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3. Non-Emergency Patient Transport Services Agreement - Kalispell Regional Medical CenterCity of Kalispell Post Office Box 1997 - Kalispell, Montana 59903-1997 Telephone (406) 758-7701 Fax - (406) 758-7758 July 29, 2009 TO: Mayor & Council FRM: Interim City Manager MTG DATE: August 3, 2009 Re: Non -Emergency Patient Transport Services Agreement 1. The attached agreement between Kalispell Regional Medical Center (KRMC) and the City of Kalispell allows the KFD (Kalispell Fire Department) ambulance to provide non - emergency transport services on an appointment basis. 2. The agreement is not exclusive. KRMC has other agreements with other EMS services for non -emergency transport. 3. Each transport will provide the ambulance fund with $105 - $150 depending on the type of service. Unlike other revenues, these are very likely to be collected. 4. As a readiness service, the KID ambulance has very high fixed costs associated with the personnel needed to man the ambulance. The additional costs to operate the ambulance are quite low in comparison. For a very modest increase in operating costs this agreement will provide significant additional revenue. 5. This agreement does not change the priority for the KFD ambulance. The KFD ambulance will always have as its first priority emergency service to the citizens of Kalispell. RECOMMENDATION- Council approve the agreement and authorize the city manager to sign on behalf of the city. Execution Copy NON -EMERGENCY PATIENT TRANSPORT SERVICES AGREEMENT THIS AGREEMENT made and entered into this 15th day of July 2009, by and between Kalispell Regional Medical Center, a Montana nonprofit corporation, hereinafter referred to as "Agency" and the City of Kalispell, Montana, a Montana Municipality, dba City of Kalispell Fire Department Ambulance Service, with its principal place of business in Kalispell, Montana, hereinafter referred to as "Ambulance". WITNESSETH: WHEREAS Agency is a multiple -service healthcare provider; WHEREAS Ambulance .i-operates an advanced life-support ground ambulance service, licensed as such by the State of Montana and, WHEREAS Agency will from time to time require non -emergency ground transportation of the type which Ambulance can provide for its patients, which transportation Ambulance is willing to provide for agreed -upon consideration, NOW, THEREFORE, in consideration of the foregoing recitals and of the mutual covenants, terms and conditions set forth below, it is hereby agreed as follows: 1. Ambulance Service. (a) Ambulance shall provide transportation for non -emergency Agency patients on an on -call basis 7 days per week, 24 hours each day during the term of this Agreement, based on availability. If the ambulance is unavailable for any transfer request, the Agency will be notified immediately. (b) It is agreed that at all times the Ambulance shall be functioning as an Independent Contractor and not as an employee in the provision of services under this Agreement. Nothing in this Agreement shall be deemed or construed by the parties or by any third person to create the relationship of principal and agent, or of a joint venture, or of any association between the parties. (c) All non -emergency transport requests shall be made to the Flathead County Dispatch non -emergency number, specifically (406) 758-5610 (or as otherwise provided in the future), during which the calling party shall request a "scheduled non -emergency transport" for the Ambulance Service. It is specifically understood and agreed that his Agreement does not apply to or supersede any 9-1-1 calls or other emergency calls for transport to or from any of the facilities hereafter listed in Paragraph 2. 2. Transport Charge. (a) The Northwest Healthcare locations covered by this Agreement include: i. Kalispell Regional Medical Center ii. HealthCenter Northwest iii. Pathways Treatment Center iv. The Cancer Center v. Brendan House vi. Home Options vii. The Summit viii.Hospice ix. Other Buffalo Hill Campus Buildings (b) Ambulance shall charge Agency the sum of One Hundred Five and No/100 Dollars ($105.00) for each individual patient transported from one location to another location within the Geographic Area covered by this Agreement. It is understood and agreed that the $105.00 transportation charge applies to a one- way transport unless and except when a patient is returned to the same location from which transport was originated within one hour of such origination. In the event that later return transport is required; Agency shall be charged $150.00 total for a two-way transport, providing return trip occurs within eight hours. It is further specifically understood and agreed that the $105.00 transport charge shall include the cost of any basic supplies or treatment provided by employees of 2 Ambulance to an Agency patient in the course of such transport, to include oxygen by nasal cannula. (c) If, during a non -emergency transport, the patient's condition becomes unstable and requires emergency transport to the Kalispell Regional Medical Center, the Ambulance Service will be permitted to bill all charges associated with a medically -necessary emergency call. 3. Payment. Agency will pay to Ambulance those sums to which Ambulance is entitled within thirty (30) days after receipt of each bill. Payment by Agency of such bills shall be considered final unless adjustments are requested in writing by Ambulance within thirty (30) days of receipt of payment. 4. Geographic Area. Ambulance will provide its ground ambulance service for Agency patients pursuant to this Agreement to location no more than five miles beyond the city limits of the City of Kalispell Montana (the "Geographic Area"). 5. Terms. The term of this Agreement shall be for the period of one (1) year beginning on the 1 st day of August, 2009. This Agreement shall automatically renew unless either party notifies the other party in writing within thirty (30) days of the anniversary date of this Agreement of its intent to terminate the Agreement. Either party shall have the right to terminate this Agreement at any time upon thirty -day written notice to the other party. 6. Insurance. It is hereby agreed that Ambulance shall during the entire term of this agreement maintain (i) a Professional Liability Insurance policy in the minimum amount of $750,000 per claim and $1,500,000 per occurrence with no aggregate, and (ii) an Excess Liability Insurance policy with a minimum limit of $10,000,000 but that only applies for Federal Claims, out of state claims or other claims where Montana's Tort limits do not apply. Ambulance shall name Agency as additional insured on each insurance policy and shall provide Agency with evidence of insurance as required in this paragraph annually. Ambulance agrees to give immediate written notice to Agency of any change (including cancellation) in the status of the insurance coverage. In the event that either of the parties becomes aware of any alleged injury arising out of the care or treatment of any patient -provided services pursuant to this Agreement, each party has a duty to give the other party notice containing the particulars sufficient to identify the name and address of the allegedly injured person, the place, and circumstances of the alleged incident and the addresses of the available witnesses. 7. Licensing and Equipment. The Ambulance shall obtain and maintain proper licensing for equipment and staff from the State of Montana to provide ground ambulance service throughout the term of this Agreement and shall equip its vehicles according to applicable laws and regulations in force in the State of Montana as applicable to such service. The equipment shall be appropriately maintained throughout the term of this Agreement. 8. Records. To the extent required by applicable federal or state laws and regulations, the Ambulance and any respective agents thereof shall make available, upon written request by the Secretary of the United States Department of Health and Human Services, the Comptroller General of the United States, any authorized federal or state official, or the duly authorized representative of the foregoing, its respective books, documents and records necessary to verify the nature and extent of costs to Ambulance for its services provided pursuant to this Agreement until the expiration of four (4) years after any such services are provided hereunder. 9. Agency will provide the following services to Ambulance: a. Patient Selection: Agency shall identify patients requiring transport services. Coordination of transport and care required at the receiving facility will be done prior to the transport by Agency. b. Coordination of Care: A report of the patient's condition will be given to ambulance staff. This will include diagnosis, physician, advance - directive information, demographics and any additional care necessary during transport. c. Inservice education to Ambulance staff as reasonably requested by Ambulance. 10. Notice: Any notice required or provided for under the terms of this 4 Agreement shall be in writing and served by personal service upon the parties herein designated or by registered or certified mail addressed as follows: Northwest Healthcare Corporation Attn: Chief Executive Officer Northwest Healthcare Corporation 310 Sunnyview Lane Kalispell, MT 59901 Ambulance: Kalispell Fire Department 312 First Avenue East P.O. Box 1997 Kalispell, MT 59903-1997 Services by registered or certified mail shall be deemed complete upon depositing the same in the United States Post Office with postage prepaid thereon properly addressed as herein above set forth. Either party may change the address to which any notice shall subsequently be given by means of delivery of an appropriate notice to that effect in writing to the other party. 11. Applicable Law. This Agreement is entered into in Kalispell, Montana. This Agreement shall be governed and construed in accordance with the laws of the State of Montana. Venue for any proceedings shall be Flathead County, Montana. 12. Assignment. This Agreement shall not be assignable by either party without the prior written consent of the other party hereto. 13. Severability. This Agreement is severable and, in the event that any one or more of the provisions hereof shall be invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions contained herein shall not in any way be affected or impaired thereby. 14. Separate Agreements. The terms and conditions of this Agreement shall not alter or amend any separate agreement not in existence or hereafter entered into between the parties hereto relating to ground ambulance service by Ambulance for patients of Agency. It is expressly understood and agreed that in the event of any conflict between any of the terms and conditions of this Agreement and the terms and conditions of any such separate agreement, the terms and conditions of said separate agreement shall govern and supersede any conflicting provisions herein. 15. Indemnification. a. Each party agrees that with respect to any claim or lawsuit arising out of the activities described in the Agreement, each party shall only be responsible for that portion of any liability resulting from the actions or omissions of its own directors, officers, employees, or agents. b. Each party shall defend, indemnify and hold harmless the other party from and against any and all liability, lost, expense, reasonable attorneys' fees, or claims for injury or damages arising out of the performance of this Agreement. Such indemnification shall only be made in proportion to, and to the extent that, such liability, loss expense, attorneys' fees, or claims for injury or damages are caused by or result from the acts or omissions of the indemnifying party. 16. Amendments. No amendment or a modification of this Agreement shall be effective, unless in writing and executed by both parties. Kalispell Regional Medical Center By: Printed Name: Ted W. Hirsch Title: CEO Date Signed: 1 O9 City of Kalispell, Montana Fire Department Ambulance Service IN Printed Name: Title: City Manager Date Signed: 6