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HomeMy WebLinkAbout2010-06-02 PACKET 04.E.REQUEST OF CITY COUNCIL ACTION COUNCIL AGENDA MEETING ITEM # DATE 06/02/10 PREPARED BY Public Safety Craig Woolery ORIGINATING DEPARTMENT STAFF AUTHOR COUNCIL ACTION REQUEST City Council pass a motion to approve the HealthPartners Research Foundation (HPRF) Agreement and authorize execution of the subaward agreement between the City of Cottage Grove Department of Public Safety and HealthPartners Research Foundation to participate in the IMMEDIATE study and authorize Director of Public Safety Craig Woolery to execute such an agreement on behalf of the City of Cottage Grove and Public Safety Department. STAFF RECOMMENDATION City Council pass a motion to approve the HealthPartners Research Foundation (HPRF) Agreement and authorize execution of the subaward agreement between the City of Cottage Grove Department of Public Safety and HealthPartners Research Foundation to participate in the IMMEDIATE study and authorize Director of Public Safety Craig Woolery to execute such an agreement on behalf of the City of Cottage Grove and Public Safety Department. SUPPORTING DOCUMENTS ® MEMO /LETTER: from Director of Public Safety Craig Woolery RESOLUTION: ❑ ORDINANCE: ❑ ENGINEERING RECOMMENDATION: ❑ LEGAL RECOMMENDATION: OTHER: HealthPartners Research Foundation IMMEDIATE Study Agreement ADMINISTRATORS COMMENTS �x I p City Administrator Date COUNCIL ACTION TAKEN: M APPROVED ❑ DENIED ❑ OTHER Date: May 26, 2010 Subject: REQUEST AUTHORIZATION TO ENTER INTO AN AGREEMENT WITH HEALTHPARTNERS RESEARCH FOUNDATION (HPRF) AND PARTICIPATE IN THE IMMEDIATE STUDY Cottage Grove EMS has been requested to participate in a National Institute of Health (NIH) study by our Medical Director at Regions Hospital. The research study is called the IMMEDIATE Trial (Immediate Myocardial Metabolize Enhancement During Initial Assessment and Treatment in Emergency Care). This research study uses an intravenous solution of glucose, insulin and potassium (GIK) to reduce the amount of damage to the heart from a heart attack. Cottage Grove Paramedics would receive training on the protocols of this study and the enrollment of qualifying consenting patients suffering from acute myocardial infarction (AMI) in the pre - hospital setting. As a participant in the study, all of Cottage Grove's MRX monitor /defibrillators would receive state of the art software upgrades that can accurately diagnose potentially life threatening heart arrhythmias. The value of the software upgrades is approximately $18,000.00 for our six (6) monitor /defibrillators. All paramedic training required to participate in this study will be reimbursed through HealthPartners (Regions Hospital). Also as an incentive, Regions Hospital has agreed to provide additional advanced life support training to Cottage grove personnel such as Rapid Sequence Induction (RSI) training. The enclosed sub award agreement between HealthPartners Research Foundation (HPRF) and the City of Cottage Grove has been reviewed by our City Attorney. There will also be a public notification process that will inform citizens of the study. The sample press release is enclosed. RECOMMENDATION The Cottage Grove Department of Public Safety, on behalf of the City of Cottage Grove, is requesting authorization from Council to enter into an agreement with the HealthPartners Research Foundation to participate in a one (1) year research study called the IMMEDIATE Trial, beginning in June 2010, CAW /cce Encl. DPS10 -016 PRESS RELEASE: In close collaboration with the team at the National Coordinating Center, the Cottage Grove Public Safety Department is participating in the IMMEDIATE Trial.. The East Metro St. Paul IMMEDIATE Trial Team is under the direction of RJ Frascone, MD, Regions Hospital Medical Director. Heart Attack Studv to Start in June Cottage Grove Public Safety along with Regions and St. Josephs Hospitals are participating in the IMMEDIATE Trial. This National Institutes of Health sponsored research study will test if an intravenous "GIK" solution of glucose, insulin, and potassium can reduce the amount of damage to the heart from a heart attack. Patient enrollment starts in M'ay and will continue for 1 years. If you have symptoms of a heart attack and, are at least 30 years old and have positive findings on an EKG done by an EMS paramedic, you may be enrolled in the Trial. People with signs of heart failure, and those receiving dialysis will not be enrolled. If you participate in the study you will receive either a standard IV solution or GIK solution for up to 12 homy. Which solution you receive is determined by chance. Neither you nor the medical staff will know which one you are assigned to receive. You will continue to receive all the standard care you would normally receive. Previous studies have shown that giving GIK as early as possible may protect the heart from damage until further therapies are available. However, if you participate there is no guarantee of benefit. Possible side effects include redness or inflammation at the IV site; change in blood sugar levels that may cause weakness, dizziness, or thirstiness; change in potassium levels that may result in a rapid heartbeat or dizziness. You will be monitored for side effects and treated if needed. Due to the emergency nature of a heart attack, informed consent will not be obtained prior to starting the study drug. In the ambulance, the paramedics will notify you of the study and you can decide to accept or decline participation. More detailed information will be provided to you at the hospital, at that time you can provide informed consent to continue or withdraw. You may withdraw from the study at any time, with no disruption in care. For more information, visit the Trial website at ... ... ... 1 11P P fl I I 1 A T r T EMS Unit Agreement Name of Institution with the Federal Wide Assurance (FWA): HealthPartners Research Foundation Applicable FWA #: 00000106 EMS Unit Name: (_ 0 eya a e C% r�/ V e C Research Covered by this Agreement: 41.0-013 -"IMMEDIATE Trial: Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency Care" Principal EMS Unit: RJ Frascone, MD (1) The above -named EMS Unit has reviewed: 1) The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research (or other internationally recognized equivalent; see section B.1. of the Terms of the Federalwide Assurance (FWA) for International (Non -U.S.) Institutions); 2) the U.S. Department of Health and Human Services (HHS) regulations for the protection of human subjects at 45 CFR part 46 (or other procedural standards; see section B.3. of the Terms of the FWA for International (Non -U.S.) Institutions); 3) the FWA and applicable Terms of the FWA for the institution referenced above; and 4) the relevant institutional policies and procedures for the protection of human subjects. (2) The EMS Unit understands and hereby accepts the responsibility to comply with the standards and requirements stipulated in the above documents and to protect the rights and welfare of human subjects involved in research conducted under this Agreement. (3) The EMS Unit will comply with all other applicable federal, international, state, and local laws, regulations, and policies that may provide additional protection for human subjects participating in research conducted under this agreement. (4) The EMS Unit will abide by all determinations of the Institutional Review Board (IRB) designated under the above FWA and will accept the final authority and decisions of the IRB, including but not limited to directives to terminate participation in designated research activities. (5) The EMS Unit will complete any educational training required by the Institution and/or the IRB prior to initiating research covered under this Agreement. (b) The EMS Unit will report promptly to the IRB any proposed changes in the research conducted under this Agreement. The EMS Unit will not initiate changes in the research without prior IRB review and approval, except where necessary to eliminate apparent immediate hazards to subjects. (7) The EMS Unit will report immediately to the IRB any unanticipated problems involving risks to subjects or others in research covered under this Agreement. (8) The EMS Unit acknowledges and agrees to cooperate in the IRB's responsibility for initial and continuing review, record keeping, reporting, and certification for the research referenced above. The EMS Unit will provide all information requested by the IRB in a timely fashion. (9) The EMS Unit will not enroll subjects in research under this Agreement prior to its review and approval by the IRB. (10) Emergency medical care may be delivered without IRB review and approval to the extent permitted under applicable federal regulations and state law. (11) This Agreement does not preclude the EMS Unit from taking part in research not covered by this Agreement. (12) The EMS Unit acknowledges that it is primarily responsible for safeguarding the rights and welfare of each research subject, and that the subject's rights and welfare must take precedence over the goals and requirements of the research. EMS Unit Signature: Printed Name: Address: City State Signature, FWA Institutional Official: Printed Name: Andrew F. Nelson, MPH Institutional Title: Executive Director, HealthPartners Research Foundation Early EMS and ED Use of GIK for ACS: The IMMEDIATE Trial Subaward Agreement Between HealthPartners Research Foundation And The City of Cottage Grove This Subaward Agreement ( "Agreement ") is entered into by and between HealthPartners Research Foundation (hereinafter referred to as "HPRF ") and the City of Cottage Grove, by and through its Public Safety Department (hereinafter referred to as "EMS Agency "). HPRF and EMS Agency are sometimes referred to herein as "parties" or individually as a "party" in this Agreement. WHEREAS, HPRF is the recipient of a subaward from Tufts University Medical Center for 51-101 HL077821 -03 ( "Award ") and CFDA# 93.837 from the National Institutes of Health, ( "Sponsor "), for the conduct of a project entitled "Early EMS and ED Use of GIK for ACS: The IMMEDIATE Trial ", ( "Study ") as detailed in the study protocol; WHEREAS, the parties acknowledge that the mission of the parties is health care and the advancement of scientific knowledge and education. The parties acknowledge that this Study will be performed in a manner best suited to carryout that mission. WHEREAS, HPRF desires EMS Agency's participation in the research activities under this Study; WHEREAS, EMS Agency would like to participate in the research activities in support of the Study; and, WHEREAS, HPRF and EMS Agency desire to enter into a Subaward Agreement under the Award for research support services NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, HPRF and EMS Agency agree as follows: •' • Ty The EMS AGENCY shall perform those services described in Exhibit A, the Scope of Work, which is attached hereto and incorporated herein by reference. Any changes to the Study proposed by EMS AGENCY shall require the prior written approval of HPRF, which shall include IRB review and approval if appropriate. EMS AGENCY shall adhere to all conditions of approval as discussed or documented in the approval process by the IRB of record. The IRB of record will be the HPRF IRB. Any significant changes in the performance of this Agreement as outlined in the Scope of Work set forth in Exhibit A require the express written approval of both HPRF and EMS AGENCY in an amendment to this Agreement. Draft Agreement HPRF ->EMS AGENCY 1 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H: \Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010 The term of this Agreement shall begin on April 15, 2010, and shall terminate on January 31, 2011. This Agreement shall not extend beyond the termination date unless agreed to in writing by both parties. Future periods are contingent upon programmatic requirements, satisfactory progress and Tuft's receipt of a continuation award under the NIH Grant. Accordingly, it is the intention of HPRF to continue this contracting relationship through the project period provided that ongoing funding from Sponsor is awarded at requested levels and that EMS AGENCY meets project performance and reporting requirements including, but not limited to, OMB A -133, Section 400 (d) regulations. 3. ESTIMATED COST AND PAYMENT: Payment for work performed by EMS AGENCY is not to exceed $ 8,100.00 unless amended by written mutual agreement. EMS AGENCY will be paid by HPRF for services rendered under the terms of this Agreement, provided that: 1. Such costs are allowable by terms of this Agreement; 2. The applicable governmental cost principles were followed, including obtaining prior written approval from HPRF for all areas requiring prior approval of the awarding agency as outlined in applicable governmental cost principles and in accordance with the NIH Grants Policy Statement. EMS AGENCY shall submit one invoice within one month following the end of training on or around May 7, 2010. Invoices must clearly delineate expenditures by expense category as shown in the budget attachment (Exhibit B — Budget). Additionally, individual invoices must correctly reference: HPRF Agreement Number X1001300. Invoices without such references will be returned to EMS AGENCY. The invoices for each project must be submitted within 30 calendar days after the termination of training, and must be signed and marked "Final" by the EMS AGENCY with the following statement: "The EMS AGENCY has an approved financial accounting management system designed to assure that all expenditures were incurred in full compliance with OMB Circular A -133 or its own applicable audit regulations. Disallowed costs, if found during the retention period of this Agreement, will be promptly refunded to HPRF." Failure to sign the final invoice and provide such a statement will not relieve the EMS AGENCY from this requirement. Execution of this Agreement will be considered to be acceptance by the EMS AGENCY of these terms. If during the record retention period of this Agreement, a finding or questioned cost is found related directly to this Agreement, then the EMS AGENCY will promptly notify HPRF in order to proceed with resolution of such matter, as may be required by HPRF's prime sponsor or applicable Federal regulations. Invoices and questions concerning invoice receipt or payments should be directed to the HPRF's Administrative Contact as shown in Exhibit C. Draft Agreement HPRF - >EMS AGENCY 2 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010 HPRF shall make payments in accordance with HPRF's accounts payable policies but in no event later than 45 days after receipt of an accurate invoice from EMS AGENCY. 4. BUDGET Any expenditures or charges beyond the specified training reimbursement requires prior approval of the HPRF's Authorized Institutional Official as provided in Exhibit C or his /her designee The EMS AGENCY may not deviate significantly from the major line items of the budget attachments (Exhibit B), as defined by the Sponsor's guidelines, unless specifically authorized by the HPRF. 5. PROGRESS REPORTS: Upon written request, EMS AGENCY will provide progress reports to HPRF within thirty (30) days of receipt of HPRF's written request. All progress reports shall be directed to HPRF's Principal Investigator and sent to HPRF's Administrative Contact as identified in Exhibit C. 6. PRINCIPAL INVESTIGATOR /SITE PRIMARY CONTACT The Principal Investigator for HPRF and Primary Contact for EMS AGENCY are noted in Exhibit C. EMS AGENCY's Primary Contact shall be responsible for the technical and administrative conduct of the Study covered by this Agreement. In the event that a change in EMS AGENCY's Primary Contact is necessary, HPRF must be notified in writing immediately. 7. NOTICES: For either party, all notices required or permitted under this Agreement shall be effective only if given in writing and delivered by personal service (including email), or by express or registered mail, to the appropriate institutional officials identified in Exhibit C. All notices and requests for approvals from HPRF on financial or administrative matters shall be submitted to the HPRF's Administrative Contact identified in Exhibit C. 8. FEDERAL STATE AND LOCAL TAXES: Except as may be otherwise provided in this Agreement, the Agreement price includes all applicable Federal, State and local taxes and duties. 9. COMPLIANCE WITH LAW Each party shall comply with any and all applicable State and Federal laws, regulations and policies applicable to this Agreement, and shall ensure that any of its contractors and subcontractors also complies with such requirements. 10. HIPAA COMPLIANCE: The parties may receive from each other certain health or medical information in the performance of this Agreement ( "Protected Health Information" or "PHI," as defined in 45 C.F.R. Section 160.103). Use or disclosure of PHI is subject to the terms of the Data Use Agreement associated with this Study. Draft Agreement HPRF ->EMS AGENCY 3 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010 11. REVIEW OF HUMAN SUBJECTS IN RESEARCH PROJECTS: As applicable, EMS AGENCY shall comply with Department of Health and Human Services (DHHS) policies and regulations regarding the Protection of Human Subjects (Title 45 Code of Federal Regulations, Part 46, Subpart A, as amended) and with 21 CFR 50 and 21 CFR 56, as applicable. 12. USE OF NAME HPRF and EMS AGENCY mutually each agree to not use the name of the other, or the name of any staff of the other in any commercial or non - commercial advertising or other public communication concerning this Study without the prior written permission of a duly authorized party hereto and individual whose name is planned to be used. 13. CONFIDENTIALITY: (a) Each party shall keep confidential that information received from the other party that is confidential or proprietary in nature, whether received directly or indirectly, during or otherwise in connection with projects governed by this Agreement. "Confidential Information" includes but is not limited to the following: i) study participant medical records, research data, and other identifiable personal health information; ii) any other patient - identifiable information; iii) provider - identifiable information; iv) any nonpublic Information about the business operations of each party; v) any other nonpublic information of each party including but not limited to health care delivery practices, utilization data, pharmacy data, membership or other health plan information; and. (vi) Confidential Information of other participating sites. (b) Each party shall make reasonable efforts to mark Confidential Information clearly, or so identify Confidential Information that is disclosed orally provided however, that items described in Section (a), (i), (ii) and (iii) above shall be automatically deemed Confidential Information without further identification. If a party determines it has made an oral disclosure of Confidential Information, the party making the disclosure shall be responsible for clearly informing the other party, in writing within thirty (30) days that the information disclosed is confidential. Except for items described in Section (a), (i), (ii) and (iii), which confidentiality shall be maintained as required by law, the parties shall use reasonable efforts to maintain the confidentiality of the items described in Section (a), (iv) and (v) for a period of five (5) years after termination of the Agreement. (c) The obligation to keep information confidential shall not apply to: i) information that is shown to have been in the possession of the receiving party before being disclosed by the disclosing party; ii) information which is now, or later becomes, generally available to the public through no fault of any party to this Agreement; iii) information which is received from a third party who is not under an obligation of confidentiality; Draft Agreement HPRF ->EMS AGENCY 4 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H:\ Agreements \SUbAWard_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010 iv) information which is independently developed by the receiving party without access to the confidential information of the disclosing party; or v) information required to be released by law provided that the other party is notified prior to making such release of information and has the opportunity, if it chooses, to contest such release. (d) Confidential Information provided from one party ( "disclosing party ") to the other ( "receiving party ") under this Agreement shall be maintained by the receiving party in a secure and confidential manner, and used by the receiving party solely in the conduct of the Study and in accordance with this Agreement, the consent documents, if any, and the Study as approved by the applicable IRBs. Any other use or disclosure is prohibited except as expressly authorized by applicable law or elsewhere in this Agreement. A receiving party shall disclose Confidential Information only to such persons (employees, agents, contractors, and vendors) having a need to know such information necessary for the receiving party to conduct the Study. The parties to this Agreement agree that any Confidential Information received from the other party and retained by either Party must be recorded in such a manner that it cannot be directly or indirectly linked through identifiers to any patient, enrollee, employee, provider, or other individual related to the party from whom the information was received. The parties agree to advise each of their investigators, subcontractors, employees and agents who have access to Confidential Information received from the other party under the terms of this Agreement from using or disclosing that Confidential Information in a manner contrary to the terms of this Agreement. The disclosing party may require the other party's agents, contractors and vendors to sign confidentiality agreements acceptable to the disclosing party before providing such individuals access to its Confidential Information. Notwithstanding anything in this Section 13 to the contrary, HPRF and EMS Agency will comply with the requirements of the Minnesota Data Practices Act (the "Act ") in performing its duties under this Agreement. No private or confidential data collected, maintained or used in the course of performance of this Agreement will be disseminated, except as authorized or required by the Act either during the term of this Agreement or thereafter, Any data supplied to EMS AGENCY by HPRF during this Agreement will be administered in accordance with the provisions of the Act. 14. TERMINATION Notwithstanding the provisions of Section 2 above, either party may terminate this Agreement for any reason upon thirty (30) days prior written notification to the other parry, effective on the date the other party receives such notice, and with cause thirty (30) days after an uncured material breach described in a written notification to the breaching party. In the event of early termination, EMS AGENCY shall take all reasonable steps to minimize further costs, and shall be entitled to reimbursement for costs and non - cancelable obligations incurred prior to the effective date of such early termination, except in no event shall such reimbursement exceed the amount set forth in Section 3. If Draft Agreement HPRF - >EMS AGENCY 5 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010 this Agreement is terminated early, then EMS AGENCY shall deliver such information and items completed up to the early termination date to the HPRF. The following Sections shall survive the expiration or termination of this Agreement: Section 10, 11, 12, 13, 15, 17, and 23. 15. DISPUTE RESOLUTION: a) Equitable Relief. Nothing in this Agreement shall prevent either party from seeking equitable relief. b) Meet and Confer. No party shall initiate legal action under or in relation to this Agreement unless it has first complied with the process described in this subsection (b), excluding actions for which equitable relief is sought. Should a dispute arise under or in relation to this Agreement or to a specific Study Agreement governed by this Agreement and equitable relief is not sought, a party shall issue a written notice to the other party describing the dispute and the remedy sought. The disputing parties shall meet and confer in person or by telephone within five business days of receipt of such notice, or such other time period as the parties may mutually agree in writing. If such dispute is not resolved through such conference within five business days, the matter shall be immediately referred to the persons to whom each such individual reports within its organization who shall attempt to resolve the dispute. If the dispute is not resolved within twenty business days after receipt of the notice, or such other time period as the parties may mutually agree in writing, either party may seek any remedy available under law including, without limitation, immediate termination of this agreement. 16. FORCE MAJEURE: No party shall be liable for any delays or failures in performance resulting from circumstances or causes beyond its reasonable control, including, without limitation, fire or other casualty, act of God, war or other violence, or any law, order or requirement of any governmental agency or authority, provided that the party claiming the force majeure event shall use reasonable efforts to continue to perform on any specific study governed by this Agreement. 17. INDEMNIFICATION: Each party shall be responsible for the negligent or willful acts or omissions of itself and its agents to the extent allowed by law. Financial records, supporting documents and other records pertinent to this Agreement shall be retained by EMS AGENCY for a period of three (3) years from the date of submission of the final expenditure report, except that records pertaining to audits, appeals, litigation or settlement of claims arising out of performance of this Agreement shall be retained until such audits, appeals, litigation or claims have been disposed of. The retention period starts from the date of the submission of the EMS AGENCY's final invoices. Draft Agreement HPRF - >EMS AGENCY 6 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010 The retention periods set forth in this section 18 are minimum retention periods; the EMS AGENCY will retain records for longer periods if required by its record retention schedule as required by state law. All research records, including but not limited to original data and primary data - yielding materials, secondarily derived tables and figures, and statistical tabulations and other summaries, pertinent to this Agreement shall be made available to HPRF upon its reasonable request during business hours and shall be retained by EMS AGENCY for a period of three (3) years from the termination date of this Agreement, except (a) to the extent a Party has requested the return of such records, or (b) that records pertaining to any allegation of scientific misconduct or investigation, appeal, administrative proceeding or litigation relating to any charge arising out of the scientific performance of this Agreement shall be retained until three (3) years after the later of the conclusion of the allegation, investigation, appeal, administrative proceeding, litigation or acceptance by Public Health Service of a final report pertaining thereto. Administration of this Agreement shall be in accordance with generally accepted accounting principles, with Office of Management and Budget (OMB) Circular A -110, A- 122, A -133 and with applicable provisions of the NIH Grants Policy Statement (NIHGPS). EMS AGENCY acknowledges and agrees that, as part of HPRF's implementation of OMB Circular A -133 HPRF will monitor EMS AGENCY's performance under this Agreement and, in the event of incomplete performance, HPRF may require EMS AGENCY to obtain, at EMS AGENCY's sole expense, an independent audit of costs claimed under this Agreement. If EMS AGENCY expends $500,000 or more in federal funds in any one year, EMS AGENCY will arrange for an annual examination by an independent accountant in order to ascertain the effectiveness of the EMS AGENCY's financial management systems and internal procedures established to meet the terms of this Agreement. If the EMS AGENCY is subject to the uniform administrative requirements of OMB Circulars A -110 and arranges for audits that comply with OMB Circular A -133 or equivalent guidelines, the EMS AGENCY shall provide its independent accountant's or firm's written report upon execution of this Agreement. Any subsequent audit report shall be sent to the HPRF within thirty (30) days of receipt by the EMS AGENCY. The report(s) shall be sent to the HPRF's Financial Contact address referenced in Exhibit C. EMS AGENCY shall monitor other entities that receive funding through the EMS AGENCY as a result of this Agreement and shall adhere to all applicable regulations outlined in OMB Circular A -133 including requirements of Subpart D-- Federal Agencies and Pass - Through Entities. If any audit report or other significant accounting errors in invoicing or budgeting reflect major shortcomings in EMS AGENCY's internal control systems, HPRF may seek to impose more stringent prior approval requirements for certain types of expenditures and /or rebudgeting and may require detailed supporting documentation for all claims for reimbursement until EMS AGENCY has reasonably demonstrated that necessary corrective action has been, or will be taken. Draft Agreement HPRF - >EMS AGENCY 7 Document modified by: IMMEDIATE TRIAL A10-013 Kate Rardin -Leahy H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010 Within six months of receipt of a report or statement identifying an instance of noncompliance with Federal laws and regulations, the EMS AGENCY shall provide to HPRF its plan for corrective action and shall cooperate with HPRF in resolving questions HPRF may have. All such records and reports or statements prepared in accordance with the requirements of OMB Circular A -133, as applicable, shall be available for inspection by representatives of HPRF or the government during normal business hours. The EMS AGENCY shall ensure that other subcontractors, as well, who receive funding or perform work through the EMS AGENCY as a result of this Agreement adhere to the terms of this section. Failure to comply with the terms of this paragraph may lead to Agreement termination in accordance with Section 16, Termination. The Comptroller General of the United States, the U.S. Department of Health and Human Services, the HPRF and any of their duly authorized representatives shall have access at any reasonable time after prior written notification to pertinent books, documents, papers and records of EMS AGENCY in order to make audits, examinations, excerpts and transcripts. In the event that any payment made to the EMS AGENCY is determined on the basis of such audits to be unallowable the EMS AGENCY shall promptly refund the unallowable amount to HPRF upon demand. 19. INDEPENDENT CONTRACTOR EMS AGENCY is deemed at all times to be an independent contractor and shall be wholly responsible for the manner in which it performs the services required of it by the terms of this Agreement. Nothing contained herein shall be construed as creating the relationship of employer and employee between HPRF and EMS AGENCY or its officers, agents, and employees. 20. SEVERABILITY If any provision of this Agreement or any provision of any document incorporated by reference shall be held invalid, the parties will try to construe the provision in a manner that eliminates the offending language but maintains the overall intent of the Agreement. If that is not possible, the provision will be excised from this Agreement. The remainder of the Agreement will remain in full force and effect only if the excised provision does not relate to payment or obligations and enforcing this Agreement would not result in substantial unfairness to a party. Otherwise, either party may terminate this Agreement upon thirty (30) days advance written notice. 21. MODIFICATIONS: No modification, amendment, supplement to, or waiver of this Agreement shall be binding upon the parties unless made in writing and duly signed by the authorized institutional officials of both HPRF and EMS AGENCY as identified in Exhibit C. 22. ASSIGNMENT/TRANSFER EMS AGENCY may not assign, subcontract, delegate, cede or otherwise transfer any of its rights or obligations under this Agreement without the prior written consent of HPRF, which consent will not be unreasonably withheld; provided, however, without HPRF's consent EMS AGENCY may assign this Agreement in connection with the transfer or Draft Agreement HPRF - >EMS AGENCY 8 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H:\ Agreements \SubAward_FINAL - COTTAGE GROVE S- 27- 10.docx April 14, 2010 sale of all or substantially all of its assets or business or its merger or consolidation with another company but in such event, the assigning party shall provide the other party with no less than 30 days prior written notice of the assignment, and the other party may terminate this agreement pursuant to Section 16, herein. This Agreement shall inure to the benefit of and be binding upon each party hereto, its successors and permitted assigns. No assignment shall relieve either party of the performance of any accrued obligation which such party may then have under this Agreement. 23. SPECIAL CONDITIONS FOR FEDERALLY FUNDED GRANTS EMS AGENCY shall comply with the Special Conditions for Federally Funded Grants as identified in Exhibit D, attached hereto and incorporated herein by reference. 24. ENTIRE AGREEMENT: This Agreement, including exhibits and attachments, constitutes the entire agreement between the parties regarding the subject matter herein and supersedes all prior agreements between the parties. 25. APPROVALS Any written approvals required under this Agreement may be made via email. IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the month, day and year specified below. HealthPartners Research Foundation Agency: Beverly A. Prawalsky Chief, EMS AGENCY Date Sr. Mgr., Financial Reporting & Grants Management Date Draft Agreement HPRF - >EMS AGENCY 9 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010 EXHIBIT A SCOPE OF WORK Members of Cottage Grove Public Safety will attend four hours of training on the IMMEDIATE trial study protocol and two hours of required NIH Human Subjects Protection online training. They will identify and recruit participants for the trial according to the eligibility criteria and the recruitment and enrollment protocol developed under the Exception from Informed Consent regulations (21 CFR 50.24). The IMMEDIATE (Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency Care) Trial will determine if an intravenous glucose, insulin and potassium (GIK) solution can reduce the incidence of acute myocardial infarction (AMI) as assessed by biomarker and electrocardiogram evidence of myocardial necrosis within the first 24 hours of enrollment. A randomized placebo - controlled double - blinded clinical trial of immediate GIK will be conducted as early as possible in the prehospital emergency medical services (EMS) setting. This subcontract is part of the overall IMMEDIATE Trial Federal grant number UOI HL077821. HealthPartners Research Foundation (HPRF) serves as the subcontractor for the St. Paul Site. The funding period for this site is anticipated to begin on 03/15/10 assuming all Pre - Funding Period deliverables are met. Funding is expected to continue through enrollment plus one month close -out support. The budget provided to Cottage Grove Public Safety under this agreement is for the funding period 02/01110 through 01/31/11. Wes Halvorsen of EMS Agency is the subcontract Co- Investigator responsible for the organization and implementation of the IMMEDIATE Trial at EMS AGENCY. EMS AGENCY contact will work with Dr. Frascone [HPRF Site PI] to supervise the EMS AGENCY staff responsible for the overall implementation of the Trial that will include enrollment in the EMS setting. He will supervise research staff, obtain all necessary institutional approvals for human subjects research, ensure completion of training at the EMS agency, overall compliance of the Protocol, and adherence to the budget and timeline. Dr. Frascone is responsible for the implementation of all study - related components involving the EMS system and paramedics and will work closely with EMS AGENCY. It is anticipated that approximately two to three study subjects per month will be enrolled at the St. Paul Site. Enrollment will be monitored on an on -going basis by the IMMEDIATE Trial CC at Tufts Medical Center (Tufts MC) using the electronic data collection and reporting systems. Study resources will be provided directly by Tufts MC to the St. Paul Site, including study protocol and training manuals, the study drug, IV pumps and tubing, study drug supply cases, online paramedic training system, and the electronic data capture system. Pre - Funding Period: • Site Visit - The CC leadership conducts a site visit during this time as part of the site assessment process. It is expected that that the site visit is attended by key representatives from the following: EMS system (medical director, paramedic leadership, fire chief, paramedic educator, state and /or local authority); receiving hospitals (emergency department physicians, cardiology department physicians, nursing, pharmacy); and others such as pharmacists, institutional review board members, and other regulatory or quality assurance staff. The CC leadership will present an overview of the study, answer questions, and view the facilities. ® Institutional Review Board (IRB) Submission and Approval - The CC will work closely with the site. Draft Agreement HPRF ->EMS AGENCY IMMEDIATE TRIAL A10 -013 10 Document modified by: Kate Rardin -Leahy April 14, 2010 H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx • Determine the EMS system's governing IRB • Ensure that a Federal Wide Assurance (FWA) is in place for the EMS system. If not, CC will lead application process for obtaining an FWA. • CC will provide assistance and guidance with IRB application and related processes. The CC will complete the primary IRB application and provide it to the EMS Site for review and signature, and for submission to the IRB. • CC will provide community consultation plan for submission to the IRB; CC will pay for the approved implementation of the community consultation plan. • IRB fees will be paid by the CC if incurred. • CC will attend IRB meeting if requested. • Conflict of Interest form signed and returned to CC (Site PI and Investigators) • Investigator's CV, license and human subject protection certification provided to CC • Protocol Signature Page signed and returned to CC o FDA form 1572 Start -Up Period: • Onsite orientation and training of research team • Schedule and convene meeting with all staff and CC Program Manager • Manual of Operations, policies and procedures • Electronic data capture (EDC) data collection system • Staff training on the study drug tracking system • IRB processes • Complete community consultation • Complete public disclosure • IRB submission and approval from EMS system's receiving hospital • Paramedic training • Complete Human Subjects Protection certification program • Complete all IMMEDIATE Trial study modules • Complete hands -on practicum • Electronic data systems • Predictive instrument software upgrade to the electrocardiographs ® Transfer of data to the Trial's Data Coordinating Center (DCC) • Report distribution and monitoring • Staff training on the study drug tracking system • Materials and study drug distribution Draft Agreement HPRF - >EMS AGENCY 11 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H: \Agreements \SubAWard_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010 1x1'11-1 ... Prior to the onset of the Enrollment Period, paramedics within the St. Paul Site will be fully prepared to participate in the screening and enrollment process and all receiving hospitals will be ready. Enrollment in the EMS setting will be monitored on an ongoing basis, providing daily, weekly and monthly reports to ensure that all patients evaluated for a cardiac event have an ECG done, and subsequently a Screening Form completed (for every ECG). All Screening Forms will be entered into the EDC system within 24 hours to allow for close monitoring and ensuring that the minimum requirements for study subject enrollment are met. The expectations are that screening and enrollment will occur 24 hours a day, 7 days a week and 365 days a year. The assigned CC Program Manager and the Site Team will review reports weekly to monitor the paramedics' performance based on study subjects who are correctly enrolled, incorrectly enrolled, and those who are missed. This will allow close monitoring of the Site's false positive rate, and if the false positive rate exceeds 10% on a continual basis then continued payment for study subjects who do not have ACS will not be provided. During this period, the Site Team will be responsible for adhering to the Protocol requirements and as specified in the Manual of Operations. Draft Agreement HPRF - >EMS AGENCY IMMEDIATE TRIAL A10 -013 F Document modified by: Kate Rardin -Leahy April 14, 2010 H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx PRITUTHM Reimbursement for Paramedic attendance at study training session Total Costs $ 8,100.00 Paramedic Training We estimate that 30 staff members of EMS AGENCY will be trained to participate in the Trial with four hours of didactic training each. Staff members will also be completing two hours of on -line training. EMS AGENCY will be reimbursed for their staff's training time at six hours times their individual hourly rate to a maximum reimbursement of $ 8,100.00. Invoice must include the following detail: Date of Training, Attendee name, rate of pay, # of hours = total reimbursement Draft Agreement HPRF ->EMS AGENCY IMMEDIATE TRIAL A10 -013 13 Document modified by: Kate Rardin -Leahy April 14, 2010 H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx Exhibit C HPRF Contacts EMS AGENCY Contacts Administrative Contact (STUDY PI Office) Administrative Contact Name: Josh Salzman Name: Address: 680 Hale Ave. N, Ste. 230 Address: Oakdale, MN 55128 Telephone: 651 - 254 -7749 Fax: 651- 778 -3778 Telephone: Email: Joshua .g.salzman @healthpartners.com Fax: Email: Principal Investigator Site Primary Contact Name: R.J. Frascone, MD Name: Address: Regions Hospital Address: 640 North Jackson Street MS13801B Saint Paul, MN 55101 Telephone: 651.254.7750 Telephone: Fax: Fax: Email: Ralph .J.Frascone @HealthPartners.com Email: Financial Contact Financial Contact Name: Kristin Simonson Name: Address: HealthPartners Research Foundation PO Box 1524 Minneapolis, MN 55440 -1524 Address: Telephone: 952 - 967 -5028 Telephone: Fax: 952 - 967 -5022 Fax: Email: Kristin .J.Simonson @HealthPartners.com Email: Authorized Institutional Official Authorized Institutional Official Name: Name: Beverly Prawalsky Address: HealthPartners Research Foundation PO Box 1524 Address: Minneapolis, MN 55440 -1524 Telephone: 952 - 967 -5003 Telephone: Fax: 952 - 967 -5022 Fax: Email: Beverly .A.Prawalsky @HealthPartners.com Email: Draft Agreement HPRF - >EMS AGENCY IMMEDIATE TRIAL A10 -013 14 Document modified by: Kate Rardin -Leahy April 14, 2010 H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx Exhibit D Special Conditions for Federally Funded Grants General terms and conditions: 1. The restrictions on the expenditure of federal funds in appropriations acts are applicable to this Subaward Agreement to the extent those restrictions are pertinent. 2. 45 CFR Part 74 or 45 CFR Part 92 as applicable. [This is the CFR governing NIH] Including 45 CFR Part 46, 45 CFR Part 50, Subpart F, 45 CFR Part 52, and 45 CFR Part 76. 3. The NIH Grants Policy Statement, including addenda, in effect as of the beginning date of the period of performance and found at http: // grants. nih .gov /grants /policy /policy,htm, except for the payment mechanism and final reporting requirements are replaced with Reporting Requirements and Terms and Conditions on the front page of this agreement. 4. EMS AGENCY assures, by signing this Subaward Agreement, that all of EMS AGENCY's personnel who are responsible for the design and conduct of projects involving human research participants have successfully completed their institutional training in accordance with the NIH Guide, Notice OD -00 -039. 5. Title to equipment costing $5,000 or more that is purchased or fabricated with research funds or collaborator cost sharing funds, as direct costs of the project or program, shall unconditionally vest in the collaborator upon acquisition without further obligation to the Federal Awarding Agency subject to the conditions specified in the NIH Grants Policy Statement. 6. All prior approvals are to be sought from the HPRF and not the Federal Awarding Agency. Agency- Specific Certifications /Assurances 1. The following assurances /certifications are made and verified by Collaborator's Authorized Official Signature on this Subaward Agreement. Descriptions of individual assurances /certifications are provided in Section III of the PHS 398. 1) Human Subjects; 2) Research Using Human Embryonic Stem Cells; 3) Research on Transplantation of Human Fetal Tissue; 4) Women and Minority Inclusion Policy; 5) Inclusion of Children Policy; 6) Vertebrate Animals; 7) Debarment and Suspension; 8) Drug -Free Workplace; 9) Lobbying; 10) Non - Delinquency on Federal Debt; 11)Research Misconduct; 12) Civil Rights (Form HHS 441 or HHS 690); 13) Handicapped Individuals (Form HHS 641 or HHS 690); 14) Sex Discrimination (Form HHS 639 -A or HHS 690); 15) Age Discrimination ( Form HHS 680 or HHS 690); 16) Recombinant DNA and Human Gene Transfer Research; 17) Financial Conflict of Interest; 18) Smoke Free Workplace; 19) Prohibited Research; 20) Select Agent Research; 21) PI Assurance. Draft Agreement HPRF ->EMS AGENCY 15 Document modified by: IMMEDIATE TRIAL A10 -013 Kate Rardin -Leahy H:\ Agreements \SubAward_FINAL - COTTAGE GROVE 5- 27- 10.docx April 14, 2010