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DocuSign Envelope ID:322475F4-3B4B-4519-AC2A-081 F7A434703 <br /> i. Records of dispatch which shall show time call was received, time <br /> dispatched, time arrived on scene, time arrived at destination, time <br /> in service, and time returned to base. <br /> ii. Trip Records stating all information required in subsection(i)of this <br /> Section in addition to information on a form approved by the <br /> County. The trip record shall be so designed as to provide the <br /> patient with a copy containing all required information. <br /> iii. Personnel Checklist and Inspection Report listing contents and <br /> description for each vehicle, signed by the individual verifying <br /> vehicle operations and equipment. <br /> iv. A detailed record of complaints received from the public, other <br /> enforcing agencies and services regarding Franchise infractions. <br /> V. Any other records required by state law, rules or regulations or <br /> deemed by the Department of Emergency Service as relevant to the <br /> effective and efficient operations of the Emergency Management <br /> System as provided in the "Operations Agreement" and necessary <br /> for a fair determination of the capability of the Grantee to continue <br /> to provide Emergency Medical Services and Rescue Services in <br /> Orange County in accordance with the requirement of law and the <br /> provision of this Franchise. <br /> b. All of the records identified in subsection(a) above shall be maintained for <br /> a minimum three (3) year period unless a longer retention period is <br /> otherwise required by law or other retention periods. <br /> C. Grantee shall establish and maintain a system to record data that used the <br /> Model Data set and data dictionary as specified in"North Carolina College <br /> of Emergency Physicians: Standards for Medical Oversight and Data <br /> Collection." <br /> d. Grantees shall maintain confidentiality of patient records as provided by the <br /> Health Insurance Portability and Accountability Act of 1996 (HIPAA), <br /> Public Law 104-191,N.C. Gen. Stat. 143-518 and all other state and federal <br /> law. <br /> e. Grantee shall submit a written monthly report to the Emergency Services <br /> Director, or their designee, providing the number of calls and runs during <br /> the month. The report shall contain the number of emergency calls, the <br /> number of convalescent calls,the total number of calls and the total number <br /> of patients transported. <br /> Priority Care Ambulance, Inc. <br /> EMS Franchise Agreement <br /> Page 11 of 22 Rev. 11/2020 <br />