1st Extension & Amendment 11/15/2006
Clelll 01 De
Circul coun
Danny L. Kolhage
Phone: 305-295-3130 Fax: 305-295-3663
Memnrandum
To:
Camille Dubroff,
Fire Rescue
Isabel C. DeSantis, . \/
Deputy Clerk j.P
From:
Date:
Thursday, December 07, 2006
The BOCC meeting held on November 15, 2006, the Board approved the fOllowing:
Extension and Amendment Number I to the Agreement between Monroe County and
Professional Emergency Services, Inc. (Dr. Schwemmer) to provide medical direction to
Fire and Emergency Medical Services extending the term through September 30, 2007,
amending Section 2 claritying the type of ambulance covered, defining and identifYing
service segments and rate of compensation, changing the effective date of the payment
increases to coincide with the beginning of the Fiscal Year, claritying rules on vehicle
usage, and adding Section 15 to incorporate medical director coverage for an added
service, Air Ambulance.
Attached hereto is a fully executed duplicate original of the subject document for
your handling. Should you have any questions concerning this matter please feel free to
contact this office.
Copies: Finance
County Attorney
File ./
EXTENSION AND AMENDMENT NUMBER 1
TO THE AGREEMENT BETWEEN
MONROE COUNTY, FLORIDA AND
PROFESSIONAL EMERGENCY SERVICES, INC.
This Extension and Amendment Number 1 ("Amendment I") is made and entered into this i 5+h day of
Nn1f. , 2006, by and between Monroe County, Florida, a political subdivision of the State of Florida
("COUNTY") and Professional Emergency Services, Inc., a corporation organized and doing business in the
State of Florida ("MEDICAL DIRECTOR").
WITNESSETH:
WHEREAS, the parties hereto entered into an agreement dated April 21, 2004 ("Agreement") to
provide medical direction to Fire and Emergency Medical Services as required by Florida Statutes; and
WHEREAS, said Agreement provided an option under Section 1- Term, for the COUNTY to renew
the Agreement for additional periods without going out for a Request for Qualifications or other proposal;
and
WHEREAS, since the Agreement was executed, the Key Largo Fire and Ambulance District, an
independent special district not under the jurisdiction of the County was created, removing some of the
COUNTY'S and MEDICAL DIRECTOR'S area of responsibility; and
......
WHEREAS, the parties desire to amend the Agreement in order to clarify ~ tfPe ~m~ance
covered, define and identify service segments, and change the termination date of the ~e~o c~cide
with the fiscal year; and fT1:; -< n .."
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WHEREAS, the parties desire to add Section 15 to the Agreement to incorpi:frafi'ine~al iliiector
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coverage for an added service, Air Ambulance; : < :":'.:: N g
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NOW, THEREFORE, the parties agree as follows: c
1. Paragraph 1 of the Agreement shall read as follows:
1. Term
This Contract shall become effective on January 1, 2004 and shall run through
September 30, 2007, and shall be renewable thereafter at the option of the COUNTY for two
additional two (2) year periods.
2. The Agreement shall be amended in Section 2 as follows:
2. Compensation - Ground Ambulance
(a) The MEDICAL DIRECTOR shall be paid at a current rate of $4,823.45 per service
segment per year. Currently there are 11 service segments computing to $53,058.00
annually or $4,421.50 monthly. This amount may change during the year if segments are
added or deleted. Payments shall be made monthly in arrears by the COUNTY pursuant
to the Florida Local Government Prompt Payment Act after receipt of proper invoice by
the MEDICAL DIRECTOR.
A service segment is defined as an entity providing service at a specific station. The
following table identifies service segments currently covered:
Station Volunteer Career Service
Fire Fire Rescue Segments
8 1 1
9 1 1 2
10 1 1
11 1 1
13 1 1 2
17 1 1
18 1 1
22 1 1 2
Totals: 5 6 11
(b) The rate of payment per service segment shall be increased five percent (5%) annually on
October 1st during the term of this contract and subsequent extensions or renewals.
*****
(g) MEDICAL DIRECTOR shall be provided one county vehicle including cost of gasoline,
repairs, insurance, and other operational costs, to use for travel within the County. Use of
the vehicle out of county must be approved by the MCFR Chief and/or County
Administrator.
All other terms and conditions of this section 2 shall remain in full force and effect.
3. Section 15 - Air Ambulance shall be added to the Agreement as follows:
Section 15- Air Ambulance
15.1 General Back2round
Prior to October I, 2006, the Monroe County Sheriff ("Sheriff') operated an air ambulance
service by helicopter at no charge to patients. MEDICAL DIRECTOR provided services to
COUNTY to enable COUNTY'S EMS personnel to provide air medical services. Sheriff has
purchased and has made arrangements to provide air ambulance services for trauma and for
inter-facility transfers using COUNTY'S emergency personnel pursuant to an agreement
dated July 19, 2006, with Monroe County, Sheriff, and Global Sky Aircharter Corporation
for which payment may be requested from the patient and/or the requesting facility.
Emergency Medical Service operations require the helicopter to have a license to operate in
the State of Florida as an Air Ambulance, pursuant to Chapter ME-2.005, F.A.e., and such
operations require the COUNTY to employ or contract with a qualified MEDICAL
DIRECTOR in order to provide air medical services pursuant to Chapter ME-2.004(1),
FAC.
15.2 Scope of Work
MEDICAL DIRECTOR shall perform the services described in Chapter 64E-2.004, and 2.005
specific to Air Medical Direction.
15.4 Compensation-Air Ambulance
MEDICAL DIRECTOR shall be paid monthly based on a rate of $30,000.00 per year, $82.19
per day. The monthly invoice prepared by the MEDICAL DIRECTOR shall be calculated
using the number of days that the Air Ambulance is in-service and shall not include days it
was/is out of service. Compensation for services shall be retroactive to October 1, 2004.
COUNTY will reimburse MEDICAL DIRECTOR for any direct expenses associated with
meetings required by COUNTY or Monroe County Sheriff's Office. All compensation shall
be according to County Ordinance and State law.
15.5 Duties and Responsibilities
MEDICAL DIRECTOR will meet with Ryder Trauma Center, local hospitals and other
medical facilities in Miami-Dade County, as needed, to coordinate the operation of the
helicopter. Such ongoing communication and interaction is needed to coordinate patient
management and emergent transport.
MEDICAL DIRECTOR will develop Trauma Transport Protocols to include the use of the
helicopter in scene evacuation of trauma patients.
MEDICAL DIRECTOR will review and approve flight medics, training programs, and the
development of additional procedures, equipment, and medication usage for in-flight
emergency patient transports and reporting/record keeping.
MEDICAL DIRECTOR will be available 24 hours/day, 365 days/year for communication and
consultation. When the MEDICAL DIRECTOR is unavailable, he/she will name a similarly
qualified licensed physician to cover during the absence.
MEDICAL DIRECTOR will create and attend the Monroe County Fire Rescue Safety
Committee meetings, required of a licensed air medical transport service as required by
F.A.e. Ch. 64E.
MEDICAL DIRECTOR will be available 24 hours/day, 365 days/year for consultation as
required by Chapter 64-E2.004(3)(b), F.A.e. to evaluate each patient in person or by written
protocol prior to each inter-facility transfer flight for the purpose of determining that
the aircraft, flight, medical crew and equipment meet the patients needs. Such evaluation may
involve direct communication with the sending and receiving physician, coordination the
appropriate crew configuration which may require nursing or other medical personnel,
additional medication and/or equipment (depending on available resource), patient informed
consent (if needed), in order to determine the need for transport, as well as coordinating
patient management while enroute to the receiving facility.
MEDICAL DIRECTOR will develop and implement a patient care quality assurance system
to asses the medical performance of the flight Paramedics and make recommendation
regarding continuing education and skills training, allowing the growth and development of
the Monroe County Air Medical Program.
MEDICAL DIRECTOR will coordinate with local hospitals and the Monroe County Sheriffs
Office Aviation Department the use of any additional personnel, including appropriate critical
care flight nurses, if available, to attend critical patients.
MEDICAL DIRECTOR will be provided communication devices, appropriate transportation
and reimbursement of travel expenses, at the expense of the COUNTY and will be provided
adequate administrative support services by the COUNTY in order to perform the above
duties and any other reports/consultations as may be required from time to time. Such
administrative support will include use of office space, file cabinets, fax and copy machine,
secretarial assistant services and one Paramedic to be chosen by Monroe County Fire Rescue
Fire Chief and MEDICAL DIRECTOR to act as Liaison/Chief of the Air Medical Program.
15.6 Insurance
County will assure that this service is included in the insurance to be provided under the
Agreement.
In all other respects, the provisions of the contract between the parties dated April 21, 2004, not inconsistent
herewith shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have caused this Amendment I to be executed the day and the
year first above written.
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Board of County Commissioners, Monroe County, FL
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ATTEST:
Danny L. Kolhage, Clerk
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Sandra Sch~em er, D.O., FACOEP, FACEP
Professional Emergency Services, Inc~
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MONROE COUNTY ATTORNEY
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