Ambulance, a corporation, hereinafter called
IISub-Contractorlli
WIT N E SSE T H :
WHEREAS, the State of California has, pursuant to the
provisions of Section 1480 et seq. of the Health & Safety Code,
established a pilot program for the provision of services
utilizing mobile intensive care paramedics for the delivery of
emergency medical care to the sick and injured, and
WHEREAS, the County of San Diego, pursuant to said pro-
visions of the Health and Safety Code, has the responsibility for
insuring the delivery of quality emergency medical services, and
WHEREAS, the City/Contractor has been designated by the
County to supply sUbject services, and
WHEREAS, Hartson's Ambulance Service, acting as a
sub-contractor to the City of Chula Vista and possessing pro-
fessional qualifications to provide specified contingent services,
has been performing said services in the City of Chula Vista since
February 8, 1979, and
WHEREAS, the agreement between City/Contractor and
Sub-Contractor expired on February 8, 1981, and
Page 1 of 9
1!-(o'loR'
WHEREAS, Sub-Contractor has continued to provide said
services to date on a month-to-month basis, and
WHEREAS, it is now desired by City/Contractor and
Sub-Contractor to enter into a First Amended Agreement for an
additional two-year period.
NOW, THEREFORE, IT IS MUTUALLY AGREED by the parties
hereto as follows:
1. Term. This First Amended Agreement shall commence
upon execution of this document and extend two (2) years unless
otherwise stipulated below.
2. Administration. City/Contractor designates the City
Manager, 276 Fourth Avenue, Chula Vista, California 92010, or his
designated representative to administer the agreement on behalf of
the City/Contractor.
Sub-Contractor designates Robert L. Hartson, President,
Hartson's Ambulance Service, Inc., dba Bay Cities Ambulance, 4318
47th Street, San Diego, California 92115, or his designated repre-
sentative to administer this First Amended Agreement on behalf of
the Sub-Contractor.
All reports, proposals, letters, notices and/or other
correspondence shall be sent to the attention of the designated
representatives at their respective addresses.
3. Service Area. Responses to calls for emergency
medical assistance shall be made in a territory consisting of the
incorporated limits of the City of Chula Vista, the City of
Imperial Beach, and the boundaries of the Bonita-Sunnyside Fire
If - /0 70Y
Page 2 of 9
Protection District and the Montgomery Fire Protection District.
Total service area equals approximately thirty-six (36) square
miles and includes some 125,000 residents.
4. City/Contractor Furnished Equipment and Services.
Subject to performance by the Sub-Contractor in a manner
acceptable to the City/Contractor, City/Contractor as an agent of
the County agrees to provide to the Sub-Contractor the following:
A. One Mobile Intensive Care Unit (hereinafter MICU)
and certain items of medical equipment described by
* on Attachment B.
B. Necessary communication equipment to operate the
paramedic service as described by * on Attachement
B.
Said vehicle and/or equipment may be declined by
Sub-Contractor if approved substitutes are otherwise obtained.
5. Sub-Contractor Furnished Personnel and Equipment.
Subject to performance in a manner acceptable to the
City/Contractor, Sub-Contractor agrees to:
A. Maintain and operate at least one (1) fully equipped
and supplied MICU available for providing paramedic
services seven (7) days a week, twenty-four (24)
hours per day on a year-round basis. Said opera-
tions shall be in accordance with County Criteria
for Mobile Intensive Care Services (Attachment A).
~1-/C1tf
Page 3 of 9
B. Staff at least one (1) Mobile Intensive Care Unit
(MICU) with at least two (2) paramedics, seven (7)
days a week, twenty-four (24) hours a day on a
year-round basis. For purposes of this Agreement,
paramedics shall be individuals certified by the
County's Health Officer to operate as paramedics in
San Diego County pursuant to Section 1480 et seq. of
the State Health and Safety Code.
C. Insure that all certified paramedics complete con-
tinuing education as required by the County of San
Diego.
D. Acquire, maintain and replace all medical equipment
interns for one (1) MICUs as described in Attachment
B.
E. Provide all medical equipment items for one (1)
additional ambulance as described by ** in
Attachment B.
6. Other Sub-Contractor Responsibilities.
Sub-Contractor further agrees to:
A. Maintain the MICU ambulance in a fully operational
condition.
B. Notify the City/Contractor immediately whenever any
condition exists which adversely affects providing
satisfactory ambulance service.
~~w
Page 4 of 9
7. Compensation and Fee Schedule. This is a no-cost
Agreement and City/Contractor will make no reimbursements as a
result thereof. Charges for ambulance service shall conform with
Chula Vista City Council Resolution No. 10069. In addition, an
additional charge of $50 per patient may be made whenever any or
all of the following paramedic procedures and/or equipment are
utilized:
A. Cardioversion
B. Defibrillation
C. EKG Monitoring
D. Esophageal Airway
E. External IV or Injection
F. Nasogastric Tube
G. Nasotracheal Suctioning
H. Magill Forceps
1. Mast Suit
J. Rotating Tourniquet
K. Venipuncture
Billing shall be made directly to persons utilizing the
service{s) and City/Contractor will in no way act as collection
agent.
8. Independent Contractor. Sub-Contractor is, for all
purposes arising out of this Agreement. an independent Contractor,
and no employee or agent of Sub-Contractor is. for any purpose
arising out of this Agreement, an employee of the City/Contractor.
~-IC 701
Page 5 of 9
9. Interest of Sub-Contractor. Sub-Contractor
covenants that he presently has no interest, including but not
limited to, other projects or independent contracts, and shall not
acquire any interest, direct or indirect, which would conflict in
any manner or degree with the performance of services required to
be performed under this Agreement. Sub-Contractor further
covenants that in the performance of this Agreement no persons
having any such interest shall be employed or retained by
Sub-Contractor under this Agreement.
10. Modifications and Extensions. The Agreement may be
modified at any time by the written consent of the parties. This
document, however, fully expresses all understandings of the
parties concerning the matters covered herein. No addition to or
alteration of the terms of this Agreement, and no verbal under-
standing of the parties, its officers, agents or employees, shall
be valid unless made in the form of a written amendment to this
Agreement, and duly approved and executed by the parties' autho-
rized representatives.
11. Property Title. Title to expendable property Whose
cost was borne in whole by the County of San Diego under this
Agreement will remain vested in the County upon termination of
this Agreement.
12. Assignability. The Sub-Contractor shall not assign
any interest in the Agreement, and shall not transfer any interest
in the same without prior written consent of the City/Contractor
thereto.
?~~(
Page 6 of 9
13. Termination and Default.
A. This Agreement may be terminated for any reason by
either party giving sixty (60) days' written notice
to other party's designated representative, except
as defined in 13.B and 14 below.
B. City/Contractor may terminate this Agreement for
default upon five (5) days written notice if
Sub-Contractor breaches this Agreement or if
Sub-Contractor refuses or fails to timely perform
any of its duties under this Agreement.
14. Indemnity. Sub-Contractor agrees to indemnify and
hold harmless City/Contractor, its officers, agents and employees
from and against all loss or expense (including costs and attor-
ney's fees) due to bodily injury, personal injury, professional/-
medical malpractice, including death at any time resulting
therefrom, sustained by any person or persons on or account of
damages to property, including loss or use thereof, arising out of
or in consequence of the performance of this Agreement, provided
such injuries to persons or damages to property are due or claimed
to be due to negligence of the Sub-Contractor, its officers,
agents or employees. Sub-Contractor shall have workers'
compensation coverage for its employees under this Agreement.
15. Affirmative Action. City/Contractor and any
subcontractors performing under this Agreement shall comply with
the Affirmative Action Program for Vendors, as set forth in
AJ-/c1J,P/
Page 7 of 9
Article III (commencing at Section 84) of the San Diego County
Administrative Code. A copy of this Affirmative Action Program is
included as Attachment C.
16. Records. Sub-Contractor shall maintain accurate
books and accounting records relative to this Agreement. Such
books and records shall be open for inspection and/or copying at
any reasonable time by the City/Contractor's designated
representative(s), the Auditor of the County of San Diego, or
their designated representatives.
17. Reports.
A. Sub-Contractor shall comply with the ambulance
report system of San Diego County by completing a
Prehospital Report Form on every call made by the
MICU or ambulance.
B. Sub-Contractor shall be responsible for submission
of completed Prehospital Report Forms on the first
and fifteenth of every month to the:
Department of Public Health
County of San Diego
Division of Emergency Medical Services (D-222)
1375 Pacific Highway
San Diego, California 92101
18. Attachments. The following attachments incor-
porated herein are part of this Agreement:
A. San Diego County Emergency Medical Services Criteria
for Mobile Intensive Care Services (revised
11/26/79).
~HU/
Page 8 of 9
B. Medical and communication items to be provided in
each MICU.
C. Affirmative Action Program for Vendors.
IN WITNESS WHEREOF, the parties have caused this First
Amended Agreement to be duly executed by their duly authorized
representatives.
THE CITY OF CHULA VISTA
HARTSON'S AMBULANCE SERVICE,
//d~_~CITIES AMBULANCE
/ .
,
INC.
~~
Lane F. Cole, City Manager
,/
,MJlt,/
Page 9 of 9
ATTACHMENT A
SAN DIEGO COUNTY
EMERGENCY MEDICAL SERVICES CRITERIA
FOR
MOBILE INTENSIVE CARE SERVICES
.~
APPROVED:
William
Medical D ector
San Diego County
EMS Agency
;?-/ tl "/tJj/'
SAN DIEGO COUNTY
CRITERIA FOR AGENCY APPROVAL TO
PROVIDE PARAMEDIC SERVICES
1. Offer 24-hour, 365-day service.
2. Agree to provide sufficient manpower to have two paramedics
assigned to each Mobile Intensive Care Unit (MICUiat all
times. A paramedic team may temporarily seperate when
all the following criteria are met:
a. More than one patient requires ACLS care and
transportation.
b. No other paramedic unit is available immediately
for backup.
c. The base hospital approves.
l/The preferred procedure is to transport two patients in
the Mobile Intensive Care Unit. However, this authoiza-
tion provides for the temporary separation of the Mobile
Intensive Care Unit Team if, in the opinion of the Base
Hospital personnel, such seperation is necessary.
3. Be selected by a local jurisdiction as the agency to provide
paramedic serVlces for a set geographical area within that
jurisdiction.*
4. Agree to abide by County Paramedic Program Criteria.
5. Agree to respond to emergency calls, or to situations in
which a medical emergency may occur.
'.
6. Insure that a first responder and a backup system of basic
life support will be available to the MICU's.
7. Enter into mutual aid agreements with adjoining paramedic
units.
8. Provide for a planned maximum response time of 15 minutes
in rural areas and 10 minutes in urban areas.
9. Insure that paramedic services will continue to be provided
as stipulated for a minimum of two years following certification.
10. Cooperate with the County in the provision of field internship
locations for future classes.
11. Agree to participate in community education programs to
teach the public access to paramedic services and CPR.
* Local Jurisdiction: Cities, districts authorized to provide
emergency medical services.
1l-/tJ?tf,r
1-1
(Rev.
11/26/79)
12. Agree to orient first responder agencies to paramedic
functions and role.
13. Designate Paramedic Coordinator(s) for the agency.
14. Agree to provide a baCkup driver to allow the two (2)
Paramedics or one (1) Paramedic and one (1) Certified
MICU Nurse to be in the patient compartment with the
patient during transportation whenever such requirement
is deemed necessary by the Base Station Hospital.
15. Agree to prepare a prehospital patient record on each
emergency call, and to distribute the various copies as
indicated on the form.
';0
If - /()7tJ~
(Rev. 11/26/79)
(Addn. 3/9/81)
1-2
Criteria for Agency
Approval to Provide
Paramedic Services
SAN DIEGO COUNTY
CRITERIA FOR SELECTION OF
BASE STATION HOSPI'l'^L
To be designated as a base station hospital, the following
criteria must be met:
1. Must be classified and remain classified at least as a
Basic Emergency Medical Service (Title 22, California
Administrative Code) .
2. Have the approval of both administrative and medical staffs
of the hospital.
3. Procure operational radio and biomedical communications
equipment specified by San Diego County.
4. Accept responsibility for replenishing medical supplies
and equipment expended by the mobile units during the
treatment of a patient who is transported to the hospital.
5. Agree to cooperate with San Diego County in gathering
statistical data on patients for mobile intensive care
units and maintain accurate patient care records, ensuring
patient confidentiality, on all MICU runs. Complete patient
disposition reports.
6. Have a County-Certified Mobile Intensive Care Physician or
Mobile Intensive Care Nurse available at all times to com-
municate immediately with the Mobile Intensive Care Paramedlc
in the field.
~ 7. Appoint a MIC Physician to be in charge of overall direction
and coordination of units and satellite hospitals.
8. Appoint a Hospital Staff Physician as Paramedic Project
Liaison Officer.
9. Appoint a Mobile Intensive Care Nurse as Paramedic Clinical
Training Coordinator.
10. Agree to provide clinical facilities for supervision, and
instruction as part of the paramedic core training course
and paramedic continuing education requirements approved
by the County Certifying Officer.
11. Agree to provide a minimum of four hours per month of
formal tape review for MIC Physicians. Nurses. and Paramedics.
if j()7t!,f
2-1
(Rev. 8/22/78)
12. Appoint a Base Station Conunittee to meet monthly. Hember-
ship shall be composed of one voting representative from
each of the following:
A. Each Area Receiving Hospital (exclude if also a
Base Station Hospital)
B. Each Area Paramedic Service Provider.
C. The Base Station MIC Physician (see Item 7 above)
D. The Base Station MIC Nurse (see Item 9 above) .
E. Base Station Administrator.
F. Each Area First Responder (Exclude if also a paramedic
service or ambulance provider) .
G. Each Ambulance Provider (Exclude if also a paramedic
service provider)
Representatives of the following agencies should also attend
meetings as non-voting technical advisors:
A. U.C.S.D. EMS Training Division.
B. San Diego County Emergency Medical Services.
C. A Paramedic from each Paramedic Service Provider,
unless representing "B" above.
D. Representatives from the Public.
'.
13. Enter into a contract with the County of San Diego to
provide services utilizing certified Mobile Intensive
Care Paramedics.
14. Agree to conununicate all patient medical management infor-
mation to receiving hospital when patient in the field is
directed to that hospital.
15. Accept such Countywide protocols for paramedic procedures
as are approved by the County Health Officer.
16. Agree to provide orientation regarding Hobile Intensive
Care to appropriate employees of the hospital.
17. Participate in Emergency tiedical Services area planning:
a} Clinical Conditions (trauma, cardiac, etc.), b) Disaster
Planning, and c} Direct patients to facilities in accordance
with the Area's Plan.
1-/0 1~1
(Rev. B/22/7B)
2-2
Criteria for Selection
of Base Station Hospital
SAN DIEGO COUNTY
MOBILE INTENSIVE CARE PHYSICIAN CERTIFICATION
Comply with American College of Emergency Physicians (ACEP)
standards for certification and recertification for Mobile
Intensive Care (MIC) Physicians when such standards are de-
veloped and implemented. Until that time, the following
criteria will be in effect.
A. Requirements for Certification:
1. Be an emergency department physician practicing
in a Base Station Hospital.
2. Be certified in Advanced Life Support by the
American Heart Association.
3. Observe on a paramedic unit for a minimum of
four paramedic responses.
4. Attend orientation program on San Diego County
paramedic system by Base Hospital MIC Physician
or Nurse Coordinator.
B. Recertification
1. Certification will be valid for two years.
2. Physician must attend 16 hours per year of
continuing education relative to paramedic
functions. (Tape reviews, paramedic or MIC
Nurse teaching.)
#~o~/
(Rev. 8/22/78)
3-1
SAN DIEGO COUNTY
MIC NURSE CERTIFICATION AND RECERTIFICATION CRITERIA
I. Basic Requirements for Certification:
A. Candidate must be a current California Registered Nurse.
B. Candidate must be recommended by the Base Hospital Paramedic
Nurse Coordinator for certification.
C. Candidate must be an employee of:
1. A Base Hospital, assigned
a. as Paramedic Nurse Coordinator
*b. a minimum of four 8-hour shifts per month in
the Base Hospital Emergency Department and
1) assigned a minimum of two 8-hour shifts
per month to the paramedic radio or
2) direct four paramedic calls per month
*Base, Hospital Paramedic ,Nurse Coordinator will be
responsible for monitoring this requirement and
report compliance on a yearly basis to the EMSTO
2. The Emergency Medical Services Training Office (EMSTO)
3. A Paramedic Provider Agency
a. designated as Paramedic MIC Nurse Coordinator
b. assigned a minimum of 8 hours/week on a MICU
,~
c. assigned a minimum of 16 hours/month working
in a Base Hospital Emergency Department as a
MIC Nurse
d. attend tape critiques relative to agency operations
D. Candidate must pass a written MIC Nurse exam with a
minimum of 80 percent knowledge in all areas
In the event of failure of a MIC Nurse exam, candidate
may be allowed to repeat the exam following a minimum
of two weeks additional study time and pass with 85 per-
cent. The exam may not be repeated a second time within
six months. At that time, the candidate must repeat all
sections of the exam and pass each section with 85 percent.
1(-/07tJY
(Rev. 8/13/80)
4-1
E. Candidate must observe paramedic functions on a minimum
of six paramedic responses.
F. Candidate must attend an orientation to Base Hospital
responsibilities.
II. Recertification:
A. Candidate must annually attend 18 hours of continuing
education relative to paramedic functions. Ten hours
of this requirement must be fulfilled at formal tape
review.
B. It is recommended that the candidate respond with a MICU
to a minimum of four emergency calls annually.
C. Qualified candidates must pass a written recertification
exam every two years, with a minimum of 80 percent
knowledge in all areas.
In the event of failure of an exam, the candidate may be
allowed to repeat the exam following a minimum of two weeks
additional study time and pass with 85 percent. The exam
may not be repeated a second time within six months. At
that time, the candidate must repeat all sections of the
exam and pass each section with 85 percent.
III. Revocation of Certification:
A. If for any reason, an individual fails to meet the criteria
for a period of three months, said certification may be
revoked by the County Health Officer.
'.
B. Certification may be questioned at any time for any of the
following reasons:
l. Inadequate clinical knowledge
2. Lack of proficiency with technical skill s
3. Lack of judgment or responsibility
4. Inability to meet recertif ica tion requirements
C. Certification may be questioned by an involved party, but
investigation procedure must be initiated by the Base
Hospital Paramedic Nurse Coordinator.
1}-I07or
(Rev. 8/13/80)
MIC Nurse Certification and
4-2 Recertification Criteria
D. Procedure for Investigating Certification shall be as
fo llows :
1. Party initiating action shall submit a written
request for investigation, including all perti-
nent data (facts, dates, names, witnesses, etc.)
to the County Health Officer.
2. County Health Officer shall inform subject of the
proceedings and request any information pertinent
to the claim.
3. County Health Officer shall call a panel of three,
an alternate Base Hospital Emergency Department
Physician, an alternate Base Hospital Paramedic
Nurse Coordinator, and County EMS Representative
to review all material and employ whatever testing
devices deemed necessary to reach a conclusion.
The person being considered for decertification
should have an opportunity to speak and to appear
before the panel.
4. The panel shall make written recommendations of
the decision to the County Health Officer.
5. The County Health Officer will notify Base Hospital
and subject.
'.
(Rev. 8/13/80)
I/-/v\ 1~1
4-3
MIC Nurse Certification and
Recertification Criteria
SAN DIEGO COUNTY
CRITERIA FOR THE DESIGNATION
OF A MOBILE INTENSIVE CARE UNIT
A. Definition
Mobile Intensive Care Unit (MICU): A unit consisting of
Certified MIC Paramedics and appropriate equipment and
supplies in order to provide prehospital emergency medi-
cal care in compliance with the provisions of the
California Health and Safety Code, and the County of
San Diego.
B. A unit must meet the following criteria to be designated
as a MICU by the San Diego County Office of Emergency
Medical Services.
1. Be staffed on all emergency responses by a minimum
of two MIC Paramedics Certified by the San Diego
County Health Officer. A Certified Mobile Intensive
Care Nurse or MIC Physician may substitute for a
Certified Paramedic under extenuating circumstances,
in order to maintain a Mobile Intensive Care Unit in
service until relieved by a Certified Paramedic.
2. Have available in the vehicle:
a. A drug and solution supply inventory approved
by the County Health Officer. Such drugs and
solutions will include only those categories
authorized by Section 1482.3(f) of the Health
and Safety Code.
b. Medical supplies and equipment approved by
the County Health Officer.
'6
3. The vehicle must have:
a. A driver's compartment, separated by a bulkhead
or partition from the patient's compartment, but
providing visual and voice communications to the
patient's compartment.
b. A patient's compartment large enough to:
1) Accommodate one gurney patient and two
paramedics.
2) Provide at least 25 inches of space from
the head of the patient to the rear of
the attendant's chair.
(Rev. 11/26/79)
5-1
fl-IO 7t1r
3) Provide space for one 76-inch long stretcher.
4) Provide at least 15 inches of clear space at
the foot of the patient.
5) Provide sufficient clear floor space (not
less than 18 inches) on one side of the
stretcher to allow a person to perform
Cardiopulmonary Resuscitation (CPR) while
kneeling.
6) Provide an inside height of at least
54 inches.
4. Be operated by a private or public agency authorized
by the County Health Officer to provide MICU services.
~~~Y
(Rev. 11/26/79)
5-2
Criteria for Designation
of a MICU
DRUG
:;...:,.,,1 LJ,;._w....;<.... ~......,-d. ~ ~ ;;...,...,......._~..
Aminophylline
Atropine
Benadryl
Calcium Chloride
Dextrose, 50'
Dopamine
Epinephrine
Gluco la
Inderal
Ipecac
Isuprel
Isuprel Inhalant
Lasix
Lidocaine
.~
Morphine Sulfate
Narcan
Nitroglycerine
Pitocin
Sodium Bicarbonate
Valium
IV Solutions
Ringer's Lactate
5' Dextrose/Water
1f-/rJ1J(
Rev. 8/13/80
INDICATIONS
bronchospasm
bradycardias
organophosphate
poisonings
allergic reactions
asystole
electro-mechanical
dissociation
diabetics
unconsciousness
seizure of unknown origin
hypotension
asystole, severe
bradyarrhythmias
bronchospasm
alert diabetics
supraventricular
tachycardias
drug overdose
(alert patient)
heart blocks
bronchospasm
pulloonary edema
ventricular
irri tabi li ty
prophylatically in the
presence of chest pain
pain- MI, burns;
pulmonary edema
narcotic & unknown
overdoses
W1consciousness
angina
post-partum
heI!llllorrhage
acidosis
status epilepticus
severe anxiety reaction
precardioversion
100Oml. Bag
250-500ml. Bag
'DOSAGE~
')_" "< "r;..
2"50-S 7
20m!. D5W
O. S-l.Omg.
2mg. (may repea t)
25-50 mg.
1 GM/IOml.
25 gros/SOml.
200-400mg./250ml. DSW
O. 5-lmg. (lOml.
1:10,000)
0.3ml. of 1:1,000
7 oz. Bottle (75 gros.)
1-4 mg.
(0.5mg. increments)
15-30 ml.
1-2mg./250-S00ml. DSW
1-2 breaths
20-80mg. (up to 200 mg.)
50-100 mg.
1-2gro/250-50Oml. D5W
1 mg/kg 50 mg/min.
2 mg/kg per minute
additional 50 mg. boluses
@ 5 min. intervals,
max. 3
2-1Smg. in 2mg. increments
5-15mg.
0.4mg. (may repeat)
0.4mg. (gr. 1/150)
3-10 u.
10-20 u./500ml. D5W
1 mEq/kg x 2 doses,
then ~ mEq/kg q 10 min.
2.5-20mg. (up to 4Omg.)
(in small increments)
Miscellaneous
" l..J,
ROUTE
IV drip/20 min.
volutrole
IV Push
IM. IV Push
1M. IV Push
IV Push; IC
IV Push
IV Drip (ti trate to B/P
IV Push, IC
SQ
p.o.
IV Push
(titrate to pulse)
p.o.
IV Drip
(titrate to pulse)
inhalation
IV Push
IV Push
IV Drip
IV Push
IV Drip
IV Push
IV Push
1M
IV Push, 1M
sublingual
1M
IV Drip
IV Push
IV Push
Ammonia Ampules- 1 to 2 deep inhalations
Normal Saline for Irrigation (lOOOml.l
Antibiotic Ointment (Polysporin)
ois intectant (Zeuherin or Betadine)
Liqu id Dt~t:urqBnt (Phisohex.)
6-1
SAN DIEGO COUNTY
GUIDELINES FOR THE
SELECTION OF PARAMEDIC TRAINEES
1. Candidate must be employed by, or have a commitment for
employment by an agency authorized to provide paramedic
services.
2. Candidate must enter training voluntarily and be willing
to commit 100% time to the training program.
3. Candidate should have at least one year experience in the
provision of emergency care in the prehospital setting or
current EMT-I Certificate.
4. Candidate must be recommended by current employer.
5. Candidate must be a high school graduate or produce aGED
Certificate.
6. Candidate must have at least Advanced American Red Cross
First Aid Training.
7. Candidate must be in good health and must comply with the
physical requirements of the employing agency.
8. Candidate must have the elementary skills to communicate
orally and in writing.
9. Candidate must hold a current CPR card.
'.
10. Candidate must pass preliminary screening by the San Diego
County EMS Training Office for elementary skills in reading,
comprehension, and arithmetic.
11. Candidate must pass an oral examination by San Diego County
EMS Training Office which evaluates motivation, reasoning,
and potential to succeed in the training program.
1l-/tJ7tJ,r/
(Rev. 8/22/78)
7-1
SAN DIEGO COUNTY
PARfu~EDIC CERTIFICATION CRITERIA
I. Base Requirements for Certification:
A. Successful completion of the San Diego County Paramedic
Training Program, or
B. Successful completion of the San Diego County Paramedic
Challenge process
C. Employed by an agency which has contracted with the
County of San Diego to provide paramedic services
II. Recertification:
A. In order to qualify for recertification, the candidate
must complete all the following each year:
*1. Work on a Mobile Intensive Care Unit at least
80 hours every month, or participate in a
minimum of 50 medical runs every month.
2. Complete the Clinical Skills Tally Sheet once
each continuing education year to the satisfac-
tion of the Base Hospital P~ramedic Care
Coordinator. (See Example on Page 8-3).
3. Accrue at least two hours of tape review at
the assigned Base Hospital during ten of the
twelve months, beginning the month after
graduation.
..
4. Attend at least 18 hours of related continuing
education classes per year, at least eight hours
of which must be classes offered by the Training
Office. (This means that ten of the 18 hours
can be accrued from outside sources, as long as
they are paramedic-related; although, it is
acceptable to get all 18 hours from the Training
Office if desired.)
The Training Office will offer monthly classes of
two to four hours each on subjects requested by
the certified paramedics, the base hospitals, or
the training staff. The schedule will be prepared
a year in advance, but the topics will be chosen
about three months in advance to accon@oddt~
reque~ts.
'Or show satisfactory equivalent to excuse vacation or illness.
#-/tJ1rJ/
(Rev. 8/13/80)
8-1
5. Perform to the satisfaction of the Base Hospital,
the sponsoring agency, and the Paramedic Training
Office. Each candidate must have at least two sat-
isfactory field evaluations on file per two-year
cycle (one per year) in order to qualify for recerti-
fication. EMSTO will be required to perform one fleld
evaluation per year for each paramedic. Additional
field evaluations may be completed by either the
training staff or the MIC Coordinators at the Base
Hospitals.
B. Recertification will be req~ired every two years in the
months of March and September. Those graduating the
first six months of the year will recertify in March,
and those graduating the last six months of the year
will recertify in September.
1. If a candidate fails any part of the recertifi-
cation exam, he/she must be retested on th~t part
within one month, and will be retested on the
entire exam again one year from that time. Follow-
ing successful performance at that time, the
individual will again be placed on a two-year
recertification schedule.
2. If a candidate fails more than one section on the
initial recertification exam, or fails any retake
exam, the records will be forwarded to the Appeals
and Review Committee, which will determine wheth~r
that individual must be formally retrained or should
be decertified.
3. . If an individual is shown to lack competence in any
given area as demonstrated by failure on any exam
or part of an exam, that individual shall not
perform in a paramedic capacity until such time as
competency is again demonstrated on a repeat exam.
';4.
C. It will be the responsibility of each individual
paramedic to prepare for the exam by self-study and
attendance at appropriate lecture sessions.
D. Candidates who qualify and successfully pass the
recertification exam will be recertified by the County
Health Officer.
III. Recertification Requirements for Paramedics Who Are Agency
Paramedic Coordinators:
A. If unable to attain eighty (80) hours on a mobile
intensive care unit, participate in at le~st six (6)
paramedic level runs per month and document on a
continuing education slip.
;?-/O(),f
(Rev. 3/18/80)
(III - New)
(Rev. 3/9/81)
8- 2
Paramedic Certification
Criteria
'#
B. In lieu of two (2) hours tape review during ten (10)
months per year, attend three (3) out of every four
(4) tape critiques offe~ed at their assigned base
hospital.
C. All other didactic and clinical recertification
requirements remain the same.
CONTINUING EDUCATION
CLINICAL TALLY'
Paramedic
C. E. Year
Recertification Date
The following listed skills are to be observed and checked off by the Base Hospital
Nurse Coordinator or her designee. Each skill must be performed once each continu-
ing education year to the satisfaction of the nurse coordinator, but must be per-
formed at intervals of not less than nine months. The nurse coordinator may
require that a skill be performed more than once.
AUTHORIZED
SKILL DATE SIGNATURE COMMENTS
l. Perform a history and physical in the
clinical setting and discuss your
findings with the base hospital nurse
coordinator or her designee.
2. Cbserve and critique an MIC Nurse or
communicating on the radio with a
field HIC unit.
3. DelIOnstrate proper IV injection
technique and calculate drip rates.
4. Demonstrate proper technique for
a~nistering medications.
IV push
IV volutrol
1M
S.C.
The follcwing may be simulated or performed on a patient.
5. Intracardiac in;ection
6. CPR Protocol (verbal auiz)
7. External iuqular IV techniaue
8. Carotid sinus massaae
9. Rotatina tourniauets
10. Cardioversion
1l. Airwav manaqement
12. Defibrillation
1l-/tJ7c/
(Rev. 3/18/80)
(New)
8-3
Paramedic Certification
Criteria
IV. Decertification:
A. If for any reason the individual fails to meet the
basic Continuing Education requirements for recerti-
fication for a period of three months, certification
may be revoked by the County Health Officer.
B. Certification may be questioned at any time for any of
the following reasons:
1. Inadequate clinical knowledge
2. Lack of proficiency with technical skills
3. Lack of judgment or responsibility
4. Inability to meet recertification requirements
C. Cert;'fication may be questioned by an involved party,
but investigation procedure must be initiated by a
representative of the Base Hospital, the Training
Agency, or the County Health Officer.
D. Procedure for investigating certification shall be as
follows:
1. Party initiating action shall submit a written
request for investigation, including all perti-
nent data (facts, dates, names, witnesses, etc.)
to the County Health Officer.
2. county Health Officer shall inform subject of the
proceedings and request any information pertinent
to the claim.
';<
3. county Health Officer shall call a panel of three,
one of whom shall be a member of the Training
Agency, to review all material and employ whatever
testing devices deemed necessary to reach a decision.
The person being considered for decertification
should have an opportunity to speak and to appear
before the panel.
4. The panel shall make a written recommendation to
the County Health Officer.
5. The County Health Officer will notify Base Hospital.
sponsor~ng agency. Training Agency, and the indi-
vidual involved. Health Officer will contact the
person lodging the complaint.
/i'-/naY
(Rev. 3/18/80)
(Numbering only)
8-4
Paramedic Certification
Criteria
V. Voluntary Temporary Decertification:
A. Certified San Diego County Paramedics may be temporarily
decertified for a period of up to 90 days without a
recertification reentry examination to allow them to
follow other professional options while still in the
employ of the provider agency.
B. 1. For any period of more than 90 days, a Certified
San Diego County Paramedic may be temporarily
decertified, with the provision that the following
be successfully completed before return to certified
status:
a. orientation to any changes in County standards
by the EMSTO instructor.
b. Reorientation to the Base Station Hospital by
the appropriate Paramedic Nurse Coordinator.
c. Pass with a grade of at least 80% a four-part
written examination in medical management,
pharmacology, arrhythmias, and policies and
procedures.
d. Pass a practical examination.
e. Pass an oral examination.
f. Complete a minimum of three 24-hour shifts of
field internship as assigned by the Director
of EMSTO.
g. Spend at least 8 hours of clinical time at a
Base Station Hospital.
2. The recertification period for individuals who are
reinstated as Certified Paramedics will be two years.
Following reinstatement, a Paramedic must immediately
return to active duty as an operational MICU Paramedic.
'4
3. Application for temporary decertification must be made
to the County Health Officer at least 30 days before
commencement of the decertification period. Only
Certified Paramedics may apply for this status.
Paramedics who fail to qualify for normal recertifi-
cation or who fail to pass the recertification process
are not eligible for temporary decertified status.
Application must include documentation from the
employer in support of the application.
4. No Paramedic who has worked less than one year in
active status may apply for this program.
5. A Paramedic who has been temporarily decertified and
then recertified may not reapply for this program
within one calendar year from the date of return to
certified status.
6. No temporarily decertified Paramedic may function as
a MICU Paramedic during the decertification period.
If the individual becomes involved in providing
patient care, he/She may function only as an EMT-I.
/1-/tJ70/
(New-3/l9/79)
(Rev. 3/l8/80-Numbering
8- 5
Only)
Paramedic Certification
Cr l ter la
SAN DIEGO COUNTY
PARAMEDIC CHALLENGE CRITERIA
The purpose of the Paramedic Challenge Exam process is to
establish a list, which is renewed annually, of individuals
eligible for employment and potential certification as a
Mobile Intensive Care (MIC) Paramedic within San Diego
County.
I. Candidate Qualifications:
A. Must meet all requirements of Section 1102(a)
(1) (C) of Title 13, California Administrative
Code, which prohibits sex offenders, narcotics
users, alcohol abusers, felons, etc., from
opera ting an ambulance.,
B. Must be licensed or certified as a physician, physi-
cian's assistant, registered nurse, or qualified
paramedic (meeting standards of HEW-DOT Curriculum) .
C. An individual failing the San Diego County Chal-
lenge Examination may repeat this examination
only if documentation of additional paramedic-
level education is submitted with the registra-
tion questionnaire. The EMS Training Office
will review applications on an individual basis
to determine eligibility for reexamination.
'J
D. Candidates who are eligible for employment, but
fail to obtain a commitment for employment dur-
ing the time frame of the eligiblity list, must
retake the Challenge Exam to remain eligible
for employment.
E. A Challenge fee may be charged to each candi-
date to recover costs of providing the chal-
lenge process. Such fee to be established by
the organization conducting the examination.
II. Candidate Certification:
Certification as a San Diego County MIC Paramedic will be
contingent upon:
A. Demonstration of competency in paramedic-level
knowledge and skills on a four-part written
exam, a practical exam, and an oral exam.
Each section must be passed with at least 80%
in order to proceed to other exam sections,
and
R- /IJlrJl
(Rev. 8/22/78)
9-1
B. Employment by an agency authorized to provide
MICU service within San Diego County, and
c. Successful completion of a field internship of
no less than 72 hours and no more than 240 hours,
during which the candidate must demonstrate compe-
tency in each of the areas defined as necessary
for the paramedic role.
h~~
~
;'y-/07j~
(R~y. 8/13/80)
9-2
Paramedic Challenge
Criter~a
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*SUl'PLIED llY WCRGWCY HEDICAL SERVIces
~
Non-Dispos,1l, 1 e Items
1. AilS Trauma Uox
2. Uackboard (spine board set short)
3. Defibrillator (combination scope
nnd defibrillator)
4. Drug Rox
5. Hare traction splint (adult)
6. Hare traction splint (pediatric)
7. Mast Suit (received) (Stand.;lrd anti-c;hock
airpants)
B. Resusci1;l\tcll:' - Robert Shaw witl. aspirator
9. Scoop stretcher
10. Splints: Inscaform Vacuum (set of 5
individual splints)
11. Splint: InScaform Vacuum-hand pump
12. Splint: Instaform Vacuum Velcco straps:
l"xl8"i l"x24"; 1"x30"; 1"x3ii"
13. Splint lnl~.tprm Vacuum-Repa,ir Kit
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COlllmunicati~:
1. Handie Talkie
2. Mobi.le R<\liio
3. COR c~l.mctry Radio and Uattety Charger
ff.-J l)70r
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Per vehicle
2 each
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Non-DispoHnt)!c Items
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1. Ambu Dag (Laerdal Resusci Foi:d~ng Dag
11 complete with case)
2. Bandage Scissors (7 1/4" S.tailllp.ss)
3. Bedding top-sheet
4. Bedding-bottom sheet
5. Bedding-pillow case
6. Beddillg- pillow (cot ambulance)
7. Bedding- blanket (cot blanket - med. gray)
8. Blankets - Disposable (KCD dhposablanket)
9. Dlood pressure cuff - adult
10. Oral Airways (package of six vssorted
sizes)
11. Bite sticks - Ipistick
12. Burn sheetll .
13. Cardboarcl splints - combinatic.n 12". 18".
24" splints
14. Cotton apPlicators
15. Cold Packs" Kwik Kold
16. Emesis ~aBin (disposal)
17. Gloves (sterile)
18. Oil Kit
19. Oxygen Mask (clear Vinyl with 84" tube)
20. Nose prongs (nasal cannula vinyl with
tub'!)
21. . Connective tubing (Oxygen soft plastic
tubiN\ S4")
22. Urinal
23. Bedpan
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ATTACHI1EIH B
Page 3
*I'r* Eo H SUPPLIED BY AMBULANCE SERVICE OR BASE STATION HOSPITAL, AS APPLlCAULE:
,
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!\on-Dispo5.,ble Itcm..~
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2.
Blood pressure cuff - pedi~tric
Electrodes (long term 4 clbctl~des
per package)
Electrode Hircs (40" lonl; lii!)
Esoph~gC~l airway (Kit)
Hemostats (Kelly 5 1/2" strai.ht)
Laryngoscope - Hook on handle
Laryngoscope - Adult Curved stainless
steel blade, size 4
Laryngoscope - Adult (straight chrome
blade, si2;e 4)
Larynol;oscope - child (straight chrome
blade, size 3)
Laryngoscope - Infant (straight chrome
blad~, ,be 2)
Rotating tourniquets
Sandbags (assorted sizes)
Stethoscope (Bard Parker DuoS01ic)
Thermometer - Oral
Thermometer - rectal
Magill Tonsil Forceps
Adhesive tape (1/2"x 10 yards)
. Adhesive tape (l"x 10 yards)
Adhesive t;ape (2"x 5 yards)
Alcohol ~wabs (100 swabs per box)
Armboard: . Long
Armboatd: Short
Bandages:
a. 4"x4" - sterile
b. 5"x!l"
e. GaUlle
3.
4.
5.
6.
7.
8.
9.
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12.
13.
14.
15.
16.
17.
18.
19.
20.
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22.
23.
24.
25.
26.
27.
Rolls'- 4"x5 yarlls - Kerlix,
Kling
d. Elastic Bandages (3"x5 yanis)
e. Eye patches (oval eye pads,}
f. TriangUlar bandages
g. Bandaids (3/4" x 3")
Cardboard Splints - Arm
Cardboarll Splints - leg
Electrode Pllste "EKG Sol"
IV Administrntion Sets: Plexitron
M.1crodrip
Plexitron Microdrip
Plexitron Micro drip with Volutrole
Nasogastric Intubntion Set-up l8fr. 4b"
Needles:
IV scalp vein - 19 g~uge
IV scalp vein - 21 gauge
IV scalp vein - 23 gauge
IV cannula - medicut - l8G
IV canouln - medicut - 16G
IV c(ll\nula - medicut - 20
28.
29.
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2 rolls
2 rolls
2 rolls
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6 each
6 each
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2 trays
2 packages
1 box
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1 packages
1 box
6 each
6 each
2 bottles
12 each
6 ('ach
6 each
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Needles:
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Vocutniner Needles 21~. x 1"
30. Penlights - disposable
31. Razors
32. SC;llpell;
33. Suction C;ltheters (14fr.}~
34. Tourniq Ull ts (1/2" Penrose Tubing)
35. Vaeutainer Helders
36. Vacuta1ner Tubes
1l-/IJ7tJ/
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4 C.:lch..
2 packaGes
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Allf.CHriENT6 "r ;'': -
Page 4 .",
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ARTICLE IIIk
ATTACHMENT C
(A new Article added by Ord. 4037 (NS) adopted 1-23-73,
effective 7-1~73.)
AFFIRMATIVE ACTION PROGRAM FOR VENIXlRS
SECTION 84. AFFIRMATIVE ACTION PROGRAM. This article establishes
an Affirmative Action Program to require vendors of the County of San
Diego, and their subcontractors, on County contracts to take affirmative
action to improve employment of minor! ties. women. and handicapped persons
in their work forces.
The goal of the Affirmative Action Program, with respect to minorities,
shall be the attainment of the condition of each vendor's work force such
that employment of Hispanics, Blacks, Philipino/Asian/Orientals and
American Indians or Alaskan Native at all levels of the vendor's work force,
for all activities, is approximately equal to the proportion of such
minority in the local labor market of the County of San Diego based on the
current Federal Census Data.
The goal of this Affirmative Action Program, with respect to women,
shall be the attainment of the condition of each vendor's work force such
that the employment of women at all levels of the vendor's work force, for
all activities, is approximately equal to the proportion of women in the
local labor market of the County of San Diego based on the current Federal
Census Data.
the goal of this Affirmative A~tion Program, with respect to handi-
capped persons, shall be the attainment of the conditions of each vender's
work force such that the employment of handicapped persons at all levels of
the vendor's work force, for all activities, is approximately equal to the
proportion of handicapped persons in the local labor market of the County of
San Diego based on the current Federal Census Data.
Nothing contained within this ordinance shall be constructed to
promote sexual discrimination.
~ended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4687 (NS)
effective 5-6-76; amended by Ord. 4721 (NS) effective 7-22-76; amended
by Ord. 5099 (NS) effective 3-16-78; amended by Ord. 6050 (NS) effective
6-11-81. )
SECTION 84.l.
otherwise requires,
Article:
DEFINITIONS. Unless the provisions of contract
these definitions govern the construction of this
(
\.
<a) "Contract" means a purchase order, offer and acceptance, lease
agreement or other arrangement creating an obligation to which the County
1s a party and would bring the other party within the definition of a vendor.
(b) "Subcontractor" means any person who agrees with any vendor
who has a contract with the County of San Diego to furnish suppliies,
goods or services to such vendor with respect to such contract.
(c) "Contract documents" means any document or group of documents
which constitute or form a part of a contract.
(d) "Person" means any individual, firm, copartnership, joint
venture, association, social club, fraternal organization, corporation.
estate, trust, reciever, syndicate, county (other than the County of
San Diego), city and county, city, municipal corporation, district or
other political subdivision, or any other group or combination acting
as a unit.
(e) "Vendor" means all persons who provide, or offer to provide
to the County, labor, equipment, materials or services of any kind or
type, pursuant to a purchase order from the Purchasing Agent of the
County or pursuant to a contract awarded by the Board of Supervisors;
service contractors performing services for the County; all banks or
institutions which receive money for deposit from the County other
than the Treasurer; all persons who lease property or equipment from
the County; and all persons who receive grant monies pursuant to a
contract awarded by the Board of Supervisors.
(f) "Competent" means possessing the requisite abilities and skills
to perform the duties and tasks required of the position.
(g) "Minority" means a male or female member of the following racial
or ethnic groups: Blacks, Hispanics, American Indians or Alaskan Native
and Philipino/Asian/Orientals.
(h) "Women" means females of all races.
(i) "Local labor market" means the entire San Diego County labor
marke t .
(j) "Good faith efforts" means efforts made in sincerity and with
genuine purpose to hire and/or promote minority, women and handicapped
employees when opportunities exist for employment and for promotion. Good
faith efforts are evidenced by the vendor taking the positive steps and
procedures set forth in Section 84.9 to recruit, employ, train, upgrade and
retain minorities, women and handicapped persons and also by including the
specific, detailed documentation in instances of failure.
Revised 6-81 6-0e
4?-/J7~r'
(
(k) "Hand1capP~d person" means any person who (1) has a physical or
mental impairment WhlCh substantially limits one or more major life
activities, (2) has a record of such an impairment, or (3) is regarded as
having such an impairment.
(1) "Physical or mental impairment" means (1) any phYSiOlogical disorder
or condition, coametic disfigurement, or anatomical 108s affecting one or
more of the fOllOWing body system: neurological musculoskeletal, special
sense organ; respiratory, inclUding speech organs; cardiovascular,
reproductive, digestive; genito-urinarYi hemic and lymphatic; skin; and
endocrine; or (2) any mental or psychOlogical disorder, such as mental
retardation, organic brain syndrome, emotional or mental illness, and
specific learning disabilities."
(m) "Major life activities" means functions such as caring for one's
self. performing manual tasks, walking, seeing, hearing, speaking, breath-
ing, learning and working.
(n) "Has a record of such an impairment" means has a history of, Or
has been misclassified as having, a mental Or physical impairment that
substantially limits one Or more major life activities.
(0) "Is regarded as having an impairment" means (1) has a physical
Or mental impairment that does not substantially limit major life
activities but that is treated by a vendor as constituting such a l~it-
ation; (2) has a physical or mental impairment that substantially limits
major life activities only as the result of the attitudes of others
toward such impairment; or (3) has none of the impairments defined in
paragraph (1) of this section, but is treated by a vendor as having such
an impairment.
(p) "Facility" mean.s all or any portion of buildings, structures,
equipment, roads, walks, parking lots, or other real or personal property
or interest in such property.
(q) "Director" means Director of the County Equal Opportunity
Management Office or staff designee.
(r) "Deputy Director" means Equal Opportunity Management Office
Deputy Director, Contract Compliance Division.
(Amended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4687 (NS)
effective 5-6-76; amended by Ord. 4721 (NS) effective 7-22-76; amended
by Ord. 5099 (NS) effective 3-16-78; ~d by Ord. 6050 (NS) effective
6-11-81. )
(
SECTION 84.2. GOALS. The Director through the Board of Supervisors
shall establish goals for vendor employment of minority, women and handi-
capped persons, with such goals being the proportion of minorities, women
and handicapped persons in the local labor market of the County of San
Diego based on the current Federal Census.
(Amended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4721 (NS)
effective 7-22-76; amended by Ord. 5099 (NS) effective 3-16-78;0 repealed
and new Section added by Ord. 6050 (NS) effective 6-11-81.)
SECTION 84.3. INCORPORAnON BY REFERENCE. Each vendor and sub-
contractor of the County shall be required to make good faith efforts to
comply with the Program. This Program shall be incorporated by reference
in all vendor contracts. A vendor who does not comply with the provisions
of this Article shall be ineligible to receive any contract from the
County during the period of vendor noncompliance.
(Amended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4721 (NS)
effective 7-22-76.)
SECTION 84.4. SUPPLEMENTARY RULES. In order to implement this
Program, the Board of Supervisors may from time to time adopt such
rules and regulations as it deems reasonable and necessary.
(Amended by Ord. 4721 (NS) effective 7-22-76; amended by Ord. 6050
(NS) effective 6-11-81.)
SECTION 84.5. SMALL WORK FORCES. Vendors and subcontractors
who have a regular paid work force of less than firteen (15)
employees are exempted from compliance with this Article. Exemption
is granted upon vendor's verification of work force size submitted
annually.
(Amended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4721 (NS)
effective 7-22-76; amended by Ord. 6050 (NS) effective 6-11-81.)
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SECTION 84.6. COMPLIANCE IIITH FEDERAL AND STATE LAII.
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(a) Each vendor shall submit certification of compliance with Civil Rights
Act of 1964, Executive Orders 11246 and 11375, the Equal Employment Oppor-
tunity Act of 1974, the Rehabilitation Act of 1973, as amended, Deparcment
of Labor Regulations, the California Fair Employment Practice Act, and the
California Labor Code Section 1777.5 and any other applicable Federal and
State laws and regulations hereinafter enacted. Such certification shall
he on forms to be provided by the County.
(b) Notwithstanding any other provision in this Article, any vendor or
subcontractor wno has an Affirmative Action Program substantially consistent
with the objectives of this Article which is approved by an agency of the
Federal Government shall be deemed to be in compliance with the provisions
of this Article upon furnishing documentary evidence of such approval satis-
factory to the Deputy Director. Loss of such approval shall be immediately
reported by such vendor or subcontractor to the Deputy Director.
(Amended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4687 (NS)
effective 5-6-76; amended by Ord. 4721 (NS) effective 7-22-76; amended
by Ord. 5099 (NS) effective 3-16-78; amended by Ord. .6050 (NS) effective
6-11-Bl. )
SECTION 84.7. COMPLIANCE IIITH AFFIRMATIVE ACTION PROGRAM.
(
'.
(a) Each vendor shall have on file with the County certification of
compliance with the provisions of t~is affirmative action program.
This form, to be provided by the County. shall include an Employment Data
Sheet, certification of the authenticity of present employment data, and
an agreement to make good faith efforts to meet the current goala as part
of the contractual obligations.
(b) This certification and employment data, if approved, will be keHt on
file for the remainder of the current year of the County's program and will
be acceptable for such term.
(e) The County will maintain a current list of vendors and subcontractors
who have been found by the Board of Supervisors to be in non-compliance with
the Affirmative Action Program. Upon request, the County will supply this
list of prospective vendors.
(d) Any vendor who does not meet the current mintmum level goals of this
Affirmative Action Program may be determined to be in nuncompliance with
this Affirmative Action Program if employment records show that hiring
subsequent to the effective date of this Article has not tended to meet
the current goals established for this Affirmative Action Program.
(e) No employer will be required to discharge any employee in order to
increase the number of minorities, women or handicapped persons.
(Amended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4721 (NS)
effective 7-22-76; amended by Ord. 5099 eNS) effective 3-16-78; amended
by Ord. 6050 (NS) effeerive 6-11-81.)
SECTION 84.8 COMPLIANCE BY SUBCONTRACTORS. Each subcontractor shall
be required to comply with this Article in the same manner as the vendor
unless the subcontractor is part of a group exempted from implementing this
program. Each subcontractor not exempted, shall submit to the vendor a
certificate that the subcontractor will comply with the provisions of the
Affirmative Action Program. This form, to be provided by the County, shall
include an Employment Date Sheet, certification of the authenticity of
present employment data, and an agreement to make good faith efforts to meet
the ~urrent goals of the Affirmative Action Program. as part of the contract.
The apparent successful vendor shall provide to the County these required
certificates for all subcontractors within the prescribed time limit.
(Amended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4721 (NS)
effective 7-22-76; amended by Ord. 6050 (NS) effective 6-11-81.)
SECTION 84.9. COUNTY OF SAN DIEGO AFFIRMATIVE ACTION PLAN-
AFFIRMATIVE ACTION EFFORTS. GOOD FAITH COMPLIANCE. The County of S'in Diego
adopts the follOWing County of San Diego Affirmative Ac~ion Plan whic~
sets forth those good faith efforts to be undertaken by a vendor'in
complying with the affirmative action program:
(a) 1118 vendor shall notif, local organizations that the vendor has
employment ovportunities available and shall maintain records of the
organization s responses.
(b) The vendor shall maintain a file of the names and addresses
of each minority, women or handicapped applicant referred to the vendor
and what action was taken with respect to each such referred applicant.
If such applicant was not sent to the union hiring hall for referral,
or if such applicant was not employed by the vendor, the vendor's file
should document this and the reasons therefor.
(c) The vendor shall notify the County's Deputy Director when the
union or unions with whom the vendor has a collective bargaining agree-
ment have not referred to the vendor a minority, women or handicapped
worker sent for by the vendor or the vendor has other information that
the union referral process has impeded the vendors effort to meet the
established goals.
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,
(d) The vendor shall par~icipate in affirmative action training
programs in the area, especially those funded by the County, State and
Federal governments.
(e) The vendor shall disseminate the vendors affirmative action
policy within the vendor's own organization by including it in any policy
manual, by publicizing it in company newspapers, annual reports, and other
company publications, by conducting staff. employee and union represent-
atives' meetings to explain and d1~s the policy; by posting the policy,
and by specific review of the policy with minority, women and handicapped
employees.
(f) The vendor shall disseminate the vendor's affirmative action
policy externally by informing and discussing it with all recruitment
sources, by advertising in news media, specifically including minority,
women and handicapped persons' news media, by notifying and discussing it
with all local minority, women's and handicapped persons' organizations
and. subcontractors.
(g) The vendor shall make specific and constant personal written
and oral recruitment efforts directed at all loeal minority, women's
and handicapped organizations; schools with minority, women and handi-
capped students; minority, women and handieapped person's recruitment
organizations; and minority, women and handicapped person's training
organizations.
(h) The vendor shall make specific efforts to encourage present
minority, WOlDen and handicapped employee. to recruit their friends and
relatives.
(
(i) The vendor shall insure that all employee specifications,
selection requirements, testa, medical examinations, and other employee
r~cruitment or evaluation procedures do not discriminate against minorities,
women or handicapped persons in application or effect.
0) The vendor shall make every effort to provide after school,
summer and vacation employment to minority, female and handicapped youths.
(k) Where reasonable, the vendor shall develop on-the-job training
opportunities and participate and assist in anr association or employer
group training programs relevant to the vendor s needs.
(1) The vendor shall continually inventory and evaluate all minority,
women and handicapped personnal for promotion opportunities and encourage
minori~y, women and handicapped employee. to seek such opportunities.
(m) The vendor shall make sure that seniority practices, job class-
ifications, rates of pay and other forms of compensation, and other employ-
ee practices and classifications do not have an unlawfully discriminatory
effect on minority, women or handicapped employees.
(n) The vendor shall make reasonable accolImOdation to the known
physical or mental 1initations of a qualified handicapped applicant or
employee including job restructuring, part-time or modification of equip.
ment or devices. the provision of readers or interpreters, and other
similar actions unless the vendor can demonstrate that the accommodation
would impose an undue hardship on the operation of the program.
(0) The vendor shall make certain that all facilities normally
used concurrently by all employees and all company activities are non.
segregated, and accessible to and usable by handicapped persons.
(p) The vendor shall continually monitor all personnel activities
to insure that this County of San Diego Affirmative Action Plan is being
carried out.
(q) The vandor .hall .clicit and maximize the utilization of adnority,
~n and handicapped.ownad bUlin.ss.. as subcontractor. depending upon
availability, including notification of minority, women and handicapped
contractor groupe and associations.
The vendor's and subcontractor's -commitment to attain the current
goa18 of minority, women and handicapped utilization as required by the
affirmative action program shall constitute a commitment to make good faith
efforts to meet said affirmative action program goals. If a vendor or
subcontractor has failed therein. "good faith" compliance will be determined
by the extent of vendor or subcontractor efforts, in accordance with the
County of San Diego Affirmative Action Plan, to meet the affirmative action
program goals.
(Amended by Ord. 4490 eNS) effective 5-1-75: amended by Ord. 4721 (NS)
effective 7-22-76; amended by Ord. 5099 (NS) effective 3-16-78; amended
by Ord. 6050 (NS) effective 6-11-81.)
SECTION 84.10. SUBMISSION OF AFFIRMATIVE ACTION PLANS.
!
(a) Any vendor may submit to the County Equal Opportunity Management
Office, Contract Compliance Division, for review and approval a written
affirmative action plan developed by the vendor in lieu of adopting the
County's Affirmative Action Program.
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(b) The vendor's or subcontractor's affirmative action plan must
include an analysis of all major job categories within the vendor's work
force, with a notation if minorities, women or handicapped persons are
currently being underutilized in anyone or more job categories. In making
the work force analysis, the vendor shall conduct such analysis separately
for minorities, women, and handicapped persons.
(c) The vendor's or subcontractor's affirmative action plan must
include goals and timetables for projected minorities. women and handi-
capped employment on a line by line (job title) basis. Goals and time-
tables must be designed to correct any identifiable deficiencies. WheEe
deficiencies exist and where numbers or percentages are relevant in develop-
ing corrective action. the vendor shall establish and set forth specific
goals and timetables separately for minorities, women and handicapped
persons.
Cd) The vendor or subcontractor shall submit a certification of
compliance with the County's Affirmative Action Program for Vendors
together with its affirmative action plan.
(Amended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4721 (NS)
effective 7-22-76; amended by Ord. 5099 (NS) effective 3-16-78; amended
by Ord. 6050 (NS) effective 6-11-81.)
SECnON 84.11. VENDOR'S DUTIES.
(
(8) If the vendor's minority. women and handicapped work forces
and the distribution of such work forces by general classification are
equal to or exceed the current goals by general classification as estab-
lished for each year of the affirmative action program, the vendor will
not be required to demonstrate the efforts made in reference to upgrading,
demotion or transfer; recruitment or recruitment advertising; layoff Or
termination for any period during which the vendor reaches Or exceeds the
established goals.
(b) The vendor shall maintain and permit access to updated employ-
ment records and information with respect to all employees directly or
indirectly performing work under the County contract, in accordance with
the direction of the County, setting forth the distribution of personnel
and members of all minority, women and handicapped groups by classification,
inClUding information relating to apprentices and trainees.
(c) Vendors shall also demonstrate compliance on the contract by
submitting evidence of minority, women and handicapped P.mployment by
general classification of both permanent and temporary employees. The
County may exempt from the affirmative action program those facilities of
the vendor and the vendor's subcontractors not involved in performance under
the County contract.
(d) The vendor shall send to each labor union, worker representative
or employment agency with which such vendor has a collective bargaining
agreement or other contract or understanding, a notice, in the form to be
provided or approved by the County, advising said group of the vendor's
commitments under this Article, and shall post copies of the notice in
conspicuous places assessible to employees and applicants for employment.
(e) The inability of the vendor to recruit and hire competent
personnel of minority, women and handicapped groups from unions, employee
representatives or employment agencies shall not exempt from the vendor
from complying with this affirmative action program except 8S provided in
Section 84 .12.
(f) Reporting procedures, for purposes of monitoring the vendor's
affirmative action program, shall be established by the Director and
reporting guidelines will be set forth adopting rules and regulations for
implementing this Article. The vendor shall be required to comply with
such reporting procedures. The vendor shall require and submit information
from the vendor's subcontractors.
(g) The vendor shall assure that the handicapped are not discriminated
against in receiving any aid. benefit, or service provided 'in or through a
facility that has been constructed, expanded, altered, leased or rented, or
otherwise acquired in whole or in part, with Federal or County assistance.
This shall include making reasonable accommodation to the known physical
or mental limitations of otherwise qualified handicapped applicants and
employees, 8S stated in Section 84.9(n) and (0) of this Code.
(Amended by Ord. 4721 (NS) effective 7-22-76; amended by Ord. 5099 (NS)
effective 3-16-78; amended by Ord. 6050 (NS) effective 6-11-81.)
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SECTION 84.12. FAILURE OF VENDOR TO COMPLY \lITH PROGRAM. In the
event that the vendor has failed to meet the current goals, or otherwise
fulfUl the County of San Dielil;o Affirmative Action Plan for complying with
the affirmative action,program, and desires to present evidence that failure
to comply or meet such ~oa18 was through no fault of the vendor, but was due
to an inability to obtain competent minority, women or handicapped employees,
after making all good faith efforts to do &0 from other sources such as
public advertisements, unions, employment or other agencies capable of
providing such employees, the vendor shall submit written evidence as
required by the County that said vendor has made such good faith efforts
and that competent minority, women and handicapped employees have not
been available by such means.
(Amended bl Ord. 4490 (NS) effective ~'l'75' amended by Ord. 4121 (NS)
effective 7-22-7': amended by Ord. 5099 (NS) effect1ve 3-16-78; amended
by Ord. 6050 (NS) effective 6-11-81.)
SECTION 84.13. CORllECTING VIOLATIONS. After. findine by the Director
that a vendor or subcontractor has failed to file with the County &1! ~orms
or reports required by this Article while operating under a County Contract
or bas committed a violation of any applicable State or Federal law concern-
ing equal employment practices, the Director shall serve written notice of
such violation on the vendor. The vendor shall be responsible for notifying
any subcontractor involved in such violation.
Upon request by the Director, the vendor fo~d to be in violation shall
meet with the Deputy Director in order to determine a method of co~recting the
violation and the time period within which such remedy shall be effected.
If the remedy 1s not agreed upon within ten (10) days of the above notice,
the Director shall prescribe the method by which the violation shall be
corrected and shall notify the vendor in writing of such method. The
vendor shall be responsible that said vendor's subcontractors correct
their violations.
If the vendor has not corrected the violation in the manner prescribed
by such notice, unless an extended period is permitted in writing by the
Director, the Director shall make a finding that the vendor is in
violation of this Article- and shall impose one or more of the sanctions
provided in this Article.
(Amended by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4721 (NS)
effective 7-22-76; amended by Ord. 6050 (NS) effective 6-11-81.)
SECTION 84.14. SANCTIONS. Upon a finding that a vendor or subcontractor
has Violated any portion of this Article, the Director, shall impose one
or more. of the following sanctions:
(a) Find that the vendor is not eligible for the award of any
contracts or any future contract until the vendor has demonstrated to the
satisfaction of County that said vendor has made a good faith effort to
improve minority, women and handicapped employment, and will comply with
the affirmative action program in effect at the time of any future con-
tracts; in no event shall the vendor be eligible for award of any contract
within one year from such finding, unless earlier approved by the Board
of Supervisors.
(b) Terminate the entire contract effective at a time specified
by the County.
(c) Te~inate any portion of the contract or work thereunder.
(d) Find that any subcontractor to the vendor in violation of this
affirmative action program is not a responsible party to a County contract
and may refuse to contract with any vendor performing County contracts,
until the subcontractor has demonstrated to the satisfaction of the
County that the vendor has made a good faith effort to improve minority,
women and handicapped employment and will comply with the affirmative
action program in effect at the time of any future contracts; in no
event shall said subcontractor be eligible to participate in any County
contract within one year from such finding unless earlier approved by
the Board of Supervisors.
(Amended by Ord. 4721 (NS) effective 7-22-76; amended by Ord. 5099 (NS)
effective 3-16-78; amended by Ord. 6050 (NS) effective 6-11-81.)
SECTION 84.15. INTENT OF BOARD OF SUPERVISORS. It is the intent of
the Board of Supervisors to enact each provision of this Article independ-
ent of every other prOvision and therefore, should any part or language or
any provision 1n this Article be declared invalid, the remaining provisions
of the Article shall be of full force and effect.
(Added by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4721(NS)
effective 7-22-76.)
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SECTION 84.16. NOTICE OF VIOLATION AND IMPOSITION OF SANCTIONS.
In any case where the Director has made a finding that a vendor 1s in
violatlon of this Article and has imposed any of the sanctions authorized
by Section 84.14, the Director shall mail or deliver to the vendor affected
at least ten (10) days prior to the effective date of such sanction, a
written notice which includes a statement of the action. a concise
explanation of the reasons for such action, the statutory basis relied upon
for such action and an explanation of the vendor's right to appeal such
action to the Board of Supervisors before the effective date of such action.
A copy of the notice shall also be sent to any subcontractor of the vendor
who the Director has made a finding that such subcontractor is in
violation of the provisions of ehis Article.
(Added by Ord. 4490 (NS) effective 5-1-75; amended by Ord. 4721 (NS)
effective 7-22-76; ameneed by Ord. 6050 (NS) effective 6-11-81.)
SECTION 84.17. APPEAL PROCEDURE
(a) . A vendor or subcontraceor who has received the notice required by
Section 84.16 may, prior to the effective date set forth in such notice.
file an appeal in writing with the Clerk of the Board of Supervisors.
Such appeal shall set forth the reasons why theactian of the Director
should not have been taken. Failure of_ the vendor or subcontractor to
appeal prior to the effective date set forth in such notice, shall make
the action taken b)' the Director final.
(b) Upon receipt of the vendor's or subcontractor's written appeal,
the Clerk. of the Board of Supervisors sball within fifteen (15) days from
Such receipt set. hearing on the appeal before the Board of Supervisors.
Such hearing shall be set at a time no more than thirty (30) days from the
date that the Clerk receives the written appeal. The Clerk shall notify
by mail the Director and vendor or subcontractor of the time and place set
for said hearing. Pending hearing and decision of the Board of Supervisors,
the effect of action of the Director shall be stayed.
(c) At the hearing on the appeal before the Board of Supervisors.
the Director and vendor or subcontractor may present evidence relating to
the action taken by the Director in the notice. Upon completion of the
presentation of the evidence the Board may affirm, IDDdify or overrule the
action of the Director. The decision of the Board shall be final.
c
(Added by Ord. 4721 (NS) effective 7-22-76; amended by Ord. 6050 (NS)
effective 6-11-81.)
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