Item C11---------------
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date. Sept. 20, 2006 Division: Emer enev Services
Bulk Item: Yes X No Department: Fire Rescue
Staff Contact Person: Darice Ha es
AGENDA ITEM WORDING: Request approval of Affiliation Agreement between hmergency
Medical Sciences Academy, Inc., (EMS Academy) and the Board of County Commissioners of Monroe
County, Florida for Monroe County Fire Rescue (MCFR) to provide an EMS training environment
from date of approval of Affiliation Agreement through December 31, 2007.
ITEM BACKGROUND: The purpose of this Agreement is for MCFR to provide a comprehensive
learning experience within a clinical setting for EMS Academy students.
PREVIOUS RELEVANT BOCC ACTION: On July 14, 2004 the BOCC approved an Agreement
between EMS Academy (formerly Para-Med Academy, Inc.) and the MCBOCC for MCFR. On
December 31, 2005 this Agreement expired.
CONTRACT/AGREEMENT CHANGES: A new Agreement to go into effect upon approval by the
MCBOCC at the September 20, 2006 meeting; to remain in effect through December 31, 2007.
STAFF RECOMMENDATIONS: Staff recommends approval of the Affiliation Agreement between
the EMS Academy and the Monroe County Board of County Commissioners for MCFR so that
Academy students can have the training environment they require to complete EMS courses.
TOTAL COST: N/A BUDGETED: Yes No
COST TO COUNTY: N/A SOURCE OF FUNDS: N/A
REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year
APPROVED BY: County Atty YES OMB/Purchasing YES Risk Management YES
DOCUMENTATION: Included X Not Required
DISPOSITION: AGENDA ITEM#
Revised 8/06
ME,NI0RANDtN'1 ATTACHMENT TO AGEM1DA ITEM SUMMARY
Meeting Date: Sept. 20 .2006 Division: Emergency Services
Bulk heirs: Yes X No Department: Fire Rescue
Staff Contact Person: Dance Haves
AGENDA'ITEM WORDING: Request approval of Affiliation Agreement between Emergency
Medic aI Sciences Academy, ln.c,, (F.MS Academy) and the Board of Cou ity Commissioners (3r
14ionroc County, -Florida fbr Monroc County Fire Rescue (MCER) to provide an EMS training
envirorimen't from date of approval of Affiliation Agreement through December 31, 2007.
ITE-M BACKGROUND: The EMS Academy students who are enrolled in Emergency Medical
Services (EMS) courses (I :MT -Basic and Paramedic) must complete a specified number of
supervised hour4 on a licensed ambulance. MCFR and EMS Academy Sought this Affiliation
Aoreemcat to prov1de a resource for a comprehensive learning experience for the EMS Acadcmy
students, within a clinical field setting, for completion of the students' program. criteria. The
`General Provisioils of Agreement prmde for either party to elect annually to extend the Affiliation
Agreement for an additional near with 30 days prior written naticc.
As noted in. the section below, a prior- Agreement had been in place and expired oil December 31,
2005. Ork'August 3, 2006 the Clinical Coordinator of the EMS Academy contacted Chief Martin
seekinLl to renew the relationship bctwteen the EMS Academy and Monroe County. :'fin updated
Affiliation Agreement vvas forw-arded to Firs: Rescue for review and routing.
PREVI0tJ1S'REI.EVANT BOARD ACTION: On July 14, 2004 the BOCC approved an
Agecment between EMS Academy (formerly Para-Med Academy, Inc.) and the MC130CC For
MCFR. On December 71, 2005 this Agreenlerlt expired.
CONTRikCTIAC.REEM F'NT CHANGES: A new Agreement to so into effect upon approval by
thte MCI30CC at the September 20, 2006 meeting and to remain in effect through December 31,
2007.
STAFF RECOMMENDATIO?VS: Staff recommends approval of the Affiliation Agreement
between the EMS Academy and the .Monroe County Board of County Conirnissioners for MCFR so
that Acadiamy students can have the training environment they require to complete EMS courses.
These EMS courses throo-h the Academy will also be available for locals who are interested 1z1
Pursuing further courses in the Enicrgency Medical Services field_
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SLM ARY
Contract ? Emergency Medical Sciences (EMS) Contract #
Academy, :.Inc. Effective Date: September 20, 2006
Expiration Date: December ' 1, 2007
Contract PurposelDescriptiow.
To provide. an EMS training environment for students of EMS Academy within a clinical field setting
with Monrm County Fire Rescue.
Contract Manager: Chri�f Clark.Martin. Jr. 6004 Fire Rescue 1 Sto #14
(Name) (Ext.) (Depart-nent/Stop #)
for BOCC meeting on Sept 20, 2006 Agenda Deadline: September.S, 2006 .
CONTRACT COSTS
Total Dallar Value of Conimci: $ NIA Current Year Portion: S
Budgeted'?' Yes❑ No [] Account Codes: - - - -
Grant. $ - - - -
County Match: $ - - -
ADDITIONAL COSTS
Estima:tetl Ongoing Costs. $ f/yr For;
(Not included in dollar. value above).: (e . maintenance; utilities, janitoti.4 salaries, etc.)
CONTRACT REVIEW
Changes Date Out
Date In Needed
Division l7irector �446 Yes❑ No ®�
..Risk Maria meat Yes❑ No[�' f r h ¢x &31-oh
O.M.B..IPurcha9ing q. ! Yes[
No[-
County 4ttamey � �.. Yes❑ No
Comments:
OMB Foim Revised 2127/ 1 MCP #2
AFFILIATION AGREEMENT
I. PARTICIPATING AGENCIES
This AGREEMENT between EMERGENCY MEDICAL SCIENCES ACADEMY,
INC., hereinafter referred to as the AGENCY, and the BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as
the AMBULANCE SERVICE is entered into this day of
2006.
II. PURPOSE OF AGREEMENT
It is mutually agreed that the purpose of this AGREEMENT is to provide a
comprehensive learning experience for participants from the AGENCY, within a
clinical setting, in accordance with provisions of the guidelines set forth in this
AGREEMENT.
III. GENERAL PROVISIONS OF AGREEMENT
A. Both parties agree that there will be no distinction in employment or
placement because of race, sex, color, creed, age, national origin, religion,
marital status, disability or handicap and adhere to the provisions of
Federal and State laws regarding discrimination.
B. The AMBULANCE SERVICE will provide, to the Participant, at the
Participant's expense, emergency care for injuries or acute illness while on
duty at the AMBULANCE SERVICE in accordance with the provisions of
this agreement.
C. The term of this AGREEMENT shall be from the date of the
AGREEMENT, and shall remain in full force and effect until December
31, 2007. Either party may elect annually to extend this AGREEMENT
for an additional one (1) year period upon providing at least thirty (30)
days prior written notice of intent to extend. Either party hereto may
terminate this AGREEMENT by giving at least thirty (30) day written
notice to the other party.
NOTICE: Where notice is required under this AGREEMENT to be given to either
party, the notice shall be mailed to:
For AGENCY: For AMBULANCE SERVICE:
Frank Galgano, Program Director Clark O. Martin, Jr., Fire Chief/Div. Director
EMS Academy, Inc. Monroe County Fire Rescue
600 N. Pine Island Rd., Suite 320 490 63`d Street, Suite 140
Plantation, FL 33324 Marathon, FL 33050
IV. SPECIFIC RESPONSIBILITIES OF THE AGENCY
A. AGENCY shall designate a person or persons to coordinate and act as a
liaison with the appropriate AMBULANCE SERVICE personnel.
B. AGENCY shall provide the AMBULANCE SERVICE with a list of
participants in the learning experience at least ten (10) days before each
program is to start.
C. AGENCY shall insure that participants have the necessary didactic
prerequisites to maximize the learning experience at the AMBULANCE
SERVICE.
D. AGENCY shall insure that the participants comply with the provisions of
Section VI.
E. AGENCY does undertake and agree that it will indemnify and hold
harmless the AMBULANCE SERVICE and its officers, directors,
employees, and agents, and reasonable attorney's fees on account thereof,
that may be sustained or incurred by reason of any and all claims,
demands, suits, actions, judgments, and executions for damages of any and
every kind and by whomever and whenever made or obtained, allegedly
caused by, arising out of, or relating in any manner to the activity of any
participant or participants supplied by the AGENCY pursuant to this
AGREEMENT.
F. AGENCY shall procure and maintain, during the term of this
AGREEMENT and any renewal, liability insurance to cover any and all
liability (including professional liability) for claims, damages, or injuries
to persons or property of whatsoever kind of nature arising out of the
activities of the participants carried out under this AGREEMENT. Such
insurance shall be on an occurrence basis in amounts no less than
$1,000,000/ $3,000,000 for personal injuries and $50,000 for property
damage; and the AMBULANCE SERVICE shall be an additional named
insured under such general and professional liability policy or policies.
AGENCY shall submit certificates of insurance to the AMBULANCE
SERVICE evidencing such insurance at the time of the execution of this
AGREEMENT, and as requested by the AMBULANCE SERVICE.
AGENCY agrees that the AMBULANCE SERVICE will receive no less
than thirty (30) days written notice prior to cancellation, modification, or
non -renewal of any of the insurance coverage's described herein.
Participants who do not have patient contact (non -allied health
participants) will not be required to be covered by professional liability
insurance.
2
V. SPECIFIC RESPONSIBILITIES OF THE AMBULANCE
SERVICE
It shall be the responsibility of the AMBULANCE SERVICE to:
A. Provide an appropriate orientation of participants in connection with its
facilities and its policies and procedures.
B. Provide opportunities for a learning experience with appropriate
supervision.
C. Retain ultimate responsibility for patient care even if that care is given by
a participating student.
D. Designate a preceptor (or coordinator) from its staff to act as the liaison
with the AGENCY in this AGREEMENT, as appropriate to the learning
objectives.
VI. SPECIFIC RESPONSIBILITIES OF THE PARTICIPANT
It shall be the responsibility of the Participant(s) assigned through this AGREEMENT
to:
A. Comply with the policies and procedures of the AMBULANCE SERVICE.
B. Provide the necessary and appropriate uniform while on duty in the
AMBULANCE SERVICE.
C. Obtain prior written approval of both parties to this AGREEMENT before
publishing any material related to the learning experience provided under
the terms of the AGREEMENT.
D. Sign a "Hold Harmless Agreement" with the AMBULANCE SERVICE
prior to commencing his/her experience within the AMBULANCE
SERVICE of which is attached to this AGREEMENT as Exhibit A.
E. At all times, must wear the appropriate badge on every clinical rotation,
and comply in all respects with the student requirements set forth in the
requirement sheets.
VII. REQUEST FOR WITHDRAWAL OF PARTICIPANT
The AMBULANCE SERVICE shall reserve the right to deny any Participant from
access to its facilities whose conduct or work with patients or personnel is not in
accordance with the policies and procedures of the AMBULANCE SERVICE or is
detrimental to patients or others.
VIII. MODIFICATION OF AGREEMENT
Modification of this AGREEMENT may be made by mutual consent of both parties,
in writing, and attached to this AGREEMENT and shall include the date and the
signatures of parties agreeing to the modification.
IX. COPIES OF AGREEMENT
Copies of this signed AGREEMENT shall be placed on file and be available at the
corporate office of the AGENCY and in the offices of the AMBULANCE SERVICE.
IN WITNESS WHEREOF the parties hereto have caused this AGREEMENT to be
executed in their respective corporate names and their corporate seals to be affixed by
duly authorized officers, all on the day and year first set forth above.
(SEAL)
Attest: Danny L. Kolhage, Clerk
By:
Deputy Clerk
Emergency Medical Sciences Academy, Inc.
Frank Galgan Director
4
Board of County Commissioners
of Monroe County, Florida
Mayor / Chairman
MONROE COUNTY ATTORNEY
PPROVED AS TO FORM:
SU8 M. GRIMSLE
A8816TA C�Q$ jY Aa RNEY
Date . dr
EXHIBIT A
EMERGENCY MEDICAL SCIENCES ACADEMY
HOLD HARMLESS AGREEMENT AND RELEASE
I, , am presently enrolled as an Emergency
Medical Technician or Emergency Medical Technician Paramedic student at Emergency
Medical Sciences (EMS) Academy. My course of instruction at this school requires me
to train, study, and receive instruction at EMS Academy and/or Monroe County Fire
Rescue (County).
In consideration for the County providing me this opportunity to acquire training and
instruction, I, the undersigned, agree to indemnify, protect, and hold harmless the
County and its officers, directors, employees, agents and assignees from any liability
judgments, claims, costs, damages or injury arising out of or in connection with any and
all acts of negligent conduct on my part, however caused, during any instructional or
training activity. I agree that I will defend at my own expense, any and all actions,
lawsuits or proceedings which may be brought against the County in connection with
the above and shall satisfy, pay and discharge any and all judgments that may be
entered against the County in any such claims, lawsuits, or proceedings.
I understand that, generally, while I am engaged in the activities of and related to this
course of instruction and training, I am not considered an employee of the County and
therefore, I am not eligible for any benefits available to County's employees, nor to
Workers Compensation coverage pursuant to Florida Statute Chapter 440 (1989-90 or
its successor amendments/statutes).
I understand that there are inherent risks in training with County, including but not
limited to, my own injury, exposure to blood -borne illnesses, and exposure to
contagious diseases and contraction of such diseases. Participation in this training can
result in severe injury and even death. I release County from any and all liability from
any consequences arising out of my training with County.
Date of Instructional Activities:
Signature:
to
Date Date
Date:
Witness: Date: