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Starting a Day Care Business in San Mateo County - DOC

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Starting a Day Care Business in San Mateo County document sample

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									Original Contract
Page 17 Schedule A 1999
                                     SCHEDULE A

                               GLOSSARY OF TERMS.

The following definitions shall apply throughout this Agreement:


Business Day

       Any day that County offices are open for public business, excluding weekends
       and holidays.

Category A Minimum Patient Contact Criteria (MPCC)

       An EMS call in which a combination of two or more of the therapeutic activites
       listed below are performed by a paramedic on a single patient:

          starting an intravenous line
          administering a medication
          endotracheal or nasotracheal intubation
          defibrillation
          control of significant hemorrhage
          extracting a foreign body from the airway
          delivering a baby
          cardiac monitoring
          determining blood glucose
          caring for a patient that meets County criteria for major trauma

Category B Minimum Patient Contact Criteria (MPCC)

       An EMS call, in which patient contact occurs, but which does not meet MPCC
       Category A above.


               Contractor and Subcontractor will ensure that all paramedics in the system
               have sufficient patient contacts to retain knowledge and skills.
               Paramedics shall maintain the following minimum patient contacts/care
               (MPCC) requirements:

               Paramedics shall meet the following MPCC requirements within each 90
               day quarter (January, February, March) (April, May, June) (July, August,
               September) (October, November, December). Paramedics newly
               accredited through three (3) years experience must obtain 30 MPCCs and
               of these at least 20% shall be Category A. Paramedics having three (3) or
more years experience as a field paramedic must obtain 20 MPCCs and of
these, at least 20% shall be Category A. Paramedics may share patient
contacts. A maximum of two (2) first responder paramedics and two (2)
transport paramedics may share a single patient contact. At the option of
Contractor’s Clinical Education and QA/QI Coordinator and the EMS
Medical Director an exemption may be granted in special situations.

In the event that a paramedics does not achieve the required MPCCs as
specified above, he/she may accomplish the remaining MPCCs in
alternative settings such as hospital or clinic rotation, structured chart
reviews, or second paramedic on an ambulance operated by Contractor or
Subcontractor. The following will serve as the equivalency formula for
meeting the remaining MPCC with alternatives to actual patient contacts.
If 100% of Category A MPCC patient contacts are not met in the field,
then up to 50% may be met in a hospital or clinic rotation. If 100% of
Category B MPCC patient contacts are not met in the field, then a
maximum of 20% of total required patient contacts may be from a hospital
or clinic rotation and 10% may be from chart review/skills labs.

Paramedics working as a paramedic in another county may fulfill up to
fifty percent (50%) of their MPCC by providing evidence of these MPCC
meeting the same criteria as above as determined by Contractor’s Clinical
Education and QA/QI Coordinator and County.

The QLC shall review the MPCC data every 90 days after commencement
of this Agreement and make recommendations to County. At the sole
option of County the above MPCC requirements may be modified if
needed.

If a paramedic does not attain the required number of MPCCs he/she can
make up the deficiency within the next 90 days, in addition to meeting the
current quarter MPCC requirement. In the event that a paramedic fails to
meet the MPCC within a 180 day period, he/she be unable to function as a
single paramedic until the requirement is met. Contractor’s Clinical
Education and QA/QI coordinator, in consultation with the County EMS
Medical Director and Clinical Coordinator, will develop a skills
maintenance action plan for the deficient paramedic. Deficient
paramedics may accomplish their Category B MPCCs in alternative
settings such as hospital or clinic rotation, structured chart reviews or third
person (second paramedic) on a Contractor or Subcontractor ambulance.

Paramedics will participate in training sessions addressing seldom used
skills. Hospital or clinic rotations and structured chart reviews shall be
considered alternatives to Category B MPCC patient contacts.
              Contractor may reserve ambulance hours that Subcontractor may staff as
              set forth in the agreement between Contractor and Subcontractor entitled
              “Pre-hospital Emergency Services Agreement.” These hours will provide
              additional patient contact opportunities for Subcontractor’s paramedics
              that are assigned to historically low call volume areas or provide
              additional opportunity for paramedics to meet the MPCC requirements.
              Any hours worked by Subcontractor’s paramedics on Contractor’s staffed
              ambulance will be done as a third person ride-along and will not displace
              any Contractor’s employee.


Amendment: 2000
                               GLOSSARY OF TERMS.

The following definitions shall apply throughout this Agreement:


Category A Minimum Patient Contact Criteria (MPCC)

       An EMS call in which one or more of the therapeutic activities listed below are
       performed by a paramedic on a single patient:

          starting an intravenous line
          administering a medication
          endotracheal or nasotracheal intubation
          defibrillation
          control of significant hemorrhage
          extracting a foreign body from the airway
          delivering a baby
          caring for a patient that meets County criteria for major trauma

Category B Minimum Patient Contact Criteria (MPCC)

       An EMS call, in which patient contact occurs, but which does not meet MPCC
       Category A above.

Later in amendment:

              Contractor and Subcontractor will ensure that all paramedics in the system
              have sufficient patient contacts to retain knowledge and skills.
              Paramedics shall maintain the following minimum patient contacts/care
              (MPCC) requirements:

              Paramedics shall meet the following MPCC requirements within each 90
              day quarter (January, February, March) (April, May, June) (July, August,
              September) (October, November, December). Paramedics with less than
three (3) years field experience must obtain 16 MPCCs and of these at
least 50% shall be Category A. Paramedics having three (3) or more
years experience as a field paramedic must obtain 10 MPCCs and of these,
at least 50% shall be Category A. Paramedics may share patient contacts
if they actually perform the patient assessment or patient treatment.

Paramedics may meet the above MPCC requirements from patient
contacts as a paramedic on an ambulance, field supervisor’s vehicle, a fire
first response vehicle, or within a hospital emergency department or a
clinic which has been approved as a paramedic training site by the EMS
agency. Paramedics obtaining MPCCs in a hospital emergency department
or clinic or in the prehospital setting in a county outside San Mateo
County must provide sufficient evidence of these MPCCs as determined
by Contractor’s Clinical Education and QA/QI Coordinator and County.

The QLC shall review the MPCC data every 90 days after commencement
of this Agreement and make recommendations to County. At the sole
option of County the above MPCC requirements may be modified if
needed.

If a paramedic does not attain the required number of MPCCs he/she can
make up the deficiency within the next 90 days, in addition to meeting the
current quarter MPCC requirement. In the event that a paramedic fails to
meet the MPCC within a 180 day period, he/she will be unable to function
as a single paramedic until the requirement is met. Contractor’s Clinical
Education and QA/QI coordinator, in consultation with the County EMS
Medical Director and Clinical Coordinator, will develop a skills
maintenance action plan for the deficient paramedic. Deficient
paramedics may accomplish their Category B MPCCs in alternative
settings such as hospital or clinic rotation, or third person (second
paramedic) on an ambulance.

Paramedics will participate in training sessions addressing seldom used
skills.

Contractor may reserve ambulance hours that Subcontractor may staff as
set forth in the agreement between Contractor and Subcontractor entitled
“Pre-hospital Emergency Services Agreement.” These hours will provide
additional patient contact opportunities for Subcontractor’s paramedics
that are assigned to historically low call volume areas or provide
additional opportunity for paramedics to meet the MPCC requirements.
Any hours worked by Subcontractor’s paramedics on Contractor’s staffed
ambulance will be done as a third person ride-along and will not displace
any Contractor’s employee.”


								
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