The URL can be used to link to this page

Home My WebLink AboutFD04-253 - Amendment - #2 - Seattle KC Dept of Public Health - Basic Life Support Services (EMS Levy) - 01/01/2005 RecordsM eme KENT Document W A9HiHOTOh CONTRACT COVER SHEET This Is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed, I you have questions, please contact City Clerks Office. Vendor Name: - Vendor Number: i JD Edwards Number Contract Number. fJ)n y-� S3 This is assigned by Deputy City Clerk Description: - v� Detail: ;900tS ides dm eT �zaj C/ 47 Project Name: JL2 a,0 Contract Effective Date: �-/0'5- Termination Date: /09 lJa Contract Renewal Notice (Daysr Number of days required notice fortermination or renewal or amendment Contract Manager: �� f�111 Department: Abstract��!' W,14 � �J .� � �D 330 y SD �r S:Pubhc\RecordsManagement\Forms\ContractCover\AOCE7832 07/02 Public Health p E C E U d E Seattle & King County D HEALTHY PEOPLE. HEALTHY COMMUNITIES. APR 1 2005 Alonzo L.Plough,Ph D.,MPH,Director and Health Officer KENT FIRE DEPARTMENT March 29, 2005 Paul Wright Kent Fire Department 24611 116th Ave SE Kent, WA 98030 RE: D33049D — Basic Life Support Services (Amendment #2) Dear Paul Wright: Enclosed is your fully signed copy of the referenced amendment. We have retained a copy of the amendment for our records. If you have any questions about the program, budget or reporting requirements, please contact your Program Monitor, Felisa Azpitarter at (206) 296-4693. If you have any other questions, please call me at (206) 296-4898. Sincerely, - Jeffrey Brown Contract Specialist II Grant & Contract Services JB: er Enclosure: D33049D — Basic Life Support Services (Amendment #2) cc: Felisa Azpitarte Grant and Contract Services—Finance&Administrative services Division 999 Third Avenue,Suite 600• Seattle,WA 98104-4039 City of Seattle King County T(206)296-4614 F(206)205-0947•www metrokc gov/health Gregory 1 Nickels,Mayor 0 Ron Sims,Executive EMERGENCY MEDICAL SERVICES FUNDS 2005 PROPOSED BUDGET FORM - BASIC LIFE SUPPORT SERVICES Applicant Agency City of Kent/King County Fire Prot. Dist. #37 Agency Service Area(s) East Kent City Limits. , North border is SE 192 east border is 188 Ave SE and the City of Covington City Limits. South border is SE 288, Kent WA Contact Person Paul Wright Title Battalion Chief/EMS Officer Address 24611 116th Ave SE Kent WA 98030 Phone 253.856.4300 Amount Requested Budget Category in 2005* A. Personnel 1. Salaries & Benefits ** 714,987 .00 2. Per Shift Payments (list rate per shift) 3. Per Call Payments (list rate per call) B. Supplies (itemized on separate sheet) 24,000 .00 C. Equipment (itemized on separate sheet) 15,026.00 D. Support Service (itemized on separate sheet) E. Total EMS Funds Allocated by King County EMS in 2005 (Please refer to the attached funding 754,013.00_ allocation) Please list only total amount of requested funds by category on this page. Attach itemized list of proposed expenditures if you are requesting funds for supplies, equipment, or support services. **Attach explanation of how requested funds for salary and benefits were calculated and how they will be used in accordance with the expenditure guidelines. An agency may request BLS funding for that portion of salaries and benefits that can be attributed to EMS (% aid calls out of total fire and aid calls) up to the BLS allocation for that agency. Show %'s and total salary/benefit budget used to derive BLS request. EXHIBIT 1 2005 PROGRAM PLAN AND PROPOSED BUDGET I. Identification information A. Name and number of Fire Protection District or Fire Department: City of Kent / King County Fire Prot. Dist. #37 B. Name of Chief: Jim Schneider Mailing Address: 24611 116 Ave SE Kent WA 98030 C. Name of EMS Coordinator (and Training Coordinator if different) : Paul Wright Telephone No. 253.856.4300 Kevin Carling Telephone No. 253.856.4331 D. Location: manned or unmanned status of all fire stations in your department of district; location of aid vehicles. Include the address of each station (use other side if necessary) . efib No. EMS Res o� No. & Type Fire Address Unit Status Vehicles at Location Vehicles at Location 1. Station #71 K Full Time X 1 Ambulance 1 Engine/Aid Part Time/ 504 West Crow St. Vol - - Ken WA 98032 2. Station #72 X Full Time X 1 Engine/Aid 25620 140 Ave SE Part Time/ 1 Tender Vol Kent WA 98042 3. Station #73 X Full Time X 1 Ambulance 1 Engine/Aid Part Time/ l buance (reserve) 26512 Military Rod So. Vol 1 Am ) 1 Mobile Command (reserve) Kent WA 98032 4. Station #74 X Full Time—1- 1 Ambulance 1 Engine/Aid Part Time/ 1 Ladder 24611 116 Ave SE Vol 1 Command Vehicle Kent WA 98030 1 Air Vehicle *Include aid units as well as fire apparatus, command cars, rescue units, etc. STATIONS PLANNNED for construction in 2005 Address Status Vehicles r� r, ADDRESS DEFIB UNIT STATUS AID VEHICLES FIRE VEHICLES Station#75 XX Full Time 1 Engine/Aid Vehicle 15635 SE 272od 1 Engine/Aid Vehicle(reserve) Kent WA 98042 1 MCI Vehicle 1 Air Vehicle Station#76 XX Full Time 1 Engine/Aid Vehicle 20676 72°d Ave So. 1 Haz Mat Unit Kent WA 98032 2 Engine/Aid(reserve) Station#77 XX Full Time 1 Ambulance(reserve) I Engine/Aid Vehicle 20717 132°d Ave Se 1 Ladder(reserve) Kent WA 98031 1 Engine/Aid(reserve) NOTE: All of our engme/aid vehicles,as well as one of our ladder units,are licensed as aid units by D.S.H.S. We have nine(13)licensed aid units and four(5)licensed ambulances. Exhibit 1 2005 Program Plan and Proposed Budget Page 2 E. Agency Response Information Number of fire suppression responses in 2004 745 - Estimated Number of EMS aid responses in 2004 9566 - Estimated Total number of responses in 2004 13,800 - Estimated Percent aid responses of total responses 70% - Estimated II. Relationships With other EMS Agencies A. Specify location of transfer points with paramedic provider groups if applicable: ✓, Exhibit 1 2005 Program Plan and Proposed Budget Page 3 III. Personnel A. Number of full-time paid fire fighters 148 of which 128 are EMT's and 12 are First Responders.* B. Number of volunteer fire fighters -0- , of which -o- are EMT's and -0- are First Responders.* C. Number of personnel currently trained in defibrillation 128 Automated External Defibrillator Certified 21 Manual Defibrillator Certified 107 * Certified as First Responders by State of Washington IV. EMT Defibrillation Program 12 - Medtronic Physio cOntrul A. Number and type of defibrillator units Life Pak 12 Manual 1 - Heartstart FR2 B. Location of defibrillation equipment (address) C. Unit numbers of aid vehicle(s) usually carrying defibrillation equipment (use number(s) recorded when completing EMS Medical Incident Reporting Form) . 57 - All firstline apparatus carry a life pack, including the Shift omman ers Vehicle V. Budget The EMS Division is seeking to collect information that documents total fire department expenditures for emergency medical services. We are also requesting each fire department to report its total operating budget for the year. In order that the information be consistent, please exclude from these totals major capitpil expenditures including vehicles and buildings, and monies earmarked for bond payments, etc. A. Estimated total EMS budgget for 2005 $ 1,753,964 of which S 754,013 is provided by EMS funds. B. Total fire department or fire district g 18,350,589 budget for 2005. Exhibit 1 2005 Program Plan and proposed Budget Page 4 VI. Fees for Services A. Does your department charge for providing emergency services? Yes No X B: If yes, please provide a list of charges below. VII. Service Improvements/Changes Please describe how EMS funds will be used by your department in 2005 to improve services to the citizens of King County. To supplement total EMS budget to maintain quality and timely delivery of EMS in the face of increasing demand for services and budget reductions, with loral finds we will cover the remaining costs of the total EMS budget_ . BLS Provider U Date Z� Alonzo Plough,�Direlcc`IJV and Health Officer Date/ Department of Public ealth r r� ITEMIZED LIST OF PROPOSED EXPENDITURES FOR SUPPLIES AND EQUIPMENT 2005 BASIC LIFE SUPPORT LEVY CATEGORY ITEM COST EQUIPMENT BACKBOARDS $2,500.00 EQUIPMENT BP CUFFS $50.00 EQUIPMENT CYLINDER REGULATOR GAUGES $1,000.00 EQUIPMENT DISP. BAG VALVE MASKS $800.00 EQUIPMENT KED'S $720.00 EQUIPMENT OXYGEN CYLINDERS $1,000.00 EQUIPMENT SCOOP STRETCHER $1,500.00 EQUIPMENT STETHOSCOPES $500 00 EQUIPMENT PULSE OXIMETERS $1,500.00 EQUIPMENT GLUCOMETERS $2,456.00 EQUIPMENT SUCTION UNITS $1,000.00 EQUIPMENT TRACTION SPLINTS $2,000.00 TOTAL EQUIPMENT $15,026.00 SUPPLY BAND-AIDS $100.00 SUPPLY BB STRAPS $1,000.00 SUPPLY BLANKETS $1,000.00 SUPPLY BLS TRAUMA PACKS $500.00 SUPPLY BURN SHEETS $300.00 SUPPLY CANNULAS/TUBING $1,500.00 SUPPLY COLD/WARM PACKS $800.00 SUPPLY CPR MICRO SHIELDS $500.00 SUPPLY ECG PRINTER PAPER $1,000.00 SUPPLY ELECTRODES 1500 SUPPLY EXTRICATION COLLARS $2,200.00 SUPPLY GAUZE $700.00 SUPPLY GAUZE PADS $500.00 SUPPLY GLOVES $6,900.00 SUPPLY IPECAC $50.00 SUPPLY LIFE PAK BATTERIES $1,000.00 SUPPLY OB KITS $100.00 SUPPLY OXYGEN CYLINDERS $1,000.00 SUPPLY PENLIGHTS $300.00 SUPPLY PILLOWS $200.00 SUPPLY SCISSORS $200.00 SUPPLY THERMOMETERS $150.00 SUPPLY TRAUMA DRESSINGS $500.00 SUPPLY TRIANGULAR BANDAGES $500.00 SUPPLY TYVEK JUMPSUITS $SW.00 SUPPLY VENT KITS $500.00 SUPPLY WATERPROOF TAPE $500.00 TOTAL SUPPLIES $24,000.00 a EXIHIBIT 2 KING COUNTY EMERGENCY MEDICAL SERVICES Basic Life Support Standards Agencies shall comply with the following standards in order to be eligible for basic life support services funding from King County. Failure to comply with the standards adopted by King County pursuant to Chapter 2.26 of the King County Code or by the County Medical Program Director pursuant to Chapter 18.73 RCW, shall be sufficient grounds for notification, remediation, and possible termination of funding. Review and modifications of BLS standards may be conducted on an annual basis. Proposed changes will be submitted to the Emergency Medical Services Advisory Committee and local provider agencies for advisory comment prior to implementation. I. Personnel: All emergency medical services personnel supported directly by King County funds must be certified as Emergency Medical Technicians ad defined by RCW 18.73. Basic EMT training standards have been established by King County Emergency Medical Services. H. Continuing Medical Education EMTs will remain certified as required by WAC 246-976. Continuing Education and proficiency standards will be set by King County Emergency Medical Services and the Medical Program Director. Agencies must report completion of education and skill proficiency updates to King County Emergency Medical Services in an agree upon summary format. III. Medical Standards: Each agency providing emergency medical services shall adhere to standards of medical care for the triage, treatment and transport of patient as authorized by the Medical Program Director pursuant to RCW 18.73 and 18.71,and Chapter 2.26 of the King County Code. Standards of medical care are delineated in the King County EMS training curriculum approved by the Washington State Department of Health, "Patient Care Guidelines for Basic Life Support",and in the 1996, 1997, 1998, 1999, and 2000 Competency Based Training(CBT)modules. Additional CBT modules will continue to be issued annually. CBT modules may also be offered by the EMS Division electronically via Internet access. a. Scope of Practice: Evaluation and treatment activities by EMTs from provider agencies not described in the standards of medical care are deemed outside the scope of practice. Changes or additions to this scope of practice will be issued periodically by the Medical Program Director. b. Record Keeping and Record Submission: The Medical Incident Report Form(MIRF)must be completed as soon as possible following an incident. These reports should them be submitted to King County Emergency Medical Services,either electronically or by mail,within 30 days from the date the incident occurred. Agencies will be responsible for retention of copies of the reports. I c. Transportation Policy: Each provider will be responsible for developing a policy for the transport of patients from the incident scene to the treatment scene. Such policy should provide for transportation based upon determinants of transport need,including medical necessity,mitigating circumstances, and provider budget. The decision to transport a patient seen by BLS personnel will be determined by the patient's medical condition as described in the Basic EMT core curriculum and any mitigating circumstances. The mode of transport will be consistent with the patient's medical condition and provide humane, efficient and expedient care. Transport destinations should be consistent with the State Trauma System Activation Guidelines. d. King County Medical Quality Assurance/Quality Improvement Programs: Each BLS provider will agree to participate in a King County Medical Quality Assurance/Quality Improvement program. This program will be developed by King County EMS Division, with the assistance of the EMS Advisory Committee and BLS providers. Elements of this program include: 1)run review by clerical and provider personnel to ensure completeness, 2) nun review by a reviewer(local paramedic or personnel from within the organization for medical appropriateness and compliance with King County Emergency Medical Services standards, 3)case follow up and discussion conducted by the run review personnel, and 4)paramedic involvement in CBT Training. e. Patient Confidentiality: Information concerning the evaluation and treatment of a patient by BLS personnel in the performance of their duties is to be handled as confidential material, including patient name, medical history, incident location, or any other confidential information. Confidential medical information may not be released unless the patient or his/her court- appointed representative completes and signs an Authorization for Release of Information form. IV. Equipment a. All vehicles used to deliver emergency medical services must meet vehicle standards as established by the Washington State Department of Health pursuant to RCW 18.73, unless waived by the State Department of Health Office of EMS Trauma Prevention Licensing. b. Medical equipment used by personnel supported funds must meet appropriate federal or state standards or county protocols. V. Mutual Aid Agreements: Each public agency providing basic life support services shall have written mutual aid agreement or similar arrangements is effect. VI. Proposed Research and Evaluation Activities: Any proposed clinical research or evaluation activities involving personnel, equipment or data supported directly or indirectly by King County funds must receive prior review and written approval by the Medical Program Director and the King County Emergency Medical Services Division Manager and must be in compliance with State, County and local regulations and laws. VII. Performance Indicators and Oversight: In accordance with findings of the EMS Financial Planning Task Force, the EMS Division—with the assistance of the EMS Advisory Committee and the Financial Staff Team—shall develop mechanisms for improved performance oversight by the EMS system and elected officials. Performance indicators will be established and reviewed by King County EMS and reported by the EMS Division to each BLS agency and in public presentations. Mitigation activities will be initiated with local providers if needed. Reports will be distributed to provider agencies on a regular basis. Standards for each provider will be monitored in the following major areas: total call volume, average response time for code red calls,percent of response times greater than or equal to 4, 6, 8, and 10 minutes, out-of-service times,number of transports and mode of transport. Additional performance indicators may be added, with the assistance of the EMS Advisory Committee and the Financial Staff Team. VIII. Financial Indicators and Oversight: In accordance with findings of the EMS Financial Planning Task Force, indicators shall be developed which improve financial oversight by the EMS system and elected officials. The EMS Division, in conjunction with the EMS Advisory Committee and the Financial Staff Team, shall develop reporting financial reporting measures that will include, but may not be limited to: a. Selection, development, and tracking of system costs. b. A standard costing system for reporting dollar expenditures for BLS activities. c. Funding allocation mechanism. :t 4, JWA Insurance Authority AUG 13 20I4 P.O. Box 1165 NUMM RESOURCES (IJTY OF KEW Renton, WA 98057 12-Aug-04 Cert#: 3739 Phone 425-277-7237 King County EMS Attn: Felisa Azpitarte 999 Third Ave. S., Suite 700 Seattle,WA 98104 RE: City of Kent 2005 BLS Funding Allocations. King County EMS Levy. Evidence of Coverage The above captioned entity is a member of the Washington Cities Insurance Authority (WCIA),which is a self insured pool of over 108 municipal corporations in the State of Washington. WCIA has at least$1 million per occurrence combined single limit of liability coverage in its self insured layer that may be applicable in the event an incident occurs that is deemed to be attributed to the negligence of the member. WCIA is an Interlocal Agreement among municipalities and liability is completely self funded by the membership. As there is no insurance policy involved and WCIA is not an insurance company,your organization cannot be named as an "additional insured'. Sincerely, Eric B. Larson AUG 16 2004 D Deputy Director KENT FIRE DEPARTMENT cc: Christopher Hills Linda Mock letter