HomeMy WebLinkAboutSt. Vincent Hosp & Health/CFD 4Je. 0300.
APPROVED, AS 1'0
AGREEMENT FOR LIFE SUPPORT SERVICESI~OR~
THIS AGREEMENT ("Agreement") is entered into by and between ST. VINCENT
HOSPITAL AND HEALTH CARE CENTER, INC., an Indiana not-for-profit corporation
(hereinafter "Hospital"), and CITY OF CARMEL FIRE DEPARTMENT (hereinafter
"Carmel").
WITNESSETH:
WHEREAS, Hospital for several years, has been, and is now acting and performing as a
supervising hospital, as defined by the State Emergency Medical Services Commission (the
"Commission"), in training, supervising and evaluating Paramedic Students in the furnishing of
emergency medical services; and
WHEREAS, this Agreement is intended to satisfy the Hospital's obligation, as a
supervising hospital, to have a written contractual agreement with one or more emergency
medical services provider organizations that furnish life support service; and
WHEREAS, the Hospital desires to provide life support Educational Experiences for its
Paramedic Students which would involve said Paramedic Students providing life support
services while aboard ambulances; and
WHEREAS, Carmel has available to it ambulances in which a qualified Paramedic
Preceptor, employed by the Hospital, could provide certain Educational Experiences for the
Paramedic Students; and
WHEREAS, Carmel is willing to allow the Paramedic Preceptors to provide life support
Educational Experiences for the Paramedic Students in such ambulances; and
WHEREAS, Carmel is a governmental entity which is,%ertified .by the Commission to
provide emergency medical services to the residents of Carmel, ~-a~r~'~unty, Indiana; and
WHEREAS, Carmel desires the Hospital to provide training for its paramedic students
and to be a supervising hospital for Carmel's life support services.
NOW, THEREFORE, in consideration of the mutual covenants contained herein, the
parties agree as follows:
I. DEFINITIONS
Unless otherwise clearly required by the context of this Agreement, the terms set forth
below shall have the following meanings. Other terms used herein shall have the
meanings ascribed thereto in the Act, as defined below.
Il.
1.1
"Life Support" shall mean basic life support and advanced life support as those
terms are defined in the Act.
1.2
"Educational Experiences" shall mean those experiences provided by the
Paramedic Preceptor pursuant to the terms of this Agreement.
1.3
"Act" shall mean the Emergency Medical Services Act, as outlined in Title 16,
Article 31, of the Indiana Code, and the regulations promulgated thereunder in
Title 836 of the Indiana Administrative Code, Articles 1 through 4.
1.4 "Paramedic student" or "Student" shall mean a paramedic student.
1.5
"Paramedic Preceptor" or "Preceptor" shall mean those certified individuals
employed by Hospital that are qualified to act as Preceptor/Instructor for
Paramedic Students.
1.6
"Policies of Hospital" shall mean and include the Bylaws and rules of the
Hospital, the Bylaws and rules of the Medical Staff as approved by the Hospital
Board of Directors, and other established policies, practices and procedures of the
Hospital.
HOSPITAL SERVICES
2.1
Certification of Hospital. The Hospital shall remain certified as a Supervising
Hospital and a Training Institution throughout the term of this Agreement.
2.2
Services. Hospital agrees to provide medical supervision of life support services
performed by Carmel's paramedics in accordance with the Act.
2.2-1
Continuing Education. The Hospital shall provide continuing education
and instruction from time to time for paramedics who have completed the
Paramedic Training Program. Hospital agrees to provide continuing
education and instruction in accordance with applicable regulations
promulgated by the Commission and any other requirements established
by the Commission. The Hospital may establish guidelines or
requirements which exceed those established by the Commission if such is
deemed advisable by the Hospital in the interests of quality patient care.
Carmel agrees that it shall not employ nor permit a paramedic to perform
life support services unless the paramedic has successfully achieved the
objectives of continuing education as determined by Hospital. Carmel
agrees to comply with any additional guidelines or requirements
established by the Hospital.
2.2-2 Audit and Review. The Hospital shall provide audit and review services
from time to time for the purpose of assessing the level of performance of
Carmel's individual paramedics and the overall performance levels of
Carmel in its rendering of life support services. The Hospital shall provide
Carmel with data relevant to the quality of care provided by its paramedics
and its general performance of life support services. Such audit and
review services will include, but are not limited to: routine audits of
patient care based on review of patient records; observance of field
operations; inspections of equipment and facilities; and critiques of radio
communications.
The Hospital shall also audit and review medical procedures performed by
Carmel's clinical personnel in order to ensure an appropriate level of
compliance with medical protocols, and an appropriate level of skill in the
performance of medical techniques by those personnel.
2.2-3 Medical Control and Direction.
(a)
Protocols. The Hospital shall develop standardized policies and
procedures for medical control and the development of system
protocol and/or standing orders to ensure the proper response to all
emergency situations by paramedics. The protocols shall be signed
by the Medical Director or his designee and said protocols are
incorporated herein by reference thereto and made a part of this
Agreement. A protocol may be terminated or modified by mutual
agreement of the parties or unilaterally by the Hospital upon
written notice to Carmel, wherein said termination or modification
by the Hospital shall be effective upon Carmel's receipt of the
Hospital's written notice.
(b)
Location of Protocols. Copies of complete and current protocols
are to be kept in all Carmel certified emergency medical vehicles,
the Carmel dispatcher's office and in the Hospital emergency
department. A copy shall also be provided to the Commission.
Carmel shall be responsible for distributing a copy of the protocols
to every EMT and paramedic and shall also distribute a copy of
every written termination or modification of a protocol to every
EMT and paramedic. The Hospital shall post copies of all written
protocols and copies of every written termination or revision of a
protocol in the Hospital's emergency department and shall make
them immediately available upon request.
(c)
Physicians' Orders. Direct communication of an instruction of
order from a physician in the Hospital's Emergency Department
shall take precedence over all written protocols.
2.3
2.4
(d)
Performance Standards. The Hospital may establish standards
regarding overall performance of Carmel paramedics which may
exceed those established by the Commission as the Hospital in its
discretion deems advisable in the interest of quality patient care.
Carmel agrees to comply with all such performance standards
within ninety (90) days after written notice of such performance
standards is provided to Carmel by the Hospital. Said ninety (90)
days notice requirement shall not apply if the Hospital determines
that the performance standards must be implemented in a shorter
period of time or upon immediate notice for medical or patient care
reasons. If such a determination is made by the Hospital and is
indicated in the written notice, Carmel agrees to implement the
performance standards immediately upon receipt of said notice or
as otherwise directed in said notice.
2.2-4
Emergency Medical Drugs and Supplies. All drugs and supplies required
for the rendering of life support services shall be supplied to Carmel by the
Hospital. The Hospital shall provide Carmel with a new drug or supply
item or its equivalent when Carmel presents the Hospital with a used drug
or supply item or documented proof that such drug or supply item has
been used. Lost, stolen or misused drugs or supplies shall only be
provided when specifically ordered in writing by Carmel's Medical
Director. Carmel agrees to comply with all accountability and
documentation requirements established by the Indiana Board of
Pharmacy and all policies and procedures of the Hospital and its pharmacy
regarding such. Carmel shall reimburse Hospital for such drugs and
supplies pursuant to Section 5.1.
Emergency Medical Equipment. The Hospital shall monitor the type and quality
of emergency medical equipment used by Carmel in the provision of life support
services. The Hospital shall make recommendations to Carmel for the use of
appropriate emergency medical equipment. Carmel may pumhase or lease certain
emergency medical equipment from the Hospital. The Hospital shall train Carmel
personnel in the proper use of such equipment. The Hospital's bio-medical
engineering service shall repair Carmel's monitor defibrillator and other
emergency medical equipment when such is repairable in the opinion of the bio-
medical engineering department. Purchased, leased or repaired equipment under
this Paragraph shall be limited to equipment necessary and appropriate for Carmel
to provide emergency medical services. Carmel hereby agrees to use such
equipment only for such limited purposes. Carmel shall reimburse Hospital for
such emergency medical equipment, and repair thereof, pursuant to Section 5.1.
Medical Director. The Hospital shall provide a physician or physician designate,
authorized in writing by the Hospital's medical staff, who shall act as the Medical
Director for the Hospital in its role as the supervising hospital for Carmel. The
Medical Director shall at all times be immediately available to supervise the
medical procedures performed by Carmel's clinical personnel via the voice
communication system identified in Section 2.8. The Medical Director, or his/her
designee, shall be appointed by the Hospital.
2.5
Certification Contingency. The provision of services as described in this Article
II is contingent upon Carmel remaining certified by the Commission as a
paramedic organization for the rendering of life support services. The Hospital
shall be under no obligation to provide the services described in this Agreement
and shall not provide said services until Carmel provides the Hospital with
documented proof that it is currently certified by the Commission as a paramedic
organization for the rendering of life support services.
2.6
Competency Review. The Hospital shall annually review the competency of the
clinical personnel of Carmel. The Hospital shall annually send a letter to Carmel
attesting to the competency of such personnel.
2.7
Reporting Changes. The Hospital shall report in writing to Carmel any material
changes to the parties relationship under this Agreement, including changes in key
clinical Hospital personnel. Such reports shall be made within thirty (30) days of
such material change.
2.8
Voice Communication System. Carmel shall provide means of voice
communication to the Hospital for medical control. The form of communication
may be through the Metropolitan Emergency Communication Agency 800 MHz
trunked radio system; the Indiana Hospital Emergency Radio Network; cellular
telephones as owned and operated by Carmel; or by standard telephone lines
available for emergency crews to utilize.
IlL PARAMEDIC TRAINING SERVICES
3.1
Paramedic Training Services. Hospital agrees to provide paramedic training
services for the Carmel Paramedic Students in accordance with the requirements
and standards for emergency paramedic training set forth in the Act.
3.2
Initial Training of Paramedic Students. The Hospital agrees to provide didactic
and clinical life support training for properly qualified individuals. Carmel agrees
that the Hospital shall have the responsibility and authority for evaluating the
paramedic students during the Training Program and for determining whether the
paramedic students have successfully achieved the objectives of the Training
Program.
The Hospital's guidelines established for the Training Program shall comply with
the current guidelines and regulations established by the Commission. The
Hospital may establish guidelines for the Training Program which exceed those
3.3
3.4
3.5
promulgated by the Commission. Carmel agrees to comply with any such
requirements established by the Hospital.
The paramedic students shall be instructed by Paramedic Preceptors who are
either employed by the Hospital or affiliated, on-duty, and Hospital-approved fire
department Paramedics. The Paramedic Preceptor will observe the paramedic
student during the course of instruction and in the performance of his/her duties.
Students who are employees of Carmel may be precepted while on duty with the
Carmel Fire Department by a Preceptor upon mutual agreement of the parties.
Hospital shall dismiss any paramedic student from the Program if the paramedic
student is determined by the Hospital to be unacceptable for reasons of health,
performance, or any other cause which could interfere with the Hospital's
operation or quality patient care.
Preceptors. Paramedic Preceptors who are either employed by the Hospital or
under contract with the Hospital shall observe the paramedics from time-to-time
in the performance of their duties and responsibilities. The Paramedic Preceptors
shall comply with the requirements of the Act.
Qualifications of Paramedic Students and Paramedics. Paramedic students and
paramedics must meet and maintain during the term of this Agreement ail
requirements established by the Commission. Carmel is responsible for requiring
its paramedic students and paramedics to meet such Commission requirements
and shall provide verification of such when requested by the Hospital.
A paramedic student and a paramedic shall not be permitted to perform any life
support skills unless said paramedic student or paramedic has first been approved
in writing by the Hospital and provided such written approval has not been
withdrawn or modified by the Hospital.
Immunization of Students. Cannel shall assign only Students believed to be in
good health at the time of reporting for their Educational Experience. Prior to
admission to Hospital to perform clinical services and prior to participation in the
Field Internship Phase of the Educational Experience, each Student shall have a
skin test for tuberculosis. If such skin test indicates a positive reaction the Student
must have a chest x-ray and the results must indicate no active tuberculosis before
the Student will be admitted to Hospital facilities. Students must also show proof
of immunization or natural history of the following diseases: Mumps, rubella and
rubeola (students must have been vaccinated twice if bom after December 31,
1956). Students must also know whether they are immune to chicken pox. While
not required, Students are strongly urged to be vaccinated against Hepatitis B.
Any Student acquiring any of the above named diseases during the course of their
rotation must inform their Faculty clinical instructor and Hospital.
IV.
RESPONSIBILITIES OF CARMEL
4.1
Regulatory and Hospital Standards. Carmel shall be solely responsible for
maintaining compliance with all federal, state and local emergency medical
service and life support laws and regulations with regard to its mobile intensive
care ambulances, its employees or independent contractors, its use of drugs,
supplies, and equipment and its general operation as a paramedic organization.
Carmel agrees to comply with OSHA requirements including bloodborne and
airborne pathogens during the Field Internship Phase of the Educational
Experience.
Carmel further agrees to comply with all guidelines and standards established by
the Hospital for training, continuing education and performance evaluation of
Carmel employees or independent contractors.
It is agreed that the Hospital has no responsibility for verifying that Carmel and/or
its employees or independent contractors satisfy all federal, state and local
requirements as referenced above.
As directed by Cannel personnel, Hospital personnel and students shall also
comply with such OSHA requirements while aboard Carmel mobile intensive care
ambulances.
4.2
Primary Duty of Paramedic to Contact Physician. Carmel understands and is
responsible for informing its employees and independent contractors that
protocols are not intended to encourage autonomous action by paramedics. The
purpose of such protocols are to equip the paramedic with a grasp of what is
expected of him in particular emergency situations to prevent the loss of valuable
time. Carmel's paramedics shall establish radio or telephone contact with the
Hospital's emergency department before intervening with life support care, except
for providing emergency first aid as allowed under the protocols established by
Hospital.
4.3
Unsuccessful Attempts to Communicate. Unsuccessful attempts to establish radio
communication with the Hospital emergency department by the paramedic neither
absolves the paramedic nor Carmel from responsibility to solicit direction from
the Hospital emergency department's Physicians, nor does it constitute authority
for the paramedic to perform any or all of the life support skills, except in those
specific instances as allowed in the protocols. The paramedic is responsible for
continuing his attempt to contact the Hospital emergency department by radio,
telephone or any other means that are available, both at the scene and while
transporting the patient to the Hospital.
4.4
Duty to Implement Standards. Carmel is responsible for implementing and
following all performance standards, protocols and requirements of the Hospital
Vo
VI.
and the Commission, as such pertain to the rendering of emergency medical
services and life support services.
4.5
Confidential Information. Cannel shall instruct Students on their responsibility
for respecting the confidential and privileged nature of information which may
come to their attention in regard to patient medical records and other Hospital
information.
REIMBURSEMENT
5.1
Reimbursement. In consideration of this Agreement, Carmel agrees to reimburse
the Hospital for the provision of drugs and supplies under Paragraph 2.2-4, the
purchase, lease and repair of emergency medical equipment under Paragraph 2.3,
and the purchase of training book and supplies. Reimbursement shall be
calculated by adding the Hospital's total cost for each item or service.
5.2
Billing. The Hospital shall bill Carmel only for those items and/or services listed
under Paragraph 5.1. The Hospital shall remit an itemized invoice to Carmel for
such items and/or services on a monthly basis. Complete payment on each
invoice is due within net thirty (30) days unless otherwise agreed in writing
between the parties.
INSURANCE
6.1
Worker's Compensation. Both parties agree to carry worker's compensation
insurance covering all of its employees and employer's liability insurance in an
amount not less than $1,000,000. Said worker's compensation policy shall
contain an endorsement waiving subrogation rights against the Hospital.
6.2
Comprehensive and Property Damage Liability. Both parties shall carry
occurrence form, primary commercial general liability insurance in minimum
amounts of $1,000,000 per occurrence, and $2,000,000 general aggregate, and
combined single limit on $1,000,000 bodily injury, $1,000,000 property damage
and $2,000,000 general aggregate. Such policies shall also include contractual
liability protection insurance to satisfy both parties' indemnification obligations
set out in Article VIII below.
6.3
Professional Liability. Both parties shall carry medical malpractice insurance
with those limits necessary to qualify themselves as providers under the Indiana
Medical Malpractice Act (I.C. 34-18 et seq.) and to remain providers thereunder
throughout the term of this Agreement. Professional shall be covered under
Hospital's medical malpractice insurance policy.
6.4
Proof of Coverage. Each party, upon request, shall provide the other with
appropriate certificates evidencing the insurance coverages set out in this Article
VI.
VII. STATUS OF THE PARTIES
7.1
Status of the Parties. In performing the services as contemplated hereunder,
Hospital and Carmel agree that Carmel and Students are acting as independent
contractors and not as the agents or employees of Hospital. As appropriate,
Carmel agrees to pay, as they become due, all federal and state income taxes, as
well as other taxes, including self-employment taxes due and payable on the
compensation paid to the Faculty by Carmel and to indemnify and hold Hospital
harmless from any and all taxes, penalties or interest which might arise by
Carmel's failure to do so. This provision shall survive the termination of this
Agreement.
No Student in the Program will be deemed to be an employee of Hospital nor will
Hospital be liable for the payment of any wage, salary, or compensation of any
kind for service provided by the Students. Further, no Student will be covered
under Hospital's Worker's Compensation, Social Security, or Unemployment
Compensation programs.
VIII. INDEMNIFICATION
8.1
Carmel Indemnification. Carmel agrees that it will indemnify and hold harmless
the Hospital, its officers, agents, and employees from any loss, cost, damage,
expense, attorney's fees, and liability by reason of bodily injury, property damage,
or both of whatsoever nature or kind, arising out of or as a result of the sole
negligent act or negligent failure to act of Carmel, its agents or employees.
8.2
Hospital Indemnification. The Hospital agrees that it will indemnify and hold
harmless Carmel, its officers, agents, and employees from any loss, cost, damage,
expense, attorney's fees, and liability by reason of personal injury or property
damage of whatsoever nature or kind, arising out of or as a result of the sole
negligent act or negligent failure to act of the Hospital, its employees or agents.
IX. TERM AND TERMINATION
9.1
Term. The term of this Agreement shall be for one (1) year commencing on the
1st day of January, 2002, and terminating on the 31st day of December, 2002.
Thereafter, the Agreement is automatically renewable for successive one (1) year
terms unless either party gives notice of termination at least sixty (60) days prior
to the end of any of the one (1) year terms.
9.2 Termination. This Agreement may be terminated as follows:
9.2-1
Termination by Agreement. In the event Hospital and Carmel shall
mutually agree in writing, this Agreement may be terminated on terms and
date stipulated therein.
9.2-2
Early Termination. This Agreement may be terminated by either party
with or without cause by delivering a written notice of termination to the
other party at least thirty (30) days prior to such early termination. Such
early termination shall not prejudice the rights of the currently enrolled
paramedic students to complete the Training Program.
9.2-3
Termination of Individual Paramedic. Carmel shall terminate the services
of a paramedic or a paramedic student in the performance of life support
skills, upon receipt of written notice from the Hospital that such individual
failed to exhibit satisfactory performance during the Training Program, or
at any time subsequent to the completion of the Training Program. The
Hospital shall not, though, have any affirmative duty or responsibility to
notify Carmel to terminate a specific paramedic or paramedic student
unless the Hospital has actual knowledge that said paramedic or paramedic
student is not performing life support skills in a satisfactory manner or that
he consistently or repeatedly fails to perform paramedic duties in
accordance with the current protocols.
ETHICAL AND RELIGIOUS DIRECTIVES
Parties acknowledge that Hospital conducts its operation in a manner consistent with the
Ethical and Religious Directives for Catholic Health Care Services ("Directives") as
promulgated by the United States Conference of Catholic Bishops, Washington D.C., of
the Roman Catholic Chumh or its successor. Nothing in this Agreement shall be
construed to require the Hospital or its employees to violate the Directives.
XI. REGULATORY AND CORPORATE COMPLIANCE
11.1
Regulatory Compliance. The parties agree that this Agreement is intended to
comply with all applicable Hospital group purchasing contracts and state and
federal laws, rules, regulations and accreditation standards, including, but not
limited to, the Medicare and Medicaid Fraud and Abuse Statute and Regulations;
Indiana regulations for supervising hospitals; the Robinson-Patman Price
Discrimination Act; the Non-Profit Institutions Act; the Food and Drug
Administration regulations; the Indiana Pharmacy Board statutes; the JCAHO
Accreditation Standards; and all regulations governing use of facilities financed
with tax exempt bonds ("Laws").
If, at any time, this Agreement is found to violate any applicable provision of
these Laws, or if any party has a reasonable belief that this Agreement creates a
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material risk of violating any Laws, and after consultation with the other party,
and after thirty (30) days written notice to the other party, the parties shall
renegotiate the portion of this Agreement that creates the violation or risk of
violation of the Laws. If the parties fail to reach agreement, this Agreement shall
automatically terminate thirty (30) days after said written notice.
11.2
Corporate Compliance. Hospital has in place a Corporate Compliance Program
(the "Program") which has as its goal to ensure that Hospital complies with
federal, state and local laws and regulations. The Program focuses on risk
management, the promotion of good corporate citizenship, including the
commitment to uphold a high standard of ethical and legal business practices, and
the prevention of misconduct. Carmel acknowledges Hospital's commitment to
the Program and agrees to conduct all business transactions which occur pursuant
to this Agreement in accordance with the underlying philosophy of the Program
adopted by Hospital.
XII. GENERAL PROVISIONS
12.1 Amendments. This Agreement may be amended only by an instrument in writing
signed by the parties hereto.
12.2
Assignment. Assignments of this Agreement or the rights or obligations
hereunder shall be invalid without the specific written consent of the other party
herein, except that this Agreement may be assigned by the Hospital without the
written approval of Carmel to any successor entity operating the facility now
operated by Hospital or to a related or affiliated organization.
12.3
Confidentiality. Hospital and Carmel agree that the terms and conditions of this
Agreement shall remain confidential. Neither Hospital nor Carmel shall distribute
this Agreement or any part thereof or reveal any of the terms of this Agreement to
parties other than their employees or agents.
12.4
Entire Agreement. This Agreement supersedes all previous contracts or
agreements between the parties with respect to the same subject matter and does
constitute the entire Agreement between the parties hereto and the Hospital and
Carmel shall neither be entitled to other benefits than those herein specifically
enumerated.
12.5
Execution. This Agreement and any amendments thereto shall be executed in
duplicate copies on behalf of the Hospital and Carmel by an official of each
specifically authorized to perform such executions. Each duplicate copy shall be
deemed an original, but both duplicate originals together constitute one and the
same instrument.
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12.6
12.7
12.8
12.9
Governing Law. This Agreement shall be construed and govemed by the laws of
the State of Indiana.
Notices. Notices or communications herein required or permitted shall be given
to the respective parties by registered or certified mail (said notice being deemed
given as of the date of mailing) or by hand delivery at the following addresses
unless either party shall otherwise designate its new address by written notice:
CARMEL
HOSPITAL
City of Carmel
Fire Department
Carmel Board of Public
Works and Safety
One Civic Square
Carmel, 1N 46032
St. Vincent Hospital and
Health Care Center, Inc.
Attn: President
2001 West 86th Street
Indianapolis, 1N 46260
Indianapolis, IN 46260
Copies To:
St. Vincent Contract Management
8402 Harcourt Road, Suite 823
Indianapolis, IN 46260
City of Carmel Attorney
1 Civic Square
Carmel, IN 46032
Severability. In the event that any provision hereof is found invalid or
unenforceable pursuant to judicial decree or decision, the remainder of this
Agreement shall remain valid and enforceable according to its terms.
Waiver of Breach. The waiver by either party of a breach or violation of any
provision of this Agreement shall not operate as nor be construed to be, a waiver
of any subsequent breach hereof.
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IN WITNESS WHEREOF, the duly authorized officers and representatives of the
Hospital and Carmel have executed this Agreement on the dates written below.
ST. VINCENT HOSPITAL AND
HEALTH CARE CENTER, INC.
By: ~Ggwt~.~pWerli?hh, V~i~e~Pres~d
ent- ' ' ' '
Date: l-/[~ )-x
CITY OF CARMEL, INDIANA
by and through its Board of Public
Works and Safety
yJames Brainard, Mayor
I¢lary/~n~' Burke, Member
By:
Bi}ty ~v~aiker,-I~ember
ATTEST FOR CARMEL:
Diana Corcl~ay~zCl~rk-Treffsurer
Date: ~],,.~./~]/_,o - O,a%
hrkhl/01503jck.doc
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