HomeMy WebLinkAboutItem 11 Approve a Contract Amendment for Critical Care Ambulance Transports with Life Flight Network, Inc. AGENDA ITEM SUMMARY Meeting Date: 6/20/2016
Meeting Type: Regular Meeting
Staff Contact/Dept.: Joe Zaludek/Fire Staff Phone No: 726-2292
Estimated Time: Consent Calendar
S P R I N G F I E L D C I T Y C O U N C I L Council Goals: Financially Responsible and Stable Government
Services ITEM TITLE: APPROVE A CONTRACT AMENDMENT FOR CRITICAL CARE
AMBULANCE TRANSPORTS WITH LIFE FLIGHT NETWORK, INC.
ACTION REQUESTED: By motion:
Authorize City Manager to sign a contract with Life Flight Network, Inc. for critical care ambulance transports in ASA #5.
ISSUE STATEMENT: Springfield Fire & Life Safety is requesting to enter into a contract for critical care ambulance transports with Life Flight Network, Inc.
ATTACHMENTS: 1. Life Flight Network, Inc. Contract
DISCUSSION/
FINANCIAL IMPACT:
Fire & Life Safety selected Life Flight Network, Inc. through an RFP process in
May 2016 to provide critical care ambulance transports within ASA #5. Life Flight Network was the only respondent to the RFP and has been serving Fire & Life Safety in this capacity for the past 4 years.
Air medical is the preferred method to transport critical care patients whose
conditions require specialized treatment and are time sensitive. Occasionally, due to
weather, mechanical breakdowns, or other unforeseen circumstances, the air medical resources in our area may be unavailable. In that case, due to the timely
nature of the transport, the option is to send these patients by ground ambulance.
This contract addresses those few occasions when this situation occurs. The projected number of critical care ground ambulance inter-facility transports is
approximately 15-20 per year.
Critical care patients require specialized medical care beyond the scope of SFLS
Paramedics. Therefore, to complete a critical care, ground transport, specially
trained nurses are required to accompany the medic unit crew and provide care to the patient during transfer. This puts a burden on the hospital staff, as well as taking
one SFLS medic unit out-of-service for ASA#5 calls. Inter-facility transports are generally to the Portland metro area, requiring approx. 5-6 hours round trip.
Life Flight Network, Inc. (LFN) currently provides these services as part of our tiered response plan. This contract does not result in a cost to the City. LFN directly bills patients/insurers for their transports. City of Eugene will contract
with Life Flight Network for the same services, once Springfield’s contract is in place.
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EXHIBIT “A”
CITY OF SPRINGFIELD
INDEPENDENT CONTRACTOR AGREEMENT
Independent Contractor Status
All performance of any labor or services required to be performed by Independent Contractor
shall be performed in accordance with the standards set forth in ORS 670.600 (2005), and as
follows:
A person is customarily engaged in an independently established business if any three of the
following six requirements are met:
1. The person maintains a business location:
a. That is separate from the business or work location of the person for whom the
services are provided; or,
b. That is in a portion of the person’s residence and that portion is used primarily
for the business.
2. The person bears the risk of loss related to the business or the provision of services as
shown by factors such as:
a. The person enters into fixed-price contracts;
b. The person is required to correct defective work;
c. The person warrants the services provided; or,
d. The person negotiates indemnification agreements or purchases liability
insurance, performance bonds or errors and omissions insurance.
4. The person provides contracted services for two or more different persons within a 12-
month period, or the person routinely engages in business advertising, solicitation or
other marketing efforts reasonably calculated to obtain new contracts to provide similar
services.
5. The person makes a significant investment in the business, through means such as:
a. Purchasing tools or equipment necessary to provide the services;
b. Paying for the premises or facilities where the services are provided; or
c. Paying for licenses, certificates or specialized training required to provide the
services.
6. The person has the authority to hire other persons to provide or to assist in providing
the services and has the authority to fire those persons.
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EXHIBIT “B”
City of Springfield Public Contracts Conformance with Oregon Public Contractors Laws Pursuant to Oregon law, every public contract shall contain the following conditions: 1) Make payment promptly, as due, to all persons supplying to the contractor labor or material for the performance of the work provided for in the contract. ORS 279B.220(1) 2) Pay all contributions or amounts due the Industrial Accident Fund from the contractor or subcontractor incurred in the performance of the contract. ORS 279B.220(2). 3) Not permit any lien or claim to be filed or prosecuted against the state or a county, school district, municipality, municipal corporation or subdivision thereof, on account of any labor or material furnished. ORS 279B.220(3). 4) Pay to the Department of Revenue all sums withheld from employees under ORS 316.167. ORS 279B.220(4). 5) If the agreement is for lawn and landscape maintenance, it shall contain a condition requiring the contractor to salvage, recycle, compost or mulch yard waste material at an approved site, if feasible and cost-effective. ORS 279B.225.
6) Promptly, as due, make payment to any person, copartnership, association or corporation furnishing medical, surgical and hospital care services or other needed care and attention, incident to sickness or injury, to the employees of the contractor, of all sums that the contractor agrees to pay for the services and all moneys and sums that the contractor collected or deducted from the wages of employees under any law, contract or agreement for the purpose of providing or paying for the services. All employers shall comply with ORS 656.017. ORS 279B.230. 7) A person may not be employed for more than 10 hours in any one day, or 40 hours in any one week, except in cases of necessity, emergency or when the public policy absolutely requires it, and in such cases, except in cases of contracts for personal services designated under ORS 279A.055, the employee shall be paid at least time and a half pay:
a) For all overtime in excess of eight hours a day or 40 hours in any one week when the work week is five consecutive days; or b) For all overtime in excess of 10 hours in any one day or 40 hours in any one week when the work week is four consecutive days, Monday through Friday; and c) For all work performed on Saturday and on any legal holiday specified in ORS 279B.020.
An employer must give notice in writing to employees who work on a public contract, either at the time of hire or before commencement of work on the contract, or by posting a notice in a location frequented by employees, of the number of hours per day and days per week that the employees may be required to work. ORS 279B.235(1)-(2).
8) If the agreement is for personal services, the contract shall contain a provision that the employee shall be paid at least time and a half for all overtime worked in excess of 40 hours in any one week, except for individuals under personal services contracts who are excluded under ORS 653.010 to 653.261 or under 29 U.S.C. 201-209 from receiving overtime. ORS 279B.235(3). 9) Contracts for services must contain a provision that requires that persons employed under contracts shall receive at least time and half pay for work performed on the legal holidays specified in a collective bargaining agreement or in ORS 279B.020(1)(b)(B)-(G) and for all time worked in excess of 10 hours in any one day or in excess of 40 hours in any one week, whichever is greater. Employer shall give notice in writing to employees who work on a contract for services, either at the time of hire or before commencement of work on the contract, or by posting a notice in a location frequented by employees, of the number hours per day and days per week that the employees may be required to work. ORS 279B.235(5).
If this agreement is for a public improvement, the contract shall contain the following conditions: 10) Make payment promptly, as due, to all persons supplying to the contractor labor or material for the performance of the work provided for in the contract. ORS 279C.505(1)(a). 11) Pay all contributions or amounts due the Industrial Accident Fund from the contractor or subcontractor incurred in the performance of the contract. ORS 279C.505(1)(b). 12) Not permit any lien or claim to be filed or prosecuted against the state or a county, school district, municipality, municipal corporation or subdivision thereof, on account of any labor or material furnished. ORS 279C.505(1)(c). 13) Pay to the Department of Revenue all sums withheld from employees under ORS 316.167. ORS 279C.505(1)(d). 14) The contractor shall demonstrate that an employee drug testing program is in place. ORS 279C.505(2).
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15) If the contractor fails, neglects or refuses to make prompt payment of any claim for labor or services furnished to the contractor or subcontractor by any person in connection with the public improvement contract as the claim becomes due, the proper officer or officers representing the state or a county, school district, municipality, municipal corporation or subdivision thereof, as the case may be, may pay such claim to the person furnishing labor or services and charge the amount of the payment against the funds due or to become due the contract by reason of the contract. If the contractor or first-tier subcontractor fails, neglects or refuses to make payment to a person furnishing labor or materials in connection with the public improvement contract within 30 days after receipt of payment from the contracting agency or a contractor, the contractor or first-tier subcontractor shall owe the person the amount due plus interest charges commencing at the end of the 10-day period that payment is due under ORS 279C.580(4) and is subject to a good faith dispute as defined in ORS 279C.580. If the contractor or a subcontractor fails, neglects or refuses to make payment to a person furnishing labor or materials in connection with the public improvement contract, the person may file a complaint with the
Construction Contractors Board, unless payment is subject to a good faith dispute as defined in ORS 279C.580. ORS 279C.515. 16) The payment of a claim does not relieve the contactor or the contractor’s surety from obligation with respect to any unpaid claims. ORS 279C.515(4).
17) A person may not be employed for more than 10 hours in any one day, or 40 hours in any one week, except in cases of necessity, emergency or when the public policy absolutely requires it, and in such cases, except in cases of contracts for personal services designated under ORS 279C.100, the employee shall be paid at least time and a half pay: a) For all overtime in excess of eight hours a day or 40 hours in any one week when the work week is five consecutive
days; or, b) For all overtime in excess of 10 hours in anyone day or 40 hours in any one week when the work week is four consecutive days, Monday through Friday; and, c) For all work performed on Saturday and on any legal holiday specified in ORS 279B.020. ORS 279C.520(1).
An employer shall give notice in writing to employees who work on a public contract either at the time of hire or before commencement of work on the contract, or by posting a notice in a location frequented by employees, of the number of hours per day and days per week that the employees may be required to work. ORS 279B.520(2). 18) If the agreement is for personal services, the contract shall contain a provision that the employee shall be paid at least time and a half
for all overtime worked in excess of 40 hours in any one week, except for individuals under personal services contracts who are excluded under ORS 653.010 to 653.261 or under 29 U.S.C. 201-209 from receiving overtime. ORS 279C.520(3). 19) Contracts for services must contain a provision that requires that persons employed under contracts shall receive at least time and half pay for work performed on the legal holidays specified in a collective bargaining agreement or in ORS 279C.540(1)(b)(B)-(G) and for all time worked in excess of 10 hours in any one day or in excess of 40 hours in any one week, whichever is greater. An employer shall give notice in writing to employees who work on a contract for services, either at the time of hire or before commencement of work on the contract, or by posting a notice in a location frequented by employees, of the number of hours per day and days per week that the employees may be required to work. ORS 279C.520(5) 20) Solicitation documents for a public improvement contract shall make specific reference to federal, state and local agencies that have enacted ordinances, rules or regulations dealing with the prevention of environmental pollution and the preservation of natural resources that affect the performance of the contract. A solicitation document must also make special reference to known conditions at the construction site that may require the successful bidder to comply with the ordinances, rules or regulations identified under ORS 279C.525(1). If the successful bidder encounters a condition not referred to in the solicitation documents, not caused by the
successful bidder and not discoverable by a reasonable prebid visual site inspection, and the condition requires compliance with the ordinances, rules or regulations referred to under ORS 279C.525(1), the successful bidder shall immediately give notice of the condition to the contracting agency. The successful bidder may not commence work nor incur any additional job site costs in regard to the condition encountered and described in ORS 279.525(3) without written direction from the contracting agency. ORS 279C.525. 21) Promptly, as due, make payment to any person, copartnership, association or corporation furnishing medical, surgical and hospital care services or other needed care and attention, incident to sickness or injury, to the employees of the contractor, of all sums that the contractor agrees to pay for the services and all moneys and sums that the contractor collected or deducted from the wages of employees under any law, contract or agreement for the purpose of providing or paying for the services. All employers shall comply with ORS 656.017. ORS 279C.530.
22) A contract for public works shall contain a provision stating the existing state prevailing rate and wage and, if applicable, the federal prevailing rate of wage required. Every contract and subcontract shall contain a provision that workers shall be paid not less than the specified minimum hourly rate of wage in accordance with ORS 279C.838. ORS 279C.830(1). If this agreement is for demolition, the contract shall also contain the following conditions:
23) Contractor must salvage or recycle construction and demolition debris, if feasible and cost-effective. ORS 279C.510(1)
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EXHIBIT C OREGON TAX LAWS COMPLIANCE AND CERTIFICATION
A. Contractor's Compliance with Tax Laws.
1. Contractor must, throughout the duration of this Contract and any extensions, comply with all tax laws of this state and all applicable tax laws of any political subdivision of this state. For the purposes of this Section, 'tax laws" includes all the provisions described in Subsection B. 3. (i) through (iv) of this Contract.
2. Any violation of Subsection 1 of this Section A shall constitute a material breach of this Contract. Further, any violation of Contractor's warranty, in Subsection B.3. of this Contract, that Contractor has complied
with the tax laws of this state and the applicable tax laws of any political subdivision of this state also shall
constitute a material breach of this Contract. Any violation shall entitle City to terminate this Contract, to pursue and recover any and all damages that arise from the breach and the termination of this Contract, and to pursue any or all
of the remedies available under this Contract, at law, or in equity, including but not limited to: a. Termination of this Contract, in whole or in part;
b. Exercise of the right of setoff, and withholding of amounts otherwise due and owing to Contractor, in an amount equal to State's setoff right, without penalty; and
c. Initiation of an action or proceeding for damages, specific performance, declaratory or
injunctive relief. City shall be entitled to recover any and all damages suffered as the result of Contractor's breach of this Contract, including but not limited to direct, indirect, incidental and consequential damages, costs of cure, and
costs incurred in securing [replacement Services/replacement Goods/ a replacement contractor]. These remedies are cumulative to the extent the remedies are not inconsistent, and City may pursue any remedy or remedies singly, collectively, successively, or in any order whatsoever.
B. Contractor's Representations and Warranties.
Contractor represents and warrants to City that:
1. Contractor (to the best of Contractor's knowledge, after due inquiry), for a period of no fewer than
six calendar years preceding the [date of Closing of {bids/proposals}for/effective date of] this Contract, faithfully has complied with:
(i) All tax laws of this state, including but not limited to ORS 305.620 and ORS chapters
316, 317, and 318;
(ii) Any tax provisions imposed by a political subdivision of this state that applied to Contractor, to Contractor's property, operations, receipts, or income, or to Contractor's performance of or
compensation for any work performed by Contractor;
(iii) Any tax provisions imposed by a political subdivision of this state that applied to Contractor, or to goods, services, or property, whether tangible or intangible, provided by Contractor; and
(iv) Any rules, regulations, charter provisions, or ordinances that implemented or enforced
any of the foregoing tax laws or provisions.
Any [Goods/Items/Equipment/Components/Hardware/Software/Intellectual Property Rights, etc.] [delivered to/granted to] City under this Contract, and Contractor's Services rendered in the performance of Contractor's
obligations under this Contract, shall be provided to City free and clear of any and all restrictions on or conditions of use, transfer, modification, or assignment, and shall be free and clear of any and all liens, claims, mortgages,
security interests, liabilities, charges, and encumbrances of any kind.
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Exhibit D City of Springfield Business Associate Agreement
Between - City of Springfield and INDEPENDENT CONTRACTOR
This Business Associate Agreement (“Agreement”) between City of Springfield (Springfield) and
INDEPENDENT CONTRACTOR is executed to ensure that INDEPENDENT CONTRACTOR will appropriately safeguard
protected health information (“PHI”) that is created, received, maintained, or transmitted on behalf of Springfield
in compliance with the applicable provisions of Public Law 104-191 of August 21, 1996, known as the Health
Insurance Portability and Accountability Act of 1996, Subtitle F – Administrative Simplification, Sections 261, et
seq., as amended ("HIPAA"), and with Public Law 111-5 of February 17, 2009, known as the American Recovery and
Reinvestment Act of 2009, Title XII, Subtitle D – Privacy, Sections 13400, et seq., the Health Information
Technology and Clinical Health Act, as amended (the “HITECH Act”).
A. General Provisions
1. Meaning of Terms. The terms used in this Agreement shall have the same meaning as those terms
defined in HIPAA.
2. Regulatory References. Any reference in this Agreement to a regulatory section means the section
currently in effect or as amended.
3. Interpretation. Any ambiguity in this Agreement shall be interpreted to permit compliance with
HIPAA.
B. Obligations of Business Associate
INDEPENDENT CONTRACTOR agrees that it will:
1. Not use or further disclose PHI other than as permitted or required by this Agreement or as required
by law;
2. Use appropriate safeguards and comply, where applicable, with the HIPAA Security Rule with respect
to electronic protected health information (“e-PHI”) and implement appropriate physical, technical
and administrative safeguards to prevent use or disclosure of PHI other than as provided for by this
Agreement;
3. Report to Springfield any use or disclosure of PHI not provided for by this Agreement of which it
becomes aware, including any security incident (as defined in the HIPAA Security Rule) and any
breaches of unsecured PHI as required by 45 CFR §164.410. Breaches of unsecured PHI shall be
reported to Springfield without unreasonable delay but in no case later than 60 days after discovery
of the breach;
4. In accordance with 45 CFR 164.502(e)(1)(ii) and 164.308(b)(2), ensure that any subcontractors that
create, receive, maintain, or transmit PHI on behalf of INDEPENDENT CONTRACTOR agree to the
same restrictions, conditions, and requirements that apply to INDEPENDENT CONTRACTOR with
respect to such information;
5. Make PHI in a designated record set available to Springfield and to an individual who has a right of
access in a manner that satisfies Springfield’s obligations to provide access to PHI in accordance with
45 CFR §164.524 within 30 days of a request;
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6. Make any amendment(s) to PHI in a designated record set as directed by Springfield , or take other
measures necessary to satisfy Springfield’s obligations under 45 CFR §164.526;
7. Maintain and make available information required to provide an accounting of disclosures to
Springfield or an individual who has a right to an accounting within 60 days and as necessary to
satisfy Springfield’s obligations under 45 CFR §164.528;
8. To the extent that INDEPENDENT CONTRACTOR is to carry out any of Springfield’s obligations under
the HIPAA Privacy Rule, INDEPENDENT CONTRACTOR shall comply with the requirements of the
Privacy Rule that apply to Springfield when it carries out that obligation;
9. Make its internal practices, books, and records relating to the use and disclosure of PHI received from, or
created or received by INDEPENDENT CONTRACTOR on behalf of Springfield , available to the Secretary of
the Department of Health and Human Services for purposes of determining INDEPENDENT CONTRACTOR
and Springfield compliance with HIPAA and the HITECH Act;
10. Restrict the use or disclosure of PHI if Springfield notifies INDEPENDENT CONTRACTOR of any
restriction on the use or disclosure of PHI that Springfield has agreed to or is required to abide by
under 45 CFR §164.522; and
11. If Springfield is subject to the Red Flags Rule (found at 16 CFR §681.1 et seq.), INDEPENDENT
CONTRACTOR agrees to assist Springfield in complying with its Red Flags Rule obligations by: (a)
implementing policies and procedures to detect relevant Red Flags (as defined under 16 C.F.R.
§681.2); (b) taking all steps necessary to comply with the policies and procedures of Springfield’s
Identity Theft Prevention Program; (c) ensuring that any agent or third party who performs services
on its behalf in connection with covered accounts of Springfield agrees to implement reasonable
policies and procedures designed to detect, prevent, and mitigate the risk of identity theft; and (d)
alerting Springfield of any red flag incident (as defined by the Red Flag Rules) of which it becomes
aware, the steps it has taken to mitigate any potential harm that may have occurred, and provide a
report to Springfield of any threat of identity theft as a result of the incident.
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C. Permitted Uses and Disclosures by Business Associate
The specific uses and disclosures of PHI that may be made by INDEPENDENT CONTRACTOR on behalf of
Springfield include:
1. The review of patient care information in the course of INDEPENDENT CONTRACTOR conducting risk
and compliance assessment activities, or providing Springfield with a Control Activity Gap Analysis, or,
the review of PHI and other information necessary to assist Springfield in developing its HIPAA
compliance program; and
2. Other uses or disclosures of PHI as permitted by HIPAA necessary to perform the services that
INDEPENDENT CONTRACTOR has been engaged to perform on behalf of Springfield.
D. Termination
1. Springfield may terminate this Agreement if Springfield determines that INDEPENDENT CONTRACTOR
has violated a material term of the Agreement.
2. If either party knows of a pattern of activity or practice of the other party that constitutes a material
breach or violation of the other party’s obligations under this Agreement, that party shall take
reasonable steps to cure the breach or end the violation, as applicable, and, if such steps are
unsuccessful, terminate the Agreement, if feasible.
3. Upon termination of this Agreement for any reason, INDEPENDENT CONTRACTOR shall return to
Springfield or destroy all PHI received from Springfield, or created, maintained, or received by
INDEPENDENT CONTRACTOR on behalf of Springfield that INDEPENDENT CONTRACTOR still maintains
in any form. INDEPENDENT CONTRACTOR shall retain no copies of the PHI. If return or destruction is
infeasible, the protections of this Agreement will extend to such PHI.
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CRITICAL CARE AMBULANCE TRANSPORT SERVICES
SCOPE OF SERVICE
1. General Information a. Description of the Area The cities of Eugene and Springfield represent the second and ninth-largest cities in Oregon, with a metro area population of approximately 238,325 (Lane Council of Governments, January 2013
estimate) and an incorporated area of 59 square miles. Located in western Oregon’s southern
Willamette Valley, the communities were first settled in the mid-1800’s. Both cities operate under a council/manager form of government. The City Council develops and
adopts legislation and policies to direct the City organization, but employs a professional administrator (the City Manager) to manage and oversee all City personnel and operations to
carry out the council’s direction. The cities are organized into departments, with the Eugene
Springfield Fire Department representing a functional consolidation of the City of Eugene Fire & EMS Department and the City of Springfield Department of Fire & Life Safety.
The City Councils consists of Councilors, who each shall reside in a specific geographic ward, and are elected by the city at large on a nonpartisan ballot for staggered four-year terms. The
Mayor is the Chief Elected Officer of each city. The Mayor is elected from the city at large on a nonpartisan ballot for a four-year term.
b. Overview of the Department The department, known as Eugene Springfield Fire, represents a functional consolidation of
Eugene Fire & EMS and Springfield Fire & Life Safety. Both departments have continually operated since the mid-1800’s and fire personnel are represented by the International Association of Fire Fighters (IAFF). The departments began providing ambulance transport services in 1981
and continue to provide this service to a large area of central Lane County.
The City Manager(s) appoint the Fire Chief, who is responsible for organizing and administering
the department. The department consists of 305 full time equivalent (FTE) positions, including 257 line fire and emergency medical service personnel , organized into four functional divisions:
Operations; Strategic Services, Fire Marshal’s Office, and the Administrative Services Bureau.
The Eugene Springfield Fire Department provides fire, rescue, emergency medical, code
enforcement, and fire/injury prevention education services to the citizens of the Eugene/Springfield area and to eight neighboring special districts through long-standing contractual agreements. See table below.
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Table 1.1 Primary Service Area Statistics
DISTRICTS POPULATION AREA
(sq mi)
City of Eugene 159,580 44.1
City of Springfield 59,990 15.7
Bailey-Spencer RFPD 465 5
Eugene Fire District #1 883 9.8
Glenwood Water District 1,189 0.4
Rainbow Water District 4,929 1.4
River Road Water District 7,295 1.7
Willakenzie-Eugene RFPD 975 1
Willakenzie-Springfield RFPD 1,864 2.4
Zumwalt RFPD 1,154 11.4
TOTALS 238,324 92.9
In addition, the Department provides emergent and non-emergent ambulance transport service to
Lane County Ambulance Service Areas (ASA) #4 and #5. These ASA’s includes all the
jurisdictions listed above plus a large adjoining rural area primarily to the south and east for a total service area of nearly 1,700 square miles.
c. Medical Control
Medical direction and oversight is provided under a contract with a local emergency department physician who is a medical director with considerable experience in the practice of pre-hospital emergency medicine and who provides medical advice and accountability.
i. Standing Medical Orders and Treatment Protocols Standing Medical Orders and Treatment Protocols are developed by the Lane County
Medical Control Board (LCMCB). The LCMCB is comprised of the Medical Directors’ representing Eugene Springfield Fire, Lane Rural Fire Rescue, Lane Fire District #1, and
South Lane Fire & EMS. The LCMB meets regularly to develop guidelines reflective of
current trends and evidence in the practice of pre-hospital care.
d. Advisory Committees
Eugene Springfield Fire actively participates in several internal and external advisory groups and
committees relating to EMS and pre-hospital care, including: i. Central Lane Emergency Medical Services - Area EMS Coordinators/EMS
Chiefs/EMS Officers meet regularly to discuss equipment needs and purchases, EMS issues and concerns. ii. Oregon State Ambulance Association
iii. Oregon Fire Chief’s Association – EMS Section
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e. Critical Care Transports (CCT) i. Definition. As defined by the Standing Medical Orders and Treatment Protocols
under which the Cities of Springfield and Eugene operate, a CCT is defined as follows:
Applies to inter-hospital transfers of critical patients that have a time-sensitive condition that need to be transported immediately, and where out-of-hospital time should be minimized
Requires a Paramedic and a Registered Nurse certified in medical and trauma
critical care that may:
o Start/maintain saline drip o Provide advanced airway management to the following patients:
Intubated patients
Respiratory distress patients that may require emergency CPAP/BiPAP
Patients on ventilator
o Medications
Administer and maintain med drips and may bolus meds
beyond Eugene Springfield Fire protocols/standing orders
o Cardiac patients:
Stable/unstable rhythms ST Segment STEMI
Active chest pain with ongoing dynamic ECG changes Potential need for manual defibrillation Patients requiring cardiovent
Patients requiring external pacing and/or external pacing already in place
o OB Transfers (stable/unstable) Acute high risk labor/delivery may be imminent
ii. Transport options. The mode of transport of a critical care patient depends on a variety of factors (weather, equipment availability, etc.) and may be done by ground
or air. Eugene Springfield Fire supports the mode of transportation best for the
patient. Air ambulance will be preferred over long distance ground transport, if available, or in cases where best for the patient.
f. Finance
Eugene Springfield Fire’s ambulance transport sections operate as user-fee-supported systems. Fees for operation are generated through patient transports, treat and release aid responses and revenue generated through the annual FireMed membership program.
The successful Contractor will honor and fulfill the FireMed contract obligations for those patients needing medically necessary transport.
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2. Response Information
a. Average Area Protected by Initial Response Companies The department’s entire fire and EMS first response area is 93 square miles. Its’ first response
needs are served by fourteen engine companies, two ladder companies, and one Airport crash truck (dedicated to response at the Eugene Airport and not available to respond to incidents off
Airport property). Therefore, the average area covered by each staffed first response crew is approximately 5.8 square miles.
b. Frequency of Calls Eugene Springfield Fire provides both EMS first response and ambulance transport services to a
large portion of east/central Lane County, and responds to approximately 28,000 emergency medical calls for service per year. Because the majority of the department’s call load involves emergency medical service delivery, every engine company is equipped as an advanced life
support (ALS) first response unit, and staffed with at firefighter/paramedics.
Eugene Springfield Fire has, incrementally, created a tiered response system within ASA#4 & #5.
Utilizing contracted providers to supply specific parts of the response system maximizes the available time for Eugene Springfield resources to be available for in-district emergency calls and
other duties.
The department currently responds to approximately 31 medical incidents each 24-hour period.
All engine companies are fully qualified paramedics, and outfitted with a complete inventory of advanced life support equipment, providing the City and its protection districts with consistent paramedic first response capability on all incidents.
Table 2.3 shows the numbers of calls when patients were actually transported, not necessarily the total number of patients. Pre-scheduled calls are included in the frequency of calls.
Table 2.3 Frequency of EMS Transports
FY13 FY14 FY15
Springfield 7035 7658 8069 Daily Avg. 19.27 21 22.1
Eugene 9764 10,374 12,035 Daily Avg. 26.75 28.42 33
c. Distribution of Calls
Calls for service are not distributed uniformly throughout a 24-hour period. The vast majority of calls for service are received between the hours of 0700-1900 each day, with slight variations by
day of the week. Critical care transports may occur and any hour of the day or night, depending
on the needs of the facilities and their critical patients.
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d. Medic Units (Ambulances)
The department currently deploys six 24-hour dual-role (firefighter/paramedic) Type I ambulances, 3 in Springfield, 3 in Eugene, staffed with at least one Paramedics.
Additionally, Eugene operates a peak hour unit daily. The remainder of the fleet is Type I
units in reserve status. All medic units carry a full complement of advanced life support equipment, and are licensed and designated by the State of Oregon as advanced life support
(ALS) ambulances. The primary role of the medic unit in Eugene Springfield Fire’s system is the treatment and
transport of the sick and injured patients within county-designated ambulance service areas. Personnel assigned to staff medic units are also qualified and able to function as firefighters, which helps augment Eugene Springfield’s overall daily firefighting force.
e. Expected Critical Care Transport Call Volume
Critical care transports have been a contracted service in Eugene Springfield Fire for several years, as critical care is beyond the scope of practice for Eugene Springfield Fire
Paramedics. The expected volume of inter-facility critical care transport calls is difficult to
predict. Historical data suggests that for Springfield 3-5 CCT calls per month, and for Eugene 1-2 CCT per month may be a reasonable expectation.
3. General Qualifications and Requirements
a. General Qualifications
1. The proposer shall have a minimum of ten (10) years’ experience providing ground or air ambulance transport services, serving a population of at least 50,000. Preference will be
given to proposer’s who have experience in air and ground critical care transports with significant resources in place, or will be in place at commencement of contract, in the Eugene/Springfield metro area. Document experience and resources in your proposal.
b. General Requirements
i. Performance Security
The successful proposer must execute and deliver a good and sufficient performance
bond in a sum equal to One Hundred Thousand Dollars ($100,000.00), for the faithful
performance of its obligations. In lieu of a surety bond, the City may allow the successful
proposer to submit a cashier’s check or certified check in the same amount or establish a
cash escrow account of the same amount at an institution and under escrow instructions
acceptable to the City. The Performance Bond shall be renewable annually for the life of
the Contract. See Attachment 3.
ii. Equal Opportunity
It is the policy of the City to promote equal opportunity to all persons regardless of race,
color, religion, national origin, sex, age, or handicap, in respect to employment, housing,
public services, facilities, and accommodations. This policy is reinforced by obligations
assumed by the City as a condition of receipt of federal and state funds. This policy
becomes an obligation which must be assumed by the successful proposer as well.
Because in some cases religion, sex, age, disability, domestic partnership, familial status,
sexual orientation, gender identity, source of income or marital status may properly be
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the basis for denial or restriction of privileges with respect to employment, housing, or
public services, facilities, or accommodations, the obligations, terms and conditions
stated in the “Standard Contract Provisions” shall apply.
Violation of these provisions may be grounds for immediate termination of any
agreement without recourse by the proposer.
iii. Successful Proposer’s Responsibilities
The successful proposer will be required to assume responsibility for all services offered
in the proposal and for all contractual matters.
iv. Insurance
The successful proposer, at its own expense, shall purchase, maintain and keep in force
insurance which meets or exceeds requirements as set forth in Attachment 2 – Sample
Contract, Section 13 – Insurance of the RFP, which will protect it and the City from
claims which may arise out of or result from the successful proposer’s operations under
the agreement.
The successful proposer must submit proof of insurance coverage as part of the
agreement signing process and prior to beginning work under the agreement.
4. Performance Requirements
a. System Integration
i. Scope of Services Generally
The provider shall provide Critical Care Transport (CCT) services from the three hospitals within Ambulance Service Areas 4 &5 (ASA #4 & 5) assigned to the City of
Springfield and the City of Eugene under the Lane County Area Service Plan. The provider’s responsibilities will include being available for air or ground ambulance transport services for CCT seven (7) days per week, twenty-four (24) hours each day. The
medically appropriate level of service must be provided without regard to the patient’s status or ability to pay costs.
ii. Start-Up
The successful provider will begin operations on or about July 1, 2016. As part of the
proposal, the proposer shall outline the earliest start date available.
b. Deployment Plan
i. Deployment Plan Required
1. The provider shall be required to develop and maintain a current deployment
plan.
2. Deployment plans must include the following elements: a. A description of 24-hour system status management strategies to deploy or redeploy resources to meet hospital requirements.
b. A description of how CCT calls will be staffed including the number
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of full-time or part-time employees utilized.
c. A description of any planned use of call back crews.
d. A description of how CCT calls will be handled during adverse weather or other conditions when aircraft are grounded.
3. Deployment or Redeployment of Resources
Notwithstanding any deployment plan, the provider shall deploy or redeploy staff
and equipment as necessary to avoid a degradation of the regional EMS system.
4. Resources The provider is required to provide critical care transport services within the
contracted ASAs with its own resources. The resources must be stationed so that the provider is able to meet the response timelines specified. All ambulance
resources must comply with all specifications herein.
c. Operations Requirements
i. Response Time Requirements
Response times are critical to patient care. Critical Care Transports are scheduled by the hospital desiring the patient transport. Response time required is within 30
minutes of dispatch.
ii. Failure to Meet Response Time Requirements
The provider is expected to meet or exceed the required response times to every call
and failure to do so may result in termination of the contract agreement. The provider
must make every effort to minimize fluctuations in response time performance
according to time of day, day of the week, or week of the month.
Response Time Exemptions
It is understood that unusual circumstances and conditions beyond the provider’s
reasonable control can produce response times that exceed the standards. If the provider
believes that any run or group of runs should be excluded from the response time
standards, a written request must be made to the City’s Contract Administrator. Any
requests for exemption from response time standards shall be made with the quarterly
Response Time Reports. The City has the sole discretion to exempt any call and is not
obligated to do so for any reason. Situations in which exemptions may be granted
include, but are not limited to:
1. Provider Services
a. Adverse weather and/or road conditions b. Vehicle problems
2. System
a. Response area obstacles (e.g., limited access, barrier devices).
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d. Dispatch Requirements
i. Communications Center
The provider is required to establish a local non-emergency contact number. For
critical care transports, the provider must provide its own dispatch services using call taking and dispatching personnel that meet or exceed Oregon standards and training
for telecommunication personnel.
e. Equipment and Supplies i. Communications Equipment
The provider must have and maintain in good operating condition portable and mobile
communications equipment as specified by the City. The provider will be financially
responsible for all costs associated with implementing, upgrading, and making changes
required by the City.
ii. Medical Equipment and Supplies
1. Specifications and Coordination: The provider must utilize ambulances with
supplies and equipment necessary to carry out critical care transports. The
provider’s equipment and supplies must meet or exceed the Oregon
Department of Human Services, Health Services Division requirements and
the City’s supply and equipment requirements. The provider will be provided
an ongoing opportunity to participate in the development and revision of the
equipment and supply specifications.
2. List: The provider must provide a list of equipment and supplies used on
ambulances providing critical care transports. The City may require the
provider to replace any equipment or supply that does not meet requirements
or the City’s specifications.
3. Exchange: The provider will be required to provide and maintain its own
equipment and will not rely on exchanges from the City or Central Lane
EMS unless a separate agreement with Central Lane EMS is reached.
4. Logistics: The provider is responsible for the purchase of all supplies and
equipment, and maintaining the cleanliness and adherence to infection
control procedures for all equipment and transport units.
iii. Ambulances
iv. Quality: All ambulances in service in the Cities ASAs shall be in good working
order and appearance. No Type I ambulance utilized by the Provider may have
mileage in excess of 200,000 miles unless otherwise approved by the City’s Fire
Chief. No Type II ambulance utilized by the provider may have mileage in excess of
100,000 miles unless otherwise approved by the City’s Fire Chief. No Type III
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ambulance utilized by the Provider may have mileage in excess of 150,000 unless
otherwise approved by the City’s Fire Chief. Vehicles or equipment that the City
reasonably determines to have cosmetic or physical deficiencies that may negatively
impact customer perception shall be removed from service and either replaced or
repaired without undue delay.
v. Specifications: All ambulances utilized must be licensed as required by the
Department of Human Services, Health Services Division and City of Springfield
Municipal Code Section 7.032 and must meet or exceed the requirements set forth in
ORS 682.051 to 682.991 and OAR 333-255-0060, in addition to the requirements
herein.
vi. Color, Marking and Warning Devices: All proposed markings and color schemes
shall be submitted to and approved by the City prior to implementation and the
Provider may be required to change markings and color schemes if required by the
City at any time.
vii. Maintenance: The Provider shall maintain all ambulances and equipment in a manner
to achieve the highest standard of safety, reliability and appearance. All personnel
utilized to maintain vehicles and equipment must be properly trained, certified, and
knowledgeable. Any vehicle or equipment utilized by Provider in providing services
that are reasonably found by the City to have any deficiency that may compromise
function, must immediately be removed from service.
viii. List: The Provider shall at all times maintain a current list of ambulances (including
reserve units), to include license number, vehicle identification number, name and
address of any applicable lien holder and shall make the list available to the City
immediately upon request.
f. Personnel and Clinical Standards
i. Staff, General
The City expects that provider’s provision of services shall conform to the highest
clinical and professional standards. In doing so, the provider shall comply with all
applicable City, County, State, and Federal laws, regulations and standards regarding the
provisions of services. All persons employed by the provider shall be competent in the
performance of their duties, hold and maintain applicable and valid
certificates/licenses/accreditations in their respective roles or profession. The provider
shall be held accountable for employee performance, licensing and actions. The provider
shall cooperate and submit to individual and corporate investigations requested by the
City.
ii. Command and Control Structure
The provider must be NIMS (National Incident Management System) compliant
throughout the duration of their contract with the City.
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iii. Ambulance Staffing
The provider shall at minimum staff ambulances providing critical care inter-facility
transports with at least one qualified driver, one certified EMT-Paramedic, and a Registered Nurse certified in medical and trauma critical care (CCRN, CEN or CFRN).
The Registered Nurse must always be with the patient in the patient compartment of the
ambulance.
When operating an ambulance, all personnel must meet the applicable requirements of
ORS 682.051 to 682.991 and OAR 333-255-0070.
All personnel staffing ambulances must be certified, in good standing, with the Oregon
Department of Human Services, Health Division. The provider must use reasonable
efforts to hire and retain personnel with bilingual skills, especially Spanish.
iv. Management and Supervision
The provider will provide the management and supervision necessary for effective
oversight, and administration of critical care transport services. At least one field
supervisor, with current credentials and clinical field experience, shall be on duty or on
call at all times in order to oversee or provide support to field personnel as necessary.
In addition, the contract administrator named by the provider in its proposal may not be
changed without approval of the City. Approval will not be unreasonably withheld.
v. Uniforms and Appearance of Personnel
The provider’s personnel shall wear clean, professional uniforms. All shirts, trousers, jackets and shoes must be approved by the City.
vi. Competence and Professionalism of Personnel
Professional and courteous conduct and appearance is required at all times from the
Provider’s personnel.
vii. Personnel Training
1. Orientation of Employees
The provider must ensure that all employees have been properly oriented before
being placed on transporting ambulances. The orientation shall include but not be
limited to: overview of the City’s EMS system; applicable policies, procedures,
orders and protocols (to include HIPAA and infection control); all
communications; navigation, mapping, hospital routes; ambulance equipment
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utilization and maintenance. The provider must maintain documentation of
compliance with these requirements.
2. Training Records
All personnel training records must be provided to the city within 24 hours of request.
3. Student Internships
It is highly recommended that the provider will assist with and accommodate
local students needing internships or field experience to obtain the necessary requirements to complete EMT training and certification.
4. Community Outreach
Provider will participate in local community injury prevention activities.
Activities will be coordinated with the Eugene Springfield Fire Battalion Chief of EMS.
g. Medical Direction
The provider must at all times, and at its’ own expense, contract with a local Medical
Director who attends a minimum of 70% of the Central Lane Medical Control Board
meetings, to act as the provider’s Supervising Physician for purposes of assigning and
monitoring the quality of care and education. The terms of the agreement, including
compensation, shall be negotiated and entered into as an independent and separate
agreement between the provider and whoever provides the medical direction.
h. Standing Medical Orders and Treatment Protocols
The provider shall have adequate standing medical orders and treatment protocols.
i. Work Schedules and Employee Affairs
The provider shall have reasonable work schedules and conditions. Patient care must not be
hampered by impaired motor skills of personnel working extended shifts, part-time jobs,
voluntary overtime, and mandatory overtime without adequate rest.
The City expects that to attract and retain outstanding personnel, the provider must offer
reasonable compensation. The City in no way intends to restrict the ingenuity of the provider
and its employees from working out new and creative compensation (salary and benefits)
programs. However, the provider should not use sub-standard compensation levels in order
to deliver economic efficiencies necessary to profitably manage its agreement with the City.
The City emphasizes that the provider is responsible for conducting its affairs with its
employees, including managing personnel and resources fairly and effectively in a manner
that ensures compliance with the agreement. The City will not otherwise involve itself in
provider’s management or employee relationships. The provider is an independent
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contractor and neither the provider nor any of its employees are considered employees or
agents of the City.
The City shall, throughout the term of the agreement, have the right of reasonable rejection
and approval of staff assigned to the work by the provider. If the City reasonably rejects
staff, the provider must provide replacement staff satisfactory to the City in a timely manner
and at no additional cost to the City.
5. Quality, Performance and Audit Programs
a. Compliance and Audit Program
The provider shall establish and maintain a compliance and audit program as recommended
by the Office of the Inspector General for all Centers for Medicare/Medicaid Services
(CMS) programs applicable to ambulance transportation. In addition, the provider must
provide prompt response and follow-up to inquiries and complaints from CMS, the Oregon
Health Plan and the City.
b. Quality Audits and Inspections
City representatives may at any time, and without notification, inspect the provider’s
operations directly related to services provided in the agreement. This shall include, but
not be limited to, CQI assessments, ambulances, repair facilities, communication and
administration facilities. In addition, City representatives may ride as observers on any
ambulance at any time.
City representatives may also audit all reports and data that the provider is required to
collect, maintain or provide. Such audits will be conducted during normal business hours
with a minimum of 48 hours’ notice.
c. Data and Information Reporting
The long-term success of any EMS system is predicated upon the ability to measure,
analyze, and report operational, clinical and administrative data. The provider shall be
responsible for data input and reporting in a manner which facilitates review by the City and
any other entity authorized by law or contract to review data and reporting. All systems and
reports must comply with the City’s ASA requirements as well as City, State, and Federal
data collection and reporting requirements.
i. Response Time Report
The provider shall submit to the City electronically quarterly response reports for each
quarter. Reports must be received no later than 5 PM, five (5) business days after the
final day of the quarter. The contact for this requirement will be the Eugene Springfield
Fire Battalion Chief of EMS.
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For each incident for which a response is dispatched, the quarterly response time
compliance report shall include, but not be limited to:
A unique call number which shall be the call number generated by 9-1-1 Central
Lane Communications, or another number that a City reviewer can easily link to the provider’s dispatching system if the call is not dispatched by 9-1-1 Central
Lane Communications;
Dispatch date;
Dispatch time;
En-route to hospital time;
Arrive at hospital time;
Time transport ended, (clear time); and
Identification number of the ambulance(s) that arrived on scene.
ii. Non-Compliant Response Report
The provider shall submit a quarterly non-compliant response report electronically to the
City, no later than 5 PM, five (5) business days after the final day of the quarter. The
contact for this requirement will be the Eugene Springfield Fire Battalion Chief of EMS.
This report shall include all information outlined in Section 5.d.i for all calls in which the
response time requirements were not achieved, if any.
iii. Incident Reports
The provider will complete and submit to the City within 48 hours, or any shorter time if
required by the Eugene Springfield Fire Battalion Chief of EMS, incident reports for each
action considered non-conforming to policies and procedures and for any other incident if
requested by the City. Non-conforming incidents include, but are not limited to, ambulance
accidents or vehicle failures while on a call, equipment failures, patient injuries, and patient
or facility complaints. A copy of all incident reports shall also be maintained on file at the
provider’s administrative offices.
Incident reports must include but not be limited to the following information:
Date of incident;
Incident number if applicable;
Personnel involved;
Unit number if applicable;
A detailed narrative of the event; and
A narrative of corrective action taken.
iv. Quality Improvement Reports
Within fifteen (15) days following the end of each quarter, the provider shall provide a
report in writing and electronically, summarizing quality improvement activities of the
previous month.
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v. Pre-Hospital Patient Care Reports
Patient care report (PCR) is required to be completed, and submitted as required, for all
patients for whom care is rendered. In order to facilitate system and quality improvement
efforts, the PCR must meet with the state of Oregon requirements. The provider must
provide a copy of a PCR within 24 hours of a city request.
d. Record Requests
The provider shall also complete, maintain, and if requested by the City, provide access to or
copies of the following records and reports (including supporting data if requested) within
fifteen (15) working days of the request.
Equipment failure records
Vehicle maintenance records
Patient account records
Deployment planning records
Continuing education and training reports
Office of Inspector General recommended Medicare Audit Compliance reports
6. Finance and Administration
a. Business Office, Billing and Collection System
The provider will be responsible for all ambulance billing and revenue for services provided
by provider’s ambulances and staff only. The City will be responsible for all ambulance
billing and revenue for services provided by City resources. However, if the provider so
chooses, the provider may negotiate billing services as a separate contract with the City.
The provider shall utilize a billing and collections systems that includes a reporting system
acceptable to the City, is easy to audit, is HIPAA compliant, minimizes the effort required to
obtain reimbursement from third party payers and is capable of electronically filing
Medicare claims.
The provider shall provide a local or toll free phone number for inquiries from patients and
third-party payers. This phone number will be included on all ambulance bills sent by
provider.
b. Ambulance Rates
The provider may set its own rates for service subject to approval of the City Manager.
Current Eugene Springfield ground ambulance rates:
Base rate $1,770, mileage $22.03/pt. mile.
c. Compliance with All Laws and Regulations and Reporting i. Compliance
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The provider must comply with all federal, state and local laws, regulations, rules and
procedures applicable to the provision of the services provided, including without any
limitation whatsoever the Health Insurance Portability and Accountability Act of
1996, Pub. L. No. 104-191 (HIPAA), and its implementing regulations; Oregon
Revised Statutes chapter 682; Oregon Administrative Rules Chapter 333 divisions 250,
255, 260 and 265; and Oregon Administrative Rules Chapter 847, division 035, and
Oregon Occupational Health & Safety Administration (OR-OSHA). The provider must
also obey all provisions of the Lane County Ambulance Service Plans and ordinances
applicable to ambulance providers (except response time reporting for which the City will
be responsible).
The provider must also comply with all provisions in this request for proposal and
nothing in the foregoing shall be construed to allow the provider to not comply with any
request for proposal requirement imposing additional or higher or stricter standards or
requirements.
ii. Reporting to City
The provider shall notify the City anytime the provider or any of its employees are named
or noticed in any administrative, civil or criminal proceeding. This notice shall be in
written form and forwarded to the City within five (5) working days of the date the
provider or any of its employees become aware of any such claim or notice.
The provider shall also notify the City anytime the provider or any of its employees are
audited by any regulatory authority. This notice shall be in written form and forwarded to
the City within five (5) working days of the date the provider or any of its employees
become aware of any such audit.
The provider shall notify the City of the results of any proceeding or audit. This notice
shall be in written form and forwarded to the City within five (5) working days of the
resolution.
7. Independent Contractor Agreement By submitting a proposal in response to this request for proposal, each proposer agrees that if selected, the
proposer will enter into an Agreement with the City in a form substantially similar to Attachment 2. Each proposer submitting a proposal specifically and expressly agrees that the following provisions will
be included in the agreement awarded as a result of this request for proposal.
a. Oregon Revised Statutes, Chapter 279 Provisions i. Provider shall make payment promptly, as due, to all persons supplying to the provider labor or material for the prosecution of the work provided for in the
agreement. ii. Provider shall not permit any lien or claim to be filed or prosecuted against the City of Springfield, on account of any labor or material furnished.
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iii. Provider shall pay to the Oregon Department of Revenue all sums withheld from
employees pursuant to ORS 316.167. iv. Provider shall demonstrate that an employee drug testing program, acceptable to the City, is in place.
v. Provider’s employees shall be paid at least time and a half for all overtime worked in
excess of 40 hours in any one week, except for individuals who are excluded under ORS 653.010 to 653.261 or under 29 U.S.C. sections 201 to 209 from receiving
overtime. vi. Provider shall promptly, as due, make payment to any person, co-partnership, association or corporation, furnishing medical, surgical and hospital care or other
needed care and attention, incident to sickness or injury, to employees, of all sums which provider agrees to pay for such services and all moneys and sums which provider collected or deducted from the wages of employees pursuant to any law,
contract or agreement for the purpose of providing or paying for such service.
b. Supporting Documents and Order of Precedence
The following documents are, by this reference, expressly incorporated in the Agreement, and are
collectively referred to as the "Supporting Documents":
i. The City's Request for Proposals (or other document, however named, which constitutes the City's written request or invitation to submit proposals), together
with any documents incorporated by reference therein.
ii. The City's Letter of Award (or other written document accepting provider's Proposal with any modifications or clarifications).
iii. The provider's written Proposal (or other written response to the City's invitation,
as accepted by the City).
The Agreement and the Supporting Documents shall be construed to be mutually complimentary
and supplementary wherever possible. In the event of a conflict which cannot be so resolved, the
provisions of the agreement itself shall control over any conflicting provisions in any of the
Supporting Documents.
c. Payment of Taxes
The provider shall assume and pay all applicable State, Federal, and Municipal taxes and
contributions which are payable by virtue of the performance of this agreement. The City shall not
be responsible for any taxes and will provide its tax exempt identification number upon request.
d. HIPAA Compliance
The City and provider will be compliant with all current and future HIPAA rules and regulations
implemented. The City and provider will enter into HIPAA Business Associate Agreements
which will be in effect throughout the terms of the agreement.
e. Identity Theft Protection Program
The City and provider will be compliant with the Oregon Identity Theft Protection Act of 2007 (ORS 646A.600). In order to comply, the provider shall maintain a program with appropriate policies designed to detect, prevent and mitigate identity theft.
]
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Response to Request for Proposal
City of Springfield: Fire and Life Safety Department
RFP #1614 Critical Care Ambulance Transports
Life Flight Network
May 9, 2016
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Life Flight Network: Response to RFP #1614 Critical Care Ambulance Transports 2
Table of Contents
Cover Letter ............................................................................................................................... 4
Proposer Information.................................................................................................................. 5
Qualifications ............................................................................................................................. 6
Background ............................................................................................................................ 6
History ................................................................................................................................ 7
Clients ................................................................................................................................12
References ...............................................................................................................................15
3. General Qualifications and Requirements .............................................................................16
a. General Qualifications .......................................................................................................16
b. General Requirements.......................................................................................................16
i. Performance Security ......................................................................................................16
ii. Equal Opportunity ...........................................................................................................16
iii. Proposer’s Responsibilities ............................................................................................16
iv. Insurance ......................................................................................................................16
4. Performance Requirements ..................................................................................................18
a. System Integration .............................................................................................................18
i. Scope of Services Generally ...........................................................................................18
ii. Start-up ..........................................................................................................................18
b. Deployment Plan ...............................................................................................................18
c. Operational Requirements .................................................................................................18
i. Response Time Requirements ........................................................................................18
ii. Failure to Meet Response Time Requirements and Exemptions ....................................19
d. Dispatch Requirements .....................................................................................................19
e. Equipment and Supplies ....................................................................................................19
i. Communications Equipment ............................................................................................19
ii. Medical Equipment and Supplies....................................................................................19
iii. Ambulances ...................................................................................................................20
iv. Quality ...........................................................................................................................20
v. Specifications .................................................................................................................21
vi. Color, Marking and Warning Devices ............................................................................21
vii. Maintenance .................................................................................................................21
viii. List ...............................................................................................................................21
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Life Flight Network: Response to RFP #1614 Critical Care Ambulance Transports 3
f. Personnel and Clinical Standards .......................................................................................21
i. Staff, General ..................................................................................................................21
ii. Command and Control Structure ....................................................................................21
iii. Ambulance Staffing........................................................................................................21
iv. Management and Supervision .......................................................................................22
v. Uniforms and Appearance of Personnel, ........................................................................22
vi. Competence and Professionalism .................................................................................22
vii. Personnel Training........................................................................................................22
g. Medical Direction ...............................................................................................................23
h. Standing Medical Orders and Treatment Protocols ............................................................23
i. Work Schedules and Employee Affairs ...............................................................................23
5. Quality, Performance, and Audit Programs ...........................................................................24
a. Compliance and Audit Program .........................................................................................24
b. Quality Audits and Inspections ...........................................................................................24
c. Data and Information Reporting .........................................................................................24
i. Response Time and Non-Compliant Response Report ...................................................24
ii. Non-Compliant Response Report ...................................................................................24
iii. Incident Reports ............................................................................................................25
iv. Quality Improvement Reports ........................................................................................25
v. Pre-Hospital Care Reports .............................................................................................25
d. Record Requests ...............................................................................................................25
6. Finance and Administration ...................................................................................................26
a. Business Office, Billing and Collection System ..................................................................26
b. Ambulance Rates ..............................................................................................................26
c. Compliance with All Laws and Regulations and Reporting .................................................26
i. Compliance .....................................................................................................................26
ii. Reporting to City .............................................................................................................26
7. Independent Contractor Agreement ...................................................................................27
Attachment 2- Sample Contract – .............................................................................................29
Attachment 3- Performance Bond .............................................................................................30
Attachment 4- Authorization to Legally Bind Bidder ...................................................................31
Attachment 5- Minority Women Emerging Small Business Form (MWESB) ..............................32
Attachment 6- FireMed Terms and Conditions (for reference only). ..........................................33
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Life Flight Network: Response to RFP #1614 Critical Care Ambulance Transports 5
Proposer Information
Proposer Life Flight Network, LLC
Mailing and Physical Address 22285 Yellow Gate Lane NE, Suite 102
Aurora, OR 97002
Phone (503) 678-4364
Fax (503) 678-4369
URL www.lifeflight.org
Federal Tax ID 20-5016802
Primary Contact and Title Justin Dillingham, Chief Customer Officer
Direct Phone (503) 756-8031
Fax (503) 678-4369
Email jdillingham@lifeflight.org
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Life Flight Network: Response to RFP #1614 Critical Care Ambulance Transports 6
Qualifications
Background
Mission
The mission of LFN is to provide critical care transportation to ill or injured patients in a safe,
compassionate, efficient, and expeditious manner. Values
The values of LFN are modeled after the core values of our consortium owners. Safety, Respect, Service, Excellence, Quality, Leadership, Compassion, and Social Justice are the
hallmarks of our program. Safety
The safety of our staff is paramount. Everything must flow from this perspective. Without a
singular focus on safety, no one, internally or in our community, will benefit from our existence.
Put simply, we must never forget our first obligation is the safety and security of our people. Our teams must live by the mantra ‘those who walk thru these doors at the beginning of the day
will walk out these doors at the end of the day’.
Vision
LFN exists to fulfill a vital role – saving lives. With its unique combination of air and ground ambulances and highly skilled personnel, we represent an integral part of local emergency
medical systems. While never losing sight of our present well-being and safety, we must also look towards the future with a vision of realizing positive and sustainable growth in a fiscally sound environment. As the population within our service area continues to expand so must our
service. While expansion allows us to serve an ever-growing population, we must also envision the
acquisition of technology and equipment to keep our fleet safe, modern, and efficient. Modern aircraft and vehicles operated by highly skilled pilots and drivers capable of safely operating in
the conditions and terrain that surrounds us are paramount.
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History
LFN is a not-for-profit medical transport service focused on Safety, Quality, and Service. We are one of the country’s oldest and most respected air ambulance providers. Beginning in 1978 as
Emanuel Life Flight, the program was owned and operated by Emanuel Hospital (now Legacy
Emanuel Medical Center). Emanuel Life Flight was the first hospital-based air ambulance on the West Coast and only the fourth in the nation. Transporting 121 patients in its first year, a French-made Allouette-3 helicopter was the program’s inaugural aircraft.
In 1993, Emanuel Life Flight merged with Aircare, a Providence Health System flight program;
our name was changed to reflect this milestone, and Emanuel Life Flight became LFN. This
merger and name change came in concert with the decision of the three largest health care providers in the Portland metropolitan area to jointly participate in the ownership and overall
operation of LFN; day-to-day operation of LFN remained under the auspices of Legacy Emanuel
Medical Center.
In 2006, the consortium made a strategic decision to transfer the organization from the governance of the hospital structure and separate it into its own entity. The consortium recognized LFN would need the strength of its own organizational structure if it was going to
survive in the rapidly growing and increasingly competitive air medical industry. On October 1, 2007, LFN was separated from the hospital structure and began operations under its own
steam.
To better serve its existing customers and to provide much needed air medical service to growing distant communities, LFN began what would ultimately lead to years of growth
throughout the region.
In September of 2009, Boise-based Saint Alphonsus Life Flight made a strategic decision to join
LFN. Both LFN and Saint Alphonsus Life Flight realized long-term survivability would depend on the ability to collaborate with other like-minded organizations. Founded in 1986, Saint
Alphonsus Life Flight’s reputation in Idaho and eastern Oregon was unparalleled.
LFN continually looks to place bases in rural communities where a recognized need exists for
air medical service. On April 1, 2016, Spokane based Northwest MedStar became part of LFN. Northwest MedStar
originally formed in 1994 by merging two existing Spokane-based flight programs. Over the following two decades, Northwest MedStar built a world class reputation for providing safe and
high quality critical care transport on the ground and in the air from six bases in Washington and
Montana. In 2012, Northwest MedStar was recognized as the Association of Air Medical Services (AAMS) Program of the Year, a small testament to its success.
Today, LFN is a nationally recognized air ambulance operator covering a large part of Oregon, Idaho, Washington, and Montana, all while never losing sight of its core mission – to serve the
community by providing critical care transportation to ill or injured patients in a safe,
compassionate, efficient, and expeditious manner.
LFN maintains a robust membership program. Membership in LFN covers medically necessary
emergent rotor-wing, fixed-wing, and critical care ground transport in LFN aircraft and vehicles. Members transported by LFN, or one of our reciprocal partners, bear no out-of-pocket expenses
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for medically necessary emergent transports (subject to the terms in the Statement of Understanding, which can be found under the membership section of our website).
The LFN Foundation, a 501(c)(3) tax exempt organization, became operational on April 1, 2010. The foundation raises funds for aircraft and the infrastructure necessary to facilitate critical care
transport, and also provides support for training and community outreach programs, including trauma, critical care, brain injury, ground safety, cardiac care and injury prevention programs. Owners LFN is a not-for-profit medical transport service owned by a consortium of Legacy Health,
Oregon Health & Science University, Providence Health & Services, and Saint Alphonsus Regional Medical Center. All stakeholders are dedicated to improving patient outcomes by
providing safe and expeditious helicopter, fixed-wing airplane, and ground support to patients in
serious need.
Strategic governance of LFN is vested in the LFN Board of Directors. The Board consists of two
representatives from each member institution; management responsibilities are the purview of the Chief Executive Officer.
Legacy Emanuel Medical Center
www.legacyhealth.org
Oregon Health & Science University
www.ohsu.edu
Providence Health & Services
www.providence.org
Saint Alphonsus Regional Medical Center
www.saintalphonsus.org
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Awards and Accreditations
LFN received the Oregon EMS Commitment to Quality Award in 2008. In 2009, LFN proudly
accepted the AAMS Program of the Year award. This prestigious honor established a benchmark of excellence the program incorporates into current planning and operations and is
dedicated to building upon into the future.
In 2011, the program was named Oregon’s Fastest Growing Private Company by the Portland Business Journal, and CEO Michael Griffiths received the Oregon EMS Administrator of the
Year Award.
LFN was named the Best Nonprofit to Work For in Oregon in 2012 by Oregon Business
Magazine, after previous top 15 rankings in 2010 and 2011. Since then, LFN has consistently ranked in the top 15.
CEO Michael Griffiths received the AAMS Program Director of the Year Award in 2015 and was a finalist for the EY Entrepreneur of the Year. LFN also received the AAMS Excellence in
Community Service Award in recognition of our continuing broad-based commitment to the communities served and our dedication to various outreach and training programs.
In 2016, LFN was recognized by the Portland Business Journal as one of the Most Admired Companies and became the first air medical program in the world to achieve dual HAI-APS and
IS-BAO safety accreditations.
Service Area
LFN offers air and ground transport across the Pacific Northwest and Intermountain West. Helicopters typically operate within a 150-mile radius of its base, but have the capability to fly
longer distances. Fixed-wing aircraft can transport patients throughout the nation.
Rotor-wing bases are located in:
Aurora, Cottage Grove, Ontario, La Grande, Redmond, Astoria, and Pendleton, Oregon
Longview, Dallesport, Tri-Cities, Palouse, Moses Lake, Brewster and Spokane, Washington
Boise, Lewiston, Coeur d'Alene, Rexburg, Burley, and Sandpoint, Idaho
Butte and Missoula, Montana
Fixed-wing bases are located in:
Aurora and La Grande, Oregon
Dallesport, Tri-Cities and Spokane, Washington
Boise, Idaho
Butte and Missoula, Montana
In addition to air medical transport service, LFN has ground transportation available at the Eagle
base in Idaho, and the Tri-Cities and Spokane bases in Washington.
LFN transports emergent scene call patients based upon local and state EMS regulations. Transports between hospitals are based upon hospital and physician referral requests.
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Aircraft and Aviation Vendors
LFN utilizes 37 aircraft to support operations. LFN is an FAA Part 135 air carrier. Additional
aviation support is provided via two vendors, Boise-based Jackson Jet Center and Shreveport, LA-based Metro Aviation. All aircraft are Visual Flight Rules capable. The range of each rotor-
wing is approximately 300 nautical miles without refueling, and all rotor-wing aircraft use Night Vision Goggles.
AW119Kx - Koala LFN operates 19 AgustaWestland AW119Kx “Koala” helicopters, the first of which was placed into service during the summer of 2013. The Koala reaches speeds of 175 miles per hour and
comes equipped with a state-of-the-art Garmin G-1000H cockpit, night vision goggle capability, satellite weather, synthetic vision, and the capacity to transport two patients or a specialty team
with unencumbered full-body access.
AW109E
Operated by LFN, the AW109E “Power” twin-engine helicopter has advanced avionics and is
capable of flying under Instrument Flight Rules, making it ideally suited to take advantage of LFN’s proprietary low-level route structures, pending approval from the FAA.
H135 Operated by Metro Aviation, the 135 twin-engine helicopters are popular aircraft in the air
medical industry. Similar to the Agusta aircraft, the H135 is capable of transporting two patients or a specialty team. The rear patient care compartment is separate from the pilot area. The H135 has an enclosed tail rotor.
LFN utilizes eight PC-12 aircraft. Four are operated by LFN, three are operated by Metro Aviation, and one is operated by Jackson Jet Center. The Pilatus offers a larger interior space
for patient and crew and advanced avionics. Two King Air fixed-wing aircraft are provided by Metro Aviation. Safety
Safety and risk management are core philosophies of LFN. To meet all challenges associated
with the safe transport of critically ill or injured patients by helicopter, fixed-wing aircraft, and ground ambulance, our focus on safety is rigorous and unrelenting. Safety and risk
management is a strongly proactive and thoroughly integrated effort, completely supported by
the entire LFN organization as well as its contracted vendors. All operations are vetted through the safety and risk management department prior to implementation and are continuously
evaluated to ensure the highest degree of safety is provided to our employees and the public at large.
An absolute premium is placed on the experience, training, and professionalism of our pilots
and mechanics. Aircraft and ambulances utilized by LFN are maintained to the most rigorous standards in the industry.
LFN safety training is ongoing and comprehensive, maintaining the highest levels of proficiency. Shift briefings, annual Air Medical Resource Management courses, post flight debriefs, and as-
needed safety updates serve as the framework for crew training.
Prior to each transport, a comprehensive analysis occurs to determine if a flight can be safely
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completed. The pilot, medical crew, mechanic, communications specialist, and operational control specialist have the ability to terminate a transport request for any reason. LFN’s
Operational Control Center (OCC) oversees all flights for which LFN is the air carrier. All low-
light / night rotor flights are aided by Night Vision Goggles to improve visibility.
In 2004, the FAA established a task force to review and guide government and industry efforts to reduce air ambulance accidents. LFN adopted each and every one of their recommendations. Our OCC was fully functioning well in advance of the FAA deadline. Recommended aircraft
technologies were also employed even though at the time they were not mandatory, which include: Synthetic Vision, Helicopter Terrain Awareness and Warning System (HTAWS), Satellite communications and tracking, Night Vision Goggles, and XM satellite weather displays.
Our desire to provide the best Safety Management System (SMS) in the industry continues with
our dual accreditation of IS-BAO (International Standard – Business Aviation Operations) and
HAI’s (Helicopter Association International) Accreditation of Program Safety (APS). Both IS-BAO and HAI accreditations are globally recognized as the safety benchmark for Helicopter Air
Ambulance (HAA) operations. Both of these audits were completed in 2016 and LFN is the first
HAA operator in the world to achieve this dual standard.
Augmenting our safety efforts, LLFN utilizes several systems to enhance our safety posture, mitigate risks and ensure our Just Culture is fully functioning at every level of operations. Baldwin Safety and Compliance provides our documentation and data analytic system needed
to have a proactive SMS. Appareo Flight Data monitoring is employed in our aircraft and is the backbone of our Flight Operations Quality Assurance (FOQA) program.
LFN complies with applicable federal and state occupational health and safety laws, and Commission on Accreditation of Medical Transport Systems (CAMTS) accreditation standards. We adopt the best feasible practices, operations, and technologies conducive to creating and
maintaining an environment where safety is emphasized and risk minimized.
LFN’s commitment to safety is just that. We are committed to provide the safest possible air
medical transportation system. We will continue vetting our processes through industry standards to validate our processes and continue to be a leader at the forefront of HAA safety.
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Clients
LFN currently has contracts in place with a number of clients to provide critical care transport.
These include with PeaceHealth Oregon for critical care air transport, Kadlec Regional Medical
Center for air and ground transport, Trios Health for ground transport, and St. Alphonsus in
Boise, Idaho for ground transport. We have critical care ground ambulances in operation in
Richland and Spokane, Washington. We also provide air support for the OHSU Panda Team,
Legacy KIDS Team and ECMO Team, and the St. Alphonsus Neonatal Team.
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Clinical Excellence
LFN provides the highest clinical standards in the Northwest and Intermountain West of any air
medical transport program, and is accredited by the (CAMTS). Transport crews are equipped to care for both pediatric and adult patients with conditions related to Trauma, Neuro, Obstetrics,
Cardiac (STEMI), Vascular, Pulmonary, and other medical problems. Under the supervision of
LFN’s Medical Director and Associate Medical Directors, all Clinical Team Members participate in bi-annual advanced skills training (including surgical procedures) in a high fidelity simulation lab. Ongoing comprehensive clinical rotations at tertiary and quaternary care facilities ensure
our Clinical Team Members set the bar in critical care transport.
Equipment Crewmembers have the ability to perform a multitude of highly skilled medical functions during
transport. Each helicopter and fixed-wing aircraft is outfitted with the medical equipment
necessary to act as a mobile critical care unit, Including:
Zoll Propaq MD Cardiac Monitor
LTV 1200 Ventilator
Alaris MiniMed Pump
Blood Products
Thermal Angel Fluid Warmer
Critical Care Flight Nurses
Minimum of 5 years of ICU/ED/Trauma experience
NRP, PALS, ACLS, TNATC, PHTLS, CFRN, CEN and/or CCRN certifications
Flight and Ground EMT – Paramedics
Minimum of 5 years of experience as a paramedic
NRP, PALS, ACLS, PHTLS certifications Community Involvement
LFN is a partner in a much larger EMS continuum. Education and collaboration with our healthcare partners ensures the team is able to provide the best possible care to the patients
and communities we serve.
Outreach involvement with our health care partners:
Visiting fire departments, EMS agencies, and hospitals to present information on LFN’s
services
Landing zone training (selection and preparation)
Helicopter safety lectures
Participation in EMS and fire department open house events
Accident prevention programs
o High school drunk driving awareness (SKIDS, Every 15 Minutes) o Trauma Nurses Talk Tough
Participation in fire department, EMS and hospital QI/QA chart review process
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Participation in mock MCI and mock STEMI drills
Funding grants for local EMS agencies
Outreach continuing education:
Sponsorship of health care conferences
o EMS o Trauma
o Neuro o Cardiac (STEMI) o Pediatrics
o Critical Care o Medical o Rural Health
o Physician, nursing, and paramedic educational programs
Regional LFN hosted educational conferences
Lectures at conferences or workshops
Participation at skills stations
High fidelity simulation mannequin training in partnership with Oregon EMS for
Children's Program, Office of Rural Health, OHSU, ODOT, Idaho State University (ISU),
and Saint Alphonsus Regional Medical Center
Outreach programs for the general public:
LFN Membership Program presentations
Informational booths at community health and safety fairs
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References
PeaceHealth Oregon Tim Herrmann, Chief Administrative Officer 1515 Village Drive, Cottage Grove, OR 97424
THerrmann@peacehealth.org 541-767-5201
OHSU PANDA Denise Foster, Division Director, Women’s and Children’s Services
3181 S.W. Sam Jackson Park Rd, Portland, Oregon 97239-3098
fosterde@ohsu.edu 503-418-4036
Legacy Health- ECMO Team Tanya Shanks-Connors, Clinical Director, Trauma, Emergency Services, Critical Care, Oregon
Burn Center, Respiratory Therapy, Cardiopulmonary, and ECMO Services. 2801 N. Gantenbein Ave., Portland, OR 97227
TShanks@LHS.ORG
503-413-4546
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3. General Qualifications and Requirements
a. General Qualifications
As described in the background information, LFN has approximately 38 years of critical care
transport experience, which includes both air and ground transportation. LFN began providing local service to the citizens of Lane County in 2008, which included basing a helicopter in
Eugene. The value of the jobs created by this base is in excess of $1,000,000 annually. Across the entire service region, the population served by LFN is conservatively in excess of eight million people.
LFN is accredited by CAMTS at the critical care level. This accreditation applies to helicopter, fixed-wing, and ground transport. b. General Requirements
i. Performance Security LFN will consider executing and delivering a performance bond should the City guarantee a minimum number of transports and or collectable revenue. In the event the City does not
guarantee a minimum number of transports, a performance bond may not be provided.
ii. Equal Opportunity
LFN is an equal opportunity employer. It is the policy of LFN to recognize the dignity of the individual and to be fair and impartial in all its relations with employees and applicants without
regard to race, color, national origin, citizenship, religion, age, gender, disability, marital status,
sexual orientation, gender identity, veteran, current or future military status, genetic information or any other basis prohibited by federal, state, or local law.
This policy applies not only to hiring but also to compensation, promotion, demotion, transfer, termination, training, facilities, seniority, and all other conditions and terms of employment. All
employees are initially selected and later considered for promotion on the basis of verified or demonstrated ability to best fulfill the requirements of the position. Our policy fully embraces equality of opportunity for all employees with respect to all employment matters.
LFN does not discriminate against any applicant or employee in hiring or in the terms, conditions, and privileges of employment based upon pregnancy, childbirth, related medical
conditions or genetic information.
LFN will make reasonable accommodations for religious beliefs.
iii. Proposer’s Responsibilities
LFN will assume responsibility for all services offered in the proposal and for all contractual
matters.
iv. Insurance Upon contract execution, LFN will, at its own expense, maintain and keep in force insurance which meets or exceeds requirements as set forth in Attachment 2 – Sample Contract, Section
13 – Insurance of the RFP, which will protect LFN and the City from claims which may arise out of or result from the operations under the agreement.
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LFN will submit proof of insurance coverage as part of the agreement signing process and prior to beginning work under the agreement.
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4. Performance Requirements
a. System Integration i. Scope of Services Generally
LFN will provide Critical Care Transport (CCT) services from the three hospitals within
Ambulance Service Areas 4 & 5 (ASA #4 & 5) assigned to the City of Springfield and the City of Eugene under the Lane County Area Service Plan. Emergent ground and air CCT ambulance
transport will be provided (7) days per week, twenty-four (24) hours each day. Medically necessary emergent transport is provided without regard to the patient’s status or ability to pay costs.
The resultant contract will contain language defining CCT transport criteria, as defined by the Lane County Medical Control Board. All CCT patients leaving Lane County, as part of this
agreement, will be transported by air. If air transport is not possible, LFN will make reasonable efforts to provide ground transport as outlined in this response.
ii. Start-up LFN will continue existing operations uninterrupted.
b. Deployment Plan
LFN will develop and maintain a current deployment plan. The Cottage Grove helicopter base is staffed 24-hours per day. The subcontracted ambulance
provider will ensure unit availability to meet response time requirements.
Services will be provided by utilizing the registered nurse (RN) and paramedic stationed at the
Cottage Grove helicopter base in partnership with a ground ambulance provider. The Cottage Grove base has four (4) RNs and seven (7) paramedics assigned to it. Two (2)
additional RNs and one additional (1) paramedic float between bases. LFN also employs nine (9) RNs and fourteen (14) paramedics who work out of the Aurora and Redmond bases. They
are capable of floating to the Cottage Grove base should there be a need.
Crew call back does not exist. Should call volume increase, this will be evaluated.
During adverse weather or other conditions that prohibit the use of aircraft, LFN will utilize subcontracted providers and respond by ground transport.
LFN subcontracts transportation services to South Lane Fire and Rescue. LFN uses Metro West as a backup service to South Lane Fire and Rescue. LFN reserves the right to change
subcontractors to maintain the integrity of the service provided. c. Operational Requirements
i. Response Time Requirements LFN will respond to CCT transports upon dispatch. Response time will be less than thirty (30)
minutes of dispatch whenever the crew and ambulance are available.
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ii. Failure to Meet Response Time Requirements and Exemptions LFN will meet or exceed required response times when the crew and resources are available.
LFN will make every effort to minimize fluctuations in response time performance according to
time of day, day of the week, and week of the month.
Circumstances and conditions beyond LFN’s control may produce response times which exceed requirements. LFN will deploy a single crew assigned to Cottage Grove to respond to air and or ground transports. A back-up crew in Aurora, OR will be available to respond by air should
another transport be in progress. If LFN believes any run or group of runs should be excluded from response time standards, a
written request will be submitted with quarterly Response Time Reports.
d. Dispatch Requirements
LFN will provide a toll-free number which will be answered by the LFN’s Communications
Center. Dispatch functions will be incorporated into LFN’s existing Communication Center. The Communications Center will be responsible for call taking and dispatching personnel. Training
for Communications Center staff meets or exceeds CAMTS standards. e. Equipment and Supplies
i. Communications Equipment LFN will provide sufficient equipment to effectively communicate with the CCT medical crew. This communication currently occurs via a Verizon push-to-talk device.
ii. Medical Equipment and Supplies
1. Specifications and Coordination LFN will utilize an ambulance with supplies and equipment necessary to carry out CCT
transports. Equipment and supplies will meet or exceed Oregon Health Authority requirements.
Equipment will meet or exceed the City’s supply and equipment requirements assuming no accommodation or list modification is unreasonably withheld.
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2. List
LTV 1200 ventilator
Thermal Angel fluid warmer 2 3-channel pumps with tubing
Zoll Propak MD monitor 2 invasive pressure monitoring setups 2 LTV 1200 ventilator circuits 1-pediatric 1- adult
Appropriate critical care medications: Ketamine, Lorazepam, Midazolam, Rocuronium, Succinylcholine, Fentanyl, Dilaudid, Morphine, Ondansetron, Racemic Epi 2.25%, Solu-Medrol,
Albuterol, Atrovent, Labetalol, Adenosine, Adenosine, Diphenhydramine, Epinephrine 1:1,000 Furosemide Metoprolol, Naloxone, Nitrostat, Ondansetron, Aspirin, Calcium Gluconate,
Clevidipine, Dopamine, Heparin, Levophed, Nitroglycerin, Sodium Chloride, Lidocaine,
Cardene, Esmolol, Dextrose, Diltiazem, Magnesium Sulfate, Acetaminophen, Cytotec, Hydralazine, Methergine, Nifedipine, Oxytocin
Miscellaneous supplies: C-Mac, ETT 2.5-8.0, chest tube insertion kit, Bi-PAP masks, Bougniac, needle decompression equipment, laryngoscopes 0-3 Mac and Miller, colormetric end tidal, tube
securing devices, OPA, NPA, non rebreather mask, nasal cannula, magill forceps, surgical cricothyrotomy supplies, needle cricothyrotomy supplies, ambu bags adult/peds-manometer, glucose monitor, ACLS medications, neonate-ex large adult cuffs, invasive temp probe,
tourniquet, pressure bags, IV start kit including angiocaths, extension sets, start kits Narcotics, benzodiazepines, IO needles, ketamine, antiemetic, OB Kit
3. Exchange LFN or ambulance subcontractor will provide and maintain its own equipment and will not rely on exchanges from the City or Central Lane EMS unless a separate agreement with Central
Lane EMS is reached.
4. Logistics
LFN and or ambulance subcontractor will purchase all supplies and equipment and maintain the cleanliness and adherence to infection control procedures for all equipment and transports. LFN
utilizes a supply distribution company for the existing helicopter base which ships supplies
directly from the distributor to the base, eliminating delays associated with a company distribution point.
iii. Ambulances
iv. Quality
All ambulances associated with CCT transport pursuant to an executed agreement will be in good working order and appearance. No Type I ambulances utilized will have mileage in excess
of 200,000 miles unless otherwise approved. No Type II ambulances utilized will have mileage
in excess of 100,000 miles unless otherwise approved. No Type III ambulances utilized will have mileage in excess of 150,000 miles unless otherwise approved. Vehicles or equipment
that the City reasonably determines to have cosmetic or physical deficiencies that may
negatively impact customer perception shall be removed from service and either replaced or repaired without undue delay.
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v. Specifications All ambulances utilized must be licensed as required by the Oregon Health Authority and City of
Springfield Municipal Code Section 7.032, and will meet or exceed the requirements set forth in
ORS 682.051 to 682.991 and OAR 333-255-0060, in addition to the requirements herein.
vi. Color, Marking and Warning Devices
Markings and color schemes will be approved by the City prior to implementation unless prior approval for the subcontracted ambulance vendor has already been provided or the ambulance vendor is currently licensed to operate in Springfield’s ASA in any capacity.
vii. Maintenance
LFN or ambulance subcontractor will maintain ambulances and equipment in a manner to
achieve the highest standard of safety, reliability and appearance. Personnel utilized to maintain
vehicles and equipment will be properly trained, certified, and knowledgeable as applicable.
viii. List
LFN or ambulance subcontractor will maintain a current list of ambulances. The list will be available upon request. The list will contain at minimum, the license number, vehicle
identification number, name, and address of any applicable lien holder. f. Personnel and Clinical Standards
i. Staff, General
LFN and subcontracted ambulance staff confirm to the highest clinical and professional standards. They will comply with all applicable City, County, State, and Federal laws. Staff are
competent in the performance of their duties and hold and maintain applicable and valid
certifications/licenses/ accreditations in their respective roles or profession.
ii. Command and Control Structure LFN and subcontracted ambulance staff associated with a resultant agreement will be NIMS compliant throughout the duration of a contract with the City. All staff will complete IS-100
(Introduction to Incident Command System) and IS-700 (National Incident Management System).
iii. Ambulance Staffing LFN will staff the CCT ambulance with the existing medical crew staffing the medical helicopter
stationed in Cottage Grove. Crew composition typically consists of one (1) RN certified in
medical and trauma care (e.g. CFRN, or CEN, or CCRN within one year of hire) and one (1) paramedic. On rare occasion, a second RN may be substitute for the paramedic. The RN will
always be with the patient in the patient compartment of the ambulance.
LFN or ambulance subcontractor will provide at least one qualified driver. All staff certified by
the Oregon Health Authority will meet applicable requirements. When operating an ambulance, all personnel will meet the applicable requirements of ORS
682.051 to 682.991 and OAR 333-255-0070. All personnel staffing ambulances will be certified, in good standing, with the Oregon Health Authority.
LFN will use reasonable efforts to hire and retain personnel with bilingual skills, especially Spanish.
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iv. Management and Supervision LFN and ambulance subcontractor will provide the management and supervision necessary for
effective oversight, and administration of CCT services. LFN employs a local Base Manager and
Clinical Manager responsible for operation of the Cottage Grove Base. When available, these managers can respond upon request. When not available, LFN provides an Administrator on
Call (AOC) at all times. AOCs are seasoned leaders within the organization who have current credentials and applicable field experience. In the event the local Base Manager or Clinical Manager is not available to respond, the AOC will provide guidance via telephone. The AOC is
accessible through LFN’s Communication Center. The contract administrator named by LFN in its proposal will not be changed without approval of
the City.
v. Uniforms and Appearance of Personnel,
LFN and ambulance subcontractor staff will wear clean and professional uniforms. The LFN RN and Paramedic typically wear Nomex flight suits, associated with critical care flight crews. Flight
suits display the crewmember’s name, and applicable certification or license. During colder
weather, staff may wear company issue outerwear clearly identifying them as employees of LFN.
vi. Competence and Professionalism
LFN and ambulance subcontractor will demonstrate professional and courteous conduct and
appearance at all times.
vii. Personnel Training
1. Orientation of Employees
LFN has a rigorous initial and ongoing education / orientation program overseen by a Clinical Education Manager. This program is detailed in policy and within LFN’s medical supervision
plan. The orientation program meets and or exceeds CAMTS and Oregon Health Authority standards. The orientation includes, but is not limited to: overview of local EMS systems, applicable policies, procedures, orders and protocols (to include HIPAA and infection control);
all communications; navigation, mapping, hospital routes; ambulance equipment utilization and maintenance.
The Clinical Education Manager maintains documentation of compliance with all records. The medical supervision plan, associated polices, training documents, and records are available for
review upon request.
2. Training Records
LFN utilizes an online records management system to coordinate training and ensure
appropriate credentials are valid. Training records are available for review upon request.
3. Student Internships
LFN has a ride along program to assist students needing experience observing in the field. In
addition, LFN has an extensive outreach education program and is actively engaged in EMS training and certification in the region.
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4. Community Outreach
LFN participates in local community injury prevention activities. LFN will work in coordination
with the Eugene Springfield Fire Battalion Chief of EMS with activities planned in the Eugene Springfield service area. g. Medical Direction
LFN will at all times, and at its’ own expense, contract with a Medical Director. LFN’s Medical Director will act as the Supervising Physician for purposes of assigning and monitoring the
quality of care and education. The terms of the agreement, including compensation, shall be
negotiated and entered into as an independent and separate agreement.
Medical Director: James (Jim) Bryan, MD, PhD
Current Associate Medical Director for Cottage Grove: Melissa Doherty, MD
Dr. Doherty is a local Emergency Medicine physician practicing at Sacred Heart Medical Center – Riverbend. In addition to her local participation with the Lane County Medical Control Board, Dr. Doherty is the Supervising Physician for Eugene Fire & EMS and Metro West.
Both Dr. Bryan and Dr. Doherty actively participate in company quality improvement and education initiatives. h. Standing Medical Orders and Treatment Protocols
Medical Treatment Protocols are reviewed by the LFN Medical Director and Associate Medical Directors annually. In addition to local review, several external physicians provide input on their
relative fields of expertise. The LFN protocols are vast, covering an array of patients commonly
encountered with aeromedical and CCT services. Protocols are available for review upon request.
i. Work Schedules and Employee Affairs
LFN has strict policies governing work schedules, as mandated by CAMTS, which exceed Oregon Health Authority requirements. Full-time employees typically work a 36-hour work week, working no more than a 24-hour shift at a time. Employees are required to have sufficient rest
between shifts, as required by CAMTS and the Oregon Health Authority.
LFN compensation policies are generous and fair.
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5. Quality, Performance, and Audit Programs
a. Compliance and Audit Program
LFN shall establish and maintain a compliance and audit program as recommended by the
Office of the Inspector General for all Centers for Medicare/Medicaid Services (CMS) programs
applicable to ambulance transportation. In addition, LFN will provide prompt response and
follow-up to inquiries and complaints from CMS, the Oregon Health Plan, and the City.
b. Quality Audits and Inspections
LFN will cooperate with City representatives at any time, and without notification, in inspections
of LFN’s operations directly related to services provided in the agreement. This shall include,
but not be limited to, CQI assessments, ambulances, repair facilities, communication, and
administration facilities. In addition, City representatives may ride as observers on any
ambulance at any time.
LFN will also provide city representatives all reports and data that LFN is required to collect, maintain or provide within 48 hours’ notice within normal business hours.
c. Data and Information Reporting
LFN shall be responsible for data input and reporting in a manner which facilitates review by the
City and any other entity authorized by law or contract to review data and reporting. All systems and reports will comply with the City’s ASA requirements as well as City, State, and Federal
data collection and reporting requirements.
i. Response Time and Non-Compliant Response Report
LFN will compile and submit to the City electronically quarterly response reports for each
quarter no later than 5 PM, five (5) business days after the final day of the quarter. The contact for this requirement will be the Eugene Springfield Fire Battalion Chief of EMS.
For each incident for which a response is dispatched, the quarterly response time compliance report shall include, but not be limited to:
A unique LFN run number;
Dispatch date;
Dispatch time;
En-route to hospital time;
Arrive at hospital time;
Time transport ended, (clear time); and
Identification number of the ambulance(s) that arrived on scene.
ii. Non-Compliant Response Report
LFN will submit a quarterly non-compliant response report electronically to the City, no later than 5 PM, five (5) business days after the final day of the quarter. The contact for this requirement will be the Eugene Springfield Fire Battalion Chief of EMS.This report shall include
all information outlined in Section 5.d.i for all calls in which the response time requirements were not achieved, if any.
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iii. Incident Reports
LFN will complete and submit to the City within 48 hours, or any shorter time if required by the
Eugene Springfield Fire Battalion Chief of EMS, incident reports for each action considered non-
conforming to policies and procedures and for any other incident if requested by the City. Non-
conforming incidents include, but are not limited to, ambulance accidents or vehicle failures
while on a call, equipment failures, patient injuries, and patient or facility complaints. A copy of
all incident reports shall also be maintained on file at LFNs administrative offices. Reports will
only be provided if disclosure is permitted by law, remains protected under applicable law, and
remains exempt from public disclosure.
Incident reports must include but not be limited to the following information:
Date of incident;
Incident number if applicable;
Personnel involved;
Unit number if applicable;
A detailed narrative of the event; and
A narrative of corrective action taken.
iv. Quality Improvement Reports
Similar to the incident reporting system described above, quality improvement reports are
captured via the online system utilized by LFN. As part of an ongoing QI program, the Director
of Quality Improvement holds general and clinical QI meetings monthly to review reports.
Upon request, LFN will provide a summary of a quality improvement report applicable to CCT
ground services provided under a resultant agreement. The summary will only be provided if
disclosure is permitted by law, remains protected under applicable law, and exempt from public
disclosure.
v. Pre-Hospital Care Reports
Electronic pre-hospital care reports (PCR) are completed for all patients for whom care is
rendered. The system currently in use is provided by emsCharts. PCRs meet Oregon Health
Authority and CAMTS requirements.
d. Record Requests
LFN and or ambulance subcontractor will complete, maintain, and if requested by the City,
provide access to or copies of the following records as related to CCT services provided under a resultant agreement:
Equipment failure records;
Vehicle maintenance records;
Patient account records;
Deployment planning records;
Continuing education and training records; and
Office of Inspector General recommended Medicare Audit Compliance reports.
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6. Finance and Administration
a. Business Office, Billing and Collection System
LFN or ambulance subcontractor will be responsible for CCT ambulance billing services
provided by LFN or ambulance subcontractor as part of a resultant agreement. LFN utilizes a
billing and collections system provided by Zoll. The system is easy to audit, is HIPAA compliant, minimizes the effort required to obtain reimbursement from third party payers and capable of
electronically filing Medicare claims.
LFN and or ambulance subcontractor will provide a local or toll free phone number for inquiring
patients and third-party payers. This phone number is included on all ambulance bills.
b. Ambulance Rates
CCT ground transport rates will remain consistent with reasonable and necessary charges
elsewhere in the company.
Current CCT ambulances rates are:
Base: $4,499.00
Loaded Mile: $53.00
c. Compliance with All Laws and Regulations and Reporting
i. Compliance
LFN and applicable ambulance subcontractor will comply with applicable federal, state and local laws, regulations, rules and procedures applicable to the provision of services provided,
including without any limitation whatsoever the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191 (HIPAA), and its implementing regulations; Oregon Revised Statutes chapter 682; Oregon Administrative Rules Chapter 333
divisions 250, 255, 260 and 265; and Oregon Administrative Rules Chapter 847, division 035,
and Oregon Occupational Health & Safety Administration (OR-OSHA). LFN must also obey all provisions of the Lane County Ambulance Service Plans and ordinances applicable to
ambulance providers (except response time reporting for which the City will be responsible).
LFN will also comply with all provisions in this response to request for proposal and nothing in
the foregoing shall be construed to allow the provider to not comply with any request for
proposal requirement imposing additional or higher or stricter standards or requirements.
ii. Reporting to City
LFN shall notify the City anytime LFN or any of its employees are named or noticed in any administrative, civil or criminal proceeding, as applicable to the services provided under a
resultant agreement. This notice shall be in written form and forwarded to the City within five (5)
working days of the date the provider or any of its employees become aware of any such claim or notice.
LFN shall also notify the City anytime the provider or any of its employees are audited by any regulatory authority, as applicable to the services provided under a resultant agreement. This
notice shall be in written form and forwarded to the City within five (5) working days of the date the provider or any of its employees become aware of any such audit.
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LFN shall notify the City of the results of any proceeding or audit, as applicable to the services provided under a resultant agreement. This notice shall be in written form and forwarded to the
City within five (5) working days of the resolution.
7. Independent Contractor Agreement
By submitting a proposal in response to this request for proposal, LFN agrees if selected, the proposer will enter into an Agreement with the City in a form substantially similar to Attachment
2. LFN specifically and expressly agrees the following provisions will be included in the
agreement awarded as a result of this request for proposal. a. Oregon Revised Statutes, Chapter 279 Provisions
i. LFN shall make payment promptly, as due, to all persons supplying to the provider labor or
material for the prosecution of the work provided for in the agreement. ii. LFN shall not permit any lien or claim to be filed or prosecuted against the
City of Springfield, on account of any labor or material furnished. iii. LFN shall pay to the Oregon Department of Revenue all sums withheld from employees
pursuant to ORS 316.167.
iv. LFN shall demonstrate an employee drug testing program, acceptable to the City, is in place. v. LFN’s employees shall be paid at least time and a half for all overtime worked in excess of 40
hours in any one week, except for individuals who are excluded under ORS 653.010 to 653.261 or under 29 U.S.C. sections 201 to 209 from receiving overtime. vi. LFN shall promptly, as due, make payment to any person, co-partnership, association or
corporation, furnishing medical, surgical and hospital care or other needed care and attention, incident to sickness or injury, to employees, of all sums which provider agrees to pay for such
services and all moneys and sums which provider collected or deducted from the wages of
employees pursuant to any law, contract or agreement for the purpose of providing or paying for such service.
b. Supporting Documents and Order of Precedence
The following documents are, by this reference, expressly incorporated in the Agreement, and are collectively referred to as the "Supporting Documents":
i. The City's Request for Proposals (or other document, however named, which constitutes the City's written request or invitation to submit proposals), together with any documents incorporated by reference RFP1614 Critical Care Ambulance Transport Services Page 27 of 55
therein.
ii. The City's Letter of Award (or other written document accepting provider's Proposal with any modifications or clarifications).
iii. The provider's written Proposal (or other written response to the City's invitation, as accepted by the City). The Agreement and the Supporting Documents shall be construed to be mutually
complimentary and supplementary wherever possible. In the event of a conflict which cannot be so resolved, the provisions of the agreement itself shall control over any conflicting provisions in
any of the Supporting Documents. c. Payment of Taxes The provider shall assume and pay all applicable State, Federal, and Municipal taxes and
contributions which are payable by virtue of the performance of this agreement. The City shall
not be responsible for any taxes and will provide its tax exempt identification number upon request.
d. HIPAA Compliance The City and provider will be compliant with all current and future HIPAA rules and regulations implemented. The City and provider will enter into HIPAA Business Associate Agreements
which will be in effect throughout the terms of the agreement.
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e. Identity Theft Protection Program The City and provider will be compliant with the Oregon Identity Theft Protection Act of 2007
(ORS 646A.600). In order to comply, the provider shall maintain a program with appropriate
policies designed to detect, prevent and mitigate identity theft.
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Attachment 2- Sample Contract
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Attachment 3- Performance Bond
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Attachment 4- Authorization to Legally Bind Bidder
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Attachment 5- Minority Women Emerging Small Business Form
(MWESB)
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Attachment 6- FireMed Terms and Conditions (for reference only).
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FireMed Ambulance Membership Program Terms of Agreement
By Joining FireMed, members agree to abide by the Terms of Agreement below.
DEFINITION: FIREMED is a voluntary ambulance membership
program operated by the City of Eugene, the City of Springfield,
and Lane Fire Authority, hereinafter referred to as FIREMED.
FIREMED is not insurance. It is in addition to any medical benefits
members may have. FIREMED will bill insurance or other coverage
for ambulance services that members may have and FIREMED is
entitled to all benefits paid for ambulance services rendered, up to
the total dollar amount of services incurred.
MEMBERSHIP BENEFITS: Membership covers applicable
patient out-of-pocket expenses for medically necessary
ground ambulance transportation to the nearest appropriate
hospital, provided by FIREMED within the FIREMED ambulance
service areas of the City of Eugene, City of Springfield, and
Lane Fire Authority. “Medically necessary ground ambulance
transportation” means that the patient must be transported to
a hospital for medically necessary services, and transportation
in any other vehicle could endanger the patient’s health.
MEMBERSHIP BENEFITS OUTSIDE OF LOCAL SERVICE AREA:
Other participating reciprocal ambulance providers may extend
member benefits to areas outside the FIREMED ambulance
service areas. These benefits are limited to the terms of
agreement in effect by the participating provider providing
services at the time benefits are used. Members who receive
reciprocal ambulance service from any other participating
provider are eligible for benefits offered by that provider, if the
member agrees to abide by the participating provider’s terms
of agreement. A current list of participating providers is on file
in the FIREMED business office and on the website: firemed.
org. FIREMED is not responsible for the type, level, or quality
of services provided by a participating provider nor is FIREMED
financially responsible for any costs or charges incurred by a
member from any other provider. Participating providers are
subject to change without notice. FIREMED is not responsible
for the withdrawal of participating reciprocal providers.
MEMBER RESPONSIBILITIES: Members pay an annual
membership fee and will assign and transfer to FIREMED all
rights and benefits for ambulance services from all insurance
policies, plans, or other benefit programs members may have,
including all rights in any claim or third party recovery, up to
the total dollar amount of services incurred, where FIREMED
provided ambulance services. Should any person covered
under this membership receive any payment for ambulance
services rendered by FIREMED, they will immediately forward
such payment to FIREMED. Members authorize the release of
medical and other information by or to FIREMED as necessary
for ambulance billing. Members agree to provide, when
requested, any or all information concerning insurance policies,
plans, third party recovery, or other benefit programs they may
have, and will cooperate and assist as necessary in any efforts
to bill and collect such ambulance reimbursements, including
the completion and submission of documents or claim forms.
MEMBERSHIP ELIGIBILITY: Residents of FIREMED’s ambulance
service areas are eligible to join by properly completing an
enrollment application available from FIREMED and by paying
the appropriate annual membership fee. FIREMED membership
includes all persons who are permanent residents of the same
single-family occupancy, non-commercial residence, living
within FIREMED’s ambulance service areas, living together as part
of a family unit, including domestic partners, but not to include
roomers or boarders. Membership benefits include household
members living in substitute care (e.g. nursing homes) in
FIREMED’s ambulance service areas. Others not included in this
definition are required to obtain their own separate membership.
The first person listed on the application form is the “Primary
Member.” Anyone who joins a household after the membership
goes into effect can be included under the membership from
the date the Primary Member notifies FIREMED of the addition.
Only those persons who meet the membership eligibility
requirements AND are listed in the membership record at the
time services are rendered are eligible for benefits.
DURATION: Membership coverage begins two business days
after acceptance of a properly completed application form
with payment, and extends for 1 year from date of issue.
TO THE MEMBER’S INSURANCE CARRIER (FOR MEMBERS WITH
INSURANCE): As a FIREMED member, I authorize use of a copy
of this agreement in place of the original on file at the FIREMED
office. I assign and authorize payment of benefits for ambulance
services directly to FIREMED, according to the FIREMED terms of
agreement and as itemized on claim forms. My membership fee
covers any applicable deductible, coinsurance, or co-payment
amounts and I expect the usual and customary ambulance
reimbursement on my behalf be sent directly to FIREMED.
DISCLAIMER: FIREMED reserves the right to add, modify, or
delete any of the program terms and conditions completely or in
part. All interpretations of the membership terms and conditions
shall be at the sole discretion of FIREMED. Membership is non-
transferable and non-refundable. Persons who receive welfare,
Medicaid, Department of Medical Assistance Programs, or Oregon
Health Plan medical benefits need not be members in order to
have full coverage for services covered under these programs.
Any such membership constitutes a voluntary contribution only.
Violations of the terms of agreement may result in membership
revocation, forfeiture of benefits associated with membership
and an obligation to pay all balances in full.
FIREMED PLUS, LIFE FLIGHT NETWORK AIR AMBULANCE
OPTION: Life Flight Network air ambulance membership is
an optional coverage available for an extra fee. See Life Flight
Network membership brochure at www.lifeflight.org, or call
1-800-982-9299 for latest membership terms. If you or a family/
household member uses Life Flight Network emergency air
transport under medically necessary circumstances, Life Flight
Network will accept an insurance settlement (if any) as payment
in full. Related ground ambulance transport is covered when
provided by a FIREMED network reciprocal provider. Life Flight
Network flies patients based on medical need, not membership
status. Within the Oregon FireMed coverage area, emergency air
membership with Life Flight Network (LFN) is limited to transports
provided by LFN. You may be billed by air services provided by
other air emergency providers. Medicaid beneficiaries should
not apply for membership. Coverage begins 72 hours after
receipt of a properly completed application form with payment,
and extends for 1 year from date of membership enrollment.
A large print version of this text is available at firemed.org
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