Item C16
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: November 20. 2001
Division: Public Safety
Bulk Item: Yes lL
No
Department: Public Safety
AGENDA ITEM WORDING:
Approval of Contract Addendum with Physician Resources, Inc., to extend agreement for Medical
Director services for an additional two year period, effective January 2, 2002, at $4,333.33 per month,
total of $52,000.00 per year
ITEM BACKGROUND: : On January 19, 2000, the Board approved a contract with Physician
Resources, Inc. as Medical Director/Fire Department Physician for Emergency Medical Services and
Fire Departments, effective January 1,2000 through January 1,2002. The agreement provides an
option to renew the contract for another two year period under the same terms and conditions.
PREVIOUS RELEVANT BOCC ACTION: On January 19, 2000, 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 1,2000 through January 1,2002.
CONTRACT/AGREEMENT CHANGES: This Contract Addendum extends the agreement for two
additional years under the same terms and conditions as the original agreement. Amount of the original
contract was reduced $4,000.00, effective October 1,2000, because Marathon Volunteer Fire
Department is no longer included.
STAFF RECOMMENDATIONS: Approval
TOTAL COST: $52.000.00
COST TO COUNTY: $52.000.00
REVENUE PRODUCING: Yes
BUDGETED: Yes X No
NoX
AMOUNT PER MONTH
APPROVED BY: County Attorney YES
DIVISION DIRECTOR APPROVAL:
Risk Management YE.h
.oz--7 'OJ 0 /
James R. "Reggie" Paros
DOCUMENTATION: Included: -X To Follow: _ Not Required: _
Agenda Item #:
/ - C/itJ
DISPOSITION:
Revised 2/27/01
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Physician Resources, Inc. Effective Date: January 2.2002
Expiration Date: January 1. 2004
Contract Purpose/Description: Contract addendum with Physician Resources. Inc. to extend
agreement for Medical Director/Fire Department Physician services. (Marathon Fire
Department is no longer included so contract amount is reduced by $4.000.00)
Contract Manager: James R. Paros
(Name)
6002
(Ext. )
Public Safety - Stop 14
(Department)
for BOCC meeting on October 17. 2001
Agenda Deadline: October 3.2001
CONTRACT COSTS
Total Dollar Value of Contract: $52,000 yr.
Budgeted? Yesl:8J No 0 Account Codes:
Grant: $
County Match: $
Current Year Portion: $52.000.00
13001-530340 - $24.000
11500-530340 - $24.000
12500-530340- $ 4.000
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (e~. maintenance, utilities, janitorial, salaries, etc.)
Changes
~re In Needed
Division Director iO(2rf?;..lJ( YesO NoW
Risk Management 10 \ C z. \ a \ Y esO No~ ' \
O.M.B./Purchasing q\:;l-,/dYesO NoO
County Attorney I~/t.f!( YesO NoW
Comments: f?,~- - ~~~ t-O-=C= .;--'~ Q..~c J~T jJ~o- C~.:jt- ~ .
~~~ ~~~'-. 0
OMB Form Revised 9/11/95 MCP #2
. Ju-.LtLlvJt4 rJUJ bN~ ~ /~j 31.33
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CONTRACT REVIEW
Date Out
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CONTRACT ADDENDUM
THIS CONTRACT ADDENDUM is made and entered into this day of
.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 shall expire on January 1,2004.
2. Compensation: Payment for services provided shall be an annual fee of $52.000
DOLLARS, $4.333.33 invoiced and payable monthly.
In all other respects, the agreement between the parties dated January 1, 2000
remains in full force and effect.
IN WITNESS WHEREOF, the parties have hereunto set their hands and seal, the
day and year first written above.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
Mayor/Chairman
(SEAL)
A TrEST: DANNY L. KOLHAGE, CLERK
By:
Deputy Clerk
Sandra Schwemmer. D.O., FACOEP, FACEP
. .
'.
MEDICAL DIRECTOR/FIRE DEPARTMENT PHYSICIAN
CONTRACT
THIS CONTRACT, made and entered into this ~ day of January, 2000, by and
between the Board of County Commissioners, Monroe County, Florida, hereinafter
referred to as the "COUNTY" and Physician Resources, Inc., hereinafter referred to as the
"Medical Director", also referred to as the "Fire Department Physician".
WITNESSETH:
WHEREAS, the COUNTY provides fire and emergency medical services pursuant
to Chapter 40 I, Florida Statutes, in the following geographic areas: Cow Key Channel
(mm4) to Channel 2 bridge (mm72.5) and from Tavernier Creek Bridge (mm90.5) to South
Bay Harbor Drive and Lobster Lane (mm95); also known ~$ 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 (mml 13) and north on SR 9D5 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 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 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, ddivered 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 ')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
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 z.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 Florida 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
, '
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 provide: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 medical
director, assistants, and/or designee will assist in implemt:ntation 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 andlor 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 :;hall be available for emergency
consultation.
COST CONTAINMENT I EQUIPMENT & PROCEDURES
The Medical Director shall periodically review all policies and procedures for cost
effectiveness. Providing state of the art fire and emergeney 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 medil~al equipment to be carried and
utilized by a participating volunteer fire department and/e,r 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 EXPOSLRE 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 persormel 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 poJicy.
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 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 payabk 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 bl~ reviewed by the COUNTY on
or before the tenth (10th) calendar day ofec:.ch month. The COUNTY EMS
provider shall verify the information submi tted 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.
._0"
Board of County Commissioners of
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Physician Re'~t _
Schw(:mmer, D.O., FACOEP, FACEP
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Witness
Medical Director Contract - EMS
7
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