MEMORANDUM OF UNDERSTANDINGBetween Department of Health and Family elfare! Go"ernment of #arnata$a% Emer&en'y Mana&ement and Re(ear'h In(tit)te *EMRI+! Se')ndera,adfor pro"idin& Emer&en'y Re(pon(e Ser"i'e(*Aro&ya #a"a'ha+ in #arnata$a a( theSole State -e"el Nodal A&en'y and to operationali(e Emer&en'y Re(pon(e Ser"i'e(.GENERA- TERMS:I. /ARTIES0On this 14th day ofAugust, 2008, this Memorand)m of Under(tandin& is signedbetween the Department of Health and amily !elfare, "o#ernment of $arnata%aand&mergen'y(anagement and)esear'h*nstitute+&()*,, a-ot.for./rofitOrgani0ation ha#ing its Head Offi'e at De#ar 1am0al, (ed'hal )oad,2e'underabad.300014, Andhra /radesh agreeing to pro#ide &mergen'y )esponse2er#i'es 4&)25 to the entire population of $arnata%a in two phases o#er a periodof two years 'ommen'ing from the finan'ial year 2008.067II. /ERIOD OF /ARTNERSHI/0 8he (O9 referred to in paragraph * +one, shall be #alid for a period of 10 year(and e:tendable for a further period of 10 years sub;e't to the 'on'urren'e ofboth the parties7 *t is also agreed that the de#elopment, management, and fun'tioning of all thefa'ilities and ser#i'es pro#ided here within shall be the responsibility of &()*7 III. THE OB1E2TI3ES OF THIS MEMORANDUM OF UNDERSTANDING ARE08he main ob;e'ti#e of the (emorandum of 9nderstanding between the"o#ernment of $arnata%a and the &mergen'y (anagement and )esear'h*nstitute, 2e'underabad is to pro#ide 'omprehensi#e &mergen'y )esponse2er#i'es for the entire population of $arnata%a in two phases7&()* has been pro#iding&mergen'y)esponse2er#i'es o#era period ofthreeyears and is 'urrently operating these ser#i'es in the states of Andhra /radesh,"u;arat and 9ttara%hand7 8hese ser#i'es are uni &(2+&mergen'y (edi'al 2er#i'es, in *ndia at a relati#ely nas'ent stage, it is proposedto deploy 31@ambulan'es for the entire 2tate of $arnata%a thereby ea'hambulan'e 'atering appro:imately a population of 1700 to 1710 Ba%hs7 Deploymentof 31@ ambulan'es also translates to a per trip distan'e of appro: 23 $( s whi'hresults into transportation of the #i'tim within the R"olden Hour7S27 8herearetwotypesofambulan'es7 8heyareAd#an'edBife2upport+AB2,>?asi' Bife 2upport +?B2,7 ?B2 with #entilator > defibrillator is %nown as AB27 8he11prime use of AB2 is for trauma 'ardio related symptoms > ailments7 Around 20.23H of the total emergen'ies relate to 'ardia' 'ases > hen'e it is proposed toha#e 23H of total fleet strength as AB2 > the remaining as ?B27A7 ?ased on the statisti's > &()*Ss e:perien'e in other states, the 'all #olume ispro;e'ted to be roughly 070@H of the population 'o#ered by ea'h ambulan'e whi'hs'ales up at later years due to in'reased awareness among the masses747 *n the initialperiod of&)2 +&mergen'y)esponse 2er#i'es,,of the total 'alls,only 3H turnout to be emergen'es > the balan'e are ineffe'ti#e 'alls7 Howe#er,with the in'reased awareness le#els at later years we e:pe't this 3H to in'reaseto 11H at the end of the 3 year7 37 Ofthetotal emergen'ies, 63.6@Hisrelatedto(edi'al emergen'iesin'ludingmedi'o legal 'ases and the rest are e:'lusi#ely for /oli'e > ire 'ases7C7 8heEmer&en'y Re(pon(e 2entrewillbemannedby4'ategoriesofpersonnel78hey are:a7 2omm)ni'ation Offi'er( *2O+ who are responsible for attending all the 108'alls > ta%ing down the basi' information related to the 'aller > emergen'y78he 'apa'ity of ea'h DO in a shift of 8 hrs is appro:imately 300 .C00 'alls78hey undergo 21 days training before assuming the role of a DO7 Hen'e theyare on board one P two months prior to laun'h of ser#i'es7 b7 Di(pat'h Offi'er( *DO+whosensiti0estheemergen'ies>de'idesthedispat'h of ambulan'e to the emergen'y site > 'oordinates with theambulan'e staffEfirst responder > &mergen'y )esponse Dentre /hysi'al+&)D/, for #irtual hand holding7 8he 'apa'ity of ea'h DO in a shift of 8 hrs isappro:imately60.100'alls7 8heyundergo21daystrainingbeforeassumingthe role of a DO7 Hen'e they are on board one P two months prior to laun'h ofser#i'es7 '7 /oli'e Di(pat'h Offi'er( */DO+ who ta%e 'are of e:'lusi#e /oli'e 'ases >andalsothelegal aspe'tofmedi'olegal 'ases7 8hesearethepersonnelpro#ided by the /oli'e department7d7 Emer&en'y Re(pon(e 2entre /hy(i'ian( *ER2/+are themedi'al do'torswith spe'iali0ation in emergen'y 'are who are present in the 'all 'enter roundthe'lo'%topro#idemedi'al dire'tiontothe&(8s7 8heypro#ide#irtualmedi'al dire'tions for all 'riti'al 'ases whi'h amount to around 23H of thetotal medi'al 'ases7 &a'h &)D/ handles appro:imately 80.60 'ases per shift7 12e7Apart from these the following personnel will also be deployed: i7 Team -eader for #ery 13 DOEDO7ii7 /atient2areRe'ordOffi'er+/D), . )esponsiblefor analysis of/atient 'are re'ord do'ument with a handling 'apa'ity of 1C0 re'ordsper shift7 iii7 8eam leader for e#ery 13 do'torsE/D) Offi'er7@7 *n the operations side,ea'h ambulan'e is manned by a trained /ilot+Dri#er,>Emer&en'y Medi'alTe'hni'ian+&(8,Eparamedi'staffintwoshiftsof12hrsea'h7 Due to highly stressful nature of wor%, they get off after e#ery A days ofduty>hen'e27@3personnel ofea'h'ategoryis'onsideredtoe:e'ute24E@responsibility7 87 8heoperations>administrationofambulan'esinthefieldwillbemanagedbyfollowing personnel:a7Operation( E:e')ti"e +O&,.&a'h O& is in 'harge of around 10 ambulan'es >is responsible for day to day operations of these ambulan'es7 8he respe'ti#e&(8s > pilots report to the O&7b7Di(tri't Mana&er+D(, . or e#ery distri't there is head of operation'alled D( > is responsible for all administrati#e fun'tions within the distri'tin'luding intera'tion with hospitalsEDistri't go#t7 offi'ials, et'7 &a'h D('ontrols around20.A0ambulan'es in his distri't7 All therespe'ti#eO&sreport to the D(7'7Re&ional Mana&er +)(, P our to i#e distri'ts are 'lubbed into a region >the regional (anager 'ontrols the region7 8he respe'ti#e D( s report to the)(7d7 Admini(trati"e Offi'er+AO, P &()* wouldha#e a small offi'e at ea'hdistri't pro#ided by the "o#t7 8he AO will pro#ide the administrati#e support7e7 Fleet E:e')ti"e P ery Distri't has one fleet e:e'uti#e7 He is responsible forrepairs > maintenan'e of all the ambulan'es within a parti'ular distri't7f7 Fleet Mana&er P He is o#erall 'entrally responsible for tie.ups with dealers >wor%shopsformaintenan'eandadministrationofambulan'es7 All theleet&:e'uti#es report to the leet (anager7 ID. FINAN2IA- ANNEDURES0 13&n'losed separately as a part of the (O9 pro;e'ting the 'osting for fi#e years7D. EDAMINATION OF RE2ORDS08he &mergen'y (anagement and )esear'h *nstitute will pro#ide the"o#ernment of $arnata%a do'uments relating to the progress andimplementation of the pro;e't as and when re amily !elfare, "o#ernment of $arnata%a shallnot be responsible for any liabilities assumed by the &mergen'y (anagementand )esear'h *nstitute nor will assume any obligations finan'ial or otherwise,entered into by the &mergen'y (anagement and )esear'h *nstitute with anythird party, unless these fall e:pli'itly within the terms of this (o97A. 2onfidentiality0-eitherparty+&()*or"o#ernmentof$arnata%a,shall, withoutthepriorwritten 'onsent of the other party:Di('lo(e the 2onfidentialInformation of the other party to anythirdpartyE orU(e the 2onfidential Information of the other party for any p)rpo(e.&ither /artymust ta%eall reasonablyne'essarystepstoensurethatitsoffi'ers, employees, agents and sub'ontra'tors do not ma%e publi' or dis'losethe Donfidential *nformation7B. Relation(hip0&ither party will not be a partner or agent of the other party and does notha#e the power or authority, dire'tly or indire'tly, to bind the other party toany agreement with a potential 'ustomer or any other third party or otherwiseto 'ontra't, negotiate or enter into a binding relationship for or on behalf oftheotherpartyinrelationtoanyoftheareasha#ingadire'torindire'tbearingontheimplementationofthis pro;e't, unless thesamehas beenagreed upon between the parties in writing714- *n the e#ent of either party failing to meet its obligations, it will try tore'tify within three +A, months from the date of su'h failure7 *n 'ase of itsinability to so re'tify, the other party shall ha#e the option to terminate theagreement after gi#ing noti'e of three +A, months7- All disputes or differen'es whatsoe#er arising between the parties outofor relatingtothe 'onstru'tion, meaningandoperationoreffe'tofthis(o9 or the brea'h thereof shall be settled mutually by the "o#ernment of$arnata%a and &mergen'y (anagement and )esear'h *nstitute7 *n 'ase of anyunresol#ed matters, Dhief 2e'retary, "o#ernment of $arnata%a or his nomineenotbelowtheran%ofAdditional Dhief2e'retaryshall bethearbitratorwhose de'ision shall be final72. All thephysi'al infrastru'ture.mo#able>immo#ableassetsandsoftwarea'amily&mergen'y(anagementand)esear'h!elfare Department *nstituteMailin& Addre((0Mailin& Addre((Room No.67=!6(t Floor! FDe#ar 1am0alG,Ii%asa 2oudha,(ed'hal )oad,Dr7 Ambed%ar Ieedhi,2e'underabad P 300014.BANGA-ORE4=B7 776.e4mail0pr(4hfwG$arnata$a.&o".ine4mail0 "en$atH'han&a"alliGemri.initne((e(0 itne((e(01TTTTTTTTTTT 1TTTTTTTTTTT2TTTTTTTTTTT 2TTTTTTTTTTT15