Resolution 450-1987
Commissioner John Stormont
RESOLUTION NO. 450 -1987
A RESOLUTION OF THE BOARD OF COUNTY COMMIS-
SIONERS OF MONROE COUNTY, FLORIDA, AUTHORIZ-
ING THE MAYOR TO EXECUTE, ON BEHALF OF MONROE
COUNTY, FLORIDA A MEMORANDUM OF UNDERSTANDING
WITH BAPTIST HOSPITAL OF MIAMI AND DIRECTING
EMERGENCY MEDICAL SERVICES PERSONNEL TO
EXECUTE PROTOCOLS WITH THE VARIOUS EMS
SERVICE DISTRICTS TO AFFECT THE MEMORANDUM'S
TEMPORARY RELATIONSHIP FOR SEVERE, TRAUMA-
RELATED EMERGENCY HEALTH CARE IN MONROE
COUNTY.
WHEREAS, Monroe County, Florida finds itself unable to
provide sufficient emergency trauma-related health care to its
visitors and residents at certain time periods of the year, and
WHEREAS, the Board of County Commissioners is continuing to
attempt to address on-going severe trauma-related emergency
health care on behalf of the public health, safety and welfare of
its people by the establishment of an Emergency Medical Services
Council, and has entered into agreement with the Health Council
of South Florida to aid in determining solutions for such on-
going severe trauma-related health care, and
WHEREAS, the Key Largo Volunteer Ambulance Corps and certain
County officials have, in parallel actions, held discussions with
Baptist Hospital of Miami, having indicated its willingness to
aid Monroe County in its on-going severe trauma-related emergency
health care problems, and,
WHEREAS, Mr. Lee S. Huntley, Vice President at Baptist
Hospital of Miami, has indicated by letter of intent to Monroe
County, Baptist Hospital of Miami's willingness and desire to
enter into a temporary relationship with Monroe County for a
period of sixty (60) days effective December 1, 1987, for accept-
ing trauma patients from Monroe County on certain terms, to help
alleviate seasonal pressures involving severe trauma-related
emergency health care in Monroe County, Florida; now, therefore,
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, as follows:
1. The Mayor is hereby authorized to execute, on behalf of
Monroe County, Florida, a Memorandum of Understanding between
11onroe County and Baptist Hospital of Miami, a copy of same being
attached hereto; and
2. The Emergency Medical Services Coordinator of Monroe
County is hereby directed to make available to and to implement
the provisions of the Memorandum of Understanding with the
Emergency medical Districts throughout Monroe County and their
respective Medical Directors immediately and upon completion of
signatures thereto attached.
PASSED AND ADOPTED by the Board of County commissioners of
Monroe County, Florida, at a regular meeting of said Board held
on the 1st day of December, A.D. 1987.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
Byg~'JL.?
a a~rman
(Seal)
Attest :DANNY L. KOLRAGE, Clerk
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APPPlOI/ED AS TO FORti/!
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MEMORARDUM OF UNDERSTANDING
WHEREAS, Monroe County, Florida, finds itself unable to
provide sufficient emergency trauma-related health care to its
visitors and residents at certain time periods of the year, and
WHEREAS, the Board of County Commissioners is continuing to
attempt to address on-going severe trauma-related emergency
health care on behalf of the public health, safety and welfare of
its people by the establishment of an Emergency Services
Committee and has entered into agreement with the Health Council
of South Florida to aid in determining solutions for such
on-going severe trauma-related health care, and
WHEREAS, the Key Largo Volunteer Ambulance Corps and certain
county officials have, in parallel actions, held discussions with
Baptist Hospital of Miami, having indicated its willingness to
aid Monroe County in its on-going severe trauma-related emergency
health care problems, and,
WHEREAS, Mr. Lee S. Huntley, Vice President at Baptist
Hospital of Miami, has indicated by letter of intent to Monroe
County, Baptist Hospital of Miami's willingness and desire to
enter into a temporary relationship with Monroe County for a
period of sixty (60) days effective December 1, 1987, for
accepting trauma patients from Monroe County on certain terms, to
help alleviate seasonal pressures involving severe trauma-related
emergency health care in Monroe County,
A MEMORANDUM OF UNDERSTANDING is hereby entered into between
the Board of County Commissioners of Monroe County, Florida, on
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behalf of the people of Monroe County, and Baptist Hospital.of
Miami as outlined in the November 25, 1987 letter of intent to
describe a temporary relationship for severe trauma-related
emergency health care, wherein both parties agree to the
following:
1. Monroe County acknowledges that Baptist Hospital
of Miami's primary function is to provide services for
patients within its service area.
2. Baptist Hospital of Miami and its Medical Staff
will do everything reasonably possible to make severe
trauma-related emergency health care available to the
visitors and residents of Monroe County, except that
these same individuals acknowledge that, from
time-to-time, demands for emergency or other critical
services saturate Baptist Hospital of Miami's limited
resources.
At those times where Baptist Hospital of Miami's
resources are s8turated so as to prohibit patient
acceptance under this temporary relationship, Baptist
Hospital of Miami will attempt to aid in placement of
the patient in other facilities, with the understanding
that Monroe County's participation under this temporary
relationship would extend to that institution.
3. Under the provisions of 2. above, Baptist Hospital
of Miami and selected members of its Medical Staff will
accept trauma patients who are able to be transported
by air or ground directly from the scene in such a
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manner as to arrive within sixty (60) minutes of injury
to Baptist Hospital of Miami's Emergency Department.
4. Monroe County on its part will contact
representatives of the state of Florida concerning this
relationship and any conflict with EMS regulations to
assure that this relationship would be allowed to
continue under recently enacted regulations.
5. Paramedics and EMS personnel operating in or on
behalf of Monroe County will be required to contact
Baptist Hospital of Miami Emergency Department
physicians, from the scene, prior to transport, to
review the condition of the patient and the
availability of resources to accept the patient.
6. It is acknowledged that patients initially
transported to Monroe County hospital facilities will
be considered on a case-by-case basis for transfer to
Baptist Hospital of Miami.
7. Prior to contact with Baptist Hospital of Miami
Emergency Department, the on scene paramedic or EMS
personnel will verify:
a) Availability, if required, of Dade County
Air-Rescue One, under Monroe County's agreement
with Dade County, for transport of patient
b) That the patient has trauma score 12, Coma score
10, or evidence of shock at the scene with
systolic BP 90.
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c) Trauma victim has been exposed to a hostile
environment (e.g. hot, cold, or noxious fumes).
d) Trauma victim has experienced penetrating trauma
to the head, neck, chest or abdomen.
e) Trauma victim has experienced amputation.
f) Trauma victim has experienced major burns
requiring treatment at a burn center, including
40% BSA, involvement of facial area, possible
airway compromise.
g) Paralysis, drowning or electrocution, or
h) In extenuating circumstances where in the opinion
of the paramedic or EMS personnel in charge, that
the situation warrants air evacuation for reasons
not specifically listed above, in which case the
paramedic or EMS personnel may call for air
evacuation at his discretion confirmed by the
Medical Director or a member of the District
medical Board of the service involved.
i) In all events, the paramedic or EMS personnel on
the scene will verify with the Medical Director
involved the need for effecting this temporary
relationship prior to contact with Baptist
Hospital of Miami Emergency Department.
8.
The relationship described is between Monroe
County and Baptist Hospital of Miami and does not
extend to Monroe County hospitals, that relationship
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being considered to be beyond the scope of this
temporary agreement.
9. All relations with Metro-Dade Air-Rescue One are
to be handled at the scene by existing protocols
utilized by Key Largo Fire Rescue/Metro-Dade Air
Rescue.
10. Monroe County agrees to guarantee Baptist Hospital
of Miami and the participating Hospital-based
physicians 80% of reasonable charges for each patient.
Where insurance coverage exists or the patient can
defray such costs, Baptist Hospital of Miami and its
physicians will bill and collect appropriately.
Should circumstances dictate that these funds are
not collectable within ninety (90) days of service,
Monroe County agrees to compensate Baptist Hospital of
Miami and its physicians 80% of those charges.
Baptist Hospital of Miami and its physicians will,
in turn, assign insurance benefits to Monroe County in
a manner acceptable to both parties.
Should health or liability insurance coverage be
less than 80% of the charges, Monroe County agrees to
compensate Baptist Hospital of Miami and its physicians
for the difference between collections and 80% of
charges.
11. Monroe County, to aid in the effectiveness of and
as requirement for evaluation of this temporary
relationship shall require its Medical Director of any
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District involved to implement criteria and protocols
included herein, not to exclude reporting of patient
on-scene score report, Air-Rescue One or land transport
report, disposition of patient and follow-up of
hospital treatment logs and reports, to the County
Administrator and Director of Emergency Medical
Services for statistical and effectiveness
determinations.
12. Monroe County hereby desires to include under the
terms of this temporary relationship, the patient case
of Linda Houston, previously transported at the request
of Commissioner Stormont and authorized by the County
Administrator.
13. Monroe County further desires to retain as
designated appointees to further review the aspects of
this temporary relationship and to discuss the content
of a relationship extending beyond January 31, 1988
with Baptist Hospital of Miami the following
individuals: G. Joey Elam and Douglas Cullen, both of
Key Largo Volunte~r Ambulance Corps, J. Allison DeFoor
II of the Monroe County EMS Council, Commissioner John
C. Stormont, and Howard Anderson of Mariner's Hospital.
IN WITBESS WHEREOF, the parties below have caused this
Memorandum of Understanding to be executed by their undersigned
officials as duly authorized.
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BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By:
4.~' ~,
Mayor
Date: D-- ( -8"7
BAPTIST HOSPITAL OF MIAMI
By:
Date:
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BAPTIST HOSPITAL
OF MIAMI
lee S. Huntley
Vice President
November 25, 1987
John C. Stormont
Monroe County Commissioner, Di.trict 5
163 Coconut Row
Tavernier, Florida 33070
Dear Mr. Stormont:
Please consider this as a letter of intent to describe a temporary relationship
effect~ve December 1, 1987, for a period of sixty (60) days between Baptist
Hospital, Monroe County and the Metro-Dade Fire Rescue Department and paramedic
services operating in the Upper Keys.
Baptist Hospital and selected me.bers of its Medical Staff will accept trauma
patients from the Upper Keys and Card Sound Road (exact service area to be
defined) who are able to be transported by air or ground directly from the
scene. Patients to be accepted under this arrangement be transported in such a
manner as to arrive within 60 minutes of injury to Baptist Hospital's Emergency
Department.
In offering this temporary relationship, Monroe County officials, residents
and visitors acknowledge that Baptist Hospital's primary function is to provide
services for patients within its service area. Baptist Hospital and its
Medical Staff will do everything reasonably possible to make these services
consistently available to the visitors and residents of Monroe County. However,
these same individuals acknowledge that, from time-to-time, demands for emergency
or other critical services saturate Baptist Hospital's limited resources.
Monroe County's obligations under this agreesent are:
.
To contact representative. of the state of Florida, concerning this
relationship and any possible conflict with 'EMS regulations, to assure
that this relationship would continue under recently enacted regulations.
To require paramedics operating in or on behalf of Monroe County to
contact Baptist Hospital Eaergency Department physicians, from the scene,
to review the condition of the patient and the availability of resources to
accept the patient. It 18 acknowledged that patients initially transported
to Monroe County facilities will be considered on a case-by-case basis for
transfer to Baptist Hospital. The relationship between Baptist Hospital and
Monroe County Hospitals is considered to be beyond the scope of this temporary
agreement and should be discussed as an issue if this relationship is to
continue beyond January, 1988.
8900 North Kendall Drive
Miami. Fl 33176-1197
(05) S96 - 6503
.
John C. Stormont
Monroe County Commissioner
Page 2
November 23, 1987
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Monroe County Commissioner aarees to work with Metro-Dade Air Rescue to
grant the necessary approvals to land their aircraft at the scene of an
accident, in compliance with regulations similar to those in place in Dade
County.
o
Monroe County agrees to guarantee Baptist Hospital and the participating
and Hospital-based physicians 80% of reasonable charges for each patient.
~lere insurance coverage exists, Baptist Hospital and its physicians will
bill and collect from those insurance companies. Should circumstances
dictate that these funds are Lot collectable within ninety (90) days of
service, Monroe County agrees to compensate Baptist Hospital and its
physicians 80X.of those charges. Baptist Hospital and its physicians will,
in turn, assign insurance benefits to Monroe County in a manner acceptable
to both parties.
Should health or liability insurance coverage be less than 80% of the
charges, Monroe County agrees to compensate Baptist Hospital and its
physicians for the difference between collections and 80% of charges.
Mr. Stormont, representatives and physicians from Baptist Hospital are willing
to review the aspects of this temporary relationship and discuss the content
of a relationship extending beyond January, 1988, with officials from Monroe
County. We look forward to speaking with you further.
Sincerely,
~<;\,\
Lee S. Huntley
Vice President
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