1989-06-05 - Resolution 1989-33 - APPROVING AN AGREEMENT RELATED TO CONTINUED PARTICIPATION IN AN ADVANCED LIFE SUPPORT / MOBILE INTENSIVE CARE (ALS/MIC) SYSTEMRESOLUTION NO. 89- 33
A RESOLUTION APPROVING AN AGREE},IENT RELATED TO
CONTINUED PARTICIPATION IN AN ADVANCED LIFE SUPPORT/
MOBILE INTENSIVE CARE (ALS/MIC) SYSTEM
WHEREAS, the Viltage of Buffalo Grove presently ParticipaEes in an
Advanced Llfe Support/Moblle Intenslve care (ALS/MIC) Systeu of whlch
Northwest Communlty Hospital has been designated as the Resource Hospital
by the Illlnois Departuent of Public Health; and,
WHEREAS, continued participatton in the ALS/MIC Systen requires that
the Vlllage fornally agree to accept and abide by certain conmltments made
upon the Vlllage by Northwest conEuniEy Hospllal; and'
WHEREAS ' said coxnmitments are in conpliance with the Illtnois DePart-
nent of PubLic Health Rules and Regulations governing the oPeration of
ALS/UIC systems; and,
WHEREAS, the Vltlage has deternlned that it ls in the best i.nterests
of lts resldents to continue to Participate in the AI-S/MIC Systen.
NOW, TI{EREFORE, BE IT RESOLVED BY TIIE PRESIDENT AND BOARD OF TRUSTEES
OF THE VILLAGE OF BUFFALO GROVE ' COOK AND LAKE COUNTIES' ILLINOIS' IhAI:
Section 1. The Viltage of Buffalo Grove hereby elects to continue
particlpatlon ln the ALS/UIC Systen.
Sectlon 2. The Village agrees to accePt and abide by the terms of the
AYES: 6 - Marient 1. Glove Reid, S 1frin. Mat hias. 0t Ma 11ev
NAYES: O - None
AISENT: O - None
I989 APPROVED:.Jrrne 5
APPROVED:
r989PASSED: Jun
ATTEST:
''f\A.$/^oL;L
vi11a e Clerk VERNA L. CLAYTON,Village Pre ent
Agreement attachedhereto and made a Part hereof'
(.----?
L.,/
NORTHWEST
COMMUNITY
HOSPITAL
THIS AGREEMENT shall be by and between Northwest Community Hospital and
the Village of Buffalo Grove Fire De artif,ent
0 prov es contracts to prov ide pre-hospjta and nLra-hospj ta emergency ca re
I ndi vi dual ownership
Group of individuals,
privately owned
Corporati on
Pa rtners h i p
Unit of 1oca1 government
Other publ i c ownership entjty
800 west Central Road
Arlrngton Herghts. lllinois 60005
312-259-1000
_ Association
_ Trust
_ Joi nt ventu re
_ I ndi vi dual doing business
under an assumed name
_ 0ther private ownership entity
at a B
Part 5
Advan
S Rul
shal'l
efore
of thi
to ren
as i c and/or
35 of the El,l
s agreement
ewal on or b
ced level to victims of illness or injury as defjned within
es and other areas specified jn this agreement. The terms
cormence 0n
June 15
June 15 1989 and be subject
Specify the type of entity under which your service operates as an Ambulance
Prov i der :
EMS SYSTEM PROCRAM
Section 535.210
d) Name and address of ambuiance provider:
NAME; VILLAGE OF BUFFAIO G.ROVE FIRE DEPA-RTI'1E:iT
ADDRESS: 505 t'l.est Dundqe Road, Buffalo Grove, IL (station 5)
109 East Busch Road, Buffalo Grove IL (station 6)
i) Describe your method of providjng EMS Services which includes the protocols
for:
1) Si ngl e vehi c1e response and transp ort: Anbulance 5 6 Arnbulance 6 each
have a rnininun of two certified paramedics on the vehicle' responding to
rhe energency and transporting to the hospital.
?) DUal VehiCle responSe: A-nbulance - a ninirnurn of tHo certified paraneCics,
and one EMT-I\ responding toSquad - a minimum of one certified paramedic
energency situaE ions.
An alrrtrate ot Csnlral Healrh Caie Co.por.nol
)L\
3) Level of first response vehicles:ALS - minimun of two certified paraneldics
on the ambulance, Sq uad will have the nininun of ohe paramedlc and one
EMT-A.
4) Leve'l o
requi re
transpo
has bee
f transport vehicles will correspond to the level of care
d bv the 0atient, either ALS or BLS. All ALS patients wjll be
rted by a minimum of twb (2) certified EMT-Ps unless a wajver
n granted by the Project Medical Director.
5) Under what circumstances will you call in mutual aid?When a1l-
See copy of Box Alarm Cards'
y. 22s
k) Provider Comni tment Letter
1) Fi l1 j n the fo1 l owi ng
within the System:
Provi der Vehi cl e # Year
i nformati on for each EMS vehi cl e parti cj pati ng
l'1ode I l4a ke VIN #
1988-Iype III Econoline 350XL Ford l FDri.E3 0I10KHA3 7 3 54
2. 249 1983-GMC fuel pincher squad truck GMC i GDMT D rG3 CU5 9 698 3
3. 248 1983-GMCSierra 3500 cllc l cDr{K34MXDV5202 63
t 226 I988-Type III Econoline 350XL Ford
5. 224 1985-Type I11 Econoline 350XL Ford l FDKE3OIXGHA5T 6i 1
6. 246 1984-F-700 Squad Ford l FDWK7 4Ii9EVA2 4 97 0
Base Location Address D t. Li cense No.unl ess Exem t
225-l Og E^ Brrs.h Roa d Ai. s 8r 7 902
249 - lO9 E. Busch Road ALS >1507 24
248 - 109 E. Busch Road ALS / BLS Ml 638
1
2
3
4
I
6
226 - 505 W. Dundee Road ALS 8r7901
224 - 5O5 W. Dundee Road ALS 81 7 903
246 - 505 It. Dundee Road ALS I11632
2) t,rle agree to provide pre-hospital
Life Support in keeping with the
EMS System po1 i cy.
3) Define primary service area (0-6 min' response)' stil1 district
and intra-hospjtal Basic or Advanced
IDPH Rules and Northwest Community
ambulance ( seecovered bv Dr inarv attached maD )
2
front l ine AT S vehi.lpc 2rp nof ..vril,hle foi pmaigan'y reqP^n<e-
l FDKE3 0M9r.itA3 7 353
ALS/BLS
Defjne secondaYy response area (7-15 min. response ): Responding to
or into an area exceeding a six minute resPonse ti.me.
response time of fifteen trinutes.
El'lS vehicle.
Our agency serves a population base of: 32'500
The square mileage of our servjcs tr7g6 i5' 8 square rniles
5) !{e comm'i t to responding to the scene within six minutes of receiv'ing
the call for assistance in primary coverage areas, unless unusual or
unpredictable situations arise. l,'le further commjt to responding with-
in 15 minutes in secondary coverage areas and w'i thin 20 minutes in out-
lying coverage areas. All runs that exceed the optimal response times
will-be inveatigated by the EMS Provider Coordinator to identify the
cause and determine the need for further action.
6) t,le conrmit to providing Advanced Life Support coverage twenty-four (24)
hours a day, everyday of the Year.
7)We affirm that each ambulance at the scene of an emergency and during
transport of emergency patients to and between hospitals will be staffed
in accordance with the requirements of the Northwest Community EMS System
pol i cy.
8) Please submit copies of (renewed) mutuai aid agreements.
e)Emergency services that our BLS and/or ALS vehicles are
provide shall not be denied on the basis of race, sex'
ability to pay or nature of medjcal complaint.
for each
as speci -
4) Provide a map indicating the base location of each
lightjng the primary, secondary and outlying areas
10)I,Je agree to file a Northwest Community EMS System run sheet
e*erlency call in which a patient assessment was performed,
fjed-jn the Northwest Community El'tS System policy.
recognize that jmproper maintenance of EMS equipment and
be i breach of dilty owed to the patient and may result
any resul ti ng patient harm.
EMS vehicle, high-
of response for each
authori zed to
creed, rel i gi on,
EMS vehi cl es
in liability11) t,Je
may
for
3
enorhpr dictii.t eithar ?c. Frih.ry ^r cecoB'rary Ygt'rcls tg Ehs S€ene'
Define outlvinq areas of response (more than 15-20 mjn. response):
Mutual Ai-d 16sponse to another municipal ity or any area exceeding a
l2l THEREFORE, we
535.150 of the 5ta
andlbe
su'i tab'le 'loaners shall be obtained in a tim
ee to carry the medication as required by th
by Secti on
EMS Sys tems. Defecti ve
d iscovery
e1y ma nne r.
e System.
extended medi cal I eave-I, "Temporary Leave From
ri 1y reduci ng thej r certi -
Medical Di rector at the
agre
te E
supp
ta k
e to maintajn the equipment required
MS Rules and the Northwest Communjty
1y List in working order at all time
en out of service immedjately (upon
cautions shal'l be taken to avoid foreseeable hazards to
patients occupying the El.lS vehicle.
Standard Drug
equ i pment shal
or noti ce ) and
We further agr
Reasonabl e pre
tactal c
ati on
ysici
fi ed
ys tem
13)Submi
hospi
expi r
or ph
certi
EMS S
urrent alphabetized list of all personnel providing pre-
are, their certjfication numbers, thejr System I.D' numbers'
dates and levels of certjfication (EMT-A, EMT-P, Fjeld R.N.
an status). |ie agree to maintain a minimum of ejght (8)
paramedics primarily responsible to the Northwest Community
for each approved veh icl e.
i4) l,le agree to notify the Pro
sonnel providing pre-hospi
fol low the provisions outl
17 )
ect Medical Djrector of any changes in per-
al care in the System. New employees will
ned in System Policy #E-3, "Entry Into the
Jt
i
sNorthwest Communi ty EMS Sy
wil l follow the provisions
Paramedic Funct'ion". EMT-
time they are requesting t
or EMT-As who have resigne
|,le
of
tem" . Empl oyees
i n System Po1 i cy
s or EMT-As vol u
ters to the Proj
eir change of st
on
#L
nta
ectwill submit iefi ed status
to the Proj
P
t
h
d
15) He agree to allow the department access to all records, equipment and
vehicles relating to the EMS System during any department inspection'
i nvest igati on or sjte visit.
16) We agree to allow the Project Hedjcal Djrector or his designee' identi-
fied in writing, access to all records, equjpment and veh'icles relating
to the EMS System durjng any inspection oLinvestjgation by the
Project Medical Director or designee to determine compl iance with the
System Program P'la n .
atus. The names of EMT-Ps
or have been terminated will be submitted
ect [tedical Director on a monthly basis.
affirm that our communjcations capabilities meet the requirements
Section 535.50 of the IDPH Rulei.
18) Please submit copies of current FCC l icenses.
19 ) lle aff i
with th
vi ded i
Drug an
dated a
approve
rm that each EMS vehicle participating 'in the System compl ies
e vehicle design, equipment and extrication criteria as pro-
n Section 535.i50 (a) (1) and (10) of the IDPH Rules and Svstem
d Supply List. (Aitich a completed Vehjcle Inventory Checklist
na sibnla as complete by the Provider EMS Coordinator for each
d EMS veh icl e. )
I
Data Col lecti on: t,le agree to
Emergency Med i ca l Data Col l ec
System activity. The Person
col lection and EMS Statistica
Medi cal Servi ces , including
to implement a "911" System
20)
2L)
22)
23)
Section 535.60
a)
We recognize that the Standards of Care for the Northwest Community
EMS Sysiem include the Standard 0perating Procedures (50Ps)' System
Policy Manual, System Procedure I'lanua'l , Numbered Sys tem- Memo ra nda and
other special diiect'ions issued by the Project f4edjcal D'i rector. lie
agree to affirm and adhere to these standards as well as the provisions
oi ttre Illinois EMS Act and all of jts amendments, the EMS Rules and
Regulations plus a1l other statutes which reference pre-hospital care
ani/or pre-hosp'ital provjders. We further agree to comply h,ith the
terms of the EMS System Program Plan, the System l''lanual and our Letter
of Cormi tment.
participate jn State and System-require
tion System Plans to aid in summarizing
responsible w'i thin our agency for data
I Tabulatjonv-lit are:"' Kathy Abangan, Joe
d
lii.eser ,. Sr
|,le agree to submjt System-approved data summary sheets by the 15th day
of the following month. *Larry K. swieca, phil Barry
tle affirm that all EMS personnel and ambulances shall maintain the'i r
certifications, I jcenses and approvals unless specific waivers are
granted by the Proiect Medical Director or IDPH.
t.le agree to participate inquality assurance and quality control .measunesfor patient iare, ambulance operation and System training actjvit'ies'
including but not limited to peer review of run sheets.
EMS SYSTEMS COMMUNICATIONS
1) List all access numbers for Emergency
a description of p1 ans to uti l'ize or
or CMED, if or when availab'l e:
Access Numbers:537-5533, 537-5543, 537 -5632 , 537-5584
PI ans to Implement "911":
Enhanced 9l I system uas recently approved by the voters
on April 4,1989. operat ion
complete until. mid to late 1990.
of the system will not be
5
2) Describe the mechan'i sm and specific procedures used to access and dis
patch EMS vehicles used by your services, including areas covered,
radio and telephone capabil itjes, 'including radio channels used:
A11 EliS calls are received and dispatched through llorthlrest Central
Dispatch System located at 33 South Arlington Heights Road in Arlington
Heights, IL. They naintain 24 hour day, 7 day rveek dispatching. Radlo
frequencies are 154.205 local fire, 154,265 NIFREN (mutual aid channel)
and 155.400, Yerci channel .
3) List the make, model , serial number of all mobile and portable com-
municatjon equ ipment:
MAKE MODEL SERIAL NUMBER
IfOTOROLA APCOR sP5880i41 3 58AEr 0000
}IOTOROLA APCOR P44ESN3191AN 258ALN0003
MOTOROT,A APCOR P44ESNil9l A ?\AFI O OOO
I'ICTOROLA APCOR sP5880r 4r 358AEl 0001
YOTOROT-A APCOR sP5841401 3 5 8ADE5004 0
MOTOROI,A MTTREC T53.rJAl 900C 43iH.r.r09712-way
2-way YOTOROLA }1I COR T73RTN119OB 6t10642
2-rvay
2-w av'5)
I'IOTOROL{ SYNTOR D2O5I BB
]ioToRoLA MTTREC T53JJAL900CK 433HJJ0972
We affirm that al1 pre-hospital pesonnel shall be capable of properly
operating their respective communications equipment.
6) l,rie affirm that all telecommunication equipment shall be maintained to
minimize breakdowns. Procedures have been estabi l ished to provide
immediate action to be taken by operating personnel to ensure rapid
restoration if breakdowns do occur.
lN WITNESS WHEREOF, the parties hereto have caused this agreement to be signed,
467 CJ 1 tol 7
t
For:
1e Executive 0fflcer of EHS Agency
Name of Agency
VERN L. CLAYToN, Vil1 Buffalo Grove, IL
SMZjr:CJl,1:SKl4
3/89
ate
6 /5 /89
6
age Preslde Date
(._-