East Dubuque Ambulance Assist - Medical Aid AgreementCopyright 2014
City of Dubuque ITEM# 12.
ITEM TITLE: East Dubuque Ambulance Assist - Medical Aid Agreement
SUMMARY: City Manager recommending approval of an agreement for Paramedic
Services with the City of East Dubuque, Illinois.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve
ATTACHMENTS:
Description Type
❑ Medical Aid Agreement with East Dubuque for Ambulance Assist -MVM
Memo City Manager Memo
❑ Staff Memo Staff Merro
❑ Agreement Staff Memo
Masterpiece on the Mississippi
Dubuque
2007 • 2012 • 2013
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Medical Aid Agreement with East Dubuque for Ambulance Assist
DATE: October 1, 2014
The East Dubuque Fire Department has taken over the ambulance service for their
community. They will be certified at the Basic EMT level and have requested to enter a
Medical Aid Agreement with the Dubuque Fire Department for paramedic intercept for
advanced calls. It is important to point out this is not a regular Mutual Aid Agreement;
just a medical agreement to assist East Dubuque.
Previously Paramount Ambulance Service has provided service to East Dubuque. The
East Dubuque City Council has voted to terminate that agreement and have the East
Dubuque Fire Department provide the service.
The East Dubuque Fire Department has approached the City of Dubuque to have an
agreement to provide a "Paramedic Intercept" for those calls that are in need of that
level of service. During an intercept one medic unit would respond or meet their medic
unit and provide advance care during transport to a local Dubuque medical facility.
Dubuque Fire Department provides this service to other agencies in the area as part of
Mutual Aid Agreements. The charge for an intercept is $400 per call; this fee would be
charged to the East Dubuque Fire Department, not the patient. The intercepts would
only be for calls that put them out far enough that immediate transport will benefit the
patient. For calls in the closer area Dubuque Fire Department would transport the
patient in a Dubuque medic unit and charge for the full amount to the patient. These
patients would be billed through Dubuque's service and if after 90 days payment is not
received, East Dubuque will guarantee payment. If the payment is then received some
time later it would be refunded to East Dubuque. East Dubuque has 170-175 medical
calls per year with 50-60 requiring advance level care. It is the intent of the East
Dubuque Fire Department to advance their service to the Paramedic level in the future.
This will in turn help to strengthen the EMS system in the Dubuque area. The
agreement will have a sunset of two years with a one year review. It is the intent of the
agreement to have East Dubuque Fire Department to advance to a paramedic level
service and at that time then a regular Mutual Aid Agreement will be used.
I have spoken at length with Dan Brown prior to his retirement as Fire Chief, as this
process began at that time, and Fire Chief Rick Steines and they are confident this will
not negatively impact service to Dubuque residents. In fact, over time, they believe it
will enhance system capabilities to respond to major incidents.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Mic ael C. Van Milligen
MCVM:jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
Rick Steines, Fire Chief
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Masterpiece on the Mississippi
TO: Michael C. Van Milligen, City Manager
FROM: Rick Steines, Fire Chief
SUBJECT: Medical Aid Agreement with East Dubuque for Ambulance Assist
DATE: September 22, 2014
Dubuque
2007 • 2012 • 2013
INTRODUCTION
The East Dubuque Fire Department has taken over the ambulance service for their
community. They will be certified at the Basic EMT level and have requested to enter a
Medical Aid Agreement with the Dubuque Fire Department for paramedic intercept for
advanced calls. It is important to point out this is not a regular Mutual Aid Agreement;
just a medical agreement to assist East Dubuque.
BACKGROUND
Previously Paramount Ambulance Service has provided service to East Dubuque. The
East Dubuque City Council has voted to terminate that agreement and have the East
Dubuque Fire Department provide the service.
The East Dubuque Fire Department has approached us to have an agreement to
provide a "Paramedic Intercept" for these calls that are in need of that level of service.
During an intercept one medic unit would respond or meet their medic unit and provide
advance care during transport to a local Dubuque medical facility. We provide this
service to other agencies in the area as part of Mutual Aid Agreements. The charge for
an intercept is $400 per call; this fee would be charged to the East Dubuque Fire
Department, not the patient. The intercepts would only be for calls that put them out far
enough that immediate transport will benefit the patient. For calls in the closer area we
would transport the patient in our medic unit and charge for the full amount to the
patient. These patients would be billed through our service and if after 90 days payment
is not received, East Dubuque will guarantee payment. If the payment is then received
some time later it would be refunded to East Dubuque. East Dubuque has 170-175
medical calls per year with 50-60 requiring advance level care. It is the intent of the
East Dubuque Fire Department to advance their service to the Paramedic level in the
future. This will in turn help to strengthen the EMS system in the Dubuque area. The
agreement will have a sunset of two years with a one year review. It is the intent of the
agreement to have East Dubuque Fire Department to advance to a paramedic level
service and at that time then a regular Mutual Aid Agreement will be used.
ACTION REQUESTED
The Medical Aid Agreement has been signed and returned by the East Dubuque Mayor.
I respectfully request that this agreement be presented for Mayor and City Council
approval.
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Preparer: Barry A. Lindahl, Esq., Suite 330 Harbor View Place 300 Main Street Dubuque, IA 52001, (563) 583-
4113
AGREEMENT
FOR PARAMEDIC SERVICES
BETWEEN AND AMONG
THE CITY OF EAST DUBUQUE, ILLINOIS
AND
THE CITY OF DUBUQUE, IOWA
This Agreement, dated for reference purposes the .2 day of •tE ISett;-2014,
is made between and among the City of East Dubuque, Illinois (hereinafter "ED") and
the City of Dubuque, Iowa (hereinafter "Dubuque").
WHEREAS, the City of East Dubuque, Illinois and its Fire Department intend to
resume the provision of emergency medical transport service to the community of East
Dubuque, Illinois; and
WHEREAS, upon resumption of emergency medical services the East Dubuque
Fire Department will only have the capacity to provide emergency medical transport
service at the Basic Life Support (BLS) level; and
WHEREAS, emergency calls may require more than the BLS response which the
East Dubuque Fire Department will be capable of providing; and
WHEREAS, in such a situation the availability of an emergency medical transport
personnel and/or equipment capable of Advanced Life Support (ALS) from outside
sources might well avert disastrous results; and
WHEREAS, the City of Dubuque, Iowa has the staffing and equipment to provide
ALS.
THEREFORE, in consideration of the promises herein contained, the City of East
Dubuque, Illinois does engage the City of Dubuque, Iowa to furnish ALS to the East
Dubuque Fire Department as needed and available under the following terms and
conditions:
SECTION 1. DEFINITIONS.
Advanced Life Support (ALS): Emergency pre -hospital care that uses invasive medical
acts under the medical supervision and control of a licensed physician. ALS ambulance
personnel use these services: intravenous therapy, endotracheal airway, cardiac
monitor (ECG), cardiac defibrillator, drugs, relief of pneumothorax, or other advanced
procedures and services.
Basic Life Support (BLS): Emergency pre -hospital care that uses non-invasive medical
acts. The provision of basic life support may be under the medical supervision and
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control of a licensed medical physician. For ambulance services, BLS includes only
transportation and first aid for the ABC's of life support (airway, breathing, circulation)
without adjunctive equipment and/or invasive procedures.
Emergency Ambulance Services or Emergency Medical Services (EMS): Emergency
pre -hospital care including both ALS and BLS.
Private person: A person not an employee or volunteer of Dubuque or ED Fire
Departments.
Private property: Property not belonging to Dubuque or ED Fire Departments.
SECTION 2. SERVICE TO BE PROVIDED.
2.1 Dubuque agrees to furnish twenty-four (24) hour emergency ALS service to ED
when notified by telephone to the Dubuque 911 Dispatch Center or in any other manner
of the need for this service within ED. Dubuque will respond and attend, when
available, upon the emergency without delay in one of the following ways:
A. Full paramedic response including, but not limited to, the use of Dubuque
equipment and staffing for the provision of ALS paramedic level care during
transport in a Dubuque emergency response vehicle;
B. Paramedic intercept wherein Dubuque provides personnel and equipment
to assist ED emergency medical services in the provision of ALS and transport in
an ED emergency response vehicle;
2.2 Dubuque agrees to incur and pay for the following operating expenses from the
consideration paid by ED under this Agreement:
A. Replacement of medical supplies and equipment;
B. All insurances set forth in this Agreement; and
C. All liability, contractual liability, malpractice, and/or errors and omissions
insurance covering Dubuque.
SECTION 3. TERM.
The term of this Agreement shall be for two (2) years, commencing September 1, 2014
and expiring at 11:59 p.m. on August 31, 2016. The Agreement will be reviewed on its
one year anniversary to evaluate ED's progression toward ALS certification.
SECTION 4. CONSIDERATION.
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4.1 The consideration for the furnishing of the services as outlined in Section 2 shall
be as follows:
A. Full paramedic response with transport: The patient will be billed by
Dubuque, but if the patient does not pay the invoice within ninety (90) days the
service will be billed to ED which guarantees payment to Dubuque from ED
within thirty (30) days. Dubuque's billing service will continue collection efforts in
excess of ninety (90) days and if successful will reimburse ED.
B. Paramedic intercept: Four hundred dollars ($400.00), billed to ED Fire
Department.
4.2 Dubuque shall periodically submit to ED a report of its ambulance calls and
contemporaneous with the billing as set forth above.
SECTION 5. REQUESTING ASSISTANCE.
5.1 The authority to make a request for assistance or to respond to a request for
assistance under this Agreement shall reside in the ED fire chief or such chief's official
designee only.
5.2 ED may request assistance from Dubuque only when ED has concluded, based
upon actual circumstances, that such assistance is essential to protect life at a location
afforded EMS service by ED.
5.3 Upon request, Dubuque, upon determination by its chief that an emergency
situation exists, and subject to the chief's determination of availability of personnel and
equipment, shall dispatch appropriate personnel and equipment to aid ED.
A. ED shall include in its request for assistance the amount and type of
equipment and number of personnel required and shall specify the location
where the personnel and equipment are needed.
B. The final decision on the number and the amount and type of equipment
and the number of personnel to be sent shall be solely that of Dubuque's chief.
Dubuque shall not be liable for any acts associated herewith provided that the
final decision is made with reasonable diligence.
C. ED shall make no claim whatsoever against Dubuque for the refusal to
send the requested equipment or personnel where such refusal is based on the
judgment of the Dubuque chief that such personnel and equipment are needed to
protect Dubuque.
SECTION 6. SCENE COMMAND.
6.1 The responding personnel and equipment shall report to the ED command officer
who shall be in charge at the emergency scene unless the command officer specifically
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relinquishes such authority to another officer. The command officer shall have the
authority to issue reasonable orders and directives.
6.2 Dubuque personnel and equipment shall be released by ED when the services of
Dubuque are no longer required or when Dubuque's personnel and/or equipment are
needed in Dubuque. Dubuque may withdraw from the emergency scene upon giving
notice to the command officer at the emergency that Dubuque is needed in its home
jurisdiction.
SECTION 7. INDEPENDENT CONTRACTOR.
It is agreed by the parties that the relation of Dubuque to the work to be performed by it
under this Agreement shall be that of an independent contractor and shall not be
construed to establish an employer/employee relationship.
SECTION 8. INDEMNITY AND HOLD HARMLESS.
8.1 Dubuque agrees to indemnify and hold ED, its officers, agents, and employees
harmless for damages, claims, demands, suits, judgments, costs, and expenses arising
from Toss of or damage to private property, or death of or injury to a private person
imposed upon ED, its officers, agents, and/or employees arising from the negligence of
Dubuque whether caused by personnel or equipment in the performance of this
Agreement.
8.2 ED agrees to indemnify and hold Dubuque, its officers, agents, and employees
harmless for damages, claims, demands, suits, judgments, costs, and expenses arising
from Toss of or damage to private property, or death of or injury to a private person
imposed upon ED, its officers, agents, and/or employees arising from the negligence of
ED whether caused by personnel or equipment in the performance of this Agreement.
SECTION 9. INSURANCE.
Each Party agrees that during the term of this Agreement it shall, at its own expense,
purchase and maintain insurance as outlined in the City of Dubuque Insurance
Schedule C attached as Exhibit A. The insurance shall be issued by a company
properly licensed and authorized to do business in the state of Iowa.
SECTION 10. TERMINATION.
10.1 If either party fails or refuses to comply with all applicable laws or ordinances, or
otherwise is guilty of a substantial violation of any provision of this Agreement, either
party may, upon thirty (30) days' written notice, terminate this Agreement.
10.2 Either party may terminate this Agreement upon a minimum of ninety (90) days'
written notice.
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SECTION 11. ASSIGNMENT.
Neither party may assign, transfer, convey, sublet, or otherwise dispose of this
Agreement or of its right, title, or interest in this Agreement, or its power to execute this
Agreement, to any other person or corporation without the previous written consent of
the other party.
SECTION 12. NOTICES. Any notice required by this Agreement shall be sent to the
address of each Party as set forth below.
East Dubuque Fire Department
183 Sinsinawa Avenue
East Dubuque, IL 61025
Dubuque Fire Department
11 W. 9th Street
Dubuque, IA 52001
SECTION 13. WAIVER.
The failure by either party to insist on strict performance by the other party of any
provision of this Agreement shall not be a waiver of any subsequent breach or default of
any provision of this Agreement or constitute a cause or excuse for a repetition of such
or any other breach.
SECTION 14. MODIFICATION.
This Agreement constitutes the complete understanding of the parties. No modification
of any provisions thereof shall be valid unless stated in writing and signed by both
parties.
SECTION 15. OWNERSHIP OF RECORDS AND CONFIDENTIAL INFORMATION.
15.1 In addition to protected health information or individually identifiable health
information, as both defined in the Code of Federal Regulations (Protected Health
Information), during the course of performing this Agreement, each party may from time
to time receive confidential information about the other including but not limited to,
information about the party's customers, patients, practices, procedures, strategies,
organization, financial, and other related information. Neither party shall use or disclose
any such confidential information for any purpose other than the limited purpose of
performing its obligations under this Agreement, without the prior written permission of
the other party. AH documents and records prepared, maintained, handled, or otherwise
related to Dubuque's performance of service hereunder are and shall be the property of
Dubuque.
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15.2 If either party is served with a public records request, subpoena, or other legal
process concerning confidential information of the other party that party shall
immediately (not more than forty-eight (48) hours after receipt) notify the other party.
15.3 During the term of this Agreement and pursuant to any record retention law or
regulation the parties are subject to, each party shall make available upon written
request of the other, to the Secretary of the Department of Health and Human Services,
or to the Comptroller General of the United States, or of any duly authorized
representatives of any governmental agency, this Agreement and the books,
documents, and records of the party that are necessary to certify the nature and extent
of the costs of this Agreement and/or compliance with the law.
SECTION 16. SEVERABILITY.
If any term, covenant, or condition of this Agreement is held by a court of competent
jurisdiction to be invalid, or unenforceable, the rest of the Agreement will remain in full
force and effect and will in no way be affected, impaired, or invalidated, unless such
enforcement will frustrate the purpose of this Agreement.
SECTION 17. PARAGRAPH HEADINGS.
The titles to the paragraphs of this Agreement are solely for the convenience of the
parties and will not be used to explain, modify, simplify, or aid in the interpretation of the
provisions of this Agreement.
SECTION 18. ENTIRE AGREEMENT.
This Agreement constitutes the entire agreement between the parties, and any prior
understanding or representation of any kind preceding the date of this Agreement will
not be binding on either party except to the extent incorporated in this Agreement.
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East Dubuque Fire Department
183 Sinsinawa Avenue, East Dubuque, IL 61025
By: George Young
Date: 7` r1- //
Printed Name and Title: 4~t g6e— 1*.;(yrop !;(y 6 f'1 A Ycs
Attest:
2-- Date: - -
City of Dubuque
50 West 13th St i et, Dj bu • ue, I ' 52001
By:
Printed Name and Title:
Attest:
Roy
D.
Buol, Mayor
Date: October 6, 2014
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Date: October 6, 2014