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June 16, 1989
ITAM 7. f.
T0: Mayor Iioke
Councilmembers: Napper
Oxborough
Walsh
Wippermann
FROM: Stephan Ji1k f �
Administrator/Clerk i
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RE: Ambulance Contract - He th East
We presentlq are opera�ing under a contract, which expired
January 1 , 1989, with Health East Corporation (named in the
contract as Divine Redeemer Hospital� for their providing
ambulance service to the Citq of Rosemount. They alsa provide,
under contract this service for the cities o£ Eagan, Inver Grove
Heights, West St. Paul, South St. Paul, Mendota Heights, Sunfish
Lake, Mendota and Lilydale.
A new contract, attached, has been proposed bp the provider.
This new contract has been reviewed, and discussed by the city
administrators and managers of the affected cities and we
collectively are requesting our citp councils to approve the new
contract.
The new contract is the same as the o1d one with two exce�tions.
These are: 1) the term of the contract is for €our years. The
term o£ the previous contract was 2 qears; and, 2) the provider
must meet "the guidelines established in the Metropolitan Health
Systems Plan." These guidelines are attached as part of the
contract.
I have discussed this with Police Chief Staats and Fire Chief
Aker and they support the contract approval.
I request your approval of the ambulance service contract with
Divine Redeemer Memorial Hospital for a period of four pears
ending January 1 , 1993.
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� AMBULANCE SERVICE AGREEME�
This AGREEMENT made and entered into effective the first day of January,
1989, by and between the cities af Eagan, Inver Grove Heights, West St. Paul,
South St. Paul , Mendota Heights, Rosemount, Sunfish Lake, Mendota, and Lilydale,
thereinafter referred to as °Cities", and p. R. Hospital , d/b/a Divine Redeemer
Memorial Nospital , hereinafter referred to as "Hospital".
WHEREAS, the Hospital , a Minnesota corporation, desires to provide
paramedic ambulance service to the Cities, and
WHEREAS, the Cities, desire to jointly assure that adequate ambulance
service is available.
NOW, THEREFORE, in consideration of mutual covenants, agreements and
matters set forth herein, the parties hereto agree as follows:
1 . Nature of Ambulanee Service to be Provided.
The Hospital agrees to provide paramedic ambulance service
to the Cities.
2. Duties and Responsibilities of the Hospital .
As part of its duty and responsibility to furnish ambulanee service
to the Cities, the Haspital agrees that it will :
a. Either own or lease and operate two fully equipped paramedic
ambulances meeting state license requirements.
b. Maintain and staff eac� ambulance on a 24-hour basis, seven {7)
days per week.
c. Staff each ambulance with two (2) paramedics with National
Certification.
d. Be self-sustaining without redueing the levet of service to
which it has agreed.
3. Fee to be�aid by the Cities
There will be no fee paid by the Cities for the contract period.
4. Miscellaneous Terms
a. There shall be no employment relationship established by this
Agreement. The Hospital , in the performanee of this Agreement, shall at all
times, be an independent contractor. Ambulance drivers, attendants and
paramedics performing, duties for the hospital are employees of the Hospital and
the City shall have no right to direct, control or influenee their actions, nor
shall the City in any way, be respansiale for tMeir acts, their salary or any
employment benefits. Likewise, police officers, firefighters or other employees
or agents of the City are under the sole direction of the City and Hospital
shall have no right to direct, control or influence their actions, nor sfiali
Hospital in any way, be responsible for their acts, their salaries or any
employment benefits.
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b. The Hos�ital ic required to maintain full and completP
administrative and medical supervision and control over the ambulance service
provided during the course of this Agreement. Ambulance service shall meet the
guidelines established in the Metrapolitan Health Systems Plan.
In this regard, the Hospital shall be responsible to the patient
during the course of transportation of the patient to the Hospital and agrees to
maintain in force, policies of insurance as set �Forth in Article 6 herein.
c. Except as indicated above, this AGREEMENT be amended only upon
60 days written notice by either party, setting forth the requested amendment
before the anniversary date of this Agreement which shall be January 1 .
d. Any disputes between the Cities and Hospital arising under this
Agreement shall be settled by arbitration in accordance with the provisians of
the Uniform Arbitration act of the State of Minnesota, by a Board of Arbitrators
composed of three members. The Nospital shall appoint one arbitrator, the City
shall appoint one arbitrator and the two so appointed shall seleet the third
arbitrator. Within 45 days of the occurrence giving rise to arbitration, the
party demanding arbitration shall notify the other party in writing of such
demand specifying the matter to be suhmitted to arbitration and the name of the
arbitrator selected by the party making such demand. Upon receipt of such
written notice, the other party shall have ten (10) days in which to select an
arbitrator, and to specify any matters which such party desires to have
submitted to arbitration and to notify the other party in writing of such
selection, and the two arbitrators so selected shall have ten (10) days in which
to select a third arbitrator. In the event the third arbitrator is not so
selected within said ten (10) days, such third arbitrator shall be appointed by
the District Court of pakota County, Minnesota, upon application of any party
after at least eight (8) days' notice to the other parties of such application.
Arbitration shall be the exclusive remedy for the settlement of disputes arising
under this Agreement and no action at law or in equity shall be instituted by
any party hereto other than to enforce the award of the arbitrators.
5. Terms of Contract
This contract shall eommence on January � , 1989, and sha11 be in
full force and effect for four (4) years, with the anniversary date being
January 1 of each year, subject to the provisions herein contained.
6. Insurance and Hold Harmless
a. The Nospital during the term of this Agreement, a5rees to
maintain in force general ]iability, auto liability and property damage
insurance with minimum limits of �300,000 per person, $500,000 per accident, and
$100,000 per occurrence for property damage with such insurance polieies to name
each city as an Additional Names Insured. A Certificate of Insurance shall be
filed with each City.
b. The Hospital agrees to maintain in force the proper Worker's
Compensation Insuranc� for its ambulance service employees.
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c. The Hospital agrees to hold harmless each City from any and all
claims or iegal action resulting from operation of the ambulance service.
7. Revision in Carporate Structure
The Cities agree to permit the Hospital to reorganize the ambulance
service under a new and separate corporate structure. The Hospital agrees that
this contract will be binding for the new ambulance corporation and will cause
no interruption in service.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement,
consisting of three (3) pages the day and year first above written.
DIVINE REDEEMER MEMORIAL HOSPITAL CITY OF
By gy
Vice res� en min�s ra or ayor
and
BY
City
Date: Date:
VI.D. I.c-1�
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ACTIONS ANO RESOURCE REOUIREMENTS � .,
SER�JICE PIAN: GOALS, OBJECTIVES, RECOMMENOED .
Goal VI .D.l.c-1: Advanced life support region-wide should be available within
10 minutes in the urban area, 15 minutes in the suburban
area, and 2Q minutes in the rural area, 90 percent of the
time.
Goal VI.D.l.c-2: Basic life support should be athelsuburban�area5and�four i�
the rural area, 10 minutes in
minutes in the urban area, 90 percent of the time.
GUIDELINfS AND CRITERIA
This section refines the general federal , state and regional policies and
priorities in Chapter II��combined with the information and data analysis in the
"�nalysis of the Service section into performance standards specific to this
service. These performance standards, called guidelines and criteria," are
aroupe� according to the six service characteristics of the health system.
Thus they are measurable need indicators for providing the service. Guidelines
and criteria will be used by the Health Board and the community for making
planning decisions, evaluating system changes and needs, long-range planninq
activities and revie��u purposes, including CON/1122, A-95 and others required or
requeste�+ by Tocal, state or federal agencies. The list is neither a11-
encomoassinq nor inflexible. In carrying out plan d�ve�opment and projeet
review, consideration should be qiven to all aoplicable statements.
Ad,;ustments may be justified due to such things as geographic isolation,
recognition that some of the numbers are extracte� from a range that may be
considered professionally acce�table, and the relationship of associated
services and ref errals necessary to the operation of a re?ional service.
Availabilitv
Guideline 1: Emergency ambulance services should be available to respond 24
hours a day exceot as otherwise provide� by law.
GuideTine 2: Applicants for ambulanc2 licenses shall demonstrate a need for
new or expanded service.
Criterion a: There shall be no other emergency ambulance praviders
covering that service area; ar
Criterion b: There shaTl be documented evidence of an existing provider's
inability to provide adequate coverage as defined in these guidelines and
criteria.
Criterion c: Wherever possible, expansion or utilization of existing
services shall be encouraged before initiating new services.
Guideline 3: Each applicant shall define a primary service area that includes
that territory in which they will regularly respond to emergency calls
(excluding response to mutual aid calls� .
VI.D. l.c-11
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Criterion a: Service area size and configuration shall be such that the
f ollowing response time goals can be met 90 percent of the time under
normal raad and weather conditions:
(1) Inside the Fully Developed Area there should be an emergency
medical technician basic life suppor� level response within 4 minutes,
and an advanced life support level response within 10 minutes 90
percent of the time;
(2) Inside the Metropolitan t}rban Service Area (MUSA) there should be
a basic life support response within 10 minutes, and an advanced life
support response within 15 minutes 90 percent of the time;
(3) Outside the MUSA there should be a basic life support response
within 15 minutes, and an advanced life support response within 20
minutes 90 percent of the time.
Criterion b: In defining service areas, consideration should also be given
to: {1) population, distr�buticn and characLeristics; (2) estimated cali
loads, which should be of sufficient volume to justify the costs of
operating a service and to enable personnel to maintain their skills; (3)
geographic features that could alter response times; and (4) special
f eatures of the area such as industrial development or recreational areas
that could affect the type and frequency of calls. Ambulance serv�ce areas
should be consistent with county EHS plans.
Criterion c: In defining advanced life support service areas,
consideration shall be given to cooperative agreements to provide coverage
for more than one political subdivision.
Criterion d: Each applica�t shall identify the health planning areas that
are included in the proposed ambulance service ar2a.
Guid�line 4: Pmbulance services shall demonstrate clearly defined and reliable
systems f or rapid notification of squad members and rapid dispatch pf the
closest, most appropriate unit.
Guideiine 5: Pmbulance services shall have written agreements with adjacent
services for backup coverage.
Accessibility
Guideline 6: Ambulance services shall be accessible to the public through a
single telephone number answered 24 hours a day.
Guideline 7: Ambulance services shall respond to al} emergency medical calls
without regard for the individual 's ability to pay.
Guideline 8: Applicants for new or expanded emergency ambulance services shall
document intent to transport patients to the facility of their choice or that
of their physician, when the patient's medical condition warrants, or the
nearest emergency faci?ity with capabilities to manage that patient's condition.
Vi.U. l.C-1�
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Continuity
Guideline 9: Ambulance services shall have comnunications capability tv natify
hospitals of the patient's arrival and condition and receive instructions from
a medical control hospital for patient care. Ambulance cortmunications shall
comply with state ambulance regulations on comnunications frequencies,
Guideline 10: Advanced iife support ambulance services shall have a formal
agreement with a designated medical control hospital to provide for medical
control by a physician of advanced life support procedures performed by
paramedics in the field.
Qualitv
Guideline 11: Ambulance services sha11 have medical direction from a qualified
physician.
Criterion a: The medical director's responsibilities shall include '
supervising personnel training; determination, development and evaluation
of appropriate standing orders and treatment and triage protocols; and
providing advice on equipment purchases.
Guideli�e I2: Applicants for new or expanded emergency ambulance services
shaTTldocument the consistency of their prvposed service and medical protocols
for treatment of the patient with existing county EMS plans. if no county plan
exists, applicants shall indicate their intent to worlc witM eounty and regior�al
plans as these are developed.
Guideline 13: Basic life support ambulances shal� be staffed on each emergency
transport run by a minimum of t�+vo emergency medical technicians.
Criterion a: finergency medical technicians shall meet training standards
as reauired for state EMT certification ard recertification.
Guideline 14: Advanced life support units shall be staffed by at least two
paramed�cs.
Criterion a: Paramedics sha�l meet state requirements for paramedic
credentials.
Guideline 15: Ambulance personnel shall participate in periodic inservice and
cantinuing education pragrams.
Criterion a: Such programs shall meet requirements for national registry
of emergency medical technicians' continuing education credits.
Criterion b: Inservice education for paramedics shall include supervised
inhospital clinical experience.
Guideline 16: All new emergency ambulance vehicles shall meet Minnesota Nealth
Department speeifications. -
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GUideline 17: All emergency ambulance vehicles shall carry equipment required
by the t� ate Department of Health.
Criterion a: Basic life support units should also carry anti-shock
trousers and the esophogeal obturator airway. Such equipment should be
used under medical direction only by personnel trained in its use.
Criterion b: Advanced life support units should carry basic life support
equipment plus additional equipment and drugs specified by tfie medical
director.
Criterion c: Basic life support applicants whose units carry antishock
trousers and the esophogeal airway shall be in compiiance with Minnesota
Health Department rules regarding equipment v�riances for the use of these
items by BLS personnel.