HomeMy WebLinkAboutRESOLUTION - 75-19 - 12/10/2019 - Emergency Medical Services Mutual Aid AgreementRESOLUTION NO.75-19
A RESOLUTION AUTHORIZING THE MAYOR TO EXECUTE A MUTUAL AID
AGREEMENT BETWEEN SURROUNDING MUNICIPALITIES AND THE VILLAGE OF
ELK GROVE VILLAGE FOR EMERGENCY MEDICAL SERVICES
NOW, THEREFORE, BE IT RESOLVED by the Mayor and Board of Trustees of the Village
of Elk Grove Village, Counties of Cook and DuPage, State of Illinois as follows:
Section 1: That the Mayor be and is hereby authorized to sign the attached document marked:
EMERGENCY MEDICAL SERVICES
MUTUAL AID AGREEMENT
with the following municipalities: Village of Schaumburg, Elk Grove Village, Hoffman Estates,
Streamwood, Bartlett Fire Protection District, Palatine, Palatine Rural and the City of Rolling
Meadows. A copy of which is attached hereto and made a part hereof as if fully set forth and the
Village Clerk is authorized to attest said document upon the signature of the Mayor.
Section 2: That this Resolution shall be in full force and effect from and after its passage and
approval according to law.
VOTE: AYES: 6 NAYS: 0 ABSENT: 0
PASSED this loth day of December 2019.
APPROVED this loth day of December 2019.
ATTEST:
Loretta M. Murphy, Village Clerk
APPROVED:
Mayor Craig B. Johnson
Village of Elk Grove Village
Emergency Medical Services
Mutual Aid Agreement
EMERGENCY MEDICAL SERVICES
MUTUAL AID AGREEMENT
THIS MUTUAL AID AGREEMENT (this "Agreement") is made as of January 1, 2020,
(the "Effective Date") by the following Illinois municipalities: Village of Schaumburg, Elk Grove
Village, Hoffman Estates, Streamwood, Bartlett Fire Protection District, Palatine, Palatine Rural
and the City of Rolling Meadows. These units of Illinois municipal government, and any additional
local governmental entity that is added to this Agreement as provided in Subsection 7B of this
Agreement, are referred to collectively as the "Members."
RECITALS:
WHEREAS, the Members are located geographically near to each other; and
WHEREAS, each Member provides emergency medical services and ambulance
transportation services within that Member's boundaries, including residents, businesses, visitors,
and all others in need; and
WHEREAS, each Member also provides emergency medical services and ambulance
transportation services to any other Member when the other Member seeks assistance; and
WHEREAS, the Members desire to memorialize in this Agreement the standards set forth
in this Agreement for mutual aid responses, billing, and other general standards;
NOW, THEREFORE, the Members agree as follows:
Section 1. Purpose of Agreement.
The principal purpose of this Agreement is to set forth certain standards for mutual aid
responses related to emergency medical and ambulance transportation services, prices, and billing
and to assure compliance with Section 1128B(b) of the federal Social Security Act and the current
amendments regarding safe harbors promulgated by the Office of the Inspector General of the
Department of Health and Human Services.
Section 2. Definitions.
"Anti -Kickback Statute" means Section I I28B(b) of the federal Social Security Act.
"Emergency Aid" means emergency medical or transportation services by a Responder.
"Member" means one of the local governmental entities listed at the beginning of this
Agreement or added under Subsection 7B of this Agreement.
"Non -Resident" means a Patient who is not a Resident (as "Resident" is defined in this
Section).
Emergency Medical Services
Mutual Aid Agreement
"OIG" means the Office of the Inspector General of the Department of Health and Human
Services.
"OIG Rule" means the current amendments regarding safe harbors promulgated by the
OIG. See Section 6 of this Agreement.
"Patient" means a person who has received Emergency Aid by a Responder.
"Rates" See Section 4 of this Agreement.
"Requester" means a Member that has requested Emergency Aid from one or more other
Members.
"Resident" means a Patient who maintains his or her primary residence within the corporate
limits of the Requester or the Responder.
"Responder" means a Member that is responding, or has responded, to a Requester.
Section 3. Mutual Aid Service Calls.
A. Requests for Emergency Aid. Any Member may initiate a request to any one or
more other Members for Emergency Aid, under any of the following circumstances or any similar
circumstances:
• If the available equipment of the Requester is insufficient to respond to an incident
under the circumstances.
• If the number of the Requester's available personnel is insufficient to respond to an
incident under the circumstances.
• If the equipment and personnel of another Member is located closer to an incident
and deployment of that Responder may be beneficial under the circumstances.
• Any other set of circumstances that the Requester and the Responder believe is
beneficial under the circumstances.
B. Responses to Requests. Members receiving a request for Emergency Aid will
promptly respond to the Requester and provide Emergency Aid as possible and practical under the
circumstances.
Section 4. Rates.
Each Member must provide all other Members the current rates and standards it applies for
emergency medical and ambulance transportation services, including without limitation BLS,
ALS, and Transportation services (the "Rates"). Each Member also must promptly provide all
other Members any changes to its Rates.
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Emergency Medical Services
Mutual Aid Agreement
Section 5. Billing.
A. Requester's Rates Apply. When a Responder provides Emergency Aid to a
Requester, the Responder must apply the Requester's Rates and out-of-pocket costs as if the
Requester had provided the Emergency Aid, except as provided in Subsection B of this Section.
B. Exceptions for Responder Residents. If the Responder provides Emergency Aid to
a Patient whose primary residence is within the corporate limits of the Responder, then the
Responder may apply its Rates for service and its out-of-pocket costs as if the Responder had
provided the Emergency Aid within its own boundaries.
Section 6. Compliance with Anti -Kickback Statute and OIG Rule.
Each Member pledges that it will not knowingly or willfully offer, pay, solicit, or receive
remuneration in order to induce or reward the referral of business reimbursable under the federal
health care programs, and otherwise will comply with all applicable provisions of the Anti -
Kickback Statute and the OIG Rule. Each Member will heed the provisions of the Anti -Kickback
Statute and the OIG Rule regarding safe harbors.
Section 7. Member Withdrawal; Additional Members.
A. Withdrawal From Agreement. A Member may withdraw from this Agreement at
any time on 14-days' written notice to the current Members.
B. Additional Members. Other Illinois local governmental entities may become
Members under this Agreement by (A) sending a written request for membership to each current
Member, and (B) written approval of membership by a majority of the current Members, and (C)
signing the New Member Statement attached to this Agreement as Exhibit A.
Section 8. Termination of Membership.
If a Member knowingly violates a provision of this Agreement or violates the Anti -
Kickback Statute or the OIG Rule, then the Member may be terminated by a majority vote of the
other Members.
Section 9. Term of Agreement.
This Agreement commences on the Effective Date and remains in effect until all current
Members determine in writing to terminate this Agreement.
Section 10. Member Representative.
Each Member will designate a representative who has the authority to act on the matters
provided in this Agreement.
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Emergency Medical Services
Mutual Aid Agreement
IN WITNESS WHEREOF, each Member has caused this Agreement to be signed by its
properly authorized representative as of the Effective Date or as of the date of approval of
membership, as the case may be.
Villaize of Elk Grove Village
Signature:
Printed Name:
Designated Rep:
Date:
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Emergency Medical Services
Mutual Aid Agreement
EXHIBIT A
Emergency Medical Services
Mutual Aid Agreement
NEW MEMBER STATEMENT
As provided in Subsection 713 of the Emergency Medical Services Agreement dated as of
October , 2019, (the "Agreement") the [Insert Name Of New Member] (the "New Member").
requested membership in the Agreement by sending a written request for membership to each
current Member. The current Members approved the request.
The New Member has read, and understands, the Agreement. The New Member agrees to
abide by all of the provisions of the Agreement and to faithfully discharge the responsibilities of a
Member stated in the Agreement. In particular, the New Member pledges that it (A) will comply
with all applicable provisions of the Anti -Kickback Statute and the OIG Rule as defined and stated
in Section 6 of the Agreement and (B) will heed the provisions of the Anti -Kickback Statute and
the OIG Rule regarding safe harbors.
The New Member represents that the person signing this Statement on behalf of the New
Member has been properly authorized by the New Member to sign this Statement and to bind the
New Member to the provisions of the Agreement.
New Member Name:
Signature:
Printed name:
Designated Representative:
Date:
New Member Representative
20
The New Member has designated the following person to be its representative:
Name:
Title:
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