HomeMy WebLinkAboutPSA - Memorial Hosp of South Bend - Ambulance Staffing Agreement1316 COUNTY -CITY BUILDING
227 W. JEFFER$ON BOULEVARD
SOUTH BEND. INIDIANA 46601-1830
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
February 14, 2017
Memorial Hospital of South Bend
615 North Michigan Street
South Bend, IN 46601
RE: Professional Services Agreement
To Whom It May Concern:
PHONE 574/235-9251
FAX 574/ 235-9171
The Board of Public Works, at its meeting held on February 14, 2017, approved the above
referenced five (5) year ambulance staffing agreement in the amount of $24,950 per month
paid to the South Bend Fire Department for 2017, with annual increases.
Enclosed please find a copy of the agreement for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
Linda M. Martin, Clerk
Enclosure
c: Todd Skwarcan, Fire Department
GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 2-7-2017 Department Fire
BPW Date 2-14-2017 Phone 9255
Name Todd Skwarcan
o Legal ® Attorney Name Michael Schmidt
o Controller review is required for all Contracts $5,000.00 or more
o o Controller ❑ and greater than one year in length per the City Purchasing
o m Policy
co Purchasing ❑
Check the Appropriate Item Tvoe — Reauired for All Submissions
® Agreement
❑ Contract I
❑ Proposal
❑ Addendum
❑ Claim
❑ Bid Opening
❑ Bid Award I
❑ Reg. to Advertise
❑ Title Sheet
❑ Quote Opening
Quote Award
❑ Chg Order No.
❑ C/O & PCA No.
❑PCA
❑ Ease./Encroach.
❑ Traffic Control
❑ Resolution
❑ Other:
mtormation
Company or Vendor Name
Memorial Hospital
New Vendor
❑ Yes
LA
No ❑ If Yes, Approved by Purchasing
MBE/WBE Contractor
❑ MBE ❑ WBE
Project Name
Project Number
Funding Source
Account No.
Amount
$
Terms of Contract
5 year
Purpose/Description
Ambulance staffing agreement
Amount of
Increase
Decrease
For Change Orders O
Total Percent of Change: %
PO No.
Copy
Original
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❑
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CHILDREN'S HOSPITAL AMBULANCE STAFFING AGREEMENT
THIS AGREEMENT is made effective the � day of ( , 2017 by and between
the City South Bend, Indiana is a municipal corporation existing anoperating as a political
subdivision of the State of Indiana as defined by Ind. Code § 36-1-2-13 and Memorial Hospital of
South Bend, a non-profit domestic corporation organized under the laws of the State of Indiana
and having its offices at 615 North Michigan, South Bend, Indiana 46601.
c a *11M
WHEREAS, the health of the citizens of the community is very important to the Civil City
of South Bend ("South Bend"); and
WHEREAS, Memorial Hospital of South Bend ("Memorial") is a not -for -profit
community hospital located in South Bend, Indiana and providing health care to area sick and
injured adult and pediatric populations; and
WHEREAS, to accomplish its goals, Memorial Hospital and the Civil City of
South Bend jointly recognize the need for safe and responsible transportation of patients across the
lifespan to hospital care when an emergency or medical necessity arises; and
WHEREAS, the parties have, for more than twenty (20) years, been operating under an
agreement to their mutual satisfaction and desire to continue such agreement, therefore, the parties
hereby enter into the following contract:
1. Subject Matter of Agreement.
Memorial is the owner of four (4) Children's Hospital Ambulance vans which shall be
referred to as collectively as the "Children's Hospital Ambulances". Each of the Children's
Hospital Ambulances is equipped medically for the transportation of infants, children or
adolescents, and the South Bend Fire Department ("SBFD") will provide a licensed driver for each
Children's Hospital Ambulance and shall maintain each Ambulance, all as set forth in this
Agreement. On occasion a Children's Hospital Ambulance may be used for adult patient transfers
in connection with Beacon Health System Hospitals or with the Children's Hospital.
For purposes of this Agreement, the primary unit for use by the Pediatric Intensive Care
Unit shall be identified as Unit 120, and the Neo-Natal Intensive Care Unit shall be identified as
Unit 122, the Peri-Natal Transport Unit shall be identified as Unit 124. These vehicles shall be
used as the primary unit for their respective functions when fit. Unit 121 shall be used to replace
any of the primary units that might be out of service or during concurrent runs. Unit 121 will be
used as the back transport vehicle.
Memorial, at its discretion, at any time may substitute a new, specially equipped,
ambulance van for any of the Children's Hospital Ambulances referenced above.
2. Memorial's Responsibilities in the Operation of the Children's Hospital
Ambulances.
(a) Memorial shall, at its expense, maintain all medical equipment in the Children's
Hospital Ambulances;
(b) Memorial shall make or be responsible, at its expense, for all vehicle repairs
(including communication equipment), regardless of cause, including parts and labor and routine
maintenance; Repairs determined to be as a result of negligence, failure to follow established
safety protocols or an unlawful act of a driver will be the responsibility of the Civil City of South
Bend.
(c) Memorial shall provide necessary professional staff in the Children's Hospital
Ambulances to render appropriate medical care to all patients;
(d) Memorial shall, at its expense, keep effective during the entire term of this
Agreement, insurance policies;
(i) Covering the Children's Hospital Ambulances against fire and theft;
(ii) Covering collision damage to the Children's Hospital Ambulances with a $500.00
deductible;
(iii) Covering the Children's Hospital Ambulances and Memorial's agents who
drive it against liability for personal injury with limits of at least $700,000.00 per person and
$5,000,000.00 per occurrence;
(iv) Covering the Children's Hospital Ambulances and Memorial's agents who drive it
against liability for property damage with a limit of not less than $100,000.00.
3. SBFD's Responsibilities in Operation of the Children's Hospital Ambulances.
(a) SBFD shall keep the Children's Hospital Ambulances in good repair and ready
mechanical condition including but not limited to the following routine maintenance: gas and oil,
lubrication, filters. For the duration of this agreement Memorial shall pay SBFD Seventy and
00/100 Dollars ($770.00) per hour for time spent maintaining the Children's Hospital Ambulances
and, in addition, shall reimburse SBFD for its actual costs (which shall reflect any discount
available to the Civil City of South Bend) for fuel and other parts and supplies necessary to
maintain the Children's Hospital Ambulances. The SBFD shall provide to Memorial a copy of the
maintenance schedules, records, and costs on a quarterly basis and Memorial shall make payment
to SBFD within thirty (30) days after receipt of the necessary information.
(b) SBFD shall be on call for the operation of the Children's Hospital Ambulances
twenty-four hours a day, 365 days a year.
(c) SBFD shall provide competent and properly licensed drivers, subject to the
approval of Memorial's insurance carrier, for the Children's Hospital Ambulances; the driver shall
have knowledge of primary and alternate routes to hospitals in the service area of Memorial.
(d) SBFD shall house all units at the Memorial Emergency Transport Facility, 110 E.
Marion Street, South Bend or other readily accessible facility mutually agreed upon by the parties.
The maintenance records for all units shall be kept at the SBFD garage, or other such secure
facility upon written notification to Memorial.
(e) A Memorial employee so designated by the Medical Director(s) of the
Neonatal/Pediatric Intensive Care Units or the Maternal Fetal Medicine department shall be solely
responsible for determining when to dispatch the Children's Hospital Ambulances. On occasion,
the hospital may determine the need for use of the Children's Hospital Ambulances for
community events/programs to be manned by Memorial personnel. Memorial understands and
acknowledges that use of any Children's Hospital Ambulance for such events may prolong the
response time of that Unit, and/or its driver due to the changed location.
(f) SBFD shall at all times maintain the Children's Hospital Ambulance radios, and
make such arrangements as are necessary for maintenance and/or repair of them.
(g) The Children's Hospital Ambulances shall be exclusively dedicated to use in
providing services under this Agreement, and the SBFD shall not use the Children's Hospital
Ambulances for any other purpose without the express written consent of Memorial.
(h) In the event a Children's Hospital Ambulance is unsafe, South Bend Fire
Department shall notify Memorial of this fact immediately and take other steps appropriate under
this contract to make it safe. In the event all Children's Hospital Ambulances are unsafe or on
runs, the South Bend Fire Department shall be excused from answering calls for transport made
pursuant to this contract.
(i) For the primary unit, an emergency response time of fifteen (15) minutes for NICU
runs and thirty (30) minutes for PICU and Maternal runs shall be established. For any back-up
units, an emergency response time of thirty (30) minutes shall be established whenever possible.
Whenever possible, a non -emergency (back transport) will be scheduled between 0800 and 1500
hours and a twenty-four (24) hour notice period shall be established.
0) The SBFD shall respond to a telephone request from Memorial for dispatch of a
Children's Hospital Ambulance for NICU within fifteen (15) minutes of the time it receives the
call for the primary run or within thirty (30) minutes of the time it receives the call for a back-up
run, and shall have the Children's Hospital Ambulance en route to the pick-up point within this
time period unless the Children's Hospital Ambulance is providing services under this Agreement
at the time the request for dispatch is received, or is delayed by adverse weather conditions or
other events outside the control of the SBFD, in which case the SBFD shall dispatch the
Children's Hospital Ambulances as soon as possible, or in accordance with the directions of
Memorial, whichever is applicable.
(i) The parties agree to meet quarterly to ensure competency, driver
proficiency, and other such training issues as are necessary to the intent and
purposes of this agreement.
4. Responsibilities of the Parties with Respect to Billing Patients Served by the Children's
Hospital Ambulances.
As compensation for services provided by SBFD pursuant to this Agreement, Memorial
shall pay to SBFD a fee of Twenty -Four Thousand Nine Hundred and Fifty Dollars ($24,950) per
month for calendar year 2017. Subsequent years this agreement is in force the annual rate
increases will generally be 2% and shall not exceed 4% in any given year. The actual amount of
increase for the upcoming year will be provided via written notification no later than November in
the preceding year of the increase. Increases will take effect on the first day of the calendar year
and remain effective for the entire calendar year. Payments shall be made on a monthly basis and
shall be due on the tenth (1 Oth) day of each month for as long as this Agreement remains in effect.
In addition to the monies received from Memorial, SBFD, or such other department of the
City of South Bend as shall be properly designated, shall bill to the patient or the patient=s
representative appropriate fees for the operation of the Children's Hospital Ambulance and
mileage applicable in the amount set forth in Ordinance 9887-08, which is attached hereto and
incorporated by reference as Exhibit A. Any changes in billing shall be approved by Memorial.
SBFD shall use its best efforts to collect all appropriate fees. If the amount collected by
SBFD in any of the 6 month periods of April through September OR October through
March exceeds $65,000, that excess will be paid to Memorial within 90 days (December 31 or
June 30 of the respective year). If the amount collected during the 6 month periods of April
through September OR October through March fails to meet the $25,000 threshold, SBFD shall
notify Memorial in writing by December 15 or June 15 of the respective year of the amount of
shortfall and Memorial shall reimburse SBFD for the shortage within 30 days after the notice.
SBFD will provide itemized collection and billing report to the Ground Transport Director for
each Memorial owned ambulance that includes: Date of Service, Pick up facility, drop off facility,
Base amount billed, and mileage billed, and total outstanding billed and total amount collected
efforts every 60 days. Memorial agrees to work with SBFD to develop this report. With 30 days'
written notice, Memorial shall have the option to remove the Billing practice from the SBFD with
no change in contractual monthly (base) rates or repair rates. In the event that Memorial removes
the billing ftom SBFD, Memorial agrees to pay, upon invoice, $200 per completed transport. The
monthly invoice will specify the number of transports for which the invoice is submitted and will
only include transports from the billed month. Any patient transported from airport to hospital or
hospital to airport will count as a completed transport for billing purposes.
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5. Responsibility of the Parties with Respect to the Housing of the Children's Hospital
Ambulances.
Memorial Hospital shall provide a facility at 110 E. Marion Street for the housing of the
Children's Hospital Ambulances. Day to day clean up of the facility and necessary personnel
supplies shall be the responsibility of the SBFD. All other repairs and maintenance, including
painting, exhaust hoses, and shorelines shall be the responsibility of Memorial Hospital.
6. License Plates and Title.
License plates used on the Children's Hospital Ambulances shall be issued to and in
Memorial's name and shall be retained by Memorial at all times.
7. Responsibility for Patient Care.
The primary nurse assigned by Memorial to staff the Children's Hospital Ambulances shall
be totally responsible for the medical management of the patient and shall have the right to control
the operation of the Children's Hospital Ambulance if necessary for the welfare of the patient.
8. Control of Vehicle.
When the Children's Hospital Ambulance is in use, the driver shall have control of the
ambulance, except as necessary for appropriate medical management of the patient. SBFD shall
have control and custody of the Children's Hospital Ambulances when not in use and shall
maintain all units upon the premises at 110 East Marion, South Bend, Indiana or as otherwise
provided in Paragraph 3, above, except during time of maintenance and repair when not in use.
Memorial reserves the right to require the driver to participate in a pre -transport Risk
Assessment Evaluation post transport debrief and to impose Safety practices consistent with best
Safety Practices. Any training required to participate in these Safety practices will be provided by
Memorial.
9. Status of Personnel.
(a) Inside the State of Indiana. When a Children's Hospital Ambulance is operating
within the State of Indiana, the parties agree that the professional medical staff furnished to the
Children's Hospital Ambulance are employees of Memorial and that the driver furnished by SBFD
is an employee of the City of South Bend. It is further agreed by the parties that SBFD is an
independent contractor in furnishing the driver and maintaining the Children's Hospital
Ambulances and that City of South Bend employees are not agents of Memorial on in -state runs.
(b) Runs Outside the State of Indiana. In the event a Children's Hospital ambulance, at
any time during a run, shall be required to leave the State of Indiana, the driver furnished by SBFD
shall be considered an agent of Memorial under the express direction of Memorial's primary nurse
assigned to that run. Memorial agents and employees shall be responsible for all matters in regard
to the operation of the Children's Hospital Ambulances on out-of-state rims.
10. Manufacturer's Warranty.
The Children's Hospital Ambulances are covered by no warranty, guarantee of
representation, written or oral, express or implied, except that the standard warranty of the
manufacturer, if any, is applicable to the Children's Hospital Ambulance.
11. Effect of Laws.
In the event of any of the following, either party may give to the other party notice of intent
to amend this Agreement in order to (i) accommodate the terms and intent of this Agreement to the
greatest extent possible consistent with the requirements of law; (ii) achieve the least burdensome
alternative for the parties which brings this Agreement into compliance with law; and (iii) render
this Agreement in compliance with law and alleviate a material adverse legal or financial
consequence. If this Agreement is not so amended in writing within thirty (30) business days after
said notice is given, this Agreement shall terminate as of midnight of the thirtieth (30th) business
day after said notice is given. The triggering of events are:
(a) A provision of law invalidates or otherwise is inconsistent with the terms of this
Agreement;
(b) A provision of law would cause one or both of the parties to be in violation of law;
(c) A provision of this Agreement is ruled by a court or other tribunal of competent
jurisdiction to be in violation of law; or
(d) In the written opinion of a reputable attorney who is demonstrably familiar with
health care law or municipal law, as appropriate, and is otherwise qualified and mutually agreed
upon by the parties, any federal, state, or local government or agency passes, issues, or
promulgates any law, rule; regulation, standard, or interpretation that would render this Agreement
illegal, or that could cause significant and material adverse legal and/or financial consequences for
any party thereto (including any such action that would adversely affect the tax-exempt state or the
present or future tax-exempt financings of Memorial).
12. Entire Agreement
This Agreement supersedes all prior agreements and sets forth all the covenants,
provisions, agreements, conditions and understandings between the parties concerning the matters
contained herein and there are no covenants, promises, agreements, conditions or understandings,
either oral or written between them other than as are herein set forth.
13. Waiver, Amendment or Cancellation
Any waiver, amendment, or modification of any of the provisions of this Agreement, or
cancellation or replacement of this Agreement, shall not be valid unless in writing and signed by
the parties hereto. The waiver by any party of a breach or violation of any provision of this
Agreement shall not operate as or be construed to be, a waiver of any subsequent breach of the
same or other provisions hereof.
14. Indiana Law.
This Agreement and Performance hereunder shall be governed by and construed in
accordance with the laws of the State of Indiana. Any and all proceedings relating to the subject
matter hereof shall be maintained in the Courts of the State of Indiana or the Federal District Court
sitting in Indiana, which Courts shall have exclusive jurisdiction for such purposes.
15. Third Parties Acquire No Rights.
The rights and obligations arising from this Agreement shall inure to the exclusive benefit
of the parties hereto. Nothing herein shall be construed to create any rights or interests in parties
other than Saint Joseph=s and the Civil City of South Bend.
16. Interruption of Service.
If either party is prevented, hindered, or delayed in performing hereunder by reason of any
cause beyond the control of such party, and which cannot be overcome by due diligence, such
party shall be excused from such performance to the extent that it is necessarily prevented,
hindered, or delayed thereby. During the continuance of any such happening or event, this
Agreement shall be deemed suspended so long as and to the extent that any such cause prevents or
delays its performance.
17. Term and Termination.
This Agreement shall be in effect for five (5) calendar years commencing in 2017 through
the end of 2021 provided, however, either Memorial or SBFD shall have the right to terminate this
Agreement upon thirty (30) days written notice to the other party in the event either party
determines that the performance of the contract is not in the best interest of Memorial or SBFD,
whichever the case may be.
Nothing in this contract shall prohibit the parties from making written modifications to this
Agreement during its term.
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18. Counterparts. This Agreement may be executed in counterparts, all of which shall
be deemed originals.
[SIGNATURE PAGES ATTACHED]
T IE WITNESS WHEREOF, the parties have executed this Agreement on the -dday
of > 2017.
THE
MEMORIAL HOSPITAL OF
SOUTH BEND, INC.
� �q r
d& - '
Gary Gilot, President
Suzanna Friit�zlb'ierg, Member
Elizabeth Maradik, Member
Therese Dora Member
d 4
Jars Mueller, Member
ATTEST:
nda Martin, Clerk
Board of Public Works
Dated: /T 1 1001-7
BOARD OF PUBLIC WORKS OF
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC SAFETY OF THE
CITY OF SOUTH BEND, INDIANA
Daniel Jones, Member
John Collins, President
Eddie L. Miller, Member
Luther Taylor, Member
Brian PaW1owSki
Attest:
Linda Martin, Clerk
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2014)_VI_130228.doc
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