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EMERGENCY MEDICAL SERVICES FIRST RESPONDER ADVANCED LIFE SUPPORT AGREEMENT (7/1/2019) In situations where the FRALS unit has responded to a location other than the Incident Location (e.g. staging areas for hazardous materials/violent crime incidents, non- secured scenes, or where rugged terrain precludes access),Arrival at Incident shall be the time the FRALS arrives at the designated staging location or the nearest public access point to the patient's location. 5.4 Performance Reporting Exemptions a. City may request that a late response be excluded from the calculation of Performance Reporting ("an Exemption"), if that call falls into one of the following categories: • A declared Multi-Casualty Incident ("MCI") or disaster that the County EMS Director determines has had a material impact on City's resources. • There was a delay because information relayed by the Medical Dispatch Center was substantially incorrect so as to prohibit timely arrival at the call. b. Request for an Exemption must be in writing and received by the County EMS Director within ten (10) calendar days following the end of the month in which the event occurred. Performance Reporting Exemptions may be granted by the County on a per call basis, following review and investigation by the County. Calls that are approved as an Exemption shall not be included in the calculations for Performance Reporting. Such requests must include all of the following: • Detailed description of the circumstances causing the response delay • Date and time of the occurrence • Dispatch agency name • Unit number • Originating location of responding unit • The request must include performance reports for the month in which the incident occurred and written documentation supporting the request. SECTION 6 - ADDITIONAL SERVICE PROVISION 6.1 5150 Response a. City shall respond paramedic ALS level personnel to 5150 Calls dispatched as Priority 2. 1. If the patient does not require medical clearance at an emergency department,the City may cancel the ALS ambulance and request through the appropriate dispatch center that a BLS ambulance or County approved alternative transport resource Page 5 of 24