HomeMy WebLinkAbout06/04/2024 13.B. Yakima County agreement with American Medical Response (AMR) for ambulance services ofYg
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BUSINESS OF THE CITY COUNCIL
YAKIMA, WASHINGTON
AGENDA STATEMENT
Item No. 13.B.
For Meeting of: June 4, 2024
ITEM TITLE: Yakima County agreement with American Medical Response (AMR)
for ambulance services
SUBMITTED BY: Dave Zabel!, Interim City Manager
SUMMARY EXPLANATION:
Attached for Council's information is the executed agreement as approved by the Yakima County Board
of County Commissioners for ambulance transport services with American Medical Response (AMR).
The agreement is for five years and outlines required response times by zone.
ITEM BUDGETED:
STRATEGIC PRIORITY:
RECOMMENDATION:
ATTACHMENTS:
BOCC_AMR Agreement.pdf
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BOARD OF YAKIMA COUNTY COMMISSIONERS
r i41�. — � - Agenda Request Form (ARF)
tai _ ,o,�,- - Deliver completed ARF and finalized agenda item to the Clerk or Deputy Clerk
_ _ of the Board at the Yakima County Commissioners'Office, Room 232.
Board of County Commissioners Record Assigned
Joseph Brusic/Stefanie Weigand
Prepared by:
Prosecutor's Office BOCC Agreement
Department: -
May 28, 2024 21 3 - 2 0 2 4
Requested Agenda Date:
Joseph Brusic Yakima County, WA
Presenting:
Action Requested—Check Applicable Box:
❑PASS RESOLUTION ✓] EXECUTE or AMEND
AGREEMENT, CONTRACT, or GRANT
PASS ORDINANCE
10THER
,ISSUE PROCLAMATION
Document Title:
Professional Services Agreement with American Medical Response(AMR)to provide 9-1-1 Ambulance
Transport Services.
Background Information:
This agreement will provide 9-1-1 Ambulance Transport Services. This is a 5-year agreement and has many
provisions that will directly benefit those individuals utilizing emergency transport. The agreement outlines
required response times by zone and allows for liquidated damages if response times and other requirements
and/or best practices are not met.
r -Describe Fiscal Impact:
N/A. This is a user paid agreement not a County paid agreement.
Summary& Recommendation:
Sign the agreement as it is in the best interests of Yakima County and the public.
— M,e., W O4A.d 6I -
r _ _ i ' l U
Department Head/Elected Official Signature Corporate Counsel Initial(for Agreements Only)
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YAKIMA COUNTY
PROFESSIONAL SERVICES AGREEMENT
FOR 9-1-1 AMBULANCE TRANSPORT SERVICES
THIS PROFESSIONAL SERVICES AGREEMENT entered this day of
2024, between Yakima County, a Washington municipal corporation ("County"), and American
Medical Response Ambulance Service, Inc. ("Contractor").
WITNESSETH: The parties, in consideration of the terms and conditions herein, do hereby
covenant and agree as follows:
1. Statement of Work
The services(hereinafter referred to as "services"or"work") that the Contractor will provide the
services set forth herein. In accordance with applicable laws,the County designates Contractor as
its exclusive provider of the services set forth herein. The service area is trauma zone one within
the County. Please see Exhibit D, Trauma Zone One map.
The services that the Contractor will provide include services described in RFP C12206P and the
Contractor's proposal documents referenced and exhibits to this contract.
2. Contract Term
The Contractor is awarded an initial 5-year contract five years from the date that all parties have
signed this contract. Up to four(4)one (1)year extensions may be earned according to the agreed
upon contract terms, including amendments. The County, upon mutual consent of all parties
involved may offer Contractor an extension on terms to be negotiated. Contract extensions shall
be in writing and signed by both parties.
3. Agency Relationship between County and Contractor
Contractor shall, at all times, be an independent Contractor and not an agent or representative of
County with regard to performance of the Services. Contractor shall not represent that it is,or hold
itself out as, an agent or representative of County. In no event shall Contractor be authorized to
enter into any agreement or undertaking for, or on,behalf of County.
4. Successors and Assigns
a. Neither the County nor the Contractor, shall assign, transfer, or encumber any rights, duties,
or interests accruing from this Contract.
b. The Contractor may request that the contract be transferred to a corporate successor in interest
or affiliate. The County has the authority to determine whether to approve such transfer of
interest,which determination shall not be unreasonably withheld,conditioned or delayed.
5. Inspection and Production of Records
a. The records relating to the Services shall, at all commercially reasonable times, be subject to
inspection by and with the approval of the County, but the making of(or failure or delay in
making) such inspection or approval shall not relieve Contractor of responsibility for
performance of the Services in accordance with this Contract, notwithstanding the County's
knowledge of defective or non-complying performance, its substantiality or the ease of its
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discovery. Contractor shall provide the County sufficient, safe, and proper facilities, and/or
send copies of the requested documents to the County. Contractor's records relating to the
Services will be provided to the County upon the County's request.
b. Contractor shall promptly furnish the County with such information and records which are
related to the Services of this Contract as may be requested by the County. Until the expiration
of six (6) years after final payment of the compensation payable under this Contract, or for a
longer period if required by law or by the Washington Secretary of State's record retention
schedule,Contractor shall retain and provide the County access to(and the County shall have
the right to examine,audit and copy)all of Contractor's books,documents,papers and records
which are related to the Services performed by Contractor under this Contract. If any litigation,
claim, or audit is started before the expiration of the six-year period, the records shall be
retained until all litigation, claims,or audit findings involving the records have been resolved.
c. All records relating to Contractor's services under this Contract must be made available to the
County, and the records relating to the Services are Yakima County records. They must be
produced to third parties, if required pursuant to the Washington State Public Records Act,
Chapter 42.56 RCW, or by law. All records relating to Contractor's services under this
Contract must be retained by Contractor for the minimum period of time required pursuant to
the Washington Secretary of State's records retention schedule.
d. The terms of this section shall survive any expiration or termination of this Contract.
6. Compliance with Law
Contractor agrees to perform all Services under and pursuant to this Contract in full compliance
with any and all applicable laws, rules, and regulations adopted or promulgated by any
governmental agency or regulatory body, whether federal, state, local, or otherwise, including
policies adopted by the County, as those laws, ordinances, rules, regulations, and policies now
exist or may hereafter be amended or enacted. Contractor shall procure and have all applicable and
necessary permits, licenses and approvals of any federal, state, and local government or
governmental authority or this project,pay all charges and fees,and give all notices necessary and
incidental to the due and lawful execution of the work.
Contractor shall procure and have all applicable and necessary permits, licenses and approvals of
any federal, state, and local government or governmental authority for the services and work
provided for pursuant to this contract,pay all charges and fees,and give all notices necessary and
incidental to the due and lawful execution of the work.
a. Procurement of a City Business License. Contractor must procure a City of Yakima Business
License and pay all charges, fees, and taxes associated with said license.
b. Contractor must provide proof of a valid Washington department of Revenue state excise tax
registration number, as required in Title 85 RCW.
c. Contractor must provide proof of a valid Washington Unified Business Identification (LBI)
number. Contractor must have a current UBI number and not be disqualified from bidding on
any public works contract under RCW 39.06.101 or 36.12.065(3).
d. Contractor must provide proof of a valid Washington Employment Security Department
number as required by Title 50 RCW.
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e. Foreign (Non-Washington) Corporations: Although the County does not require foreign
corporate proposers to qualify in the City,County or State prior to submitting a proposal, it is
specifically understood and agreed that any such corporation will promptly take all necessary
measures to become authorized to conduct business in Yakima County,at their own expense,
without regard to whether such corporation is actually awarded the contract, and in the event
that the award is made,prior to conducting any business in the County.
7. Nondiscrimination Provision
During the performance of this Contract,the Contractor agrees as follows:
The Contractor shall not discriminate against any person on the grounds of race, creed, color,
religion, national origin, sex, age, marital status, sexual orientation, gender identity, pregnancy,
veteran's status, political affiliation or belief, or the presence of any sensory, mental or physical
disability in violation of the Washington State Law Against Discrimination(RCW chapter 49.60)
or the Americans with Disabilities Act(42 USC 1210I et seq.).
This provision shall include but not be limited to the following:employment,upgrading,demotion,
transfer, recruitment, advertising, layoff or termination, rates of pay or other forms of
compensation,selection for training,and the provision of Services under this Agreement.
In the event of the Contractor's noncompliance with the non-discrimination clause of this contract
or with any such rules, regulations, or orders, this Contract may be cancelled, terminated, or
suspended in whole or in part and the Contractor may be declared ineligible for any future County
contracts.
8. Pay Transparency Nondiscrimination Provision:
The Contractor will not discharge or in any other manner discriminate against employees or
applicants because they have inquired about, discussed,or disclosed their own pay or the pay of
another employee or applicant. However, employees who have access to the compensation
information of other employees or applicants as a part of their essential job functions cannot
disclose the pay of other employees or applicants to individuals who do not otherwise have access
to compensation information, unless the disclosure is (a) in response to a formal complaint or
charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an
investigation conducted by the employer, or (c) consistent with the contractor's legal duty to
furnish information.
9. Indemnification and Hold Harmless
a. Contractor shall take all necessary precautions in performing the Services to prevent injury to
persons or property. The Contractor agrees to release, indemnify, defend, and hold harmless
the County, its elected and appointed officials, officers, employees, agents, representatives,
insurers,attorneys,and volunteers from all liabilities,losses,damages,and expenses related to
all claims, suits, arbitration actions, investigations, and regulatory or other governmental
proceedings arising from or in connection with this Agreement or the acts, failures to act,errors
or omissions of the Contractor, or any Contractor's agent or subcontractor, in performance of
this Agreement, except for claims caused by the County's negligence or intentional conduct.
b. It is specifically and expressly understood that the Contractor waives any immunity that may
be granted to it under the Washington State industrial insurance act, Title 5l RCW,solely for
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the purposes of this indemnification. Contractor's indemnification shall not be limited in any
way by any limitation on the amount of damages, compensation or benefits payable to or by
any third party under workers' compensation acts, disability benefit acts or any other benefits
acts or programs. Contractor shall require that its subcontractors, and anyone directly or
indirectly employed or hired by Contractor, and anyone for whose acts Contractor may be
liable in connection with its performance of this Agreement, comply with the terms of this
paragraph,waive any immunity granted under Title 51 RCW,and assume all potential liability
for actions brought by their respective employees. The Parties acknowledge that they have
mutually negotiated this waiver.
c. Nothing contained in this Section,or this Contract shall be construed to create a liability or a
right of indemnification in any third party.
d. The terms of this Section shall survive any expiration or termination of this Contract.
10. Contractor's Liability Insurance
At all times during performance of the Services and this Contract, Contractor shall secure and
maintain in effect insurance to protect the County and Contractor from and against any and all
claims, damages, losses, and expenses arising out of or resulting from the performance of this
Contract. Contractor shall provide and maintain in force insurance in limits no less than that stated
below, as applicable. The County reserves the right to require higher limits should it deem it
necessary in the best interest of the public. Since these are the minimum required insurance levels,
if Contractor maintains higher limits than the minimums shown above, the County requires and
shall be entitled to coverage for the higher limits maintained by Contractor.Contractor's insurance
shall be primary and non-contributory to any insurance held by Yakima County.
Contractor shall provide a Certificate of Insurance to the County as evidence of coverage for each
of the policies and outlined herein. A copy of the additional insured endorsement attached to the
policy shall be included with the certificate. This Certificate of insurance shall be provided to the
County,prior to commencement of work.
Failure of County to demand such verification of coverage with these insurance requirements or
failure of County to identify a deficiency from the insurance documentation provided shall not be
construed as a waiver of Contractor's obligation to maintain such insurance.
Contractor's insurance coverage shall be primary insurance with respect to those who are
Additional Insureds under this Contract. Any insurance,self-insurance or insurance pool coverage
maintained by the County shall be in excess of the Contractor's insurance and neither the County
nor its insurance providers shall contribute to any settlements, defense costs, or other payments
made by Contractor's insurance.
If at any time during the life of the Contract, or any extension, Contractor fails to maintain the
required insurance in full force and effect, all work under the contract shall be discontinued
immediately.Any failure to maintain the required insurance maybe sufficient cause for the County
to terminate the Contract.
The following insurance is required:
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a. Commercial Liability Insurance
Before this Contract is fully executed by the parties,Contractor shall provide the County with
a certificate of insurance and additional insured endorsements as proof of commercial liability
insurance with a minimum liability limit of Two Million Dollars ($2,000,000.00) per
occurrence,combined single limit bodily injury and property damage,and Five Million Dollars
($5,000,000.00)general aggregate, such limits shall be shown on the Certificate of Insurance
and Endorsements and the County, its elected and appointed officials, employees, agents,
attorneys and volunteers shall be named as additional insureds. The certificate shall clearly
state who the provider is, the coverage amount, the policy number, and when the policy and
provisions provided are in effect. Said policy shall be in effect for the duration of this Contract.
The certificate of insurance and additional insured endorsements shall name Yakima County,
its elected and appointed officials, employees, agents, attorneys and volunteers as additional
insureds, and shall contain a clause that the insurer will not cancel the insurance without first
giving the County prior written notice. The insurance shall be with an insurance company or
companies rated A-VII or higher in Best's Guide and admitted in the State of Washington.The
requirements contained herein, as well as Yakima County's review or acceptance of insurance
maintained by Contractor is not intended to and shall not in any manner limit or qualify the
liabilities or obligations assumed by Contractor under this contract.
b. Automobile Liability Insurance
Before this Contract is fully executed by the parties,Contractor shall provide the County with
a certificate of insurance as proof of automobile liability insurance with a minimum liability
limit of Five Million Dollars ($5,000,000.00) per occurrence, such limits shall be shown on
the Certificate of Insurance and Endorsements and the County, its elected and appointed
officials, employees, agents, attorneys and volunteers shall be named as additional insureds.
The certificate shall clearly state who the provider is,the coverage amount,the policy number,
and when the policy and provisions provided are in effect. Said policy shall be in effect for the
duration of this Contract. The certificate of insurance and additional insured endorsements
shall name Yakima County, its elected and appointed officials, employees, agents, attorneys
and volunteers as additional insureds, and shall contain a clause that the insurer will not cancel
the insurance without first giving the County prior written notice. The insurance shall be with
an insurance company or companies rated A-VII or higher in Best's Guide and admitted in the
State of Washington. The requirements contained herein, as well as Yakima County's review
or acceptance of insurance maintained by Contractor is not intended to and shall not in any
manner limit or qualify the liabilities or obligations assumed by Contractor under this contract.
The business auto liability shall include Hired and Non-Owned coverage if necessary.
c. Employer's Liability(Stop Gap)
Contractor and aII subcontractor(s) shall at all times comply with all applicable workers'
compensation, occupational disease, and occupational health and safety laws, statutes, and
regulations to the full extent applicable,and shall maintain Employer's Liability insurance with
a limit of no less than Two Million Dollars ($2,000,000.00). The County shall not be held
responsible in any way for claims filed by Contractor or its employees for services performed
under the terms of this Contract. Contractor agrees to assume full liability for all claims arising
from this Contract including claims resulting from negligent acts of all subcontractor(s).
Contractor is responsible to ensure subcontractor(s) have insurance as
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needed. Failure of subcontractors(s) to comply with insurance requirements does not limit
Contractor's liability or responsibility.
d. Professional Liability Insurance
Insurance appropriate to the Contractor's profession, with limits no less than $2,000,000 per
occurrence or$5,000,000 aggregate.
Excess Insurance:If the Contractor has excess insurance,then Yakima County shall be entitled
to that insurance. The excess insurance is primary and non-contributory to that held by Yakima
County.
11.Severability
If any term or condition of this Contract or the application thereof to any person(s)or circumstances
is held invalid, such invalidity shall not affect other terms, conditions or applications which can be
given effect without the invalid term,condition or application. To this end,the terms and conditions
of this Contract are declared severable.
12.Termination
a. Termination for Cause
In the event the Contractor breaches this Contract, the County may terminate the Contract at
its sole discretion in such event that it provides the Contractor with written notice of
Contractor's material breach and the Contractor fails to cure its breach within thirty (30)
business days of this notice.
In the event that the Contractor materially breaches its contractual duty by failing to provide
emergency ambulance service, the County shall have access to Contractor's twelve (12)
ambulances and equipment it uses in the system("Performance Security").
If the County terminates this Agreement for material breach,Contractor shall immediately,and
without legal protest,surrender the Performance Security to the County. The County shall pay
fair market value rental for the Performance Security usage during the interim period not to
exceed six(6)months.The following shall be the conditions precedent before the County may
draw on the Performance Security: (i) the County declares the Contractor in material breach;
(ii)the Contractor fails to cure the material breach within 30 business days;and(iii)the County
terminates the Contract.
b. Bond
Contractor shall obtain and maintain throughout the term of this Agreement a bond in the
amount of One Million Dollars($1,000,000)with a reputable and financially stable surety.
The bond shall be for a term of one (1)year and shall be continuously renewed, extended or
replaced so that it remains in effect for the entire term of this Agreement,or such shorter period
of time as determined by the County in its sole discretion.
The County may make one or more draws not to exceed the bond amount, upon certification
to the issuing surety that the following three(3) conditions precedent: (i)the County declares
Contractor in Material Breach; (ii) the Contractor failed to cure the Material Breach within
thirty(30) business days; and(iii)the County terminates the Agreement.
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The bond shall serve as security for the performance of the Contractor's obligations under the
contract provided the stated amount ofthe bond shall not limit the amount of damages to which
the County may be entitled for any Material Breach by the Contractor.
The following shall constitute a material breach of the Contractor:
i. Files a petition in bankruptcy,becomes insolvent,or otherwise takes action to dissolve
as a legal entity;
ii. Allows any final judgment not to be satisfied or a lien not to be disputed after a legally
imposed 30-day notice;
iii. Makes an assignment for the benefit of creditors;
iv. Fails to follow the sales and use tax certification requirements of the State of
Washington;
v. Incurs a delinquent Washington tax liability;
vi. Becomes a State or Federally debarred Contractor;
vii. Is excluded from federal procurement and non-procurement Contracts;
viii.Fails to maintain and keep in force all required insurance, permits and licenses as
provided in the Contract;
ix. Fails to maintain the confidentiality of the County information that is considered to be
Confidential Information, proprietary, or containing Personally Identifiable
Information; or
x. Contractor's performance is an immediate and existential threat to the health, safety
and welfare of the public at large.
c. Termination for Convenience
Because of the vital emergency services provided by the Contractor as a sole source for
services, the termination for convenience clause shall be one year(365 days). Contractor has
a duty to cooperate with the County in any transition if a termination for convenience occurs.
Failure to do so will constitute a breach of this agreement.
d. City Withdrawal from the EMS System
The City of Yakima may withdraw from the EMS System only upon providing Three Hundred
and Sixty-five(365)days'prior written notice to Yakima County and the Contractor. Upon the
effective date of the City withdrawal, this contract shall automatically and simultaneously
terminate.
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13.Dispute Resolution
In the event that any dispute shall arise as to the interpretation of this agreement, or in the event of
a notice of default as to whether such default does constitute a breach of the contract, and if the
parties hereto cannot mutually settle such differences, then the parties shall first pursue mediation
as a means to resolve the dispute. If the afore mentioned methods are not successful then any
dispute relating to this Agreement shall be decided in the courts of Yakima County,in accordance
with the laws of Washington. If both parties consent in writing, other available means of dispute
resolution may be implemented.
14. Communication
At its own cost, Contractor shall maintain twenty-four (24) hours daily, seven (7) days a week
direct communication between its ambulances at any location within their service area and its
dispatch center, subject to network availability.
Contractor shall maintain a windows device that maintains connectivity and have the County's
SPILLMAN client installed. Connectivity by VPN connection back to Yakima County, or other
connectivity method approved by the County shall be required. Contractor shall cooperate with
County on future changes to connectivity and interfacing with County systems and processes to
maintain and/or improve communication and/or emergency responses subject to this agreement,
including Computer Aided Dispatch to enhance EMS response.
The County retains the option to change connectivity and interface requirements at its sole
discretion and Contractor shall adopt the changes as required by the County after 90 days' notice,
subject to vendor availability. Contractor is required to test redundant systems monthly by taking
and completing at least one call each month and reporting the results of the test or tests to the
County. Such change shall be subject to rate adjustment to fund the venture.
15. Contractor's Employee Training and Certifications
Contractor shall maintain an annual driver training program for ambulance personnel. The
program, the number of instruction hours, and the system for integration into the Contractor's
operations (i.e., accident review boards, impact of accidents on employee performance reviews
and compensation, etc.) will be reviewed and is subject to approval by County initially and on an
annual basis thereafter. Driver training must meet or exceed current edition of Washington Fire
Chiefs, Emergency Vehicle Incident Prevention program. Training and skill proficiency is required
at initial employment with annual training refresher and skill confirmation. On an annual basis,
Contractor clinical employees shall successfully pass Contractor's criminal background checks.
Contractor clinical personnel shall be required to report any criminal charges related to the delivery
of services, abuse of patients or vulnerable persons, or controlled substances promptly to
Contractor and Contractor shall promptly report those charges to the County in accordance with
applicable laws.
16. Contract Implementation Date and Coverage Plan
a. Implementation Date
Pursuant to the timeline in the Contractor's proposal documents, the implementation date of this
contract will be 90 days after this contract is signed by Yakima County and the City of Yakima.
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b. Coverage Plan
Thirty (30) calendar days prior to the contract implementation date, Contractor shall provide the
County with a proposed written plan of ambulance transport coverage, including base stations and
post positions with unit hours for each. Contractor may modify its coverage plan from time to time
and will provide the County with any material changes within thirty (30) days of the material
change. The coverage plan will be reviewed on or about the anniversary date of the contract or
more often, if necessary. Contractor shall endeavor to create a community stakeholder committee
for the review of system status management and any committee recommendations are purely
advisory.
17.Performance Liquidated Damages
Performance Liquidated Damages are any liquidated damages resulting from the Contractor's
performance, which are required to be paid by the Contractor for or on account of any failure,
diminished performance,or inefficiency with respect to the services supplied under this contract.
The Contractor agrees to pay the County liquidated damages for the specific events identified
below. These liquidated damages are not a penalty for non-performance but an estimate of the
damages to the County caused by virtue of such non-performance.The County and the Contractor
agree that such damages are very difficult to accurately estimate because of numerous factors,
including delay, inconvenience to the County and to County customers,staff time,and damage to
the public service; further,the parties agree that the liquidated damages stated below are reasonable
forecasts of all factors now known and available for consideration relating to the damages caused.
The tights of the County to liquidated damages are in addition to all of the other rights and remedies
the County has pursuant to the contract and by law. The County may elect to waive its right to
liquidated damages.
Contractor shall submit their reports to the EMS Administration Board by the 151h of every month.
Failure to submit reports constitutes a separate basis for fining the Contractor.
a. Procedure for Liquidated Damages Assessment:
i. Before assessing liquidated damages, Yakima County shall determine whether the
failure to meet the contract standard could reasonably have been prevented by the
Contractor. Failures caused by inaccurate or untimely communication by Yakima
County, natural disasters, or extreme and unusual weather, or unusual traffic
conditions, or local emergency department delays shall not be considered preventable
by the Contractor.
ii. If Yakima County determines that the failure could have been prevented by the
Contractor, Yakima County will notify the Contractor of the incident and of its intent
to assess liquidated damages. If the Contractor requests a meeting, the EMS
Administration Board will meet with the Contractor to discuss the incident prior to
assessing liquidated damages.
iii. The Contractor authorizes the County, any time after such meeting and to the fullest
extent permitted by law, to set off and apply any liquidated damages assessed by the
County to any and all sums due and owing the Contractor held by the County and/or
accrued under the contract.
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b. Damages
i. Performance Liquidated Damages
Liquidated Damages will be assessed according to Response Zones in accordance with
the maps in Exhibit E. The times listed in the response zones are for the purposes of
liquidated damages only. "Response Time" is defined as the total time from when the
call is either: (i) sent by the County to Contractor with all necessary information (e.g.,
call type,address, etc.)for Contractor to respond until the time Contractors ambulance
arrives on the scene; or (ii) sent by the County to Contractor's nurse navigation line.
Response Times for the defined Area Classifications are as follows:
Area Response Time for 90%of 9-1-1 Calls,
Classification Minutes
Code No Code
Zones 1 &5 <10 ASAP
(10:00
is late)
Zone 2 <15 ASAP
(15:00
is late)
Zone 3 <25 ASAP
(25:00
is late)
Zone 4 ASAP ASAP
Zone 6 <20 ASAP
(20:00
is late)
Zone 7 <30 ASAP
(30:00
is late)
Zones 8 & 9 <35 ASAP
(35:00
is late)
Notwithstanding, Contractor shall report response times in accordance with any local
ordinances,but shall not incur liquidated damages for any local ordinance.
As a percentage basis, the standards may apply as follows when a 90% aggregate is
not achieved within a qualifying zone.
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Zone
Response Time Damages for Failure
Percentage to Achieve 90% in a Zone
Code No Code
<90% $1000 $0
<89% $2000 $0
<88% $3000 $0
<87% $4000 $0
<86% $5000 $0
ii. Other Damages. As set forth below, damages for failure to meet response time
performance may apply to individual calls depending on the circumstances.
Failed response. Contractor shall pay performance damages of two hundred fifty
dollars($250.00)for each time the Contractor fails to respond to an emergency call and
fails to refer the call to another provider of ambulance services (i.e., the call receives
no response), and such incident requires an ambulance response in accordance with
EMS dispatch protocols.
Damages for failure to provide data to determine compliance. Each time an
ambulance is dispatched, and the crew fails to report and document an on-scene time,
Contractor shall pay performance damages of two hundred-fifty dollars($250.00) for
each such occurrence. Additionally, when the on-scene time cannot be provided for
said emergency call, the response time for that call shall be deemed to have exceeded
the required response time for the purposes of determining response time compliance.
In order to rectify the failure to report an on-scene time and to avoid payment of
performance damages,Contractor may demonstrate to the satisfaction of the County an
accurate on-scene time; however, the response would still be subject to response time
penalty calculations, if applicable.
Damages for mechanical failure. Contractor shall pay performance damages of five
hundred dollars($500.00)for each preventable mechanical failure or exhaustion of fuel
while transporting a patient from a call, or any situation that requires substitution of
one ambulance for another once the first ambulance is assigned to a call. Within three
(3) business days of such event, Contractor shall provide the County with a full
description of each response where there was a preventable mechanical failure and the
remedial action taken to prevent a reoccurrence.The County will consider the vehicle's
maintenance history in determining whether mechanical failures were preventable.
Damages for failure to meet ambulance staffing. Contractor shall pay a fine of five
hundred dollars ($500.00) whenever an ambulance, not staffed as required by the
Request for Proposals C12206P, responds to a call. Within three (3) business days of
such event,Contractor shall provide the County with a full description of each response
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where there was a failure to meet ambulance clinical or staffing standards and the
remedial action taken to prevent a reoccurrence.
Failure to meet ambulance equipment availability. Subject to the performance
standard exemptions set forth in the Request for Proposals, the Contractor shall incur
performance damages of one thousand dollars($1,000.00)per occurrence for each time
an inspection made determines that an ambulance is not fully equipped with all items
listed on the daily Ambulance Inventory Checklist,as required by the Washington State
Ground Ambulance and Aid Service Equipment WAC 246-976-300.
j. Invoicing and Payment of Liquidated Damages
No more frequently than monthly and at least quarterly, the County shall invoice Contractor
for any liquidated damages assessed during the prior period. The Contractor shall pay the
liquidated damages within thirty(30)business days of receipt of invoice.
k. Appeal of Liquidated Damages Assessment
In instances when the County's Contract Administrator, at the request of the Contractor, has
reviewed the circumstances for imposing liquidated damages,and determined that the grounds
are sufficient to justify the imposition of the liquidated damages, the Contract Administrator
shall report the Contractor's appeal and the reasons for denial to the Yakima County EMS
Designated Contact. The Contractor shall have the right to appeal such ruling to the Yakima
County EMS Designated Contact within two weeks. The determination of the Yakima County
EMS Designated Contact shall be final unless Contractor requests that the determination be
reviewed by the Yakima County Commissioners. Requests for review, if any, must be made
within two weeks of the EMS Board's decision. The Yakima County Commissioners shall
respond in a reasonable amount of time.
Liquidated Damages Waived for Start-Up Period.
The County may waive the liquidated damages for the first three (3) months of the Contract
but is under no requirement to do so.
I. Liquidated Damages Adjustment
Liquidated damages may be adjusted annually by the County in an amount not to exceed the
rate of inflation for the period since the last adjustment.
m. Liquidated Damages Exemptions
Utilizing a reasonable person standard,the County upon application by Contractor shall grant
exemptions to liquidated damages resulting from situations beyond the Contractor's control
that cause unavoidable delay or no response. The County shall examine each request for
exemption and shall take into consideration the Contractor's system status management plan,
staffing levels,dispatch times,in-service times, traffic,street blockages,and other influencing
factors. Except where there is an automatic exemption as set forth herein, if the County
determines the circumstances warrant, the County shall grant an exemption to liquidated
damages resulting from the response time performance standards.
i. Concurrent Responses. In the event three or more units are simultaneously committed
to one incident and two or more additional units are concurrently responding to at least
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two other separate incidents, Yakima County shall grant an exemption for each unit
starting with the third incident.
ii. Declared disaster. In the event an emergency is officially declared, Yakima County
shall grant exemption to liquidated damages resulting from response time performance
standards for all during the declared emergency that directly impacts Yakima County
EMS.
iii. Multiple Unit Response. In the event two or more units are simultaneously committed
to one incident,the first arriving unit shall be held to the response time standard.
iv. Response Location Errors.In the event Yakima County provides an inaccurate address,
or if the location does not exist,Yakima County shall grant a response time exemption.
v. Response Location Change. In the event Yakima County changes the incident location
and the change delays the unit's response time because the unit must re-route farther
than one city block to respond to the call, Yakima County shall grant an exemption.
vi. Canceled Request. In the event a request is canceled prior to or at the unit's arrival on
scene for reasons other than exceeding the maximum response time standard, Yakima
County shall grant an exemption.
vii. Response Delayed by Accident. In the event the ambulance unit is involved in an
accident and cannot continue to respond to the call, Yakima County will grant an
exemption provided the accident is not the fault of the ambulance unit.
viii. The following shall constitute exemptions. These shall be noted by Contractor in its
monthly reports.
a) Zones 3, 5, 6, 7, 8, and 9. The second response within any twenty-minute(20)period
to prior requests for service anywhere within these zones.
b) Zones I and 2. The third response within any twenty-minute (20) period to prior
requests for service anywhere within these zones.
c) When a hospital is on diversion status.
d) A hospital acceptance of a patient that exceeds twenty(20)minutes to accept the patient
from the time the Contractor arrives at the hospital.
e) In the event of a local declared MCI as defined in the Yakima County Operating
Procedures (COPs)for an MCI or nationally declared MCI,disaster,or pandemic with
direct implications to the Yakima EMS System. Please see Exhibit F for the Yakima
County Operating Procedures.
ix. Reduced/Upgraded Response. In the event Yakima County reduces the priority of the
response from Emergency to Non-Emergency or upgrades the response from Non-
Emergency to Emergency,the response shall be considered a Non-Emergency response
solely for the imposition of liquidated damages.
18. Substitution
The Contractor shall not substitute or deviate from said specifications of this Contract without a
written amendment, signed by the Board of County Commissioners, or pursuant to the Section
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below entitled "Change or Notice". Any violation of this procedure by the Contractor will be
considered cause for immediate cancellation of the Contract for cause by the County.
19. Contractor Shall Furnish
Except as otherwise specifically provided in this Contract, Contractor shall furnish the following,
all as the same may be required to perform and provide the services in accordance with the terms
of this Contract. personnel, labor,products and supervision; and technical,professional and other
services. All such services, products, property and other items furnished or required to be
furnished,together with all other obligations performed or required to be performed,by Contractor
under this Contract are sometime collectively referred to in this Contract as the"(Services)."
20.Complementary Provisions
All provisions of this Contract are intended to be complementary, and any services required by
one and not mentioned in another shall be performed to the same extent as though required by all.
Details of the services that are not necessary to carry out the intent of this Contract, but that are
not expressly required, shall be performed or furnished by Contractor as part of the services,
without any increase in the compensation otherwise payable under this Contract.
21.Prime Contractor
Contractor is the Prime Contractor hereunder. The Prime Contractor shall be the sole point of
contact with regard to all contractual matters arising hereunder, including the performance of
services and the payment of any and all charges resulting from its contractual obligations.
22.Delegation of Professional Services
The services provided for herein shall be performed by Contractor, and no person other than
regular associates or employees of Contractor shall be engaged on such work or services.
Contractor shall not (by contract, operation of law or otherwise) delegate or subcontract
performance of any services to any other person or entity without the prior written consent of the
County which consent shall not be unreasonably withheld, conditioned or delayed. Any such
delegation or subcontracting without the County's prior written consent shall be voidable at the
County's option.
No delegation of subcontracting the performance of any of the services, with or without the
County's prior written consent,shall relieve Contractor of its responsibility to perform the services
in accordance with this Contract. Contractor shall be fully responsible for the performance, acts
and omissions of Contractor's employees, Contractor's subcontractors,and any other person who
performs or furnishes any services(collectively,the"Support").
Contractor shall at all times be an independent contractor and not an agent or representative of the
County with regard to performance of the services. Contractor shall not represent that it is, nor
hold itself out as, an agent or representative of the County. In no event shall Contractor be
authorized to enter into any agreement or undertaking for or on behalf of the County. Neither the
Contractor nor any employee of the Contractor is entitled to any benefits that the County provides
its employees. The Contractor is solely responsible for payment of any statutory workers
compensation or employer's liability insurance as required by state law. The Contractor will have
an active account with the Department of Revenue, other state agencies as needed, and a separate
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set of books or records that reflect all items of income and expenses of the business that the
Contractor is conducting.
Contractor shall perform the services in a timely manner and in accordance with the standards of
the profession. At the time of performance, Contractor shall be properly licensed, equipped,
organized, and financed to perform the services in accordance with this Contract. Subject to
compliance with the requirements of this Contract, Contractor shall perform the services in
accordance with its own methods.
23. Licenses
Contractor shall have a valid and current business license as required by the Yakima Municipal
Code covering this type of business and shall satisfy all applicable City Code provisions. Said
license shall be obtained prior to the award of any contract. Inquiries as to fees, etc., should be
made to the Office of Code Administration, telephone (509)575-6126 or email
codes et vak j a. aa� .
In addition, Contractors are required to be registered by the State per Chapter 18.27 of the Revised
Code of Washington and their registration number must be listed on the bid/RFP/quote.
Contractor shall take all reasonable precautions to protect against any bodily injury (including
death)or property damage that may occur in connection with the services.
24. Removal of Subcontractor
In the event Contractor deems it necessary or appropriate to hire a subcontractor to provide services
or do work under this Contract, that subcontractor shall be subject to each and every term and
condition of this Contract,including,but not limited to,the insurance and indemnification sections.
All subcontractors shall provide proof of insurance to the County prior to performing services or
doing work. Contractor shall enter a written contract with subcontractor for service or work being
subcontracted and shall incorporate by reference this Contract and attach it as an Exhibit thereto.
If dissatisfied with the background, performance, and/or general methodologies of any
subcontractor, the County may request in writing that the subcontractor be removed. The
Contractor shall comply with this request at once and shall not employ the subcontractor for any
further work/services under this Contract.
25. Taxes and Assessments
Contractor shall be solely responsible for and shall pay all taxes, deductions, and assessments,
including but not limited to federal income tax, FICA, social security tax, assessments for
unemployment and industrial injury insurance, and other deductions from income which may be
required by law or assessed against either party as a result of this Contract. In the event the County
is assessed a tax or assessment as a result of this Contract,Contractor shall pay the same before it
becomes due.
The County and its agencies are exempt from payment of all federal excise taxes,but not sales tax
(currently at 8.3%).Tax will not be considered in determining which proposal is the lowest or best,
however RCW 39.30.040 allows the County to take any sales tax and B&O tax that it will receive
from purchasing supplies, materials and equipment within its boundaries into consideration when
determining the lowest responsible Proposer.
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26. Contractor Tax Delinquency
Contractors who have a delinquent Washington tax liability may have their payments offset by the
State of Washington.
27. Inspection: Examination of Records
The Contractor agrees to furnish the County with reasonable periodic reports and documents as it
may request and in such form as the County requires pertaining to the work or services undertaken
pursuant to this Agreement. The costs and obligations incurred or to be incurred in connection
therewith,and any other matter are to be covered by this Agreement.
The records relating to the services shall, at all times, be subject to inspection by and with the
approval of the County, but the making of(or failure or delay in making) such inspection or
approval shall not relieve Contractor of responsibility for performance of the services in
accordance with this Contract, notwithstanding the County's knowledge of defective or non-
complying performance,its substantiality or the ease of its discovery. Contractor shall provide the
County sufficient, safe, and proper facilities and equipment for such inspection and free access to
such facilities.
28. Recordkeeping and Record Retention
The Contractor shall establish and maintain adequate records of all expenditures incurred under
the contract. All records must be kept in accordance with generally accepted accounting
procedures.All procedures must be in accordance with federal, state and local ordinances.
The County shall have the right to audit, review, examine, copy, and transcribe any pertinent
records or documents relating to any contract resulting from this proposal held by the Contractor.
The Contractor will retain all documents applicable to the contract for a period of not less than
three(3)years after final payment is made.
29. Confidential, Proprietary and Personally Identifiable Information
Contractor shall not use Confidential, Proprietary or Personally Identifiable Information of
County, or any of its' employees or elected officials, for any purpose other than the limited
purposes set forth in this Contract, and all related and necessary actions taken in fulfillment of the
obligations there under. Contractor shall hold all Confidential Information in confidence,and shall
not disclose such Confidential Information to any persons other than those directors, officers,
employees, and agents ("Representatives") who have a business-related need to have access to
such Confidential Information in furtherance of the limited purposes of this Contract and who have
been apprised of,and agree to maintain, the confidential nature of such information in accordance
with the terms of this Contract.
Contractor shall institute and maintain such security procedures as are commercially reasonable to
maintain the confidentiality of the Confidential Information while in its possession or control
including transportation, whether physically or electronically.
Contractor shall ensure that all indications of confidentiality contained on or included in any item
of Confidential Information shall be reproduced by Contractor on any reproduction,modification,
or translation of such Confidential Information. If requested by the County in writing, Contractor
shall make a reasonable effort to add a proprietary notice or indication of confidentiality to any
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tangible materials within its possession that contain Confidential Information of the County, as
directed.
Contractor shall maintain all Confidential Information as confidential for a period of three(3)years
from the date of termination of this Contract and shall return or destroy said Confidential
Information as directed by the County in writing.
Contractor may disclose Confidential Information in connection with a judicial or administrative
proceeding to the extent such disclosure is required under law or a court order, provided that the
County shall be given prompt written notice of such proceeding if giving such notice is legally
permissible.
30. Rates and Rate Increases
The County finds that regulating ambulance service rates is necessary to ensure availability,
sustainability,and adequacy of ambulance services in the County. The initial rates are set forth in
Exhibit B and arc hereby established by the County exercising sound legislative judgment and
shall be the only allowable ambulance service fees to be charged and collected in the County for
both private and public ambulances. Contractor shall comply with the rate requirements set forth
by the County. Further, Contractor shall not discount its rates or collect a rate less than the rates
set forth in herein (except where required by law, e.g., Medicare or Medicaid, or where a patient
meets Contractor's compassionate care policy or County well program).
a. Regular and Ordinary Rate Increase
If provided by the Contractor in writing thirty(30) days before the anniversary date of each
year of the Contract, the County may increase the Contractor's rates per the Seattle-Tacoma-
Bremerton Consumer Price Index for the previous twelve months with a maximum increase of
5 percent.The adjustment will be determined by the average of the percentage changes of the
following consumer price indexes(CPI):
• the US Medical Care Services index,and
• the All Items—Seattle-Tacoma-Bremerton
• Modified to adiust for Contractor's ability to collect increased rates from fixed government
payors.
The County may also refer to the CMS.gov Ambulance Fee Schedule Public Use Files for
Geographic Area 02402 WA"Rest of Washington"to confirm the price increase request is
fair and reasonable. The County shall not unreasonably withhold,condition, or delay the rate
increase request or any part thereof within thirty(30)days of receipt of the request.
The consumer price indexes to be used are those compiled and reported by the U.S.Department
of Labor, Bureau of Labor Statistics for the most recent 12-month period, not seasonally
adjusted.
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EXAMPLE:WEIGHTED CPI CALCULATION
2.9% US Medical Care Services
2.3% All Items-Seattle-Tacoma-Bremerton
5.2% SUM
2.6% AVE
- -
EXAMPLE:CPI ADJUSTED FOR GOVERNMENT PAYORS
Percent of CPI
Contractor Allowed Source Weighted Net
Payor Mix inflator Collections
(Mowed Inflator+
Weighted CPI Increase)
Medicare 54.3% 0.8% CMS AIF 30.8% 16.7%
Medicaid 12.3% 0.0% 0.0% 0.0%
Insurance& 33.4% 2.6% Weighted 100.0% 33.4%
Self Pay CPI Increase
Potential collection of user fee increase(sum of Weighted Net Collections): 50.1%
Weighted CPI Increase 2.6%
Adjusted Allowable Annual Rate Increase(Weighted CPI Increase 4-Sum of 5 2%
Weighted Net Collections):
b. Market Conditions and Inflationary Pressures
The County understands that price increases above five percent may at times be necessary
depending on market conditions and inflationary pressures. Requests above 5 percent will be
considered on a case-by-case basis; however, such requests should not exceed 8.5 percent.
Price increase requests will not be considered or granted until a written request with justifying
documentation has been submitted to the County. If approved, the increase shall take effect
thirty (30) days after approval. Given the importance of the emergency services provided by
the Contractor, approval of rate increases shall not be unreasonably withheld. Please see the
next section for language regarding negotiating special rate increases different from the regular
and ordinary rate increases described above.
The annual rate adjustment will be applied to the approved rates and mileage, and rates will
be adjusted accordingly. The effective period shall be the anniversary of each Contract year.
c. Special Rate Increase
The Contractor may request in writing a special rate increase to the rates other than the
Regular and Ordinary Increase based on the following. The request shall be submitted to the
County in writing at least sixty(60)days before scheduled implementation.
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i. Changes in Technology. Authorization for new or revised rates may be based on
technology changes required by the County.
ii. Changes in Collections Due to Fixed Rate Payers/Non-Payers. The Contractor may
request a Special Rate Increase to compensate for the effect that fixed rate payers(e.g.,
Medicare,Medicaid)and non-payers have on its collections.
iii. Significant Circumstances Beyond Contractor's Reasonable Control. The Contractor
may request a Special Rate Increase for significant circumstances beyond Contractor's
reasonable control.
iv. In the event the County rejects Contractor's request for Special Rate Increase, either
party may terminate this Contract with one hundred and eighty(180)days prior written
notice to the other party. Alternatively, the parties may negotiate other administrative
or operational changes to the Contract.
31. Suspension of Work
The County may suspend with sixty (60) days notice, in writing by certified mail or by hand
delivery,all or a portion of the services under this Agreement if unforeseen circumstances beyond
the County's control are interfering with normal progress of the services.
32. Provision of Services
The Contractor shall provide the services set forth herein with all due skill,care, and diligence, in
accordance with accepted industry practices, standards and legal requirements, and to the County
's satisfaction;the County's decision in that regard shall be final and conclusive.The County may
inspect,observe and examine the performance of the services performed on the County premises
at any time. The County may inspect, observe and examine the performance of Contractor's
services at reasonable times, without notice, at any other premises.
a. If the County notifies the Contractor that any part of the services rendered are inadequate or in
any way differ from the Contract requirements for any reason, other than as a result of the
County's default or negligence, the Contractor shall, at its own expense, reschedule and
perform the services correctly within such reasonable time as the County specifies. This
remedy shall be in addition to any other remedies available to the County by law or in equity.
b. The Contractor shall be solely responsible for controlling the manner and means by which it
and its Contracted Personnel or its subcontractors perform the services, and the Contractor
shall observe, abide by, and perform all of its obligations in accordance with all legal
requirements and County work rules.
33.Notice of Change in Financial Condition
If, during the Contract Term, the Contractor experiences a change in its financial condition that
may materially affect its ability to perform under the Contract,or experiences a direct change of
ownership or control, the Contractor shall immediately notify the County in writing. Failure to
notify the County of such a material change in financial condition or direct change of ownership
or control shall be sufficient grounds for Contract termination by the County as set forth herein. In
addition to being sufficient grounds for termination of the contract, a change in the financial
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condition of the Contractor may also impact the exclusive nature of this Contract with the County
exploring other options for service.
34.No Conflict of Interest
Contractor represents that it or its employees do not have any interest and shall not hereafter
acquire any interest, direct or indirect, which would conflict in any manner or degree with the
performance of this Contract. Contractor further covenants that it will not hire anyone or any entity
having such a conflict of interest during the performance of this Contract.
35. Contract Preservation
If any provision of the Contract,or the application of such provision,shall be rendered or declared
invalid by a court of competent jurisdiction,or by reason of it requiring any steps,actions or results..
the remaining parts or portions of this Contract shall remain in full force and effect.
36. Promotional Advertising/News Releases
Reference to or use of the County,any of its departments,agencies or other subunits,or any official
or employee for commercial promotion is prohibited.News releases pertaining to this procurement
shall not be made without prior approval of the County.Release of broadcast e-mails pertaining to
this procurement shall not be made without prior written authorization of the contracting agency.
37.Access and Review of Contractor's Facilities
In accordance with applicable laws including HIPAA, the County may visit and view any of the
offices,premises, facilities and vehicles of the Contractor and/or Contractor's Subcontractor upon
request and reasonable notice during the term of the Contract and Contract renewals/extensions.
38.County Facility Security
The County may prohibit entry to any secure facility, or remove from the facility, a Contract
employee who does not perform his/her duties in a professional manner,or who violates the secure
facility's security rules and procedures. The County reserves the right to search any person,
property,or article entering its facilities.
39. Waiver of Breach
A waiver by either party hereto of a breach of the other party hereto of any covenant or condition
of this Contract shall not impair the right of the party not in default to avail itself of any subsequent
breach thereof. Leniency, delay or failure of either party to insist upon strict performance of any
agreement, covenant or condition of this Contract,or to exercise any right herein given in any one
or more instances, shall not be construed as a waiver or relinquishment of any such agreement,
covenant, condition or right.
40. Integration
This Contract represents the entire understanding of the County and Contractor as to those matters
contained herein.No prior oral or written understanding shall be of any force or effect with respect
to those matters covered herein. This Contract may not be modified or altered except in writing
signed by both parties.
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41.Governing Law
This Contract shall be governed by and construed in accordance with the laws of the State of
Washington.
42.Venue
The venue for any judicial action to enforce or interpret this Contract shall lie in a court of
competent jurisdiction in Yakima County, Washington.
43.Authority
The person executing this Contract,on behalf of Contractor,represents and warrants that they have
been fully authorized by Contractor to execute this Contract on its behalf and to legally bind
Contractor to all the terms,performances and provisions of this Contract.
44.Change or Notice
Any alterations, including changes to the nature of the service, made to the Contract shall be
rendered in writing and signed by both responsible parties; no changes without such signed
documentation shall be valid.No alterations outside of the general scope and intent of the original
Request for Proposals or in excess of allowable and accepted price changes shall be made.
In no event shall the Contractor be paid or be entitled to payment for services that are not
authorized herein or any properly executed amendment.
Notice of Business Changes:Contractor shall notify the County in writing within three(3)business
days of any change in ownership of the facilities of the Contractor or of the facilities of any
subcontractor. The Contractor shall notify the County in writing as soon as possible, and in no
event later than three (3) business days, after any decision by the Contractor to change or
discontinue service that will affect services provided to the County under this Contract.
The County shall have the right to renegotiate the terms and conditions of this Contract to the
extent required to accommodate a change in governing law or policy that, in the sole discretion of
the County, either substantially and unreasonably enlarges the Contractor's duties hereunder, or
renders performance, enforcement or compliance with the totality of the Contract impossible,
patently unreasonable, or unnecessary.
Notices and demands under and related to this Contract shall be in writing and sent to the parties
at their addresses as follows:
TO COUNTY:
Corporate Counsel/Prosecutor's Office
Yakima County Courthouse
128 North Second Street
Room 211
Yakima, WA 98901.
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COPY TO:
Tony Miller,EMS Director
2403 S 18th St Ste 200,
Union Gap,WA 98903
TO CONTRACTOR:
Paul Priest,American Medical Response Regional Director
229 South Second Avenue
Yakima,WA 98902
COPY TO:
American Medical Response Law Department
4400 State Hwy 121
Lewisville,TX 7505
45.Survival
The foregoing sections of this Contract shall survive the expiration or termination of this Contract
in accordance with their terms.
[Signature Page Follows]
Agreement C12206P 9-1-1 Ambulance Transport Services—Yakima County EMS Page 22 of 23
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IN WITNESS WHEREOF, the parties hereto execute this Contract as of the day and year first
above written.
BOARD OF COUNTY COMMISSIONERS
,..la leCo&e,..e,
Amanda McKinney, Chair
Kyle Curtis, Commissioner
LVotn, utA.k
BOCC Agreement LaDon Linde, Commissioner ,,
21 3 - 2024 10,•Z
DATED: MAY 16 2024 t .-•
County, WA Attest: w ems~
Julie Lawrence, Clerk of the Board or
Erin Franklin, Deputy Clerk of the Board
Approved as to Form:
Jtebuw, _
Deputy Prosecuting Attorney
AMERICAN MEDCIAL RESPONSE AMBULANCE SERVICE,INC.
DATED this day of 2024.
5❑nc s v.5by: 5/23/2024
t,abt, KASSt11,
FrFESC S IF@$59P
SEAN RUSSELL,REGION PRESIDENT
Agreement C12206P 9-1-1 Ambulance Transport Services—Yakima County EMS
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EXHIBIT A
RFP Specifications Incorporated
A. Vehicles and Staffing
Vehicles will be a seventeen(1 7)Type 3 ambulances with 75%of fleet having a maximum mileage
of 200,000 on vehicle (maximum vehicle mileage will be less than 250,000 for any vehicle).
Contractor will retain fleet resources at 110%of peak deployment. All replacement vehicles must
be new.
In addition to standard ambulances contractor will be required to have in service one (1)Type 1
4X4 ambulance. 1 Bariatric ambulance, and 1 4X4 UTV capable of transporting a single patient.
In unusual circumstances,e.g., unusually high call volumes or disaster situations,older units may
also be utilized.
Contractor will begin service with a minimum of nine(9)Type 3 Ambulances meeting the mileage
requirements shown above, seven (7) Type 3 Ambulances from current fleet, 1 Bariatric
Ambulance from current fleet.and 1 dedicated 4X4 UTV capable of transporting a single patient.
Units from current fleet will be replaced no later than October 2024.
Each ambulance will be equipped with Drive Cam devices, Stryker Power Load Systems,Lucas 3
Chest Compression Devices,PowerPRO Stretchers equipped with XPS,Stair Pro 6252 stair chairs,
McGrath Video Scopes,LifePak 15 cardiac monitors,and Saphire IV Pumps on ALS ambulances.
Contractor will begin service with all ambulances equipped with Drive Cam devices, PowerPRO
Stretchers equipped with XPS, Stair Pro 6252 stair chairs, LifePak 15 cardiac monitors, and
Saphire IV Pumps on ALS ambulances. All ambulances, with the exception of the bariatric unit,
will be equipped with Stryker Power Load Systems and Lucas 3 Chest Compression Devices no
later than October 2024.
Contractor shall endeavor to maintain clinical workforce consisting of fifty-one percent (51%)
full-time employees. Contractor shall endeavor to maintain six (6) stations for deployment of
ambulances.
B. Nurse Navigation
Contractor will implement a nurse navigation program to provide low acuity patients with
alternatives to the emergency department(e.g., nurse advice, urgent care or primary care visits)
and assure adequate follow-up.EMS stakeholders and medical directors will have full involvement
in program design and the authority to approve the EMD-based procedures and protocols
associated with the program. Contractor will begin implementation process following Yakima
Counties MPDS System switch and green light from Suncomm to proceed.
C. CAAS Accreditation
Contractor aims to achieve CAAS accreditation in Yakima County by the cnd of the second
Contract year.
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D. Clinical Equipment Upgrades
Contractor will contribute $12,000 annually, which can be rolled over each year up to the five-
year term.As such, Contractor commits to a cumulative maximum of$60,000 over the life of the
Contract to be used at any point over the term of the Contract that can be invested into non-
mandatory clinical upgrades for Contractor.
E. Community Education
Contractor will be expected to be active and participate in community events as well as assisting
with community educational programs and special events at no additional cost to the County or its
member entities. Contractor shall have a .5 FTE dedicated for community education and standby
events.
F. Patient Satisfaction Surveys
Contractor shall complete patient satisfaction/patient experience survey from time to time in a
mutually agreed upon format with the County. The survey will be included with all invoices to
patients.
G. Cares Data Submission and AHA
Contractor shall participate in the CARES system collection for cardiac arrests. Contractor shall
endeavor to have the system recognized by the American Heart Association Mission("AHA")
Lifeline Systems of Care for Cardiac Emergencies.
H. Agency Restock program
In accordance with applicable laws, Contractor will resupply first responders with replacement
disposable supplies and equipment used on-scene in a one-for-one exchange program.If a patient's
condition precludes an immediate restock, a Contractor supervisor will be deployed to restock a
one-for-one exchange at the scene with the first responding fire crew. Contractor will coordinate
an electronic process with our partner agencies to ensure timely restocking needs are met.
I. Purchasing Power
In accordance with applicable laws and as may be permitted by Contractor's vendors and supplies,
Contractor will allow County and area first responders to access Contractor's purchasing programs
at their own costs.
J. FD Personnel Return
Contractor believes it is a priority to return any County fire and first responder that accompany our
ambulance crew to local hospitals. Contractor will return fire and first responder personnel to their
assigned duty station through Contractor resources, or a ride-share paid for by Contractor.
K. Supervisors Off Car
Contractor will endeavor to schedule a stand-alone supervisor unit per shift.
L Communication Staff Training
Contractor communication personnel will be trained according to EMD National Standard
Curriculum, be certified in EMD and receive appropriate orientation to Contractor's deployment
methods. Contractor training will include the use of pre-arrival protocols and the Proposer's
computer aided dispatch system. Contractor will endeavor to provide bilingual communication
capabilities during each shift. If desired and without any out-of-pocket expense, Contractor shall
assist the County's communication center personnel with application for EMD certification.
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M. Uniforms Approval
Contractor uniforms will be approved by the County. County's approval shall not be
unreasonably withheld,conditioned or delayed.
N. Participate in EMS Exercises and Joint Trainings
Contractor will participate in any tabletop exercises, functional and full-scale emergency and
disaster exercises that take place to enhance the preparedness and responses within the
community.Contractor shall participate in joint trainings with EMS system stakeholders and first
responders that improve patient care and the EMS system. Contractor shall host a one-time
presentation by Dr. Kishel (or similar presenter)to educate community first responders regarding
critical incident stress management.
O. Participation in the County EMS meetings and Continuous Quality Improvement
e"L(2I„)
Contractor will participate in EMS meetings and CQI.
P. ICS training
Contractor shall train its personnel in National Incident Management System ("NIMS") and
management personnel in NIMS and the Incident Command System ("ICS"), consistent with
federal, state and local doctrine. Our training classes are open to EMS system stakeholders and
first responders when offered to our personnel. All Contractor field supervisors shall have ICS
100, 200,300,400. 700, and 800 certifications and trainings.
Q. Pulsepoint
If desired by the County, Contractor shall implement Pulsepoint at a cost not to exceed twenty
thousand five hundred dollars($20.500) for start-up and the first year of service.
R. Earn While You Learn
Contractor shall continue with its current earn while you learn program as needed to attract and
retain emergency medical technicians. This program may change from time to time in order to
address the hiring needs of Contractor.
S. Technology.
Contractor may implement First Watch and FirstPass to monitor,evaluate and analyze Contractor
response time performance. Contractor will establish a data lockbox to provide security,
continuity,and accountability of CAD response data through our operations planning and analytics
platform system.
T. Incumbent Workforce
In accordance with. Contractor hiring policies and practices, Contractor shall give preference to
hiring current incumbent clinical personnel that meet Contractor customary hiring standards.
Incumbent clinical personnel experience and tenure working in the County will be recognized.At
its expense, Contractor shall enable clinical personnel to receive immediate health and welfare
benefits or alternatively reimburse hired clinical personnel for thirty(30)days of COBRA benefits
until Contractor's benefits platforms become available.
U. Mutual Aid
The Contractor shall consult with the County on mutual aid agreements and Contractor shall enter
mutual aid agreements with other providers as needed.
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EXHIBIT B
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EXHIBIT B
Rates*
January 1, 2024
Service — — — — s——
Rates
Basic Life Support—Non- $1,597.94
Emergency
Basic Life Support—Emergency $1,641.40
Basic Life Support Mileage $39.09 per mile with patient on-
board
$1,727.60
Advanced Life Support—Non-
Emergency
Advanced Life Support— $2,271.85
Emergency
Advanced Life Support Mileage --
$47.17 per mile with patient on-
board
Oxygen f $200.86 — —
L Standby Rate $150.00 per hour
*These are the only services that may be charged and is inclusive of supplies,disposals and
medications.
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Exhibit C
PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS:
That we,the undersigned, as Principal, and _
a corporation organized and existing under the laws of the State of
as a surety
corporation,and qualified under the laws of the State of Washington to become surety upon bonds
of Contractors with municipal corporations, as surety, are jointly and severally held and firmly
bound to YAKIMA COUNTY in the penal sum of $ for the payment of
which sum on demand we bind ourselves and our successors, heirs, administrators or personal
representatives, as the ease may be.
This obligation is entered into in pursuance of the statutes of the State of Washington, the
Ordinances of YAKIMA COUNTY.
DATED at Yakima, Washington,this day of . 20
Nevertheless, the conditions of the above obligations are such that:
WHEREAS,pursuant to action taken by Yakima County on . 20
YAKIMA COUNTY has let or is about to let to the said
above bounden Principal,a certain contract, the said contract being numbered the
and providing for ---
(which contract is referred to herein and is made a part hereof as though attached hereto),
and,
WHEREAS, the said Principal has accepted, or is about to accept, the said contract, and
undertake to perform the work therein provided for in the manner and within the time set forth;
NOW, THEREFORE, if the said shall
faithfully perform all of the provisions of said contract in the manner and within the time therein
set forth, or with such extensions of time as may be granted under said contract,and shall pay all
laborers, mechanics, sub-Contractors and material men, and all persons who shall supply said
principal of sub-Contractors with provisions and supplies for the carrying on of said work, and
shall hold said YAKIMA COUNTY harmless from any loss or damage occasioned to any person
or shall supply said principal or sub-Contractors with provisions and supplies for the carrying on
of said work,and shall hold said YAKIMA COUNTY,its officers,employees and agents,harmless
from any loss or damage occasioned to any person or property by reason of any carelessness or
negligence on the part of said principal, or any sub-Contractor in the performance of said work,
and shall indemnify and hold YAKIMA COUNTY, its officers, employees and agents, harmless
from any damage or expense by reason of failure of performance as specified in said contract or
from defects appearing or developing in the material or workmanship provided or performed under
said contract within a period of one year after its acceptance thereof by YAKIMA COUNTY,then
and in that event this obligation shall be void;but otherwise it shall be and remain in full force and
effect.
Approved:
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COUNTY OPERATING PROCEDURE(110,1)MASS CASUALTY INCIDENT
Effective Date:03/2023
1. PURPOSE:
A. Implement local policies and procedures for mass casualty incidents in accordance with South
Central Region EMS&Trauma Care Council,Patient Care Procedure#10.1,MCI.
B. Ensure that patients involved in a mass casualty incident are transported to the most
appropriate hospital facility in a timely manner and with swift efficiency and effective
communication.
2. SCOPE:
The following material represents a broad guideline for the common practice of our EMS providers
when dealing with a mass casualty event.
3. GENERAL PROCEDURES:
A. Dispatch
I. Upon receipt of a potential mass casualty incident(MCI)call,the applicable fire dispatch
center should advise responding fire district/department units of which designated facility
will be Medical Control for the incident(in Yakima County it is MultiCare Yakima Memorial
Hospital;Out of County then advise)and at this time, it is recommended that the dispatch
center notify Medical Control of the"potential"situation.
B. First Responder/EMS
I. The first EMS provider(or agency),certified in ICS,determines that an MCI exists should
immediately establish incident command, per local agency procedures utilizing National
Incident Management System(NIMS)guidelines.
a. This should be done immediately upon the determination that the number of patients
may overload local EMS and/or hospital resources.
b. The following levels will be relayed from the first EMS provider on-scene to the
applicable fire dispatch center:
- MCI Level I: 5-10 patients are critically injured in a single incident.Initial response
may include:
i. UPPER VALLEY:Confirm with Incident Command for an EMS Level 2 transport
ii. LOWER VALLEY: Request additional resources.
iii. Four additional ambulances.
iv. One helicopter to the scene or airport
Yakima County Operating Procedure Updated 03/2023
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- MCI Level II: 11-20 patients are involved in a single incident. Initial response may
include:
i. UPPER VALLEY: Confirm with Incident Command for an EMS Level 2&3
transport.
ii. LOWER VALLEY: Request for additional resources,notify Yakima Valley Office of
Emergency Management.
iii. All available transport resources.
a) Notification from ambulance supervisors to Incident Command of available
call-back crews is recommended.
iv. Two helicopters to the scene or airport.
v. Public transit.
vi. For areas on the outer edges of the county consider requesting
nearoy/neighboring county resources.
- MCI Level III: Greater than 20 patients all involved in a single incident. Initial
response may include:
i. UPPER VALLEY: Confirm with Incident Command for an EMS Level 4 Transport.
ii. LOWER VALLEY: Request for additional resources, notify Yakima Valley office of
Emergency Management.
iii. All available transport resources.
a) Notification from ambulance supervisors to Incident Command of available
call-back crews is recommended.
iv. For assistance with the incident for back-filling coverage of daily 911 calls,
consider requests for assistance from neighboring agencies
v. Two helicopters to the scene or airport.
vi. Notification given to all available helicopter agencies of the situation with
notification to Incident Commander on number of available helicopters.
vii. Public Transit
C. Radio or'verbal responses'to receiving hospitals from transporting units are not necessary,
unless the attendant feels it is in the best interest of the patient(s)that contact be made.
I. If the transporting EMS agency determines contact with the receiving facility is necessary,
they will provide them with following information:
a. Identification of EMS agency
b. Patients'identification numbers(located on START triage tag)
c. Patients'START category(Green,Yellow, Red,or Black)
D. Simple Triage and Rapid Transport(START)criteria will be utilized at Mass Casualty Incidents.
E. If contact with Medical Control is impossible due to the incident location or other
complications,EMS agencies may transmit patient information to the applicable fire dispatch
center,who shall notify the Medical Control center.
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F. Patients involved in a confirmed MCI may not make a transport destination request or
determine the destination of any ground or air transport vehicle.
G. Radio contact with Medical Control should be preceded with the phrase: "This is an MCI
transmission."
H. Transport Officer(typically a Fire Department/District representative)
I. The Transport Officer is responsible for providing Medical Control with all necessary patient
information.This may include:
I. Updates on the total number of patients known,as available.
II. Updates on the total number of patients per color category,as available.
III• Updates on the total number of patients ready for transport.
IV. The transporting unit agency name and number.
V. The number of patients on board.
VI. The number of each color category on board.
J. Medical Control
The designated Medical Control Facility for Yakima County is MufiiCare Yakima Memorial Hospital and in
the event of a mass casualty incident and/or disaster,the Medical Control Facility will:
I. Ascertain the staffing and availability of other resources from local hospitals in Yakima
County,
II. Determine patient transport destination.
W. Communicate patient transport destinations with prehospital providers(on scene Transport
Officer or their delegate) in accordance with the Yakima County Operating Procedure for
MCIs. "Medical Control should determine the transport destination far each ground-
transporting agency. Destination assignments should be relayed from Medical Control to
the Transport Officer and then to the transporting unit. It should not be via direct contact
between the transporting unit and Medical Control as is done on a single patient incident."
IV. Medical Control Facility will notify each receiving facility of the incoming unit,its patient
load,and each of the patient's"START"triage color classification (Green,Yellow,Red,or
Black).
V. In the event the Medical Control Facility determines a shortage of hospital resources within
the county exists,the Medical Control Facility should begin contacting out-of-county
hospitals. It is recommended that any large ground transport vehicle(i.e.,public transit),
carrying no red patients,be considered for an out-of-county transport destination.In
addition, all air transport agencies should consider both in and out-of-county transport
destinations.
Yakima County Operating Procedure Updated 03/2023
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