Item C24
Ma~ 07 03 07:18a
Sent By: B 0 C Cj
James L Roberts Co Admin
305-292-4544
p.c
, 305 289 6336;
May.6.03 13:53;
Page 2
BOARO OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
.-
Meeting Dal~: May 21. 2003
Division:
County Administrator
Bulk Item: YesX___
Nll_
Department: FiI~ Rescue
AGENDA ITEM WORDIN(i: Approval of i\mcndmentlo Traullll\ Cllre Agreement between the
Monroe County Board of County Commissioners acting as governing 11I)ard of the Upper Keys Health
Care Taxin~ District and the Keys Hospital Foundation, Inc.. d/b/a Mariners Hospital which eliminates
the requirement for the response of a Trauma Transport Offi.ccr 10 Mariners Hospital to certify the
eligibility of paliellts for Iran~fer to a rcgionaltraumi:l C~nler.
ITEM BACKGROUND: The current procedure. arti(.:uJaled in Resolution 246-1990, Section 2,
Subsection a)4), requires an agent of the cnunly, lht UK.flTD Trauma J)ir~ctor or a designated trauma
transporl offi'er. to respond to the bospitalto certify that a patient mccb trauma criteria. This exposes
the County to unnecessary liability with regard to JddY in patient cart: lJ~cause this individual may be ~. - .
many mllc~ distant from the hospital. In addition, it potentially plal:t:<, I h~ trauma transport officer,
usually someone with training, certification or license less lhan that of a physician. in contlict with lhe
attending ('lhysici<ln. Monroe County provid~s this servi<.:e to no other hospital in Monroe County.
PREVIOUS REVELANT BOCC ACTION: On April 18, 1990, Resolution 246-1990 was passed
authorizing the MiJyor/Chairman of the Board to execute a Trauma Can: Agreement with Key~
Hospital Foundation. Inc. d/b/a Mariners Hospital concerning emergency trauma-related heOilth care.
CONTRACT/AGRE~MENT CHANGES: Eliminalion of lhe requirement for a Trauma Transport
Officer to respond to Marinero; HospitaltlJ certify patients as having mt:l trauma criteria.
STAFF RECOMMENDATIONS: Approval.
TOTAL COST:
N/A
BUDGETl:D: Yes
No
COST TO COUNTY: N/A
SOURCE OF FUNDS:__...N-IA_....._.
REVENUE PRODUCING: Y~s _ No __. AMOUNT PER MONTH_ Year_
DIVISION UlREl.'TOR APPROVAL:
Clark Martin
,--
r~ ......
J L R b' t ~v i I i"~G C\..h) 1\1 I y hur..!lI'~IG II JIl vii
ames . 0 l;r
ent N/A
AI'PROVEO BY: County Any Yes
FIRE eHIEt' API'ROV AL:
,
DOCUMENTATION:
Included
x
To Follow
Not Required_
DISPOSITION:
ACENUA ITEM 1# /""' .Jy
Rl'VI~,.tl 1/03
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: Mav 21. 2003
Division:
Countv Administrator
--
Bulk Item: Yes X
No
Department: Fire Rescue
AGENDA ITEM WORDING: Approval of Amendment to Trauma Care Agreement between the
Monroe County Board of County Commissioners acting as governing board of the Upper Keys Health
Care Taxing District and the Keys Hospital Foundation, Inc., d/b/a Mariners Hospital which eliminates
the requirement for the response of a Trauma Transport Officer to Mariners Hospital to certify the
eligibility of patients for transfer to a regional trauma center.
ITEM BACKGROUND: The current procedure, articulated in Resolution 246-1990, Section 2,
Subsection a)4), requires an agent of the county, the UKHTD Trauma Director or a designated trauma
transport officer, to respond to the hospital to certify that a patient meets trauma criteria. This exposes
the County to unnecessary liability with regard to delay in patient care because this individual may be
many miles distant from the hospital. In addition, it potentially places the trauma transport officer,
usually someone with training, certification or license less than that of a physician, in conflict with the
attending physician. Monroe County provides this service to no other hospital in Monroe County.
PREVIOUS REVELANT BOCC ACTION: On April 18, 1990, Resolution 246-1990 was passed
authorizing the Mayor/Chairman of the Board to execute a Trauma Care Agreement with Keys
Hospital Foundation, Inc. d/b/a Mariners Hospital concerning emergency trauma-related health care.
CONTRACT/AGREEMENT CHANGES: Elimination of the requirement for a Trauma Transport
Officer to respond to Mariners Hospital to certify patients as having met trauma criteria.
STAFF RECOMMENDATIONS: Approval.
TOTAL COST:
N/A
COST TO COUNTY: N/A
BUDGETED: Yes
No
SOURCE OF FUNDS: N/ A
REVENUE PRODUCING: Yes
No
AMOUNTPERMONTH_ Year
FIRE CHIEF APPROVAL:
ent N/ A
APPROVED BY: County Atty Yes
DIVISION DIRECTOR APPROVAL:
James L. Roberts
DOCUMENTATION:
Included
X
To Follow
Not Required
DISPOSITION:
AGENDA ITEM #
Revised 1/03
Sent By: B 0 C C; 1 305 2HY ~33~; May-~-UJ 11 :JOj
"M.-Ub-a~ .a'~~ ~~U~I"ONROE COUNT~ ATTY OFFICE JD:3052S23S16
r-age .c.
PACE 1.13
MONROE COUNTY BOARD OF COMMISSIONERS
--
CONTRACT SUMMARY
Contract #
Effective Datc:OSI2112003
Cont:raCt with; Keys Hospital
Foundation. Inc. dlbJa Mariners Hospital
Expiration Date:
Contract PurposeIDescription: Amendment tQ Trauma Care Agreement between the Monroe
Coun,y: Board of Co\lnty Commissioners acting u IOveminl board oiebe UWetK.eys Health
5= Taxin~ District .M the Keys Ho~tal Fonn"mOIL IDe. d/b/a Mariners Ho.ta1 wlJich
e' imtcs the req)linmcnt for the rcsoonse of a l)'amna TtQ$DOrt Officer to Mariners Hospital
to certify the elie:ibility of patients for ft'!II"lF' to a regig,p,I trauma center.
Contract Manager:S!lsan Hover
(Name)
6088
(Ext) .
..Eim~escue
(Depart1nent)
enda Deadline: 05/06103
CONTRACT COSTS
Total Dollar Value of Contract: S NlA Current Y ear PortiOJ1~
Budgeted? YcaD No 0 Account Codes: - ----
- - -
--
County Match: $
- - -
--
- . .
---
CONTRACT RE~W
Changes Date Out
DBIO In Needed Reviewer
Division Dir~tor YesO NoD --:-n--
RislcM.a1lagt.mont s-Mo, Vca[JNoQ" W. ~ ~
O.M.B./PurClwing y..ONoW,,/ . ~J 'C- f?" ~~Jeiv ,~/o3
County Attonley 5/ to'! ves[] No!Y': 5/~)'
Cnmments:
l"1a:::l UI U.:l U/:ltla
~ames L ~ooer~s LO HomIn
.::IU;:)-C;::JC-"t;:)"t"t
,.....;J
Sent By: B 0 C Cj
1 305 289 6336;
May.6.D3 13:53j
Page 3
MONROE COUNTY BOARD OF COMMlssrONERS
--
CONTRACT SUMMARY
Contract fI
(omract with: K~v~ Hosoital Effective Date:05/2112IX))
Foundation, Inc. d/b/a Mariners Hospital
Expiration Dare:
Contract PurposelDescription: Amendment to Trauma CAre ^gr~pll~nl between the Monroe
County Board of County Commissioners actine as ~overning board_Qf the Upper Keys Health
Care Taxin! District and the Keys Hospital Foundation, Inc. dlb/a Mariners Ho!;pit.!!Ly.hich
eliminates the reQuiremenr for the re!:pnn"e of a Trauma Tran!lport Officer to Mariners Hospital
to certify the e1igibilitv of patients for Iran~fer to a rellional trilUlTliJ center.
Contract Manager:Susan Hover 6088 Fjt~..R9$Cue
(Name) (Ex t.) (DepartmcnI)
for BOeC meetinf! On 05121 /03 A~enda Deadline: 05/U6/03
CONTRACT COSTS
Total DollaI Value of Contract: S N/A Current Yeur I'mlion;
Budgeled? YesD No 0 Account Codes: _-____ _._ ___
. - -
--- -...---
County Match; $
-
--
ADDITIONAL COSTS
Estimated Ongoing Costs: $---1yr For:
(N(l1 includ~d in <IuU.II Yillu,; a\.lvyc;) (O:jl,. ul"iIlIC:lloAlI\:C:. I.Ilililin, Idllihlliitl. ~iolo1ri~S. ~I<;.)
~t6
"'.I)aic"Oiii
5fi/o3
DJle In
Uivision Director !:Jj 0/'0.3
Risk Managern~nl
CONTRACT REVIEW ~ ?@
~f/
.. - y-t
. ' (....'~.4 " t....... .. I I ~t...... ,..~~.I.
Changes ,.\J Ili\\~ CC,l.." , v /! I,
Needed -/' ((JvI4Vi~wcr
Yc~D Nu~ I '
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O.M.B./Purchasing
y ~sD NoD
YesO NoD
YesD NoD
Counly Anomey
Commems:
AMENDMENT TO TRAUMA CARE AGREEMENT
This is --an amendment to a 1990 Trauma Care Agreement (hereafter Original
Agreement) and is entered into on , 2003 by and between the Monroe
County Board of County Commissioners acting as the governing board of the Upper
Keys Health Care Taxing District (hereafter District) and the Keys Hospital Foundation,
Inc., d/b/a Mariners Hospital (hereafter Hospital). A copy of the Original Agreement is
attached and made a part of this amendment.
In consideration of the mutual promises, covenants and benefits set forth
below, the parties agree as follows:
1.
follows:
Section 2(a) of the Original Agreement is hereby amended to read as
a)
The Hospital acknowledges that:
(i) it is obligated to treat all individuals needing emergency medical
attention that arrive at its emergency room;
(ii) some of those individuals are trauma patients as described in Chap.
64E-2, FAC, who require pre-transport treatment prior to an interfacility
transfer to an out of County provisionally approved trauma center or
provisionally approved pediatric trauma referral center under the criteria of
Chaps. 395, 401, FS, and Chap. 64-2, FAC.
b) In the case of the individuals described in subparagraph 2(a)(ii), the
District agrees to pay the Hospital 80% of its pre-transport treatment costs for the
individuals with no or inadequate insurance or without any other means of paying the
costs themselves. The District's obligation to pay the Hospital is subject to the
following:
(i) The Hospital as a precondition of District payment must initially
attempt to recover the costs from whatever insurance the individual might have
and from the individual.
(ii) For individuals covered by Medicare or Medicaid, the Hospital must
accept payment from either of those two programs as full payment of it pre-
transport costs.
c) The District agrees to pay the Hospital within thirty (30) days of receipt
of an invoice from the Hospital for any individual described in 2(a)(ii) who is not
awaiting Medicaid eligibility.
d) The Hospital agrees to allow the District to send a designated individual
representing the District to audit any invoices which are presented to the District for
payment.
e) The District and Hospital and its medical staff and administration agree to
participate in a Utilitzation Review in order to determine any disputed medical or
social needs orthe patient, to be able to effectively utilize available resources under
this agreement.
2. Except as provided in this amendment in all other respects the Original
Agreement between the parties remains in full force and effect.
IN WITNESS WHEREOF, the parties hereto have set their hands and seals
the day and year first above written.
(SEAL)
ATTEST: DANNY L. KOLHAGE, Clerk
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
Deputy Clerk
Mayor/Chairman
(SEAL)
Attest:
KEYS HOSPITAL FOUNDATION, INC.,
d/b/a MARINERS HOSPITAL
By
By
Title
Title
jconMarinerTraumaA
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,.--....-:.
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RESOLUTION NO. 246-1990
A RESOLUTION OF THE BOARD OF COUNTY COMMIS-
SIONERS OF MONROE COUNTY. FLORIDA, AUTHORIZING
THE MAYOR/CHAIRMAN OF THE BOARD TO EXECUTE TRAUMA
CARE AGREEMENT WITH KEYS HOSPITAL FOUNDATION,
INC. D/B/A MARINERS HOSPITAL (THE DISTRICT
HOSPITAL) CONCERNING EMERGENCY TRAUMA-RELATED
HEALTH CARE.
BE IT RESOLVED BY THE BOARD OF COUNTY CO~ISSIONERS OF
MONROE COUNTY, FLORIDA, that the Mayor/Chairman of the Board is
hereby authorized to execute a trauma care agreement with Keys
Hospital Foundation, Inc. d/b/a Mariners Hospital, a copy of same
being attached hereto and made a part hereof, concern~ng
emergency trauma-related health care.
PASSED AND ADOPTED by the Board of County Commissioners of
Monroe County, Florida, at a regular meeting of said Board held
on che ~ day of April, A.D. 1990.
(Seal)
Attest:: DANNY 1.. KOLl:IAGE, Clerk
~htJzt- ./). (! .
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
c;tfLc i.::;&:""......-v_
BY: ~~l. "-1
MA YOR/ CHAII<l~N )
ilPPflOVi:D A,s rp FOR"'''
AW) LE(3/l/J" :'C~NCY.
-'r ' I '//,
!i". I; (,.~, ,
A{(.Jrnr>y:~ Of!!,,/>
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U~JJ.:Jb ~Jj 031/.;1
--
TRAUMA CARE AGREENENT
~~[QJ
WHEREAS, I;he lJ.oard..o~ County Conuni~;sioncrs of Monroe Cou.nty
has, by Ordinance No. 008-1986 .(amended by Ordinances 041-1988
and 052-1988) created the Upper Keys Health Care 'I'axing District
f~r the purposes of providing cartain health and tramna care,
and,
HrIE~E^S, aforesaid Ordinance provides for the designation of
"the District Hospit.J.l" for the purposes of receiving funds from
the Upper Keys Hnalth Care Taxing District, which was
accom:;>lishcd by Boar'i of County Commissioner's Resolution No.
293-1989, and
l'THEREAS, aforesaid Ordinance provide:: that funds may be
.....' -...
paid, as aid for off-setting costs of pre-transport treatment, if
unassurnable by the pati.ent., tathe D.l.st:rict Hospital for pre-
transport hospital and physician care, if necessary, prior to
t::ansfer to medical institutions outside of 11onroe County, and
\.,'HERE.'\S, upon rccornmenda tion of the lJpper Keys Heal th Care
Taxing District Advisory Soard,
the Board of
County
commissiorH:lrs, sitting as the governing body of the Upper Keys
Health Care Taxing District has recon~endcd to the governing body
the need and desirability to enter into this agr~ement withoKers
Hospital Foundation, Inc., DBA MarinCl"S Hospital for ordinanced
purposes, therefore,
The following Trawna Care Agreement is entered into between
the Board of County Co~missioners, acting as the governing body
of the lJpper Keys Health Care Taxing District and Keys Ho~pit~l
Foundation, Inc.~ DBA Mariners Hospital:
:?ection 1.
Purpq~
The 9urpose of this agreement is to formaliz~
an &r-rangem<::nt \...hereby the Upper Keys Health Care
Taxing District will reimburse Mariners Hospital
for patients receiving pre-transport treatment and
physicinn cara, if necessaty, prior to transfer of
trauma-related
injury patients
to medical
institutions outside of Monroe County, if cost of
2
such care is. unassumahlc by the patient, and as
qualified el5ewh~re within this agreement.
Section 2.
provisions
--
a) [.Iarincrs Hospital agrees to treat patients, in
its &nergcncy Room, who qualify for pre-transport
treatment
prior
to
transfer
to medical
,
insti tution~. outside of r~onr.oc County, and who are
being handled under other provisions of th~ Upper
Keys Health Care Taxing District as to criteria in
place with accepting institutions outsid~ of
Monroe County.
Such criteria shall be, at a minimllin:
1) Tr.auma"Score 12, coma score 10, or
evidence of shock at t_hc scene \'lith
systolic BP 90 or below.
2)' Or that the trauma victim has
experienced o1.rnputilt~ion proximal to the
hand or foot.
3) Or any other. tra~~a triage as may be
required in trauma cransport protocols.
4l And that a Certificate of Eligibility
ha~; been signad by one of the designated
Trauma Transport Officers.
Such care offered by Mariners Hospital sh~ll
br.:l to assure stabilization and other advanced
trauma life support (ATLS) actions sufficient to
enable tr~nsportation to other institutions
outsid~ of l~onroe County for additional treatment
for such trauma-related injury which cannot be
provided by Marincrl;; Hospital.
As part of such emergency room treatment,
coordination shall be made b~{ 11ariners Hospital
Emergency Room physician by verbal review of the
nature of the injuries of each patient with the
emergency 4'oom physicians and trauma surgeons of
the receiving hospital.
Mariners Hospital further agrees to transfer
3
complete medical records, to include emer~ency
room report, with the patient when transferred to
--
,10"'-
institutions outside of Monroe Co~nty. Mariners
Hospital shall also obtain the signature of an
authorized paramedic, acting on behalf of the
Upper Keys Health Care Taxing District, on a
Certification of Eligibility form to accompany the
patient.
b)
Hariners
Hospital
agre,es
to
bill
any
insurance carrier which such trauma-injury related
patients may have, and to bill such trauma-related
injury patie~ts themselves for all balances not
covered by insurance.
c) Mariners Hospital agrees to bill Upper Keys
Health Care Taxing District for such trauma-
related injury patients who are not covered by any
insurance carriers and have no means of paying for
their pre-transport trauma-related injury care at
,Mariners Hospital, including but not limited to
Emergency Room fees, ancillary fees to include but
not be limited to laboratory fees" X-ray fees,
Respiratory therapy fees, etc.
d)' For those patients listed in c) above, the
Upper Keys Health Care Taxing District agrees to
pay 80Z of such patient's accrued charges and
Mariners Hospit~l to absorb the remaining 20% of
such patient's accrued charges.
e) Mariners Hospital agrees to ace,ept ,the
assignment of Medicare and Medicaid patients as
payment in full.
f) Mariners Hospital agrees to allow the Upper
Keys Health Care Taxing District to send a
designated individual representing the Upper Keys
Health Care Taxing District to audit any bills
which are presented for payment.
g) Upper Keys Health Care Taxing District agrees
to pay Mariners Hospital within thirty (30) days
4
of receipt of bill from Mariners ilaspital for any
qualifying patienl,
nCll".
awaiting
Medicaid
~-
eligibility.
.' . ~/
,
h) The Board of County Commissioners, acting" as
governing body of. the Upper Keys Healt.h Care
Taxing District, to aid in the effectiveness of
and as re~liremcnt for evaluation o~ this
agreement, shall require the Mudical Director of
any C1onroe county Emergency services District
involved ~o implement criteria and prGtocols
includad herein regarding patients transported to
Mariners Hospital under this ac;;recment from within
the geographic area of the Upper Keys Health Care
Taxing District, which shall includ(~ reporting of'" ,
patient on-scene score report, Air-Rescue One or
land transport report, disposition of patient and
follO\~-UP of hospital treatment logs and reports,
to the County Administrator and the Upper Keys
Health Care Taxing District for statistical and
effectiveness determinations.
i) The Upper K~ys Health Care Taxing District
and Mariners Hospital and its medical staff and
adminlst,ration agree to participi:lte
in a
Utilization Review in ol.del' to determine any
disputed medical or social needs of the patient,
to be able to effectively utilize available
resources under this agreement.
:<;~cti.on 3
Termination
a)
Either party may terminate this agreement,
with or \-lithout causa, upon thirty (30) days.
written notice to the other party.
b) In the e''';nt that a thirty (30) day
termination notice is invoked by either party, or
other termination, all obligations incurred on the
part of the Upper Key.c;: Ht')<1lth Care Taxing
District, under the terms of this agreement, or
under any amendments thereto, prior to. the date of
5
-J"'C
.'
to..l'Inin..ll:ion, l;h,lll b,~ ful~i.llcd llS per the tCl-ms
of t.hl:; il<]rccllIcllt, and as it: may be amended.
..'
IN IH'l'Nf.SS loJHEru':Ol", the pal:t:ics belo\~ have caus<.:ld this
.:\'lthuri:!.r.d.
<I'1:'C!I~J\\Cnt to be: c;~e<:utcd by their undel'signed officials as duly
(S!::>"L)
HOAHi) OF COUNTY COMIUSSIONERS
OF NlJNR95'; COllN'I":" FI,ORID,\
....t;;,-~~~ .'-
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~lYj)r / ~-""'-'l
Datc_~/.lf / 9()
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^ t tc~ t: DANNY 1.. KOLHAGE, Clerk
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