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HomeMy WebLinkAboutC-6335 - Reimbursement Agreement for the Community Paramedicine Pilot Programl� AMENDMENT NO. ONE TO U REIMBURSEMENT AGREEMENT WITH SHIRA A. SCHLESINGER, MD, MPH, PC FOR THE COMMUNITY PARAMEDICINE PILOT PROGRAM THIS AMENDMENT NO. ONE TO REIMBURSEMENT AGREEMENT ("Amendment No. One") is made and entered into as of this 30th day of June, 2017 ("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California municipal corporation and charter city ("CITY"), and SHIRA A. SCHLESINGER, MD, MPH, PC a California Corporation ("CONSULTANT") whose address is 129 Orange Avenue, Long Beach, CA 90814, and is made with reference to the following: RECITALS A. On October 15, 2015, CITY and CONSULTANT entered into a Reimbursement Agreement ("Agreement") related to the Community Paramedicine Pilot Program. B. The parties desire to enter into this Amendment No. One to extend the term of the Agreement to November 30, 2018, to increase Reimbursement, to update Indemnification and Hold Harmless language, to update Notices, to update Equal Opportunity Employment Language, to update Amendment language and to update the Reimbursement Process. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. TERM Section 1 of the Agreement is amended in its entirety and replaced with the following: "The term of this Agreement shall commence on the Effective Date, and shall terminate on November 30, 2018, unless terminated earlier as set forth herein." 2. REIMBURSEMENT Section 3.1 of the Agreement is amended in its entirety and replaced with the following: "3.1 CITY shall reimburse CONSULTANT for the Services on a time and expense not -to -exceed basis in accordance with the provisions of this Section and the Reimbursement Process attached hereto as Exhibit B and incorporated herein by reference. CONSULTANT'S compensation for all work performed in accordance with this Agreement, including all reimbursable items shall not exceed Seventy -Four Thousand Six Hundred Fifty Dollars and 00/100 ($74,650.00). City shall not utilize any funding other than grant funding." 3. INDEMNIFICATION AND HOLD HARMLESS Section 9 of the Agreement is amended in its entirety and replaced with the following: "9.1 To the fullest extent permitted by law, CONSULTANT shall indemnify, defend and hold harmless CITY, its City Council, boards and commissions, officers, agents, volunteers, employees and any person or entity owning or otherwise in legal control of the property upon which CONSULTANT performs the Services contemplated by this Agreement (collectively, the "Indemnified Parties") from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorneys' fees for counsel acceptable to CITY, disbursements and court costs) of every kind and nature whatsoever (individually, a Claim; collectively, "Claims"), and which may arise from or in any manner relate (directly or indirectly) to any breach of the terms and conditions of this Agreement, any work performed or Services provided under this Agreement including, without limitation, defects in workmanship or materials or CONSULTANT'S presence or activities conducted in connection with the OCADPP and Services provided under this Agreement (including the negligent, reckless, and/or willful acts, errors and/or omissions of CONSULTANT, its principals, officers, agents, employees, vendors, suppliers, consultants, subconsultants, anyone employed directly or indirectly by any of them or for whose acts they may be liable, or any or all of them.) 9.2 Notwithstanding the foregoing, nothing herein shall be construed to require CONSULTANT to indemnify the Indemnified Parties from any Claim arising from the sole negligence or willful misconduct of the Indemnified Parties. Nothing in this indemnity shall be construed as authorizing any award of attorney's fees in any action on or to enforce the terms of this Agreement. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONSULTANT." 4. NOTICES Section 10.3 of the Agreement is amended in its entirety and replaced with the following: "10.3 All notices, demands, requests or approvals from CITY to CONSULTANT shall be addressed to CONSULTANT at: To CONSULTANT: Shira Schlesinger, MD 129 Orange Avenue Long Beach, CA 90814 5. EQUAL OPPORTUNITY EMPLOYMENT Section 13.8 of the Agreement is amended in its entirety and replaced with the following: "Equal Opportunity Employment. CONSULTANT represents that it is an equal opportunity employer and it shall not discriminate against any subconsultant, employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical handicap, medical condition, marital status, sex, sexual orientation, age or any other impermissible basis under law." SHIRA A. SCHLESINGER, MD, MPH, PC Page 2 6. AMENDMENTS Section 13.13 of the Agreement is amended in its entirety and replaced with the following: "Amendments. This Agreement may be modified or amended only by a written document executed by both parties and approved as to form by the City Attorney." 7. EXHIBIT D Exhibit D to the Agreement is amended in its entirety and replaced with the Reimbursement Process, attached hereto as Exhibit B and incorporated herein by reference. 8. INTEGRATED CONTRACT Except as expressly modified herein, all other provisions, terms, and covenants set forth in the Agreement shall remain unchanged and shall be in full force and effect. [SIGNATURES ON NEXT PAGE] SHIRAA. SCHLESINGER, MD, MPH, PC Page 3 IN WITNESS WHEREOF, the parties have caused this Amendment No. One to be executed on the dates written below. APPROVED AS TO FORM: CITY OF NEWPORT BEACH, CITY ATTORNEY'S OFFICE a California mu icip I corporation Date: (P��v 6'� Date: J % By: By: l C Aaro . Harp /CV Chip Duncan QK�Atfornev Fire Chief ATTEST: CONSULTANT: Shira A. Schlesinger, Date: �•�� MD, MPH, PC, a California Corporation Date: Signed in Counterpart By: By: Leilani 1. Brown Shira A. Schlesinger, MD, MPH, PC City Clerk President / Secretary Attach [END OF SIGNATURES] Dit D — Reimbursement Process SHIRAA. SCHLESINGER, MD, MPH, PC Page IN WITNESS WHEREOF, the parties have caused this Amendment No. One to be executed on the dates written below. APPROVED AS TO FORM: CITY A T N Y;�S OFFICE Date: alt C. City Att ATTEST: Date: By: Leilani I. Brown City Clerk CITY OF NEWPORT BEACH, a California mu ici al corporation Date: `l/ 51 J By:l fY Chip Duncan Fire Chief CONSULTANT: Shira A. Schlesinger, MD, MPH, PC, a Cali rnia Corp ra ' n Date: By: S A. ehles r, MD, MPH, PC Presi ent / Secr6tary [END OF SIGNATURES] Attachments: Exhibit D — Reimbursement Process SHIRA A. SCHLESINGER, MD, MPH, PC Page 4 EXHIBIT D REIMBURSEMENT PROCESS FY 2015 Research/Principal Investigator — Shira Schlesinger, MD Contract Services I Up to $16,200 $90/hr; up to 15 hrs/month FY 2015 TOTAL $16,200 FY 2016 Research/Principal Investigator — Shira Schlesinger, MD Total Costs Rate of Pa Contract Services Up to $16,200 $90/hr; up to 15 hrs/month Translation Services Up to $2,100 Office Supplies/Printing *Up to $250 FY 2016 TOTAL $18,550 1901 IN Research/Principal Investigator — Shira Schlesinger, MD Total Costs Rate of Pa Contract Services Up to $16,200 $90/hr; up to 15 hrs/month Office Supplies/Printing *Up to $250 FY 2017 TOTAL $16,450 FY 2018 Research/Principal Investigator — Shira Schlesinger, MD Total Costs Rate of Pa Contract Services Up to $16,200 $90/hr; up to 15 hrs/month Office Supplies/Printing *Up to $250 FY 2018 TOTAL $16,450 FY 2019 Research/Principal Investigator — Shira Schlesinger, MD Total Costs Rate of Pa Contract Services Up to $6,750 $90/hr; up to 15 hrs/month Office Supplies/Printing *Up to $250 FY 2019 TOTAL $7,000 FIVE YEAR GRAND TOTAL: $74,650 *Note: the total costs for these line items are spread over 5 fiscal years; however, it is possible that these expenses may occur in only 1, 2, 3 or 4 fiscal years. SHIRA A. SCHLESINGER, MD, MPH, PC Page D-1 REIMBURSEMENT AGREEMENT WITH SHIRA A. SCHLESINGER, MD, MPH, PC FOR THE COMMUNITY PARAMEDICINE PILOT PROGRAM THIS REIMBURSEMENT AGREEMENT ("Agreement") is made and entered into as of this 15th day of October, 2015 ("Effective Date'), by and between the CITY OF NEWPORT BEACH, a California municipal corporation and charter city ("CITY"), and, SHIRA A. SCHLESINGER, MD, MPH, PC a California Corporation ("CONSULTANT") whose address is 3044 E. 5th Street, Long Beach, CA 90814, and is made with reference to the following: RECITALS A. CITY is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of CITY. B. Pursuant to that certain agreement entitled "Data Use Agreement" between the CITY and the Regents of the University of Califomia on behalf of University of California Imine Healthcare ("Data Use Agreement"), CONSULTANT was designated as an authorized Data User. CONSULTANT is bound by the terms of the Data Use Agreement with respect to data integrity, confidentiality, Health Insurance Portability and Accountability ("HIPPA") and document ownership issues. C. On November 14, 2014, the California Emergency Medical Services Authority ("EMSA") was approved by the Office of Statewide Health Planning and Development (OSHPD) Health Workforce Pilot Projects ("HWPP") program to pilot Community Paramedicine in twelve (12) sites across the state. One of the approved pilot projects is the Orange County Alternate Destinations Pilot Project ("OCADPP") led by the Orange County Fire Chiefs' Association ("OCFCA"). D. Under the leadership of OCFCA, the OCADPP explores a regional approach to Community Paramedicine and will study if paramedics with advanced training can safely determine if 9-1-1 patients with non-critical conditions can be transported to urgent care centers instead of to emergency departments ("EDs") utilizing approved medical protocols. The overarching goal of this project is to transport 9-1-1 patients to the right level of healthcare services from the onset to free up the EDs to care for more critical patients. E. The objectives of the pilot study are to determine whether applying this new intervention is safe, effective at reducing costs, and maintains patient satisfaction. Success of the pilot project will be measured through data collection regarding patient outcome, patient satisfaction, and cost of services indicators. Local and State evaluators from University of California Irvine ("UCI"), Orange County EMS, and the State EMS Authority will be conducting the research and validating the data. F. Each fire department has selected a cadre of Alternate Destination Paramedics (ADPs). The ADPs have attended advanced training and successfully passed written and practical evaluations that ensure competency of ADPs in making the determination that 9-1-1 patients with non-critical conditions can be transported to an urgent care center. Ultimately, the patient must consent to enrollment in the study and agree to be transported to a designated urgent care center. G. CONSULTANT has been identified as an OCADPP member and designated as the Research/Principal Investigator("Principal Investigator'). H. The CITY has been identified as an OCADPP member and designated as the fiscal agent. As the fiscal agent, the CITY is responsible for dispersing grant funds it receives on behalf of the OCADPP to other OCADPP members to specifically cover the cost of operations related to the OCADPP. I. As of the Effective Date, the CITY has received grant funds from the Hoag Hospital Community Benefit Program and California Healthcare Foundation to cover the cost of operations for the OCADPP. The terms of the grant from the Hoag Hospital Community Benefit Program and California Healthcare Foundation are attached hereto as Exhibits A (Grant Award Letter from HOAG Hospital) and B(Grant Award Letter from California Healthcare Foundation) respectively and incorporated herein by reference. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. TERM The term of this Agreement shall commence on the Effective Date and shall terminate on June 30, 2017, unless extended or terminated earlier as set forth herein. 2. SERVICES TO BE PERFORMED 2.1 CITY and CONSULTANT acknowledge that the above Recitals are true and correct and are hereby incorporated by reference. CONSULTANT shall diligently perform all the services described in the Scope of Services attached hereto as Exhibit C and incorporated herein by reference ("Services"). 2.2 CITY's Specific Obligations and Rights. 2.2.1 CITY shall act as the fiscal agent by receiving invoices and reimbursing CONSULTANT pursuant to the Reimbursement Process attached hereto as Exhibit D and incorporated herein by reference. SHIRA A. SCHLESINGER, MD, MPH, PC Page 2 2.3 CONSULTANT'S Specific Obligations and Rights. 2.3.1 CONSULTANT shall act as the Principal Investigator. As the Principal Investigator, CONSULTANT shall perform all the services described in the Scope of Services attached hereto as Exhibit C and incorporated herein by reference. CONSULTANT shall also . comply with and be fully bound by all applicable provisions of Exhibits C and D hereto. CONSULTANT shall notify CITY immediately upon discovery that it has not abided or no longer will abide by any applicable provision of Attachments C and D hereto. 3. REIMBURSEMENT 3.1 CITY shall reimburse CONSULTANT for the Services on a time and expense not-to-exceed basis in accordance with the provisions of this Section and the Reimbursement Process attached hereto as Exhibit D and incorporated herein by reference. CONSULTANT'S compensation for all work performed in accordance with this Agreement, including all reimbursable items shall not exceed Fifty-One Thousand Two Hundred Dollars and 00/100 ($51,200.00). City shall not utilize any funding other than grant funding. 3.2 CONSULTANT shall submit monthly invoices to CITY describing the Services performed the preceding month. CONSULTANT'S invoices shall include the name and/or classification of employee who performed the Services, a brief description of the Services performed and/or the specific task in the Scope of Services to which it relates, the date the Services were performed, the number of hours spent on all Services billed on an hourly basis, and a description of any reimbursable expenditures. CITY shall pay CONSULTANT no later than thirty (30) calendar days after approval of the monthly invoice by CITY staff. 3.3 CITY shall reimburse CONSULTANT only for those costs or expenses specifically approved in this Agreement, or specifically approved in writing in advance by CITY. 3.4 CITY may terminate this Agreement and be relieved of the payment to CONSULTANT if a) CONSULTANT fails to perform any of the covenants contained in this Agreement, including but not limited to Attachments C and D hereto, at the time and in the manner herein provided, or b) CITY loses funding under the grant. 4. ADMINISTRATION This Agreement will be administered by the Fire Department. City's EMS Division Chief or designee shall be the Project Administrator and shall have the authority to act for CITY under this Agreement. The Project Administrator shall represent CITY in all matters pertaining to the Services to be rendered pursuant to this Agreement. 5. RELATIONSHIP BETWEEN THE PARTIES It is understood that CONSULTANT shall act in an independent capacity in the performance of this Agreement and shall not be considered an officer, agent or employee of CITY or of the entity from which CITY received grant funds. The manner and means of conducting the Services are under the control of CONSULTANT, except to the extent limited SHIRA A. SCHLESINGER, MD, MPH, PC Page 3 by statute, rule or regulation and the expressed terms of this Agreement. Nothing in this Agreement shall be deemed to constitute approval for CONSULTANT or any of CONSULTANT'S employees or agents, to be the agents or employees of CITY. Nothing in this Agreement shall create any contractual relationship between CITY and any subconsultant nor shall it create any obligation on the part of CITY to pay or to see to the payment of any monies due to any such subconsultant other than as otherwise required by law. CONSULTANT shall have the responsibility for and control over the means of performing the Services, provided that CONSULTANT is in compliance with the terms of this Agreement. 6. PROHIBITION AGAINST ASSIGNMENTS AND TRANSFERS Except as specifically authorized under this Agreement, the Services to be provided under this Agreement shall not be assigned, transferred contracted or subcontracted out without the prior written approval of CITY. Any of the following shall be construed as an assignment: The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock of CONSULTANT, or of the interest of any general partner or joint venturer or syndicate member or cotenant if CONSULTANT is a partnership or joint-venture or syndicate or co-tenancy, which shall result in changing the control of CONSULTANT. Control means fifty percent (50%) or more of the voting power or twenty-five percent (25%) or more of the assets of the corporation, partnership or joint-venture. 7. SUBCONTRACTING The subcontractors authorized by CITY, if any, to perform Work on this Project are identified in Exhibit C. CONSULTANT shall be fully responsible to CITY for all acts and omissions of any subcontractor. Nothing in this Agreement shall create any contractual relationship between CITY and any subcontractor nor shall it create any obligation on the part of CITY to pay or to see to the payment of any monies due to any such subcontractor other than as otherwise required by law. CITY is an intended beneficiary of any Work performed by the subcontractor for purposes of establishing a duty of care between the subcontractor and CITY. Except as specifically authorized herein, the Services to be provided under this Agreement shall not be otherwise assigned, transferred, contracted or subcontracted out without the prior written approval of CITY. 8. RECORDS CONSULTANT shall keep complete and accurate records and invoices in connection with the OCADPP and Services provided and any costs charged to CITY for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to CONSULTANT under this Agreement. All such records and invoices shall be clearly identifiable. CONSULTANT shall allow a representative of CITY to examine, audit and make transcripts or copies of such records and invoices during regular business hours. CONSULTANT shall allow inspection of all work, data, documents, proceedings and activities related to the Agreement for a period of three (3) years from the date of final payment to CONSULTANT under this Agreement. SHIRA A. SCHLESINGER, MD, MPH, PC Page 4 9. INDEMNIFICATION AND HOLD HARMLESS 9.1 General Indemnity and Hold Harmless. 9.1.1 To the fullest extent permitted by law, CONSULTANT shall indemnify, defend and hold harmless CITY, its City Council, boards and commissions, officers, agents, volunteers and employees (collectively, the "Indemnified Parties") from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorneys' fees for counsel acceptable to CITY, disbursements and court costs) of every kind and nature whatsoever (individually, a Claim; collectively, "Claims"), which may arise from or in any manner relate (directly or indirectly) to any breach of the terms and conditions of this Agreement, any work performed or services provided under this Agreement including, without limitation, defects in workmanship or materials or CONSULTANT'S presence or activities conducted in connection with the OCADPP and Services provided under this Agreement (including the negligent, reckless, and/or willful acts, errors and/or omissions of CONSULTANT, its principals, officers, agents, employees, vendors, suppliers, consultants, subconsultants, anyone employed directly or indirectly by any of them or for whose acts they may be liable, or any or all of them.) 9.1.2 Notwithstanding the foregoing, nothing herein shall be construed to require CONSULTANT to indemnify the Indemnified Parties from any Claim arising from the sole negligence or willful misconduct of the Indemnified Parties. Nothing in this indemnity shall be construed as authorizing any award of attorney's fees in any action on or to enforce the terms of this Agreement. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONSULTANT. 10. NOTICES 10.1 All notices, demands, requests or approvals, including any change in mailing address, to be given under the terms of this Agreement shall be given in writing, and conclusively shall be deemed served when delivered personally, or on the third business day after the deposit thereof in the United States mail, postage prepaid, first-class mail, addressed as hereinafter provided. 10.2 All notices, demands, requests or approvals from CONSULTANT to CITY shall be addressed to CITY at: To CITY: City of Newport Beach Attention: Linda Foeldi, Senior Fiscal Clerk, EMS Division P.O. Box 1768 100 Civic Center Drive Newport Beach, CA 92658 SHIRA A. SCHLESINGER, MD, MPH, PC Page 5 10.3 All notices, demands, requests or approvals from CITY to CONSULTANT shall be addressed to CONSULTANT at: To CONSULTANT: Shira A. Schlesinger, MD, MPH, PC 3044 E. 5th Street Long Beach, CA 90814 11. CLAIMS Unless a shorter time is specified elsewhere in this Agreement, before making its final request for payment under this Agreement, CONSULTANT shall submit to CITY, in writing, all claims for compensation under or arising out of this Agreement. CONSULTANT'S acceptance of the final payment shall constitute a waiver of all claims for compensation under or arising out of this Agreement except those previously made in writing and identified by CONSULTANT in writing as unsettled at the time of its final request for payment. CONSULTANT and CITY expressly agree that in addition to any claims filing requirements set forth in the Agreement, CONSULTANT shall be required to file any claim CONSULTANT may have against CITY in strict conformance with the Government Claims Act (Government Code sections 900 et seq.). 12. TERMINATION 12.1 In the event that either party fails or refuses to perform any of the provisions of this Agreement at the time and in the manner required, that party shall be deemed in default in the performance of this Agreement. If such default is not cured within a period of two (2) calendar days, or if more than two (2) calendar days are reasonably required to cure the default and the defaulting party fails to give adequate assurance of due performance within two (2) calendar days after receipt of written notice of default, specifying the nature of such default and the steps necessary to cure such default, and thereafter diligently take steps to cure the default, the non-defaulting party may terminate the Agreement forthwith by giving to the defaulting party written notice thereof. 12.2 Notwithstanding the above provisions, CITY shall have the right, at its sole and absolute discretion and without cause, of terminating this Agreement at any time by giving no less than seven (7) calendar days' prior written notice to CONSULTANT. In the event of termination under this Section, CITY shall pay CONSULTANT for Services satisfactorily performed and costs incurred up to the effective date of termination for which CONSULTANT has not been previously paid. On the effective date of termination, CONSULTANT shall deliver to CITY all reports, Documents and other information developed or accumulated in the performance of this Agreement, whether in draft or final form. 13. STANDARD PROVISIONS 13.1 Recitals. CITY and CONSULTANT acknowledge that the above Recitals are true and correct and are hereby incorporated by reference into this Agreement. 13.2 Compliance with all Laws. CONSULTANT shall, at its own cost and expense, comply with all applicable statutes, ordinances, regulations and requirements of all governmental entities, including federal, state, county or municipal, whether now in force or SHIRA A. SCHLESINGER, MD, MPH, PC Page 6 hereinafter enacted. In addition, all work prepared by CONSULTANT shall conform to applicable CITY, county, state and federal laws, rules, regulations and permit requirements and be subject to approval of the CITY. 13.3 Waiver. A waiver by either party of any breach, of any term, covenant or condition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant or condition contained herein, whether of the same or a different character. 13.4 Integrated Contract. This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions herein. In the event there are any conflicts or inconsistencies between this Agreement and any other communication between the parties, the terms of this Agreement shall govern. 13.5 Interpretation. The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of the Agreement or any other rule of construction which might otherwise apply. 13.6 Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. 13.7 Controlling Law and Venue. The laws of the State of California shall govern this Agreement and all matters relating to it and any action brought relating to this Agreement shall be adjudicated in a court of competent jurisdiction in the County of Orange, State of California. 13.8 Eaual Opportunity Employment. CONSULTANT represents that it is an equal opportunity employer and it shall not discriminate against any subconsultant, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex, age or any other impermissible basis under law. 13.9 No Attorney's Fees. In the event of any dispute or legal action arising under this Agreement, the prevailing party shall not be entitled to attorney's fees. 13.10 Counterparts. This Agreement may be executed in two (2) or more counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. 13.11 No Third Party Beneficiaries. This Agreement is entered into by and for CONSULTANT and the CITY, and nothing herein is intended to establish rights or interests in individuals or entities not a party hereto. 13.12 Force Majeure. Except for the payment of money, neither party will be liable for any delays or other non-performance resulting from circumstances or causes beyond its SHIRA A. SCHLESINGER, MD, MPH, PC Page 7 reasonable control, including without limitation, fire or other casualty, Act of God, strike or labor dispute, war or other violence, acts of third parties, or any law, order, or requirement of any governmental agency or authority other than that of the parties. 13.13 Modification. Alteration, change, or modification of this Agreement shall be in the form of a written amendment signed by both parties and approved as to form by the City Attorney. [SIGNATURES ON NEXT PAGE] SHIRA A. SCHLESINGER, MD, MPH, PC Page 8 IN WITNESS WHEREOF, the parties are signing this Agreement as of the Effective Date. APPROVED AS TO FORM: CITY ATTORNr,3 O FICE Date: 1(2 'A By: V V Aaron C. Harp3 City Attorney ATTEST: �, � • Lam' Date: By: 111 Leila . City Clerk Attachments ,1 O, CITY OF NEWPORT BEACH, a California municipal corporation Date: OCT 2015 By: Scott Poster Fire Chief CONSULTANT: Shira A. Schlesinger, MD, MPH, PC, a lifozrnia Corporation Date:��C By. ra chIesinr, MD, MPH, PC President / Secre ary cqu Boa Exhibi ant Award Letter from HOAG Exhibit B — Grant Award Letter from California Healthcare Foundation Exhibit C — Scope of Work Exhibit D — Reimbursement Process SHIRA A. SCHLESINGER, MD, MPH, PC Page 9 EXHIBIT A GRANT AWARD LETTER FROM HOAG SHIRA A. SCHLESINGER, MD, MPH, PC Page A-1 ATTACHMENT A hoagHORG MEMORIA[HGSPITAL PRESSYI FRIM On_Hn q Dmrz An a.61co kzwf��l Sea.h c"T 9?%e-GtDO May 14, 2015 Chief Randy Bruegman Orange County Fire Chiefs'Association 2400 E, Orangewood Ave Anaheim,CA 92806 Dear Chief Randy Bruegman, Congratulations! We are pleased to inform you that a grant in the amount of$50,685 has been approved by Hoag Memorial Hospital Presbyterian Community Benefit Program for the project titled Orange County Alternate Destinations Pilot Project. Our mission as a nonprofit,faith-based hospital is to provide the highest quality health care services to the communities we serve. We are excited to partner with your organization in fulfilling our mission and the unmet needs of our community. Acceptance of this grant acknowledges agreement to the following: • The grant term:July 1,2014-June 30,2015 • The funds must be used specifically for the designated project Iisted above as outlined in your FY15 grant application • Maintain your records to show and account for the uses of grant funds • Your organization must notify us immediately if there is any change in your public charity status • We will be sending a request for a progress report and a final report in the months to come. More details to follow. Please submit an invoice with the specified project title and approved amount to: CommunitvBenefitGrants@hoaae org. After we receive your invoice, please allow 2-4 weeks for the delivery of the grant check Once again,congratulations on this recognition of the great work you do to serve the community. We look forward to working.with you during the coming year. Sincerely,. C&�ho Gwyn Parry, MD Minzah Malik, MPH, MBA Director Community Benefit Manger Community Benefit �/4"Mo/ &"/m/ Michae!I Rose, MSW, LCSW Director of Community Programs 18 3 EXHIBIT B GRANT AWARD LETTER FROM CALIFORNIA HEALTHCARE FOUNDATION SHIRA A. SCHLESINGER, MD, MPH, PC Page B-1 CALIFORNIA HEALTHCARE FOUNDATION March 5,2015 Mr. David Kiff City Manager City of Newport Beach 100 Civic Center Drive Newport Beach,CA 92660 Dear Mr.Kiff: Reference Number: 18762 This letter officially approves your request for a no-cost extension to the project, Community Paramedicine Data Project Fountain valley Fire Department. The project is now scheduled to end on September 30,2015. The revised schedule for the remaining deliverables due for this grant is as follows: Current Due Date Revised Due Date Tvve of Re ort Report Description February 15,2015 April 15,2015 Signed Agreement May be submitted early. February 27,2015 April 30,2015 Interim Verification from UCSF that Deliverable initial data submission of baseline data has been received. (may be submitted early—as soon as deliverable is met February 27,2015 April 30,2015 Invoice Invoice for Interim Deliverable. (may be submitted early—as soon as deliverable is met). July 31, 2015 September 30,2015 Final Deliverable Pilot site achieving operational status as designated by EMSA.Pilot site to submit invoice for this payment along with verification letter from EMSA of"operational status"of site. (may be submitted early—as soon as deliverable is met). July 31, 2015 September 30, 2015 Invoice Invoice of Final Deliverable (may be submitted early-as soon as deliverable is met). i 1438'Neb5le,Street.Sud a 600 Oakland.Calilemia 96612 T 510 2381040 F 510 2381388 WWW.CFICFORO City or Newport A18762,page 2 Payments will be made within 30 days of receipt and acceptance of the contingency for that payment as detailed below: Amount Contingency Contingency Due Date $8,600 Interim Deliverable& Invoice April 30,2015 $8,000 Final Deliverable&Invoice September 30,2015 Please call me if you have any questions. Yours truly, Sandra Shewry Director, State Health Policy Program cc: Lisa Kang, Director,Grants Administration Other Terms The California HealthCare Foundation may periodically issue a general press release announcing funded projects,or include this grant in a published list of grants awarded by CHCF. If the Grantee wishes to issue a press release regarding this grant,CHCF requires review and final sign-off of the text by its Publishing and Communications Department. Any publication produced by the Grantee that refers or results from this agreement should include an acknowledgment of CHCF that reads: Supported by the California Healthcare Foundation, based in Oakland, California. Funds paid under this agreement may not be used to: 1)carry out propaganda or otherwise attempt to influence legislation; 2)influence the outcome of any specific public election;or 3)carry on directly or indirectly any voter registration drive. If the work performed under this agreement result in access to information that is confidential to, or a trade secret of the California HealthCare Foundation,you hereby agree not to disclose any such information without written authorization from the Foundation. Your signature below acknowledges your acceptance of the agreement as described in this letter. Please sign this letter,and mail or fax (510-587-0149)one signed copy to Danny Sandoval Program Associate. Yours truly, web '1 2 3015 6.@O f+M Craig C.Ziegler VP of Finance,Administration&Investments cc: Sandra Shewry,Director,State Health Policy Lisa bang,Director,Grants Administration Name/Signature: Organization: City of Newport Beach Tax ID: 95-6000751 Date: 7n '�s ATM i�liU7bY--- 3.13.J� PAP �.OWM AS '�O _7"D cil�l�• Lailaril 1.BraWn,M Owk Mtg:ol(levmon Reach.Reference#18762,Page 3 ��PO'4r %it: torney Uroot-laahr 5 L%CA I.1 rORKIA FUU N UATIOY February 12,2015 Mr. David Kiff City Manager City of Newport Beach 100 Civic Center Drive Newport Beach,CA 42660 Dear Mr. Kiff: Reference Number: 18762 The California HealthCare Foundation is pleased to award a grant to City of Newport Beach as a stipend to provide data in support of the Community Parantedicbre Data Project. The amount of this grant is a fixed amount of$16,600. This agreement is effective February 15,2015 and terminates on July 31, 2015, unless extended by written agreement initiated by the Foundation.Sandra Shewry, Director, State Health Policy, will be your Foundation contact during the course of this project. All correspondence and invoices related to this project should be addressed to her. Scope of Work In support of OSHPD's Health Workforce Pilot Project#173, the grantee will provide the Community Paramedicine's Independent Evaluator(the Philip R. Lee Institute or Health Policy Studies at the University of California,San Francisco) with all required data elements. These data include: • Baseline data on care provided by pilot sites prior to implementation of the pilot interventions • Data on site specific training provided to prospective community paramedics within 30 days of completion of each of these training components • Data on implementation of the pilot interventions The grantee's Local Pilot Program Managers have had opportunities to review and comment on the data elements for the evaluation and have agreed to provide them.They will have an opportunity to comment on any proposed changes to the required data elements. Each Local Pilot Program Managers will have the responsibility for collecting all required data and forwarding them to the Independent Evaluator. Local Pilot Program Managers may designate other staff to assist with data collecting and reporting but will be responsible for the accuracy of data and the timeliness with which data are submitted to the independent evaluator. Pilot sites will provide the Independent Evaluator with up to date names and contact information for Local Pilot Program Managers and any other staff assisting with data collection and reporting. The grantee understands and agrees that there is a need for all pilot sites to collect similar data elements. In Iight of this, the grantee agrees that grantee's pilot site will: • collect standardized data pertinent to the community paramedicine concept being tested; • report data elements on each concept being tested(if site is testing more than one concept). • use the web-based data reporting tools that the Independent Evaluator has developed to transmit data to the Independent Evaluator, • report baseline and implementation data on a monthly basis. Baseline data will be reported for five months, from August 2014 through December 2014. Implementation data will be reported for the duration of the pilot project—estimated to be from June 2015 through May 2016. The University of California,Los Angeles Center for Prehospital Care will be responsible for submitting all data on the core training. Individual pilot sites' Local Pilot Program Managers will be responsible for submitting data on site specific training. Deliverables/Payments: The following deliverables will be due on this grant: Date Due Type of Report Report Description February 15,2015 Signed Agreement February 27,2015 Interim Deliverable Verification from UCSF that initial data submission of baseline data has been received. February 27,2015 Invoice Invoice for$8,600 July 31,2015 Final Deliverable Pilot site achieving operational status as designated by EMSA. Pilot site to submit invoice for this payment along with verification letter from EMSA of"operational status' of site. July 31,2015 Invoice Invoice for$8,000(may be submitted early—as soon as deliverable is met). Payments will be made within 30 days of receipt and approval of the contingency for that payment detailed as follows: Amount Contingency Contin enc Due Date $8,600 Interim Deliverable and Invoice February 27,2015 $8,000 Final Deliverable and Invoice July 31,2015 Invoices should include Reference#18762. City of Newport Beach,Reference#18762,Page 2 February 24, 2015 infosend BiliPrint.e8ills. Delivered. PROCESS SUMMARY REPORT File Name Page #of Total Non Bar- Job Code Company Name No Accounts Pages Coded Dupl. Total Amount NPB0224A NPB.0224.MISC.001.TXT 1 1 1 0 0 $8,800.00 CITY OF NEWPORT BEACH Totals: 1 1 0 0 $8,600.00 CITY OF NEWPORT BEACH = REVENUE DIVISION c"doRh�r. P.O. BOX 3080 NEWPORT BEACH, CA 92658-3080 Email:revenvehelp@newportbeachca.gov MISCELLANEOUS BILLING-INVOICE' CALIFORNIA HEALTHCARE FOUNDATION R104 AC,C,T# ATTN: SANTRA SHEWRY, DIRECTOR 574123 0000022085 GN01002882 1415 L STREET#820 SACRAMENTO CA 95814-5009 INV DATE DUE'DATE AMOUNT DUE. 02/24/15 03/26/15 8,600.00 Description: Qty: Unit Price Tax: IExtention: COMMUNITY PARAMEDICINE 1.00 8,600.00 0.00 8,600.00 DATA PROJECT REFERENCE NUMBER: 18762 DATES: 02/15/2015-07/31/2015 Payments received after the original due date may be transferred to other City of Newport Beach accounts or sent to a Collection Agency for recovery.Cost recovery fees or late payment penalties may be applied after the original due date. Payments can be made online at www,newportbeachca.govlpayments TOTAL INVOICE: $ 8,600.00 and referencing the"NBID#"on the billing statement. PAYMENTS/ADJUSTMENTS: $ 0.00PAST DUE: $ 0.00 PENALTIES/INTEREST: $ 0.00 Please see the reverse side for details on non-payment penalties. TOTAL AMOUNT DUE: $ 8,600.00 MISCELLANEOUS BILLING INVOICE- CITY OF NEWPORT BEACH NBID# 574123 O� A REVENUE DIVISION P.O.Box 3080 ACCT# 0000022085 = NEWPORT BEACH,CIA 92658-3080 INVOICE# GN01002882 o"�+ron+�r I�1111�III6IdI �Itll��� I� INV ED DDA E 03/26/15 Please review the back of this document for important information. Amount Due: 8,600.00 NP80224A 4000000001 1/1 ngtputplylr1111IrIrlPlhulrtlrr�tllyltlrgtddtulPpt CALIFORNIA HEALTHCARE FOUNDATION ��Ot�t'lt'trf I14nrtlttltnitll�tl'�'ttlt'tf rltl'n�IIt1111r'Itt1 y' ATTN:SANTRA SHEWRY,DIRECTOR �2t 1415LSTREET#820 CITY OF NEWPORT BEACH SACRAMENTO CA 95814-5009 PO Box 3080 Newport Beach, CA 92658-3080 AROOOOOOOD0022085000008L00003 nr�i IMPORTANT NI-STI CE u3?i;:2 Hollis' 7 NOTICE OF !NTENT TO NOTIFY FRANCHUSE I AX BOARD OF UNPAID LIABILITIES M)-,vp�,q a�flcjn i, ciiflrec - '�prr,4!dc, • wil, msd�,z -d by kl�.�t,- ?�Arl�; th at f��I�Mre io pl,-� rrte Ir"kAity o"ved nis cebt being r-pnO ! tfi the State Franchise Tax Board f", tis cJ'sei in the event ftat VOU are oved a tax r.4,nd -.Iain mm wiii ritercppt `'or.,I Fy Cadf r,T� Lortery onze or have i en i.M, lax n, am:,;Lwt you owc tN ,agency- Cafilorma Gween) -N C"Idl- 124!v'd and ill" 19 10 aAhknn,,e the Offiu of h- 1om,colleci rlloney owed to a county or?, ctty i)y inipmppting any nioney that Che State owed thr ,ectfir if you Katie any of(I'D nit Vefi--Ilc tlj,47 r OPe !nis please wotact us in writing witlirp, "o jays rm rl tile :5te of not(, 'e, re,orescntative o.-;;i t.:,i_ trv,.;y yo,l co not t;,'nit any are', MSLAOIr'.r !hO CIf'/ cj M�K C., N 6. 2 END OF JOB REPORT TOTAL NO. OF RECORDS 1 SUMMARY PAGE NO: z FIRST RECORD: COMPANY: CITY OF NEWPORT BEACH CONTROL NO: 4000000001 SUBSCRIBER: CALIFORNIA HEALTHCARE FOUNDATION LAST RECORD: COMPANY: CITY OF NEWPORT BEACH CONTROL NO: 4000000001 SUBSCRIBER: CALIFORNIA HEALTHCARE FOUNDATION IMPORTANT OTICE Lf�c It�on of C tt� Hol! SiPing LoCairio; p'-l'imenz 1-ocavolk Olffi,s Hours' Thzlrli,,ja� 7 1ABILITIES TirClzy "'t I%k.vPofi Haoch is reclureJ by a;w to F,re,1 J tln!; Mato j th3! faiiur-- to pay ilre wi -FujIf it t!ql rlvbi loenng t000ted to the Stere tianoi;sp Bohr' fL.- 'I In the ;tiPrif that you are owed q tax rpfullrl, mfo C%iIJ ni!a Lottery pr; p a have mclairnpe, pff,a)erty on,ms "ot Pianch;se Tax Boa 0 PtFrc..pt from, Jlai mone,,; "'Al (lwp tnjs.'Agrrwy Califorflrn Govprniil- nt Cude 12419.8 and a,;thoriz- rh�- Office of th Contrnher to cullect money oned t a 'o-inty r a ;ty a 1.. by jnterueptmq any money that oie state owo,' the no:0a!ray. 1144 yz--)u r,,.,, trils deb,p -oWact us in wr[mc .1 within 30 jays ):,I ir� -i ;t. ct tris r 1 C)ti"e A mpres n,7 t;e vy i res,-. vos 1, 1 ,:0. s of Ite the y arm rt,,c:tiveo t vuo flo riot -31i ol� -tions irg ir�suf ,,it D1 I' is aJVo,I 3r C", cel j AV& 119,1* 0 T. EXHIBIT C SCOPE OF SERVICES OCFCA Alternate Destination Community Paramedicine Pilot Project This Scope of Work Agreement ("Scope of Work Agreement") describes the tasks to be performed by the CONSULTANT in assisting the Orange County Fire Chiefs Association, Newport Beach Fire Department ("NBFD"), and other members of the Orange County Alternate Destination Community Paramedicine Project Advisory Council ("Advisory Council") in fulfillment of the requirements of the California EMS Authority ("EMSK) as an approved pilot site for the OSHPD approved Community Paramedicine Alternate Destination Pilot Project ("Pilot Project"). The purpose of the Pilot Project is to determine whether paramedics working in an expanded role in their community can help improve health system integration, efficiency, and/or fill identified health care needs. The Pilot Project will allow the Newport Beach Fire Department, Orange County EMS Agency ("OCEMS") and the EMSA to generate, collect and analyze data that will examine the practice of community paramedicine and serve as a basis to recommend changes to existing statutes and regulations to allow transport of patients with specified conditions that can be managed in health care settings to alternate locations other than an acute care emergency department, such as an urgent care or general medical clinic. Basic Scope of Services CONSULTANT shall provide overall data coordination in fulfillment of local and EMSA objectives; organizational and administrative assistance to the Advisory Council; report writing; delivery of data to the EMSA and its representatives; delivery of data reports to the Advisory Council on project progress and adverse events; and maintenance of data for current and future analysis and publication. The goal of this Scope is to enable CONSULTANT to access data from the NBFD required for quality assurance in the Pilot Project, and to compile and analyze data for both internal analysis within the NBFD and for overall analysis in conjunction with the other participating Fire Departments. Project Activities CONSULTANT will work with the NBFD and the Advisory Council to collect, maintain, and analyze data on EMS responses who are deemed potentially eligible for alternate destination transport, or who were transported to an alternate destination (Urgent Care Clinic) as part of the Pilot Project. To fulfill this objective, CONSULTANT will: 1. Extract information from the participating Fire Department's electronic patient care records on all patients who meet primary impression criteria for the Pilot Project. 2. Maintain database of all patients who meet primary impression criteria for the Pilot Project. SHIRA A. SCHLESINGER, MD, MPH, PC Page C-1 3. Deliver a monthly list of eligible alternate destination patient candidates to the Orange County EMS Agency for hospital outcomes follow-up, as permitted for quality assurance purposes. 4. Deliver a monthly list of eligible alternate destination patient candidates to the participating Fire Department's billing agency for collection of transport charges and claims data. 5. Collect and maintain transport and billing data for all transported patients who meet criteria for Pilot Project participation. 6. Collect and maintain database of patient care on patients transported to alternate destination sites (Urgent Care Clinics) as part of the Pilot Project. Report patient care, hospital outcomes, and billing data to the California EMSA on behalf of the participating Fire Department, and in accordance with the participating Fire Department's obligation to meet reporting requirements as a Pilot Project site SHIRA A. SCHLESINGER, MD, MPH, PC Page C-2 EXHIBIT D REIMBURSEMENT PROCESS PRINCIPAL INVESTIGATOR FY 2015 Research/Principal Investigator— Shirai A. Schlesinger,.MD, MPH, PC Contract Services Up to $16,200 $90/hr; up to 15 hrs/month FY 2015 TOTAL $16,200 FY 2016 Research/Principal Investi' ator- Shira A. Schlesin er, MD MPH, PC Total Costs Rate of Pa Contract Services Up to $16,200 $90/hr; up to 15 hrs/month Translation Services Up to $2,100 Office Supplies/Printing *Up to $250 FY 2016 TOTAL $18,550 FY 2017 Research/Principal Investigator- Shire A. Schlesinger, MD, MPH, PC Total Costs Rate of Pa Contract Services Up to $16,200 $90/hr; up to 15 hrs/month Office Supplies/Printing *Up to $250 FY 2017 TOTAL $16,450 THREE YEAR GRAND TOTAL: $51,200 *Note: The total costs for these line items are spread over 2 fiscal years; however, it is possible that these expenses may occur in only 1 fiscal year SHIRR A. SCHLESINGER, MD, MPH, PC Page D-1