HomeMy WebLinkAboutCity of Newport Beach - 2015-10-26 (5)REIMBURSEMENT AGREEMENT
WITH THE CITY OF HUNTINGTON BEACH
FOR THE COMMUNITY PARAMEDICINE PILOT PROGRAM
THIS REIMBURSEMENT AGREEMENT ("Agreement") is made and entered into,
as of this 26th day of October, 2015 ("Effective Date"), by and between the CITY OFi
NEWPORT BEACH, a California municipal corporation and charter city ("NEWPORTi
BEACH"), and the CITY OF HUNTINGTON BEACH, a California municipal corporation
and charter city ("HUNTINGTON BEACH") whose address is 2000 Main Street,!
Huntington Beach CA 92648, and is made with reference to the following
RECITALS
A NEWPORT BEACH is a municipal corporation duly organized and validly existing,
under the laws of the State of California with the power to carry on its business;
as it is now being conducted under the statutes of the State of California and the
Charter of NEWPORT BEACH
B On November 14, 2014, the California Emergency Medical Services Authority
("EMSA") was approved by the Office of Statewide Health Planning and
Development ("OSHPD") Health Workforce Pilot Projects ("HWPP") program to
pilot Community Paramedicine in twelve (12) sites across the state One of the
approved pilot projects is the Orange County Alternate Destinations Pilot Project
("OCADPP") led by the Orange County Fire Chiefs' Association ("OCFCA") and
includes the cities of Fountain Valley, Huntington Beach and Newport Beach
C Under the leadership of OCFCA, the OCADPP explores a regional approach to%
Community Paramedicine and will study if paramedics with advanced training,
can safely determine if 9-1-1 patients with non -critical conditions can be:
transported to urgent care centers instead of to emergency departments ("EDs")!
utilizing approved medical protocols The overarching goal of this project is to
transport 9-1-1 patients to the right level of healthcare services from the onset to
free up the EDs to care for more critical patients
D The objectives of the pilot study are to determine whether applying this new;
intervention is safe, effective at reducing costs, and maintains patient
satisfaction. Success of the pilot project will be measured through data collection
regarding patient outcome, patient satisfaction, and cost of services indicators
Local and State evaluators from University of California Irvine ("UCI"), Orange
County EMS, and the State EMS Authority will be conducting the research and
validating the data
E Each fire department has selected a cadre of Alternate Destination Paramedics
("ADPs") The ADPs have attended advanced training and successfully passed
written and practical evaluations that ensure the competency of ADPs in making
the determination that 9-1-1 patients with non -critical conditions can be
transported to an urgent care center Ultimately, the patient must consent to
enrollment in the study and agree to be transported to a designated urgent care
center
F HUNTINGTON BEACH has been identified as an OCADPP member and
designated as an Emergency Services Provider ("EMS PROVIDER")
G NEWPORT BEACH has been identified as an OCADPP member and designated
as the fiscal agent As the fiscal agent, NEWPORT BEACH is responsible for
dispersing grant funds it receives on behalf of the OCADPP to other OCADPP,
members to specifically cover the cost of operations related to the OCADPP
H As of the Effective Date, NEWPORT BEACH has received grant funds from the
Hoag Hospital Community Benefit Program and California Healthcare Foundation
to cover the cost of operations for the OCADPP The terms of the grant from the
Hoag Hospital Community Benefit Program and California Healthcare Foundation
are attached hereto as Exhibits A (Grant Award Letter from HOAG Hospital) and
B (Grant Award Letter from California Healthcare Foundation) respectively and
incorporated herein by reference
NOW, THEREFORE, it is mutually agreed by and between the undersigned
parties as follows
1. TERM
The term of this Agreement shall commence on the Effective Date and shall
terminate on June 30, 2017 unless extended or terminated earlier as set forth herein
2. SERVICES TO BE PERFORMED
21 NEWPORT BEACH and HUNTINGTON BEACH acknowledge that the
above Recitals are true and correct and are hereby incorporated by reference
HUNTINGTON BEACH shall diligently perform all the services described in the Scope
of Services attached hereto as Exhibit C and incorporated herein by reference
("Services")
22 Specific Obligations and Rights of Newport Beach
2 2 1 NEWPORT BEACH shall act as the fiscal agent by receiving
invoices and reimbursing HUNTINGTON BEACH pursuant to the Reimbursement
Amounts attached hereto as Exhibit D and incorporated herein by reference
23 Specific Obligations and Rights of Huntington Beach
2 31 HUNTINGTON BEACH shall act as an EMS PROVIDER
HUNTINGTON BEACH shall perform all the services described in the Scope of
Services attached hereto as Exhibit C and incorporated herein by reference
CITY OF HUNTINGTON BEACH Page 2
HUNTINGTON BEACH shall also comply with and be fully bound by all applicable
provisions of Exhibits C and D hereto HUNTINGTON BEACH shall notify NEWPORT
BEACH immediately upon discovery that it has not abided or no longer will abide by any
applicable provision of Attachments C and D hereto.
3. REIMBURSEMENT
31 NEWPORT BEACH shall reimburse HUNTINGTON BEACH for the
Services on a time and expense not -to -exceed basis in accordance with the provisions
of this Section, the Reimbursement Amounts and the Billing Process attached hereto as
Exhibits D and E, respectively and incorporated herein by reference NEWPORT
BEACH shall not utilize or provide any funding other than the grant fundsit receives on
behalf of OCADPP to cover the costs of operations related to the OCADPP
32 HUNTINGTON BEACH shall submit monthly invoices to NEWPORT
BEACH describing the Services performed the preceding month HUNTINGTON
BEACH'S invoices shall include the name and/or classification of employee who
performed the Services, a brief description of the Services performed and/or the specific
task in the Scope of Services to which it relates, the date the Services were performed,,
the number of hours spent on all Services billed on an hourly basis and a description of
any reimbursable expenditures Supporting documentation, such as copies of receipts,
ambulance billing invoices, insurance denial letters, rate of pay for ADPT's, etc must be
attached to monthly invoices To the extent sufficient grant funds exist, NEWPORT'
BEACH shall pay HUNTINGTON BEACH no later than thirty calendar (30) days after
approval of the monthly invoice by NEWPORT BEACH staff
33 NEWPORT BEACH shall reimburse HUNTINGTON BEACH only for those
costs or expenses specifically approved in this Agreement, or specifically approved in'
writing in advance by NEWPORT BEACH
34 NEWPORT BEACH may terminate this Agreement and be relieved of the
payment to HUNTINGTON BEACH if a) HUNTINGTON BEACH fails to perform any of
the covenants contained in this Agreement, including but not limited to Attachments C
and D hereto, at the time and in the manner herein provided, or b) NEWPORT BEACH
loses funding under the grant
4. PROJECT MANAGER
41 HUNTINGTON BEACH shall designate a Project Manager, who shall.
coordinate all phases of the Project This Project Manager shall be available to!
NEWPORT BEACH at all reasonable times during the Agreement term HUNTINGTON
BEACH has designated FIRE CHIEF (or his/her designee) to be its Project Manager
HUNTINGTON BEACH shall not remove or reassign the Project Manager or any
personnel listed in Exhibit C or assign any new or replacement personnel to the Project
without the prior written consent of NEWPORT BEACH NEWPORT BEACH'S
approval shall not be unreasonably withheld with respect to the removal or assignment
of non -key personnel
CITY OF HUNTINGTON BEACH Page 3
42 HUNTINGTON BEACH, at the sole discretion of NEWPORT BEACH, shall
remove from the Project any of its personnel assigned to the performance of Services,
upon written request of NEWPORT BEACH HUNTINGTON BEACH warrants that it
will continuously furnish the necessary personnel to complete the Project on a timely
basis as contemplated by this Agreement
5. ADMINISTRATION
This Agreement will be administered by the Fire Department NEWPORT
BEACH's EMS Division Chief or designee shall be the Project Administrator and shall
have the authority to act for NEWPORT BEACH under this Agreement The Project
Administrator shall represent NEWPORT BEACH in all matters pertaining to the,
Services to be rendered pursuant to this Agreement
6. RELATIONSHIP BETWEEN THE PARTIES
It is understood that HUNTINGTON BEACH shall act in an independent capacity
in the performance of this Agreement and shall not be considered an officer, agent or
employee of NEWPORT BEACH or of the entity from which NEWPORT BEACH
received grant funds The manner and means of conducting the Services are under the
control of HUNTINGTON BEACH, except to the extent limited by statute, rule or,
regulation and the expressed terms of this Agreement Nothing in this Agreement shall
be deemed to constitute approval for HUNTINGTON BEACH or any of HUNTINGTON
BEACH'S employees or agents, to be the agents or employees of NEWPORT BEACH
Nothing in this Agreement shall create any contractual relationship between NEWPORT
BEACH and any subconsultant nor shall it create any obligation on the part of
NEWPORT BEACH to pay or to see to the payment of any monies due to any such
subconsultant other than as otherwise required by law HUNTINGTON BEACH shall
have the responsibility for and control over the means of performing the Services,
provided that HUNTINGTON BEACH is in compliance with the terms of this Agreement
7. PROHIBITION AGAINST ASSIGNMENTS AND TRANSFERS
Except as specifically authorized under this Agreement, the Services to be
provided under this Agreement shall not be assigned, transferred contracted or
subcontracted out without the prior written approval of NEWPORT BEACH
8. SUBCONTRACTING
The subcontractors authorized by NEWPORT BEACH, if any, to perform Work
on this Project are identified in Exhibit C HUNTINGTON BEACH shall be fully
responsible to NEWPORT BEACH for all acts and omissions of any subcontractor
Nothing in this Agreement shall create any contractual relationship between NEWPORT
BEACH and any subcontractor nor shall it create any obligation on the part of
NEWPORT BEACH to pay or to see to the payment of any monies due to any such
subcontractor other than as otherwise required by law NEWPORT BEACH is an
intended beneficiary of any Work performed by the subcontractor for purposes of
establishing a duty of care between the subcontractor and NEWPORT BEACH Except
CITY OF HUNTINGTON BEACH Page 4
as specifically authorized herein, the Services to be provided under this Agreement,
shall not be otherwise assigned, transferred, contracted or subcontracted out without
the prior written approval of NEWPORT BEACH
9. RECORDS
HUNTINGTON BEACH shall keep complete and accurate records and invoices
in connection with the OCADPP and Services provided and any costs charged to,
NEWPORT BEACH for a minimum period of three (3) years, or for any longer period
required by law, from the date of final payment to HUNTINGTON BEACH under this
Agreement All such records and invoices shall be clearly identifiable HUNTINGTON
BEACH shall allow a representative of NEWPORT BEACH to examine, audit and make
transcripts or copies of such records and invoices during regular business hours.
HUNTINGTON BEACH shall allow inspection of all work, data, documents, proceedings
and activities related to the Agreement for a period of three (3) years from the date of
final payment to HUNTINGTON BEACH under this Agreement
10. INDEMNIFICATION AND HOLD HARMLESS
101 General Indemnity and Hold Harmless
1011 To the fullest extent permitted by law, HUNTINGTON
BEACH shall indemnify, defend and hold harmless NEWPORT BEACH, its City Council,
boards and commissions, officers, agents, volunteers and employees (collectively, the
"Indemnified Parties") from and against any and all claims (including, without limitation,
claims for bodily injury, death or damage to property), demands, obligations, damages,
actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs ands
expenses (including, without limitation, attorneys' fees for counsel acceptable to�
NEWPORT BEACH, disbursements and court costs) of every kind and nature
whatsoever (individually, a Claim, collectively, "Claims"), which may arise from or in any,
manner relate (directly or indirectly) to any breach of the terms and conditions of this
Agreement, any work performed or services provided under this Agreement including,
without limitation, defects in workmanship or materials or HUNTINGTON BEACH'S
presence or activities conducted in connection with the OCADPP and Services provided
under this Agreement (including the negligent, reckless, and/or willful acts, errors and/or
omissions of HUNTINGTON BEACH, its principals, officers, agents, employees,
vendors, suppliers, consultants, subconsultants, anyone employed directly or indirectly
by any of them or for whose acts they may be liable, or any or all of them )
1012 Notwithstanding the foregoing, nothing herein shall be
construed to require HUNTINGTON BEACH to indemnify the Indemnified Parties from
any Claim arising from the sole negligence or willful misconduct of the Indemnified
Parties Nothing in this indemnity shall be construed as authorizing any award of
attorney's fees in any action on or to enforce the terms of this Agreement This,
indemnity shall apply to all claims and liability regardless of whether any insurance
policies are applicable. The policy limits do not act as a limitation upon the amount of
indemnification to be provided by HUNTINGTON BEACH
CITY OF HUNTINGTON BEACH Page 5
11. NOTICES
11 1 All notices, demands, requests or approvals, including any change in
mailing address, to be given under the terms of this Agreement shall be given in writing,
and conclusively shall be deemed served when delivered personally, or on the third
business day after the deposit thereof in the United States mail, postage prepaid, first-
class mail, addressed as hereinafter provided
11 2 All notices, demands, requests or approvals from HUNTINGTON BEACH
to NEWPORT BEACH shall be addressed to NEWPORT BEACH at:
To NEWPORT BEACH. City of Newport Beach
Attention. EMS Division Chief
P.O. Box 1768
100 Civic Center Drive
Newport Beach, CA 92658
11 3 All notices, demands, requests or approvals from NEWPORT BEACH to
HUNTINGTON BEACH shall be addressed to HUNTINGTON BEACH at
To HUNTINGTON BEACH Fire Chief
City of Huntington Beach
2000 Main Street
Huntington Beach, CA 92648
12. CLAIMS
Unless a shorter time is specified elsewhere in this Agreement, before making its
final request for payment under this Agreement, HUNTINGTON BEACH shall submit to
NEWPORT BEACH, in writing, all claims for compensation under or arising out of this
Agreement HUNTINGTON BEACH'S acceptance of the final payment shall constitute
a waiver of all claims for compensation under or arising out of this Agreement except
those previously made in writing and identified by HUNTINGTON BEACH in writing as
unsettled at the time of its final request for payment HUNTINGTON BEACH and
NEWPORT BEACH expressly agree that in addition to any claims filing requirements
set forth in the Agreement, HUNTINGTON BEACH shall be required to file any claim
HUNTINGTON BEACH may have against NEWPORT BEACH in strict conformance
with the Government Claims Act (Government Code sections 900 et seq )
13. TERMINATION
131 In the event that either party fails or refuses to perform any of the'
provisions of this Agreement at the time and in the manner required, that party shall be
deemed in default in the performance of this Agreement. If such default is not cured
within a period of two (2) calendar days, or if more than two (2) calendar days are
reasonably required to cure the default and the defaulting party fails to give adequate
assurance of due performance within two (2) calendar days after receipt of written
CITY OF HUNTINGTON BEACH Page 6
notice of default, specifying the nature of such default and the steps necessary to cure
such default, and thereafter diligently take steps to cure the default, the non -defaulting
party may terminate the Agreement forthwith by giving to the defaulting party written
notice thereof
13 2 Notwithstanding the above provisions, NEWPORT BEACH shall have the
right, at its sole and absolute discretion and without cause, of terminating this
Agreement at any time by giving no less than seven (7) calendar days' prior written
notice to HUNTINGTON BEACH. In the event of termination under this Section,
NEWPORT BEACH shall pay HUNTINGTON BEACH for Services satisfactorily
performed and costs incurred up to the effective date of termination for which
HUNTINGTON BEACH has not been previously paid. On the effective date of
termination, HUNTINGTON BEACH shall deliver to NEWPORT BEACH all reports,
Documents and other information developed or accumulated in the performance of this
Agreement, whether in draft or final form
14. STANDARD PROVISIONS
141 Recitals NEWPORT BEACH and HUNTINGTON BEACH acknowledge
that the above Recitals are true and correct and are hereby incorporated by reference
into this Agreement
14 2 Compliance with all Laws. HUNTINGTON BEACH shall, at its own cost
and expense, comply with all applicable statutes, ordinances, regulations and
requirements of all governmental entities, including federal, state, county or municipal,
whether now in force or hereinafter enacted In addition, all work prepared by
HUNTINGTON BEACH shall conform to applicable NEWPORT BEACH, county, state
and federal laws, rules, regulations and permit requirements and be subject to approval
of the NEWPORT BEACH
14 3 Waiver A waiver by either party of any breach, of any term, covenant or
condition contained herein shall not be deemed to be a waiver of any subsequent
breach of the same or any other term, covenant or condition contained herein, whether
of the same or a different character
14 4 Integrated Contract. This Agreement represents the full and complete
understanding of every kind or nature whatsoever between the parties hereto, and all
preliminary negotiations and agreements of whatsoever kind or nature are merged
herein No verbal agreement or implied covenant shall be held to vary the provisions'
herein In the event there are any conflicts or inconsistencies between this Agreement
and any other communication between the parties, the terms of this Agreement shall
govern
14.5 Interpretation. The terms of this Agreement shall be construed in
accordance with the meaning of the language used and shall not be construed for or
against either party by reason of the authorship of the Agreement or any other rule of
construction which might otherwise apply
CITY OF HUNTINGTON BEACH Page 7
14 6 Severability. If any term or portion of this Agreement is held to be invalid,
illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining
provisions of this Agreement shall continue in full force and effect
14 7 Controlling Law and Venue The laws of the State of California shall,
govern this Agreement and all matters relating to it and any action brought relating to
this Agreement shall be adjudicated in a court of competent jurisdiction in the County of
Orange, State of California
14 8 Equal Opportunity Employment HUNTINGTON BEACH represents that it
is an equal opportunity employer and it shall not discriminate against any subconsultant,
employee or applicant for employment because of race, religion, color, national origin,
handicap, ancestry, sex, age or any other impermissible basis under law
14 9 No Attorney's Fees In the event of any dispute or legal action arising
under this Agreement, the prevailing party shall not be entitled to attorney's fees
14 10 Counterparts This Agreement may be executed in two (2) or more
counterparts, each of which shall be deemed an original and all of which together shall
constitute one and the same instrument
14 11 No Third Party Beneficiaries. This Agreement is entered into by and for
HUNTINGTON BEACH and the NEWPORT BEACH, and nothing herein is intended to
establish rights or interests in individuals or entities not a party hereto
14 12 Force Ma1eure Except for the payment of money, neither party will be
liable for any delays or other non-performance resulting from circumstances or causes
beyond its reasonable control, including without limitation, fire or other casualty, Act of
God, strike or labor dispute, war or other violence, acts of third parties, or any law,
order, or requirement of any governmental agency or authority other than that of the
parties
14 13 Modification Alteration, change, or modification of this Agreement shall
be in the form of a written amendment signed by both parties and approved as to form
by the City Attorney
[SIGNATURES ON NEXT PAGE]
CITY OF HUNTINGTON BEACH Page 8
IN WITNESS WHEREOF, the parties are signing this Agreement as of the
Effective Date
APPROVED AS TO FORM:
CITY ATTOR� EY' FFICE
Date
By.
Aaron C. Harp fo"
City Attorney'
Pl-
ATTEST:
Date
By W0rJJA,-,(>40�1,,
Lei ani I rown
City Clerk
CALIF",
CITY OF NEWPORT BEACH,
a California municipal corporation
Date ram o n gna 12A�
--vvr
Dave Rift
City Manager
REQUESTED AND REVIEWED:
Fire Department
Date'_
By: <!ffa -
Scott Poster
Fire Chief
CITY OF HUNTINGTON BEACH,
a California municipal corporation
Date
Signed in Counterpart
Bv'
Patrick McIntosh
Fire Chief
Attachments Exhibit A — Grant Award Letter from HOAG
Exhibit B — Grant Award Letter from California Healthcare Foundation
Exhibit C — Scope of Work
Exhibit D — Reimbursement Amounts
Exhibit E — Billing Process
Exhibit F — Election and Consent Form
CITY OF HUNTINGTON BEACH Page 9
IN WITNESS WHEREOF, the
Effective Date
APPROVED AS TO FORM:
CITY ATTOR� EY' FFICE
Date: ((
Y
I
Aaron C. Harp
City Attorney
ATTEST:
Date:
By:
Leilani I. Brown
City Clerk
rties are signing this Agreement as of the
CITY OF NEWPORT BEACH,
a California municipal corporation
Date
Bv.
Dave Kiff
City Manager
REQUESTED AND REVIEWED:
Fire Department
Date:
Bv:
Scott Poster
Fire Chief
CITY OF HUNTINGTON BEACH,
a California municipal corporation
Date- L (-- 5-- r S
Patrick McIntosh
Fire Chief
Attachments: Exhibit A — Grant Award Letter from HOAG
Exhibit B — Grant Awa Id Letter from California Healthcare Foundation
Exhibit C — Scope of Work
Exhibit D — Reimbursement Amounts
Exhibit E — Billing Process
Exhibit F — Election and Consent Form
1
APPROVED AS TO FORM
By.
t�hoel gates, City Attorney
CITY OF HUNTINGTON BEACH Page 9
EXHIBIT A
GRANT AWARD LETTER FROM HOAG
CITY OF HUNTINGTON BEACH Page A-1
ATTACHMENT A
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May 14, 2015
Chief Randy Bruegman
Orange County Fire Chiefs' Association
2400 E. Orangewood Ave
Anaheim, CA 92806
Dear Chief Randy Bruegman,
Congratulations! We are pleased to inform you that a grant in the amount of $50,685 has
been approved by Hoag Memorial Hospital Presbyterian Community Benefit Program for the
project titled Orange County Alternate Destinations Pilot Project.
Our mission as a nonprofit, faith -based hospital is to provide the highest quality health care
services to the communities we serve. We are excited to partner with your organization in
fulfilling our mission and the unmet needs of our community. Acceptance of this grant ,
acknowledges agreement to the following:
• The grant term: July 1, 2014-June 30, 2015
• The funds must be used specifically for the designated project listed above as outlined
in your FY15 grant application
• Maintain your records to show and account for the uses of grant funds
• Your organization must notify us immediately if there is any change in your public
charity status
• We will be sending a request for a progress report and a final report in the months to
come. More details to follow.
Please submit an invoice with the specified project title and approved amount to:
CommunityBenefitGrants0hoag org. After we receive your invoice, please allow 2-4 weeks
for the delivery of the grant check.
Once again, congratulations on this recognition of the great work you do to serve the
community. We look forward to working with you during the coming year.
Sincerely,
Gwyn Parry, MD
Director Community Benefit
A�al*l lm�nl Z6, �/
Michaell Rose, MSW, LCSW
Director of Community Programs
Minzah Malik, MPH, MBA
Manger Community Benefit
9 18-3
June 09, 2015
Agenda Item No 18
TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
FROM: Scott L Poster, Fire Chief — (949) 644-3101, sposter@nbfd net
PREPARED BY: Angela Crespi, Administrative Manager
PHONE: (949) 644-3352
TITLE: Acceptance of Grant Funding for the Community Paramedicine Pilot Project
ABSTRACT:
The Hoag Hospital Community Benefit Program provides grant funding in support of efforts to achieve high
quality health care services for the communities they serve The City of Newport Beach, under the
sponsorship of the Orange County Fire Chiefs Association, is a participant in the State's Community
Paramedicine pilot study on Alternate Destinations. Acceptance of the grant funding will support the
necessary core and local staff training for the Orange County Alternative Destinations Pilot Project
participants
RECOMMENDATION:
a) Accept the grant funding in the amount of $50,685 to be utilized for staff training; and
b) Approve Budget Amendment No 15BA-048 to accept grant funds from the Hoag Memorial Hospital
Presbyterian Community Benefit Program, increase revenue estimates by $50,685 in account 2340-5066,
and increase expenditure appropriations by $50,685 in account 2340-82007
FUNDING REQUIREMENTS:
This budget amendment records and appropriates $50,685 in additional revenue from the Hoag Memorial
Hospital Presbyterian Community Benefit Program and $50,685 in increased expenditure appropriations
There are no matching fund requirements to accept this grant
DISCUSSION:
On November 14, 2014, the California Emergency Medical Services Authority (EMSA) was approved by the
Office of Statewide Health Planning and Development (OSHPD) Health Workforce Pilot Projects (HWPP)
program to pilot Community Paramedicine in 12 sites across California. One of the approved pilot projects
is the Orange County Alternative Destinations Pilot Project (OCADPP) led by the Orange County Fire
Chiefs Association (OCFCA)
Under the leadership of the OCFCA, the Orange County Emergency Medical Services (EMS) system
partners, which includes fire departments in Newport Beach, Huntington Beach, and Fountain Valley, will
explore a regional approach to the Community Paramedic project through the development of an approved
triage process and protocols for transporting patients with non-cntical conditions to alternative destinations
other than emergency departments Patients meeting the approved criteria, and agreeing to participate in
the pilot, will be transported to urgent care centers instead of the emergency department (ED) The
overarching goal of this project is to assist in transporting patients to the right level of heath care services
when they call 911 and freeing up the ED to care for more critical patients.
The objectives of the pilot study are to determine whether applying this new intervention is safe, effective at
reducing costs, and maintains patient satisfaction. Success of the pilot study will be measured through
data collection regarding patient outcomes, patient satisfaction, and cost of service indicators To validate
the data, both local and State evaluators will be utilized including University of California Irvine (UCI),
Orange County EMS Agency, and the State EMS Authority
To ensure the safety of the study participants, each participating agency has selected a cadre of Alternate
Destination Paramedics (ADPs) These Paramedics are required to attend educational sessions and
successfully pass the written and practical evaluations prior to study implementation This training will
ensure that the ADPs are prepared to make the correct determination regarding the appropriateness of
transporting a patient to an urgent care center
If approved, the grant provided by the Hoag Hospital Community Benefit Program will provide the financial
support needed to cover the necessary staff training. As the designated fiscal agent for the Orange County
study, the City of Newport Beach will be responsible for acceptance and distribution of the grant funds.
The OCFCA and the Orange County EMS system partners are in the process of seeking additional grant
funding required for operation of the OCADPP through Hoag Hospital's Community Benefit Program and
other potential funding sources. If awarded, acceptance of additional grant funding will be brought forth to
the City Council for review and approval
The baseline data collection phase began in April 2014 and will continue until the start of the
implementation phase of the study which commences in June 2015 and is expected to run for a period of
up to 2 years
ENVIRONMENTAL REVIEW:
Staff recommends the City Council find this action is not subject to the California Environmental Quality Act
(" CEQX) pursuant to Sections 15060(c)(2) (the activity will not result in a direct or reasonably foreseeable
indirect physical change in the environment) and 15060(c)(3) (the activity is not a project as defined in
Section 15378) of the CEQA Guidelines, California Code of Regulations, Title 14, Chapter 3, because it has
no potential for resulting in physical change to the environment, directly or indirectly
NOTICING:
The agenda item has been noticed according to the Brown Act (72 hours in advance of the meeting at
which the City Council considers the item)
ATTACHMENTS:
Description
Attachment A - Grant Award Letter
Attachment B - Budget Amendment
EXHIBIT B
GRANT AWARD LETTER FROM CALIFORNIA HEALTHCARE FOUNDATION
CITY OF HUNTINGTON BEACH Page 1371
CALIrORN1A
HEALTHCARE
FOUNDATION
--%
March 5, 2015
Mr. David Kiff
City Manager
City of Newport Beach
100 Civic Center Drive
Newport Beach, CA 92660
Dear Mr. Kiff:
Reference Number: 18762
This letter officially approves your request for a no -cost extension to the project, Community
Paramedicine Data Project Fountain Valley Fire Department. The project is now scheduled to
end on September 30, 2015.
The revised schedule for the remaining deliverables due for this grant is as follows:
current Due ante Revised Due Date Tvne of Report Report Description
February 15, 2015
April 15, 2015
Signed Agreement
May be submitted early.
February 27, 2015
April 30, 2015
Interim
Verification from UCSF that
Deliverable
initial data submission of
baseline data has been
received. (may be submitted
early — as soon as deliverable
is met).
February 27, 2015
April 30, 2015
Invoice
Invoice for Interim
Deliverable. (maybe
submitted early — as soon as
deliverable is met)
July 31, 2015
September 30, 2015
Final Deliverable
Pilot site achieving
operational status as
designated by EMSA. Pilot
site to submit invoice for this
payment along with
verification letter from EMSA
of "operational status" of site.
(may be submitted early — as
soon as deliverable is met)
July 31, 2015
September 30, 2015
Invoice
Invoice of Final Deliverable
(may be submitted early — as
soon as deliverable is met).
1418Web5ter Street 5ur1e400
Oakland, Cahforota 94612
i 510 2381040 F 510 W 1388
WWW CHCF ORG
City of Newport # 18762, page 2
Payments will be made within 30 days of receipt and acceptance of the contingency for that
payment as detailed below -
Amount
Contingency
Contingeng Due Date
$8,600
Interim Deliverable & Invoice
April 30, 2015
$8,000
Final Deliverable & Invoice
September 30, 2015
Please call me iryou have any questions
Yours truly,
Sandra Shewry
Director, State Health Policy Program
cc: Lisa Kang, Director, Grants Administration
Other Terms
The California HealthCare Foundation may periodically issue a general press release announcing
funded projects, or include this grant in a published list of grants awarded by CHCF. If the
Grantee wishes to issue a press release regarding this grant, CHCF requires review and final
sign -off of the text by its Publishing and Communications Department. Any publication
produced by the Grantee that refers or results from this agreement should include an
acknowledgment of CHCF that reads: Supported by the California HealthCare Foundation,
based in Oakland, California.
Funds paid under this agreement may not be used to: 1) carry out propaganda or otherwise
attempt to influence legislation; 2) influence the outcome of any specific public election; or
3) carry on directly or indirectly any voter registration drive.
If the work performed under this agreement result in access to information that is confidential to,
or a trade secret of the California HealthCare Foundation, you hereby agree not to disclose any
such information without written authorization from the Foundation.
Your signature below acknowledges your acceptance of the agreement as described in this letter
Please sign this letter, and mail or fax (510-587-0149) one signed copy to Danny Sandoval
Program Associate.
Yours truly,
Fob '12 ZO'I3 4 20 1'+M
Craig C Ziegler
VP of Finance, Administration & Investments
CC. Sandra Shewry, Director, State Health Policy
Lisa Kang, Director, Grants Administration
Name/Signature._,1�.
Organization. City of Newport Beach
Tax ID. 95-60))00751
Date-
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February 12, 2015
Mr David Kiff
City Manager
City of Newport Beach
100 Civic Center Drive
Newport Beach, CA 92660
Dear Mr. Kift;
Reference Number 18762
The California HealthCare Foundation is pleased to award a grant to City of Newport Beach
as a stipend to piovide data in support of the Community Paramedichte Data Pr oject. The
amount of this grant is a fixed amount of $16,600
This agreement is effective February 15, 2015 and terminates on July 31, 2015, unless extended
by written agreement initiated by the Foundation. Sandia Shewry, Director, State Health Policy,
will be your Foundation contact during the course of this project. All correspondence and
invoices related to this project should be addressed to her.
Scope of Work
In support of OSHPD's Health Workfoice Pilot Project #173, the grantee will provide the
Community Paiamedicine's Independent Evaluator (the Philip R Lee Institute or Health Policy
Studies at the University of California, San Francisco) with all iequired data elements
These data include
Baseline data on care provided by pilot sites pi nor to implementation of the pilot
interventions
Data on site specific tiaining provided to prospective community paramedics within 30 days
of completion of each of these training components
Data on implementation of the pilot interventions
The grantee's Local Pilot Piogram Manageis have had opportunities to review and comment on
the data elements for the evaluation and have agreed to piovide them They will have an
opportunity to comment on any pioposed changes to the icquiied data elements
Each Local Pilot Piogiam Managers will have the iesponsibility foi collecting all icquiied data
and foiwarding them to the Independent Evaluatoi Local Pilot Piogiam Managers may
designate other staff to assist with data collecting and wpoiting but will be iesponsible foi the
accuracy of data and the timeliness with which data are submitted to the independent evaluator.
Pilot sites will provide the Independent Evaluator with up to date names and contact information
for Local Pilot Program Managers and any other staff assisting with data collection and
reporting.
The grantee understands and agrees that there is a need for all pilot sites to collect similar data
elements In light of this, the grantee agrees that grantee's pilot site will:
• collect standardized data pertinent to the community paramedicine concept being tested;
• report data elements on each concept being tested (if site is testing more than one concept).
• use the web -based data reporting tools that the Independent Evaluator has developed to
transmit data to the Independent Evaluator;
• report baseline and implementation data on a monthly basis. Baseline data will be reported
for five months, from August 2014 through December 2014. Implementation data will be
reported for the duration of the pilot project — estimated to be from June 2015 through May
2016.
The University of California, Los Angeles Center for Prehospital Care will be responsible for
submitting all data on the core training Individual pilot sites' Local Pilot Program Managers will
be responsible for submitting data on site specific training.
Deliverables/Payments:
The following deliverables will be due on this grant:
Date Due Tvne of Renort Resort Description
February 15, 2015
Signed Agreement
February 27, 2015
Interim Deliverable
Verification from UCSF that initial data
submission of baseline data has been received
February 27, 2015
Invoice
Invoice for $8,600
July 31, 2015
Final Deliverable
Pilot site achieving operational status as
designated by EMSA Pilot site to submit
invoice for this payment along with verification
letter from EMSA of "operational status" of site
July 31, 2015
Invoice
Invoice for $8,000 (may be submitted early — as
soon as deliverable is met).
Payments will be made within 30 days of receipt and approval of the contingency for that
payment detailed as follows -
Amount
Contingency
Contingency Due Date
$8,600
Interim Deliverable and Invoice
February 27, 2015
$8,000
Final Deliverable and Invoice
July 31, 2015
Invoices should include Reference #18762.
City of Newport Beach, Reference #18762, Page 2
�N���II��IIII�IIfi
February 24, 20,15
�- -
File Name
Job Code Company Name
Page # of Total Non Bar -
No Accounts Pages Coded Dupl. Total Amount
NPB0224A
NPB 0224 MISC 001 TXT
1
1
1
0
0
$8,600 00
I CITY OF NEWPORT BEACH
Totals: 1 1 0 0 $8,600.00
tiWPoR CITY OF NEWPORT BEACH
$ REVENUE DIVISION
P O BOX 3080
NEWPORT BEACH, CA 92658-3080
Email revenuehelp@newportbeachca gov
MISCEL`IANEOUS�BILLING
CALIFORNIA HEALTHCARE FOUNDATION
ATTN SANTRA SHEWRY, DIRECTOR
1415 L STREET #820
SACRAMENTO CA 95814-5009
NBID #
ACCT #,,' �
-,,'INVOICE#',,'
574123
0000022085
GN01002882
INV DATE
DUE DATE _
AMOUNT -DUE,
02/24/15
03/26/15
8,60000
Description i Qty I Unit Price I Tax Extention
COMMUNITY PARAMEDICINE
DATA PROJECT
REFERENCE NUMBER 18762
DATES 02/15/2015 - 07/31 /2015
100 8,60000 000 8,60000
Payments received after the original due date maybe transferred to other City of Newport Beach accounts or sent to a Collection Agency for recovery Cost recovery fees or
late payment penalties may be applied after the original due date
Payments can be made online at www newportbeachca gov/payments TOTAL INVOICE $ 8,600 00
PAYMENTS /ADJUSTMENTS $ 000
and referencing the "NBID #" on the billing statement PAST DUE $ 000
PENALTIES / INTEREST $ 000
Please see the reverse side for details on non-payment penalties TOTAL AMOUNT DUE' $ 8,60000
MISCELLANEOUS -BILLING - INVOICE
��WRr CITY OF NEWPORT BEACH
O`` a REVENUE DIVISION
P 0 BOX 3080
u r NEWPORT BEACH, CA 92658-3080
c'+trcoa�`r IIIIIIIIflall II�III�IIIIII�IIIIIII�I �II�III�
Please review the back of this document for important information
NPB0224A
4000000001 1/1
uoo�l4i�l�o.d�IPq�l�olupi�p�i��I�oi�P�h�l�dd�idl'pi
CALIFORNIA HEALTHCARE FOUNDATION
"T ATTN SANTRA SHEWRY, DIRECTOR
iWE.&t 1415 L STREET #820
SACRAMENTO CA 95814-5009
NBID #
574123
ACCT #
0000022085
INVOICE #
GN01002882
INV DATE
02/24/15
DUE DATE
03/26/15
Amount Due:
8,600 00
hiugl�p�lpl���ihd'�•Ig4�lpl��i�lq�p�l���lh�oll�l�m
CITY OF NEWPORT BEACH
PO Box 3080
Newport Beach, CA 92658-3080
AROOOD00000022085000008600003
I � 1 1 1
`7151•�
L!2�- �tjoa.Rfit 3�€�
I CA) Civic Cerilef Drive Newport Be-ach, CA 92k-6O
Billing Location - Revenue Omsion (949164-1-3141 Payment Location - Ca�hiers (949) 644-3121
Office Hours'
%Ionda� - Thursday 7 Warr - 5 30pm
Frida� 7 Zam - 4 Wpm
Xi-xclodmq hondayb
T,,e City of Newpoit each is reqjtred by law to provide this nooce reiating that tarlure to pay the liability owed will result
in tnis debt being reporters to the State Franchise Tax Board for tax offset In the event that you are owed a tax refund
atn a Cairforma Lottery prize or have Unclaimed property claim s, tote Ranchise Tax Board will intercept from that money
the awount you owe this agency California Government Code Sections 12419 8 and 124 19 10 authonre the Office of toe
State Cordroller to collect money owed to a couniy or a city acienoy ty intercepting any money that the state oved the
debtor If YOU nave any questions, or do not believe that you ov,,e thib debt please contact us in writing within 30 days
from the date of this notice A representative will review your objections once they ate received If you do not su�m4 arty
obipctions or is your ob;ections are insufficient the City will proceed with this action
lire, ki� 1, Aiih c , A-Iii , in
Cnin,,e "M,ng AdoreSF for a:l a: count types
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View P-33, Stateinenu-, for NISS and Business Licene
$tg,i,jp ic,, Seect Alert
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END OF #:
REPORT
TOTAL NO OF RECORDS
SUMMARY PAGE NO
FIRST RECORD
COMPANY CITY OF NEWPORT BEACH
CONTROL NO 4000000001
SUBSCRIBER CALIFORNIA HEALTHCARE FOUNDATION
LAST RECORD
COMPANY CITY OF NEWPORT BEACH
CONTROL NO 4000000001
SUBSCRIBER CALIFORNIA HEALTHCARE FOUNDATION
EXHIBIT C
SCOPE OF SERVICES
Huntington Beach shall:
Agree to participate and provide signatories in the OC Alternate Destination pilot
project
Provide eligible paramedics to undergo specialized training.
Develop curriculum and evaluation methods for AD Paramedic education.
Follow approved pilot medical protocols.
Obtain informed consent to eligible study patients utilizing forms provided by University
of California Irvine (UCI)
Transport eligible patients with their consent to approved urgent care centers or
emergency departments. Prior to transport, obtain informed consent to transport
utilizing the form in substantially the same form as included in Exhibit F
Must participate in the baseline and study data collection, provide ePCR via OCMEDS
Data collection involves FD incident data, ePCR data, financial data, and training data
• Establish fee schedule and billing process for ambulance transport reimbursement for
study patients
CITY OF HUNTINGTON BEACH Page C-1
EXHIBIT D
REIMBURSEMENT AMOUNTS
City of Huntington Beach
FY 2015
fr
F " `° VFD;HBFDi11BFD,Rw:�
EMS I?roviclers -
TOTAL COSTS
RATE OF PAY
Training — Core Education
Up to $25,920
$60/hr per person
Training — Core Education
FVFD, HBFD, NBFD
Up to $8,640 per FD
Up to 144 hrs/6 week course
x 1 erson/FD
Travel — Core Education
Up to $1,725
$0.575 per mile
Travel -Core Education FVFD,
HBFD, NBFD
Up to $575 per FD
Up to 1000 miles/6 week
course x 1 person/FD
Training — Local ADPT
Up to $23,040
Up to $60/hr per person,
Training — Core Education-
HBFD
Up to $7,680
8 ADPTs x 16 hrs each
FY 2015 TOTAL
$16,895
FY 2016
,EMS "Providers =;Care {Ambulance, FVFD;-'HBFD;€NBFD ,"j"-,,-° "fiZ = ; ;" �1�i�°4
Emergency Ambulance
Services to designated
Urgent Care Center
*Up to $50,000
Up to $500/transport (see
Billing Process Flowchart)
Office Supplies/Printing
*Up to $1,000
FY 2016 TOTAL
$51,000
FY 2017
EMS Providersr�—, Care�Ambulance,',FVFD,` HBFD; NBFD
Emergency Ambulance
Services to designated
Urgent Care Center
*Up to $50,000
Up to $500/transport (see
Billing Process Flowchart)
Office Supplies/Printing
*Up to $1,000
FY 2017 TOTAL
$51,000
*Note The total costs for these line items are spread over 2 fiscal years, however, it is possible
that all expenses may occur in only 1 fiscal year
CITY OF HUNTINGTON BEACH Page D-1
EXHIBIT E
BILLING PROCESS
CITY OF HUNTINGTON BEACH Page E-1
ORANGE COUNTY ALTERNATE DESTINATION PILOT PROJECT
Billing Process for Enrolled Patients
Transported to and Treated at Urgent Care Centers
Transport Providers and Urgent mare Centers
participating in the pilot project will utilize
these guidelines when billing enrolled
patients for 9-1-1 transport to UCCs
and for UCC services
Process payments lrfthe normal
1 manner
' Trans6 oh Providers - r
Process payments ¢i the normal manner,
do nat`balance bill -patient,
For payments E$500; balance bill Prbjeet
up to.$500
For payments $50[], aajust, alance to $(l _
UTu nt Care,Centers
-Process payments in the normal'mahner;-- .,
do not balance bi 1,patient •=y, ,
For payments �$225°[initial v�sit]I$125 _ -
(follovrance-bill Project upto those
amounts' ' •r . 'a _;'
y5
Payments' $225(initial]J$125 (follov up),
aifaust balance`to $Ll
1 Tr'ansoort:Provider
Adjust balance to$500 and send°kxrfl to
Project
lJ µ n are Centers - = l y�Y
Acljai balance,to $225 (ni 1,1 vtsit) and' k
$125 (follow --up and send bill
I Pilot Projects -
;Tran sport+Providers
,4djust balance t `$5{i0 and"sentlb EI
# Urgent Care Centers � �� � �z �"
i Adjust balance to $2Z5 (rriit al wrs�t}
ari`d $1Z5 (follow up} n`disend III tom
�xt
�P�o�ect
Rev 5-6-2015
EXHIBIT F
ELECTION AND CONSENT FORM
ELECTION AND CONSENT TO BE TRANSPORTED TO AN
ORANGE COUNTY EMERGENCY MEDICAL SERVICES
(OCEMS) ALTERNATIVE DESTINATION SITE (ADS)
I acknowledge that that I have consented to enrollment in the Community Paramedicine Pilot Program,
voluntarily signed the "University of California, Irvine Consent to Act as a Human Research Subject" and
the "University of California, Irvine Health Permission to Use Personal Health Information for Research"
and I hereby consent and agree to be transported to the Alternate Destination Site (ADS) approved by the
Orange County Emergency Medical Services (OCEMS) to receive Pilot patients who elect to be
transported to the ADS rather than an acute care hospital emergency department I hereby release the
EMS personnel and their employing agencies from any and all legal liability for medical claims resulting
from my election to be transported to the ADS site
❑ 1 agree ❑ 1 Disagree ❑ Not Applicable
't t ," '�+,+,1 ,»r� s e s :'s '1" }Gum�i� , �".kyi7
4p4",r : i '�� a i
4'�r�R
4,d
��%-,P,',,YrPLEASEnSIGN;HERE;',=�m��fi"���-
f�
`X�/ -1 Op"qJ,
_ .., Sri". —=. r� a, �'� .k; ;s `L: `,i�, �;s^ i�tY
» axe _. �`�` �t''�
,z c-. ` `' ''"*n •`.^
,P6tidnfSignature��r � ��� °�r � "r. ;�� �, x� ��� �� �1 �r�l
Patient Name Date
Address
Patient Phone
WITNESS
I acknowledge that I have witnessed the patient/guardian sign this Patient Care Report
❑ 1 agree ❑ 1 Disagree ❑ Not Applicable
v' � � ,� t� ?=' , „�, �" " t � i 4 �, E•
, ' `_ i� � } :" �_;.... �r txk�z
-,'' t ""'qXt
, t - _r,-; a"�`
-_,,'PLEASE SIGN,HERE';,h
,Witness,Si
nature
Witness Printed Name I I Date F-
CITY OF HUNTINGTON BEACH Page F-1
CITY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3005 1 949 644-3039 FAX
newportbeachca gov/cityclerk
�PFOR
December 8, 2015
City of Huntington Beach
Community Paramedicme Pilot Program
2000 Main Street
Huntington Beach, CA 92648
Re: Contract No. 6403
To Whom It May Concern.
Enclosed please find your executed copy of the Reimbursement Agreement for the
Community Paramedicine Pilot Program.
If you have any questions or need additional information, please contact EMS Division
Chief Cathy Ord at (949) 644-3384.
Smcerel
r
Leilani I Brown, MMC
City Clerk
Enclosure
cc: Cathy Ord, Fire Department (via email only)