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AGREEMENT
THIS AGREEMENT is made and entered into this 1st day of November,2003,by and
between the COUNTY OF FRESNO,a Political Subdivision of the State of California,hereinafter3
4 referred to as "COUNTY",and Fresno Community Hospital and Medical Center doing business as
University Medical Center whose address is 445 S.Cedar Avenue,Fresno,hereinafter referred to as5
6 "CONTRACTOR".
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RECITALS
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The CONTRACTOR location University Medical Center located at 445 S.Cedar Avenue,Fresno
is the location which service under this agreement are to take place.The CONTRACTOR is duly
licensed in the State of California.
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CONTRACTOR and COUNTY desire to enter into this Agreement in order to set forth the
arrangements for legal blood draws as requested by the California Highway Patrol (CHP)from persons
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brought to the CONTRACTOR by CHP who were arrested pursuant to Vehicle Code sections 23103,
23104,23152 and 23153 in the unincorporated area of the COUNTY.Blood draw services performed
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by the CONTRACTOR pursuant to CHP arrests made in the incorporated areas of the COUNTY (e.g.
municipalities)shall be billed by the CONTRACTOR to the incorporated entity wherein the CHP arrest
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occurred,not the COUNTY District Attorney.
I.AGREEMENT
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20 A.Services -CONTRACTOR shall provide the blood draws ("Services")in
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accordance with the CONTRACTOR's Legal Blood Draw Request by California Highway Patrol Policy,
attached hereto as Exhibit A and made part of this Agreement,for those patient's brought to
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CONTRACTOR by CHP.In the event,the patient is not admitted to CONTRACTOR for further
treatment,CHP shall be responsible for arranging for patient's transportation to a location outside of the
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CONTRACTOR's campus after completion of the blood draw.
B.Exhibit A,the consent statute Vehicle Code Section 23612,Title 17,California Code
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of Regulations,Sections 1219 and 1219.1 and pursuant to the law enforcement officer's right to conduct
reasonable searches.
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1.In all cases,CHP must request the Services in writing from CONTRACTOR.
The Law Enforcement Request attached hereto as Exhibit B will be used for
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this purpose.
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2.CHP may use reasonable force,in accordance with the law,on persons
arrested for Vehicle Code sections 23103,23104,23152 and 23153 in order
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to obtain a blood sample (for example,by holding the subject or the subject's
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arm),but may not use violence,beatings,or any excessive or unreasonable
force.
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C.Performance -CONTRACTOR agrees to perform the Services in compliance with all
applicable governmental laws and regulations and in accordance with all applicable CONTRACTOR
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standards and requirements of the Joint Commission on Accreditation of Health Care Organizations.
1.CONTRACTOR shall furnish personnel,space,equipment and supplies,all as
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are reasonably necessary for the proper and efficient operation and conduct of
the Services and in accordance with normal and customary practices.
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18 2.Notwithstanding the above,CONTRACTOR personnel may decline to
withdraw blood if the subject refuses to consent or is violent or struggling and19
20 the CONTRACTOR personnel feels his/her safety and/or wellbeing are
threatened.21
22 D.Compensation/lnvoicina -COUNTY agrees to pay CONTRACTOR and
CONTRACTOR agrees to receive compensation as follows:CONTRACTOR shall submit monthly23
24 invoices to the County of Fresno,District Attorney.Invoices shall include a Legal Blood Draw Request
Form completed and signed by the arresting CHP officer noting that the arrest occurred in the25
26 unincorporated area of the County of Fresno.COUNTY shall pay CONTRACTOR in accordance with
Exhibit C,attached hereto and incorporated herein by this reference,for Services rendered.27
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Blood draw services provided to the CHP by CONTRACTOR as a result of CHP
arrests made pursuant to Vehicle Code sections 23103,23104,23152,and 23153,shall be billed to the
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COUNTY District Attorney when said arrests are made in the unincorporated area of the COUNTY.
Blood draw services performed by the CONTRACTOR pursuant to CHP arrests made in the
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incorporated areas of the COUNTY (e.g.municipalities)shall be billed by the contractor to the
incorporated entity wherein the CHP arrest occurred,not the COUNTY District Attorney.
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In no event shall the total cost of services performed under this Agreement be in
excess of eighty-five thousand dollars ($85,000.00)for anyone year period during the term of this
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Agreement.It is understood that all expenses incidental to CONTRACTOR'S performance of services
under this Agreement shall be borne by CONTRACTOR.
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II.GENERAL PROVISIONS
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A.Term of AQreement -This Agreement shall be in effect once signed by both parties
and for a term of one year and shall thereafter automatically renew for successive one-year terms
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subject to the termination provisions set forth herein.This agreement shall cover invoices dated April 1,
2003 through March 31,2004.This Agreement may be terminated by either party upon thirty (30)days
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prior notice with or without cause.
B.Entiretv -This Agreement,together with all attachments hereto,constitutes the sole
and entire Agreement between the parties regarding the subject matter hereof and shall supersede any19
20 and all other agreements between the parties.The Parties acknowledge and agree that neither of them
have made any representations with respect to the subject matter of this Agreement,or any21
22 representation inducing the execution and delivery hereof except such representations as are
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specifically set forth herein and each of the parties hereto acknowledges that such party has relied on
such party's own judgment in entering into the same.
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C.Waiver -It is agreed that no waiver or modification of this Agreement or of any
covenant,condition or limitation herein contained shall be valid unless in writing and duly executed by
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both the COUNTY and the CONTRACTOR.
D.Non-Allocation of Funds -The terms of this Agreement,and the services to be
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provided thereunder,are contingent on the approval of funds by the appropriating government agency.
Should sufficient funds not be allocated,the services provided may be modified,or this Agreement
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terminated,at any time by giving the CONTRACTOR thirty (30)days advance written notice.
E.Independent Contractor -In performance of the work,duties and obligations assumed
by CONTRACTOR under this Agreement,it is mutually understood and agreed that CONTRACTOR,5
6 including any and all of the CONTRACTOR'S officers,agents,and employees will at all times be acting
and performing as an independent contractor,and shall act in an independent capacity and not as an7
8 officer,agent,servant,employee,joint venturer,partner,or associate of the COUNTY.Furthermore,
COUNTY shall have no right to control or supervise or direct the manner or method by which9
10 CONTRACTOR shall perform its work and function.However,COUNTY shall retain the right to
administer this Agreement so as to verify that CONTRACTOR is performing its obligations in11
12 accordance with the terms and conditions thereof.
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CONTRACTOR and COUNTY shall comply with all applicable provisions of law and the
rules and regulations,if any,of governmental authorities having jurisdiction over matters the subject
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thereof.
Because of its status as an independent contractor,CONTRACTOR shall have
absolutely no right to employment rights and benefits available to COUNTY employees.CONTRACTOR17
18 shall be solely liable and responsible for providing to,or on behalf of,its employees all legally-required
employee benefits.In addition,CONTRACTOR shall be solely responsible and save COUNTY harmless19
20 from all matters relating to payment of CONTRACTOR'S employees,including compliance with Social
Security withholding and all other regulations governing such matters.It is acknowledged that during the21
22 term of this Agreement,CONTRACTOR may be providing services to others unrelated to the COUNTY
or to this Agreement.23
24 F.Severability -If any provision of this Agreement is declared illegal or unenforceable,
the other provisions of this Agreement shall remain in full force and effect.25
26 G.Assiqnment -Nothing contained in this Agreement shall be construed to permit the
assignment or delegation by CONTRACTOR or COUNTY of any rights or obligations hereunder and27
28 such assignment and delegation are expressly prohibited.
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H.Warranty of Authoritv-The Parties warrant that they have the full power and
authorityto enter intothis Agreement,that all requiredcorporateactionhas been duly taken in
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connection herewith,and that upon execution of this Agreement shall become a binding obligation of
each Party enforceable in accordance with its terms and applicable law.
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I.Breach of Contract -The COUNTY may immediately suspend or terminate this
Agreement in whole or in part,where in the determination of the COUNTY there is:
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1)
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An illegal or improper use of funds;
A failure to comply with any term of this Agreement;
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A substantially incorrect or incomplete report submitted to the COUNTY;
Improperly performed service.
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In no event shall any payment by the COUNTY constitute a waiver by the COUNTY
of any breach of this Agreement or any default which may then exist on the part of the CONTRACTOR.
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Neither shall such payment impair or prejudice any remedy available to the COUNTY with respect to the
breach or default.The COUNTY shall have the right to demand of the CONTRACTOR the repayment to
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the COUNTY of any funds disbursed to the CONTRACTOR under this Agreement,which in the
judgment of the COUNTY were not expended in accordance with the terms of this Agreement.The
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CONTRACTOR shall promptly refund any such funds upon demand.
J.Non-AssiQnment -Neither party shall assign,transfer or sub-contract this Agreement
nor their rights or duties under this Agreement without the prior written consent of the other party.19
20 K.Audits And Inspections -The CONTRACTOR shall at any time during business hours,
and as often as the COUNTY may deem necessary,make available to the COUNTY for examination all21
22 of its records and data with respect to the matters covered by this Agreement.The CONTRACTOR
shall,upon request by the COUNTY,permit the COUNTY to audit and inspect all of such records and23
24 data necessary to ensure CONTRACTOR'S compliance with the terms of this Agreement.
L.GoverninQ Law -Venue for any action arising out of or related to this Agreement shall25
26 only be in Fresno County,California.
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M.Indemnification and Hold Harmless:
1.COUNTY shall indemnify and hold harmless CONTRACTOR,the
CONTRACTOR governing body,and CONTRACTOR's employees and3
4 agents,from any and all liability,claims,damages,costs and expenses,
caused by or resulting from the negligent or intentional acts or omission of5
6 COUNTY or any of COUNTY's employees.
2.CONTRACTOR shall indemnify and hold harmless COUNTY from any and all7
8 liability,claims,damages,costs and expenses,caused by or resulting from
the negligent or intentional acts or omission of CONTRACTOR or9
10 CONTRACTOR's employees.
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12 N.NOTICES -The persons and their addresses having authority to give and receive
notices under this Agreement include the following:13
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If to CONTRACTOR:If to COUNTY:
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Christine Darmanian Elizabeth A.Egan
District AttorneyDirector,Laboratory Services
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P.O.Box 1232 2220 Tulare Street,Suite 1000
Fresno,CA 93721Fresno,CA 93715-1232
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Any and all notices between the COUNTY and the CONTRACTOR provided for or
permitted under this Agreement or by law shall be in writing and shall be deemed duly served
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when personally delivered to one of the parties,or in lieu of such personal services,when
deposited in the United States Mail,postage prepaid,addressed to such party.
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Exhibit "A"
COMMUNITY MEDICAL CENTERS
LEGAL BLOOD DRAW REQUEST BY CALIFORNIA HIGHWAY PATROL
PURPOSE:
To obtain blood for legal purposes at the request of California Highway Patrol (CHP)for persons
brought to the hospital.Blood for medical testing purposes will be drawn by licensed staff or
phlebotomy staff.
POLICY:
A.Blood drawn at the request of CHP shall be performed by an RN,LVN,or lab phlebotomist.
B.The same standards in this policy apply whether the patient is or is not in the custody of
CHP.
C.To ensure the patient's rights are followed according to California State law.
D.To ensure a chain of possession for legal action if necessary for patient or authorities.
EQUIPMENT:
.Povidone iodine pledget (not swab)or benzalkonium chloride pledget (no alcohol)
.Gauze sponges
.Gray top tube/s supplied by CHP
.Venipuncture supplies
"Legal"blood analysis specimen container supplied by CHP.
PROCEDURE:
A.CHP officer is responsible for initiating Community "Legal Blood Draw Request Form,"
completing top section "Law Enforcement Request",indicating where the arrest occurred
(incorporated or unincorporated area of the COUNTY)and advising patient of legal
implications.If CHP officer is not willing to complete the Request form,no blood draw will be
performed.
B.CHP must be in attendance throughout entire procedure.
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C.Patient should sign "Legal Blood Draw Request Form"under the consent section.If patient
submits to the blood draw but refuses to sign,staff will check box on form and sign as
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witness.
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D.Procedure is strictly voluntary between the patient (suspect)and the CHP.If the patient does
not consent and the CHP officer (not hospital staff)chooses to apply force he/she identifies
as reasonable to obtain patient compliance in a patient offering manageable resistance,staff
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may perform venipuncture.
E.No blood should be drawn by hospital staff if the patient is violent or forcibly resists the
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procedure.
F.Notwithstanding the foregoing,staff members reserve the right to withdraw participation in
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the procedure if their personal safety cannot be reasonably assured by CHP officer(s)
holding the patient.For purposes of this policy,risk of personal exposure to an uncapped
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needle to complete the procedure shall be deemed unreasonable and thus grounds for staff
to refuse to complete the requested blood draw.Likewise staff is not legally obligated to
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perform the procedure regardless of the insistence of the CHP officer if the personal safety of
the staff or the patient would be compromised due to the patient's forcible resistance.
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G.The staff may refuse to draw blood if any of the following conditions apply:
.Staff feels concern for their own safety due to a combative patient.
patient is a hemophiliac19
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.patient is affected with a heart condition and is using anticoagulants
the procedure,at the staff member's discretion,may jeopardize the patient's21
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health
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H.The staff will annotate on the request form the reason for not drawing the specimen.This
decision will be made without any retribution from the CHP officer.Once this decision is
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made,the CHP officer will not threaten or intimidate the staff to do the procedure.The
charge nurse,Hospital Supervisor,and,as appropriate,the Administrator on call should be
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notified of the incident.Administrator on call may involve Legal Services at their discretion.
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I.Explain procedure to patient.
J.Cleanse venipuncture site.
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K.Obtain requested number of gray top tube/so
L.Initial and lor sign blood tube label/s,Legal Blood Draw Request Form and legal blood
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analysis envelope as indicated.
M.Hand sample/s directly to CHP officer.
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8 DOCUMENTATION:
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1.Document that blood was drawn for legal purposes at request of CHP.
2.Documentskin prepof povidoneiodineor benzalkoniumchloride-alcohol free product.
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3.Complete Statement of Person Withdrawing the Blood on the Legal Blood Draw Request Form.
4.Retain original Legal Blood Draw Request Form in patient's chart or laboratory.
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5.Give copy of Legal Blood Draw Request Form to CHP Officer.
6.Document specimen given to CHP Officer,including name and badge number.
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EXHIBIT B
Legal Blood Draw Request Form (attached)
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