Item C06
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BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
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Meeting Date: December 17.2003
Bulk Item: Yes X
No
Division: County Administrator
Department: Fire Rescue
AGENDA ITEM WORDING: Approval of Contract Amendment with Professional Emergency
Services, Inc., to extend the existing agreement for two months, January 02, 2004 through February 29,
2004, to allow parties sufficient time to determine the details of future operations,
ITEM BACKGROUND: The existing contract between Professional Emergency Services, Inc, is due to
expire on January 01, 2004, Due to the fact that the existing relationship has been altered to include air
ambulance medical services, sufficient time is required to determine the details of future operations,
therefore, a two-month contract amendment has been prepared,
PREVIOUS RELEVANT BOCC ACTION: On January 19,2000, the Board granted approval and
authorized execution of a contract between Monroe County and Physician Resources, Inc, as Medical
Director/Fire Department Physician for Emergency Medical Services and Fire Departments, effective
January 01, 2000 through January 01, 2002.
On November 20, 2001, the Board approved a Contract Addendum to extend the agreement for Medical
Director Services for an additional two year period, effective January 02, 2002 through January 01, 2004.
On April 17,2002, the Board granted approval of an Agreement Addendum with Physician Resources, Inc,
to change the contractor's name to Professional Emergency Services, Inc., and reduce the annual contract
amount by $4,000,00,
CONTRACT/AGREEMENT CHANGES: Extend the existing Agreement for two additional months
effective January 02, 2004 through February 29, 2004.
ST AFF RECOMMENDATIONS: Approval.
TOTAL COST: $8.000.00
BUDGETED: Yes X
No
COST TO COUNTY: $8.000,00
SOURCE OF FUNDS: Ad Valorem Taxes
REVENUE PRODUCING: Yes
NoX AMOUNTPERMONTHN/A
Year
DIVISION DIRECTOR APPROVAL:
DOCUMENTATION: Included---X-
DISPOSITION:
To Follow
Not Required
AGENDAITEM#~
Revised I/03
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Professional Emer!!:encv Services. Contract#_
Inc. Effective Date: January 02, 2004
Expiration Date: February 29,2004
Contract Purpose/Description: Contract Amendment with Professional Emergency Services, Inc. to extend exist-
in!!: agreement.
Contract Manager: Clark O. Martin, Jr. 6006 Fire Rescue 1 Stop #14
(Name) (Ext. ) (Department/Stop #)
for BOCC meeting on Dec. 17,2003 Agenda Deadline: Dec. 02, 2003
CONTRACT COSTS
Total Dollar Value of Contract: $
Budgeted? Yes[8J No 0
Grant: $ nla
County Match: $
$8,000.00
Account Codes:
Current Year Portion: $
13001-530340 - $3.333.34
11500-530340 - $4.000.00
12500-530340 - $ 666.66
ADDITIONAL COSTS
For:
(eg. maintenance, utilities, janitorial, salaries, etc.)
Estimated Ongoing Costs: $_/yr
(Not included in dollar value above)
CONTRACT REVIEW
Change, ~ Date Out
Date In
Division Director /~~ Yes8e~~~;t;Jjf:.; -= } )..-:J-tO
Risk Management 1)!3/o 3 1;I/J/oJ
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O.M.B.lPurchasing ~3 YesD NoGr ,~~~.""- t:' 4~_/,--_, /2ft),-,
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County Attorney 12102/03 YesO Nol2J 12/02/03
I
Comments:
OMB Form Revised 2/27/01 MCP #2
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CONTRACT AMENDMENT
THIS CONTRACT AMENDMENT entered this 17th day of December,
2003, between the Board of County Commissioners of Monroe County
(BOARD) and Professional Emergency Services, Inc.
WHEREAS. the parties entered into an agreement on January 19,2000,
and thereafter amended said agreement on November 20,2001, and on April
17,2002;and
WHEREAS. said agreement as amended previously terminates January
1, 2004; and
WHEREAS, the parties recognize that the existing relationship has been
altered to include air ambulance medical services; and
WHEREAS, it is desired to extend the agreement for two months to allow
the parties sufficient time to determine the details of future operations; now
therefore
The parties agree as follows:
1. The contract dated January 19,2000, as previously amended,
shall be extended through February 29,2004, at the rate of $4,000.00
per month.
2, All other provisions of the contract dated January 19, 2000, as
amended November 20, 2001, and April 17, 2002, not inconsistent
herewith, shall remain in full force and effect,
IN WITNESS WHEREOF. the parties have hereunto set their hands and
seal, the day and year first above written.
(SEAL)
ATTEST:
BOARD OF COUN'lY COMMISSIONERS
OF MONROE COUN'lY, FLORIDA
BY:
DANNYL.KOLHAGE, CLERK
By:
Mayor
Deputy Clerk
MONROE COUNTY ATT NEY
,......-APPROVED A R ,
PROFESSIONAL EMERGENCY SERVICES, INC.
BY:
Sandra Schwemmer. D.O., FACOEP, FACEP
AGREEMENT ADDENDUM
for
MEDICAL DIRECfOR SERVICES
TIllS AGREEMENT ADDENDUM is made and entered into this 17 th day
of ADd! .2002, between the Board of County Commissioners, Monroe
County, Florida and Physician Resources. Inc.
WHEREAS, on January 19, 2000, the parties entered into an agreement for the
period January 1,2000 through January 1,2002; and
WHEREAS, on November 20, 2001, the parties agreed to an agreement
addendum for the period commencing January 2, 2002 and ending January 1, 2004; and
WHEREAS, it is desired to reflect in this amendment the corporate name change
of Physician Resources, Inc.; now therefore,
IT IS AGREED as follows:
1. CONTRACTOR: The agreement for Medical Director Services will be between
the Board of County Commissioners of Monroe County, Florida and Professional
Emergency Services, Inc.
2. COMPENSATION: As of April 1, 2002, payment for services provided shall be
an annual fee of$48,000 DOLLARS; $4,000 invoiced and payable monthly.
3. In all other respects, the agreement between the parties dated January 1,2000, as
previously amended, not inconsistent herewith, shall remain in full force and effect.
IN WITNESS WHEREOF, the parties have hereunto set their hands and seal, the
day and year first written above.
BOARD OF COUNlY COMMISSIONERS
OF MONRO UNlY, FLORIDA
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Ar~~OUlAGE, CLERK
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P/lJJFESSION~SERVICES. INC.
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Sandra Schwemmer, D.O., FACOEP, FACEP
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CONTRACT ADDENDUM
THIS CONTRACT ADDENDUM is made and entered into this 20th day of
November .2001, between the Board of County Commissioners of Monroe
County, Florida, and Physician Resources, Inc., in order to amend the agreement between
the parties dated January 1,2000, as follows:
1. Term: This CONTRACT ADDENDUM shall become effective on January 2,
2002 and shaH expire on January I, 2004.
2. Comoensation: Payment for services provided shall be an annual fee of $52.000
DOLLARS,S4.333.33 invoiced and payable monthly.
In all other respects, the agreement between the parties dated January I, 2000
remains in full force andetfect.
IN WITNESS WHEREOF, the parties have hereunto set their hands and seal, the
day and year first written above.
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~: DANNYL.
B .L,-.-r..~
Depu Clerk
BOARD OF CO
OF MONROE C
COMMISSIONERS
, FLORIDA
Sandra S
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MEDICAL DIRECTOR/FIRE DEPARTMENT PHYSICIAN
CONTRACT
THIS CONTRACT, made and entered into this ~ day of January. 2000. by and
between the Board of County Commissioners, Monroe County. Florida, hereinafter
.referred to as the "COUNTY" and Physician Resources. Inc., hereinafter referred to as the
"Medical Director", also referred to as the "Fire Department Physician".
WITNESSETH:
WHEREAS, the COUNTY provides fire and emergency medical services pursuant
to Chapter 401, Florida Statutes, in the foJlowing geographic areas: Cow Key Channel
(mm4) to Channel 2 bridge (mm72,5) and from Tavernier Creek Bridge (mm90.5) to South
Bay Harbor Drive and Lobster Lane (mm95); also known zs the Lower and Middle Keys
Fire and Ambulance District, and South Bay Harbor Drive and Lobster Lane (mm95) to
the Dade County line on US I (mmI13) and north on SR 9:>5 to the intersection of Card
Sound Road, Municipal Service Taxing District 6, in regards to Key Largo Volunteer Fire
Department; and
WHEREAS. the COUNTY is required to employ (lr contract with a Medical
Director who shall be a licensed physician; a corporation, association or partnership
composed of physicians; or physicians employed by any hospital which delivers in-
hospital emergency medical services and which employs or contracts with physicians
specifically for that purpose; and
WHEREAS, the COUNTY chooses to contract with a Medical Director for the
purpose of providing direction to the Fire and Emergency Medical Services;
Medical Director Contract - EMS
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WHEREAS, legislation requiring the establishment of trauma systems requires
close interaction between the EMS system and hospitals; and
WHEREAS, the Medical Director is licensed in the State of Florida and desires to
provide professional services as the Monroe County Medical Director according to the
.terms and conditions stated herein.
NOW THEREFORE, in consideration of the mu':ual understandings and
agreements set forth herein, the COUNTY and Medical Director agree as follows:
1. Term.
This Contract shall become effective on January I. 2000, and shall run through January 1,
2002, and shall be renewable thereafter at the option of the COUNTY for an additional two
(2) year period,
2. Termination.
(a) This Contract may be terminated by the Medical Director, with or without
cause, upon not less than ninety (90) days written notice delivered to the
COUNTY,
(b) The COUNTY may terminate this Contract in whole or in part, upon not
less than thirty (30) days written notice, d~:livered to the terminated party or,
at the option of the COUNTY, immediately in the event that any party fails
to fulfill any of the terms, understandings o:>r covenants of this Contract.
3. Purpose.
The purpose of this Contract is to assure compliance of the COUNTY in medical direction
of its Fire and Emergency Medical Services System.
Medical Director Contract - EMS
2
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4. Duties and Responsibilities.
The Medical Director shall be responsible to the Fire and Emergency Medical Service
Departments of the Division of Public Safety and report to the Emergency Medical
Services Chief.
The Medical Director shall adhere to the responsibilities ,.s set forth in Florida Statutes
401, Medical Directors, Florida Administrative Code 64E-2, Emergency Medical Services,
Medical Direction, and National Fire Protection Association 1582. 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 or designee will provide formal training with lecture topics and dates
which will allow each Monroe County EMT, Paramedic ,.nd Firefighter to fulfill the
continuing education requirements for bi-annual State of ::;'lorida re-certification.
Annually, the Professional Education Program will be evaluated for content, location and
dates.
The Medical Director will be available for consulting and advising on all EMS activities
undertaken by the career and volunteer emergency response departments of Monroe
County as requested by the County. The Medical Director shall be available 24 hours a
day for emergency consultation from system Fire-EMS provider. He/She shall carry a
pager and be supplied a portable radio by the Division of Public Safety. He/She shall
respond in a timely manner to any pages from the EMS Provider, 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
Medical Director Contract - EMS
3
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certain duties and responsibilities as outline in this agreement, upon approval of the EMS
Chief.
PROTOCOLS
The Medical Director shall provide an annual documented review of the pre-hospital
treatment protocols and when necessary, the EMS providt:r and the Medical Director shall
jointly approve each protocol revision prior to implementltion, These protocols shall be
developed with consideration to the fiscal impact of such protocols on the participating
agencies and the citizens of Monroe County,
At such time as the County determines that implementation of Basic Life Support
protocols is appropriate and feasible for a particular volunteer fire department, the m'edical
director, assistants, and/or designee will assist in implem(:ntation and appropriate in-
servicing of the medical treatment protocols.
Deviations, from these protocols, shall be reviewed by th,: 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,
QUALITY ASSURANCE
The Medical Director shall establish a quality assurance committee to provide for quality
assurance review of all emergency medical technicians and paramedics operating under
hislher supervision and function as an integral part of the County" Quality Assurance
program,
The Medical Director and/or each appointee of the medical director's staffshall audit the
performance of system personnel by use of a quality assurance program to include but not
limited to a prompt review of patient care records, direct observation, and comparison of
performance standards for drugs, equipment, system protocols and procedures. The
Medical Director Contract - EMS
4
Medical Director or appointee shall not be required to provide direct patient care during
these activities.
LOCAL DISASTERS
In the event of a local disaster or impending emergency situation with the possibility of
multiple casualties, the Medical Director or an appointee :;hall be available for emergency
consultation.
COST CONTAINMENT / EQUIPMENT & PROCEDURES
The Medical Director shall periodically review ail policies and procedures for cost .
effectiveness, Providing state of the art fire and emergency medical services to the citizens
of Monroe County in the most cost effective manner shall be a top priority of the Medical
Director,
The Medical Director will consult and advise on all medi.;al equipment to be carried and
utilized by a participating volunteer fire department and/cor any other emergency response
agency. Specifically, if the County elects to implement use of Automatic External
Defibrillators (AED's), the Medical Director will develop the required protocols, and in
cooperation with the County EMS office, implement the necessary training,
INFECTIOUS DISEASE EXPOSl'RE POLICY
The Medical Director shall assist in developing an infectious disease exposure policy that
complies with State and Federal requirements. The Medical Director shall assure that a
comprehensive plan exists for prompt medical review of all possible infectious exposures
reported by Monroe County EMS persoMel and members of the participating volunteer
fire department, and for post-exposure medical follow-up when indicated.
Medical Director Contract - EMS
5
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The Medical Director or designee shall be available to assist in the in-servicing of the
individual volunteer fire department regarding the exposure policy,
The Medical Director or designee shall be available for consultations with field persoMel
.to determine the significance of any body fluid exposure and to suggest appropriate action
for such an exposure,
STATE INVOLVEMENT
The Medical Director shall become involved in the Florida Association of EMS Medical
Directors and preferably an equivalent Fire Association,
S. Insurance.
The insurance requirements for AgreementS/Contracts whi-:h supply goods or services to
the County are incorporated by reference, submitted in Request for Qualifications, and
include the following:
. Indemnification and Hold Harmless Provisions
. General Insurance Requirements
. Workers' Compensation Provisions
6. Compensation,
(a) Payment for services provided shall be an annual fee of$56,000
DOLLARS, ($4,667) invoiced and payablt: monthly;
(b) The annual fee may be revised, based on future modifications to the
County's emergency response areas of responsibility, through a written
Medical Director Contracl - EMS
6
notification to the Contractor based on an annual fee of $4,000 for each of
the eight currently participatory volunteer fire departments and six existing
career Emergency Medical Services stations.
(c) Original invoices for compensation must bt: reviewed by the COUNTY on
or before the tenth (I Olh) calendar day of e~ich month. The COUNTY EMS
provider shall verify the information submitted and then process an original
invoice for payment by the County Finance: Office,
(d) Monroe County's performance and obligation to pay under this contract is
contingent upon an annual appropriation by the Board of County
Commissioners.
IN WITNESS WHEREOF, the parties hereto have caused this Medical Director Conlract
to be executed the day and year first above written,
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Medical Director Contract - EMS
7