Item C33
MONROE COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: January 19-20, 2000
Division: Public Safety
Bulk Item: Yes X
No
Department:
EMS
AGENDA ITEM WORDING: Approval to contract with Physician Resources, Incorporation
as Medical Director/Fire Department Physician for Emergency Medical Services and Fire
Departments.
AGENDA ITEM BACKGROUND: A sealed response to an advertised Request for
Qualifications (RFQ) for Medical Director was opened on September 21, 1999. Only one
(1) Request for Qualifications was received and opened by the Purchasing Department.
PREVIOUS RELEVANT BOCC ACTION: The Board of County Commissioners approved a
request to negotiate with Physician Resources, Inc. at a regularly scheduled meeting on
October 13, 1999. At the November 9, 1999, Board of County Commission meeting,
approval was granted to extend the Medical Director Contract, which expired on November
30, 1999, to a month-to-month basis pending execution of a new contract.
STAFF RECOMMENDATION: Approval.
TOTAL COST: $56,000.00
Budgeted: YES X NO
COST TO COUNTY: $4,667.00 a month
REVENUE PRODUCING: YES
NO X
APPROVED BY: CO. ATTY. YES OMB/PURCH. YES RISK MNGT. YES
EMS DIRECTOR APPROVAL: , j L A (A.A Y jj o-u~
Teresa L. Gorentz / /{~
PUBLIC SAFETY DIVISION DIRECTOR APPROVAL:
J
l'
DOCUMENTATION: Included: X
To Follow: Not Required:
--::genda Item #: ~
DISPOSITION:
MEDICAL DIRECTORIFIRE DEPARTMENT PHYSICIAN
CONTRACT
THIS CONTRACT, made and entered into this r 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 following 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 as 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 1 (mml13) and north on SR 905 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 or 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
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 mutual understandings and
agreements set forth herein, the COUNTY and Medical Director agree as follows:
1. Term.
This Contract shall become effective on January 1,2000, 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, delivered 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 or 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
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 as 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 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
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 provider and the Medical Director shall
jointly approve each protocol revision 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.
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 medical
director, assistants, and/or designee will assist in implementation and appropriate in-
servicing of the medical treatment 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.
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
his/her 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 staff shall 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 shall be available for emergency
consultation,
COST CONTAINMENT / EQUIPMENT & PROCEDURES
The Medical Director shall periodically review all 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 medical equipment to be carried and
utilized by a participating volunteer fire department and/or 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 EXPOSURE 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 personnel and members of the participating volunteer
fire department, and for post-exposure medical follow-up when indicated,
Medical Director Contract - EMS
5
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 personnel
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.
5. Insurance.
The insurance requirements for Agreements/Contracts which 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 payable 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 Contract - 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 be reviewed by the COUNTY on
or before the tenth (10th) calendar day of each 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 Contract
to be executed the day and year first above written.
Board of County Commissioners of
Monroe County, Florida
Mayor/Chairman
(SEAL)
Attest: Danny L. Kolhage, Clerk
Ph .. R J
YSlclan esour ,
(
Sandra Sc wemmer, 0,0., FACOEP, FACEP
Deputy Clerk
ANNti.~TiON
/1 9'1 -
n b IE _ I
Medical Director Contract - EMS
7