HomeMy WebLinkAboutRESOLUTION - 16-20 - 3/10/2020 - Letter of Committment Northwest Community EMS System(NWCEMSS)RESOLUTION NO. 16-20
A RESOLUTION AUTHORIZING THE VILLAGE OF ELK GROVE FIRE CHIEF TO
EXECUTE A LETTER OF COMMITMENT WITH THE NORTHWEST COMMUNITY
EMS SYSTEM CONFIRMING THE ELK GROVE VILLAGE FIRE DEPARTMENT AS A
PARTICIPATING EMS TRANSPORT VEHICLE PROVIDER IN THE NORTHWEST
COMMUNITY EMS SYSTEM (NWCEMSS)
WHEREAS, in compliance with the Illinois Department of Public Health Rules and
Regulations and the EMS Act — PA 81-1518, this document is provided to reaffirm the commitment
of the Village of Elk Grove and its Fire Department to continue participation in the Northwest
Community Hospital Emergency Medical Services System (NWCEMSS); and
WHEREAS, the Elk Grove Village Fire Department provides a municipally funded and
operated Advanced Life Support ambulance service. This service is provided 24 hours of every day
and assures that at least two (2) paramedics function at the scene of all Advanced Life Support calls.
This service also provides this staffing en route to the hospital; and
WHEREAS, provision of this service is done on a per need basis without regard to the
patient's ability to pay. Access to the service is gained primarily by telephone through the 9-1-1
system as the number to call for emergency medical service; and
WHEREAS, the Elk Grove Village Fire Department is committed to and provides response
times within the required 4-6 minute optimum. Dispatching of these units is provided through
Northwest Central Dispatch (NWCDS). Methods of dispatch, area coverage and mutual aid backup
systems are provided for in standard operating procedures and appropriate signed agreements with
mutual aid agencies; and
WHEREAS, all ambulances operated by the Elk Grove Village Fire Department comply with
State of Illinois standards for EMS vehicle service providers. The equipment, supplies, drugs and
biologics required by the hospital EMS system Standard Drug and Supply list is maintained in each
of three (3) front line ambulances as well as backup units; and
WHEARAS, these vehicles meet design and equipment standards as referenced in the Illinois
Emergency Medical Services Act. The requirements for rescue and extrication capabilities are met
by simultaneous response of other Fire Department vehicles. These vehicles carry a full
complement of rescue and extrication equipment and trained personnel; and
WHEREAS, communications equipment has two-way ambulance to hospital capability and
operators receive instruction and continuing education in the operation and utilization of all radio
and communication devices available. This training includes utilization of proper radio technique,
unit identification and conformance to standard operating procedures; and
WHEREAS, the Paramedic is required to establish communications with the resource or an
associate hospital in order to initiate ALS treatment. In the event that communication cannot be
established, EMS personnel are committed to proceed with system SOP's as developed by the EMS
System Director. These SOP's, the provisions of the Illinois EMS Act, IDPH Rules and Regulations
and the Northwest Community Hospital EMS System Policy Manual form the framework and
guidelines of the Elk Grove Village Fire Department commitment to medical ambulatory transport
and care; and
WHEREAS, the Elk Grove Village Fire Department is committed to fulfilling the reporting
and data collection requirements of the system. This includes filing of the appropriate EMS reports
in accordance with the Illinois EMS Act, IDPH Rules and Regulations, and NWCEMSS policies and
procedures.
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 Fire Chief be and is hereby authorized to sign the attached Letter of
Commitment to continue participation in the Northwest Community Hospital EMS System
(NWCEMSS).
Section 2: That this Resolution shall be in full force and effect from and after its passage and
approval according to law.
VOTE: AYES: 5 NAYS: 0 ABSENT: 1
PASSED this loth day of March 2020.
APPROVED this loth day of March 2020.
APPROVED:
Mayor Craip, B. Johnson
Village of Elk Grove Village
ATTEST:
Loretta M. Murphy, Village Clerk
r State of Illinois Emergency Medical Services (EMS) Systems
i Illinois Department of Public Health Vehicle Service Provider
0
Letter of Commitment
Resource Hospital Name Northwest Community Hospital
Mailing Address 800 W. Central
City Arlington Heights State Illinois ZIP Code 60005
Vehicle Service Provider Name Elk Grove Village Fire Department
Provider Number 09-8-183
Emergency Contact Name B/C Michael Sharp
EMS System Northwest Community EMS System (0907)
Cell Phone 847- 734- 8022 E-mail Address msharp@elkgrove.org
This letter shall serve as a commitment by as a participating EMS Provider in Northwest Community EMS System (0907).
As outlined in Section 515.810 and 515.8130 of the EMS rules and regulations, I/we commit to the following:
The following information is attached:
• List of all vehicles, including year, model, make, VIN number, license plate number, department license number, base location and
level of service;
• Description of the vehicles role in providing pre -hospital care and patient transport services;
• Definition of primary, secondary and outlining areas of response for each EMS vehicle;
• Map (s) indicating the base locations of each EMS vehicle, the population base of each service area and square mileage of service
area;
• Copies of mutual aid agreements with other providers and/or a descridtion of own back-up system which details adequate
coverage when an EMS vehicle is responding to a call and a simultaneous call is received for service within that vehicles coverage
area;
• Copy of current FCC license; and
• List of all personnel providing pre -hospital care and level of Iicensure (only copy of highest level of licensure), license numbers and
expiration dates.
• Agree to not operate any of our ambulance(s) at a level exceeding the level for which it is licensed (basic life support, intermediate
life support, advanced life support), unless the vehicle is operated pursuant to an EMS System approved in -field service level
upgrade or ambulance service upgrades— rural population.
• Provide 24-hour, seven -day -a -week coverage at our highest level of care. (check all that apply)
❑ Alternate Rural Staffing has been authorized by the EMS System and submitted to the Department
❑ Each CCT ambulance during the provision of Tier 11 and/oi• Tier III services shall be staffed with the minimum requirements
(i Ambulance Assistance Vehicles, which are dispatched simultaneously with an ambulance and assist with patient care prior
to the arrival of the ambulance (Ambulance assistance'vehicles shall not function as assist vehicles if staff and equipment
required by this Section are not available).
Non -Transport Vehicles, which are dispatched prior to dispatch of a transporting ambulance and include ambulances and
fire engines that contain the staff and equipment by this section
• Agree to promptly & completely document an appropriate run report and submit data according to most current version of
NEMSIS, i.e. NEMSIS 3 for each emergency call, as required by the EMS System & IDPH.
• Agree that emergency services which an EMS vehicle is authorized to provide shall not be denied on the basis of patient's
ethnicity, gender, creed, nationality, religious beliefs, sexual preference, or ability to pay for such services.
• Agree to continuously carry and maintain all of the required equipment in working order at all times, and to carry and properly
store medications and equipment required by the EMS System. .
• Agree to notify the EMS Medical Director of any changes in personnel providing pre -hospital care in the EMS System in accordance
with the policies In the EMS manual.
Page 1 of 3 100 19-348 O
+ State of Illinois
Emergency Medical Services (EMS) Systems
Illinois Department of Public Health Vehicle Service Provider
Letter of Commitment
• Agree to continuously follow all of the approved EMS policies and protocols of the EMS System.
• Agree to maintaining the optimum response times up to six minutes in primary coverage areas, six to 15 minutes in secondary
coverage areas, and 15 to 20 minutes in outlying coverage areas;
As outlined in Section 515.400 General Communications d), I/we commit to:
• Have continuous two-way ambulance -to -hospital communications capability on a frequency determined and assigned by the
Department.
• Comply with the Resource Hospital's communication plan.
As outlined in Section 515.350 Data Collection and Submission a)1 and 2), I/we commit to:
• Completing a run report for every emergency pre -hospital or inter -hospital transport and for refusal of care;
•. Agree to leave one copy, paper or electronic, with the receiving hospital emergency department, trauma center or health care
facility before leaving their facility.
By signing below, the Ambulance Provider fully commits to complying with all applicable requirements of the EMS Act, Code and the EMS
System Program Plan, as all may be amended from time to time.
A fully executed copy is forthcoming for the file.