1st Addendum 08/12/1998
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BRANCH OFFICE
3117 OVERSEAS HIGHWAY
MARA rnON, FLORIDA 33050
TEL. (305) 289~27
FAX (305) 289-1745
CLERK OF THE CIRCUIT COURT
MONROE COUNTY
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
FAX (305) 295-3660
BRANCH OFFICE
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
FAX (305) 852-7146
MEMORANDUM'
TO: Reggie Paros
Director of Public Safety
FROM:
Ruth Ann Jantzen
Deputy Clerk
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DATE:
August 21,1998
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On August 12, 1998, the Board of County Commissioners granted approval and
authorized execution of a Medical Director Contract Addendum between Monroe County
and EmCare, Inc., dlb/a PES-EmCare, for expansion of services and to extend the
contract tenn for an additional one (1) year period, expiring September 30, 1999.
Enclosed please find one fully executed duplicate original of the above Addendum
for return to EmCare.
If you have any questions regarding the above, please do not hesitate to conta'ct
this office.
cc: County Attorney
Finance
County Administrator, wlo document
File
MEDICAL DIRECTOR CONTRACT ADDENDUM
THIS ADDENDUM TO MEDICAL DIRECTOR CONTRACT, made and entered
into this 12th day of AUGUs'r , 1998 A.D., by and
between the Board of County Commissioners, Monroe County, Florida,
hereinafter called the COUNTY and EmCare, Inc. d/b/a PES-EmCare
hereinafter referred to as the "MEDICAL DIRECTOR" , also referred to as the
"Fire Department Physician", in order to amend the Agreement between the
parties dated September 21, 1995, as amended on February 19, 1997 and
October 1, 1997, as follows:
Paragraph 1 of the Recitals shall be amended to read:
Whereas, the COUNTY provides Pre-hospital emergency medical
services pursuant to Chapter 401, Florida Statutes, in the following
geographic areas: Cow Key Channel to Mile Marker 95 on US 1, South Bay
Harbor Drive and Lobster Lane; also known as the Lower and Middle Keys
Fire and Ambulance District, including Municipal Service Taxing District 6Jr
regards to Key Largo Volunteer Fire Department. 6 0 0)
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Item 2, Term shall be amended to read: ~~:::~ N
This Contract shall become effective on October 1 st, 1995, ~fhl5hall
run through September 30th, 1999. ~?5s ~
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Item 5, Duties and Responsibilities shall be amended to read:;1' ~ ;;
The Medical Director shall be responsible to the EMS Departmint 6f -
the Division of Public Safety and report to the Emergency Medical Services
Chief.
The Medical Director shall adhere to the responsibilities as set forth in
Florida Statutes 401, Medical Directors. These include supervising and
assuming direct responsibility for the medical performance of the Emergency
Medical Technicians, Paramedics and Firefighters operating for that
Emergency Medical Services system. The Medical Director shall perform
duties including advising, consulting, training, counseling and overseeing of
services, but not including administrative and managerial functions. The
Medical Director will provide 48 hours of formal training (lecture topics and
dates incorporated by reference under Scope of Work) which will allow each
Monroe County EMT, Paramedic and Firefighter to fulfill the continuing
education requirements for bi-annual State of Florida recertification.
Additionally, a BLS-C, ACLS course, as well as required HIV-AIDS
course will be given. Annually, the Professional Education Program will be
evaluated for content, location and dates.
The Medical Director shall adhere to the duties and responsibilities as
set forth in Florida Administrative Code Chapter 64E-2, Emergency Medical
Services, Medical Direction.
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The Medical Director will be available for consulting and advising on all
EMS activities undertaken by the volunteer emergency response departments
(volunteer fire departments) of Monroe County as requested by the County.
The Medical Director shall be available 24 hours a day for emergency
consultations with system EMS providers. He/She shall carry a pager and be
supplied a radio by the EMS Department. He/She shall respond in a timely
manner to any pages from the Communications Center. In the event the
Medical Director is unavailable, he/she shall appoint a similarly qualified
physician to cover all responsibilities.
The Medical Director may appoint a qualified individual to perform
certain duties and responsibilities as outlined in this agreement, upon
approval of the EMS Chief.
Section titled Exposure Control shall be amended to read:
The Medical Director shall assure that a comprehensive plan exists for
prompt medical review of all possible infectious exposures reported by
Monroe County EMS personnel and members of the participating volunteer
emergency response departments (volunteer fire departments), and for post-
exposure medical follow-up when indicated, in compliance with State and
Federal requirements.
The Medical Director or designee shall be available to assist in the
inservicing of the individual volunteer emergency response departments
(volunteer fire departments) regarding the exposure policy.
The Medical Director or designee shall be available for consultations
with field personnel to determine the significance of any body fluid exposure
and to suggest appropriate action for such an exposure.
Item 6 Compensation shall be amended to read:
(a) Payment for services provided shall be at the annual rate of
$72,760.00 commencing October 1, 1998, to be paid in equal monthly
payments.
(b) Original invoices shall be submitted for review by the County
on or before the tenth (10th) calendar day of each month. The County's
Public Safety Director or his designee shall verify the information submitted
and then process and original invoice for payment by the County Finance
Department.
(c) Monroe County's performance and obligation to pay under
this contract is contingent upon an annual appropriation by the Board of
County Commissioners.
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Section titled Protocols shall be amended to read:
The Medical Director shall provide an annual documented review and
revision of the pre-hospital treatment protocols and shall jointly approve each
protocol prior to implementation. These protocols shall be developed with
consideration to the fiscal impact of such protocols on the participating
agencies and the citizens of Monroe County.
Additionally, the Medical Director shall develop BLS protocols at the
request of the County. At such time as the County determines that
implementation of BLS protocols is appropriate and feasible for a particular
volunteer emergency response department (volunteer fire department) the
director, assistants, and/or designee will assist in implementation and
appropriate inservicing of the protocols.
Deviations from these protocols shall be reviewed by the Medical
Director and appropriate corrective action shall be suggested to the EMS
provider. Notification to State and local agencies shall be completed in
accordance with the appropriate laws.
Section titled Quality Assurance shall be amended to read:
The Medical Director shall establish a quality assurance committee to
provide for quality assurance review of all Emergency Medical Technicians
and Paramedics operating under his/her supervision and function as an
integral part of the County's Quality Assurance program.
The Medical Director shall periodically review run reports including
those generated by participating volunteer emergency response departments
(volunteer fire departments) for completeness and compliance with the
established pre-hospital protocols.
Each appointee to the Medical Director's staff shall function as an
observer in an emergency unit a minimum of three hours per month. The
Medical Director shall not be required to provide direct patient care during
this activity.
A New Section titled Equipment and Procedures shall be added and
read:
Equipment and Procedures: The Medical Director will consult and
advise on all medical equipment to be carried and utilized by the participating
volunteer emergency response departments (volunteer fire departments).
Specifically, if the County elects to implement use of AED's the Medical
Director will develop the required protocols, and in cooperation with the
County EMS office, implement the necessary training.
Section titled, Hold Harmless, shall be amended to read:
The Medical Director covenants and agrees to indemnify and hold
harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property
damage (including property owned by Monroe County) and any other losses,
damages, and expenses (including attorney's fees) which arise out of, in
connection with, or by reason of services provided by the Medical Director or
any of its Subcontractor(s) in any tier, occasioned by the negligence, errors,
or other wrongful act or omission of the Medical Director or its
Subcontractors in any tier, their employees, or agents, not related to services
provided under F.S. 401.265.
Monroe County agrees to be liable for its own negligence, errors and
omissions and those of its employees and agents.
In all other respects, the Medical Director Contract between the parties
dated September 21, 1995 as amended, remains in full force and effect.
IN WITNESS WHEREOF, the parties hereto have caused this Medical
Director Contract Addendum to be executed the day and year first above
written.
County Commissioners of
Count ~
Mayor /Chairman
Attest: Danny L. Kolhage, Clerk
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Deputy rk -
Sa dra Schwemmer,
D.O., FACOEP, FACEP
Wi ess
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Witness