Hospital Council of San Francisco
Inter-Hospital Mutual Aid Memorandum of Understanding (“MOU”)
I. SCOPE AND APPLICABILITY
The Participants agree that in the event of a declared or undeclared event affecting hospital services as a result of natural, man-made or technological causes or a mass casualty incident, which exceeds the effective response capabilities of the impacted health care facility or facilities (hereinafter “Disaster”), the affected Participant may request assistance from the other Participants as is more generally set forth herein.
In the event of a Disaster, an affected Participant should first contact the other Participants. If the Disaster is broader than the Participants determine they can handle by working together, they will contact the San Francisco Department of Public Health and other agencies as appropriate. The Participants will use the guidelines established herein to coordinate the care and services necessary to deal with the Disaster.
Each Participant agrees to take action during a Disaster without regard to race, color, creed, national origin, age, sex, gender orientation, religion, or handicap to assist the affected Participant as necessary. No Participant shall be required to provide treatment, care, medical supplies, equipment, services or personnel beyond its own resources.
In the event that the affected Participant is unable to continue patient care for some or all of its patients, the other Participants agree to make reasonable efforts to accept a transfer of these patients.
Each Participant agrees to use best efforts to follow the guidelines set forth herein. There shall be no cause of action or basis of liability for breach of this MOU by any Participant(s) against any other Participant(s) or by any third-party against Participants.
This MOU is not intended to replace each Participant’s Disaster Plan or to affect adversely existing transfer agreements between Participants, but is intended to support those plans and agreements. Each Participant shall incorporate this MOU into its disaster plan consistent with the principles agreed to herein.
II. GUIDELINES
A. EMERGENCY TREATMENT
Each Participant agrees to provide assistance, as available within its reasonable capabilities, including:
1) Accepting as many casualties/patients.
2) Accepting as many transfers.
3) Providing emergency treatment/care.
4) Providing emergency physician and medical support services and personnel.
5) Providing diagnostic services.
6) Assisting in placing casualties/transfers.
7) Facilitating transportation as available and requested by other Participants.
8) Notifying the Participants when vacancies no longer exist.
9) Sending identifying administrative, medical and related information as may be necessary for the care of the transferred patient to the receiving healthcare facility at the time of transfer.
10) Providing other medical services that may be necessary and requested.
B. EMERGENCY MEDICAL SUPPLIES AND EQUIPMENT
A Participant shall provide emergency medical supplies and equipment within resource capabilities. The Participant will provide instructional material and product information about such supplies and equipment as appropriate.
C. COST OF SERVICES, EQUIPMENT AND PERSONNEL
A Participant receiving services, equipment and personnel will replace or reimburse for the actual costs of such services, equipment and personnel to each Participant providing services, equipment and personnel. Each participant will keep records for accurate accounting of such services, equipment and personnel. Receiving Participant will make reimbursement within ninety days following receipt of invoice.
D. ADMINISTRATIVE SERVICES
A Participant will provide the following administrative services for themselves and will assist other Participants by:
1) Maintaining a current listing of all casualties or transfers made to and from the Participant’s facility.
2) Maintaining a current listing of all discharges, their assigned areas and locations.
3) Maintaining a current listing of all deaths at the Participant’s facility.
4) Notifying the other Participants when patients or personnel can be returned to their facility.
5) Furnishing other information or record keeping, as may be requested or deemed necessary by the Participant, to the extent disclosure is allowed by applicable laws.
6) Maintaining a record of all treatment administered, including medical supplies, and charges made.
7) Notifying attending physicians of the disaster and disposition of their patients.
8) Contacting family members of patients and informing them of the disposition of their relative.
E. COMMUNICATION SERVICES
In the event the Participants’ normal lines of communication are disrupted, other
Participants, as feasible, will:
1) Monitor Emergency Department 800 MHz radios and the EM system for emergency information transmitted.
2) Communicate amongst themselves and with the San Francisco County DPH, including relaying information and requests for other facilities, if needed.
3) Notify local fire, police and other municipal services.
III. EFFECTIVE DATE, FUTURE AMENDMENT AND CONSTRUCTION
This MOU shall become effective on July 1, 2008. A Participant may terminate its participation in this MOU by giving a sixty (60) day written notice to the other Participants of its intentions to so terminate.
This MOU shall be reviewed periodically to ensure that it meets the needs of the Participants.
The Participants, through the Hospital Council of San Francisco’s Emergency Preparedness Task Force, shall develop operational procedures, forms and other tools to operationalize this MOU. Updates to those procedures, forms or tools do not require revision of this MOU.
Participation by the Department of Veterans Affairs is limited by certain statutory obligations that take precedence over the responsibilities under this Mutual Aid MOU. The Stafford Act (42 U.S.C. 5121 et seq) requires the Federal Government to respond to major disasters and emergencies initiated by Presidential declaration and may direct any Federal agency to use its authorities and resources to support State and local assistance efforts. The FEMA Interim Federal Response Plan [42 U.S.C. 5170a(1) and 5192(a)(1); Executive Orders 12148, 12673] requires Federal agencies to respond to the FEMA Director's request to provide assistance to support State and local efforts. The VA's ability to assist the local facility under this MOU is also subject to participation in the National Disaster Medical Systems, which provides resources for natural and man-made disasters and supports patient treatment requirements for armed conflict. Under 38 USC 8111(a)(1), the Secretary of Veterans Affairs is required to maintain a contingency capacity of hospital beds to assist the Department of Defense in a time of war or national emergency. Finally, 38 USC 1784 requires VA to assist non-veteran patients referred to a VA facility on a humanitarian basis outside the Stafford Act.
This MOU is in no way meant to affect any of the Participants’ rights, privileges, titles, claims, or defenses provided under federal or state law or common law.
This MOU shall be governed under Federal and California law. To the extent there is conflict between Federal and California Law, Federal Law will apply. This MOU may be amended upon written consent of the Participants. This MOU contains the entire agreement of the subject matter contained herein and shall give rights to no other parties except where expressly stated. In the event a court of competent jurisdiction deems one or more provisions invalid, the remaining provisions shall remain in full force and effect. Waiver of any breach shall not operate to be a waiver of any other or subsequent breach. The Participants shall maintain the confidentiality of patient and other records as required by law.
IN WITNESS WHEREOF, the undersigned hereby agrees to be a participant under this agreement.Date: June 16, 2008
______
MARTIN BROTMAN, M.D. PRESIDENT and CEO
CALIFORNIAPACIFICMEDICALCENTER
______
BRENDA YEE, CEO
CHINESEHOSPITAL
______
JOHN KANALEY, EXECUTIVE ADMINISTRATOR
LAGUNA HONDA HOSPITAL
______
CHRISTINE ROBISCH, CEO/SENIOR VICE PRESIDENT
KAISER SAN FRANCISCO
______
THOMAS HENNESSY, PRESIDENT/CEO
SAINT FRANCIS MEMORIAL HOSPITAL
______
GENE MARIE O’CONNELL, EXECUTIVE ADMINISTRATOR
SAN FRANCISCO GENERALHOSPITAL
______
ANNA CHEUNG, INTERIM PRESIDENT
ST. MARY’S MEDICALCENTER
______
MARK LARET, CEO
UCSFMEDICALCENTER
______
EZRA R. SAFDIE, ACTING DIRECTOR
VETERANSAFFAIRSMEDICALCENTER
1