HomeMy WebLinkAboutFIR 02-25Report to
Executive Committee
Report Number: FIR 02-25 Date: January 13, 2025
From: Steve Boyd
Fire Chief
Subject: Agreement to Provide Medical Oversight Services
- Lakeridge Health Central East Prehospital Care Program (CEPCP) - File: A-1440-001-25
Recommendation:
1. That Report FIR 02-25, regarding the Agreement to provide Medical Oversight Services between The Corporation of the City of Pickering and Lakeridge Health, be received; 2. That the Mayor and City Clerk be authorized to execute the Agreement with Lakeridge
Health to provide Medical Oversight Services to the City of Pickering, as set out in
Attachment 1 of this report, subject to such revisions as may be required by the Fire Chief and the Director, Corporate Services & City Solicitor; and, 3. That the appropriate City of Pickering officials be authorized to take the necessary
actions to implement the recommendations in this report.
Executive Summary: The purpose of this report is to seek Council’s approval to extend
the Agreement, as set out in Attachment 1, between the City of Pickering and Lakeridge Health
to provide Medical Oversight Services that include training of Pickering Fire Services staff and defibrillator maintenance and calibration.
This is a three-year extension of an existing agreement between both parties that provides the required training and certification to Pickering Fire Services staff responding to a range of
medical calls.
Relationship to the Pickering Strategic Plan: The recommendations in this report respond
to the Pickering Strategic Plan Priority of Advocate for an Inclusive, Welcoming, Safe &
Healthy Community; and Strengthen Existing & Build New Partnerships.
Financial Implications: The agreement’s total annual cost is estimated to be $45,500.00
per year and the cost is included in the Mayor’s proposed 2025 Current Budget for Fire Protection (10700). The funds for Emergency Medical Response Training are budgeted under 501110.10700 at $35,000.00 and the funds for Defibrillator Maintenance are budgeted under 502380.10700 at $10,000.00.
FIR 02-25 January 13, 2025
Subject: Agreement to Provide Medical Oversight Services Page 2
Schedule C – Fees & Payment for Services in Attachment 1 indicate that costs will remain fixed for the duration of this agreement.
Discussion: The purpose of this report is to seek Council’s approval to extend the Agreement, as set out in Attachment 1, between the City of Pickering and Lakeridge Health to
provide Medical Oversight Services that include training of Pickering Fire Services staff and
defibrillator maintenance and calibration.
Pickering Fire Services staff respond to a range of medical calls, including but not limited to, cardiac arrest, VSA (vital signs absent), uncontrolled bleeding, unconscious individuals, motor vehicle accidents, and other medical emergencies as required. Through these responses, Fire
Services staff utilize the skills they have acquired through EMR Direct Delivery Program
training in first aid, CPR, AED (automatic external defibrillator) use, and symptom relief (epi-pen and Naloxone) administration.
Fire Services staff are required to recertify in these areas on an annual basis and must be signed off under the medical oversight of the Physician heading the Lakeridge Health Central
East Prehospital Care Program. Lakeridge Health CEPCP provides training and oversight to all
Pickering Fire Services staff on an annual basis, and also provide training to all new hires with Fire Services.
This agreement provides a three-year extension to the agreement currently in place.
Attachment:
1.Agreement to Provide Medical Oversight Services January 1, 2025 to December 31, 2027.
Prepared By: Approved/Endorsed By:
Jason Yoshida Steve Boyd Deputy Fire Chief Fire Chief
SB:jm
Original Signed By:Original Signed By:
FIR 02-25 January 13, 2025
Subject: Agreement to Provide Medical Oversight Services Page 3
Recommended for the consideration of Pickering City Council
Marisa Carpino, M.A. Chief Administrative Officer
Original Signed By:
Agreement to Provide Medical Oversight Services
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Agreement to Provide
Medical Oversight
Services
Between
The Corporation of the City of Pickering
and
Lakeridge Health
January 1st 2025 to December 31st 2027
Attachment 1 to Report FIR 01-25
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Contents
1. RECITALS......................................................................................................................................... 3
2. DEFINITIONS.................................................................................................................................... 3
3. INTERPRETATION ........................................................................................................................... 6
4. AGREEMENT.................................................................................................................................... 7
5. MEDICAL EDUCATION .................................................................................................................... 8
6. MEDICAL ADVICE RELATING TO PATIENT CARE ....................................................................... 8
7. TRAINING ......................................................................................................................................... 8
8. AUTHORIZATION AND RE-AUTHORIZATION ............................................................................... 9
9. QUALITY ASSURANCE ................................................................................................................. 10
10. INFORMATION SHARING.............................................................................................................. 11
11. SUPPLIES AND EQUIPMENT........................................................................................................ 12
12. RESEARCH .................................................................................................................................... 12
13. INSURANCE AND INDEMNIFICATION ......................................................................................... 12
14. TERM AND TERMINATION............................................................................................................ 14
15. GENERAL PROVISIONS................................................................................................................ 15
16. RESPONSIBILITIES……………………………………………………………………………………...19
SCHEDULE A - Designated Representatives............................................................................................. 20
SCHEDULE B – Training Programs ........................................................................................................... 21
SCHEDULE C – Fees & Payment for Services .......................................................................................... 21
SCHEDULE D – Quality Assurance............................................................................................................ 23
SCHEDULE E – Controlled Acts and Advanced Medical Procedures ....................................................... 24
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AGREEMENT
BETWEEN:
The Corporation of the City of Pickering (“Pickering”)
– and –
Lakeridge Health (“LH”)
1. RECITALS
WHEREAS “Pickering” provides patient care when “Pickering” is called to provide assistance to the
residents of the City of Pickering;
AND WHEREAS “Pickering” and the Central East Prehospital Care Program (“CEPCP”) located at LH
wish to enter into an agreement for the provision of Medical Oversight subject to and in accordance
with the terms and conditions set out below.
NOW THEREFORE in consideration of the respective covenants and agreements contained in this
AGREEMENT and for other good and valuable consideration, the receipt and sufficiency of which the
parties acknowledge, “Pickering” and LH hereby agree as follows:
2. DEFINITIONS
In this AGREEMENT, in addition to the terms defined above, the following terms shall, unless the context
otherwise requires, have the respective meanings set out below:
a. “AED” means Automated External Defibrillation.
b. “AGREEMENT” means this agreement as the same may be amended or restated from time to
time and includes all schedules and all uses of the words “hereto”, “herein”, “hereof”, ‘hereby” and
“hereunder” and similar expressions refer to this AGREEMENT and not to any particular section
or portion of it.
c. “Applicable Law” at any time and in respect of any Person, property, transaction or event,
means all laws including statutes, regulations, treaties, judgments and decrees then applicable to
that Person, property, transaction or event and, whether or not having the force of law, all
applicable official directives, rules, consents, approvals, authorizations, guidelines, bulletins,
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orders and policies of any Governmental Authority then having or purporting to have authority
over that Person, property, transaction or event.
d. “Approved” means something that has been reviewed and/or sanctioned by LH.
e. “Business Day” means any day other than a Saturday, Sunday or any statutory or civic holiday
observed by one or both Parties.
f. “Call Report” means a record of patient care in paper or electronic form.
g. “Case Review” means the routine review of call reports submitted by “Pickering” and performed
by LH.
h. “CEPCP Standards” means the standards of CEPCP related to the provision of Medical
Oversight and prehospital emergency care developed by the Medical Advisory Board of the
CEPCP and based on best practices and evidenced based medicine.
i. “CME” means continuing medical education that is provided to the individual firefighter.
j. “Controlled Act” has the meaning ascribed to it in the Regulated Health Professions Act, 1991,
(Ontario), S.O. 1991, c.18.
k. “CPSO” means the College of Physicians and Surgeons of Ontario.
l. “CPR” means a potentially lifesaving procedure, that combines chest compressions and
ventilations to partially restore oxygenated blood flow to the essential organs.
m. “CPSO Policy” means the CPSO policy for the Delegation of Controlled Acts and Guidelines for
teaching Controlled Acts under Section 28 of the Regulated Health Professions Act, 1991 and
under the Medicine Act, 1991, S.O. 1991, c. 30.
n. “Data” has the meaning ascribed to it in Section 9 herein.
o. “Designated Representative” is the designated representative of a Party as set out in
SCHEDULE A .
p. “Direct delivery” is when the training program provided is delivered by staff of the CEPCP.
q. “EFR” Emergency First Responder is a program that authorizes a firefighter in CPR and the
Controlled Acts and Advanced Medical Procedures (SCHEDULE D ) following an initial 3 day
authorization course, completed online and in person. and maintains their authorization through
approximately 8 hours of CME delivered annually.
r. “EMR” Emergency Medical Responder is a program that authorizes a firefighter in CPR and the
Controlled Acts and Advanced Medical Procedures (SCHEDULE D ) following an initial 3 day
authorization course and maintains their authorization through approximately 16 hours of CME
delivered annually.
s. “Firefighter” is a person currently employed by “Pickering”, and has the meaning ascribed to it
under the Fire Protection and Prevention Act, 1997, S.O. 1997, c. 4.
t. “Governmental Authority” means any domestic or foreign government including any federal,
provincial, state, territorial or municipal government and any domestic or foreign government
agency, board, commission, tribunal or other authority exercising executive, legislative, judicial,
regulatory or administrative function of, or pertaining to, government.
u. “Host Hospital” means Lakeridge Health (LH).
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v. “Including” means “including without limitation” and shall not be construed to limit any general
statement which it follows to the specific or similar or matters immediately following it.
w. “Instructor” is a person trained and approved by CEPCP to deliver training.
x. “Investigation” means the process of review arising from a concern regarding patient care
provided by “Pickering”.
y. “Medical Advisory Board” means the Physicians that comprise the Medical Advisory Board of
the CEPCP that provides medical oversight.
z. “Medical Oversight” has the meaning described in section 4.2.
aa. “Medical Director” means a physician appointed to the Medical Advisory Board of the CEPCP.
bb. “Medical Education” has the meaning described in section 5.
cc. “Order” means a direction from a CEPCP Medical Advisory Board physician with legislative
ordering authority that permits performance of a procedure by another.
dd. “Paramedic” has the meaning ascribed to it under the Ambulance Act, R.S.O. 1990, c. A.19 and
any regulations thereunder;
ee. “Parties” means the “Pickering” and LH; and “Party” means either one of them.
ff. “Patient” is any person who has suffered a medical or traumatic emergency and receives medical
attention, care, or treatment by “Pickering”.
gg. “Person” shall be broadly interpreted and includes an individual, body corporate, partnership,
joint venture, trust, association, unincorporated organization, the Crown, any Governmental
Authority or any other entity recognized by law.
hh. “Personal Health Information” has the meaning ascribed to it in the Personal Health Information
Protection Act, 2004,(Ontario), S.O. 2004, c.3, Sch. A.
ii. “PHIPA” means the Personal Health Information Protection Act, 2004, (Ontario), S.O. 2004, c.3
Sch. A.
jj. “Pickering” means the fire and emergency services operated by “Pickering”
kk. “Purposes” has the meaning ascribed to it in Section 9.1.
ll. “Self delivered” is when the training program provided is delivered by CEPCP trained and
approved staff of the service named in this contract.
mm. “Standard First Aid” (SFA) means a standardized program approved by the Worker’s Safety
Insurance Board (WSIB) designed to provide immediate assistance to a person suffering illness or
injury
nn. “Standards” means all industry accepted standards of practice relating to the provision of
Medical Oversight and prehospital emergency care in the Province of Ontario.
oo. “Term” has the meaning ascribed to it in Section 14.
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3. INTERPRETATION
3.1. Statutes
Unless specified otherwise, reference in this AGREEMENT to a statute refers to that statute as
such statute may be amended from time to time, or to any restated or successor legislation of
comparable effect, and refers to any regulations then in force and effect thereunder.
3.2. Headings
The division of this AGREEMENT into articles, sections and schedules and the insertion of
headings are for convenience of reference only and shall not affect the construction or
interpretation of this AGREEMENT. The article, section and schedule headings in this
AGREEMENT are not intended to be full or precise descriptions of the text to which they refer
and are not to be considered part of this AGREEMENT. Reference to an Article, Section or
Schedule refers to the applicable article, section or schedule of this AGREEMENT.
3.3. Number and Gender
In this AGREEMENT, words in the singular include the plural and vice-versa and words in one
gender include all genders.
3.4. Entire Agreement
This AGREEMENT constitutes the entire agreement between the Parties pertaining to the subject
matter hereof and supersedes all prior agreements, negotiations, discussions and
understandings, written or oral, express or implied, between the Parties related thereto. There
are no representations, warranties, conditions, other agreements or acknowledgements, whether
direct or collateral, express or implied, that form part of or affect this AGREEMENT, or which
induced any Party to enter into this AGREEMENT or on which reliance is placed by any Party,
except as specifically set forth in this AGREEMENT.
3.5. Amendment
This AGREEMENT may be amended, modified or supplemented only by a written agreement
signed by each Party.
3.6. Waiver of Right
Any waiver of, or consent to depart from, the requirements of any provision of this AGREEMENT
shall be effective only if it is in writing and signed by the Party giving it, and only in the specific
instance and for the specific purpose for which it has been given. No failure on the part of any
Party to exercise, and no delay in exercising, any right under this AGREEMENT shall operate as
a waiver of such right. No single or partial exercise of any such right shall preclude any other or
further exercise of such right or the exercise of any other right.
3.7. Governing Law
This AGREEMENT shall be governed by, and interpreted and enforced in accordance with, the
laws in force in the Province of Ontario (excluding any rule or principle of the conflict of laws
which might refer such interpretation to the laws of another jurisdiction). Each Party irrevocably
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submits to the non-exclusive jurisdiction of the courts of Ontario with respect to any matter arising
hereunder or related hereto.
3.8. Performance on Holidays
If any action is required to be taken pursuant to this AGREEMENT on or by a specified date that
is not a Business Day, then such action shall be valid if taken on or by the next succeeding
Business Day.
3.9. Schedules
The Schedules to this AGREEMENT are as follows:
SCHEDULE A - Designated Representatives
SCHEDULE B – Training Programs
SCHEDULE C – Fees & Payment for Services
SCHEDULE D – Quality Assurance
SCHEDULE E – Controlled Acts and Advanced Medical Procedures
4. AGREEMENT
4.1. General
LH, through its Medical Advisory Board of the CEPCP, agrees to provide Medical Oversight to
“Pickering”, who hereby agrees to the provision of such Services, subject to and in accordance
with the terms and conditions set forth in this AGREEMENT.
4.2. MEDICAL OVERSIGHT
The Parties hereby agree that LH shall provide to “Pickering” the following
(collectively hereinafter referred to as “Medical Oversight”):
(a) authorization to qualified Firefighters to perform the specified controlled acts as per
section 8;
(b) provide medical advice to “Pickering” to ensure a smooth and medically sound transfer
of care from “Pickering” to Paramedics;
(c) provide quality assurance information to “Pickering” as per SCHEDULE D
4.3. The Parties agree “Pickering” will provide the resources necessary to act as a designate of the
Medical Director, and at the sole discretion of a Medical Director, in accordance with the terms
and conditions set forth in this AGREEMENT.
4.4. The Parties agree that LH, at its sole discretion, will utilize the Medical Director and/or LH program
staff as required, subject to and in accordance with the terms and conditions set forth in this
AGREEMENT.
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4.5. “Pickering” will, where possible, provide LH with the use of a desk and private meeting space,
and make available to LH access to electrical power and internet access in order to facilitate the
provision of Medical Oversight pursuant to the terms and conditions of this AGREEMENT
including Section 7.3 herein.
5. MEDICAL EDUCATION
5.1. LH, through its Medical Advisory Board of the CEPCP, and a Medical Director shall establish
policies and procedures to support Medical Education to “Pickering” in accordance with
applicable laws, standards and the CPSO policy. LH shall review such policies, procedures, and
Medical Education materials as required and will advise “Pickering” of any changes as
necessary.
5.2. LH, through its Medical Advisory Board of the CEPCP will develop and review all training and
delivery of Medical Education provided to “Pickering” . These programs will comply with
Applicable Law, applicable Standards and the CPSO Policy.
5.3. Qualifications of Physicians
LH, through the Medical Advisory Board of the CEPCP, shall ensure that the program Medical
Directors maintain current and valid certificate of registration with the CPSO and a current
certificate of professional conduct from the CPSO or such other documents as may be issued by
the CPSO to evidence that the Medical Director has the appropriate registration, status,
qualifications, skills, experience and training to perform the role of Medical Director.
6. MEDICAL ADVICE RELATING TO PATIENT CARE
6.1. LH, through the Medical Advisory Board, may at its sole discretion, provide advice and guidance
to “Pickering” with respect to “Pickering” policies and procedures as it pertains to Medical
Education and Medical Oversight.
6.2. LH will provide written medical directives for controlled acts to “Pickering” .
6.3. Where the Patient care provided by a Firefighter does not meet the applicable Standards, LH will
so advise “Pickering” including by providing feedback (as per SCHEDULE D ) regarding the
nature and type of Patient care provided by the Firefighter(s) and the nature of the identified
Patient care issue.
6.4. Quarterly meetings between “Pickering” and LH will be scheduled for a mutually agreeable
time and may be supported by additional meetings as required or requested.
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7. TRAINING
7.1. “Pickering” will ensure each participant in the LH program has the pre-requisite of Standard
First Aid certification from a WSIB approved provider, and will provide LH with a copy of the
participants certificate prior to commencement of New Hire Orientation.
7.2. Training records will be maintained by either “Pickering” or LH, whoever conducts the training.
Upon request the training records for each Firefighter who is authorized to receive Medical
Oversight will be shared with the other party.
7.3. LH will be responsible for ensuring that the training content for the Firefighters to receive Medical
Oversight is in accordance with Applicable Law, the applicable Standards and CPSO Policy.
7.4. “Pickering” agrees to reimburse LH for additional costs incurred for additional training
beyond that prescribed in the schedule(s).
7.5. Where required, scheduling will be done by LH in consultation with “Pickering” .
7.6. “Pickering” full time will be scheduled for 24 class sessions in order to recertify all firefighters in
the service. Any additional class sessions will be at extra cost to “Pickering” . This will be based
on $43 per hour multiplied by the number of hours of the course. LH will also offer 4 make-up
sessions throughout the year at its Pickering location at no charge.
7.7. All “Core program”(see appendix B) training is mandatory to maintain authorization.
7.8. Any auxiliary training or services are not mandatory to maintain authorization.
7.9. Cancellations of courses that are taught by LH must be received 24 hours in advance during
business hours or by Thursday at 1500 for any weekend courses. If notice is not received, you
will be invoiced for the cost of the instructor. This will be based on $43 per hour x a minimum of
4 hours to a maximum of 8 depending on course type.
8. AUTHORIZATION AND RE-AUTHORIZATION
8.1. LH will provide appropriate authorization to eligible candidates identified by “Pickering” .
“Pickering” will ensure that eligible candidates have met the following criteria:
(a) are either employed by “Pickering” on an indefinite or fixed term basis or have received
an offer of employment from “Pickering” that has not expired, AND;
(b) have successfully completed all LH required training and evaluation.
8.2. “Pickering” will advise LH of any changes in the status of a Firefighter that may affect
his/her authorization.
8.3. LH will contact “Pickering” immediately upon identification that a Firefighter requires remedial
training to continue to receive authorization. LH is responsible for the development of
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remedial training (as required) and that training may be delivered by LH or “Pickering”.
8.4. The Parties agree that LH may oversee the Controlled Act and Advanced Medical Procedure
(SCHEDULE F) training and testing of eligible “Pickering” staff.
8.5. The Parties agree that each Firefighter receiving Medical Oversight will complete a LH approved
annual re-authorization process.
9. QUALITY ASSURANCE
9.1. “Pickering” and LH acknowledge and agree that:
(a) LH must receive all of the information contained in the Call Report (the ”Data”) in order
to facilitate its quality assurance obligations under this AGREEMENT;
(b) “Pickering” is responsible to ensure the accuracy of the Data collected and disclosed
to LH.
(c) LH is a Health Information Custodian (HIC) as defined in the Ontario Personal Health
Information Protection Act, 2004 (“PHIPA”), and therefore is required to comply with
PHIPA, and as such is required to take steps that are reasonable in the circumstances
to ensure that Personal Health Information, including the Data, in LH’s custody or control
is protected against theft, loss and unauthorized use or disclosure and to ensure that the
records containing such personal information are protected against unauthorized
copying, modification or disposal;
(d) where the Data contains Personal Health Information, “Pickering” and LH further agree
to collect, hold and disclose Personal Health Information pursuant to the provisions of
PHIPA as Health Information Custodians (HIC) and Section 19 of the Act as
applicable;
(e) in light of the foregoing, “Pickering” agrees to provide LH with access to the Data for the
purposes set out in (a) above and as otherwise required or permitted by Applicable Law
(the “Purposes”);
(f) “Pickering” and LH shall each notify the other of any problem with or errors in the Data
of which such party may become aware.
9.2. LH shall develop and implement a quality assurance program consistent with applicable
Standards including:
(a) monitoring the delivery of patient care related to Medical Oversight provided by “Pickering”
Firefighters through Case Reviews;
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10. INFORMATION SHARING
10.1. Issues Resulting from Information Sharing
(a) Case Reviews will be performed by LH, through the Medical Advisory Board, on all
patient care calls involving a controlled act provided by “Pickering”,
(b) All concerns received by “Pickering” pertaining to Medical Oversight issues will be
forwarded to LH for Investigation and action and LH will notify “Pickering” of the results
of its Investigation within two Business Days of completion of the Investigation.
10.2. Investigations
(a) LH will be lead investigative organization in the case of any/all investigations involving
Medical Oversight. The final report will be provided to “Pickering” from LH and
“Pickering” will be responsible for communicating the report and its findings to any
external parties to the extent “Pickering” deems appropriate.
(b) LH may draw on any internal resources or personnel of the other Party that may assist
the lead investigator in conducting and concluding investigations.
(c) In the event an investigation has both service delivery as well as Medical Oversight
issues as a component of the overall scope of the investigation “Pickering” shall remain
the lead investigative authority, but will have LH address the Medical Oversight issues
as a co-investigation organization or upon mutual agreement separate from the
oversight issues for investigation by LH.
10.3. Information To Be Shared between the Parties
To the extent requested, the following shall be shared between the Parties during an
Investigation:
(a) All relevant written/typed incident reports;
(b) All relevant audio recordings;
(c) All relevant Call reports pertaining to an Investigation or Case Review;
(d) Contact information of individuals involved in the Investigation; and
(e) Other details as deemed appropriate by the parties.
10.4 “Pickering” will provide an up to date roster of all staff bi-annually to LH for billing and
authorization tracking purposes.
10.5 “Pickering” will request LH certify new recruits for NHO (new hire orientation), minimum of
60 days before commencement of the dates requested.
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11. SUPPLIES AND EQUIPMENT
11.1. LH and “Pickering” will collaborate regarding the supply, use and evaluation of equipment
and supplies specific to Medical Oversight.
12. RESEARCH
12.1. LH will obtain the approval in writing of “Pickering” for all LH research proposals involving
“Pickering”. If applicable, LH will obtain the approval of the Director of the Emergency Health
Regulatory and Accountability Branch, Ministry of Health.
12.2. “Pickering”, at its discretion, may agree to support research conducted by LH with
in-kind resources, if acceptable to LH, or financial resources. Any such support jointly agreed to
by “Pickering” and LH shall be included in the budget of each study protocol.
12.3. Each Party will seek advice and input from the other for all publications relating to research
described in Section 12.1 or 12.2 at least 30 days prior to submission for publication without peer
review or, when applicable, for submission of the manuscript for peer review. The Parties each
agree to keep confidential prior to publication all information contained in a publication or
manuscript that has been submitted by the other for advice and input.
12.4. Authorship on any document submitted for publication will be granted in accordance with the
guidelines outlined in the Uniform Requirements for manuscripts submitted to biomedical
journals (NEJM Vol.336 (4); 1997: pp309-315) as regularly updated and published.
12.5. Each Party will acknowledge the other Party’s contributions to the study and/or publication in any
publication or presentation derived from the study, if the other Party’s contribution does not meet
the Uniform Requirements for authorship.
13. INSURANCE AND INDEMNIFICATION
13.1. Insurance of “Pickering”
“Pickering” shall, at its own expense, obtain and maintain in full force during the Term, all
insurance that would be necessary and appropriate for a prudent Person in the same
business. Such insurance shall include the following:
(a) commercial general and professional liability insurance on an occurrence basis for
third party bodily injury, personal injury and property damage, to an inclusive limit of
not less than $10,000,000 per occurrence and the policy shall include LH as an
additional insured with respect to liability arising in the course of performance of the
Services or under or in connection with this AGREEMENT. “Pickering” will provide
LH with 30 days notice of change or non-renewal of the policy. Such policy shall
include but not be limited to the following:
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i. products and completed operations;
ii. personal injury;
iii. cross liability;
iv. contractual liability;
v. 30-days’ prior written notice of cancellation.
(b) errors and omissions liability insurance insuring for liability for errors and omissions in
the performance of or failure to perform its obligations under this AGREEMENT, in an
amount not less than $10,000,000 per claim.
(c) Network Security and Privacy Liability Coverage of not less than one million
dollars ($1,000,000) and underwritten by an insurer licensed to conduct
business in the Province of Ontario. Coverage shall include unauthorized
access, electronic security breaches, theft or destruction of data within
Provider’s computer network or other electronic information system. The
Privacy Liability coverage shall include the theft of private personal information
and include the failure to comply with privacy laws and their respective
regulations regarding the collection, access, transmission, use and
accuracy. Coverage shall be extended to include the costs associated with
notification of affected parties as well as any fines or penalties imposed as a
result of the breach.
13.2. Insurance of LH
LH shall, at its own expense, obtain and maintain in full force during the Term, all insurance
that would be necessary and appropriate for a prudent Person in the same business. Such
insurance shall include the following:
(a) commercial general and professional liability insurance on an occurrence basis
for third party bodily injury, personal injury and property damage, to an inclusive
limit of not less than $10,000,000 per occurrence and the policy shall include
“Pickering” as an additional insured with respect to liability arising in the course
of performance of the Services or under or in connection with this
AGREEMENT. Such policy shall include but not be limited to the following:
i. products and completed operations;
ii. personal injury;
iii. cross liability;
iv. contractual liability;
v. 30-days’ prior written notice of change to the policy, cancellation, and/or
non-renewal.
(b) errors and omissions liability insurance insuring for liability for errors and
omissions in the performance of or failure to perform its obligations under this
AGREEMENT, in an amount not less than $10,000,000 per claim.
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(c) Network Security and Privacy Liability Coverage of not less than one million
dollars ($1,000,000) and underwritten by an insurer licensed to conduct
business in the Province of Ontario. Coverage shall include unauthorized
access, electronic security breaches, theft or destruction of data within
Provider’s computer network or other electronic information system. The
Privacy Liability coverage shall include the theft of private personal information
and include the failure to comply with privacy laws and their respective
regulations regarding the collection, access, transmission, use and
accuracy. Coverage shall be extended to include the costs associated with
notification of affected parties as well as any fines or penalties imposed as a
result of the breach.
13.3. Indemnification by “Pickering”
“Pickering” agrees to defend, indemnify, and hold harmless, LH and its officers, directors,
employees, agents and representatives (the “Indemnified Parties”) from and against any and all
liability, loss, costs, damages and expenses, causes of action, actions, claims, demands, lawsuits
or other proceedings (“Claims”) which the Indemnified Parties, or any of them, may suffer or incur
as a result of LH entering into this AGREEMENT. “Pickering” shall not however be responsible for
any such Claims to the extent it is solely caused by the negligence or misconduct of LH.
13.4. Indemnification by Lakeridge Health
LH agrees to defend, indemnify, and hold harmless, and its officers, directors, employees,
agents and representatives (the “Indemnified Parties”) from and against any and all liability,
loss, costs, damages and expenses, causes of action, actions, claims, demands, lawsuits or
other proceedings (“Claims”) which the Indemnified Parties, or any of them, may suffer or incur
as a result of “Pickering” entering into this AGREEMENT. LH shall not however be responsible
for any such Claims to the extent it is solely caused by the negligence or misconduct of
“Pickering”.
14. TERM AND TERMINATION
14.1. Term
This AGREEMENT shall commence on/as of January 1st, 2025 and shall continue for the period
of 3 years, expiring on December 31st, 2027 or as terminated pursuant to this Article 15 (the
“Term”).
14.2. Termination by Either Party
Either Party may, at any time, and for any reason, terminate this AGREEMENT upon giving 30
days’ prior written notice to the other Party.
14.3. Effective Date of Termination
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The effective date of the termination of this AGREEMENT shall be the last day of the notice
period or such other date as the Parties agree.
14.4. Consequences of Termination
Upon termination of this AGREEMENT the provisions which by their nature are intended to
survive beyond such termination will remain in effect. The termination of this AGREEMENT shall
not relieve either of the Parties of their respective obligations or rights accrued up to and
including the date of such termination.
14.5. Force Majeure
Notwithstanding anything contained in this AGREEMENT, neither Party shall be liable for any
failure or delay on its part to perform any of the terms, conditions, covenants or obligations of this
AGREEMENT to the extent that such failure or delay is the result of a cause beyond its
reasonable control including such things as unavailability of material, equipment, utilities,
services, an act of God, a fire, an act of the public enemy, an act of His Majesty in his sovereign
capacity, laws, a flood, a quarantine restriction, an epidemic, a labour dispute, a riot, a civil
commotion, vandalism, malicious mischief or other similar cause beyond its control and not
avoidable by the exercise of reasonable foresight (excluding the inability to pay for the
performance of such obligation) and which occurs without the default or negligence of the Party
seeking relief. The Party being delayed shall be entitled to extend the time for fulfillment of such
obligation by a time equal to the duration of such delay and the other Party shall not be entitled
to any compensation for any loss or inconvenience occasioned thereby. The Party delayed shall
however, use its best efforts to fulfill the obligation in question as soon as reasonably possible.
15. GENERAL PROVISIONS
15.1. Co-operation
“Pickering” shall co-operate with and provide assistance to LH as reasonably required by LH
to facilitate the provision of LH’s obligations under this AGREEMENT.
15.2. Confidentiality
LH shall not disclose to any third party any trade secret of or confidential information about
“Pickering” that LH may acquire through the use of the Data. Confidential information is Data and
information which is designated as such by “Pickering” and includes personal information and
personal health information as defined in PHIPA (“Confidential Information”). LH shall use
Confidential Information only for the Purposes. LH shall limit disclosure of Confidential
Information within its own organization to
its directors, officers, employees, agents, consultants and other representatives having a need to
know and shall not disclose Confidential Information to any third party (whether an individual,
corporation, or other entity) without the prior written consent of “Pickering” The parties herein
mutually agree that the confidentiality covenant herein shall survive the termination or discharge
of this AGREEMENT.
“Pickering” shall not disclose to any third party any trade secret of or confidential information
about LH that “Pickering” may acquire through the use of
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the Data. Confidential information is Data and information which is designated as such by LH
and includes personal information and personal health information as defined in PHIPA
(“Confidential Information”). “Pickering” shall use Confidential Information only for the
Purposes. “Pickering” shall limit disclosure of Confidential Information within its own
organization to its directors, officers, employees, agents, consultants and other representatives
having a need to know and shall not disclose Confidential Information to any third party (whether
an individual, corporation, or other entity)
without the prior written consent of LH, except where required by law. LH acknowledges that
“Pickering” is subject to the Municipal Freedom of Information and Protection of Privacy Act,
R.S.O. 1990, c.M.56, The parties herein mutually agree that the confidentiality covenant herein
shall survive the termination or discharge of this AGREEMENT.
15.3. Nature of Relationship
Nothing contained in this AGREEMENT shall be construed as making the Parties (or their
respective successors or permitted assigns), partners or joint venturers or construed as making
any Party, its directors, officers, employees, volunteers, agents or other representatives an agent
of any other Party. For greater certainty, none of the employees, principals, shareholders or
independent contractors of “Pickering” shall be or be deemed to be employees of LH.
15.4. Assignment
Neither this AGREEMENT, nor any rights or obligations hereunder, may be assigned by LH or
“Pickering” without the prior written consent of the other Party and any purported assignment
done without such consent shall be of no force or effect. This AGREEMENT is binding upon
and shall inure to the benefit of the Parties and their respective successors and permitted
assigns and shall not be enforceable by or otherwise inure to the benefit of any other Person.
15.5. Invalidity
If any provision of this AGREEMENT is determined to be invalid, illegal or unenforceable in any
respect by a court of competent jurisdiction, the validity, legality or enforceability of the remaining
provisions of this AGREEMENT shall not in any way be affected or impaired thereby so long as
the economic or legal substance of the matters contemplated hereby is not affected in any
manner materially adverse to either Party.
15.6. Costs
Each Party shall bear its own costs with respect to the drafting, negotiation and interpretation of
this AGREEMENT.
All other costs are outlined in schedule C as per this AGREEMENT.
15.7. Notices
Any notice, demand or other communication (in this Section 16.6 a “Notice”) required or
permitted to be given or made hereunder shall be in writing and shall be well and sufficiently
given or made if it is:
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(a) delivered in person during normal business hours on a Business Day and left with a
receptionist or other responsible employee of the relevant Party at the applicable
address set forth below;
(b) sent by prepaid first class mail; or
(c) sent by any electronic means of sending messages, including facsimile transmission,
which produces a paper record (an “Electronic Transmission”);
in the case of LH, addressed to it at:
Lakeridge Health
1 Hospital Ct
Oshawa, ON
L1G 2B9
Attn: Chief Financial Officer
Tel: 905-576-8711
Fax: 905-721-4862
and in the case of “Pickering” addressed to:
Pickering Fire Services
1700 Zents Drive
Pickering, ON L1X 0N7
Attn: Chief Steve Boyd
Tel: 905-839-9968
Any Notice given or made in accordance with this Section shall be deemed to have been given or made
and to have been received:
(a) on the day it was delivered, if delivered as aforesaid;
(b) on the third Business Day (excluding each day during which there exists any general
interruption of postal services due to strike, lockout or other cause) after it was
mailed, if mailed as aforesaid; and
(c) on the day of sending if sent by Electronic Transmission during normal business
hours of the addressee on a Business Day and, if not, then on the first Business Day
after the sending thereof.
Any Party may from time to time change its address for notice by giving Notice to the other Party in
accordance with the provisions of this Section.
15.8. Further Assurances
Each Party shall do such acts and shall execute and deliver such further agreements,
documents, conveyances, deeds, assignments, transfers and the like, and shall cause the doing
of such acts and the execution and delivery of such further it as is within its power and as the
other Party may in writing at any time and from time to time reasonably request, in order to give
full effect to the provisions of this AGREEMENT.
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15.9. Remedies Cumulative
The rights and remedies under this AGREEMENT are cumulative and in addition to, and not in
substitution for, any other rights and remedies, available at law or in equity or otherwise. No
single or partial exercise by a Party of any right or remedy precludes or otherwise affects the
exercise of any other right or remedy to which that Party may be entitled.
15.10. Counterparts and Facsimile Execution
This AGREEMENT may be executed in any number of counterparts, each of which shall be
deemed to be an original, and all of which together shall be deemed to be one and the same
instrument and receipt of a facsimile version of an executed signature page of this AGREEMENT
by a Party shall constitute satisfactory evidence of execution of this AGREEMENT by such Party.
15.11. Dispute Resolution/Consultation and Negotiation
(a) In the event of a dispute between the Parties, each Party’s Designated Representative
shall meet to attempt to resolve the Dispute. Each Party acknowledges that it is in their
mutual interest to have their respective Designated Representative resolve all matters by
mutual agreement and each agrees to act reasonably and in good faith to permit and
encourage their respective representatives to do so.
(b) If such Designated Representatives are not able to resolve any Dispute referred to them
within 15 Business Days, the matter shall be referred to the Director of LH and the Fire
Chief or his designate of “Pickering”, each of whom shall be fully briefed on the matter
and shall have the authority to negotiate on behalf of and bind their respective Party. If
such senior representatives are not able to resolve any Dispute referred to them within 15
Business Days (the “Resolution Date”) of such referral, then the matter shall be referred
to arbitration as provided for herein.
15.12. Dispute Resolution/Arbitration
(a) If the Parties do not reach a solution pursuant to Section 16.10 by the Resolution Date,
the Dispute shall be arbitrated and finally resolved, pursuant to the National Arbitration
Rules of the ADR Institute of Canada, Inc., as amended from time to time, by a single
arbitrator appointed pursuant to Rule 14(d) of the said Rules. The place of arbitration
shall be Toronto, Canada. The language of the arbitration shall be English.
(b) Judgment upon the award rendered in any such arbitration may be entered in any court
having jurisdiction thereof, or application may be made to such court for a judicial
acceptance of the award and an enforcement, as the law of such jurisdiction may require
or allow.
Signature Page Follows
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IN WITNESS WHEREOF the Parties hereto have duly executed on the day of
, 2024.
The Corporation of the City of Pickering
By:
Name:
Title:
By:
Name:
Title:
LAKERIDGE HEALTH
By:
Name: Chris Squire
Title: HSE, Corporate Services & Chief Financial
Officer
By:
Name:
Title:
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SCHEDULE A - Designated Representatives
LAKERIDGE HEALTH
Jennifer Shanley, Manager Office Operations
jshanley@lh.ca
Lakeridge Health
1 Hospital Ct
Oshawa, Ontario L1G 2B9
Tel: 905-433-4370
Fax: 905-721-4737
Pickering Fire Services
Steve Boyd, Chief
sboyd@pickering.ca
Pickering Fire Services
1700 Zents Drive
Pickering, ON L1X 0N7
Tel: 905-839-9968
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SCHEDULE B – Training Programs
EMR Program – Core plus Auxillary Program
1 Initial EMR certification (New Hire)
(24 hrs, maximum 15 participants) includes:
CPR/AED certification
Delegation of controlled acts
Authority to perform scope of practice,
as per medical directives
Blended delivery available
Bi-annual EMR recertification, (16hrs) includes:
CPR/AED recertification
Remain in good standing with CEPCP
for scope of practice and delegated
acts
Maintenance of skills, updates as
needed
1 make up session per shift & 4 make –
up sessions at CEPCP (1st come 1st
serve)
Oversight with documentation of medical calls
on MAR system
Remediation as required
Access to CEPCP resources
Access to LMS
Digital copies of medical directives, first
responder manual
CEPCP serves in advisory role for pre-
hospital patient care, this is facilitated
through clinical coordinators, and the
Medical Advisory Board.
Meeting with CEPCP for overview of
service
Annual Biomedical Engineering quality
assurance & technical support
Additional at Cost Services
Additional New Hire Certification (maximum of
12) during the year if services wish to hire
another recruit class
CEPCP First Aid Certification and CPR/AED
certification for services staff
Make up sessions over and above what is
provided
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SCHEDULE C – Fees & Payment for Services
Item
Frequency Amount Initial
Selection202520262027
EMR Direct
delivery program
Bi-Annual $275 per
firefighter
$275 per
firefighter
$275 per
firefighter
EMR Additional
New Hire
As required $1200 per course
max 12
$1200 per course
max 12
$1200 per course
max 12
EMR Additional
New Hire
As required
$100 per
firefighter above
12
$100 per
firefighter above
12
$100 per
firefighter above
12
Make-up
Sessions
As required See 7.6 See 7.6 See 7.6
Course
Cancellation Fee
As required See 7.9 See 7.9 See 7.9
Emergency First
Aid
As required $710 plus HST
Max 12
$710 plus HST
Max 12
$710 plus HST
Max 12
Standard First Aid As required $1365 plus HST
Max 12
$1365 plus HST
Max 12
$1365 plus HST
Max 12
CPR – Healthcare
Provider
As required $100 per person
Max 12
$100 per person
Max 12
$100 per person
Max 12
AED Supplies &
Maintenance
Bi-Annual $450 per AED
($900 per year)
$450 per AED
($900 per year)
$450 per AED
($900 per year)
Notes:
LH will invoice “Pickering” bi-annually in June & December for:
1. the total number of Firefighters who receive medical oversight from the Medical Advisory Board of
CEPCP, at any point during the calendar year.
2. any additional items required by “Pickering”
The Parties agree to negotiate and append additional fee structures for work not described in this
AGREEMENT.
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SCHEDULE D – Quality Assurance
It is recognized that the quality assurance requirements will need to be reviewed regularly to ensure that
the needs of both Parties are being met and in fulfillment of the terms of this AGREEMENT.
Data Requirements:
Data will be provided to LH as described in the AGREEMENT. The minimum data required are to be
captured in a form mutually agreed to by both Parties.
Case reviews:
LH will audit all calls where a Call Report for patient care involving controlled act(s) is received by LH from
“Pickering”, using a standardized audit tool.
The results of a chart audit will be available no later than five weeks following the commencement of the
audit.
The Parties agree to the following process:
LH will issue individual case feedback forms when clarification is required “Pickering” will make
reasonable efforts to encourage a response within 3 weeks of receipt. An additional 2 weeks may
be added where the Firefighters are reasonably unavailable to complete the request, or where it is
likely that the feedback form was not received.
Report Requirements:
LH will provide the following minimum reports to “Pickering”. If additional reports are required they will be
negotiated and appended to this AGREEMENT:
Case Review reports:
Semi-annual.
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SCHEDULE E – Controlled Acts and Advanced Medical Procedures
“Pickering” requests authorization to perform the following Controlled Acts and Advanced Medical
Procedures, in accordance with CEPCP’s Fire Services Medical Directives, Policies and Guidelines.
“Pickering” to initial beside each item they are requesting delegation to perform.
Directive and Controlled Act and Advanced Medical
Procedures Fire Service Initials
Cardiac Arrest General Medical Directive
Use of AED and provide defibrillation
Medical Cardiac Arrest Medical Directive
Use of AED and provide defibrillation
Hypothermia Cardiac Arrest Directive
Use of AED and provide defibrillation
Trauma Arrest Medical Directive
Use of AED and provide defibrillation
Foreign Body Airway Obstruction Cardiac Arrest Medical Directive
Use of AED and provide defibrillation
Newborn Resuscitation Medical Directive
Advanced medical procedures
Anaphylaxis Medical Directive
Administer Epinephrine, IM
Opioid Toxicity Medical Directive
Administer Naloxone, IN
Emergency Bandage Application Medical Directive
Medical grade tourniquet application
Hemostatic dressing application