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HomeMy WebLinkAbout2000 CON American Medical Response AMR - AmendmentMEETING DATE 11/14/00 City of National City, California COUNCIL AGENDA STATEMENT AGENDA ITEM NO. 7 ITEM TITLE A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY AUTHORIZING THE MAYOR TO EXECUTE AN AMENDMENT TO THE AGREEMENT FOR BASIC AND ADVANCE LIFE SUPPORT AMBULANCE SERVICE BETWEEN THE CITY OF NATIONAL CITY AND LAIDLAW MEDICAL TRANSPORTATION, INC., DBA AMERICAN MEDICAL RESPONSE, SUCCESSOR IN INTEREST TO HARTSON MEDICAL SERVICES AND MEDTRANS, INC. PREPARED BY DEPARTMENT EXPLANATION Walter Amedee, Management Analyst II Fire The City's ambulance services contract with American Medical Response (AMR) will expire on November 20, 2000. Hartson Medical Services (now AMR), at no cost to the City, has been providing basic and advanced life support ambulance transportation services to the City since October 1, 1983. To ensure the continued delivery of quality emergency medical services and provide for future quality enhancements to the system, including the implementation of a Paramedic First Responder Program, Staff recommends that the current Ambulance Services Agreement with AMR be extended for a period of three (3) years. The extension of this Agreement will provide for the City's ambulance services needs, ensuring that these services are delivered in an effective and efficient manner without a City revenue subsidy, while also supporting the Fire Department's Paramedic First Responder Program. CEnvironmental Review X N/A Financial Statement No negative impact; Ambulance Serv. Agreement is revenue generated: $142,840. V, A J, Approved By: Finance Director a fee for service with no City revenue subsidy. Projected Account No. STAFF RECOMMENDATION Approve Amendment to the Ambulance Services Agreement with American Medical Response extending the current agreement for a three-(3) year period beginning December 1, 2000. BOARD / COMMISSION RECOMMENDATION N/A ATTACHMENTS ( Listed Below) Resolution No. 2000-143 1. Resolution authorizing the Mayor to sign an Agreement to the current Ambulance Services Agreement. 2. Amendment to American Medical Response - Ambulance Services Agreement. 3. Ambulance Services Contract Extension Report. A-200 (9,'99) RESOLUTION NO. 2000-143 RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY AUTHORIZING THE MAYOR TO EXECUTE AN AMENDMENT TO THE AGREEMENT FOR BASIC AND ADVANCE LIFE SUPPORT AMBULANCE SERVICE BETWEEN THE CITY OF NATIONAL CITY AND LAIDLAW MEDICAL TRANSPORTATION INC., DBA AMERICAN MEDICAL RESPONSE, SUCCESSOR IN INTEREST TO HARTSON MEDICAL SERVICES AND MEDTRANS, INC. WHEREAS, on October 1, 1987, the City and MedTrans, dba Hartson Medical Services ("Hartson") entered into an agreement entitled "Agreement Between the City of. National City and Hartson Medical Services for Basic and Advanced Life Support Services"; said Agreement has been assigned to Laidlaw Medical Transportation Inc., dba American Medical Response ("AMR"); and WHEREAS, the term of said Agreement has subsequently been extended from time to time, with the current term of said Agreement to expire on November 30, 2000; and WHEREAS, the City and AMR now wish to amend Sections 1, 3, and 17 of said Agreement, concerning the extension of the term of said Agreement, to permit the City to extend the Agreement for an additional three (3) years, subject to either party having a right of cancellation upon one -hundred eighty (180) days prior written notice; and WHEREAS, the City and AMR wish to further amend said Agreement, to provide that AMR shall provide additional reimbursements and assistance not addressed in the current Agreement to support the City's First responder Program as delivered by the Fire Department. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of National City that the Mayor is hereby authorized to execute an Amendment to the Agreement between the City of National City and Laidlaw Medical Transportation Inc. , dba American Medical Response for Basic and Advanced Life Support Services. Said Amendment to Agreement is on file in the office of the City Clerk. PASSED and ADOPTED this 14th day of November 2000. ATTEST: Mic ael R. Dall . , City Clerk George H. Waters, Mayor APPROVED AS TO FORM: do George H. iser, III City Attorney Passed and adopted by the Council of the City of National City, California, on November 14, 2000, by the following vote, to -wit: Ayes: Councilmembers Beauchamp, Inzunza, Soto, Waters. Nays: None. Absent: Councilmember Morrison. Abstain: None. AUTHENTICATED BY: GEORGE H. WATERS Mayor of the City of National City, California H City Jerk of the i National City, California By: Deputy I HEREBY CERTIFY that the above and foregoing is a full, true and correct copy of RESOLUTION NO. 2000-143 of the City of National City, California, passed and adopted by the Council of said City on November 14, 2000. City Clerk of the City of National City, California By: Deputy AMENDMENT TO AGREEMENT FOR BASIC AND ADVANCE LIFE SUPPORT AMBULANCE SERVICE BETWEEN THE CITY OF NATIONAL CITY AND LAIDLAW MEDICAL TRANSPORTATION INC., DBAAMERICAN MEDICAL RESPONSE, SUCCESSOR IN INTEREST TO HARTSON MEDICAL SERVICES AND MEDTRANS, INC. This amendment is entered into this 14th day of November 2000, by and between the City of National City ("CITY") and Laidlaw Medical Transportation, Inc., d.b.a., American Medical Response ("AMR") as successor in interest to Hartson Medical Services and/or MedTrans, Inc. in master and previous amendment agreements. A. RECITALS Whereas, on October 1, 1987, CITY and American Medical Response's predecessor in interest entered into an agreement entitled "Agreement between City of National City and Hartson Medical Services for Basic and Advanced Life Support Services", and B. Whereas, AMR is the legal and rightful successor entity to that agreement, and C. D. E. Whereas, the term of said Agreement has been extended from time to time with the current term set to expire on November 30, 2000, and Whereas, CITY and AMR now wish to extend said agreement pursuant to Section 17 thereof, and Whereas, CITY and AMR are aware of changes in Statewide Standards of care and AMR is desirous of assisting CITY in the attainment of these changing standards of care in an effort to enhance patient care in a cost effective manner. NOW, THEREFORE, in consideration of the mutual benefit to be derived therefrom, CITY and AMR agree to amend Sections 1, 3, and 17 of the "Agreement between the City of National City and AMR for Basic and Advanced Life Support Services", to include as follows: I — Section I — Amendments to Existing Provisions I. Section 1(b), Paragraph 3 of Page 7 is hereby amended as follows: These "unusual circumstances" means only unusually severe weather conditions, disaster, unusual periods of very high demand upon the system, or delays due to road and/or transportation related construction projects that have an 1 adverse effect on the normal flow of traffic. Additionally, insufficient or inaccurate information provided to AMR from designated 911 PSAP shall constitute "unusual circumstances". II. Section 3, Page 17 paragraphs 1 and 2 are deleted. In lieu of the language therein, the following language is added: A) Adjustments - The parties agree that the fee schedule will be adjusted on a continuous basis so that CITY's base rate is at the mean, fully adjusted ALS2 ambulance base rate found in ambulance systems in California. For purposes of clarification, "ALS2 Rate" is understood to mean the designation, or some other future designation, of that class of ambulance calls defined by HCFA as requiring Advanced Life Support interventions. For purposes of this comparison, the systems and/or agencies identified in "Attachment A" shall be utilized. In no event shall the base rate fall below the approved base rate in effect at the time of the execution of this agreement. The parties further agree that the percentage increase or decrease of such change related to ALS2 Mean Base rates shall apply (on a percentage basis) to all other elements of the fee schedule as represented by Section 3 and related Exhibits of the Agreement for Basic and Advanced Life Support Services referenced above. For purposes of example the following reflects the understanding of the parties: a. ALS Base Rate comparison increase is 2%. b. That 2% increase is applied to all elements of the allowable billing categories that include mileage, oxygen, etc. Resulting in a 2% increase of the gross bill. B) Medicare Reimbursement Changes - The Parties understand and acknowledge that the Healthcare Financing Administration is currently devising revisions to the Medicare Reimbursement schedule and methodology. The Parties further understand that such changes could provide substantial and immediate negative impact to the stability and sustainability of the EMS System within the City of National City. The City, desirous of maintaining a high degree of stability and sustainability to the system while minimizing the potential impacts of such changes to their general fund, agrees that upon written notification by AMR that the implementation of these Medicare reimbursement changes cause AMR to receive a reduction in net revenues from those received under the rate structure described in paragraph "A" above, AMR shall be allowed to increase rates sufficient to fully recover the net revenue lost within the City of National City by the changes in Medicare Reimbursement rates or methodology. Such rate increases will take affect thirty (30) days after such notification to CITY and shall be based upon the impact from the prior fiscal years actual collections. In the event the increases required to offset the loss of revenue from the Medicare Reimbursement changes are greater than the statewide mean rates outlined above, the rates AMR implements to offset the financial impact of the Medicare adjustments shall supercede the statewide ambulance system rates above until such time as the statewide mean rates are equal to or greater than the Medicare adjusted rates. III. Section 17, Page 37 shall be deleted in its entirety. In lieu thereof, the following shall be inserted. Section 17 - EXTENSION Upon the execution of this amendment the term of this agreement shall be extended for a period of three additional years beyond the current expiration date of November 30, 2000, provided that either party may, at any time during the extended term, cancel this extension by (A) giving one - hundred eighty (180) days prior written notice of such cancellation subject to the conditions found in Section A.1 below: Or, (B) with mutual consent of both parties two additional extension periods of one year each shall be implemented. Section II — Additional Responsibilities - In addition, AMR agrees to the following: 1. Subject to the provisions of sub -paragraph "2" below, AMR shall provide CITY with a loan over the term of this agreement to meet CITY's costs of establishing and providing ALS First Responder Capability. AMR shall, upon request of CITY, provide CITY with a maximum of three annual loan installments based on CITY'S actual costs of establishing and providing an ALS First Responder Capability. The First such installment shall not exceed the amount of $17,420. The second annual installment shall not exceed the amount of $20,290, and the third annual installment shall not exceed the amount of $23,360. Such installments shall be made upon request of CITY at their sole discretion. However, AMR shall not be obliged to provide loan funding if such request follows, or comes within ninety (90) days of receiving a Notice of Termination of this agreement from CITY. 3 CITY shall provide such loan request to AMR prior to February 1 of each year that CITY is desirous of such funding. To the outstanding balance of this payment each month, AMR shall be entitled to add interest charges in the amount of 6.5%, calculated on an annualized basis after credit for monthly first responder reimbursements. The balance of installments made to National City, plus the interest accrued shall be paid back to AMR through the First Responder reimbursements previously paid to CITY pursuant to "First Amendment to the Agreement between the City of National City and Hartson Medical Service for Basic and Advanced Life Support Services" effective date October 1, 1989. The first responder fees due from AMR shall be used to credit the balance due by CITY. Prior to January 31 of each year during the term of this contract, AMR and CITY will reconcile the amounts credited to CITY based upon First Responder Reimbursements and adjust such credits for changes to call volumes and/or collection rates and rate changes experienced during the prior year. Any balance (including interest) that remains at the end of this agreement shall continue in force and effect into any successor agreement. Should this agreement be terminated for any reason, or AMR or any successor in interest is replaced by another provider, the amount due shall become due and payable upon the termination of this agreement in one, lump sum payment and CITY further agrees that such amount shall be included as a system cost identified within the RFP for ambulance and/or ALS services. CITY certifies that the amounts agreed to in this agreement do not exceed their actual costs of providing the services subject to this agreement. 2. AMR agrees to allow the City to purchase equipment utilizing AMR vendor agreements and purchasing programs. 3. AMR agrees to re -supply the CITY's Fire Department on a one for one basis, all Medicare Allowable reimbursable supplies and equipment and medicines, excluding, controlled substances, used on joint incidents to the extent that AMR is able to bill for use of those supplies. Replacement of specific supplies will occur on scene when possible. 4. To properly transport and dispose of all biological/medical waste generated by Fire Department personnel while rendering services pursuant to this agreement. 5. To allow access to AMR training programs by the CITY's Fire Department personnel, including ambulance unit driving and EMT-P Continuing Education Programs. AMR will hold at least one training session per year in National City or an appropriate South Bay venue. 6. To provide assessment unit Medical Control and Quality Assurance and Improvement Programs and mechanisms to City as units become operational. For this service the following compensation will be due to AMR and shall be credited against rent charges described in sub -paragraph 7 below: First Unit (12 month Period): $ 6,750 Second Unit (12 month Period): $ 9,600 Third Unit (12 month Period): $15,300 In addition, a dispute resolution procedure shall be mutually agreed upon to resolve differences between AMR Staff, contractors and agents. Disputes related to clinical care and patient services shall be directed through AMR's Quality Assurance and Improvement Program of which CITY will be a participating member. 7. To provide payment for rental of space in Fire Station 15 in the amount of $23,580 per year, Tess the amounts specified in sub- paragraph 6 above. Such rental amount to be paid in quarterly installments, commencing on May 1st and at the first of each fiscal year quarter as utilized and defined by AMR. 8. To provide ambulance support to the CITY's Fire Department at major emergency alarm fires. Nothing in this section is deemed to require AMR to take units out -of -service for this function, however, AMR will make reasonable efforts to provide such support as requested. 9. To design, carry out and report on a quarterly basis the results of a comprehensive public education program designed to meet the specific needs of the CITY's citizens. The programs should focus on child, elderly and family health and safety issues and will include, but not be limited to, infant/child injury prevention and rescue, proper use of the 911 EMS system, and other programs related to widespread health abuse issues. 10. To participate in disaster preparedness planning and training activities carried out by the CITY's Fire Department and the County of San Diego. AMR is not responsible for providing medical supplies or equipment for such activities. 11. AMR agrees to assist CITY in the funding of costs associated with a Diesel exhaust system utilized by AMR's ambulances in Station 15. AMR agrees to pay CITY AMR's prorated cost of Diesel Exhaust System installation in Station 15. AMR's contribution to such costs shall not exceed $15,000 and AMR shall pay CITY in three annual installments over the term of this agreement. Such payments shall be due on March 1 of each year. CITY agrees that if AMR is replaced as contractor for any reason, the amount paid by AMR under this section shall be treated as a capital investment by AMR and the equipment is 5 A. therefore owned by AMR and the investment amount shall be paid back to AMR in one, lump -sum payment by the successor paramedic contractor to AMR. SECTION III — RETENTION OF PREVIOUS PROVISIONS With the foregoing exceptions, each and every provision of the "Agreement between the City of National City and Hartson Medical Services for Basic and Advanced Life Support Services", dated October 1, 1987, and as amended from time to time shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be executed the day and year first herein set forth. CITY OF NATIONAL CITY By: George H. Waters, Mayor APPROVED AS TO FORM: By: George H. Eiser, III City Attorney LAIDLAW MEDICAL TRANSPORTATION INC. By: David Mintz , Vice President, Laidlaw Medical Transportation, Inc. B: Lai ical ransp• ion, Inc. 6