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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