HomeMy WebLinkAbout06. Authorize CM & Chief of PD to Execute Agrmt w-Vital Medical SvciteM No.
APPROVED BY
CITY MANAGER
TO:; HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
FROM' OFFICE OF ,
BY: CARL D. CHARLES, CHIEF OF POLICE
DATE, JAN UARY 23, 2018
.• r _19,-•,
That the City Council authorize the City Manager and the Chief of Police to execute a Medical
Services Agreement with Vital Medical Services, LLC.
•
Police officers are often first on the scene following a 9-1-1 call. With the continued increase in
deaths from opioid overdoses (over 50,000 in 2016), the U.S. Department of Justice has
recognized the need to provide law enforcement with the knowledge and the tools to reverse
overdoses in the field. Opioids, including heroin, cause death by slowing, and eventually
stopping, a person's breathing. When administered, Naloxone (Narcan) restores respiration
within two to five minutes, and may prevent brain injury and death. Narcan works on overdoses
caused by opioids, which includes prescription painkillers such as hydrocodone, morphine, and
oxycodone, and street drugs like heroin.
Since time is critical on Opioid related overdoses, having police officers properly trained and
equipped to administer Narcan provides a greater opportunity to reverse the sometimes fatal
exposure to the drug. Besides being able to administer Narcan to civilians, it can also be given
to officers and/or other public safety personnel that become exposed to Opioids, including the
oftentimes deadly drug known as Fentanyl. Fentanyl is hundreds of times more potent than
heroin. It is also transdermal, meaning that it can be absorbed through the skin. Further, it can
be inhaled if it becomes airborne. If an officer comes in contact with anything containing
Fentanyl, the potentially deadly drug can be almost immediately absorbed into the bloodstream.
Again, having Narcan immediately accessible provides a greater opportunity to avoid a tragedy.
When looking at the most efficient way to provide training and oversight for a Narcan program
within the police department, we came in contact with Vital Medical Services LLC. Vital Medical
Services provides Nasal NARCAN medical director oversight coupled with a standing order to
public safety agencies. Program administration includes education, training, oversight,
implementation, and reporting protocols pursuant to local, state and federal guidelines.
JANUARY 23, 2018
FISCAL IMPACT
Annual cost for Vital Medical Services would be $2,100.00 ($175.00 per month) and will be
funded from the department's administrative contract services account (10-4-2110-0700).
Start-up cost for the program, including the purchasing of the NARCAN and the necessary
storage and safety equipment, would be $6,500.00 which would be funded through account
number 10-4-2110-0887.
Attachment.,
Agreement
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'�Jffl V 9) 9 1 A i I � x , i ': A !
"S""' -"CAL SERVICES AGREEMENT (airs .Ar (i,-,t-rn nt � is rn-,ide and entered into effective as
20W)y and bctwoen VITAL MEDICAL SERVICES, LLC, a California hirril 'ted liability
r_ any IIVP�L �A
) id THE OF CITY DOI.A0,1EY t fTY ), a r -I corporation and charlt�lr city with
reference to the following recitals:
A. CITY wishes to engage VITAL and its designated medical director to provide oversight for
the Nasal Naloxone (Narcan) administration, education, training. program and implementaiiion as well as
covered services described in th e Exhiblts: each of which is attached hereto and incorporated herein by this
rc,ference
B, CITY wishes to engage VITAL to provide or cause to be provided certain medical
screen rico and seirvices, medical tests and lirnited treatment to, Police Officers, Local, State, arid federal
Agents, Poke Service employees Arrestees and Prisoners, in accordance with terms and subject to
provissons set forth bekow in this Agreement
C CITY and VITAL wish to enter into this Agreement ur order to as,, forty the tennis arid
coedit ons upon which VITAL v,,ill agree to perform or cause to be performed certain serviccis for CITY
L'uptiq Jh& terin, hereoll
a "
NOW, THEREFORE, in reliance on the foregoing recitals and in COnsideration Of the Muhial r0v(,�i nr-
and conditions set forth herein, and for Such other good and valuable consideration, the receipt and
sufficiency of which are hereby acknowledged, the parties hereto agree as follows,
1 1 "Aduthorgation" means the approval of Covered Serv'ces to be issued by CITY and is
obtained by completion of the appropriate form by CITY police officer and pro%ifded to VITAL, by CITY
police officer or other authorized CITY personnel, prior to treatment,
l;2 t�-G—vere
,�g —&zLytces' means those services set forth in the Exhibit A attached hereto and
incorporate herein by this reference which are Medically Necessary Services (as that i is defined
below)
1 3 rileans those medical services provided by or under the
supervision of a heaMicare profess*nai engaged by VITAL to provide such servic*es, and which are
determined by such healtricare professional, in accordance with standard practice in the medical
cornmunity to be appropriate wind necf�jssary for the 5ysterns, diagnosiri arid treatment of a condition, iJtriess
or injury and are not expenmewt@l of investigative,
2 PqMDjad —ServicLs VITAL shall provide Covered Se(vices and/or shaIl Cause such Covered
Services to be provided by duly licensed healthcare Professionals engaged lay VITAL as described in
Exhibit A attached hereto and incorporated herein by this reference in accordance with the provisions set
forth belnw in this Section 2 and elsewhere in this Agreement,
2.1 Without the need for prior authorization by CITY, VITAL shall provide Covered Services to each
ArrAS$PF2 nr Pricnnor ac ranuactarl by a CITY nnlira nffir.Pr nr nthaa
r uthnn
ri7Pd rRraggntntiva of r:ITY; Tha
purpose of the medical evaluation will be to evaluate an Arrestee's medical condition, including any injuries,
to determine if the Arrestee is healthy enough to go through CITY Police Department's booking process, be
placed in jail and/or to remain in jail Covered Service shall be provided at CITY's jail or other booking
location, as requested by CITY.
2.2 If necessary, VITAL shall perform or cause to be performed minor evaluative tests and
minor treatment procedures such as stitching wounds. If VITAL believes that an Arrestee needs a more in-
depth procedure or test, VITAL- shall inform CITY so CITY may determine if the Arrestee should be
released from CITY's custody and/or transferred to the custody of another law enforcement agency.
3. Certain Covenants and e reentat`ons of VITAL
3.1 Commitment of Tune by VITAL. During the Term, VITAL shall devote such time to the
performance of VITAL's duties under this Agreement as is reasonably necessary to fulfill VITAL's
obligations under this Agreement.
3.2 Co dance with Laws. VITAL shall comply with all applicable federal, state and local laws,
rules and regulations and to the performance of the services contemplated hereunder by VITAL on behalf
of CITY.
3.3 Practice of Medicine. VITAL is not a professional medical corporation or other person or
entity authorized to practice medicine and VITAL does not and shall not engage in the practice of medicine.
VITAL has engaged the services of duly licensed professionals, including, without limitation, physician(s)
licensed to practice medicine in the State of California, who shall provide any Covered Services provided
hereunder that constitute the practice of medicine. In accordance with applicable law, all decisions,
procedures, diagnoses and treatments that constitute the practice of medicine shall be provided by duly
licensed physicians who shall have sole and absolute discretion regarding all such matters.
3.4 Inaurance.
3.4.1 Time for Comyplianc ,. VITAL shall not commence the Services under this
Agreement until it has provided evidence satisfactory to the CITY that it has secured all insurance required
under this section. In addition, VITAL shall not allow any subcontractor to commence work on any
subcontract until it has provided evidence satisfactory to the CITY that the subcontractor has secured all
insurance required under this section.
3.4.2 Minimum t eouirements. VITAL shall, at its expense, procure and maintain for the
duration of the Agreement insurance against claims for injuries to persons or damages to property which
may arise from or in connection with the performance of the Agreement by the VITAL, its agents,
representatives, employees or subcontractors. VITAL shall also require all of its subcontractors to procure
and maintain the same insurance for the duration of the Agreement. Such insurance shall meet at least the
following minimum levels of coverage;
(A) Minimum Sco e of Insurance. Coverage shall be at least as broad
as the latest version of the following: (1) General Liability: Insurance Services Office Commercial General
Liability coverage (occurrence form CG 0001); (2) Automobile Liability; Insurance Services Office Business
Auto Coverage form number CA 0001, code 1 (any auto); and (3) Workers' Compensation and Employer's
Liability. Workers' Compensation insurance as required by the State of California and Employer's Liability
Insurance.
(B) Minimum Limi s of _Insurance. VITAL shall maintain limits no less
than: (1) General Liability: $2,000,000 per occurrence for bodily injury, personal injury and property
damage. If Commercial General Liability Insurance or other form with general aggregate limit is used,
either the general aggregate limit shall apply separately to this Agreement/location or the general aggregate
limit shall be twice the required occurrence limit; (2) Automobile Liability: $2,000,000 per accident for bodily
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injury and "property damage; and (3) Workers' Compensation and Employer's Liability: Workers'
Compensation limits as required by the Labor Code of the State of California. Employer's Liability limits of
$2,000,000 per accident for bodily injury or disease.
• . • _ • . -�
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3.4.4 Other Insurance Provisions. The insurance policies are to contain, or be endorsed
to contain, the following previsions:
A General Liability. General liability coverage may be provided in
the form of an endorsement to the VITAL's insurance tat least as broad as ISO Form Co 20 14 1185 or
both -CG 20 f 0, CG 20 25, CG 20 33, or CG 20 38: and CG 20 37 forms if later revisions used): The
employees, shall be covered as additional insureds with respect to the Services or operations performed by
or on behalf of VITAL, including materials;, parts or equipment furnished in connection with such work; and
(2) the insurance coverage shall be primary insurance as respects the CITY, its directors, officials, officers,
employees, or if excess, shall stand in an unbroken chain of coverage excess of the VITAL's scheduled'
underlying coverage. Any insurance or self-insurance maintained by the CITY, its directors, officials,
officers, employees shall be excess of VITAL's insurance and shall not be called upon to contribute with it
in any way.
(C) Automobile Liability. VITAL shall maintain automobile insurance at
least as broad as Insurance Services Office form CA 00 01 covering bodily injury and property damage for
all activities of VITAL, arising out of or in connection with Work to be performed under this Agreement;
including coverage for any owned, hired, non -owned or rented vehicles, in an amount net less than two
million dollars ($2,040,040) combined single limit for each accident.
(D) Workers' Comoensation.. The insurer shall agree to waive all
rights of subrogation against the CITY, its directors, officials, officers, employees for losses paid under the
terms of the insurance policy which arise from work performed by VITAL,;
(E) Em to ers Liability Coverage, The insurer shall agree to waive all
rights of subrogation against the CITY, its directors, officials, officers, employees for losses paid under the
terms of the insurance policy which arise from work performed by the VITAL.
Sectionthis • •! separation of • • ■ on6� in . addkion,not
specialcoritaiii any • on ••; •f protection
officers,e*
3,4,5 C�educlibles and Self -Insurance eters iotas. Any deductibles or self-
insured retentions must be declared to and approved by ttae CITY. VITAL shall guarantee that, at the
option of the CITY, either (1) 4he insurer shall reduce or eliminate such deductibles or self-insured
retentions as respects the CITY, its directors, officials, officers, employees; or (2) VITAL shall procure a
bond guaranteeing payment of losses and related investigation costs, claims and administrative and
defense expenses......... _
3.4.7 Acceptability of Insurers. Insurance is to be placed with insurers with a
current A.M. Best's rating no less than A:VII, licensed to do business in California, and satisfactory to the
City.
3.4.8 1lerNfication of Coverace. VITAL shall furnish CITY with original certificates
of insurance and endorsements effecting coverage required by this Agreement on formssatisfactory to the
CITY. The certificates and endorsements for each insurance policy shall be signed by a person; authorized
by that insurer to bind coverage on its behalf, and shall be on forms provided by the CITY if requested, All
certificates and endorsements must be received and approved by the CITY before work commences. The
CITY reserves the right to require complete, certified copies of all required insurance policies, at any time.
3.5 f Leppr in„; VITAL shall, at such time and In such formas CITY may reasonably request,
furnish such periodic 'reports and other information concerning the status of the services provided pursuant;
to this Agreement.
3.6 _Records.. VITAL shall maintain full and accurate records with respect to all matters
covered and all services, provided under this Agreement. upon reasonable prior written notice, CITY may
request access, during normal business hours, to such records pertaining to Covered Services provided
under this Agreement.
37` Re_rsonnel,; VITAL represents that it has, or shall secure at its own expense, all personnel
required to perform the Covered Services contemplated in this Agreement. All personnel shall be qualified
to perform the Covered Serrvices which they provide pursuant to this Agreement.
4.1 Term. Subject to early termination
ent of the parties, the terra of this Agreement
otherwise would renew pursuant to this Section 4, 1.
4.2 Tdnrningfitjj�
Te ination upon 6 It
•- s :.: • of
trly
. ;r^� •
(b) Te lnation upon iotice. Either party may terminate this Agreement, with or
without cause, "upon sixty () days" advance written notice to the other party.
4,3 Termination Procedures, Upon the effective date of termination of this Agreement, CITY
shall` pay VITAL all amounts due hereunder up to and including the effective date of termination,
Termination of this Agreement shall not limit or affect any obligations arising under this Agreement that, by
their terms. extend beyond the effective date of termination, specifically including,, without limitation, the
provisions of this Section 4 3, Section 5 (Compensation) and Section 7 (General Provisions).
services herein specified, it is mutually understood and agreed that VITAL is acting as an independent
contractor and its employees, independent contractors and other agents shall not be considered employees
of CITY. In no event shall this Agreement be construed as establishing a partnership or joint venture or
similar relationship between the parties hereto. Each party shall be liable for its own debts, obligations,
acts and omissions.
7. General P oyisions.
7.1 Notices. All notices, requests, demands or other communications required or permitted to
be given under this Agreement shall be in writing or by e-mail, and shall be delivered to the party to whom
notice is to be given either (a) by facsimile (in which case such notice shall be deemed given upon
electronic confirmation of receipt); (b) personal delivery (in which case such notice shall be deemed given
on the date of delivery); (c) by next business day air courier service (e.g., Federal Express or other similar
service) (in which case such notice shall be deemed given on the business day next following deposit with
the air courier service); or (d) by United States mail, first class, postage prepaid, registered or certified,
return receipt requested (in which case such notice shall be deemed given on the third (3rd) day following
the date of deposit with the United States Postal Service), and properly addressed as follows:
To CITY: At the address set forth on the Signature Page
To VITAL: At the address set forth on the Signature Page
A party to this Agreement may change its address for purposes of this Section by giving written notice to
the other parties in the manner specified in this Section 7.1.
7.2 Severability. if for any reason any clause or provisionof this Agreement; or the
application of any such clause or provision in a particular context or to a particular situation, circumstance
or person, should be held unenforceable, invalid or in violation of law by a court of competent jurisdiction or
as a result of arbitration, or shall be determined unlawful by a federal, state or local governmental agency or
other authority, then the application of such clause or provision in contexts or to situations, circumstances
or persons other than that in or to which it is held unenforceable, invalid or in violation of law shall not be
affected thereby, and the remaining clauses and provisions hereof shall nevertheless remain in full force
and effect.
7.3 (Entire Agrgernent This Agreement and the Exhibits attached hereto constitute the full
and complete agreement and understanding between the parties hereto and shall supersede any and all
prior written and oral agreements concerning the subject matter contained herein.
7.4 Amendments and Modifications This Agreement may be amended only by written
agreement signed by VITAL_ and CITY.
7.5 &greament to Perform Necessary 6gts. Each party shall perform any further acts and
shall execute and deliver any further documents as may be reasonably necessary to fully effectuate the
provisions of this Agreement.
7.6 Assignment. Neither party shall have the right to assign or transfer this Agreement, or to
delegate any of its rights, duties or obligations arising herein, without the prior written consent of the other
party, which consent may be given or withheld in the other party's sole and absolute discretion. Any such
purported or attempted assignment, transfer or delegation shall be null, void and of no force or effect
whatsoever.
7.7 Binding Effect. Subject to Section 7.6 above, this Agreement shall be binding upon and
inure to the benefit of the parties and their respective heirs, legal representatives, successors and assigns.
7.8 Number and Gender. Words in the singular shall include the plural, and words in a
particular gender shall include either or both genders, as appropriate to the context in which such words are
used.
7.9 Govejjjir La i, #venue, This Agreement shall be governed by and construed in
accordance with the laws of the State of California, without giving effect to conflict of law principles. Venue
shall be in the courts in Los Angeles County.
7.10 Force MAgure- Neither party shall be liable nor deemed to be in default for any delay or
in performance under this Agreement or other interruption of service or employment resulting,
or indirectly, from acts of God, civil or military authority, criminal acts, riots, civil disobedience, war,
its, fires, explosions, earthquakes, floods, failure of transportation, machinery or supplies,
sm, strikes or other work interruptions by the employees of any party, or any other use beyond the
We control of the party affected thereby. However, each party shall utilize its best good faith efforts
irm under this Aqreement in the event of any such occurrence or circumstance.
his costs of Wi
arbitration or other action proceeds to final judgment. A party not entitled to recover its costs shall not
recover attorneys' fees.
7.14 Ambiguities. The general rule that ambiguities are to be construed against the drafter of a
document shall not apply to this Agreement. In the event that any provision of this Agreement is found to
be ambiguous, each party shall have an opportunity to present evidence as to the actual intent of the
parties with respect to such ambiguous provision;
7.15 Non -Waiver. No failure or delay by a party to insist upon strict performance of any term,
condition, covenant or agreement of this Agreement, or to exercise any right, power or remedy hereunder
or under law or as a result of a breach hereof or thereof shall constitute a waiver of any such term,
condition, covenant, agreement, right, power or remedy hereunder or under law or as a result of a breach
hereof or thereof or preclude such party from exercise of any such right. power or remedy at any later time
or times.
7.16 Eacsimile S_:tg_natures. A facsimile signature by a party to this Agreement that is delivered
to another party to this Agreement shall be binding on the signatory party.
7.17 g_qMDLerp_arts. This Agreement may be executed in one or more counterparts, each of
which shall be deemed an original, and all such counterparts together shall constitute but one and the same
instrument.
7.18 Indemnification. VITAL shall defend, indemnify and hold the CITY, its officials, officers,
employees, volunteers and agents free and harmless from any and all claims, demands, causes of action,
costs, expenses, liability, loss, damage or injury, in law or equity, to property or persons, including wrongful
death, arising out of or incident to any alleged negligent acts, errors, omissions or willful misconduct of
VITAL, its officials, officers, employees, agents, contractors< and subcontractors arising out of or in
connection with the performance of the Services or the performance of this Agreement, VITAL shall defend,
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of VITAL's own cost, expense and risk, any and all such aforesaid suits, actions or other legal proceedings
of every kind that may be brought or instituted against CITY, its directors, officials, officers, employees,
agents or volunteers. VITAL shall pay and satisfy any judgment, award or decree that may be rendered
against CITY or its directors, officials, officers, employees, agents or volunteers, in any such suit, action or
other legal proceeding VITAL shall reimburse CITY and its directors, officials, officers, employees, agents
and/or volunteers, for any and all legal expenses and costs incurred by each of them in connection
therewith or in enforcing the indemnity herein provided. VITAL's obligation to indemnify shall not be
restricted to insurance proceeds, if any, received by the CITY, its directors, officials officers, employees,
and agents or volunteers. VITAL shall not be obligated to defend, indemnify or hold the CITY harmless in
any manner whatsoever for any claims or liability arising solely out of the CITY's own negligent acts, errors
or omissions or willful misconduct.
(Signature page follows]
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IN W"ESt HEREOF, �6adfi of the parties hOetO has Calus6d this Agreement to be signed by
duly authoriiW MOresent4tjV4 or officer of such patty as of the daw fi� above written.
Vital Medicai services. LLC-.
By:
Alex G. 0661210bur
Chief operating Officer
Armen Vartbrilan
Managing Director
Address:
655 North Central Avenue
17"'Floor
Glendalei CA 91203
Attn: Alex G. Ghazalpour, COO
MTi�
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By:
Name: Gilbert A. Livas,
Title: City Manager
By:
Name, C r Charlesi Chief of Policel
Address: 10911 Brookshire Avenue
—Downey, CA 90241
—ATTN; Chief of Police
FILTIMM
City Cle(K
jM_ �
APPROVED AS TO M:
I y Attorney
EXHIBIT A
SCOPE OF +
TZTOTT_rjwm•�
Items 1-6 are further detailed in the attached VITAL -A004 Policy.
1. Medical Director oversight for Nasal Naloxone (Narcan) administration
2. Executed Standing Order
3. Nasal Naloxone (Narcan) Education
4. Nasal Naloxone (Narcan) Training; The use of Naloxone via a nasal Injector is relatively
simple and generally not dangerous or difficult. VITAL will create a comprehensive
curriculum in accordance with the manufacturer's suggested training recommendation,
for a 1 -2 -hour training course to be required for all officers who will deploy with Naloxone
kits. The course will include the following:
a. Course of instruction
b. Demonstrations
c._ Brief competency skills and demonstrative examination
5. Nasal Naloxone (Narcan) Program Oversight and Implementation.
6. Nasal Naloxone (Narcan) Customized Policy Implementation
All equipment and supplies needed to provide the Scope of Services will be supplied by VITAL,
except for the Nasal Naloxone (Narcan);; which the parties understand will be provided to CITY by
their` preferred manufacturer (Adapt Pharma), Furthermore, it is recommended that the medication
along with the appropriate personal protective equipment be placed In a separate marked orange
case ,(Peli n) to sustain its integrity and to have it differentiated from other gear. CITY will be
responsible for direct purchasing of the Nasal Naloxone (Narcan) Medication through the
manufacturer Adapt Pharma or any distributor of their choice. The cost per case excluding the
medication is $195.00.
• •PROGRAM
Payment for the Nasal Naloxone (Narcan) program implementation and administration will be
$2,100.00 annually, which equates to $175.00 per month. This compensation includes the following:
training, education, competency, and continued medical director oversight.
The purchase for the Nasal Naloxone_ (Narcan) will be executed directly by CITY and/or its directed
representatives. The Chief Medical Officer of VITAL will write a standing order/ prescription for the
disbursement of the Naloxone for this program.
STAFFING
VITAL will serve as CITY's Program Coordinator, as referenced in VITAL -A004 Policy.' The Program
Coordinator will designate and be responsible for reporting requirements. The Program Coordinator
will be available to all CITY agents on an on-call basis (24) hours per day, seven (7) days per week.
E•]
EXHIBIT B
OPTIONAL SERVICES AND RATES
CITY will pay VITAL for the Optional Services provided VITAL has obtained prior written consent
from CITY to provide any of the Optional Services described belovv�
payment for Optional Services will be determi ned on a fee for service basis The Current rate for
pre -booking and. rnedic-al screening examination is 5495 00 per examination The current rate for a
blood dravv conducted at the CITY's jail is S`1414�00 per Arrestee or Prisoner encounter The current
rate for a forced blood draw or off-site blood draw is S29500, The current rate for Post Exposure
Hazard (infectious Disease Exposure) testing provided by VITAL hereunder is 3995.00 per person
tested (e,g., Officer, Employee of City, Arrestee, Prisoner), The current rate for reasonable
suspicion drug and alcohol testing in conformity with CITY's policies on an as needed basis is an
additional cost of $395.00 per lestThe current rate for courtroom testimony shall not exceed
$12000 per hour and only applies when VITAL must be in court of at a DMV hearing physically for
testimony purposes This not apply to on -rail subpoenas
Select Summary Schedule Services Offered
Pre -Booking and Medical Screening Exaniinal!ion 3495 00
Blood Draw $144 00
Forced Blood Dray; or Offsite Blood Drew $29500
Reasonable Suspicion Drug and Alcohol Testing $39r 00
DUI Check Point(OTS Reimbursement per detail) $40000
Post Exposure Hazard $995,00
Nurse Testinnony Hourly Rate (maximurn rate) $12000
At the request of the CITY, VITAL agrees to reengage with CITY regarding a monthly subscription
plan or other indmdual occurrence payment based productivity numbers
VITAL will provide CITY with monthly reports Which detail all encounters in the immediately
preceding month, including any excess encounters, VITAL will also include associated report
numbers for all medical clearances and blood draws for the CITY's accounting purposes, The
reports vid! detail the total amounts due to VITAL for Covered Services rendered in the preceding
rnopay CONTRACTOR all undisputed amounts of such billing Mthin thirty [30) days
of receipt of the same,
VITAL expressly acknowledges that the loi 'it cost for Optional Services sel forth above mus( no',
exceed fifteen thousand dollars (515,000 00) ('Waximun'i Ccs'`) per year %,V sera VITAL ups billed
75% of the Maximum Cost, VITAL will providf;., written notice to CITY notifyin"I CITY that 75% of the
'
Maximum Cost has bftn incurred by CITY, to alert CITY that additional funding may be necessary
for Covered Services to continue under this Agreement
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