CONTRACT 3375 Service Agreement CLOSEDE
UCLA
And
The City of El Segundo
Services Agreement
September 7, 2004
This Agreement ( "Agreement ") is made and entered as of , 2004
by and between The Regents of the University of California, a California corporation, on
behalf of the UCLA Medical Center, Center for Prehospital Care ( "UCLA ") and the City
of El Segundo ( "City "), on behalf of the El Segundo Fire Department (" Fire
Department" and El Segundo Police Department ( "Police Department "), collectively
referred to as "Department(s) ".
RECITALS
A. The UCLA Center for Prehospital Care conducts continuing education in
prehospital and emergency medicine to maintain certification and licensure as
EMT -Basic or EMT - Paramedic (collectively referred to as "CE Programs "),
conducts primary education to obtain licensure as an EMT - Defibrillation ("EMT -
D") Provider, provides quality improvement services to maintain or enhance the
quality of patient care (referred to as "QI Services "), and conducts Automatic
External Defibrillation (AED) training to law enforcement and the public.
B. Department desires to utilize the services to maintain the certifications of their
employees and to continue to deliver quality patient care to their community.
NOW THEREFORE, the Parties hereby agree as follows:
Article 1
Rights and Responsibilities of UCLA
1.1 Provide a Educators. UCLA shall provide one Nurse Educator ( "Educator ") to
Fire Department to conduct CE Programs and QI Services and a AED
Coordinator ( "Coordinator ") to conduct EMT -D education and services ( "EMT -D
Education and Services ") to Fire Department and AED education and services
( "AED Education and Services ") to Police Department and personnel in City
Buildings. The Educator and Coordinator shall be subject to the mutual approval
of both UCLA and Fire Department.
1.2 Provide CE Programs For Fire Department.
1.21 Scheduling CE Programs. CE Programs will be provided on each
of three shifts monthly for three hours. UCLA shall develop a
schedule and submit it to Fire Department for approval. The
schedule will provide a minimum of twenty -four (24) hours of
continuing education for each Fire Department EMT - Paramedic
and twelve (12) hours of continuing education for each Fire
Department EMT - Basic. This will provide a Fire Department
Paramedic thirty -six (36) hours of continuing education annually if
he /she attends all continuing education conducted on their
scheduled shifts.
1.22 CE Program Content. All Education Programs shall meet the
criteria established by the County of Los Angeles and the State of
California to fulfill EMT -Basic and EMT - Paramedic continuing
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education and recertification requirements. Content shall be
developed in collaboration with Fire Department.
1.3 Provide EMT -D Education and Services for Fire Department.
1.31 UCLA shall provide a coordinator ( "Coordinator ") to conduct the services
under this section. The Coordinator shall be subject to the mutual
approval of both UCLA and Fire Department. The Coordinator will work
cooperatively with the Educator.
1.32 Prepare EMT -D application materials for Department to submit to the
Los Angeles Department of Health Services.
1.33 Prepare and submit operational policies for operation of the EMT -D
program at Department.
1.34 Coordinate with the Los Angeles County Department of Health Services
to facilitate Department taking the certifying examination for EMT-
Defibrillation Providers.
1.35 Provide competency testing every nine months for 60 Department
personnel. Education will be offered in two sessions on each of three
consecutive Department shifts. One make -up session will be scheduled
for personnel unable to attend scheduled sessions for any reason. Sessions
will accommodate approximately 20 personnel per day and will be
organized in the morning from 0800 to 1100 and afternoon from 1300-
1600.
1.36 Review Department patient care reports, dispatch records, and defibrillator
usage downloads where appropriate within 72 hours for each cardiac arrest
and generate a report that will be reviewed by the Medical Director.
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1.37 Maintain a log that will include usage of the defibrillator, primary
education dates, competency test dates, and defibrillator maintenance logs.
1.38 Prepare the annual EMT -D report for Department to submit to the Los
Angeles Department of Health Services as required policy 412.2 of the
Los Angeles County Department of Health Services Prehospital Care
Policy Manual and included as Exhibit A.
1.4 Provide a Medical Director. Provide a medical director to supervise the EMT -D
Education and Services, including the quality of instruction and use of the
automatic external defibrillator, as defined by Policy 412 of the Los Angeles
County Department of Health Services Prehospital Care Policy Manual and
included as Exhibit B ( "Medical Director "). UCLA and Medical Director assume
no responsibility for the clinical activities and care provided by any of
Department's employees or agents, including but not limited to care relating to
the EMT - Defibrillation.
1.5 Provide OI Services for Fire Department.
1.51 On Site Evaluation. The Educator shall ride along and evaluate
Department paramedics under field conditions and design and provide
education to any specific needs identified.
1.52 Ouality Improvement Activities. The Educator shall develop, coordinate
and maintain a quality improvement plan for Department. This shall
include: developing a system to review Department's patient care reports,
developing patient care report review criteria, reviewing patient care
reports, coordinating quarterly quality improvement meetings, providing
direct field observation, developing a plan to evaluate the competency of
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Department personnel, assisting in fact - finding for specific incidents and
attending the Los Angeles County EMS Agency Quality Improvement
Committee meetings to gather information regarding updates and changes
to policies and/or procedures and reporting to the Department.
1.52 Reports and Records. The Educator will report on QI Activities to the
fire chief and QI designee (as identified in Section 3.2) and implement the
recommendations under the direction of the QI designee.
1.6 AED Services for Police Department:
1.61 Coordinator will provide two re- training courses each year. One program
may be scheduled as a primary course to accommodate new personnel.
1.62 Maintain master list of employees training and re- training dates.
1.63 Review Police Department patient care reports, dispatch records, and
defibrillator usage downloads where appropriate within 72 hours for each
cardiac arrest and generate a report that will be reviewed by the Medical
Director.
1.64 Maintain a log that will include usage of the defibrillator, primary
education dates, competency test dates, and defibrillator maintenance logs.
1.65 Prepare the annual AED Service Provider Report on behalf of the Police
Department to submit to the Los Angeles Department of Health Services
as required by policy 412.2 of the Los Angeles County Department of
Health Services Prehospital Care Policy Manual and included as Exhibit
A.
1.66 Coordinate the re- approval of the AED Service Provider Program with the
Los Angeles Department of Health Services.
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1.7 AED Services for City Personnel in City Buildines.
1.70 Provide primary AED /CPR training four times each year for up to 12
students.
1.71 Coordinator will recommend key personnel in each location for training
and recommend the placement location of the AED in each building.
1.72 Maintain master list of City employee training and re- training dates.
1.73 Review all defibrillator usage downloads if notified and where
appropriate, within 72 hours for each cardiac arrest and generate a report
that will be reviewed by the Medical Director.
1.74 Maintain a log that will include usage of the defibrillator, primary
education dates, competency test dates, and defibrillator maintenance logs.
1.75 Prepare and submit operational policies for operation of the AED at four
City locations.
Article 2
Confidentiality
2.1 Definition. For purposes of this Agreement, the term "Confidential Information"
shall mean any information disclosed in order to accomplish the work under this
Agreement by one party ( "Disclosing Party ") to another party ( "Receiving Party ")
that is considered confidential by the Disclosing Party, provided such information
is in writing or other tangible form and clearly marked as confidential when
disclosed, or is so designated in writing within thirty (30) days of such disclosure.
The parties agree to disclose only information that is necessary to the work and to
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send such information directly to the parties noticed in Section 9 of this
Agreement.
2.2 Obligations of the parties. The Receiving Party agrees, to the extent permitted
by law, that Confidential Information shall remain the property of the Disclosing
Party and that the Receiving Party shall only use, disclose or distribute
Confidential Information within its own organization as is reasonably necessary to
carry out the intent of this Agreement. For the period of the Agreement and for a
period of five (5) years after disclosure, Confidential Information shall not be
used or disclosed to others except in furtherance of this Agreement, provided,
however, that the foregoing obligation of non -use and non - disclosure shall not
apply to any portion of the Confidential Information that:
2.21 is or shall have been known to the Receiving Party before his/her receipt
thereof;
2.22 is or shall have been disclosed to the Receiving Party by a third party;
2.23 is or shall have become known to the public other than through the
Receiving Party;
2.24 is independently created by the Receiving Party's personnel who have had
no exposure to the Confidential Information; or
2.25 is required by law, regulation, a court of competent jurisdiction or any
rules of civil procedure applicable to any court or administrative
proceeding to be disclosed.
•• <)
377
2.3 Return of Confidential Information. Upon the expiration or earlier termination
of this Agreement, the Receiving Party shall promptly return to the Disclosing
Party all Confidential Information of the Disclosing Party and any copies made
thereof, whether in written, electronic or any other form.
Article 3
Rights and Responsibilities of City
3.1 Provide Space and Equipment. Department shall provide a classroom sufficient
to provide quality instruction, audiovisual equipment, and access to City's
equipment and supplies for the purposes of CE Programs and instruction.
Specifically, the City will provide access to training defibrillators and manikins
for the EMT -D and AED courses.
3.2 Designate QI Person. Fire Department shall designate a person responsible for
QI Services in the Department and to receive the information under this
agreement and direct the QI Activities ( "QI Designee ").
3.3 Designate Maintenance Person. Fire Department shall designate a person
responsible for the maintenance checks on defibrillators in the Fire Department,
Police Department and city buildings
3.4 Training Requirements.
3.41 Fire Department shall ensure all personnel are currently certified EMT -
Basics to ensure certification as an EMT -D provider.
3.42 Police Department shall ensure all personnel maintain a current CPR and
First Aid card every two years.
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3.5 Registration. The City will coordinate the registration of City personnel into
AED courses at City buildings.
3.6 Textbooks. The City will provide the textbooks for participants at AED courses
at City Buildings.
3.7 Responsibility. City understands and accepts the responsibility for the clinical
activities and care provided by its employees and agents and for the
implementation of all services provided herein.
Article 4
Term
4.1 The term of this Agreement shall commence on July 1, 2004 and be in effect
through June 30, 2005. This Agreement shall automatically renew for two
additional one -year terms unless terminated earlier as set forth in this Agreement.
Article 5
Termination
5.1 Termination without Cause. Either party may terminate this Agreement at any
time without cause by providing the other party with sixty (60) days notice to the
names set forth in Article 9 below.
5.2 Termination for Cause. Either party may terminate this Agreement for cause or
a material breach by providing the other party with thirty (30) days written notice
to the names set forth in Article 9 below. If the breaching party fails to cure the
breach, the termination shall be effective at the end of the thirty (30) day period.
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Article 6
Payment
6.1 Compensation for Services. Department agrees to compensate UCLA for the
services provided under this Agreement as described in Exhibit C. At the end of
each one year term, as set forth in section 4.1. UCLA shall increase the cost of
services by 5% per year to cover cost of living increases. Department shall pay
this amount due within 30 days of receipt of the invoice from UCLA.
6.2 Payment. Any payment to UCLA made pursuant to this Agreement shall be
made by check payable to the Regents of the University of California and mailed
to:
Office Manager
UCLA Center for Prehospital Care
11303 W. Washington Blvd., Suite 200
Los Angeles, CA 900
Article 7
Insurance
7.1 The parties agree to obtain and maintain the insurance set forth in Exhibit D.
Article 8
Indemnification
8.1 Department and the City agree to defend, indemnify, and hold harmless UCLA,
its officers, employees and agents from and against any and all liability, loss,
expense (including reasonable attorneys' fees) or claims for injury or damages
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arising out of the performance of this Agreement, but only in proportion to and to
the extent such liability, loss, expense, attorneys' fees, or claims for injury or
damages are caused by or result from the negligent or intentional acts or
omissions of the City, Department, its officers, employees or agents.
8.2 UCLA agrees to defend, indemnify, and hold harmless Department and the City,
its officers, employees and agents from and against any and all liability, loss,
expense (including reasonable attorneys' fees) or claims for injury or damages
arising out of the performance of this Agreement, but only in proportion to and to
the extent such liability, loss, expense, attorneys' fees, or claims for injury or
damages are caused by or result from the negligent or intentional acts or
omissions of UCLA, its officers, employees or agents.
Article 9
Notice
9.1 Any notice required to be given to any Party is deemed to have been given and to
be effective on the date of delivery if delivered in person, or five days after
mailing if mailed by first -class certified mail, postage paid, or on the date of the
fax confirmation if made by fax, to the respective addresses given below or to any
other address as designated in writing to the other Party:
UCLA:
Todd LeGassick
Managing Director
UCLA Center for Prehospital Care
11303 W. Washington Blvd., Suite 200
3375 ..
Los Angeles, CA 9006695 -1369
With a copy to:
UCLA Medical Center Legal Affairs
10920 Wilshire Blvd., Suite 420
Los Angeles, CA 90095 -1632
Department:
City Clerk's Office
City of E1 Segundo
350 Main Street
E1 Segundo, CA 90245
With a copy to:
E1 Segundo Fire Department
314 Main Street
E1 Segundo, CA 90245
Article 10
Use of Name
10.1 Neither Party may use the name of the other, including the name UCLA, the
Regents of the University of California, or the University of California, in any
advertising, publicity, or otherwise, without the prior written approval of the other
Party.
Article 11
General Terms
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11.1 Relationship. This Agreement is not construed as creating a partnership, joint
venture, or agency relationship among the Parties. The relationship between the
parties shall at all times be that of independent contractors.
11.2 Governing Law. This Agreement must be interpreted and construed according to
the laws of the State of California.
11.3 Modifications. Any amendments or modifications to this Agreement must be in
writing and signed by authorized representatives of both parties.
11.4 Assignment. Neither Party may assign their rights, duties, or obligations under
this Agreement, either in whole or in part, without the prior written consent of the
other Party.
11.5 Severability. The provisions of this Agreement are severable. If any provision
of this Agreement is determined to be invalid or unenforceable under any
controlling body of law, the invalidity or enforceability does not in any way affect
the validity or enforceability of the remaining provisions of this Agreement.
11.6 Waiver. Waiver by any Party of any breach of any provision of this Agreement
or warranty or representation shall not be construed as a waiver of any subsequent
breach of the same or any other provision. The failure to exercise any right in this
Agreement shall not operate as a waiver of such right.
11.7 Entire Agreement. This Agreement, and the Exhibits, contain the entire
Agreement between the parties with respect to the subject matter of the
Agreement and supersedes all prior written or oral agreements with respect to the
subject matter in the Agreement.
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31375 • .
11.8 No Third Party Beneficiaries. None of the provisions contained in this
Agreement are intended by the parties, nor shall they be deemed, to confer any
benefit on any person not a party to this Agreement.
[Signature page follows.]
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IN WITNESS THEREOF, the parties hereto have executed this Agreement on the dates
indicated.
THE CITY OF EL SEGUNDO
a general law city
ary tr nn, Date
City Manager
ATTEST:
Cindy Mo sen Date
City Clerk
APPROV D . TO FORM:
Mark . H yi y Attorney
A// V
arl H. BR/Z
Assistant ttorney
UCLA, The REGENTS OF THE
UNIVERSITY OF CALIFORNIA, on
behalf of UCLA Medical Center
David L. Callender, M.D. Date
Vice Provost, Hospital Systems
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3375. ..
Exhibit A
Los Angeles County Department of Health Services Prehospital Care Policy 412.1
and 412.2
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REFERENCE NO. 412.1
AED SERVICE PROVIDER
AUTOMATED EXTERNAL DEFIBRILLATOR PROTOCOLS
Standing Orders for Apneic /Pulseless Patients
Condition
Key Action
Specific Action
Shockable Rhythm
Defibrillate in series of three
1. Deliver defibrillations in sets of three (escalating
wattage until after the third shock then continue
at highest setting).
2. After each series of 3 shocks, check pulses. If
no pulse, perform CPR for 60 seconds then re-
analyze.
3. Continue analyzing and shocking in repeated
sets of three shocks with 1 minute of CPR
between each set until "no shock advised"
message is received.
Non - Shockable Rhythm
Analyze
1. Check pulse
• If no pulse - perform CPR for 60 seconds.
• If pulse - check ventilations and perform
rescue breathing as needed.
2. Perform an ongoing analysis of rhythm every
1 -2 minutes. Press analyze or anticipate
automatic analysis.
Post Defibrillation
If return of pulse
1. Check for return of pulses after "no shock
Vital signs
advised" message.
2. If a pulse is present, check breathing:
If no return of pulse
• If present, place patient in recovery position,
CPR/re- analyze
monitor pulse & breathing.
• If absent, perform rescue breathing.
3. if return of pulse then loss of pulse, restart
treatment sequence (defibrillate using highest
energy level available if possible).
Interface with ALS
Follow AED Protocols
1. If Paramedics arrive during any series of 3
shocks, AED operator shall complete that series
allowing Paramedics to begin other ALS
procedures.
2. If physician arrives, AED operator should
continue to follow AED protocols.
3. If ALS and BLS arrive simultaneously, AED
Service Provider should defer decision to use
the AED to ALS providers (defibrillation of
shockable rhythm is of prime importance).
4. After Paramedic arrival, AED operator should
defer patient care decisions to Paramedics.
5. If no shock advised, immediately turn over care
decisions to arriving AILS providers.
Patient Destination
Transport
AED operators should shock until a "no shock
advised" message is received. If ALS has still not
Note:
arrived on scene, after the second series of three
AEDs cannot properly analyze
shocks:
rhythms in a moving vehicle.
• EMTs should consider loading patient for
Vehicle must be stopped for
transport to closest basic emergency facility if
proper rhythm analysis
ALS arrival is longer than ETA to hospital.
Analysis and administration of third set of
defibrillations should happen before moving
vehicle.
• Public Safety Personnel do not transport and
shall wait for EMS arrival in all situations.
NOTE: An Automated External Defibrillator is not an assessment device and cannot detect or identify life threatening
arrhythmias beyond V -tach and V -fib. It cannot determine if a patient is having a "heart attack" or other serious
arrhythmias beyond V -tach and V -fib. An AED should not be applied unless the patient is pulseless and apneic.
Revised: 11 /01
o
REFERENCE NO. 412.2
Los Angeles County EMS Agency Page 1 of 2
AED SERVICE PROVIDER ANNUAL REPORT
January 1 through December 31,
As required by State law and /or local polices, the following statistical information must be submitted.
Deadline for submission is March 1 of the subsequent year.
1. Population served (estimated):
2. No. of department responses (ALS and /or BLS) to patients who suffered sudden cardiac arrest:
No. of resuscitations attempted: No. not attempted':
3. No. of patients on whom an AED was applied:
4. Response of patients on whom AED was applied: (% of incidents per time period):
RESPONSE PERIOD
<30 sec.
30 -60 sec.
>60 sec.
If known, time 911 access to
dispatch time
No. with
Prior to ALS2:
5. No. of patients on whom AED defibrillatory shocks were administered:
a. No. of these patients who suffered a witnessed cardiac arrest:
WITNESSED
(seen or heard by a bystander)
<4 mins.
4 -8 mins.
>8 mins.
Dispatch time to time of
AED at patient's side
No. with
Prior to ALS2:
5. No. of patients on whom AED defibrillatory shocks were administered:
a. No. of these patients who suffered a witnessed cardiac arrest:
WITNESSED
(seen or heard by a bystander)
<30 sec.
30 -60 sec.
>60 sec.
Time from patient's side to
1 st press of "ANALYZE"
No. with
Prior to ALS2:
5. No. of patients on whom AED defibrillatory shocks were administered:
a. No. of these patients who suffered a witnessed cardiac arrest:
WITNESSED
(seen or heard by a bystander)
UNWITNESSED
No. with
Prior to ALS2:
No. with
Prior to ALS2:
bystander
bystander
CPR
regained
CPR
regained pulse
pulse
did not regain
did not regain
pulse
pulse
No. without
bystander
Prior to ALS2:
❑
No. without
bystander
Prior to ALSZ:
❑
CPR
regained pulse
CPR
❑
regained pulse
El
did not regain
did not regain
pulse
pulse
3375
REFERENCE NO. 412.2
Page 2 of 2
AED SERVICE PROVIDER ANNUAL REPORT (continued)
Initial monitored rh thm of natients whom AED defibrillatory shocks were administered:
From witnessed patient group, the # whose
From unwitnessed patient group, the #
initial monitored rhythm was:
❑
whose initial monitored rhythm was:
Ventricular fibrillation
Ventricular fibrillation
❑
Ventricular tachycardia
F-1
Ventricular tachycardia
Asystole
Asystole
❑
Other
❑
Other
F-1
From witnessed patient group:
# discharged from hospital alive'
El
From unwitnessed patient group:
# discharged from hospital alive'
El
If available, # discharged with
If available, # discharged with
neuro status unchanged
neuro status unchanged
El
7. Number of AED units in place at submission of report:
8. Brand name(s) of defibrillation devices in use:
PROBLEM DATA
Equipment failure:
Machine shocks rhythm other than V -Fib or V Tach:
No discharge:
Tape malfunction:
Other
Lack of skill proficiency° Critical skill
Non - critical skill
Not attempted due to patient having met obviously dead criteria, valid DNR presented, patient's personal physician at scene
withholds resuscitation efforts.
If field ALS service available, "prior to ALS" is prior to paramedic arrival.
If no field ALS service, "prior to ALS" is prior to arrival at hospital.
Please attach EMS report form sequence number.
Critical skill - could affect patient outcome or endanger the operator, e.g., forgetting to say "stand clear".
Non critical skill - does not affect patient outcome or endanger operator, e.g., operator forgets to state name on tape, open box first, etc.
You are encouraged to provide additional information which will assist the EMS Agency in implementing and
evaluating AED Service Provider Programs in Los Angeles.
Mail this report to : Los Angeles County EMS Agency
5555 Ferguson Drive, Suite 220
Commerce, California 90022
Attn: EMS Agency Medical Director
AED Service Provider Submitting Report:
AED Program Coordinator:
(please type /print)
AED Program Coordinator's Signature:
Revised: 7/01
Date / /
3375
Exhibit B
Los Aniieles County Department of Health Services Prehospital Care Policy 412
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331
DEPARTMENT OF HEALTH SERVICES REFERENCE NO. 412
COUNTY OF LOS ANGELES
SUBJECT: AUTOMATED EXTERNAL DEFIBRILLATOR (AED)
SERVICE PROVIDER PROGRAM REQUIREMENTS
PURPOSE: To establish policies and procedures for Automated External Defibrillator
(AED) Service Providers in Los Angeles County.
AUTHORITY: Health and Safety Code Sections; 1797.52, 1797.107, 1797.170
California Code of Regulations, Title 22, Chapter 1.5 Sections 100005,
100006,100020, 100021, 100023, Chapter Sections 100056,100056.1,
100063.1, 100070, 100075.
DEFINITIONS: Automated External Defibrillator or AED: An external defibrillator capable
of cardiac rhythm analysis that will charge and deliver a shock, either
automatically or by user interaction, after electronically detecting and
assessing ventricular fibrillation or rapid ventricular tachycardia.
AED Service Provider: An agency or organization which is approved by the
EMS agency and is responsible for and authorizes EMT -Is or public safety
personnel to operate an AED for the purpose of providing services to the
general public.
EMT- I: An EMT is an individual who is currently certified as an EMT -I by an
EMT -I certifying authority.
Public Safety Personnel: Public safety personnel includes firefighter,
lifeguard and peace officer.
POLICY: Automated External Defibrillator Service Provider Approval Process.
I. Program Requirements
An agency or organization employing certified EMT -Is or public safety personnel seeking
approval to use an automated external defibrillator(s) (AED) shall submit the following
information to the EMS Agency:
A. The name of the individual designated by the Chief Executive Officer of the organization
or agency to accept responsibility for the AED Service Provider Program including data
collection and reporting. This person shall be identified as the Program Coordinator.
Any changes in the Program Coordinator shall be reported to the EMS Agency in writing
within fifteen (15) days.
B. Description of the method to be used to document that each individual authorized to
operate an AED has had a minimum of four (4) hours of initial training. This initial
training shall have been provided only by a currently California licensed physician,
EFFECTIVE DATE: 8 -1 -88
REVISED: 7 -01 -01
SUPERCEDES: 9 -01 -96
APPROVED:
Director, EMS Agency
PAGE 1 OF 3
Medical Director, EMS Agency
33,5- . .J
SUBJECT: AUTOMATED EXTERNAL DEFIBRILLATOR (AED) REFERENCE NO. 412
SERVICE PROVIDER PROGRAM REQUIREMENTS
registered nurse or physician assistant or paramedic who has been previously certified
in California; or instructor(s) who have been approved by the EMS Agency. Approved
instructors must be recognized by the American Heart Association or American Red
Cross or equivalent as CPR /AED instructor(s) and have shown competency in proper
utilization of an AED and have demonstrated competencies in adult teaching
methodologies. Initial training must include the following topics.
(a) Assessment of an unconscious patient to determine when CPR and defibrillation
may be necessary.
(b) The importance of adequate airway care, advanced life support and defibrillation.
(c) Proper use of the AED. Including information relating to defibrillator safety
precautions to enable the individual to administer a shock without jeopardizing the
safety of the patient, rescuers, or other persons.
(d) Recognition that an electrical shock has been delivered to the patient and that the
defibrillator is no longer charged.
(e) Rapid, accurate assessment of the patient's post -shock status.
C. Procedures and training methods that will ensure that all authorized personnel have
been oriented to the proper use and maintenance of the Service Provider's AED and Los
Angeles County's AED Protocols (Reference No. 412.1).
D. Procedures such that each individual authorized for AED use will demonstrate their skill
proficiency and continued competency. This evaluation shall be conducted at least
annually.
E. A description of the procedures that will be used to ensure that the AED equipment is
properly maintained.
F. A statement to abide by all EMS Agency policies and procedures related to AED
programs.
G. A description of the program that will be used to monitor the effectiveness and quality of
AED events including data collection methodology .
H. A sample of an approved form that will be used to document each situation when the
AED is applied.
II. Reporting Requirements
As required by the CCR, Title 22, Chapter 1.5 and Chapter 2, information shall be reported
annually to the Los Angeles County EMS Agency (Reference No. 412.2) for every patient on
whom the AED is applied in Los Angeles County. Reports shall be submitted regardless of
which EMS Agency has approved that AED service provider. These reports are due by
March 1 st for the previous calendar year and shall include at least:
PAGE 2OF3
3775 °•
SUBJECT: AUTOMATED EXTERNAL DEFIBRILLATOR (AED) REFERENCE NO. 412
SERVICE PROVIDER PROGRAM REQUIREMENTS
A. The total number of cardiac arrests responded to by the AED service provider in Los
Angeles County.
B. The total population served by this AED service provider.
C. The number of patients with sudden cardiac arrest receiving CPR prior to arrival of
emergency medical care.
D. The total number of patients on whom defibrillatory shocks were administered,
witnessed (seen or heard) and not witnessed.
E. The number of these persons who suffered a witnessed cardiac arrest whose initial
monitored rhythm was ventricular tachycardia or ventricular fibrillation.
III. Record Keeping
All relevant records used for training, monitoring and evaluation shall be available for review
by the EMS Agency for a period of three years.
IV. Program Approval
Upon receipt and review of all elements of the program requirements, the EMS Agency will
provide written approval to provide AED services. Approval may be revoked or suspended
prohibiting use of the AED, if upon EMS Agency audit or review the AED service provider is
found to be out of compliance with applicable State regulations and /or Los Angeles County
EMS Agency policies, procedures or reporting requirements.
CROSS REFERENCE:
Prehospital Care Policy Manual:
Reference No. 412.1, Automated External Defibrillator Protocols
Reference No. 412.2, AED Service Provider Annual Report
PAGE 3OF3
Fire Department Services:
CE Programs and QI Services
EMT -D Education and Services
Police Department Services:
AED Education and Services
City Building Services:
AED Education and Services
3375 • .
Exhibit C
Fees
$17,364.48 per year ($1,447.04 per month)
$ 4,961.25 per year ($412.44 per month)
$4,347.00 per year ($362.25 per month)
$1653.75 per year ($137.81 per month)
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Exhibit D
Insurance
I. Department
3315
Department at its sole cost and expense shall insure its activities in connection
with this Agreement by maintaining programs of insurance or self - insurance as
follows:
1. General Liability Self- Insurance with a limit of five million dollars
($5,000,000) per occurrence.
2. Business Automobile Liability Self - Insurance Program for owned, non -
owned, or hired automobiles with a combined single limit of not less than
five million dollars ($5,000,000) per occurrence.
3. Professional Medical Self - Insurance Program with limits of five million
dollars ($5,000,000) per occurrence.
4. Workers' Compensation and Employers Liability Self - Insurance Program
covering City's full liability under the Workers' Compensation Insurance
and Safety Act of the State of California as amended from time to time.
5. Such other insurance in such amounts which from time to time may be
reasonably required by mutual consent of the parties against other
insurable risks relating to performance.
It should be expressly understood, however, that the coverages required under
Sections 1, 2, and 3 above shall not in any way limit the liability of Department
and the City.
The coverages referred to under Sections 1 and 2 above shall include UCLA as an
insured. Such a provision, however, shall apply only in proportion to and to the
extent of the negligent acts or omissions of Department and the City, its officers,
employees and agents under this Agreement. Department and the City, upon
execution of this Agreement, shall furnish UCLA with Certificates of Self -
Insurance evidencing compliance with all requirements.
II. UCLA
UCLA at its sole cost and expense shall insure its activities in connection with
this Agreement by maintaining programs of self - insurance as follows:
1. General Liability Self- Insurance with a limit of five million dollars
($5,000,000) per occurrence.
2. Business Automobile Liability Self- Insurance Program for owned, non -
owned, or hired automobiles with a combined single limit of not less than
five million dollars ($5,000,000) per occurrence.
3. Professional Medical and Hospital Liability Self- Insurance Program with
limits of five million dollars ($5,000,000) per occurrence.
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3375
4. Workers' Compensation and Employers Liability Self- Insurance Program
covering University's full liability under the Workers' Compensation
Insurance and Safety Act of the State of California as amended from time
to time.
5. Such other insurance in such amounts which from time to time may be
reasonably required by mutual consent of the parties against other
insurable risks relating to performance.
It should be expressly understood, however, that the coverages required under
Sections 1, 2, and 3 above shall not in any way limit the liability of UCLA.
The coverages referred to under Sections 1 and 2 above shall include Department
and City as insureds. Such a provision, however, shall apply only in proportion to
and to the extent of the negligent acts or omissions of UCLA, its officers,
employees and agents under this Agreement. UCLA, upon execution of this
Agreement, shall furnish Department with Certificates of Self- Insurance
evidencing compliance with all requirements.
III. NOTICE
Each party shall provide the other with at least thirty (30) days advance written
notice to the names set forth in Article 9 of this Agreement of any changes,
modifications or cancellations of the above coverages.
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