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HomeMy WebLinkAboutStudy Session Packet 05/16/2011 amended STUDY SESSION AGENDA CITY COUNCIL MEETING CITY OF WHEAT RIDGE, COLORADO Council Chambers 7500 W. 29th Ave. Mav 16. 2011 6:30 p.m. Individuals with disabilities are encouraged to participate in all public meetings sponsored by the City of Wheat Ridge. Call Heather Geyer, Public Information Officer at 303-235-2826 at least one week in advance of a meeting if you are interested in participating and need inclusion assistance. APPROVAL OF AGENDA .L Staff Report( s) 2. Impact of Wheat Ridge Business District 3. Debt Policy and Unrestricted Fund Balance Policy 4. Citywide Emergency Medical Services Partners in aVibrantWheat Ridge MEMORANDUM To: CITY COUNCIL, MAYOR CITY OF WHEAT RJOGE Wheat Ridge BUSINESS DISTRICT FROM: BRITTA FISHER, WR2020 JOHN MARRIOTT, WRBD RE: IMPACT OF WHEAT RJOGE BUSINESS DISTRICT MAy 10, 2011 Attached you will find a map overview and photo portfolio of the grants made by the Wheat Ridge Business District. The portfolio demonstrates impactful projects since 2007. For this study session, we will focus on our recent impacts and grants made since January 2010. Regular Grants made: 12 Total amount granted: $72,244 Estimated total project costs on those 12 grants: $632,662 One Large Project grant with CDBG contract: $60,000 Total project costs on large grant: $90,000 Grants pending: 3 As Wheat Ridge Business District has no staff and a volunteer board, we have a management agreement with Wheat Ridge 2020. This has proven to be an effective partnership. In fact the Wheat Ridge 2020 loan and grant program have complimented one another in 5 very visible projects on 38th Avenue -Cress Kitchen & Bath, Lucky Pony Properties (Big Sky Espresso Cafe), Dairy Queen Orange Julius, Molly Marie Properties (Compass Construction), and Tom Yang (Cebiche). The total impact of these five projects is estimated at over $900,000. We will discuss the future direction of the Wheat Ridge Business District with you on May 16. P.O. BOX 1268 WHEAT RIDGE. CO 80034-1268 WWWWHEATRIDGE2020.0RG PH: 7202591030 FAX: 303 9409332 , neat Ridge BUSINESS DISTRICT Wheat Ridge Lanes 6595 W 38th Avenue Before After Fac;ade and Awning Improvements Grant -$7,500 Total Project Cost Estimate -$17,000 January 2007 , " ~or WheatRi9ge Map Location I Before Wheat Ridge BUSINESS DISTRICT Jackson Hewitt 4385 Wadsworth Boulevard Sign Improvements Grant -$2,359 Total Project Cost Estimate -$4,709 June 2007 Map Location 2 After •• • Tar ~ityof WheatR.;L.dge Wheat Ridge Family Clinic 6301 w 38th Avenue -Before After Sign, Fac;ade, Awning Improvements and Architectural Assistance Grant -$14,000 Total Project Cost Estimated -$400,000 Wheat Ridge December 2007 BUSINESS DISTRICT '" " , # ~Of Wheat Rl..-dge Map Location 3 Before neat Ridge BUSINESS DISTRICT Lakewood Plumbing 9800 w 44th Avenue Sign Improvement Grant -$3,000 Total Project Cost Estimate -$8,000 February 2008 Map Location 4 After .' < ~or WheatRt-dge Wheat Ridge BUSINESS DISTRICT DTI 8955 W 44th Avenue Before After Fac;ade and Awning Improvements Grant -$3,131 Total Project Cost Estimate -$6,324 April 2008 . , . ~rv ~ityof WheatRl.-dge Map Location 5 Cress Kitchen & Bath 6770 W 38th Avenue Before After WRBD Fac;ade, Sign, and Awning Improvements and Architectural Assistance Grant -$14,000 WR2020 Building Up Business Loan-$50,000 Total Project Cost -$175,000 completed January 2009 , < Wheat Ridge BUSINESS DISTRICT =rar ~ityof Wheat~ge Amici's Italian Restaurant 4300 Wadsworth Boulevard Before After Wheat Ridge BUSINESS DISTRICT Fac;ade, Sign, and Awning Improvements and Architectural Assistance Grant -$12,348 Total Project Cost Estimate -$56,000 July 2009 Map Location 7 ~ \. 10 ~ 4ra' ~jlyor WheatR!e-ge Big Sky Espresso Cafe 7300 W 38th Avenue Before After WRBD Fac;ade, Sign, and Awning Improvements and Architectural Assistance Grant -$11,000 WR2020 Building Up Business Loan-$so,ooo Total Project Cost -$180,000 \.,V.lU d January 2009 &2 q '" .. , ~ Wheat Ridge BUSINESS DISTRICT ~rar ~ityof WheatR!9ge Cone AppetitjDairy Queen 6790 w 38th Avenue Before After WRBD Fac;ade, Sign, and Awning Improvements Grant -$12,000 WR2020 Building Up Business Loan -$50,000 Total Project Cost -$135,000 May 2009 Wheat Ridge BUSINESS DISTRICT (r 2llJ.C ~/.... '" , . ~Of W heat Rl..dge Before Wheat Ridge BUSINESS DISTRICT Seyfer Automotive 4501 Harlan Street Sign Improvements Grant -$3,000 Total Project Cost Estimate -$9,140 April 2009 Map Location 10 After " ~ , 4 :~ .P'c:ilyof WheatRL-dge Sandalwood Partnership 3825 Harlan Street Before After Fac;ade, Sign, and Awning Improvements Grant -$10,070 Total Project Cost Estimate -$25,000 November 2009 ... t. 4 ... Wheat Ridge BUSINESS DISTRICT :rP!' ~jlyof WheatRi9ge Map Location 1 1 The Growing Company 4830 Ward Road Before After Fa<;ade, Sign, and Awning Improvements Grant -$12,008 Total Project Cost Estimate -$48,652 August 2010 Wheat Ridge BUSINESS DISTRICT , < ~or WheatRL-dge Map Location 12 Before Wheat Ridge BUSINESS DISTRICT Super Car Wash 9500 W 44th Avenue Sign Improvements Grant -$3,000 Total Project Cost Estimate -$17,816 July 2010 Map Location 13 After .. ~ • # -rar ~ilyof WheatR!9ge Lakeside Animal Hospital 4243 Harlan Street Before After Fac;ade & Sign Improvements and Architectural Design Grant -$11,000 Total Project Cost Estimate -$91,359 July 2010 • '< Wheat Ridge BUSINESS DISTRICT :~ ~ilyof WheatRL..dge Map Location 14 Long Shots Bar & Grill 4400 Ward Road , Before After Wheat Ridge BUSINESS DISTRICT Fac;ade & Sign Improvements Grant -$9,000 Total Project Cost Estimate -$19,777 May 2010 Map Location 15 " , . ~Of WheatRL-dge Roger Loecher 4325 Wadsworth Boulevard -Before After Fac;ade Improvements and Architectural Design Grant -$4,518 Total Project Cost Estimate -$10,134 July 2010 , , Wheat Ridge BUSINESS DISTRICT ~or WheatRL..dge Map Location 16 Eileen Loecher (Black & Read II) 4335 Wadsworth Boulevard Before After Fac;ade & Sign Improvements and Architectural Design Grant -$6,725 Total Project Cost Estimate -$22,753 July 2010 '" ~ • 4 Wheat Ridge BUSINESS DISTRICT ~rar ~jtyof WheatR,igge Map Location 17 Before Wheat Ridge BUSINESS DISTRICT Leid Financial Group 12851 W 43rd Drive Sign Improvements Grant -$3,000 Total Project Cost Estimate -$7,696 July 2010 Map Location 18 After . , . ~or WheatRL-dge Compass Construction 7020 W 38th Avenue Before After WRBD Fac;ade, Sign, and Awning Improvements Grant -$10,100 WR2020 Building Up Business Loan -$50,000 Total Project Cost -$175,000 March 2011 ... \ . ~ :~ ~ityof WheatR;!9ge heat Ridge BUSINESS DISTRICT Before Wheat Ridge BUSINESS DISTRICT Patrick Nichols Associates 7700 w 44th Avenue After Large Project Grant -$60,000 Total Project Cost Estimate -$90,000 February 2011 Map Location 20 , • • ~Of Wheat~dge John Villachica 9685 w 44th Avenue Before After Fac;ade and Architectural Design Grant -$8,000 Commercial Exterior Paint Grant -$500 Total Project Cost Estimate -$205,200 September 2010 . '. :~ Wheat Ridge BUSINESS CISTRICT ~ityof WheatR!9ge Map Location 21 Before Eileen Loecher (Jackson Hewitt/Salsa's Mexican Restaurant) 7610 W 44th Avenue After Fac;ade and Architectural Design Grant -$8,000 Total Project Cost Estimate -$59,886 April 2011 •• 4(P" neat Ridge BUSINESS DISTRICT ~ilyor WheatRJe-ge Map Location 22 Before Wheat Ridge BUSINESS DISTRICT Styles Reynas Salon 5455 w 38th Avenue Anticipated completion August 2011 Sign Grant -$1,301 Total Project Cost Estimate -$ August 2011 Map Location 23 After , •• ~Of W h eat R-L..dge Eileen Loecher 2DI~ I( I (Advanced Transmission) 7650 W 44th Avenue TRANSMISSION CENTER Before After Wheat Ridge BUSINESS DISTRICT Fac;ade and Architectural Design Grant -$6,900 Total Project Cost Estimate -$15,847 April 2011 Map Location 24 , . ~Of Wheat~ge Before Wheat Ridge BUSINESS DISTRICT GIA Risk Management 9195 W 44th Avenue PROGRESSIVE GIA Risk Management Sign Grant -$1,481 Total Project Cost Estimate -$2,961 March 2011 Map Location 25 After ... ~ , 4 :rar .P'Cityof WheatRL-dge Before Wheat Ridge BUSINESS DISTRICT Designers Hair Loft 7110 w 44th Avenue Anticipated completion May 2011 Sign Grant -$3,000 Total Project Cost Estimate -$7,910 Anticipated completion May 2011 Map Location 26 After , , :~ ~ilyor Wheat~ge Thomas Yang 7000 W 38th Avenue Before Anticipated completion July 2011 After Fa<;ade & Sign Improvements and Architectural Design Grant -$9,953 Wheat Ridge BUSINESS DISTRICT Total Project Cost Estimate -$ Anticipated completion July 2011 Map Location 27 '" \ ;, ~ ~Of WheatR.L..dge ~ ~ A ~ ... ~ ~ Cityof. "~Wheat~dge ~OFFICE OF THE CIlY MANAGER ~ft/fYl 3. Memorandum TO: Mayor and City Council FROM: Patrick Goff, City Manager~ DATE: May 11,2011 SUBJECT: Debt Policy and Unrestricted Fund Balance Policy A top priority in the 2010/2011 Wheat Ridge Strategic Plan is the development of a long term financial sustainability plan which is an action item under the goal of "Financially Sound City Providing Quality Services." In 2010, the City contracted with Clifton Gunderson to conduct a "Financial Checkup" of the City's current fiscal condition. The Financial Checkup utilized eighteen (18) indicators covering areas such as revenues, expenditures, cash liquidity, unrestricted fund balance ratio as well as other key indicators to identify significant trends and "red flags" that may impede long-term financial stability. On August 16,2010, staff presented the results of the "Financial Checkup" to City Council. Staff prioritized the recommendations from the report and contracted with Clifton Gunderson to draft a Debt Management Policy and an Unrestricted Fund Balance Policy. Clifton Gunderson and staff will present both draft policies to City Council at the May 16th study session. Attachments: 1. Draft Debt Management Policy 2. Draft Unrestricted Fund Balance Policy City of Wheat Ridge Debt Management Policy The City of Wheat Ridge (City) recognizes the importance of long-range, financial planning in order to meet its capital project and improvement needs. The following debt management policy provides guidance on the issuance of debt to help ensure that the City maintains a sound debt position and that its credit quality is protected. As such, the policy allows for an appropriate balance between establishing debt parameters while also providing flexibility to respond to unforeseen circumstances and new opportunities. Responsibility and Administration of Policy The primary responsibility for developing long-term, financing reGommendations rests with the City Manager. During the annual budget process, and at an t er time during the year that may be warranted, the City Manager will work with the Ad . 'strative Services Director and the City Treasurer (the internal working group) to det . mine if re is a need for long-term financing consideration. As part of the determination ocess, the I ernal working group shall review the financing needs outlined by the Capita' 1m rovement Program (see below) to analyze the capital financing needs compared with v.ail Ble resources. The internal working group will also provide recommendations regarding r funding and restructuring of existing debt. The City Manager and Cit asurer will review the Debt Management Policy annually in connection with the City's annual budget process to ensure that the City is adhering to the framework outlined in this policy and will make recommendations to revise the policy as needed. Capital Improvement Program The Capital Improvement Program (CIP) will be utilized to identify capital projects and/or improvements that are part of the City's strategic vision and economic development efforts. The CIP will cover, at a minimum, a ten (10) year period and provide a projection of the financing needs required to implement the CIP. The CIP will include the associated ongoing operations and maintenance costs of such capital assets and/or improvements so that the total costs of the projects are considered. The CIP will be updated annually by the City's Public Works' Director as part of the budget process. Attachment 1 Purpose of Debt Incurrence of debt or long-term borrowing will only be used for the purpose of providing financing for capital assets, which include but are not limited to buildings, infrastructure, land acquisition and purchase of significant equipment. The City, under no circumstances, will issue debt or borrow funds to finance City operations and maintenance costs. The City will strive to maximize the use of pay-as-you-go financing for capital projects and improvements. Debt borrowing will be considered when annual revenues and accumulation of fund balances are not sufficient to provide the necessary funding for such projects. Types of Debt The types of debt instruments to be used by the City may i e o General Obligation and Revenue Bond o Short-term notes o Special or Local Improvement bonds o Certificates of Participation o Any other legally recognized s cl:.lrity~ Although permitted anticipation notes. by City Council arket conditions favor this type of issuance, and when feasible, ensure the e is a maxi int rest rate provided within the variable rate structure. Credit enhancements iI be used 0 Iy in instances where the anticipated present value savings in terms of reduced intere expe se exceeds the cost of the credit enhancement. level of Debt The City's aggregate amount of bonds or other evidences of indebtedness outstanding will not exceed three percent (3%) of the actual valuation of the taxable property within the City as shown by the last preceding assessment. In determining the amount of indebtedness outstanding, the City will adhere with the computation guidelines as established by City Charter. The City will strive to maintain its annual debt service costs (principal and interest) for its governmental activities at a level of no greater than ten percent (10%) of general fund expenditures. The repayment terms of the debt will not exceed the useful life of the capital asset financed. Further, the City will seek level or declining debt repayment schedules and will not issue debt that provides for a a balloon principal payment reserved at the end of the term of the issue. Moreover, the City will also strive to obtain redemption terms that allow for the prepayment of debt without paying a redemption penalty. Debt Issuance Practices As part of its debt issuance process, the City will at all times manage its debt and sustain its financial position in order to secure and maintain an Aa/AA or higher bond rating. The City will market its debt through the use of a competitive bid process when issuing general obligation debt. The competitive bid process will also be used for other debt issuances unless time, interest rates and/or other factors make it more favorable for the City to use a negotiated process. If needed, the City will hire an independent financial advisor, a provider (e .g. bond counsel), to assist in the structuring of t overall guidance throughout the process. Guidelines for Refunding The City shall consider refunding (advance an analysis indicates the potential for net pr sa (3%) can be achieved. The City may also existing restrictive covenants. planning. planning. any other professional service bt transaction and to provide The City will invest its deb oceeds in accordance with the City's investment policy and statutory requirements. Funds will be invested in instruments and with related maturities that will provide the liquidity needed to meet the cash flow needs of each project. In this regard, the City Treasurer will prepare a cash flow projection to determine the availability of funds available to be invested and their respective required maturities. The City will comply with all arbitrage rebate requirements as established by the Internal Revenue Service. Arbitrage will be calculated at the end of each fiscal year and interest earned on the investment of debt proceeds will be reserved to pay any penalties due. Secondary market disclosures requirements established within the terms of the debt transaction will be adhered to and filed on a timely basis. The City Treasurer will be responsible for managing the post issuance requirements listed above and/or cause any post issuance requirements to be completed. City of Wheat Ridge Unrestricted Fund Balance Policy The City of Wheat Ridge (City) has determined it to be a sound, financial practice to maintain adequate levels of unrestricted fund balance in its General Fund in order to mitigate current and future risks such as revenue shortfalls and unanticipated expenditures as well as to ensure stable tax rates. Additionally, the City believes that adequate unrestricted fund balance levels are a critical consideration to the City's long-term financial planning. In this regard, the City has established the following fiscal policy related to its unrestricted fund balance. Maximum and Minimum Amounts The City will maintain a minimum unrestricted fund balao of at least two months or approximately 17%, as recommended by the Government Fi a Ee Officer's Association (GFOA), of its General Fund operating expenditures. The City' unrestricted fund balance shall not exceed 35.0% of General Fund opera i expenditll s. Not precluding the aforementioned minimum and maximum percent percent ge , the (S·ty will an · ually target to maintain a 25.0% unrestricted fund balance percentage level ga of its annual budget process. Use of Funds While targeting to maintain an ann there may be circumstances tha . arra has established the following il'-lst nce u apprppriated costs to service and maintain current City o Unexpecte on-budgeted emergencies, natural disaster costs, and/or litigation suit o Grant matching o Early retirement of debt o To cover deficits in other funds due to a shortfall in budgeted revenues o Capital asset acquisition, construction and improvement projects The use of the unrestricted fund balance for the above permitted events will require a majority vote by City Council with the exception of capital asset acquisition, construction, and improvement projects, which will require a super majority vote. Attachment 2 Terms for Replenishing In instances where the City elects to use its unrestricted fund balance for capital asset acquisition, construction and improvement projects, the City shall replenish the unrestricted fund balance to its previous levels as soon as possible, but only after the City's current operational needs are met, and in no case, more than two years subsequent in which the unrestricted fund balance was used. For any and all other instances, as permitted by this policy, in which the City elects to use its unrestricted fund balance, the City will replenish the unrestricted fund balance as soon as revenues are available, but only after the City's current operational needs have been met. Excess Funds In the event the City has accumulated its permitted, maxi 40.0%, the City, at the discretion and determination of CitY Cou designate such excess funds for the following purpose . o Reserves for equipment replacement o Repair and maintenance of City, facilitie o Funding of infrastructure imp Review of policy unrestricted fund balance of ci and the City Manager, will The City Treasurer will review Unrestricted Eund Balance Policy annually in connection with the City's annual budgeting,J2rocess t ensure Hat the City is maintaining adequate unrestricted fund balance levels. Ad Ition Iy a st every three years, the City Manager will review the policy and will mak tion for modification as deemed appropriate. This policy modifications to this policy. t forth by the GFOA. As such, any updates issued by the he City Manager when making recommendations for ~ J ~ .. ~ ~ City of "~Wheat~ge ~Oi..ICE DEPARTMENT TO: VIA: FROM: DATE: Memorandum Mayor DiTullio and City Council Patrick Goff, City Manager Daniel Brennan, Chief of Police Joe Cassa, Division Commander May 9, 2011 (for the May 16 Study Session) SUBJECT: Citywide Emergency Medical Services ISSUE: JfenL 4. The City of Wheat Ridge is served by four fire protection districts. On July 25, 1988, the City of Wheat Ridge, by Council Resolution, assumed the responsibility of providing Emergency Medical Services (EMS) throughout the City, due to concerns about the level of care provided by volunteer fire departments. Based upon service delivery concerns, City Council made a policy decision to have the City provide emergency medical services by contract with a private vendor at no cost to the City of Wheat Ridge within the boundaries of the Wheat Ridge Fire Protection District. City Council designated the Police Department to oversee this program. Since that time, the City has contracted EMS services through a competitive bid process, and the contract now includes the provision of EMS services throughout the City. These contracts have been assigned in five-year time increments. The current contract with Pridemark Ambulance Service expires on January 23, 2012. Commander Joe Cassa and I have met with staff representatives from each fire protection district to discuss the role of the City in providing overall EMS services for the City, as well as each fire district's vision of EMS services within their respective districts. The Arvada and Wheat Ridge Fire Protection Districts both indicated a desire to assume responsibility for EMS services in their respective districts in the near future. The West Metro Fire Protection District has a longstanding history of providing EMS services in their district, and will continue to do so. The Fairmount Fire Protection District expressed a strong desire to maintain the current EMS services contract. PRIOR ACTION: On August 1, 1988, the City of Wheat Ridge assumed the responsibility of providing Emergency Medical Services (EMS) throughout the Wheat Ridge Fire Protection District as a policy. Staff Report: Citywide Emergency Medical Services May 9, 2011 Page 2 FINANCIAL IMPACT: There are no hard dollar costs associated with the City contracting EMS services. There are monthly soft dollar costs related to the time Department staff spends attending monthly meetings. These meetings include the current EMS provider and representatives from the fire protection districts. BACKGROUND: The City of Wheat Ridge is served by four fire protection districts: (1) Wheat Ridge Fire Protection District (WRFPD), (2) Arvada Fire Protection District (AFPD), (3) West Metro Fire Protection District (WMFPD), and (4) the Fairmount Fire Protection District (FFPD). The City currently consists of 10.92 square miles, with WRFPD serving 7.66 square miles; AFPD serving 2.58 square miles; FFPD serving 0.39 square miles, and WMFPD serving 0.29 square miles. In early 1988, the Wheat Ridge Fire Protection District Board (WRFPD) announced that the volunteer-run ambulance service would discontinue transport of EMS patients as of July 31 , 1988. This announcement was the result of a number of patient care concerns to include: • Only 35% of the EMS runs made by the volunteer ambulance crews were staffed with paramedics. • A lack of volunteer fire EMS personnel coverage during the day and delayed responses throughout the late evening and early morning hours. • A response time of the ambulance crews ranging from fifteen to twenty-five minutes, with the response time defined as the time the call was received to the time the ambulance arrives on scene. At that time, the standards of adequate response time around the nation called for eight minutes or less. • The issue of paid EMS personnel was discussed and the WRFPD philosophy at that time was to continue volunteer services, because of the costs involved and their belief that their service was adequate. As a result, an Emergency Medical Services Board was formed to educate the public and resolve the problems of the extended response times and the availability of fire personnel trained as paramedics. The Board consisted of the head of emergency services at Lutheran Medical Center, the Wheat Ridge Fire Protection District, City officials and City residents. On July 25, 1988, City Resolution Number 1102 was passed by the City Council, which resulted in an intergovernmental agreement between the City, the Wheat Ridge Fire Protection District, and Ambulance Service Company to provide emergency ambulance services to residents residing within the City of Wheat Ridge and the Wheat Ridge Fire Protection District. On October 24, 1995, an intergovernmental agreement between the City, Wheat Ridge Fire Protection District, and the American Medical Response of Colorado, Inc. (AMR) was entered into. The agreement was the result of AMR purchasing the Ambulance Service Company. The term of this agreement was for a single year, with the provision of yearly renewal for the following four years. In 1996, there were multiple ambulance providers responding to a single call for emergency Staff Report: Citywide Emergency Medical Services May 9, 2011 Page 3 medical services within the City. As a result, there were unsafe response practices by ambulance providers. The issue prompted a draft of an ordinance to amend the City Code of Laws to provide the addition of a new section. The new section would have provided the response of a single emergency ambulance services provider for those calls received by the Police Department. There was no City Council action taken on this matter. In part, this was the result of the four fire protection districts serving the City. On December 27, 1999, an intergovernmental agreement between the City, Wheat Ridge Fire Protection District and Pridemark Paramedic Services, LLC was completed. This agreement was the result of performance issues involving AMR to include interagency communication and cooperation. The term of this agreement was the same as is reflected in the AMR agreement. On January 23, 2006, an intergovernmental agreement among the City of Wheat Ridge, the Wheat Ridge Fire Protection District, and Pridemark Paramedic Services, LLC for the provision of emergency ambulance services within the entire corporate limits of the City of Wheat Ridge, and the boundaries of the Wheat Ridge Fire Protection District, was written. The WRFPD participated in the Request for Proposal process, interviews and the drafting of the IGA. The term of the agreement was from January 2006 through January 2007, with the provision of yearly renewal for a period of five years. This agreement will expire on January 23, 2012. Throughout Commander Cassa's current assignment to the Patrol Operations Division, he has been the chairperson for the City Response Review Committee for emergency medical services. As established in the IGA, the purpose of this committee is to act in an advisory capacity only as to the operational and administrative terms contained within the IGA. The performance measures with regard to response time have been amended over time, with input from all committee members, and currently require an emergency response time of six minutes at the 90% fractile and a non-emergency response time of ten minutes at the 90% fractile. The current IGA consists of the following sections: • Terms and Conditions • Communications • Medical Supervision • Helicopter • Crime Scene Control • Training • Equipment • Company Employees • Term (establishes an annual performance evaluation by the City Council and the Wheat Ridge Fire Protection District) • Assignment • Policy (establishes the response review committee) • Liability • Insurance A copy of the current IGA is attached for your review as well as copies of the last three yearly performance evaluations Staff Report: Citywide Emergency Medical Services May 9,2011 Page 4 The Response Review Committee is structured to allow active participation by the agencies that are parties to the IGA on a monthly basis. A typical committee meeting is attended by Pridemark personnel, to include the Operations and/or the Clinical Directors; Wheat Ridge Fire Protection District personnel, to include the Fire Chief and/or his designee; West Metro Fire Protection District personnel, to include the Division Chief of Communications and the Assistant Communications Manager; Wheat Ridge Police Department personnel, to include the Patrol Operations Division Commander, the Communications Center Manager, and the Lead Emergency Services Specialist. The meeting agenda typically involves the review of Pridemark Paramedic response times of both priority one calls (emergency response) and priority two calls (non-emergency response). Those response times that do not meet the IGA requirements are discussed in detail, and a plan is agreed to by committee members regarding the solution(s) to the extended response times. This presentation and discussion is followed by a round table discussion with those present to include follow up from previous meetings and/or other noteworthy events. Both the Arvada and Fairmont Fire Protection Districts are invited to participate and do so on an occasional basis. The Police Department provides an administrative person to take meeting minutes. A review of the EMS services provided by Pridemark and the Wheat Ridge Fire Protection District, as reflected in the annual performance evaluations, is demonstrated in the following table: Agency Pridemark Wheat Ridge Fire Protection Paramedics District EMS Calls: 2008 2,338 Not Reported 2008 Transports 2,297 Not Applicable A vg Emergent Response Time 3:20 4:35 EMS Calls: 2009 3,260 3,292 2009 Transports 2,609 Not Applicable A vg Emergent Response Time 3:37 4:49 EMS Calls: 2010 3,207 2,697 2010 Transports 2,449 Not Applicable A vg Emergent Response Time 3:52 4:21 It should be noted that the City experiences more than one EMS call for service at the same time on a frequent basis (call surge capability). This situation requires multiple ambulance crews and related equipment to respond within the City at the same time. In more serious EMS calls, it is not unusual to require more than one ambulance crew and related equipment to the same scene (e.g., injury traffic accidents, and major critical incidents that often require multijurisdictional responses). Commander Cassa and I met with staff representatives from each of the fire protection districts Staff Report: Citywide Emergency Medical Services May 9, 2011 Page 5 to discuss the roles of their fire district and the City in providing overall EMS services within their respective districts in an effort to determine each district's short and long-term vision about providing EMS services within their districts. Wheat Ridge Fire Protection District The following is a summary of a meeting with Wheat Ridge Fire Chief Gillespie regarding the provision of EMS services within the WRFPD. • Currently, 85% of all firefighters are trained at the Emergency Medical Technician -Basic level. As their department transitions to career firefighter personnel, they will be required to obtain paramedic certifications within 36 months of hire. Volunteer firefighters will be required to maintain EMT -Basic certifications. • Average response time on emergency EMS calls: 4:21 in 2010. • WRFPD plans to staff two paramedics on each fire apparatus no later than 2016. Chief Gillespie's vision is to have each fire apparatus staffed at an Advanced Life Support level. • Chief Gillespie envisions an EMS model, based on the Aurora Fire Department model for the Wheat Ridge Fire Protection District. In summary, each fire apparatus is staffed with paramedic firefighters. The Fire Department contracts with a private transport vendor that provides Basic Life Support and Advanced Life Support transports. • Chief Gillespie's desire is for the WRFPD to be the sole administrator and a provider of EMS services within the boundaries of their district by 2016. He would prefer that contracts with ambulance services be a responsibility of the District and not the City. • WRFPD uses Dr. Beckman at the Exempla Lutheran Hospital as their agency's medical director to oversee policies and protocols related to EMS services. • Chief Gillespie's stated goal is to provide fire and EMS services within four minutes, 100% of the time. • Chief Gillespie has provided an Executive Summary of a consultant's study regarding EMS services as part of his agency's business plan in terms of moving towards being an EMS service provider. The business plan describes how the district will deliver ALS service using fire engines. • WRFPD understands that the City reserves the right to provide EMS services, and they will continue to work cooperatively with the City and its Police Department on EMS servlces. Arvada Fire Protection District The following is a summary of a meeting with Arvada Fire Chief Jon Greer and his staff regarding the provision of EMS services within the AFPD. • All firefighters are EMT -Basic certified. The Department currently has 12 paramedics staffing four of the agencies eight fire engines. Future plans are to staff at least 5 of the 8 stations with paramedics. • Average response time on emergency EMS calls: 3 :27 • Chief Greer envisions providing EMS transport services no later than March, 2013. Staff Report: Citywide Emergency Medical Services May 9, 2011 Page 6 • The District's current business plan is to run three EMS ambulances and contract with an ambulance provider for backup responses. There would be three ambulances positioned at three fire stations and three ALS engines placed at three other fire stations. Arvada Fire will have two more ambulances in reserve, located at Stations 7 and 8 that will be crossstaffed when needed in the case of more than three EMS calls occurring at once. • AFPD understands that the City reserves the right to provide EMS services, and they will continue to work cooperatively with the City and its Police Department on EMS services. West Metro Fire Protection District The following is a summary of a meeting with West Metro Fire Chief Doug McBee and his staff regarding the provision of EMS services within the WMFPD. • WMFPD has 335 personnel, 220 are trained as paramedics and the remaining staff have EMT -Basic certifications • The Department has 18 paramedic ambulances. They normally staff their district with 9 to 11 ambulances. There is always an on-duty EMS supervisor. • Chief McBee noted that fire and EMS associations state that an acceptable response time standard for emergency calls for medical services is 8 minutes, 90% of the time. • All fire apparatus are ALS equipped. • The District's philosophy is to send an ambulance and fire truck to every call for service. • WMFPD understands that the City reserves the right to provide EMS services and they will continue to work cooperatively with the City and its Police Department on EMS servIces. • WMFPD's preference is to be the sole provider of EMS services within their district. Fairmount Fire Protection District The following is a summary of a meeting with former Fairmount Fire Chief Don Angell and his staff regarding the provision of EMS services within the FFPD. • The Department has 21 full-time personnel and 65 volunteers. One hundred percent of the Department's full-time staff are certified as EMT -Basic or higher. Eighty-five percent of the volunteers have EMT -Basic certifications. • The Department does not anticipate staffing paramedics on fire apparatus due to economic costs involved. In addition, the agency does not respond to enough EMS calls to require paramedic certifications for their firefighters. The agency will continue to require EMT -Basic certification for all paid and volunteer personnel. • FFPD favors a continuation of EMS services through Pridemark Ambulance Services or a similar ambulance service vendor. FFPD is satisfied with the current system, including the continuation of the City of Wheat Ridge being the contractor of those services. • FFPD has some reservations in assuming responsibility for EMS services in their district. In summary, the West Metro Fire Protection District has a long history of providing emergency medical services and transports within their district. Leadership within the Arvada and Wheat Ridge Fire Protection Districts envision providing BLS and ALS services, although th eir Staff Report: Citywide Emergency Medical Services May 9, 2011 Page 7 timeframes differ on when they would start offering services. AFPD will have transport vehicles, while WRFPD will contract with an ambulance transport service. The Fairmount Fire Protection District will continue to operate without paramedics, and will rely on a contracted service with an ambulance service to provide advanced and basic life support services. LEGAL REVIEW City Attorney Gerald E. Dahl authored a memorandum on December 22, 2008 regarding the legal obligations of the City to provide ambulance or emergency medical services. Mr. Dahl noted that neither the State Constitution nor the City Charter mention, or require a municipal duty to provide these services. Mr. Dahl notes that State Statute authorizes a municipality to adopt rules and regulations in furtherance of public health, safety and welfare. ALTERNATIVES The Police Department has identified the following alternatives for City Council consideration: 1. Continue with the current process of the City contracting with a private vendor to provide EMS services within the corporate limits of the City. The Police Department would oversee this process for the entire City and maintain monthly meetings to ensure service levels specified in the IGA are met. The department has planned to add performance measurements to any future IGA. 2. Allow the four fire protection districts to provide EMS services within their district boundaries. Because of past history in this area, the Police Department would recommend some service performance expectations be established to ensure consistent and professional services. 3. The City maintains an EMS contract with a private contractor, while Arvada and Wheat Ridge Fire Protection Districts train EMS paramedic personnel to staff their fire apparatus and submit a complete business plan for review by the Police Department and City Council before further actions are taken. A cutover date would need to be established. RECOMMENDATIONS: Commentaries on emergency medical services today note that while the response time related to EMS services is important, what is more important is the intervention and level of care provided by trained and experienced paramedics. Council has been provided with an annual report related to the current EMS services provisions with Pridemark Ambulance Services, which includes a thorough review of the contract provisions. Pridemark Ambulance Service continues to meet its contractual obligations. Staff recommends the City, through the Police Department, continue to provide EMS services via a contract with a private ambulance service until each fire protection district has submitted a complete business plan for City Council consideration to assume appropriate EMS services within their district. Discussions can occur regarding the content of the business plan. In the interim, the Response Review Committee can meet to agree upon performance standards for the Staff Report: Citywide Emergency Medical Services May 9, 2011 Page 8 next EMS contract. Since West Metro Fire Protection District provides ALS and BLS services, staff recommends this agency be excluded from this requirement. Fairmount Fire Protection District has several options available to their district in this area regarding EMS services. JC: DB ATTACHMENTS: 1. Wheat Ridge Fire Protection District Emergency Medical Service: Analysis of Infrastructure and On-Going Management 2. City of Wheat Ridge and Wheat Ridge Fire Protection District Intergovernmental Agreement with Pridemark Ambulance Service 3. 2008,2009 and 2010 Yearly IGA Evaluations 4. 1996 Ordinance Wheat Ridge Fire Protection District Emergency Medical Services Analysis of Infrastructure and On-Going Management May 2, 2011 Prepared by: Gemsbok Consulting, Inc. GEMS BOK CONSULTING , 523 Park Point Drive #360 Golden, CO 80401 Phone: 303.679.6332 Fax: 720.384.0739 info@gemsbokconsulting.com gemsbokconsulti ng .com Vour vi:,-ioll. Our I/wllrIgeml!l1t t(/()/~. Attachment 1 I ! I I I i i I I I ! I I ~ I , i i ! I ! i I I i I I. i , i ~ ! i l I I I i" ,,~ ~ ~ Wheat Ridge Fire Protection District Analysis of Infrastructure and On-Going Management Executive Summary Wheat Ridge Fire Protection District (WRFPD), in keeping with many fire organizations across the nation, is expanding its service model to include Emergency Medical Services (EMS). This includes having five (5) Advanced Life Support (ALS) apparatus online by December 31, 2014. EMS transports will continue utilizing a third-party ambulance provider. This report is an analysis of the EMS infrastructure, implementation of ALS apparatus and the on-going successful management of the EMS system for WRFPD. The infrastructure of EMS to be adopted by WRFPD, the timeline to accomplish this integration and the benefits to the community will be outlined in the report. Additionally, this report explores how to best manage a third-party EMS transport provider to ensure the best system possible for the community served. In this report, EMS refers to care provided to a patient from the moment a call is received and personnel first arrive on the scene through transporting of a patient to the hospital. Not all EMS calls require transport services, but are still considered EMS calls if medical care is provided. EMS care includes both Basic Life Support (BLS) and Advanced Life Support (ALS) regardless of a transport outcome. The actual process of transporting a patient to the hospital is one piece of the process within EMS and is currently provided by Pridemark Paramedic Services, LLC (Pridemark). Another critical term used in this report is medic unit versus ambulance. Although both terms describe a unit that can transport a patient to a hospital, the medic unit, is staffed with fire personnel and eqUipment to respond to all calls. For example, the medic unit can assist with f ire, hazmat, and the other critical functions of a fire department. An ambulance is typically only able to respond to medical calls and does not carry the additional equipment for other types of incidents. EMS Infrastructure One of the most essential public 'safety functions provided by the fire service is prehospital 9-1-1 emergency response. The Federal EMS Act of 1973 defined an EMS system as "an entity that provides for the arrangement of personnel, facilities, and eqUipment for the effective and coordinated delivery of health care services under emergency conditions in an appropriate geographic area" (EMS Act 1973, (P.L. 93-154)i. Fire Departments that have Advanced Life Support (ALS) EMS systems are strategically positioned to deliver time critical response and effective patient care. When EMS is provided by firefighter paramedics "they are capable of simultaneously securing a scene, mitigating the hazard, and triage, extricating, treating, and decontaminating . . . the patient. There is no service more capable of rapid multi-faceted response than a fire-based EMS system,,2. 1 Prehospital 9-1-1 Emergency Medical Response: The Role of the United States Fire Service in Delivery and Coordination 2 Fire Service-Based EMS Advocates WRFPD EMS: Analysis of of Infrastructure and On-Going Management 2/Pa g e Wheat Ridge Fire Protection District Analysis of Infrastructure and On-Going Management There are many different models that can be adopted to provide Fire-Based EMS. The three general structures according to an International Association of Firefighters (IAFF) 2007 whitepaper include3 : a. Fire service-based system using cross-trainedjmulti-role firefighters. Firefighters are all-hazards responders, prepared to handle any situation that may arise at a scene -. including patient care and transport. b. Fire service-based system using employees who are not cross-trained as fire suppression personnel. Single role EMS-trained responders accompanying fi refighter first-responders on 9-1-1 emergency medical calls. c. Combined system using the fire department for emergency response and a private or "third service" provider for transportation support. Single role emergency medical technicians and paramedics accompany firefighter first responders to emergency scenes to provide patient transport in a private or third service ambulance. Currently, WRFPD responds to all ALS (Priority I) calls along with Pridemark, who provides the ALS certified personnel and transport unit. WRFPD's new service model, being integrated in 2012, will be a mix of the A and C EMS structures as outl ined above. The model they are adopting will include firefighter paramedics on all shifts, but transports will continue to be provided by a third-party transport service. ALS Personnel A critical component of emergency medicine is the various levels of EMS certifications providers may acquire. There are currently five (5) levels of certification and four (4) of these are Emergency Medical Technician (EMT) certifications. The highest level of EMT certification, EMT-Paramedic, is required in order to provide ALS care. Currently WRFPD has an all volunteer firefighting force that is 75% EMT-Basic with the remaining at a first responder certification. WRFPD will be hiring 12 career shift personnel from its volunteer ranks in 2011 of which six (6) will start paramedic school in January of 2012 . OVer the next 36 months, WRFPD anticipates hiring up to a total of 39 personnel with a total of 15 individuals attending paramedic school. Once these personnel graduate from paramedic school WRFPD will have full-time staffing certified to provide ALS care. The actual number of individuals to be hired will be determined as the District determines the best deployment strategy to serve the changing needs of the community. ALS Apparatus Under WRFPD's current structure, ALS care and transport is provided by Pridemark. With the addition of ALS apparatus, patients will receive ALS care approximately 33% sooner than under the current model. 3 International Association of Firefighters, "Prehospital 9-1-1 Emergency Medical Response: The Role of the United Station Fire Service in Delivery and Coordination " WRFPD EMS: Analysis of Infrastructure and On-Going Management 31 Page 1 I ~ I• j 1 I I I ! I i I I i . r ! I i i I I ! i !. I ~ i I ! ! I I , i ~ . 5 I ! I i ! I r i ~ ~ l f· · R I. I I,. I ~ I ~ . ~ ~ ( Wheat Ridge Fire Protection District Analysis of Infrastructure and On-Going Management According to the Journal of Emergency Medical Services (JEMS) 2007 200-City Survey, 50.4% of the respondents reported having ALS 1st response and ALS transport4 • In a study completed by the National Highway Traffic Safety Administration (NHTSA) in March of 2008 70% of respondents indicated that a fire department arrived on scene first and 52% reported that the fire service was the primary group expected to be on scene first. However, they also reported that most respondents (60%) have more than one type of agency that is involved in first response as well as transports .s The study covered 405 regions of which 81 counties were categorized as large-metropolitan; 100 as small metropolitan; 31 as large non-metropolitan; 112 as small non-metropolitan and 81 as completely rural. (Definitions of these categorized can be found on page 16 of the report.) Although the study showed that fire departments were often on scene first, first, they were identified as the primary transport agency only 36.1% of the time, with private services following at 31%. The study also showed that larger systems are significantly more likely to complete transports than their smaller counterparts. The primary reason the rural fire departments are less likely to provide transport service as part of EMS is a lack of resources. These departments are often volunteer or combination and do not have the tax revenue to provide the transport function. WRFPD plans on adding a tower in 2011 and two (2) medic units in 2012 to bring the apparatus total up to five (5). Even though WRFPD will not be completing transports, it is choosing to add medic units since they are significantly less expensive to purchase, staff, and operate. ALS Equipment In order to provide ALS 1st response, not only does at least one responding fire department personnel need to be EMT-Paramedic certified/but the apparatus used in the response must have the equipment required by the Colorado Department of Public Health and Environment (CDPHE). This eqUipment, as outlined in the section 12.9.3 of the CDPHE Rules pertaining to Emergency Medical Services Division has four (4) main categories of equipment required to be conSidered ALS equipped. WRFPD will have at a minimum two (2) apparatus ALS equipped by the end of 2012. ALS Infrastructure Infrastructure is the technology and tools used to increase the efficiencies of the processes used by the staff. For WRFPD the infrastructure needed to support ALS 1st response includes operating standards anq procedures and oversight of all EMS personnel including Paramedics and performance of any third-party transport agency. This oversight also includes on-going training for the various EMT certification and EMS performance metrics to ensure that the new model is meeting the demands of the community and that it remains cost effective. 4 JEMS, February 2008 Issue: 2007 JEMS 200-City Survey Is the Status QUo Acceptable? 5 U.S. Department of Transportation, National Highway Traffic Safety Administration, "Configuration of EMS Systems: A Pilot Study". WRFPD EMS: Analysis of Infrastructure and On-Going Management 41 P a ge Wheat Ridge Fire Protection District Analysis of Infrastructure and On-Going Management In order for this infrastructure to be flexible with the changing demands of the community and with changes in emergency medicine, updates will need to be implemented quickly and efficiently between WRFPD and Pridemark. This enables both organizations to have the best practices and best tools with the least cost. These changes will occur quickly and more efficiently when all parties involved are familiar with EMS best practices. Decision and implementation time are greatly minimized when both organizations are familiar with and able to stay abreast of current best practices as a part of doing buSiness, since time will not be taken away to educate decisio'n-makers on the fundamentals of EMS and on the changes in the industry as to what providers need to stay current. By streamlining oversight it keeps costs reasonable and enables the District to be flexible to the needs of the community. Third-Partv Transport Provider Under the current and new model being adopted by WRFPD, all transports will continue to be provided by a third -party. In the Journal of Emergency Medical Services (JEMS) February 2011 issue the 2010 JEMS 200-City Survey stated that of the respondents, 47% reported using a private company to complete transports with 35% being completed by fire departments. These results are in-line with the trend reported in NHTSA report that typically larger fire-departments are using the full fire-based EMS while smaller organizations are using third-party ALS transport providers. Even though WRFPD is adding apparatus and personnel to provide ALS response, th is new model does not lessen the District's need to have a third-party transport provider. The District does not currently have the resources needed to set up the infrastructure to complete transports. Some of this additional infrastructure would include electronic patient care reporting (ePCR) software, tough books or tablets for field use, billing software, and additional administrative staff. In addition, research has found that non-government EMS transport providers are able to provide this service at a lower cost6 . Performance Metrics Moving to an ALS 1st response has benefits to the community along with costs of implementing and maintaining the system. Since WRFPD will be one of two agencies that will be providing ALS response and care, it is critical to ensure that the quality of care provided by the two agencies is consistent and uniform. The most effective way to accomplish this is to develop performance metrics around the key components . Some of the critical performance metrics other EMS providers use include response time, cl inical metriCS, financial metriCS, fleet metrics and customer satisfaction. WRFPD will need to determine which performance metrics are needed to ensure that ALS 1st response is meeting the demands of the community and that patients are receiving the quality of care expected within the standards required. Some of the performance metrics WRPFD may consider include, but are not limited to: 6 JEMS, February 2008: 2007 JEMS 200 City SU/vey, Is the Status Quo Acceptable? WRFPD EMS: Analysis of Infrastructure and On-Going Management SI P age I I· f I i I. , .. I I i· ! I I I. ! I. I ~ I I I ~ I I· I Wheat Ridge Fire Protection District Analysis of Infrastructure and On-Going Management • Cost of ALS per call • Emergent and Non-Emergent Response Time Results and Variance Reports • How often a patient receives CPR prior to the EMS crew arriving on scene • EMS Customer Satisfaction Surveys • ALS Apparatus Productivity Ratio Quality Assurance (QA) I Quality Improvement (QJ) In addition to the performance metrics, WRFPD is going to establish an Advisory Board to review EMS calls, assist in resolving operational or care problems and make recommendations to WRFPD on how to improve the overall EMS care provided by the District. Having all EMS components managed by one organization will enable this Advisory Board to have more control over changes that need to be made and be able to be implement these changes faster. The Advisory Board will be headed by the District's Medical Director, Dr. Jeff Beckman. This means that the patients will benefit from these changes sooner than when multiple organizations are involved with the management of EMS. The Advisory Board's findings, along with the performance metrics captured by both EMS providers, will need to be reported monthly to the WRFPD leadership. Consistently reporting the results enables problems to be address quickly and efficiently, which saves the District money and time. On-Going Management of EMS The management Guru Peter Drucker is often credited with saying "If you can't measure it, you can't manage it". The principle behind this is that good data is needed to make a good, sustainable decision. As many . EMS reports and articles over the past ten years have pOinted out, the EMS industry struggles with measuring its performance. 7 If experts in the EMS field struggle with how to best measure and manage EMS, how does an organization that does not possess this expertise successfully manage EMS? The key areas of successful EMS management include the on-going monitoring of performance metrics, quality assurance (QA) and quality improvement (QI) processes and the reporting of the results to the Fire Chief, the Medical Director and the District's Board of Directors. Without this ongoing oversight patient care may slide and costs related to providing the service may become too high. Successful management of EMS also includes understanding the challenges facing the industry and the challenges of being a paramedic in the field. The organization responsible for managing an EMS provider must be able to actively determine what performance metrics should be reported to ensure that the service being provided meets its commitment to the community. Not only does the EMS expertise assist in monitoring and understanding the implications of various performance metrics, it is required to ensure the EMS transport provider's contract 7 U.S. Department of Transportation, National Highway Traffic Safety Administration, "Configuration of EMS Systems: A Pilot Study" and 2007 JEMS 200-City Survey. WRFPD EMS: Analysis of Infrastructure and On-Going Management 61 Page Wheat Ridge Fire Protection District Analysis of Infrastructure and On-Going Management is in the best interest of the community. Management of EMS includes updating the thirdparty contract annually so that it is aligned with the current expectations for EMS. WRFPD would like to update the third-party service agreement at the next renewal period to be more similar to a neighboring City's agreement. Following is a chart outlining the current contract between the City of Wheat Ridge and Pridemark versus the neighboring City's contract with Pridemark. Only some of the differences are outlined in the chart since the neighboring City's agreement is approximately 88% longer than the City of Wheat Ridge's agreement. ALS Transeort Provider Contract Provision Comparison City of Wheat Ridge . Neighboring City8 Policy: The Provider agreed to partiCipate in meetings to review the response t ime results. None None Service: Provides the minutes & seconds for the response time req uirements. None · Advisory Committees: the contract outlines · two different committees that will be involved v"ith QA/QI. City's Emergency IYledical Services Leadership Advisory Council City's Performance Improvement Committee ! ALS Fire Department Companies; Explains , why the Fire Departmen t will have ALS · Apparatus and its affect on the ALS transport , provider. , Performance Requirements: Deployment : Plan: Outlines the speci fic requirements for deployment strategies during peak periods · and specific requirements within the deployment strategy. Performance Requirements: Response Times: How response times are calcu lated Who the timekeeper is Response time expectation for all ambulances Definition of arrival Emergent and non-emergent response time requirements by zone type Description of upgrades, downgrades, reassignments and cancellations The consequences of fail ing to meet response time requirements 8 City of Aurora Request for Proposal No.: R1307 and City of Aurora Service Agreement, Ambulance Transport Services WRFPD EMS: Analysis of Infrastructure and On-Going Management 71 Pag e ,~ § i i I. ! I ! f ,I I !, I I, ! ! I ~ I i I i I ~ I I. I i I ! I I , i I t ~; n ~ i I ~ I ! ! ~ i. I I i I ... _._ ... ._.... _. _. _._ __ .._ ._ _ .. _ ._ ._ _ .. _._ _... .. __ .. . _ .._. _..._ __ ...... _i. Wheat Ridge Fire Protection District Analysis of Infrastructure and On-Going Management Quality Policy: (See above) Specifications Color, ["larking and Warning Devices Fleet Size I Maintenance I List of cu rrent ambulances in fleet I Committee Participation: Outlines that .the ! provider must participate in committees are ! request by the Fire Chief. --------------------------------------~ ; --None None None Performance Improvems;.nt.Jlnd Audit , Proqram Performance Improvement Programs Quality Audit and Inspections ; Data and I nfo rmation Reporting : This ; section provides deta iled expectations o'n the l following areas: Q f'.'10nthly Response Time Report ~ Non-Compliant Response Report I ncident Reports Performance Improvement and Clinica l Reports Community and Public Information Reports Prehospital Patient Ca re Reports o Record Requests . Liquidated Damages: This section outlines the amount the Provider will owe t he City when ca ll response requi rements are not met. This includes: o Per Minute Damages Fa ilure to Respond Release from tile Scene Failure to Report on Scene Requi red Equipment o Citywide Damages Equipment and Supplies 1V1echanicai Fai lures Ambulance Staffing G Ambulance Deployment Overall, the current contract is vague and relies on the state and county rules for EMS to be expectation of results and patient care rather than taking an active role in the management and expectations of services to be provided to its community . EMS, like any profession, has its own language, performance tools and standards of operation. Although some of the standards are dictated by the state, many of the detailed WRFPD EMS: Analysis of Infrastructure and On-Going Management 8 1Page Wheat Ridge Fire Protection District Analysis of Infrastructure and On-Going Management performance measures need to be developed by the individual agencies providing EMS. When two agencies are working together to provide EMS, performance metrics need to be integrated as wells as patient care expectations. For successful management of EMS, there needs to be a complete understanding of the industry. Utilizing an organization that is not proficient in the industry to manage an EMS contract may result in lower quality of care for the community, disconnected communication between the ALS providers, and longer resolution to problems. These same results will occur if too many organizations are involved in the management. Having an organization(s) that is not intimately familiar with EMS manage an EMS provider is no different than asking professional baseball players to play in the NHL Stanley cup finals. Although the baseball players and NHL players are all highly skilled and professional athletes, each sport requires different skills, knowledge and expertise. WRFPD EMS: Analysis of Infrastructure and On-Going Management 91 Page ................ ...... _ ..... ..1. i j. I r INTERGOVERNMENTAL AGREEMENT AN AGREEMENT AMONG THE CITY OF WHEAT RIDGE, THE W.HEAT RIDGE FIRE PROTECTION DISTRICT, AND PRIDEMARK PARAMEDIC SERVICES, LLC., FOR AMBULANCE SERVICES. 1.0 PARTIES. The parties to this Agreement are the City of Wheat Ridge, a Colorado municipal corporation (hereinafter referred to as the "City"), Wheat Ridge Fire Protection District, an independent, quasi-municipal corporation, (hereinafter referred to as the "Fire District") and Pride mark Paramedic Services, LLC. (hereinafter referred to as the "Company"). . 2.0 RECITALS AND PURPOSE. The City and Fire District desire to ensure the availability of adequate emergency ambulance service within the entire corporate limits of the City of Wheat Ridge, and the boundaries of the Fire District, and the Company agrees to provide such services pursuant to the terms of this Agreement. 3.0 TERMS AND CONDITIONS. 3.1 Service. The Company will maintain a response time of five (5) minutes and thirty (30) seconds on emergency responses 90% of the time and a response time of eight minutes on non-emergency 90% of the time. The Company shall make available a minimum of one (1) ALS ambulance to respond to calls for medical assistance within the City and Fire District at all times. The Company further agrees to make available backup ambulances to the City and Fire District with response times of eight (8) minutes or less. If the Company is unable to respond with a backup ambulance the Company shall immediately call another ambulance company to provide the required ambulance service and shall immediately notify the City dispatcher. 3.2 Calls. In consideration of keeping such ambulances available, the City and Fire District agree that except when a helicopter is used, in all cases where a request is made to the City or Fire District for emergency ambulance service and/or where ambulance service is found io be needed in the course of investigative or rescue operations, all such caffs shall be referred to the Company. 3.2.1 The Company further agrees that it shall respond to all calls directed by the City or Fire District, and shall perform its duties under the direction and control of the requesting agency. 3.3 Compliance with Law and Accreditation. The Company agrees to comply with all federal, state, county, and local statutes, regulations, or ordinances in its provision of the services described within this Agreement, and to maintain its current ambulance license issued by Jefferson County. The Company agrees that its records and rosters regarding equipment, vehicles, and training may be reviewed by the City or Fire District during regular business hours. 3.4 Communications. The Company agrees to maintain communications capabilities with the City of Wheat Ridge Police/Fire Communications Center and all police, fire, and ambulance vehicles and equipment, as well as communications between the Company's vehicles and the City and Fire District personnel on scene, and to maintain two back-up speed dial lines containing the caller identification feature to the Communication Center, all at the Company's expense using direct telephone line capabilities. The Company agrees to maintain channels one and two on the frequency of the Company's vehicles and dispatch center. All radios used shall be programmed by LakewoodlWest Metro Area communication personnel. 3.5 Medical Supervision. The Company agrees to utilize a Physician Advisor agreed upon by the City and Fire District. A Physician Advisor is defined as a physician who establishes protocols for medical acts performed by paramedics, and who is specifically designated and responsible to assure the competency of the performance of those acts allowed by such paramedics. The parties hereto agree that this Section 3.5 shall be in effect only for the scope of service detailed in this Agreement. The Company further agrees to adhere to, as a minimum standard, the Denver MetropOlitan Paramedic Attachment 2 I I ! ! lI ! [ i I I I ! I ! I ! I I I ! ! i ~ I. ! ! I I i I I.-l Protocols, as amended, with respect to medical acts not governed by the protocols developed by the Company Physician Advisor. 3.6 Rate~. The Company shall be allowed to charge patients it's usually and customary rates. A copy of the Company's current rate schedule attached to this Agreement as Exhibit A Any changes to the rate schedule which exceed a Denver-Boulder Medical CPI must be approved by the City and Fire District before taking effect. Rates will be evaluated as part of the performance evaluation. 4.0 HELICOPTER. It is understood that in cases of extreme emergency, it may be necessary to use a helicopter in lieu of, or in addition to, the Company's ground services. Such medical decisions to use the helicopter service shall be made by the police and/or fire personnel or Company personnel on scene, with the primary responsibility for such medical decision making resting with the Company after consultation with fire and police personnel on the scene. 5.0 CONTROL. The Wheat Ridge Police Department shall have control of all crime scenes to which the Company is requested to respond. The Wheat Ridge Fire Protection District's ranking officer on scene shall have control of all fire and EMS scenes. Company employees shall follow the orders and directions given by the appropriate Police or Fire personnel, as such orders relate to scene control. The Company shall be in charge of all medical treatment, patient care and transport issues, and shall consult appropriate police and fire personnel upon arrival at the scene. 6.0 TRAINING. The Company agrees to provide upon request by either the City or the Fire District and at the Company's own expense, personnel to assist with the training of the City police department personnel and/or Fire District personnel in the areas of First Responder, EMT and CPR classes, along with appropriate CE medical training. These classes shall be held at times mutually agreed upon by the parties hereto. 7.0 EQUIPM~NT 7.1 The Company shall furnish , at its own expense, ambulances and accessory equipment. All one-time use medica! equipment expended in the performance of care by Fire DistricUDepartment personnel shall be repla ced by the Company. 7.2 The Company agrees that Jefferson County or any other licensing authority shall have the right to inspect on an annual basis the Company's vehicles used for performance of ambulance service, for the purpose of determining safety standards of the vehicles used and, further, to ensure that the vehicles so used are equipped with that accessory equipment required by the Department of Health, and said equipment shall be in proper working order for the use in Advanced Life Support treatment. A permit issued by the County or any other licensing authority shall be deemed as evidence of said annual inspections. 7.3 The Company agrees, when operating its ambulance vehicles in an emergency or nonemergency capacity, said vehicles will be driven in a safe and prudent manner, in compliance with all State statutes, City and County ordinances relating to the operation of emergency vehicles. 8.0 COMPANY EMPLOYEES Each crew shall consist of no less than a licensed paramedic and one qualified EMT whose qualification meet the guidelines of the statutes, rules, and regulations of the Emergency Medical Services Division of the Colorado Department of Health, as amended, and are acceptable to the Company PhYSician Advisor. 8.1 The Company agrees, while operating its ambulance in and around the City and Fire District boundaries, the employees of the Company shall maintain a professional attitude and performance standard and level of conduct for Emergency Medical Technicians and Paramedics. 8.2 The Company agrees to notify the City and Fire District within thirty (30) days of changes in personneL Staff changes shall never degrade the level of services provided by the Company. 2 I,.. I I ! l' I r I I i I ! i i . I I ! I I I 1 ~ , ! ! i j ! i ~ I I I I I i I I I. ! 1. 9.0 TERM. The parties mutually agree and understand that the term of this Agreement shall be for a period of one (1) year from January 2006 thru January 2007 and upon the expiration of said period, this Agreement may continue for four (4) additional one-year periods, subject to the provisions hereof, provided that no event shall this Agreement continue for a period beyond five (5) years from the date of execution hereof. Said Agreement shall be renewed for successive one (1) year periods, as provided herein, subject to review and performance evaluation by the Wheat Ridge City Council and the Wheat Ridge Fire District annually. This Agreement may be terminated by either the City Councilor the Fire District, following said review, or pursuant to the provisions of this Agreement. Unless so terminated, this Agreement shall continue in full force and effect. In addition, the Company's performance shall be reviewed semi-annually by the City, Fire District and Physician AdvisoL The parties further agree that the City or Fire District, upon a determination that the Company is not performing the agreed upon services in a reasonable manner and/or in a timely fashion, shall give written notice of such dissatisfaction, and failure of the Company to develop and implement a plan to rectify substandard practices within ten (10) days from receipt of notice thereof, shall give rise to the cancellation of this Agreement. Should such determination of dissatisfaction result from a particular incident, the City or the Fire District will attempt to give oral notice within two (2) business days of the incident giving rise to the dissatisfaction. Upon issuance of a second notice of dissatisfaction, the City or Fire District may, at its option, cancel this Agreement without affording the Company the opportunity to correct the complained of substandard practice. 9.1 Nothing contained herein shall be construed as establishing any obligation on behalf of the City . and/or Fire District to make any monetary payment or other subsidy to the the Company by virtue of this agreement. _ 9,2 This Agreement shall remain in full force and ·effect provided, however, that either party may terminate this Agreement sooner, other than for cause, upon one hundred twenty (120) days notice. This termination provision shall also be applicable to any renewable period exercised by the parties. 9.3 If any party fails to comply with any term of this Agreement, any other party may terminate this Agreement immediately upon written notice indicating the termination date andlor sue for breach of contract. In such event, the prevailing party in such dispute shall be entitled to its reasonable costs, including its attorneys' fees. 9.4 The obligations of the City and the Fire District hereunder are expressly subject to the approval of annual appropriations, therefore. In the event of non-appropriation, this Agreement shall be deemed terminated as of the end of the fiscal year for which funds have been appropriated. Termination of the Agreement for this reason shall not constitute a default or breach of the Agreement within the scope of Section 9.3. This Agreement does not create or constitute a multi-year fiscal obligation of the City or of the Fire District. 10.0 ASSIGNMENT. Except as provided in this Section, the Company may not assign or subcontract, its rights and obligations under this Agreement, without this prior written approval of the City and Fire District. 11.0 POLICY. The Company agrees to be a participating member in any review committee which is established by the City, the Fire District or by the approved Physician Advisor. The purposes of this committee shall be to act in an advisory capacity only as to the operational and administrative terms contained within this Agreement. This will include review of response times and determination of allowable exemptions as determined by the committee. 12.0 LIABILITY. Notwithstanding any language to the Contrary contained in this Agreement, the Company is an independent contractor and is not an employee or agent of the the City or Fire District. The Company assumes all liability for and agrees to indemnify and hold harmless the City and Fire District. The Company assumes all liability for and agrees to indemnify and hold harmless the City and Fire District from any and all claims for injuries or damages, including attorney's fees, arising from the Company's performance or lack of performance under this Agreement except to the extent such claim for injury or damages which are the direct and proximate result of an act or order of a police officer or other employee or volunteer of the City or Fire District. 3 I i i 1 ! i I I ! ! I I I I I I ' j i i I ~ ! I I j ! J. I· i I I I I ! I I: .. I. I 13.0 INSURANCE. The parties further agree and understand that the Company shall maintain and keep in force an automobile insurance liability Policy with a minimum coverage of One Million Dollars ($1 ,000,000) combined single limit for bodily injury and property damage. 13.1 The Company shall maintain and keep in force a Professional and General Liability insurance policy covering the employees of the Company for any and all malpractice andlor negligent acts performed or committed by those employees of the Company. Coverage for ProfessionallGeneral liability shall be a minimum of one million dollars ($1,000,000) for anyone claim and one million dollars ($1,000,000) combines single limit bodily injury and property damage. 13.2 Provided, however, that any language contained in this paragraph 13 to the contrary notwithstanding, the Company agrees that there shall be in effect, no less than one million dollars ($1,000,000) of insurance protection for each of the types of insurance protection specified in paragraph 13.1 hereof, which one million dollars ($1 ,000,000) of minimum insurance coverage shall be available to each person or patient attended to or transported by the Company pursuant to the terms hereof. The Company also agrees to furnish the City and Fire District a Certificate of Insurance evidencing the minimum amounts of coverage described above, and said policy shall further provide a specific prOVision relating that, in the event of cancellation of said policy, the City and Fire District shall be notified in writing ten (10) days prior to cancellation. The Company agrees to name the City and Fire District as additional insured parties. 13.3 The Company shall maintain and keep in force a Workers' Compensation insurance policy for all its employees. This coverage shall meet the statutory limits set forth by the state of Colorado. 13.4 Each party shall be responsible for its own negligent acts, provided, however, that nothing in this Agreement shall waiver any immunity, defense, or limitation of liability available to either the City or the Fire District under the Colorado Governmental Immunity Act, Section 24-10-101, et. Seq., C.R.S. IN WITNESS V~iJ;-I...ER~F, the partie ave executed this Agreement and intend for it to be in full force and effect on the ;,L-:5 rt) day of _~=jZf.!::::'.~:::!d~~"'::;' ____ ___ ' 2006 . CITY OF WHEAT RIDGE 4 I i I I , i ,. I l~ r i ! I j . ! ! I i i ! I i I i i ! i I· I ! i I I. I I I ! I i ! i I ~ r i I I I I i ! ~ WHEAT RIDGE FIRE DISTRICT J) ( '? /) { ,-H ! /I .//1 I £=~~7.L:::..t.~ ·, --ec'./p;,l~!ff-j ~VJ!ljv k. Board Sec~re""-t""'a::":'ry-=-----~,zabe~illiS. 2nviCe President ATTEST. piBemark Paramedic Servl ?/:~:~ PRIDEMii/PARAMEDIC SERVICES, LLC 5 i ; ! I l i ! 1 i I I L ~ I I I j j ! I I ! ! ! ! I I I !. I I I !,r. ! ! . ! . ! I INTERGOVERNMENTAL AGREEMENT AMENDMENT TO RFP-05-41 AMBULANCE SERVICES AGREEMENT AMENDMENT #1, December 04,2006: Pursuant to the original contract with PRIDE MARK PARAMEDICS, INC., 6385 W 52ND AVENUE, ARVADA, CO 80002, regarding the above project, the City hereby authorizes this amendment to the original contract as follows: 1. ARTICLg 3.0 -TERMS AND CONDITIONS, 3.1 SERVICE: a. Change the original response time to: 6 minutes at the 90% fractile. 2. ARTICLE 9.0 -TERM a. Renewal Term effective: January 31, 2007 through January 30, 2008 All other original terms and conditions remain the same. In Witness whereof, the parties hereto have executed or caused to be executed by their duly authorized officials, this Amendment in two (2) copies, each of which shall be deemed an original on the date first written. "CITY" CITY OF WHEAT RIDGE 7500 W 29TH AVENUE WHJ;AT RIDGE, CO 80033 By: Date Attest: WHEAT RIDGJ:: FIRE DISTRICT Date "CONTRACTOR" PRIDEMARK PARAMEDICS 6385 W 52ND AVENUE ARVADA, CO 80002 By: ~ orized Signature t/T VLL c! /VI v //, '.-, .s Print Name ' Attest: Date I I i I i I 1 I · I ! I I I I I I I ! i I !" I I I I I t I I I ! ,!1 I I I INTERGOVERNMENTAL AGREEMENT AMENDMENT TO RFP-05-41 AMBULANCE SERVICES AGREEMENT AMENDMENT #2, December 15, 2008: Pursuant to the original contract with PRIDEMARK PARAMEDICS, INC., 6385 W 52 NO AVENUE, ARVADA, CO 80002, regarding the above project, the City hereby authorizes this amendment to the original contract as follows : 1. ARTICLE 3.0 -TERMS AND CONDITIONS, 3.1 SERVICE: a. Change the non-emergency response time from 8 minutes to 10 minutes at the 90% fractile. 2. SECTION 8.2 COMPANY EMPLOYEES: a. Change the first sentence to read "The Company agrees to notify the City and Fire District within thirty (30) days of changes in management/executive level personnel." 3. ARTICLE 9.0 -TERM a. Renewal Term effective: January 31, 2009 through January 30, 2010 4. ARTICLE 11.0 -REVIEW COMMITTEE: a. Change the last sentence of the section, and add two additional sentences: 'This will include review of response times and the determination of allowable exemptions." "The determination of allowable exemptions will be based upon the circumstances that existed during the particular situation being reviewed." "At the discretion of committee members, the allowance exemptions may not be reflected in subsequent monthly sta tistics " All other original terms and conditions remain the same. In Witness whereof, the parties hereto have executed or caused to be executed by their duly authorized officials, this Amendment in two (2) copies, each of which shall be deemed an original on the date first written. "CITY" CITY OF WHEAT RIDGE 7500 W 29TH AVENUE WHEAT RIDGE, CO 80033 By: Jerry DiTulliO, City Mayor Date purchas inglconsuhing services amendment "CONTRACTOR" PRIDEMARK PARAMEDICS 6385 W 52NO AVENUE ARVADA, CO 80002 By: Authorized Signature Print Name I i I I t i ! !1 . I I I I· ! I ! I I,. I I I I I I I I l I I j I I B i i i f I· I I INTERGOVERNMENTAL AGREEMENT AMENDMENT TO RFP-05-41 AMBULANCE SERVICES AGREEMENT AMENDMENT #3, December 22, 2009: Pursuant to the original contract with PRIDEMARK PARAMEDICS, INC., 6385 W 52ND AVENUE, ARVADA, CO 80002, regarding the above project, the City hereby authorizes this amendment to the original contract as follows: 1. ARTICLE 3.4 -COMMUNICATIONS: a. Add the following sentence, "The Company agrees to maintain communications capabilities with City of Wheat Ridge PolicelFire Communications Center and the fire districts contracted , , provider." All other original terms and conditions remain the same. In Witness whereof, the parties hereto have executed or caused to be executed by their duly authorized Officials, this Amendment in two (2) copIes, each of which shall be deemed an original on the date first written , "CITY" CITY OF WHEAT RIDGE 7500 W 29TH AVENUE WHEAT RIDGE, CO 80033 By: l /r'~ !1 (/r~ J \ IM{~'I 2.0 \ 0 Date Attest: ~ Michael Snow, City Clerk WHEAT RIDGE FIRE DISTRICT Atte~ ,yY7~jJ Date Date ( purchasing/consul ling services a ll1en d ll1~n t J. "CONTRACTOR" PRIDEMARK PARAMEDICS 6385 W 52ND AVENUE ARVADA, CO 80002 vvt.: e--"u~ ( D eM ~ if Print Name /~ 9-c7 Date ATTACHlVIENT 3 1 ! j ,! 1 I i ! I !' i · I j I I I ! I I 1 -I I t I i ~ I j ! ! I. f I f I I ! ! I i I ! I I ~ . r i I I i I I I , j <" -.,'" _ r City of ~WheatRl..dge ~OllCE DEPARTMENT TO: "'-.,., FROM: DATE: SUBJECT: Memorandum Daniel G. Brennan Chief of Police Joseph E. Cassa J f-f,1 Division CommandU Patrol Operations Division December 23, 2008 Pridemark Paramedic Services: 2008 Annual Review A series of meetings were held in November and December, 2008, to review the services provided by Pridemark Paramedic Services for the time period of November 1; 2007, through and including November 5, 2008. The first review committee meeting was held on November 19, 2008, in the Police Chiefs Conference Room located at the Wheat Ridge Police Department. Those in attendance were: ~ Mike Donner, President, CEO, Pridemark Paramedic Services ~ Joe Dannofal, Clinical Director, Plidemark Paramedic Services ~ Dave Mitchell, Manager of Operations, Pridemark Paramedic Services ~ Doug Saba, Acting Fire Chief: Wheat Ridge Fire Department ~ Jeny Cassel, Board President, Wheat Ridge Fire Protection District ~ Liz Willis, Board Member, Wheat Ridge Fire Protection District ~ Joe Cassa, Division Commander, Wheat Ridge Police Depaliment ~ Jim Lorentz, Division Commander, Wheat Ridge Police Department ~ Larry Stodden, Communications Manager, Wheat Ridge Police Department ~ Michelle Stodden, Administrative Assistant, Wheat Ridge Police Department The second review committee meeting was held on December 2,2008, in the Police Chiefs Conference Room located at the Wheat Ridge Police Department. Those in attendance were: ~ Joe DalIDofal, Clinical Director, Pridemark Paramedic Services ~ Jerry Cassel, Board President, Wheat Ridge Fire Protection District ~ Steve Gillespie, Captain of Training and Safety, Wheat Ridge Fire Depaliment ~ Lany Stodden, Communications Manager, Wheat Ridge Police ~ Joe Cassa, Division Commander, Wheat Ridge Police Department ~ Michelle Stodden, Administrative Assistant, Wheat Ridge Police Department The purpose of the meetings was to review the perfonnance of Pridemark as outlined in the Intergovernmental Agreement (lGA) between the City of of Wheat Ridge, Wheat Ridge Fire Protection District and Pridemark Paramedic Services, which was executed on January 23,2006. The IGA is for a period of five calendar years and can be renewed for successive one year Attachment 3 , , ~ . 1 I 1 ! !, I· ,~ I I. I. !i . I I I i ! ! ! i , I ,! ! . ! I i ! I I, 1 ! I I I ! I i i ; ! . I ~ ~ i I· I I ! ! I I: I ! . I I Pridemark Annual Review December 23,2008 Page 2 periods for an additional four years. Under these terms, the current IGA will expire on January 1, 2012. The methodology used to conduct the review consisted of reviewing the terms of the agreement followed by discussion between those parties in attendance. The purpose of the IGA is to ensure the availability of adequate emergency ambulance service within the entire corporate limits of the City of Wheat Ridge, and the boundaries of the Fire District. This annual report includes all calls beginning November 1, 2007, through and including November 5, 2008, in order to complete the IGA review prior to January 1,2009. 3.1 Service From November 1, 2007, through and including November 5,2008, Pridemark Paramedic Services was dispatched to 2,338 calls for service. Of these calls, there were 2,297 transports. The IGA requires a six minute response time to emergency calls for service ninety percent of the time. The IGA requires a response time of eight minutes on non-emergency calls for service ninety percent of the time. From November 1,2007, through and including November 5, 2008, there were a total of 1,766 emergency calls for service responded to by Pridemark. The average emergent response time was three minutes and twenty seconds. Of these calls, 92.41 % (1,632) were responded to in under the six minutes as required by the IGA. The six minute fractile of 90% was reached in all, but one month of2008, of the time period included in this report. The month is which the IGA requirement was not reached was August, 2008 (88.95%). The National Fire Protection Association has standards for the organization and deployment of emergency medical operations by Career Fire Departments. The 2010 edition specifies a standard of eight minutes or less travel time for the arrival of an advanced life support (ALS) unit at an emergency medical incident when the fire department provides a first responder with AED or basic life support (BLS) unit aJTives in four minutes or less travel time. time. (NFPA Section 4.1.2.1, 2010 edition) The State of Colorado Health Facilities and Emergency Medical Services, Division of the State of Colorado Department of Public Health and Envirorunent, has developed state emergency medical and trauma care system standards. Chapter two (section 202.B.2.) establishes the emergency response times for ground transport agencies. The minimum emergency response time is divided into three sections. Section a., applies to high density areas (metropolitan) where one provider service area encompasses 100,000 people or more. The time limit is eleven (11) minutes, 90% of the time. According to Wheat Ridge Fire Department Acting Fire Chief Doug Saba, the average response time of the Wheat Ridge Fire Department for the reporting period of time in the report is four minutes and thirty-five seconds. I Ji ,f ! I j ! ! i ! ! !. I I I i , I ! ~ ". i ~ . I I f ! ; I i ! ! i i 1 I· I ,I. . i ~ . 1 ! ! i ! I I i i ! . I ~ Pridemark Annual Review December 23,2008 Page 3 When all of this information is taken into consideration, the IGA required response time of six minutes, ninety percent of the time, appears to be aggressive in nature. From November 1,2007, through and including November 5,2008 there were a total of 1,144 non-emergency calls for service responded to by Pridemark. The average non-emergency response time was five minutes and five seconds. The eight minute fractile of 90% was reached only in the month of November, 2008. 84.88% (971) of the non-emergency calls were responded to within the required eight minute fTactile of90%. The reasons for this include: » Traffic conditions are not under the control of the responding ambulance crew. » Emergency responses are prioritized over non-emergency responses. Thus an ambulance having a longer distance to travel may be dispatched in order to maintain the ability to respond in the required period of time to an emergency call for service district wide. » There are also occasions that there may be an ambulance responding to a non-emergency call (i.e. a sprained ankle) and an emergency call is received (i.e. a cardiac arrest) in which the non-emergent ambulance would be rerouted to the emergency call for service. As a result, another ambulance would then respond to the non-emergency call, thus exceeding the required ninety percent fractile. Throughout the year, Pridemark adjusted their posting plan to address the issues of exceeding the non-emergency fractile response time. In light of the significant discussions held at the response review meetings this year, the ninety percent fractile of 8 minutes for non-emergency calls continues to be unrealistic. This was discussed thoroughly during the review committee meeting. The committee members recommend that the contract be changed to a ninety percent fractile of 10 minutes for nonemergency calls. All other portions of this section of the IGA were complicd with throughout the year 2008. Copies of the 2008 emergency and non-emergency emergency response perfonnance tables are attached for your reVlew. Bimonthly EMS Board meetings continue to be held. The Board broadened its membership to include West Metro Fire Department, Fairmount Fire Department, Edgewater Fire and Police. Attendance has been sporadic from Arvada Police Department, the Lutheran Hospital representative and the Pridemark Physician Advisor. West Metro Fire Department and the Edgewater Fire and Police have not attended any of these meetings during the year 2008. The goal of this group is to address EMS issues which atTect all of the agencies and organizations. Thcse meetings have been refocused to infolmation/topic driven. Items to be discussed will be policies, procedures, operational issues, etc. Examples of the topics discussed at these meetings include: » Policy and procedures affecting all parties involved in the provision of EMS, Fire and Law Enforcement services to the communities we serve. » Ambulance transpolts » Chemical Sedation of Arrestees » Crisis Intervention Training for EMS persOtmel » SWAT call outs ! J 1 I ! I ,! i ! t ~ ! ,! I ! I i I !" ! i ! I l. I I I I,t I ,~ I I ! Pridemark Annual Review December 23,2008 Page 4 » Continuing education eff0l1s 3.2 Calls All pOltions of the section of the IGA were complied with throughout the year 2008. 3.3 Compliance with Law and Accreditation All portions of the section of the IGA were complied with throughout the year 2008. A copy of the Jefferson County license to operate ambulance service is attached for your revicw. The ClUTent license expires in May, 2009. 3.4 Communications Pridemark currently maintains one T-lline for communications with the police department communications center, and two back up speed dial lines having caller ID. Pridemark completed the upgrade of their telephone system early in 2007. Pridemark maintains radio communications on Fire Chalmeis one and two in their ambulances and communications center. 3.5 Medical Supervision Throughout the year 2008, Dr. Mike Stackpool (Lutheran Medical Center) remains the physician advisor for Pridemark. No change is anticipated for the year 2009. 3.6 Rates The Denver area Medical CPI showed an increase of 5.8% for the first half of 2008. Pridemark proposes to increase their base rate no more than 3%. The rate increase is made to help absorb some of the increased costs such a fuel and medical supplies, etc. As the rate increase does not exceed the Denver area Medical CPI, City and Fire District approval is not required prior to the increase taking effect. 4.0 Helicopter Pridemark continues to be in compliance during the year 2008. There were no issues to resolve during this evaluation period. 5.0 Control Pridemark continues to maintain compliance with this section during 2008. There were no issues to resolve during this evaluation period. 6.0 Training A Pridemark Paramedic continues to be assigned as liaison with the Wheat Ridge Fire Protection District. Pridemark continues to provide two classes, monthly, for Wheat Ridge Fire Department personnel. For the second year in a row, Crisis Intervention Training was provided to Pridemark EMS personnel through collaboration between the Wheat Ridge Police Department, the Community College of Aurora, and the Crisis Company. This unique, creative, and innovative training relies heavily upon the adult learning model and experiential training pel1inent to the class participants. Pridemark has conducted/presented several trainings to the Wheat Ridge Police Department personnel which includes CPR, sedation of arrestee's, and flu shots. 7.0 Equipment There were no issues during 2008 regarding medical equipment and the operation of Pridemark I I ! I I l I,! I ! I ! ! I 1 I ! I 1-L I I I I· I ! ! I I I i , -~ .. f· . i Pridemark Annual Review December 23, 2008 Page 5 vehicles in a safe and prudent marmer, and being in compliance with appropriate state statutes, city and county ordinances relating to the operation of emergency vehicles. 8.0 Company Employees During 2008, the Wheat Ridge Police Department had no issues regarding Plidemark employees professional attitude and performance standards. The Wheat Ridge Fire Department is in the process of reestablishing lines of communication with Pridemark. 8.2 Company Employees The review committee recommends a change in this section of the lOA. The proposed modification is "The Company agrees to notify the City and Fire District within thirty (30) days of changes in management/executive level personnel". 9.0 Term The IGA requires the term of the agreement to be for periods of one year, not to exceed five years. The agreement was originally executed in Januaty, 2006. The agreement requires successive one year agreements be subject to review by the Wheat Ridge City Council and the Wheat Ridge Fire Protection District annually. The requirements conceming agreement telmination were reviewed as well. 11.0 Review Committee The review committee convened on a regular and consistent basis throughout the course of the year. These "Response Time Review Meetings" include a variety of topics and issues to include review of Pride mark response times to emergency and non-emergency calls. Attendees include Pridemark management and operations personnel, the Wheat Ridge Fire Department Fire Chief, and myself. Meeting minutes are taken by Michelle Stodden, Wheat Ridge Police Department.. These meetings have proven to be valuable and insightful for all parties at the table. Considerable time has been spent at these meetings discussing and dealing with terminology, repolt definitions and educational processes between the Pridemark and Wheat Ridge communication centers. The Wheat Ridge Fire Department will be changing dispatching services in 2009. They will be using the West Metro Fire Protection District. A transition plan is being compiled and reviewed by Wheat Ridge Police Department, Wheat Ridge Fire Department, and West Metro personnel. The committee proposed a clarification regarding the determination of allowable exemptions by the review committee. The last line of this section is recommended to be changed as follows: "This will include review of response times and the determination of allowable exemptions". The following two sentences are recommended to be added to this section of the IGA. "The detelmination of allowable exemptions will be based upon the circumstances that existed during the particular situation being reviewed. At the discretion of committee members, the allowance exemptions may not be reflected in subsequent monthly statistics. 13.0 Insurance Pridemark provided a copy of their certificate of liability insurance. Committee review of the certificate shows the company to be in compliance with the insurance requirements of the IGA. j t ,. I I i. I l I ! I I I· I I I' I,. I· t I ,I . I Pridemark Annual Review December 23 , 2008 Page 6 Conclusion Based upon this performance evaluation, the review committee recommends the lOA be continued for the calendar year January 2009 through January 2010. I have also attached the proposed changes to the lOA. All three of these changes have been verbally approved by the Wheat Ridge Fire Protection District and Pridemark Paramedic Services. As the representative of the City, I also approve of these changes. The 2009 annual review is expected to be completed in December, 2009. Please contact me if you have any questions or need additional information. I J I ! i I i r I I I I I I . Attest: Attest: Michael Snow, City Clerk Signature and Date WHEAT RIDGE FIRE DISTRICT Attest: President: Jerry Cassel Date Date purchas ing/consu lting services amendment , i 1 I i ~ ! i. I ! I I I ,! i ! ! ~ ! I· I· ! I i ! ,. ! I ! I !. ! ! ! I i I ~ }. { .s ~ . _ .... . .. . Cityof "~Wheat~dge ~OLICE DEPARTMENT Memorandum TO: Daniel G. Brennan Chief of Police FROM: _ Joseph E. Cassa (}~ Division CommanderO' '1} .1 Patrol Operations Division DATE: December 10, 2009 SUBJECT: Pridemark Paramedic Services: 2009 Annual Review A series of meetings were heJd in November, 2009, to review the services provided by Pridemark Paramedic Services for the time period of November 1,2008, through and including October 31,2009. The first review committee meeting was held on November 12, 2009, in the conference room at Pridemark Paramedic Services located at 6385 West 52nd Avenue. Those in attendance were: ~ Mike Donner, President, CEO, Pridemark Paramedic Services ~ Joe Darmofal, Clinical Director, Pridemark Paramedic Services ~ Dave Mitchell, Manager of Operations, Pridemark Paramedic Services ~ Steven Gillespie, Fire Chief, Wheat Ridge Fire Department ~ Joe Cassa, Division Commander, Wheat Ridge Police Depatiment » Jim Lorentz, Division Commander, Wheat Ridge Police Police Depat-tment ~ Mike Piper, Deputy Chief, Arvada Fire Protection District ~ Michelle Stodden, Administrative Assistant, Wheat Ridge Police Department The second review committee meeting was held on November 18,2009 in the Police Chiefs Conference Room located at the Wheat Ridge Police Department. Those in attendance were: ~ Joe Darmofal, Clinical Director, Pridemark Paramedic Services ~ Dave Mitchell, Manager of Operations, Pridemark Paramedic Services ~ Mike Donner, President, CEO, Pridemark Paramedic Services ~ Steven Gillespie, Fire Chief, Wheat Ridge Fire Department ~ Joe Cassa, Division COlmnander, Wheat Ridge Police Depaliment ~ Michelle Stodden, Administrative Assistant, Wheat Ridge Police Department The purpose of the meetings was to review the performance of Pridemark as outlined in the Intergovernmental Agreement (IGA) between the City of Wheat Ridge, Wheat Ridge Fire Protection Disttict and Pridemark Paramedic Services, which was executed on January 23, 2006. The IGA is for a period of five calendar years and can be renewed for successive one year periods for an additional four years. Under these tenns, the current IGA will expire on January 1,2012. f i ! 1 I ! I ! I ! ~ . r ! I ~ . I ! I I I ! I I i I,. i ~ j ~ ~ ~ i I I ! ! ! ! ! t I· i ! , . I i I ! ,~ I ! I. j .. I ! t" I !! . I ! I I ! Pridemark Annual Review December 10, 2009 Page 2 The methodology used to conduct the review consisted of reviewing the terms of the agreement followed by discussion between those patties in attendance. The purpose of the TGA is to ensure the availability of adequate emergency ambulance service within the entire corporate limits of the City of Wheat Ridge, and the boundaties of the Fire District. This annual rcport includes all calls beginning November 1, 2008, through and including October 31,2009, in order to complete the IGA review prior to Januat·y 1,2009. 3.1 Service From November 1, 2008, tlu·ough and including October 31, 2009, Pridemark Paramedic Services was dispatched to 3,260 calls for service. Of these calis, there were 2,609 (includes both priority one and two calls) transports. The IGA requires a six minute response time to emergency calls for service ninety percent of the time. The IGA requires a response time of ten minutes on non-emergency calls for service ninety percent of the time. From November 1,2008, tlu'ough and including October 31,2009, there were a total of2,183 emergency calls for service responded to by Pridemark. The average emergent response time was three minutes and thirty seven seconds. Of these calls, 92.61 % (2,021) were responded to in under the six minutes as required by the IGA. The six minute fractile of90% was reached in all months of the time period included in this repOlt. According to Wheat Ridge Fire Department Chief Steven Gillespie, the average response time of the Wheat Ridge Fire Department for the reporting period of time in the report is 4.49 minutes. During this reporting period Wheat Ridge Fire responded on 3,292 calls for service. From November 1, 2008, through and including October 31,2009 there were a total of 1,077 non-emergency calls for service responded to by Pridemark. The average non-emergency response time was four minutes and fifty six seconds. The 10 minute fractile of 90% was reached in all months included in this reporting period. 97.19% (1047) of the non-emergency calls were responded to within the required ten minute fractile of 90%. Throughout the year, Prtdemark adjusted their posting plan to address the issues of exceeding the non-emergency fractile response time. All other portions of this section of the IGA were complied with throughout the year 2009. Copies of the 2008-2009 emergency and non-emergency response performance tables are attached for your review. The bimonthly EMS Board meetings were changed to quarterly meetings. There were four meetings held dUling the reported period of time in this report. In 2008, the Board broadened its membership to include West Metro Fire Department, Fairmount Fire Department, Edgewater Fire and Police. Attendance from the Arvada Police Department increased significantly during the reported period of time in this report. The Lutheran Hospital representative consistently I I I I I I i ! i I i ! I ! . ! ! !,I . I I ! i I j I I ! ~ I. i i I !; ! I ~ J Pridemark Annual Review December 10, 2009 Page 3 attended these meetings. The Pridemark Physician Advisor was not present at any of these meetings, but sent a representative to one half of these meetings. West Metro Fire Department attended one meeting. Fairmount Fire Department attended all of the scheduled meetings. The Edgewater Fire and Police have not attended any of these meetings during the year 2009. The goal of this group is to address EMS issues which affect all of the agencies and organizations. These meetings continue to be information/topic driven. Items to be discussed were policies, procedures, operational issues, etc. Examples of the topics discussed at these meetings include: >-Wheat Ridge Police Depaltment Off Duty assignments in the Lutheran Emergency Room. >-Dispatching services for Wheat Ridge Fire Protection Distlict changing from the Wheat Ridge Police Department Communications Center to the West Metro Fire Protection District Communications Center. >-Police Taser policies to include medical transpOlt. >-Arapahoe House does not accept intoxicated juveniles. >-Heart attack hypothermia (TfH) protocol. >-Continuing education efforts. >-Wheat Ridge Police Department SWAT Exercise at Lutheran Hospital ER. >-HINI and seasonal flu > Lutheran Hospital Construction and Bi-Directional-Antenna (BDA) issues. 3.2 Calls All portions of the section of the IGA were complied with throughout the year 2009. 3.3 Compliance with Law and Accreditation All portions of the section of the IGA were complied with throughout the year 2009. A copy of the Jefferson County license to operate ambulance service is attached for your review. The current license expires in May, 2010. 3.4 Communications Pridemark currently maintains one T-l line for communications with the police department communications center, and two back up speed dial lines having caller ID. The Wheat Ridge Fire Department changed dispatching services on February 2,2009. They are using the West Metro Fire Protection District. The Committee recommends the following language addition: "The Company agrees to maintain communications capabilities with City of Wheat Ridge Police/Fire Communications Center and the fire districts contracted provider." 3.5 Medical Supervision Throughout the year 2009, Dr. Mike Stackpool (Lutheran Medical Center) remains the physician advisor for Pridemark. No change is anticipated for the year 2010. 3.6 Rates The Denver area Medical CPI showed an increase of 4% for the first half of 2009. Pridemark does not anticipate any rate increase during the upcoming evaluation period. I. i I I i f I i i ! ! t Ir' I t I ! f i £ Plidemark Annual Review Decembet: 10, 2009 Page 4 4.0 Helicopter Pridemark continues to be in compliance during the year 2009. There were no issues to resolve during this evaluation period. -" . 5.0 Control Pridemark continues to maintain compliance with this section during 2009. There were no issues to resolve during this evaluation period. 6.0 Training A Pridemark Paramedic co;1tinues to be assigned as liaison with the Wheat Ridge Fire Protection District. Pridemark continues to provide two classes, quarterly, for Wheat Ridge Fire Department personnel. These include train-the-trainer classes on a variety of medical topics. Pridemark has presented several roll call trainings to the Wheat Ridge Police Department personnel regarding taser policies, procedures, and protocols. Additionally, Wheat Ridge Police Department conducted the taser training to Pridemark personnel. Pridemark also provided seasonal and HI Nl flu shots to Wheat Ridge Police Department personnel. Pridemark Paramedic employee, Dave Pace, won the "Educator ofthe Year" award at the State EMS Conference. This award is presented by the Emergency Medical Services Association of Colorado (EMSAC) for excellence in Education. 7.0 Equipment There were no issues during 2009 regarding medical equipment and the operation of Pride mark vehicles in a safe and prudent manner and being in compliance with appropriate state statutes, city and county ordinances relating to the operation of emergency vehicles. There was citizen complaint of speeding. An investigation, which included AVL data, was conducted and it was determined the ambulance was not speeding. 8.0 Company Employees During 2009, the Wheat Ridge Police Department had no issues regarding Pridemark employee's professional attitude and perfomlance standards. The Wheat Ridge Fire Department and Pridemark continue to enhance their relationship to continue improving customer service delivery. 8.2 Company Employees During 2009, Plidemark made notitication regarding the change of one management position within the Company. 9.0 Term The IGA requires the term of the agreement to be for periods of one year, not to exceed five years. The agreement was originally executed in January, 2006. The agreement requires successive one year agreements be subject to review by the Wheat Ridge City Council and the Wheat Ridge Fire Protection District alUmally. The requirements concerning agreement tennination were reviewed as well. 11.0 Review Committee The review committee convened on a regular and consistent basis throughout the course of the year. These "Response Time Review Meetings" include a variety or topics and issues to include ~ I [ i I I I I ! I ! ! ! ! ; ~ ! I I I I ! ! I I ! I i ! I. J ! i ! ! I ! ~ ! I I ~ l ~ I ! s I .; Pridemark Annual Review December 10, 2009 Page 5 review of Pridemark response times to emergency, non-emergency calls and communication processes. Attendees include Pridemark management and operations persormei, the Wheat Ridge Fire Department Fire Chie( and me. Meeting minutes are taken by Michelle Stodden, Wheat Ridge Police Department. These meetings have proven to be valuable and insightful for all parties at the table. 13.0 Insurance Pridemark provided a copy of their certificate of liability insurance. Committee review of the certificate shows the company to be in compliance with the insurance requirements of the IGA. Additional Information During this report period of time, Pridemark won the "Good Samaritan Award" presented by the Exempla Good Samaritan Medical Center Foundation for helping others in need in the community serviced by Good Samaritan Hospital. Plidemark introduced the Therapeutic Induced Hypothermia (TIH) protocol to the EMS industry in Colorado. Please see attached press release. Conclusion Based upon this perfonnanee evaluation, the review committee recommends the IGA be continued for the calendar year January 20 I 0 through January 2011. I have also attached the proposed change to the IGA. This change has been verbally approved by the Wheat Ridge Fire Protection District and Plidemark Paramedic Services. As the representative of the City, I also approve of the change. The 2010 aIIDual review is expected to be completed in December, 2010. Please contact me if you have any questions or need additional infonnation. i I } -i j I ! I ~ I ! I i· i ! I I I ! ,I I I I I I I I ! I ~ ~ A -( ... ~ '" City of • A~Wheat&9ge ~OLlCE DEPARTMENT TO: FROM: DATE: SUBJECT: Memorandum Daniel G. Brennan Chief of Police Joseph E. Cassa Division Commander Patrol Operations Division December 17,2010 Pridemark Paramedic Services: 2010 Annual Review A series of meetings were held in December of 2010, to review the services provided by Pridemark Paramedic Services for the time period of November 1, 2009, through and including October 31,2010. The first review committee meeting was held on December 13, 2010, in the Police Chiefs Conference Room at the Wheat Ridge Police. Those in attendance were: }-Mike Donner, President, Pridemark Paramedic Services Division General Manager }-Dave Mitchell, Manager of Operations, Pridemark Paramedic Services }-Steven Gillespie, Fire Chief, Wheat Ridge Fire Protection District }-Joe Cassa, Division Commander, Wheat Ridge Police Depa11ment }-Michelle Stodden, Administrative Assistant, Wheat Ridge Police Department The second review committee meeting was held on December 17, 2010 in the Police Chiefs Conference Room located at the Wheat Ridge Police Department. Those in attendance were: }-Mike Donner, President, Pridemark Paramedic Services Division General Manager }-Dave Mitchell, Manager of Operations, Pridemark Paramedic Services }-Steven Gillespie, Fire Chief, Wheat Ridge Fire Protection District }-Joe Cassa, Division Commander, Wheat Ridge Police Department » Michelle Stodden, Administrative Assistant, Wheat Ridge Police Department The purpose of the meetings was to review the performance of Pridemark as outlined in the Intergovernmental Agreement (IGA) between the City of Wheat Ridge, Wheat Ridge Fire Protection District and Pridemark Paramedic Services, which was executed on January 23, 2006. The IGA is for a period of five calendar years and can be renewed for successive one year periods for an additional four years. Under these terms, the current IGA will expire on January 1,2012. The methodology used to conduct the review consisted of reviewing the terms of the agreement followed by discussion between those parties in attendance . • •••. ~ ' __ 'n --," __ .,_ ~.~--.-.. . • •••• • ~.~ __ • __ • __ , ___ ._;,_"_ •• _ _ ._ •.• •• • "~.".: _ •••• _ .•••• • _. __ •••• _~ •• ~_._ •• _ •••••• _ .•• _. .. ~~. ___ ••• __ .~ .. _ •• _~ • • _ • •• ___ •• •• ~ •• __ •• R •. __ • _~ __ •• ~ • ___ Pridemark Annual Review December 2010 Page 2 The purpose of the IGA is to ensure the availability of adequate emergency ambulance service within the entire corporate limits of the City of Wheat Ridge, and the boundaries of the Fire District. This annual report includes all calls beginning November 1, 2009, through and including October 31,2010, in order to complete the IGA review prior to January 1,2010. 3.1 Service From November 1, 2009, through and including October 31, 2010, Pridemark Paramedic Services was dispatched to 3,207 calls for service. Of these calls, there were 2449 (includes both priority one and two calls) transports. The IGA requires a six-minute response time to emergency calls for service ninety percent of the time. The IGA requires a response time of ten minutes on non-emergency calls for service ninety percent of the time. From November 1,2009, through and including October 31,2010, there were 1,855 emergency calls for service responded to by Pridemark. The average emergent response time was three minutes and fifty two seconds. Of these calls, 92.81 % (1721) were responded to in under the six minutes as required by the IGA. The six -minute fractile of 90% was reached in all months of the time period included in this report. According to Wheat Ridge Fire Department Chief Steven Gillespie, the average response time of the Wheat Ridge Fire Department for the reporting period of time in the report is 4.21 minutes. This represents a 28-second or 9.96% reduction in the average response when compared to the previous evaluation year. During this reporting period Wheat Ridge Fire responded on 2,697 calls for service. From November 1, 2009 through and including October 31, 2010, there were 1,352 nonemergency calls for service responded to by Pridemark. The average non-emergency response time was five minutes and twenty-nine seconds. The 10-minute fractile of 90% was reached in all months included in this reporting period. 94.53% (1278) of the non-emergency calls were responded to within the required required ten-minute fractile of90%. Throughout the year, Pridemark adjusted their unit hours due to volume changes. All other portions of this section of the IGA were complied with throughout the year 2010. Copies of the 2009 -2010 emergency and non-emergency response performance tables are attached for your review. 3.2 Calls All portions of the section of the IGA were complied with throughout the year 2010. 3.3 Compliance with Law and Accreditation All portions of the section of the IGA were complied with throughout the year 2010. A copy of the Jefferson County license to operate ambulance service is attached for your review. The current license expires in May, 2011. Pridemark AImual Review December. 20 I 0 Page 3 3.4 Communications Pridemark currently maintains one T-1 Line for communications with the police depaIiment communications center, and two back up speed dial lines having caller ID. The Wheat Ridge Fire Protection District continued it's contract with West Metro Fire Protection District to provide dispatching services. 3.5 Medical Supervision Throughout the year 2010, Dr. Mike Stackpool (Lutheran Medical Center) remains the physician advisor for Pridemark. No change is anticipated for the year 2011 . . 3.6 Rates Pridemark has requested a 2% increase with the last increase being January 2009. Even with the 2% increase, Pridemark still won't be in the top ten expensive ambulance services. The Denver area Medical cpr showed an increase of3.6% for the 12 month period ending October 31, 2010. Pridemark anticipates a 2% increase effective January 1,2011. 4.0 Helicopter Pridemark continues to be in compliance during the year 2010. There were no issues to resolve during this evaluation period. 5.0 Control Pridemark continues to maintain compliance with this section during 2010. There were no issues to resolve during this evaluation period. 6.0 Training A Pridemark Paramedic continues to be assigned as liaison with the Wheat Ridge Fire Protection District. Pridemark continues to provide two classes, quarterly, for Wheat Ridge Fire Department personnel. These include train-the-trainer classes on a variety of medical topics. Pridemark also provided seasonal and HlNl flu shots to Wheat Ridge Police Department and Fire District personnel. Ongoing Taser training is being provided. 7.0 Equipment There were no issues during 2010 regarding medical equipment and the operation of Pridemark vehicles in a safe and prudent manner and being in compliance with appropriate state statutes, city and county ordinances relating to the operation of emergency vehicles. 8.0 Company Employees Throughout the last year, Pridemark and Wheat Ridge Fire Protection District continues to strengthen their partnership, and through a cooperative effort both organizations have demonstrated the ability to work through complicated issues. The development of the protocol for dispatch services is a good example of this groups ability to work through complicated issues. DUling 2010, the Wheat Ridge Police Department and Wheat Ridge Fire Protection District had no issues regarding Pridemark employees' professional attitude and performance standards. 8.2 Company Employees During 2010, Pridemark made notification regarding the change of one management position within the Company. • • ••• •• _-' ___ •••••• ___ • ___ • ____ :._. ___ ' ______ " ••• '._ • -••• __ •.• ~ ___ •• _ .... '."" • .-.... " ••• _, __ ....... ,,_ ••• _.. -.-. __ 0.-__ ," __ '¥ ___ "._ ••• ",_,_" _ _ ••••• .-. _., __ .~ •• _. Pridemark Annual Review December 2010 Page 4 9.0 Term The IGA requires the term of the agreement to be for periods of one year, not to exceed five years. The agreement was originally executed in January of 2006. The agreement requires successive one year agreements be subject to review by the Wheat Ridge City Council and the Wheat Ridge Fire Protection District armuaHy. The requirements concerning agreement tennination were reviewed as well. 11.0 Review Committee The review committee convened on a regular and consistent basis throughout the course of the year. These "Response Time Review Meetings" include a variety of topics and issues to include review of Pridemark response times to emergency, non-emergency calls and communication processes. Attendees include Pridemark management and operations persormel, the Wheat Ridge Fire Protection District Fire Chief, and the Wheat Ridge Police Department Patrol Commander. Meeting minutes are taken by Michelle Stodden, Wheat Ridge Police Department. These meetings have proven to be valuable and insightful for all parties at the table. Those Fire Protection Districts who provide EMS seJVlce within the City corporate limits were invited to participate in the Response Time Review Meetings. Those in attendance are satisfied with Pridemark's performance. 13.0 Insurance Pridemark provided a copy of their certificate of liability insurance, Committee review of the certificate shows the company to be in compliance with the insurance requirements of the IGA. Additional Information Pridemark participated in the 2010 evacuation drill of Lutheran Hospital. Pridemark had people involved in all stages of patient evacuation and worked closely with police and fire in the EOC and incident command post. The EMSystem program which tracks hospital bed counts was introduced to representatives at the EOC. The testing of the patient h'acking system that the State of Colorado has adopted went fairly well. There were a number of areas identified that need to be worked on in future drills. Representatives from Pridemark, West Metro and Wheat Ridge Police met to discuss the dual response area outlined in the attached SOP that was prepared by Chief Mark Krapf. All parties agree that this process is the best way to deal with the dual response area. Pridemark headquarters has been located in a building at 6385 W. 52nd Avenue since its inception in 1997. Pridemark moved around inside this complex as they've grown but eventually they outgrew this location. Late last year, Pridemark began the process of designing a building that will meet their needs in the future and spent almost all of2010 making that building a reality. Pridemark moved into the new facility is located at 6100 W. 54th Avenue on November 20 and 21. The new facility meets the needs of the growing operation as well as provide a safe, clean and comfortable working space for all of their employees and partners. There is an expanded classroom that will be made available to their partners to use. An open house will be held sometime in early 2011. With the health care industry evolving and the future llnsure in regards to reimbursement and Medicare rules it made sense for Pridemark to partner with a larger company with a national Pridemark Annual Review December.2010 Page 5 presence. On October 15th, 2010 Pridemark merged with Rural/Metro Ambulance Company and will be a subsidiary of RurallMetro of Central Colorado, Inc. Pridemark will continue to operate under the name Pridemark Paramedic Services as they feel they have a very strong brand with an excellent reputation. Pridemark is confident that this transition will be a smooth one and that their customers will not see any decrease in service. Pridemark understands that there is some trepidation regarding their ability to maintain the level of responsiveness and personalized service that their clients have become accustomed. Pridemark would like to point out that their management team has remained intact and will continue to meet the needs of their cHents, patients and employees as they always have. Historically, mergers and acquisitions in the Denver metro area have not gone as smoothly as this one is going and this bas left customers underserviced. Pridemark is acutely aware of the problems of the past and have taken steps to ensure that their clients are still receiving the level of service that they have come to expect. Pridemark looks forward to continuing the relationships they have built over the last decade in the decades to come. Pridemark was selected as the 2010 recipient of Children's Hospital EMSAC Award, which recognizes "an EMS agency/organization that demonstrates outstanding commitment to pediatric prehospital and out-of-hospital care." Conclusion Based upon this performance evaluation, the review committee recommends the IGA be continued for the calendar year January 2011 through January 2012. The calendar year 2011 is the final year of the current IGA. During the calendar year 2011, direction will be sought from the Wheat Ridge City Council on the course of action to be taken with the IGA expires. The Wheat Ridge Fire Protection District recommends issuing a "sole-source" or "piggy-back" contract extension to Pridemark Paramedic Services for calendar year 2012. Please contact me if you have any questions or need additional information . .... --,~ .. -.. ~ -.. ~: ~'-"-.".-.'-"~' 7··-········~----··-·-· . .. .. ~ ............. --.,..-.. .~,-... -_ ... '._. ---_._-.. ~--~.~-.. ---. _______ . _ . __ .. ._._ -... ~ .. -.... -,--._,_, __ .. _." _~ ,. .... '_~"'" ___ '_' __ .' TITLE: CITY OF WHEAT RIDGE, COLORADO INTRODUCED BY COUNCIL MEMBER ----Council Bill No. Ordinance No. Series of 1996 AN ORDINANCE AMENDING 'rHE WHEAT RIDGE CODE OF LAWS BY THE ADDIT!ON OF A NEW SECTION 16 -68, CONCERNING_ AMBULANCE PROVIDERS, AND DECLARING AN EMERGENCY WHEREAS, multiple ambulance provide~s responding to a single call for such service within the city for which an emergency call has been placed to the Wheat Ridge Police Department communications, E911 or emergency system, or to which the Department has or is· responding, has resulted and presently continues to ~esult in unsafe practices by ambulance providers, which pract i ces threaten ptiblic health. peace and safety; and • _ ;. WHEREAS, the City Council finds,determines, a nd declal!es that the unsafe practices by ambulance providers constit.ute an ~mergency 'requiring the immediate effectiveness of this Ol~dinance in order to protect the public health, peace and safety. .... BE IT ORDAINED BY THE CITY COUNCIL OF THE CI'I'Y OF WHEA._l' RID~E, COLORADO, AS FOLLOWS: • l Section 1. Chapt~r 16 of the Wheat Ridge Co dB of Laws is hereby amended by the addition of a new Section 16 -68, to read as -follows: Sec. 16-68 -It is unlawful for any person, corporation or organization -to direct any ~mbulance provider to respond or attempt to respond, or for any ambulance provider to respond or attempt to respond,--to the scene of any accident or incident within the City for which an emergency call has been placed to the Wheat Ridge Police Department communications, E911 or emergency system or to which _the Department has or is responding, unless the ambulance provider has been direct.ly requested to respond by the Department. Nothing in this Section is intended to or shall be construed to apply to, govern or limit in any manner, the prOVision of _ambu~ lance -services to accidents or incidents wi thin the City for which an emergency call has not been placed to the Wheat Ridge Poli~e G~D \S3 027 \ 14 2 191 . ~ Attachment 4 • I I I I· I l I I I I ; I ,! \ i II I !-I I i I I I· ,-! I f I III-I i I. I I, 1 I ! ! ~ i i