ROUTINE (NON-EMERGENCY) GROUND AMBULANCE SERVICES

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1 California Department of Corrections and Rehabilitation (CDCR)/ (CPHCS) Scope of Work ROUTINE (NON-EMERGENCY) GROUND AMBULANCE SERVICES 1. INTRODUCTION/SERVICES A. Contractor shall provide on an as-needed basis, twenty-four (24) hours a day, seven (7) days a week, Routine (Non-Emergency) Ground Ambulance Services and all labor, supplies, licenses, permits, equipment, transportation, pre-hospital emergency care personnel and every other item of expense required to transport acutely ill or injured inmates under the jurisdiction of the California Department of Corrections and Rehabilitation (CDCR). Refer to Exhibit H, List of Participating Institutions for a list of CDCR institutions and addresses. Services shall be provided upon request and direction of the California Prison Health Care Services (CPHCS), Health Care Manager/Chief Medical Officer (HCM/CMO) of Clinical Services or designee. For the purposes of this Agreement, the designee shall be a civil service employee. CDCR and CPHCS retain professional and administrative responsibility for services rendered. B. All services performed outside the scope of this Agreement will be at the sole risk and expense of the Contractor. 2. LICENSE/PERMIT/CERTIFICATION REQUIREMENTS A. Contractor shall, throughout the term of the Agreement, be licensed, operated and equipped in accordance with all applicable federal, State, and local statutes, ordinances, policies, regulations, and procedures governing Ground Ambulance Services. Contractor shall maintain throughout the term of the Agreement the following documentation, which includes, but is not limited to: 1. Copy of valid county Department of Public Health Ambulance Operator permit; 2. Copy of valid California pre-hospital emergency care personnel certificates/licenses for each attendant providing service under this contract; a. EMT I, EMT II or EMT - P license/certificate, all services shall be provided in accordance with the Health and Safety Code 1797 et seq and to their respective county EMS Agency Policies and Procedures Manual (if applicable); b. Nurses and Respiratory Therapists (if applicable); or c. Any other medical classification used for medical transport 3. Copy of valid California Highway Patrol (CHP) Emergency Ambulance Nontransferable license (if applicable); 4. Written authorization by local Emergency Medical Service Agency (EMSA) permitting transports within their jurisdiction; and 5. Valid copies of ambulance California Department of Motor Vehicle driver s license for the appropriate class of vehicle to be driven and a certificate permitting the operation of an ambulance. Page 1 of 6

2 3. CONTRACTOR RESPONSIBILITIES A. Overview of Duties 1. Contractor shall provide Basic Life Support (BLS), Limited Advanced Life Support (LALS), Advance Life Support (ALS) - Level I, Critical Care Transport (CCT) or Specialty Care Transport (SCT), if required. All services shall be provided in accordance with the Health and Safety Code, Division 2.5, Emergency Medical Services (EMS), commencing with a. BLS services shall include emergency first aid and cardiopulmonary resuscitation (CPR) procedures to maintain life, without employing invasive techniques, and other procedures as defined in California Code of Regulations (CCR), Title 22, Division 9, Chapter 2, Article 2, Section , until the inmate reaches the facility or until LALS or ALS services are available. b. LALS services, if required, shall include the provision of basic life support and first aid, and LALS skills approved by the local EMS agency in accordance with CCR, Title 22, Division 9, Chapter 3, Article 2, Section , to include pre-hospital emergency medical care limited techniques and procedures that exceed BLS but are less than ALS and are specified pursuant to the EMS. c. ALS services, if required, shall include definitive pre-hospital emergency medical care including, but not limited to, CPR, cardiac monitoring, cardiac defibrillation, advanced airway management, intravenous therapy, administration of approved pre-hospital care drugs and other medicinal preparations, and other specified techniques and procedures administered by authorized personnel in accordance with CCR, Title 22, Division 9, Chapter 4, Article 2, Section d. CCT services, if required, shall include the provision of basic life support and first aid approved by the local EMSA, in accordance with CRR, Title 22, Chapter 3, Article 2, Section to include pre-hospital emergency medical care limited to techniques and procedures that exceed BLS. In addition, CCT services will be provided when medically necessary, for critically injured inmate/patient(s), by providing a level of inter-hospital service furnished beyond the scope of the paramedic, as approved by the local EMSA. CCT services are necessary when an inmate/patient s condition requires ongoing care that must be furnished by one or more health professionals in an appropriate specialty area, such as nursing, emergency medicine, respiratory care, cardiovascular care or a paramedic with additional training. e. SCT services, if required, shall include where medically necessary, in a critically injured or ill patient, a level of inter-facility service or hospital-to-hospital ground transportation provided beyond the scope of the Paramedic as defined in the National EMS Education and Practice Blueprint. This service shall be necessary when an inmate/patient s condition requires ongoing care that must be provided by one or more health professionals in an appropriate specialty area (nursing, Page 2 of 6

3 medicine, respiratory care, cardiovascular care or a paramedic with additional training). B. Requests for Services 1. Contractor shall have a designated dispatch center and shall be available on an asneeded basis twenty-four (24) hours a day, seven (7) days a week. 2. Contractor shall respond to all calls within the timeframes specified by the local EMS agency standards. The response time to the institution shall not exceed EMS timeframes for non-emergency 911 ambulance service. 3. Contractor shall respond using the most direct route except when weather and/or traffic conditions dictate otherwise. CDCR/CPHCS reserves the right to determine the route which shall be utilized when transporting inmate/patient(s) to and/or from an outside medical facility or hospital for treatment. 4. Contractor shall transport inmate/patient(s) to CDCR/CPHCS-contracted community hospitals, except in cases of life-threatening emergencies and community hospital emergency room diversions. If an emergency or diversion to a non-contracted community hospital occurs, the Contractor must verbally notify the HCM/CMO or designee within one hour of occurrence. Contractor must provide written justification for the diversion to the HCM/CMO or designee by fax within twenty-four (24) hours of the transport. At the time of award, CDCR/CPHCS will provide a list of all CDCR/CPHCS contracted hospitals. Failure to notify and provide written justification for the diversion to the HCM/CMO or designee may result in a denial for the diversion of payment of the transport. 5. Except in the event of an immediate life-threatening emergency, the Contractor in conjunction with the HCM/CMO or designee will negotiate the level of care to be provided in an effort to establish the least cost to the State while continuing to provide adequate care. 6. Contractor shall provide the minimum pre-hospital emergency care personnel per ambulance as required by the local EMS. CDCR/CPHCS reserves the right to determine the path of travel to the inmate/patient(s) inside the Institution perimeter. CDCR/CPHCS will make every effort to notify the Contractor in advance of any changes in the normal path of travel. 7. Contractor shall be in compliance with the State of California, California Highway Patrol standards for operation of vehicles and maintenance of emergency care equipment and supplies. 8. Contractor and Contractor s staff and/or Contractor s subcontractors or referred personnel shall comply with all laws, rules, regulations and procedures as required by CDCR in the transportation of inmates. Page 3 of 6

4 9. Contractor shall inform CPHCS immediately if Contractor is unable to respond in accordance with the local EMS agency timeframes to CPHCS request for ambulance services. CPHCS reserves the right to arrange for alternative ambulance services in the event that the Contractor is unable to respond within the local EMS timeframes or is unable to provide services in accordance with the agreed upon terms of the contract. If an alternative ambulance service is used, charges in excess of the Contractor s rates will be deducted from the Contractor s subsequent billings. 10. Contractor agrees that any transports provided which do not have a contracted rate of compensation shall be paid at 100% of the current Medicare Fee Schedule at the time of service regardless of pre-hospital emergency care personnel dispatched by the Contractor for any services provided which are not covered by contracted rates. If, however, during the transport an emergency or other situation occurs that results in the inmate/patient requiring a higher level of care, CPHCS will reimburse the Contractor for actual treatment rendered by the Contractor providing supporting documentation to the HCM/CMO or designee confirming that the inmate/patient s condition required a higher lever of care according to the regulations of the local EMS Agency. 11. Contractor agrees to submit the Paramedic Field Report to HCM/CMO or designee within 24 hours (including the hospital to which the inmate/patient was transferred). 12. The State reserves the right to award multiple agreements for back-up purposes. When services are needed, the primary contractor, defined as the lowest responsible bidder, will be contacted first. WHEN and ONLY IF, the primary contractor is unable to provide services, the secondary contractor, defined as the second lowest responsible bidder, will be contacted. This process will be repeated based on the number of agreements awarded and will take place each time the Institution contacts the Contractor to provide services. C. Failure to Perform Services 1. In order to determine if EMS standards and departmental/institution policies and procedures are adhered to and maintained, CPHCS will routinely evaluate the work performance of all personnel assigned to CDCR/CPHCS. Any personnel who fails to perform, does not meet the minimum qualifications, or who is physically or mentally incapable of performing the required duties of the position, shall not be permitted to perform service. The HCM/CMO or designee shall state in writing the reasons the personnel do not meet the qualifications, and CPHCS shall not be required to pay Contractor for any services performed. Contractor will be required to provide an immediate replacement. 2. Failure to provide service on three (3) or more occasions may result in termination of your Agreement or the institution not having to contact your company prior to going to the other Contractors for the duration of the agreement term. The HCM/CMO or designee has sole discretion in this selection. Page 4 of 6

5 D. Staff List/Personnel Résumés/Qualifications 1. All medical personnel provided by the Contractor shall be properly trained and must be licensed and certified for all services performed per the regulations specified and approved by the Emergency Medical Services Authority and as defined in CCR, Title 22, Division 9, Pre-hospital Emergency Medical Services, and in accordance with Health and Safety Code, Division 2.5, EMS, commencing with Upon request and prior to providing services, Contractor shall submit to CPHCS a listing of all personnel designated for assignment to CDCR/CPHCS. The list shall include the Emergency Medical Technician (EMT) and/or their Paramedic License number and expiration date. 4. CDCR/CPHCS RESPONSIBILITIES A. Overview of Duties 1. When requesting services, CDCR/CPHCS shall identify the name and address of the Institution, name of the person placing the call and the condition of the inmate/patient(s). 2. The HCM/CMO or designee shall pre-arrange all needed services to ensure continuity of care and minimize the disruption of CDCR/CPHCS workload. 3. Any Correctional Officer(s), required security escort(s), and/or escort vehicle(s) will be provided by CDCR and shall accompany the inmate/patient(s) during all transports. 4. The HCM/CMO or designee shall determine what medical facility or hospital the inmate/patient(s) will be transported to for medical services. The Contractor may be required to transport inmate/patient(s) to and/or from any of the following: APPROXIMATE MEDICAL FACILITY/HOSPITAL NAME MILES FROM THE INSTITUTION Doctors Hospital of Manteca 15 Doctors Hospital of Manteca to Doctors Medical Center Modesto 33 San Joaquin General Hospital 11 University of California Davis (UCD) Medical Center 75 Queen of the Valley Hospital CDCR/CPHCS reserves the right to add or delete medical facilities/hospitals during the term of this agreement when found to be in the best interest of the State. The mileage will be adjusted in accordance with the established rates. Page 5 of 6

6 6. Routine Non-emergency cases may be transported to another CDCR Institution. B. Department of Corrections and Rehabilitation Contact Information: Should questions or problems arise during the term of this Agreement, the Contractor should contact the following offices: 1. Billing/Payment Issues See Exhibit B 2. Scope of Work /Performance Issues See Exhibit H The Institution contract representative may be contacted Monday through Friday, from 8:00 a.m. to 4:00 p.m. The Institution s contract liaison or his/her designee shall pre-arrange all needed services to assure continuity of care and to minimize the disruption of CDCR s workload. 3. General Agreement Issues Medical Contracts P.O. Box 4038, Suite 3701 Sacramento, CA Phone Number: (916) Fax Number: (916) Page 6 of 6

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