Loading...
HomeMy WebLinkAboutReso 1979-9491(_ ~ . Form No. 342 Revm 3/7~ RESOLUTION N0. 9491 resol~ betweE Hartsc provic adjacE dated which fully Vista agreer Prese RESOLUTION OF THE CITY ~, COUNCIL OF "THE CITY 0~" CHULA VISTA, APPROVING AGREEll~~[[ENT BETWEEN THE CITY OF CHULA VISTA AND HARTSON'S AM~ULANCE SERVICE, INC., DBA BAY CITIES AMBULANCE TO PROVIDE PARAMEDIC SERVICES TO THE CITY OF CHULA VISTA ANID SPECIFIED ADJACENT AREAS AND AUTHORIZING TEiE MAS~OR 'I'O EXECUTE SAID A1REEMENT The City Council of the City of Chula Vista does hereby e as follows: NOW, THEREFORE, BE IT k2ESOLVED that that certain agreement n THE CITY OF CHULA VISTA, a municipal corporation, and n's Ambulance Service, Inc}, dba Bay Cities Ambulance, to e paramedic services to the City of Chula Vista and specified nt areas, the 8th day of February' , 19 79 a copy of is attached hereto and incorporated herein, the same as though set forth herein be, and tl~e same is hereby approveda BE IT FURTHER RESOLVED that the Mayor of the City of Chula be, and he is hereby authoxiZed ar~d directed to execute said lent for and on behalf of tie City of Chula Vistar iced by ' Approved as to form by Lane Cole, City Manag ,~4~-~° ~ George Lindberg, City Atto~ ADOPTED AND APPROVED by the CITY COUNCIL of the CITY 0~` Cf~ULA VISTA CALIFORNIA, this 8th day of February 19 79 by the f 1lowinr vote, to-wit: AYES:I Councilmen Gillow, Slott, Cox, Egdahl, Hyde__ NAYES ~: Counc Llmen None ABSENfi': Councx.lmen None AT'TES City Clerk " STATE OF CALIFORNIA) COUNT OF SAN DIEGO ss. CITY F CHULA VIS'TAj ~'Iayor of the City of Chula Vista I, , City Clerk of the City of C la Vista, California, DO ~iEREBY CERTIFY that the above is a full, true nd correct cony of Resolution No. and that the same has not een amended or repealed. DATED_ __ City Clerk AGREEMENT TO PROVIDE PARAMEDIC SERVICES TO THII: CITY OF CHULA VISTA AND SPECIFIED ADJACENT AREAS This greement is made and entered into this 8th day of February , 1979, by and between the City of Chula Vista, a municipal corporation, herein- after called "City/Contractor" and Hartson's Ambulance Service, Inc., DBA Bay Cities Ambulance, a corporation, hereinafter called "Sub-Contractor". W I T N E S S E T H EREAS, the County of San Diego 'has responsibility for ensuring the deliv ry of quality emergency medical, services; and HEREAS, the City/Contractor has'', been designated by the County to supply subje t services; and ,JHEREAS, Sub-Contractor possessed professional qualifications to provide specified contingent services; OW, THEREFORE, the parties do mutually agree as follows: Term - This Agreement shall commence upon execution of this document and e~Ctend two (2) years unless otherwise stipulated below. Page 1 of 8 ~'9/ Administration - City/Contractor designates the City Manager, 276 F urth Avenue, Chula Vista, Califprnia 92010, or his designated repre- sentative to administer the Agreement,on behalf of the City/Contractor. ub-Contractor designates Robert.. L. Hartson, President, Hartson's Ambul nce Service, Inc., DBA Bay Cities Ambulance, 4318 47th Street, San Diego, CA 92115, or his designated representative to administer this Agreement on behalf of the Sub-Contractor. 11 reports, proposals, letters,'notices and/or other correspondence shall be sent to the attention of the designated representatives at their respe tive addresses. Service Area - Responses to Calls for emergency medical assistance shall be made in a territory consisting of the incorporated limits of the City pf Chula Vista, the City of Imperial Beach, and the boundaries of the Bonita-Sunnyside Fire Protection District and the Montgomery Fire Protection Dist ict. Total service area equals 8pproximately thirty-six (36) square miles and includes some 125,000 residents. 4. City/Contractor Furnished Eq~ipment and Services - Subject to per- formance 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 ollowing: A. One Mobile Intensive Cary 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 t'~ on Attachment B. Said vehicle and/or equipment may be declined by Sub-Contractor if approved subs itutes are otherwise obtained. i. Sub-Contractor Furnished Personnel and Equipment - Subject to perform- ante in a manner acceptable to the City/Contractor, Sub-Contractor agrees to: Page 2 of 8 ~~~ 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 operations shall be in accordance with County Criteria for Mobile Intensive Care Services (A~tachment A). 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 basiso For purposes of this Agreement, paramedics shall be individuals certified by the County's klealth Officer to operate as paramedics in San Diego County pursuarpt to Section 1480 et. seq, of the State Health and Safety Codeo C. Insure that all certified paramedics complete continuing education as required by the County ~f San Diego. ~I Do Acquire, maintain and replace all medical equipment items for t~.+o (2) MICUs as described jn Attachment 6. E. Provide all medical equipment items for two (2) additional ambulances as described byl,** in Attachment B. 60l Other Sub-Contractor Responsibilities - Sub-Contractor further agrees ,---- to: A. Maintain the MICU ambulances in a fully operational condition. B. Notify the City/Contractor immediately whenever any condition exists which adversely affects providing satisfactory ambulance service. Page 3 of 8 R 9~ 7. Compensation and Fee Schedulie - This is a no-cost Agreement and City Contractor will make no reimbursements as a result thereof. Charges for ambu ance services shall conform with Chula Vista City Council Resolution No. 062. In addition, an additional! charge of $50 per patient may be made whenever any or all of the follgwing paramedic procedures and/or equi ment are utilized: A. Cardipversion B. Defibrillation C. EKG Monitoring D. Esophageal Airway E. External IV or Injectio-~ F. Nasogastric Tube G. Nasotracheal Suctioning) H. Magi l l Forceps I. Mast Suit J. Rotating Tourniquet K. Venipuncture ', Billing shall be made directly to persons utilizing the service(s) and Cit /Contractor will in no way act a~ collection agent. 8. Independent Contractor - Sub-Contractor is, for all purposes arising i out of this Agreement, an independentt Contractor, and no employee or agent of Sub Contractor is, for any purpose art~ising out of this Agreement, an employee of he City/Contractor. rq~ Page 4 of 8 1 prey ind 9. Interest of Sub-Contractor ~ Sub-Contractor covenants that he ~ntly has no interest, including', but not limited to, other projects or pendent contracts, and shall not acquire any interest, direct or indirect, which would conflict in any manner o~ degree with the performance of services required to be performed under this Agreement. Sub-Contractor further covenants tha in the performance of this Agreement no persons having any such interest shall be employed~or retained by SubtContractor under this Agreement. 10. Modifications and Extensions - The Agreement may be modified at any tim by the written consent of the parties. This document, however, fully ex- pre ses all understandings of the parties concerning the matters covered her in. No addition to or alteration of the terms of this Agreement, and no erbal understanding of the parties, its officers, agents or employees, shall be valid unless made in the form of a written amendment to this Agree- men ,and duly approved and executed'by the parties' authorized representatives. 11. Property Title - Title to e'pcpendable property whose cost was borne in hole by the County of San Diego 'finder this Agreement will remain vested in he County upon termination of th~iis Agreement. 12. Assignability - The Sub-Conttractor shall not assign any interest in the Agreement, and shall not transfer any interest in the same without prior wri ten consent of City/Contractor hereto. 13. Termination and Default - i A. This Agreement may be tjerminated for any reason by either party giving sixty (60) days' ti~rritten notice to other party's designated representative, except as defined in "13.B" and "14"below. page 5 of 8 '9/ 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 underl,this Agreement. 14. Indemnity - Sub-Contractor I!agrees to indemnify and hold harmless City Contractor, its officers, agents,and employees from and against al] loss or e pense (including costs and attorney's fees) due to bodily injury, personal injury, professional/medical malpract',ice, including death at any time resulting they from, sustained by any person orspersons or on account of damages to prop rty, including loss or use thereof, arising out of or in consequence of the erformance of this Agreement, prpvided such injuries to persons or dama es to property are due or claime~'d to be due to negligence of the Sub- Cont actor, its officers, agents or employees. Sub-Contractor shall have Work rs' Compensation coverage for its employees under this Agreement. 15. Affirmative Action - City/Contractor and any subcontractors performing unde this Agreement shall comply with the Affirmative Action Program for Vend rs, as set forth in Article III ;(commencing at Section 84) of the San Dieg County Administrative Code. A copy of this Affirmative Action Program is i cluded as Attachment C. Page 6 of 8 ~9/ 1Q. Records - Sub-Contractor shall maintain accurate books and accounting recor s relative to this Agreement. such books and records shall be open for inspe tion and/or copying at any reasonable time by the City/Contractor's desig ated representative(s), the Audjtor of the County of San Diego, or their designated representatives. lh. Reports - A. Sub-Contractor shall comply with the ambulance report system of San Diego County by I~ompleting a Prehospital Report Form on every call made by t~,he MICU or ambulances. B. Sub-Contractor shall by responsible for submission of completed Prehospital deport Forms on the first and fifteenth pa of every month to the: rtment If Public Health Depa ¢ County of Sin Diego Division of'iEmergency Medical Services (D-222) 1375 Pacifi Highway San Diego, California 92101 fig. Attachments - The following attachments incorporated herein are of this Agreement: ', A. San Diego County Emerglency Medical Services Criteria for P~tobile Intensive Care 'Services (revised 8/22/78). 8. P~1edical and communication items to be provided in each f~1ICU. C. Affirmative Action Prdgram for Vendors. I w_ I Page 7 of 8 ~// execut N WITNESS 1JHEREDF, the parties hive caused this Agreement to be duly ed by their duly authorized representatives. HARTSDN'S AMBULANCE SERVICE, INC. ~' DBA BAY CITIES AMBULANCE {~ '~ , ~~ Robert L. Hartson, President CITY OF CHULA VISTA BY Lane F. Cole, City Manager Page 8 of 8 "9~ ATTACHMENT "A" SAN DIEGO COUNTY EMERGENCY MEDICAy SERVICES CRITERIA FOR MOBILE INTENSIVE CARE SERVICES 1. Criteria for Agency Approval to Provide Paramedic Services 2. Criteria for Selection of Base Station Hospital 3. Mobile Intensive Care Physician Certification 4. Mobile Intensive'Care Nurse Certification 5. Criteria for the~Designation of a Mobile Intensive Care Unit 6. Medication List 7. Guidelines for Selection of Paramedic Trainees 8. Paramedic Certiflication Criteria 9. Paramedic Challenge Criteria (Rev. 8/22/78) ~l SAN DIEGO COUNTY CRITEP.IA FOR AGENCY APPROVAL TO PROVID~ PARA~~DIC 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 (MICU) at all times. 3. Be selected by a loyal jurisdiction as the agency to pro- vide paramedic services for a set geographical area within that jurisdiction.* 4. Agree to a7~ide by Cdunty Paramedic Program Criteria. 5. P.gree 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 l',0 minutes in urban areas. 9. Insure that paramedic services will continue to be pro- vided 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 service and CPR. 12. Agree to orient first responder agencies to paramedic functions and role. 13. Designate Paramedic coordinator(s) for the agency. *Local Jurisdiction: Cities, districts authorized to provide emergency medical services. (Rev. 8/22/78) 1-1 SAl1 DLEGO COUNTY CRITERIA FOiR SELECTION OF BASE STATION HOSPITAL 2 41 > be designated as a base station hospital, the following -iteria must be met: Must be classified and r~,emain classified at least as a Basic Emergency Medical' Service (Title 22, California Administrative Code). Have the approval of both administrative and medical staffs of the hospital. ' Procure operational radio and biomedical communications equipment specified by Slan Diego County. Accept responsibility fdr replenishing medical supplies and equipment expended Ly the mobile units during the treatment of a patient w'ho is transported to the hospital. Agree to cooperate with'',San Diego County in gathering statistical data on patients from mobile intensive care units and maintain accurlate patient care records, ensuring patient confidentiality,' on all MICU runs. Complete patient disposition reports. Have a County-Certified ',Mobile Intensive Care Physician or Mobile Intensive Care Nurse available at all times to com- municate immediately wi~h the Mobile Intensive Care Paramedic in the field. Appoint a MIC Physician 'to be in charge of overall direction and coordination of units and satellite hospitals. 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 clinicall facilities for supervision,. and instruction as part of ~.he 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. ev. 8/22/78) 2-1 9~ 12. Appoint a Base Station Committee to meet monthly, r4ember- ship shall be composted 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 Admlinistrator. F. Each Area FirstjP.esponder (Exclude if also a paramedic service or ambulance provider). G. Each Ambulance Pjrovider (Exclude if also a paramedic service provider) Representatives of ~,he 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 communicatq all patient medical management infor- mation to receiving ',hospital when patient in the field is directed to that ho~!pital. 15. Accept such Countywide protocols for paramedic procedures as are approved by the County Health Officer. 16. Agree to provide orientation regarding Mobile Intensive Care to appropriate'~employees of the hospital. 17. Participants in Emercency Medical 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. Criteria for Selection (Rev. 8/22/78) 2-2 of Base Station Hospital SAN DIEGO COUNTY MOBILE INTENSIVE CARE PHYSICIAN CERTIFICATION s I c A B, (R~ imply with American College of Emergency Physicians (ACEP) :andards for certif ication land recertification for Mobile itensive Care (MIC) Physicians when such standards are de- :loped and implemented.' Until that time, the. following -iteria will be in effect. Requirements for Certification: 1. Be an emergency. department physician practicing in a Base Station Hoispital. 2. Be certified in Advanced Life Support by the American Heart Association. 3. Observe on a paramed~.c unit for a minimum of four paramedic, respo#~ses. 4. Attend orientation program on San Diego County paramedic system by 1$ase Hospital MIC Physician or Nurse Coordinator, Recertification 1. Certification will b~ 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.) 'v. 8/22/78) 3-1 4/ SAN DIEGO COUNTY MIC NURSE CERTIFICATION CRITERIA I. Basic Requirements for Certification: A. Candidate must Abe a current California Registered Nurse , B. Candidate must be a permanent employee of either: 1. A Base Stat~lon Hospital, assigned a. Full-time in a paramedic receiving area, o b. Part-tide with a minimum of 16 hours per weep in a paramedic receivinq area, or c. In a critical care area and attend a monthlyl,orientation including eight hours ofi Emergency Room assignment with specific emphasis on acutely ill patients'„ or d. To a critical care area and monitor and/or participate in at least two MICU radio calls per month, or e. As param~~edic nurse coordinator 2, The Paramedic Training Office C. Candidate must pass a written MICU exam with a minimum of 80o knowledge,in all areas,* D. Candidate must o~serve paramedic functions on a minimum of eight paramedic responses. E. Candidate must attend are orientation to Base Station responsibilities:. II: Recertification: A. Candidate must a~hnually attend 16 hours of continuing education relati~e to paramedic functions. Eight hours of this requirement may be fulfilled at formal tape review. B. It is recommended. that the candidate respond with an MICU to a minimum of four emergency calls every six months. *See note at bcttom of page 4-2, (Rev. 8/22/78) 4-1 C. Qualified candidates.. must pass a written recertifica- tion exam every two years, with a minimum of 800 knowledge in all areas.* III1 Revocation of Certification: A. If for any reason an,individual fails to meet the criteria for a period of three months, said certifi- cation may, be revoke by the County Health Officer. B. Certification may be ', questioned at any time for any of the following rea~ons: 1. Inadequate clinical knowledge 2. Lack of proficienc~y with technical skills 3. Lack of judgment'or responsibility 4. Inability to mee~+ recertification requirements C. Certification may bequestioned by an involved party, but investigation procedure must be initiated by a representative of thq 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 ~~~ritter~ request flor investigation including all pertinent dat',a (facts, dates, names, wit- nesses, etc.) to ''..the County Health Officer. 2. County Health Off~,icer shall inform subject of the proceedingjs and request any informa- tion pertinent td the claim. 3. County Health Off'',icer shall call a panel of three, one of whom shall be a member of the EMS Training Offijce, to review all material and employ whatevler testing devices deemed necessary to reac'~h a conclusion. The person being considered ',for decertification should have an opportunil,ty to speak and to appear before the panel. 4. The panel shall mike written recommendation of the decision to the County Health Officer. - 5. The County Health Officer will notify Base Hospital and subject. Health Officer will contact the persom lodging the complaint. *I the event of failure of an MIC Nurse exam, candidate may be a lowed to repeat exam following additional study. Exam may n t be repeated a second time within 12 months. A minimum of 8 o is the required pass level on repeat exams. /9/ 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) whi'',le 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. (Rev. 8/22/78) 5_2 Criteria for Designation of a MICU SAN DIEGO COUNTY GUIDELINES FOR THE SELECTION 'OF PARAMEDIC TRAINEES 1. Candidate must be employed by, or have a commitment for emplo~~nent 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 hate 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 a GED 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 Off ice ',which evaluates motivation, reasoning, and potential to suGCeed in the training program. (Rev. 8/22/78) 7-1 MEi)IC.1TIOi] i_IS'I' effective 3/1/76 (1/25/78 Rev.) DRUG minophyllin tropine enadryl alcium Ch1o ide extrose, 50% opamine pinephrine lucola nderal nstant Gluco e pecac suprel susprel Inha ant 3S1X .idocaine [orphine Sul_ate arcan itroglycerin itocin odium Bicarb note alium J Solutions finger's Lact to o De~arose/td ter ilt Poor Alb min IND7 ~ATIO;~~ bronchospasm brad_ycardias organophosphate poisonings allergic reactions asystole electro-mechanical dissociation diabetics unconsciousness seizure of unknown origin hypotension asystole, severe bradyarrh_ythmias bronchospasm alert diabetics supraventricular tachycardias diabetics drug overdose (alert patient) heart blocks bronchospasm pulmonary edema ventricular irritability pre IV insertion pain- MI,burns; pulmonary edema narcotic & unlcno"m overdoses unconsciousness angina post-partum hemorrhage acidosis DOSAGE ROUTE 250-500m~/ IV drip/20 min. 20m1. D5W volutrole 0.5-1.Omg. IV Push 2mg. (may repeat) IM, IV Push 25-50 mg. IM, IV Push 1 GI`;/lOml. IV Push; IC 25 gms/50m1. IV Push status epilepticus severe an>:iety reaction precardioversion 200-400mg./250m1. DSi~ IV drip (titrate to B/P) 0.5-lmg. ,(lOml. IV Push, IC ', 1:10,000) ', 0.3m1. of 1:1,000 SQ ~ 7 oz. Bottle p,o. (75gms.) 1-4mg.(0.5mg. increments) IV Push (titrate to pulse) 1/2 tube (12.5gms.) between gum and cheek 15-30m1. p.o.~ 1-2mg./250-500m1. D5W IV drip (titrate to pulse) 1-2 breaths inhalation 20-80mg. (up to 200mg.) IV push 50-100mgg IV Push 1-2gm/250-500m1. DSTJ IV drip 0.1 cc intradermal 2-15mg, in 2mg. increments IV Push ', 5-15mg. IM 0.4mg. (may repeat) IV Push, IM 0.4mg (gr. 1/150) sublingual '' 3-10 u. IM 10-20 u./500m1. D5W iV drip i m%a/kg X 2 dcses, IV Push then 1 mEq /l:g q 10 min. 2.5-20mo. (up to 40mg.) IV Push (in small increments) ?`liscellaneous ~OOOml. Bag Ammonia Ampules- i to 2 deep inhalations 50-500m1. Bag ?Formal Saline for Irri€ation (1000m1.) 12.5 gms/50m1. Bottle Antibiotic Ointment (Polysporin) Disinfectant (Zenherin or I3etadine) Liquid Deterhent (Pl~isohe::) X75; reviscc? 1/76 ~rrectc~:] '/7 ~viscd <<i 77 (Licio~aine-?:cute) ~~ -. ,_, _ , SAN DIEGO COUNTY PARAMEDIIC 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 (1~IC) 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 operating an ambulance. B. Must be 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. D. Candidates who axe eligible for employment, but fail to obtain a' commitment for employment dur- ing the time frame of the eligiblity list, must retake the Chall',enge 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 Certificatlion: Certification as a S!~n Diego County MIC Paramedic will be contingent upon: A. Demonstration of',competency in paramedic-level knowledge and sk',ills on a four-part written exam, a practical) exam, and an oral exam. Each section must be passed with at least 800 in order to proceed to other exam sections, and (Rev. 8/22/78) 9-1 B. Certification may b~ 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. Certification may bel questioned by any involved party, but investigation procedure must be initiated by a representative of th;e Base Hospital, the Training Agency, or the Count',y Health Officer. D. Procedure for investigating certification shall be as follows: 1. Party initiating action shall submit a written request for investigation, including all pertinent dajta (facts, dates, names, witnesses, etc.) to the Cour_ty Health Officer. 2. County Health Officer -shall inform subject of the proceedings and request any informa- tion pertinent to the claim. 3. County Health Officer shall call a panel of three, one of :ahem shall be a member of the Training Aaenc;%,' to review all material and employ ;ahatever'testing devices deemed neces- sary 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 rake a written recommendation to the County Health Officer. 5. Tl:e County Health Officer will notify Base Hospital, sponsofing agency, Training Agency, and the individu«1 involved. Health Officer will contact thelperson lodging the complaint. (~ev. 8/22/78) 8-3 Paramedic Certification Criteria ~4/ SAN DIEGO COUNTY PAF.AhZEDIC CERT'',IFICATION CRITERIA I Base Requirements for Ce',rtification: 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 Recertification: ' A. In order to qualify 'f or recertification, the candidate must complete all of the following each year: *l. t;'ork on a Mobils Intensive Care Unit at least 80 hours every month, or participate in a min- imum of 50 medial r-uns every month. I 2. Accrue at least ,five hours of clinical exper- ience every three months, beginning the month of graduation. A maximum of two hours every three months car be accrued at a hospital other than the assigned Base Station Hospital if prior permission is given by both hospitals. 3. Accrue at least two hours of tape review at the assicrned Base Hospital during ten of the 12 months, beginning the month of graduation. 4. P.ttend at least'18 hours of related continuing education classes per year, at least eight hours of which must b~ 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 parame~ic-related; although, it is acceptable to get all 18 hours from the Training Office if desired . ) The Training Office will offer monthly classes of four hours eachion subjects requested by the certi- fied paramedics', the base hospitals, or the train- ing staff. Thel,schedule will be prepared a year in advance, but the topics ~-gill be chosen about three months in advance to accommodate requests. ~Or show satisfactory equivalent to excuse vacation or illness. (~ev. 8/22/78) 8- 1 /4/ 5. Perform to the satisfaction of the Base Hospital, the sponsoring agency, and the Para- medic Training Office. Each candidate must have at least twp satisfactory field evaluations on file annually in order to qualify for re- certification. Field evaluations can be com- pleted by either the training staff or the MIC Coordinators at the Base Hospitals. B. Recertification will be required every two years in the months of Marchand 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 recerti- fication exam, he/she must be retested on that part within one month, and will be retested on the entire exam again one year from that time. Following 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 wi~ether 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 I,in a paramedic capacity until such time as compjetency is again demonstrated on a repeat exam.' C. It will be the riesponsibility of each individual para- medic to preparelfor the exam by self-study and attendance at appropriate lecture sessions. D. Candidates vaho gjualify and successfully pass the recerti- fication exam wi',11 be recertified by the County Health Officer. III. Decertification: A. If for any Continuing for a perm revoked by (Rev. 8/22/78) reason the individual fails to meet the basic Education requirements for recertification ~d of 'three months, certification may be the Cr~unty Health Officer. 8-2 Paramedic Certification Criteria B. Employment by an agency authorized to provide MICU service within 'SS an Diego County, and C. Successful completion of a field internship of no less than 72 hour's and no more than 480 hours, during which the can',didate must demonstrate compe- tency in each of the areas defined as necessary for the paramedic role. (R~v. x/22/78) %y~ 9-2 Paramedic Challenge Crite~~ia ATTACHP1ENT B Page 1 *S~pLIED BY EMERGENCY p1EDICAL SERVICES Non-}Disposable Items 1. ABS Trauma 13ox 2. IIackboard (spine boar d', set short) 3, Defibrillator (combinakion scope and defibrillator) 4. Drug Rox 5. Hare traction splint ('adult) 6. Hare traction splint (;pediatric) 7, Mast Suit (received} (,Standard anti-shock airpants) 8. Resuscitator - Robert Shaw with aspirator 9, Scoop stretcher 10. Splints: Instaform Vacuum (set of 5 individual splints)' 11. Splint: Instaform Vacuum-hand pump 12. Splint: Instaform Vacuum Velcro straps: 1"x18"; 1"x24"; 1"x~0"; 1"x36" 13. Splint Instaform Vacuum-Repair Kit ications: 1. Handie Talkie • 2. Mobile Radio 3. COR telemetry Radio and Battery Charger X19/ Minimum ~l Per vehicle 2 each 1 each 1 each 1 each 1 each 1 each 1 each 1 each 1 each 1 set 1 each 1 each 1 each 1 each 1 each 1 each **S~PPI;IED BY BAY CITIES A.~tBULANCE -9/ ATTACNi9ENT B • Page 2_ Piinimum ~>f Non-Disposable Items ' per Vehicle 1. Ambu Bag (Laerdal Resu;~sci Folding Bag II complete with c'~ase) 1 each 2. Bandage Scissors (7 1/~+" Stainless) 2 each 3. Bedding top-sheet ' 1 set 4. Bedding-bottom sheet ' 1 set 5. Bedding-pillow case 1 set 6. Bedding- pillow (cot a bulance) 2 each 7. Bedding- blanket (cot ~lanket - med. gray) 2 each 8. Blan}cots - Disposable (KCD disposablanket) 1 package 9. flood pressure cuff - adult 1 each 10. Oral Airways (package of six assorted sizes) 1 package 11. Bite sticks - Ipistick', 1 box 12. Burn sheets ~ 1 box 13. Cardboard splints - co#nbination 12", 18", 24" splints 1 package 14. Cotton applicators 1 box 15. Cold Packs - Kwik Kold'', 2 boxes 16. Emesis basin (disposal;) 6 each 17. Gloves (sterile) 2 each 18. OB Kit ~ ~ 2 each 19. Oxygen Mask (clear Vinyl with 84" tube) 3 each 20. Nose prongs (nasal cant~ula vinyl with tube) '~ 3 each 21. Connective tubing (Oxygen soft plastic tubing 84") ' 6 each 22. Urinal 1 each 23. Bedpan ', 1 each ATTACHf1EWT B Page 3. ~~~~* (& '91 SUPPLIED BY AMBULANCE SERVICE OR BASE STATION HOSPITAL, AS APPLICABLE: Minimum /I Non-Disposable Items per vehicle 1. Blood pressure cuff - pediatric 1 each 2. Electrodes (long term 4 electrodes per package) ', 1 box 3. Electrode LJires (40" lgng life) 2 sets 4. Esophageal airway (Kit) 2 each 5. hemostats (1:e11y 5 1/2'! straight) 2 each 6. Laryngoscope - Hook on ',handle 1 each 7. Laryngoscope - Adult Carved stainless steel blade, size /~ 1 each 8. Laryngoscope - Adult (straight chrome blade, size 4) 1 each 9. Larynogoscope - child straight chrome blade, size 3) 1 each 10. Laryngoscope - Infant straight chrome blade, size 2) ' 1 each 11. Rotating tourniquets 1 set 12. Sandbags (assorted sines) 1 set 13. Stethoscope (Bard Parker Duosonic) 2 each 14. Thermometer - Oral - 2 each 15. Thermometer - rectal ~ 2 each 16. Magill Tonsil Forceps ', 1 each 17. Adhesi~~e tape (1/2"x la yards) 2 rolls 18. Adhesive tape (1"x 10 yards) 2 rolls 19. Adhesive tape (2"x 5 yajrds) 2 rolls 20. Alcohol Swabs (100 swabs per box) 1 box 21. Armboard: Long ' 6 each 22. Armboard: Short 6 each 23. Bandages: ', > - a. 4"x4" - sterile 1 box b. 5"x9" ', 2 trays c. Gauze Rolls - 4"x5 'yards - Kerlix, . Kling 2 packages d. Elastic Bandages (31"x5 yards) 1 box e. Eye patches (oval eye pads) 1 box f. Triangular bandages. 1 packages g. Bandaids (3/4" x 3"''~,) 1 box 24. Cardboard Splints - Arun 6 each 25. Cardboard Splints - leg, 6 each 26. Electrode Paste "EKG So',1" 2 bottles 27. IV Administration Sets:'. Plexitron Macrodrip 12 each Plexitron ~{icrodrip'' 6 each Plexitron riicro dri~ with Volutrole 6 each 28. Nasogastric Intubation Set-up 18fr. 45" 1 each 29. Needles: IV scalp vein - 19 gauge 8 each IV scalp vein - 21 gauge 6 each IV scalp vein - 23 gauge 6 each IV cannula - medicut - 18G 8 each IV cannula - medicut - 16G 6 each IV cannula - medicut - 20 6 each -B General Community Hospital -2 Non-Disposable Items - continued Needles: z r i 21 G x 1" S.C. 23 G. x 3/8" Vacutainer Needles 21 G. x 1" 30. Penlights - disposable 31. Razors 32. Scalpels 33. Suction catheters (14~r.) 34. Tourniquets (1/2" Penrose Tubing) 35. Vacutainer Holders 36. Vacutainer Tubes ~9/ .ATT~.CHtiENT 3 Page 4 tiinimum ~1 per vehicle 6 each 4 each 4 each 2 packages 2 each 2 each 3 each 2 each 2 each 6 each