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11/03/1987 Agreement-S s couwryc C:�e� f•. 9.� .w U; ;0 •• _ 4,POF OOUNT•4. Fy� wlannp V Rotbage BRANCH OFFICE CLERK OF THE CIRCUIT COURT BRANCH OFFICE 3117 OVERSEAS HIGHWAY MONROE COUNTY P.O. BOX 379 MARATHON, FLORIDA 33050 500 WHITEHEAD STREET PLANTATION KEY, FLORIDA 33070 TEL. (305) 743.9036 KEY WEST, FLORIDA 33040 TEL. (305) 852-9253 TEL. (305) 294-4641 M E M O R A N D U M To: Reggie Paros, Emergency Services Director From: Rosalie L. Connolly, Deputy Clerk Subject: Resolution No. 428-1987 Date: November 9, 1987 As you are aware, on November 3, 1987, the Board of County Commissioners adopted Resolution No. 428-1987 authorizing the Chairman of the Board to execute an Agreement with Professional Emergency Services, Inc. concerning the perform- ance and services of Medical Director. Attached hereto are two certified copies of the Resolution and two copies of the fully -executed One set of documents should be retained for your the other set should go to your consulting firm. Rosalie L. tonnolly Deputy Clerk Attachments cc: Mayor E. Lytton County Attorney County Administrator F1 e Department 1' l subject Agreement. records and THIS AGREff4ENT, made and entered into effective this .3*0 day of AJ&Af6a , 198 , by and between Professional Emergency Services, Inc., hereinafter referred to as � "Consultant," and the Board of County Commissioners, Monroe County, Florida, hereinafter referred to as the "County." WITNESSETH: WHEREAS, Monroe County is responsible for pre -hospital emergency medical services in the following geographic areas: Municipal Services Taxing Districts (M M) 1-A, 1-B, 1-C, 1 D, 2, 3, 4 A, and 4-B, Monroe County, Florida. WAS, medical direction is essential to the integration of Basic and Advanced Life Support; and, it is deemed most feasible to have a consultant with the skills and experience to deal with emergency medical issues and institutions; and WHEREAS, Professional Emergency Services, Inc. -is a Florida Corporation providing emergency physician staffing and management,. with physicians duly licensed in the State of Florida, and possessing qualifications and experience in the area of Emergency Medicine, and WHEREAS, Dr. Sandra Schwemner, of Professional Emergency Services, Inc. or designee, shall perform duties of Medical Director; and the parties have agreed upon the terms and conditions of providing service to Monroe County and desire to reduce such terms and conditions to writing: NOW, THEREFORE, in consideration of the mutual promises set out herein, the parties hereto mutually agree as follows: ARTICLE I: Scope of Services: Professional Emergency Services shall do the following: 1. Be responsible to the Director of Monroe County Emergency Services Department for the performance of the services of Medical Director, as required by Section 401.265, Florida Statutes and 1OD-66.50 Florida Administrative Code, and as more specifically defined in this agreement, for the following geographic areas: Municipal Services Taxing Districts (MSTD) 1 A, 1-B, 1-C, 1D, 2, 3, 4A and 4B, Monroe County, Florida; excluding MSTD 5, 6 and 7, Monroe County, Florida. 2. Supervise and accept direct responsibility for the medical performance of the Emergency Medical Technicians and Paramedics working for Monroe County. 3. Be responsible for advising the County as to his/her assessment of the competence of each of the Monroe County enployed Emergency Medical Technicians and Paramedics and for making recommendation regarding the medical procedures which each Emergency Medical Technician and Paramedic should be authorized to perform. 4. Continually evaluate the medical capability of the Emergency Medical Technicians and Paramedics employed by Monroe County and advise the County regarding the appropriate level and standard of care which its ambulance service should seek to achieve. 5. umrediately report to the Florida State Department of Health and Rehabilitative Services and to the Monroe County Director of Emergency Services any Paramedic or Emergency Medical Technician he deems to be incompetent in the performance of his/her duties. 6. Assist in identifying the specific medical skills and knowledge which Emergency Medical Technicians and Paramedics must possess to achieve the desired level and standard of care. 7. Assist in identifying the training and experience necessary for the Emergency Medical Technicians and Paramedics to acquire the desired skills and knowledge and, in cooperation with approved educational programs, in assuring that each Emergency Medical Technician and Paramedic receives such training and experience as required. 8. Participate as an instructor in the in-service educational program of the service. 9. Develop and implement a patient care Quality Assurance System to assess the medical performance of Paramedics and Emergency Medical Technicians working for Monroe County. Such Quality Assurance System must comply with such standards and requirements as may be set forth by the Florida State Department of Health and Rehabilitative Services from time to time. 10. Develop, or review for medical correctness, and authorize for use, standing orders and protocols to permit specified Advanced Life Support procedures when co nmications cannot be established with a physician or when any delay in patient care would have potential life threatening consequences. 11. Be responsible for the medical correctness of the standing orders and for properly instructing the Emergency Medical Technicians and Paramedics regarding the use of standing orders. 12. Retain the ultimate authority to prohibit any Paramedic from performing Basic Life Support or Advanced Life Support procedures or any Emergency Medical Technician from performing Basic Life Support procedures for Monroe County, based on the medical performance of the personnel. 13. Approve medications and/or equipment that is to be carried on board the Basic or Advanced Life Support vehicles. 14. Approve medication inventory techniques and schedules and assure that they be in compliance with all applicable Federal and State Laws. 15. Coordinate hospital and emergency roan liaison between the various hospitals and the Basic or Advanced Life Support Services of Monroe County. 16. Provide for on-line medical direction by a Physician who is immediately available, when medically appropriate, for communication with Paramedics and Emergency Medical Technicians. 17. Establish and implement protocols for medical communication. 18. Serve, in concert with the Monroe County Director Emergency Services, as liaison between Monroe County and the various community hospitals, medical associations, and the various training institutions within the community. 19. Serve as medical consultant to Monroe County in the development of analyses and recomae-ndations related to such emergency medical issues as may arise frcan time to time. 20. Assist in making applications for variances, as may be needed from time to time in the operation of the ambulance service, in compliance with 1OD-66.63 Florida Administrative Code. ARTICLE II: Monroe County agrees to do the following: 1. To comply with the Federal, State statutes and County Ordinances as well as rules and regulations relating to Advanced Life Support and to maintain an Advanced Life Support Ambulance Service State License. 2. To provide the Medical Director access to all files and records of Emergency Medical Technicians/Paramedics when requested, and provide copies of pertinent om minication and/or documents involved with the operation of the Monroe County Pre -Hospital Emergency Medical Services System. 3. To provide Medical Director a written report of any and all EMS personnel who are known to have violated any standing order or verbal order. To immediately suspend or renove, upon the request of the Medical Director, from any ambulance, any Paramedic or Emergency Medical Technician deemed by the Medical Director as not having exercised appropriate medical judgement, not maintaining the required level of emergency medical competency and knowledge, or who may be under investigation in regard to the foregoing. 4. Except as may be provided by general law, to keep all medical records confidential and allow no communication of records or patient information without a written release from the Medical Director. 5. To provide for, through the Monroe County Emergency Services Office, secretarial services to facilitate Medical Director's performance of the duties required under this Agreement. 6. To pay the Professional Emergency Services, Inc., the amount of $30,000.00 annually, to be paid in twelve (12) equal monthly payments, for the services provided pursuant to this contract. Payment may be mailed to: Professional Emergency Services, Inc. P.O. Box 1131 Islamorada, FL 33036 ARTICLE III: 1. The term of this contract shall be for two years, effective October 1, 1987. This contract shall be automatically renewed unless either party shall give at least sixty (60) days written notice, prior to the conclusion of any two year term, of such party's intention to terminate this Contract. ARTTMF. TV 1. Professional Ruergency Services, Inc. agrees to provide and keep in effect, at its own expense, professional liability insurance in the amounts of $100,000/$300,000 covering the Medical Director during the tern of this agreement. IN WITNESS WHEREOF the parties hereto have set their hands on the date first written above at �GP� , Monroe County, Florida. �l l Witness �i Witness Attest: DAN"Y L 1"OLHAGE Clerk ,4Q4- Z". 0z. r C= e # r •4 a. •' r����•,ca ��• M ���I� • � vr= � Ili• � • BY: /,... AS TO FORAM 1 t:nomef's Offir,a