Item C20
MONROE COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: September 20.2000
Bulk Item: Y es ~ No
Division: Public Safety
Department: Medical Examiner
AGENDA ITEM WORDING: Approval of agreement between Monroe County Board of
County Commissioners and Robert 1. Nelms, Jr., MD, District Sixteen Medical Examiner
ITEM BACKGROUND: This is a renewal agreement with Robert 1. Nelms, Jr., MD, for
medical examiner services, as provided for under Florida Statutes Chapter 406. The agreement is
for a one year period, commencing October 1, 2000.
PREVIOUS RELEVANT BOCC ACTION: On September 8, 1999, the Board approved a
one year agreement between Monroe County and Robert 1. Nelms, MD for medical examiner
sefVlces
STAFF RECOMMENDATION: Approval
TOTAL COST: $291.170.00 BUDGETED: Yes~ No
COST TO COUNTY: $291.170.00
REVENUE PRODUCING: Yes
No --X- AMOUNT PER MONTH
APPROVED BY: County Attorney YES OMBfPurchasing YES Risk Management YES
/"1 / ./1
~r - I~v~'
)/ James R. "Reggie" Paros
DOCUMENTATION: Included: -.X n; Follow: _ Not Required: _
Agenda Item #: 1..~
DIVISION DIRECTOR APPROVAL:
DISPOSITION:
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Robert 1. Nelms, Jr., MD Effective Date: October 1. 2000
Expiration Date: September 30.2001
Contract Purpose/Description: Medical Examiner services
Contract Manager: James R. Paros
(Name)
6002
(Ext. )
t7~? If -
Public Safety
(Department)
for BOCC meeting on Sentember 20 2000 Agenda Deadline: Sentember 6 2000
CONTRACT COSTS
Total Dollar Value of Contract: $291,170.00 Current Year Portion: n/a
Budgeted? Yes[g] No 0 Account Codes: 68000-530340 -_-_
Grant: $ _-_-_-_
County Match: $ _-_-_-_
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (e~. maintenance, utilities, ianitorial. salaries, etc.)
CONTRACT REVIEW
Changes D~te ut
. . .. te Needed .A ~.
DIVISIon Drrector f~~J YesD NO~ ~ /l. t5 ~~
Risk Manage!pent S\1\OO YesONo0 ,tJ~ ~~ <i:>/1Iau
OMB~ng8\--t\CD YesDNoG' ~D 'lS'\'il/OO
County Attorney ~/ll/or> YesO Nog/' . '.. _ . . /,--. ~yfwri
Comments:
OMS Form Revised 9/11/95 MCP #2
AGREEMENT
THIS AGREEMENT entered this day of September, 2000, between the
BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA
(hereinafter "County"), 5100 College Road, Key West, Fl. 33040, and ROBERT J.
NELMS, JR., MD, Medical Examiner, District Sixteen (Monroe County), (hereinafter
"Medical Examiner"), appointed by the Governor of the State of Florida.
WHEREAS, Chapter 406, FS establishes Medical Examiner Districts, now,
therefore,
IN CONSIDERATION ofthe mutual covenants below:
1. CONTRACT PERIOD. This agreement is for the period October 1,
2000, through September 30,2001. This agreement shall remain in effect for the stated
period unless one party gives to the other written notification of termination pursuant to,
and in compliance with, paragraph 13 below.
2. SCOPE OF AGREEMENT. Medical Examiner shall provide the work
plan and services as described in detail in Exhibit A, an attachment to this document,
which Exhibit is incorporated herein by reference.
3. AMOUNT OF AGREEMENT/PAYMENT. County shall appropriate
funds for the Medical Examiner's Budget. County shall make payments in accordance
with the budget for County fiscal year ending September 30,2001, which budget is
attached hereto as Exhibit B and incorporated herein by reference, upon its approval by
County. County has the authority, under FS 406.06(3), to establish reasonable salary, fees
and other costs as are necessary for the operation of the Medical Examiner's office. The
Medical Examiner's Budget is intended to cover the anticipated normal activities/work
load of the Medical Examiner based upon past statistics and reasonable projections, and
shall be disbursed through pro rata montWy payments. Reimbursement for use of cellular
phones shall be made only for those phone calls which are documented as relating to
Medical Examiner activities.
In the event of a disaster or occurrence unusual in nature or magnitude, the
Medical Examiner shall petition the Board of County Commissioners for reimbursement of
all extraordinary expenses and compensation due to the disaster.
The Medical Examiner shall develop a schedule of reasonable and customary fees
which shall be charged to third parties for specific services. Revenue received from the
collection of such fees shall be retained and accounted for by the Medical Examiner and
used for operating expenses, thus reducing the overall level of County funding required for
Medical Examiner activities.
4. ACCOUNTING AND RECORDS. The Medical Examiner shall keep
logs of cellular telephone calls, denoting which calls to relate to Medical Examiner
activities and which calls do not. Records of Medical Examiner pertaining to this
Agreement shall be kept on generally recognized accounting principles, and shall be
available to the County or to an authorized representative of County, FDLE and the
Auditor General for audit. Both parties shall maintain such records as are necessary to
account for state funds disbursed by the Medical Examiners Commission. All records
related to this Agreement shall be kept for a minimum of three years subsequent to the
termination of this Agreement. Medical Examiner shall be responsible for repayment of
any and all audit exceptions identified by County or its agents or representatives. In the
event of an audit exception, the County's obligation under this Agreement shall be
reduced if the exception is ascertained prior to the termination of this Agreement. In the
event there are insufficient moneys due to Medical Examiner at the time of identification
and notice thereof to Medical Examiner to cover the amount of audit exception or the
Agreement has terminated, Medical Examiner shall reimburse County for the amount of
the audit exception.
County shall provide the Medical Examiners Commission with the County Annual
Expenditure Report, identifying total funds expended or encumbered and budgeted, for
Medical Examiner services during the current County fiscal year (forms to be provided by
Commission); a copy of the budget adopted by County for Medical Examiner for FYE
September 30,2001, and a copy of any Medical Examiner Office financial audit report
prepared for County.
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5. MODIFICATIONS AND AMENDMENTS. Any and all modifications
and amendments of this agreement shall be approved by the County and Medical Examiner
in writing. No modification or amendment shall become effective until approved in
writing by both parties.
6. ASSIGNMENT. Medical Examiner shall not assign this agreement,
except in writing and with the prior written approval of County, which approval shall be
subject to such conditions and provisions as County may deem necessary. This agreement
shall be incorporated 'by reference into any assignment and any assignee shall comply with
all of the provisions herein, unless expressly provided otherwise in an amendment
authorizing such assignment. Unless expressly provided for therein, such approval shall in
no manner or event be deemed to impose any obligation upon either party in addition to
the covenants and promises contained herein.
7. INDEMNIFICATION. Medical Examiner hereby agrees to indemnify
and hold harmless the County and any of its officers and employees from and against any
and all claims, liabilities, litigation, causes of action, damages, costs, expenses - including
but not limited to fees and expenses arising from any factual investigation, discovery or
preparation for litigation - and the payment of any and all of the foregoing or any
demands, settlements or judgments (collectively the "Claims") arising directly or indirectly
from any negligence or criminal conduct on the part of Medical Examiner in the
performance of the terms of this Agreement except to the extent that, in the case of any
act of negligence, Medical Examiner reasonably relied on material supplied by, or any
employee of, the County. Medical Examiner shall immediately give notice to County, by
certified mail to the Mayor of County, of any suit, claim or action against Medical
Examiner that is related to the activity under this contract and will cooperate with County
in any investigation arising as a result of any suit, action or claim related to this contract.
8. ANTI-DISCRIMINA nON. Medical Examiner will not discriminate
against any person on the basis of race, creed, color, religion, sex, age, national origin,
physical handicap, or any other characteristic which is not job-related, in its recruiting,
hiring, promoting, terminating or any other area affecting employment under this
Agreement. Medical Examiner agrees to include this paragraph in all contracts it enters
into with other persons or entities and to abide by all Federal and State laws regarding
3
non-discrimination, including but not limited to, Titles VI and VII of the Civil Rights Act
of 1964 (42 USC 2000d), Executive Order 11246, Executive Order 11375 and U.S.
Department of Labor Regulations (42 CFR Part 60).
9. ANTI-KICKBACK. Medical Examiner warrants that he has not
employed, retained or otherwise had acted on his behalf any former county officer subject
to the prohibition in Section 2 of Ordinance No. 10-1990 or any county officer or
employee in violation of Section 3 of Ordinance No. 10-1990, and that no employee or
officer of the County has any interest, financially or otherwise, in Medical Examiner
except for such interests permissible by law and fully disclosed by affidavit attached
hereto. For breach or violation of this paragraph, the County may, in its discretion,
terminate this Agreement without liability and may also, in its discretion, deduct from the
contract or purchase price, or otherwise recover, the full amount of any fee, commission,
percentage, gift, or consideration paid to the former county officer or employee.
10. PUBLIC ENTITY CRIME. A person or affiliate who has been placed
on the convicted vendor list following a conviction for public entity crime may not submit
a bid on a contract to provide any goods or services to a public entity, may not submit a
bid on a contract with a public entity for the construction or repair of a public building or
public work, may not submit bids on leases of real property to public entity, may not be
awarded or perform work as a contractor, supplier, subcontractor, or consultant under a
contract with any public entity, any may not transact business with any public entity in
excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a
period of36 months from the date of being placed on the convicted vendor list.
11. COMPLIANCE WITH LAW. Medical Examiner shall comply with all
federal, state, and local laws, ordinances, regulations and rules applicable to the services to
be performed by each party under the terms of this Agreement. Medical Examiner shall
maintain such licensure as is required by law to cany out the services in this Agreement.
12. INDEPENDENT CONTRACTOR At all times and for all purposes
hereunder, Medical Examiner is an independent contractor and not an employee, agent or
servant of the County or of the Florida Department of Law Enforcement. No statement in
this Agreement shall be construed so as to find Medical Examiner or any of its employees,
contractors, servants, or agents to be employees of the County or State, and they shall be
4
entitled to none of the rights, privileges, or benefits of employees of County or State. The
Medical Examiner may subcontract for services as deemed necessary and shall be
ultimately responsible legally, operationally, and financially for any such subcontracts.
13. TERMINATION FOR CAUSE OR LACK OF FUNDS AND
NON-WAIVER.
A. If Medical Examiner fails to fulfill the terms ofthis Agreement, or
attachments, properly or on time, or otherwise violates the provisions of the Agreement or
of applicable laws or regulations governing the use of funds, County may terminate the
Agreement by written notice of sixty days, which notice shall specify cause. All finished
or unfinished supplies or services compensated under this Agreement shall, at the option
of County or pursuant to state statute become property of County. The County shall pay
Medical Examiner fair and equitable compensation for expenses incurred prior to
termination of the Agreement, less any amount of damages caused by Medical Examiner's
breach. If the damages are more than compensation payable, Medical Examiner will
remain liable after termination and County can affirmatively collect damages.
B. In the event that the Governor appoints a successor to the Medical
Examiner named herein, this Agreement shall terminate on the day prior to the effective
date of such successor's appointment.
C. In the event that funds from County cannot be continued at a level
sufficient to allow for the purchase of services specified herein, this Agreement may be
terminated upon giving written notice of thirty days to Medical Examiner delivered in
person or by mail to Medical Examiner.
D. The County shall not be obligated to pay for any services or goods
provided by Medical Examiner after the effective date of termination.
E. Any waiver of any breach of covenants herein contained to be kept
and performed by Medical Examiner shall not be deemed or considered as a continuing
waiver and shall not operate to bar or prevent County from declaring a forfeiture for any
succeeding breach either of the same conditions or covenants or otherwise.
14. INSURANCE. County shall provide insurance for Medical Examiner in
compliance with FS 406.16.
5
15. SEVERABILITY. If any provision of the Agreement shall be held by a
court of competent jurisdiction to be invalid or unenforceable, the remainder of this
Agreement or the application of such provision other than those as to which it is invalid or
unenforceable, shall not be effected thereby~ and each provision of the Agreement shall be
valid and enforceable to the fullest extent permitted by law.
16. NOTICE. Unless specifically provided otherwise in this Agreement, any
notice required or permitted under this Agreement shall be in writing and hand-delivered
or mailed, postage prepaid by certified mail, return receipt requested, to the other party as
follows:
To County:
County Administrator
Public Service Building
5100 College Road, Stock Island
Key West, Fl. 33040
(305) 292-4441
To Medical Examiner:
Robert 1. Nelms, Jr., MD
P.O. Box 500879
Marathon, Fl. 33050-0879
17. CONSENT TO JURISDICTION. This Agreement, its performance,
and all disputes arising hereunder, shall be governed by the laws of the State of Florida
and both parties agree that a proper venue for any action shall be Monroe County.
18. REPORTS. Medical Examiner shall develop a record-keeping system
which can be used to provide County with a monthly report, which shall be submitted on a
monthly basis and begin no later than a report for the month of October, 2000, and which
shall include, as a minimum the following:
A. Number of all investigations.
B. Number of all autopsies performed.
C. Number of authorizations for all cremations and burials at
sea and anatomical dissections.
The activity report shall be submitted by the 10th day of the following month to
the County Administrator.
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19. ENTIRE AGREEMENT. This Agreement constitutes the entire
agreement of the parties hereto with respect to the subject matter hereof and
supersedes any and all prior agreements with respect to such subject matter between
Medical Examiner and the County.
20. FDLE. The Florida Department of Law Enforcement shall not be
deemed to assume any liability for the acts, omissions to act, or negligence of the County
or the Medical Examiner, their agents, servants and employees~ nor shall County or
Medical Examiner exclude its own negligence to FDLE or any third party.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
the date first above written.
(SEAL)
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
Attest:
DANNY L. KOLHAGE, CLERK
By
Mayor/Chairman
By
Deputy Clerk
MEDICAL EXAMINER
ik 1i. ;J1, 0.
'Robert 1. elms, Jr., MD
Medical Examiner
,~/a1f~
Witness
APPROVED AS TO F
AND IJ.GAL'SUFFIC
B /;
7
EXHIBIT A
SERVICES TO BE PROVIDED BY ROBERT 1. NELMS, JR., MD
This Exhibit, incorporated into the Agreement between County and Medical
Examiner, on the day of , 2000, sets forth the services
to be provided by Medical Examiner pursuant to paragraph 2 thereof:
The District Medical Examiner agrees to fulfill his duties as set forth in Chapter
406, FS and rules promulgated by the Medical Examiners Commission as follows:
A. OFFICE
1. The Office of the Medical Examiner shall be established and maintained in such
a manner that it provides for the necessary facilities and personnel to
accomplish its duties and responsibilities. .
2. The Office shall be an independent agency.
B. APPOINTMENT
1. The Medical Examiner shall be appointed by the Governor of the State of
Florida. His tenure will be for the length of the appointment which normally is
three (3) years.
2. The Medical Examiner shall name and appoint qualified professional, technical,
clerical and other staff of the Office. The staff shall be directly responsible to
the Medical Examiner, and shall include associate medical examiners,
secretary, forensic investigator(s), diener, custodian, histotechnologist, et
cetera.
c. INVESTIGATION OF DEATH The Medical Examiner or his appointed
associate medical examiners shall have the authority and responsibility:
1. To investigate and certify any death that falls in the following categories:
a. Criminal violence suspected
b. Suicide
c. Accidental (motor vehicle, boating, aircraft, diving, snorkeling,
swimming, electrocution, et cetera)
d. Suddenly when in apparent good health
e. Unattended by a practicing physician (over 30 days)
f Suspicious or unusual circumstances
g. Gunshot
h. Sudden infant death syndrome (SillS)
1. Suspected poisoning
J. Drowning
k. Abortion
1. In prison or police custody
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m. In state institution
n. Diseases constituting a threat to public health
o. Disease, injury, or toxic agent resulting from employment
p. Unexpected death associated with diagnostic or therapeutic
procedure
q. When body is to be cremated, dissected or buried at sea
r. Unclaimed bodies
s. When a dead body is brought into a new medicolegal
jurisdiction without proper medical certification
2. To take charge of the dead body upon direct notification of such death. He or
his duly authorized associate medical examiner or forensic investigator shall
respond to the scene upon request by proper authorities whenever possible and
appropriate. The dead body shall not be disturbed unless permission is granted
by the Medical Examiner or his designee.
3. To conduct an investigation of circumstances surrounding the death in
conjunction with proper authorities.
4. To conduct all necessary examinations of the dead body which could include
performance of any autopsy and retention of whatever tissues and biological
specimens that he deems are necessary.
5. To take possession of any object or article which, in his opinion, may be useful
in establishing the identify of the deceased and/or the cause and manner of
death.
6. To reduce his investigation and findings in writing and shall keep such records
in his Office.
7. To administer oath and have the power of subpoena.
D. SPECIFIC TASKS In order to effect above general requirements, the specific
duties itemized below describe in greater detail how duties are accomplished and the
responses to be made.
1. Answering telephone
a. Mode - telephone, digital pager, cellular telephone, radio
b. Source of calls - Police, Sheriff, Navy, FBI, Highway Patrol,
National Forestry or Park Service, Coast Guard, NTSB, FAA,
funeral homes, family or acquaintances of deceased, attorneys,
insurance companies, private investigators, newspaper reporters,
TV or radio reporters, physicians, nurses, et cetera.
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c. Nature of calls
1. Request for oral information - toxicology results, cause of
death, mechanism of death, et cetera
2. Request for written information or reports - autopsies,
statistical reports, death certificates, et cetera
3. Questions about previous cases
4. Requests for immediate scene investigations
5. Notification of deaths
6. Cremation, dissection, or burial at sea approvals
7. Scheduling depositions
8. Electronic depositions
9. Request for testimony as expert witness in court
10. Other questions or considerations
2. District Medical Examiner shall initiate such phone calls as are necessary to
carry out his duties, including but not limited to the following:
a. To whom:
1. Law enforcement agencies
2. Funeral homes
3. Witnesses, family, friends
4. Personal physicians or dentists
5. Attorneys
6. Others
b. Nature of calls
1. Case investigations
2. Scheduling exams or autopsies
3. Answering digital pager
4. Returning phone messages
5. Calling secretary for information
6. Changing appointment times
7. Calling for toxicology results past due
3. Subpoenas
a. Received at Office
b. If conflicts in scheduling, would necessitate phone calls to
reschedule
4. Automobile travel
a. Scene investigations - up to 60 miles distant, one way,
irrimediate response always requested, day or night, seven
days a week - performed by Medical Examiner, associate
medical examiner, or forensic investigator appointed by
Medical Examiner.
b. Autopsies usually scheduled within 24 hours, may be 50
miles away where performed
10
c. Florida Association of Medical Examiners (FAME)
Conferences - usually at least once annually, in Florida, 50-
300 miles one way
d. Depositions
e. Court trial witnessing, usually 40-50 miles each way
f. Grand Jury, usually 50 miles each way, usually less than one
week's notice
5. Autopsies/Examinations
a. Time 2-4 hours, not counting travel, for autopsy, 1/2 to 1
hour for post mortem examination
b. X-rays, sometimes taken by Medical Examiner
c. Photographs
d. Collection of toxicology specimens, and/or esoteric tests
(DNA probes)
e. Gathering of some trace evidence - fluids, hair, particles,
clothing, jewelry, et cetera
f. Preparation of bones and teeth for anthropological studies
g. Microscopic examination after preparation by
histotechnologist
h. Collection of insects at scene to better estimate post mortem
interval
6. Generation of reports
a. Handwritten
1. Labeling tubes, photographs and x-rays
2. Notes during autopsy
3. Notes during telephone conversations
4. Correspondence
5. Preparing rough drafts on statistical reports, correspondence,
contracts, et cetera
6. Keeping case log
7. Keeping cremation log
8. Completing death certificates
9. Budgets
10. Cellular telephone logs
11. Other reports requested
b. Dictated
1. Autopsies, some postmortem exams
2. Some correspondence
3. Some statistical reports
4. Rules and regulations
5. Review laboratory examinations and prepare reports
6. Contracts
7. Other reports
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c. Typing - usually by computer with word processor, e.g.,
county burial letters, appointment letters, new call schedules, et cetera
7. Depositions
a. Some electronically (by telephone)
b. Some in attorney's office, clerical or electronic
c. Frequently travel 50 miles each way
d. Grand Jury
8. Witness in Court
a. Location - usually 50 miles each way
b. Duration - 4 hours up to 3 days portal to portal
c. Preparation of testimony - 2-6 hours minimum
9. Arrange transportation of bodies
10. Provide professional consultations
11. Prepare and present materials for teaching/public presentations
12. Counsel families
13. Continuing education - ASCP Check Samples, conferences - 20
hours per year generally required.
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MONROE COUNTY
BOARD OF COUNTY COMMISSIONERS
APPROPRIATION DETAIL
BY OFF1CIAUDIVISION, DEPARTMENT, COST CENTER
------.-.--.---....---..
- -..---...-.......---- -.--...---.--.--..-.---.--..--..-.--
.------------.---...------.------------
Ofcl/Div: MEDICAL EXAMINER
Department: Medical Examiner
Cost Center/Fund 68000 1001 MEDICAL EXAMINER
EXHIBIT B
Date: 7/612000
'::!!:ca at Managmllt'll and Budget
.._---- ......---..---.------....--- -.....--
Actual 99 Adopted 99
-
.---
Proposed 01 INC/(DEC) % Change Adopted 00
Operating Expendltu"8s
530340 OTHER CONTRACTUAL SERVICE
530440 RENTALS AND LEASES
530451 RISK MANAGEMENT CHARGES
Sub-total Operating expenditures
Cost Center Total MEDICAL EXAMINER
291.170 0
10.217 0
3.124 0
304,511 0
304,511 0
Page 334
----------........
0.0% 291.170 2B5,460 2B5,4130
0.0% 10,217 7.BOO 9,C 00
0.0% 3,124 3.004 3.l'J4
.-- ------ _______4"
0.0% 304,511 296.264 297.464
---- .-.--..--.--..-- .
0.0% 304,511 296,264 297,464