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Item C12 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: September 16. 2009 Division: Emergency Services Bulk Item: Yes --L No ~ Department: Fire Rescue Staff Contact PersonIPhone #: Darice Hayes / 6004 AGENDA ITEM WORDING: Approval of Renewal Agreement effective from October 1, 2009 through September 30,2011, with Professional Emergency Services, Inc. to provide medical direction to Fire and Emergency Medical Services as required by Florida Statutes. ITEM BACKGROUND: On April 21, 2004, the Board of County Commissioners approved a contract with Professional Emergency Services, Inc. to be effective January 1, 2004 and run through January 1,2007 with the option to renew for two additional two (2) year periods. On November 15, 2006, the Board of County Commissioners approved an extension and Amendment No. 1 to the existing contract extending the term through September 30, 2007, amending Section 2 clarifying the type of ambulance covered, defining and identifying service segments and rate of compensation, changing the effective date of the payment increases to coincide with the beginning of the Fiscal Year, clarifying rules on vehicle usage, and adding Section 15 to incorporate medical director coverage for an added service, Air Ambulance. Weare now requesting approval to exercise the renewal option for the second two-year period, commencing on October 1, 2009 and ending on September 30, 2011. PREVIOUS RELEVANT BOCC ACTION: On April 21, 2004, the Board of County Commissioners approved a contract with Professional Emergency Services, Inc. to be effective January 1, 2004 and run through January 1, 2007 with renewable options thereafter at the option of the County for two additional two (2) year periods. On November 15, 2006, the Board of County Commissioners approved an extension and Amendment number 1 to the agreement with Professional Emergency Service Inc. to provide medical direction to Fire and Emergency Medical Services existing contract extending the term through September 30, 2007, amending Section 2 clarifying the type of ambulance covered, defming and identifying service segments and rate of compensation, changing the effective date of the payment increases to coincide with the beginning of the Fiscal Year, clarifying rules on vehicle usage, and adding Section 15 to incorporate medical director coverage for an added service, Air Ambulance. On September 19,2007, the Board of County Commissioners approved the first Renewal Agreement for the two-year period from October 1,2007 through September 30,2009. CONTRACT/ AGREEMENT CHANGES: Second two-year Renewal Agreement will cover the period October 1, 2009 through September 30, 201 L STAFF RECOMMENDATIONS: All conditions of the contract have been met and services provided have been satisfactory. Staff recommends renewing as the contract allows. TOTAL COST: FY 10 - $91.421.00 FY 11- $94.492.00 FY10 - Ground: $61.421.00 01500-$34,396.00 /13001 - $27.025.00) Air: $30,000.00 01001- $30.000.00) FY11 - Ground: $64.492.00 01500-$36.116.00/13001 - $28.376.00) Air: $30,000.00 01001-$30.000.00) INDIRECT COST: - BUDGETED: YesX _ DIFFERENTIAL OF LOCAL PREFERENCE: N/ A COST TO COUNTY: See Above SOURCE OF FUNDS: Ad Valorem Taxes REVENUE PRODUCING: Yes NoX AMOUNT PER MONTH - Year - APPROVED BY: County Alty ~ OMB/Purchasing _ Risk Management_ DOCUMENTATION: Included X Not Required_ DISPOSITION: AGENDA ITEM # Revised 7/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Professional Emergenc~ Contract #_ Services, Inc. Effective Date: 10/1/2009 / Expiration Date: 9/30/2011 / Contract Purpose/Description: Renewal of Agreement dated 1/1/2004 for medical direction to Fire and Emergency Medical Services (ground & air) as required by Florida Statutes. / Contract Manager: Darice Hayes 6004 Fire Rescue / Stop 14 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 9/16/2009 / Agenda Deadline: 9/112009 CONTRACT COSTS Total Dollar Value of Contract: $ FY 10- $ 91,421.00 Current Year FY 11 - $94,492.00 Portion: $ Budgeted? Yescg] NoD Account Codes: /11500- FY 10 - $34,396.00 I FY 11 - $36,116.00 Grant: $ ] 3001- FY 10 - $27 ,025.00 I FY 11 - $28,376.00 County Match: $ 11001- FY 10 - $30.000.00 I FY 11- $30.000.00 - - - - ----- ADDITIONAL COSTS Estimated Ongoing Costs: $~yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date Out Date In Needed Division Director 1~1 ~ 01 YesD NoG'" ~ '1-1 ~O~ Risk Man~ement ~-o. 7{/j YesO NoB' ) ~B.IP ch~lg %-31...cr"7 YesD NO~ County Attorney '6 \d-.C)\tf\ YesD NO~ c;~ 1. I+vJ 8- ?-~--o Comments: OMB Form Revised 2/27/01 MCP #2 RENEWAL AGREEJ\1ENT This AGREEJ\1ENT dated the day of , 2009, by and between the Board of County Commissioners of Monroe County, Florida, hereinafter called the "District" and Professional Emergency Services, Inc., hereinafter called the "Contractor". WITNESSETH WHEREAS, the parties hereto did enter into an agreement dated January 1,2004 for medical direction to Fire and Emergency Medical Services as required by Florida Statutes~ and WHEREAS, said agreement provided an option to the District to renew the contract for two additional two year terms; and WHEREAS, the DISTRICT has elected to exercise said second two (2) year renewal option for the continuation of ground and air medical direction; now therefore IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as follows: 1. The District elects to renew the contract for an additional two years pursuant to paragraph 1 of the Agreement dated January 1,2004 and Extended and Amended on November 15,2006. 2. The effective date of this amendment is October 1, 2009 and shall extend through September 30, 2011, under the same terms and conditions of the contract dated January 1, 2004 and the Extension and Amendment Number 1 dated November 15,2006. 3. Compensation for Ground Ambulance for Fiscal Year 2010 shall be increased on October 1, 2009 and paid at a rate of $5,583.73 per service segment per year. Currently there are 11 service ~egments computing to $61,421.00 annually or $5,118.42 monthly. 4. Compensation for Ground Ambulance Fiscal year 2011 shall be increased on October 1,2010 and paid at a rate of$5,862.91 per service segment per year. Currently there are 11 service segments computing at $64,492.00 annually or $5,374.33 monthly. 5. Compensation for Air Ambulance medical direction for both Fiscal Year 2010 and 2011 shall be paid at a current rate of $82.19 per day and shall be calculated using the number of days that the Air Ambulance is in-service and shall not include days when it was out of service, up to a maximum of$30,000 per year. (Maximum annual amount = $30,000~ maximum monthly amount $2,500). 6. All other terms and conditions of the contract, extensions and amendments shall remain in full force and effect. Attest: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COM1vITSSIONERS By: By: Deputy Clerk Mayor/Chairman ekervices, Inc. Aut orized Representative. - 5ct.V\d-r<t 5c~ RENEWAL AGREEMENT This AGREEMENT dated the 1:1~ay of J~ , 2007, by and between the Board of County Commissioners of Monroe County': Florida, hereinafter called the "District" and Professional Emergency Services, Inc., hereinafter called the "Contractor". WITNESSETH WHEREAS, the parties hereto did enter into an agreement dated January 1, 2004 for medical direction to Fire and Emergency Medical Services as required by Florida Statutes; and WHEREAS, said agreement provided an option to the District to renew the contract for two additional two year terms; and WHEREAS, the DISTRICT has elected to exercise said first two (2) year renewal option for the continuation of ground and air medical direction; now therefore IN-CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as follows: 1. The District elects to renew the contract for an additional two years pursuant to paragraph 1 of the agreement dated January 1,2004 and Extended and Amended on November 15,2006. 2. The effective date of this amendment is October 1, 2007 and shall extend through September 30,2009, under the same terms and conditions of the contract dated January 1,2004 and the Extension and Amendment Number 1 dated November 15,2006. 3. Compensation for Ground Ambulance for Fiscal Year 2008 shall be increased on October 1, 2007 and paid at a rate of $5,064.64 per service segment per year. Currently there are 11 service segments computing to $55',711.00 annually or $4,642.58 monthly. 4. Compensation for Ground Ambulance Fiscal year 2009 shall be increased on October 1, 2008 and paid at a rate of $5,317.82 per service segment per year. Currently there are 11 service segments computing at $58,496.00 annually or $4,874.67 monthly. 5. Compensation for Air Ambulance medical direction for both Fiscal Year 2008 and 2009 shall be paid at a current rate of $82.19 per day and shall be calculated using the number of days that the Air Ambulance is in-service and shall not include days when it was out of service, up to a maximum of $30,000 per year. (Maximum annual amount = $30,000; maximum monthly amount $2,500). 6. All other terms and conditions of the contract, extensions and amendments shall remain in full force and effect. Attest: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS By: ~aLJC. l2vrfcun to) ~l}~ By: Deputy Clerk ./' Mayor/Chairman , y Services, Inc. WITNESSQ(JMPJl)P!bAti1JytJ r.'.<< Authbrized Representative MONROE COUNTY AT ORNEY PROVED AS M: 1 EXTENSION AND AMENDMENT NUMBER 1 TO THE AGREEMENT BETWEEN MONROE COUNTY, FLORIDA AND PROFESSIONAL EMERGENCY SERVICES, INC. This Extension and Amendment Number 1 ("Amendment I") is made and entered into this 15+h day of Nt\{. , 2006, by and between Monroe County, Florida, a political subdivision of the State of Florida ("COUNTY") and Professional Emergency Services, Inc., a corporation organized and doing business in the State of Florida ("MEDICAL DIRECTOR"). WITNESSETH: WHEREAS, the parties hereto entered into an agreement dated April 21, 2004 ("Agreement") to provide medical direction to Fire and Emergency Medical Services as required by Florida Statutes; and WHEREAS, said Agreement provided an option under Section 1- Term, for the COUNTY to renew the Agreement for additional periods without going out for a Request for Qualifications or other proposal; and WHEREAS, since the Agreement was executed, the Key Largo Fire and Ambulance District, an independent special district not under the jurisdiction of the County was created, removing some of the COUNTY'S and MEDICAL DIRECTOR'S area ofresponsibility; and ~ WHEREAS, the parties desire to amend the Agreement in order to clarify ~ tiPe ~m~ance covered; define and identify service segments, and change the termination date of the ~erMo c<ffi1cide with the fiscal year; and [T\ ~ -< ~ -rt n. r 0 on- ....... ..t) WHEREAS, the parties desire to add Section 15 to the Agreement to incorp&fff(ine~al director --'Ie :x P1 coverage for an added service, Air Ambulance; -< -~. -:: - n :.... ". N C) .1 ,-' .. -.!J . !-- 1';-1 0 0 NOW, THEREFORE. the parties agree as follows: ?' Q 1. Paragraph 1 of the Agreement sha.ll read as follows: 1. Term This Contract shall become effective on January 1, 2004 and shall run through September 30,2007, and ~han be rene~thereafter at the option of the COUNTY for two additional two (2) year periods. 2. The Agreement shall be amended in Section 2 as follows: 2. Compensation" Ground Ambulance (a) The MEDICAL DIRECTOR shall be paid at a current rate of $4,823.45 per service segment per year. Currently there are 11 service segments computing to $53,058.00 annually or $4,421.50 monthly. This amount may change during the year if segments are added or deleted. Payments shall be made monthly in arrears by the COUNTY pursuant to the Florida Local Government Prompt Payment Act after receipt of proper invoice by the MEDICAL DIRECTOR. . , , A service segment is defined as an entity providing service at a specific station. The following table identifies service segments currently covered: . Statim! Volunteer Career Service Pire Fire Rescue Segments 8 1 1 9 1 1 2 10 1 1 11 1 1 13 1 1 2 17 1 1 18 1 1 22 1 1 2 Totals: 5 6 11 / (b) The rate of payment per service segment shall be increased five percent (5%) annually on October 1 st during the term of this contract and subsequent extensions or renewals. ------ * * * * * (g) MEDICAL DIRECTOR shall be provided one county vehicle including cost of gasoline, repairs, insurance, and other operational costs, to use for travel within the County. Use of the vehicle out of county must be approved by the MCFR Chief and/or County Administrator. All other terms and conditions of this section 2 shall remain in full force and effect. 3. Section 15 - Air Ambulance shall be added to the Agreement as follows: Section 15- Air Ambulance 15.1 General Background Prior to October I, 2006, the Monroe County Sheriff ("Sheriff') operated an air ambulance service by helicopter at no charge to patients. MEDICAL DIRECTOR provided services to COUNTY to enable COUNTY'S EMS personnel to provide air medical services. Sheriff has purchased and has made arrangements to provide air ambulance services for trauma and for inter-facility transfers using COUNTY'S emergency personnel pursuant to an agreement dated July 19, 2006, with Monroe County, Sheriff, and Global Sky Aircharter Corporation for which payment may be requested from the patient and/or the requesting facility. Emergency Medical Service operations require the helicopter to have a license to operate in the State of Florida as an Air Ambulance, pursuant to Chapter 64E~2.005, F.A.C., and such operations require the COUNTY to employ or contract with a qualified MEDICAL DIRECTOR in order to provide air medical services pursuant to Chapter 64E-2.004(1), F.A.C. 15.2 Scope of Work MEDICAL DIRECTOR shall perform the services described in Chapter 64E-2.004, and 2.005 specific to Air Medical Direction. .' , , adequate administrative support services by the COUNTY in order to pelform the above duties and any other reports/consultations as may be required from time to time. Such administrative support will include use of office space, file cabinets, fax and copy machine, secretarial assistant services and one Paramedic to be chosen by Monroe County Fire Rescue Fire ChiefandMEDICAL DIRECTOR to act as LiaisonlChiefofthe Air Medical Program. 15.6 Insurance County will assure that this service is included in the insurance to be provided under the Agreement. In all other respects, the provisions of the contract between the parties dated April 21, 2004, not inconsistent herewith shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have caused this Amendment 1 to be executed the day and the year first above written. d~~~~ ,.,' ,..."-- .... '-,1-",~ /..':: .;;--~\ t. {(,({ ~~:,,~ 6.': / /) ","P .. .:. ",J., ~: r'r'.(g~. .. Board of County Commissioners, Monroe County, FL :; ...,.. . 0) ..~~ ~ -+~ .~,..,. :~:.:~;:~ -.i" f u"W ~ By: ~ i, " "" .~! !j' ~:;.~P . ~ ,,' ffi..~ . ".~- ~ ... ~~"i.{'S ((I\i ill " ~o ~~~ ~(.c.'1s "l~ . Mayor/Chairman 'C-\....o..\ \t. OS Date: . l \.: \ "5..- O~ ATTEST: Danny L. Kolhage, Clerk By: ,~ Sandra Schytem er, D.O., FACOEP, FACEP Professional Emergency Services, In~ Date: 7J-.j ( 10 (P .btl4k~ / l - 0 - lcJ <( ~ .. (,:J -J C) - ..~ LI.. <...~ - ";:~>=: MONROE COUNTY ATTORNEY l...~ :a: -:){.) :-. e:..- c:c ~:'? cc =c APPRO D AS TQ FORM: 0:: .:L. --. =- (:J r- . ,..:I e:;. o_ f ...J -I:-) sus M. GRIMSLEY C" (...) :>-:5w Ll.A I.LJ z(..)o ASSISTA~T COUNTY ~TTORNeY -' Q Z 0:: ..c <C .z () .- 3/- (/') Date ---" LJ.. c::. 0 0 c::t J: "" I . . Medical Director/Fire Department Physician Contract THIS CONTRACT, made and entered into this 21stdayof April, 2004, by and between the Board of County Commissioners of Monroe County, Florida, hereinafter referred to as the "COUNTY," and PROFESSIONAL EMERGENCY SERVICES, INC., hereinafter referred to as the " MEDICAL DIRECTOR", WITNESSETH: WHEREAS. the COUNTY provides fire and/or emergency medical services purs,:,ant to Chapter 401, Florida Statutes, in the following geographic areas; Cow Key Channel (mm 4) to the south end of the Seven Mile Bridge, also known as the Lower Keys Fire and Ambulance DIstrict, and from Tavernier Creek Bridge (mm90.5) to South Bay Harbor Drive and Lobster Lane (mm95); and South Bay-Harbor Drive and Lobster lane (mm95) to the Dade County Line on US 1 (mm113) 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 Florida licensed physician, Board Certified In Emergency Medicine with added qualification in EMS and pre-hospital care experience, or corporation which employs ar contracts with similarly qualified physicians: and WHEREAS, the COUNTY has determined It to be in the best interest of the residents of and vIsitors to Monroe County to cantract with a MEDICAL DIRECTOR for the purpose of providing direction to the Fire and Emergency Medical Services; and WHEREAS, the MEDICAL DIRECTOR desires - to provide professional services 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, 2004, and shall run through January 1, 2007, and shall be renewable thereafter at the option of the COUNTY for two additional two (2)- year perlads. 2. ComDen.atlon (a) The MEDICAl DIRECTOR shall be paid an annual fee of fifty thousand dollars ($50,000.00). Upon receipt of a proper Invoice. the County shall pay the annual fee In twelve monthly installments, pursuant to the Florida Prompt Payment Act. The annual fee may be revIsed based upon future modifications to the prov7 of Fire and EMS services through a written amendment. (b) Payment shall increase five percent (5%) per annum during the term of this Contract and subsequent renewals. (c) Professional services.r,equested beyond the scope of' this Contract will be Invoiced sepa"'lely at a "'Ie of $250.oo/hour and will be approved in advance by Ih7FR Fir. ChIef and/or County AdmInIstrator. (d) Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by. the Board of County Commissioners. (e) Invoices received from MEDICAL DIRECTOR shall be reviewed and approved by the County Fire Rescue~Chief or his designee, Indlcatfng that services have been rendered in conformity with the Agreement and then will be sent to the Finance Department for payment. Invoices must reference this Agreement and will be paid In accordance with the State of Florida Prompt Payment Act. (f) In order for both parties to close their books and records. MEDICAl DIRECTOR clearly state "FINAlINVOICE" on the MEDICAL DIRECTOR's final and last billing to COUNTY. This certifies that all services have been properly performed and all charges and costs have been invoiced to Monroe COUNTY. Since this account will thereupon be closed, any and other future charges if not properly included in this final Invoice are waived by the MEDICAL DIRECTOR. g) MEDICAL DIRECTOR will be provided a county vehicls, InCluding cost of gasoline, repairs, insurance, and other operational costs, to use for travel within the County. Use of the vehicle out of county will be approved by the MCFR Chief and/or County Administrator. h) Nothing In this agreement prohibits the MEDICAl DIRECTOR from billing any third party for medical services rendered outside the scope of this agreement that may arise during or after the term of this agreement. 3. Pumo.e. The purpose of this Contract is to assure compliance of the COUNTY in Medical Direction of its Fire and Emergency Medical ServIces System. 4. Duties and Resoonsiblllties. . (a) The MEDICAL DIRECTOR shall be responSible - to Monroe County Fire Rescue. and report directly to the Fire Chief and County Administrator. (b) The MEDICAL DIRECTOR shall adhere to the responsibilities as set for the in Florida Statutes 401, Florida Administrative Code 64E-2.004, Medical Direction. These include supervising and assuming direct responsibility for the medical performance of the Emergency Medical Technicians, and Paramedics employed by Monroe County Fire Rescue hereinafter MCFR). (c) The MEDICAL DIRECTOR shall be knowledgeable of the standards as set by National Fire Protection Association Standard #1582. (d) The MEDICAl DIRECTOR shaH coordinate and approve aU formal training which will allow each Monroe County EMT, and Paramedic to fufflll the continuing education requirements for biannual certification in the Sta~e of Florida. The MEDICAL DIRECTOR shall meet annually with the MCFR Chief, or designee, to review the Educational Program for content, location and dates. (e) The MEDICAL DIRECTOR will be available for consulting and advising on all EMS and Fire activities undertaken by the career and volunteer emergency response departments of Monroe County as req'uested by the County and authortzed by the MCFR ChIef or County AdminIstrator. (f) The MEDICAL DIRECTOR shall be available 24 hr/day, 365 days/year for emergency consultation with MCFR personnel. He/she shall carry a pager and/or radi%r other communication device, said equipment to be provided by the County. HeJshe shall respond in a timely manner to any pages fro.m MCFR. In the event the MEDICAL DIRECTOR Is unavailable, he/she shall appoint a similarly qualified physician to cover all responsibilities. (g) This Agreement Is a personal services contract based on the qualifications of Sandra Schwemmer, D.O.. FACOEP, FACEP, and the services required hereunder shall be performed by Dr. Schwemmer or under her supervision. Any additional personnel necessary for the fulfillment of the servioes required under this Agreement shall be secured at MEDICAL DIRECTOR's sole expense, and such personnel shall be fully qualified and, if required, authorized Of permitted under State and local law to perform such services. 5. Protocols The MEDICAL DIRECTOR shall provide an annual review of the pre-hospital treabnent protocols and when necessary, the MCFR Chief and the Medical Director shall jointly approve each protocol revision prior to implementation. These protocols shall be developed with consideration of the fiscal impact of such protocols on the participating agencies and citizens of Monroe County, Florida. MEDICAL DIRECTOR shall develop and revise when necessary Trauma Transport Protocols (TTP's) for submission to the Department of Health, Bureau of EMS, for approval. All EMT's and Paramedics will be trained In the use of the trauma scorecard methodologies as provided In Rule 64E-2.017, F.A.C., for adult trauma patlents and Rule 64E-2.0175, F.A.C., for pediatric trauma patients. COUNTY will prOvide such secretarial and administrative assistance as necessary tor the production and distribution of such protocols. 6. DEA Cortlficate MEDICAL DIRECTOR shall procure on behalf of Monroe County Fire Rescue a DEA registration in order to provide medications and controlled substances to the COUNTY. OEA registration shall Include the address at whloh controlled substances are stored. Proof of such registration shall be maintained on file with MCFR and shall be readily available for Inspection. MCFR will forward all renewal documents as received from the Dept. of Justice, DEA, to the MEDICAL DIRECTOR to assure continuous registration and wlll reimburse MEDICAL DIRECTOR for the cost of such registration. 7. Quality Assurance The MEDICAL DIRECTOR shall establish '8 quality assurance system to provide for process of quality review of all emergency medical technicians and paramedics operating under hlslher medical license and supervision. The Medical Director andior each aPPOintee of MEDICAL DIRECTOR'S staff shall audit the performance of MCFR 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 perfonnance standards for drugs, equipment, system protocols and procedures. Administrative assistance with regard to data collection, report production and distribution will be provided by the COUNTY. 8. Local Disasters In the event of a local disaster or Impending emergency situation with the possibility of multiple casualties, the MEDICAL DIRECTOR or appointee shall be available for emergency consultation. 9. Cost Containment/Eaulpment & 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. 10. InfecUous EXDosure Pollcv The MEDICAL DIRECTOR shall assist in developing an infectious disease exposure policy that complies with State and Federal OSHA requirements. The MEDICAL DIRECTOR shall assure that a comprehensive plan exists for prompt medical review of all possible Infectious exposures reported by MCFR personnel and members of the participating volunteer fire departments, and for post~exposure medical follow-up when indicated. The MEDICAL DIRECTOR shall be available 24hr/day. 365 days of the year for consultation with field personnel who have had any infectious or potential infectious exposure. 11. State Involveme~ The MEDICAL DIRECTOR shall become involved in the Florida Association of EMS Medical Directors. The COUNTY shall reimburse MEDICAL DIRECTOR for costs of such memberships, and any other recommended or required associatIon membershIp dues as required by the COUNTY. -MEDICAL DIRECTOR will attend EMS meetings as recommended and approved by the MCFR Chief. Such cost of attendance at such meetings will be reImbursed by the COUNTY. 12. Insurance The COUNTY shall maintain In full force and effect for the term of this Contract, and any subsequent renewals, professional and general liability insurance with minimum limits of $1,000,000.00 per occurrence. The COUNTY shall be responsible for maintaining this professfonalliability insurance for a minimum of three years from the date of termination If this Contract The Professional and General Liability certificate will specify coverage for "EMS oversight/medical direction~. The COUNTY will provide certificate or proof of such insurance to the MEDICAL DIRECTOR on an annual basis. MEDICAL DIRECTOR wf/J be provided thirty (30) days notice of cancellation, change in policy limits, and/or any. restrictions placed on coverage of the insurance provided by the COUNTY during the'term of this CONTRACT. The COUNTY wlfl be responsible for the payment of any deductible and/or self"insured retention In the event of a claim. 13. Termination. 13.1 Eany termination may occur as follows: (a) This Contract may be tennlnated by the MEDICAL DIRECTOR, with or without cause, upon not Jess than ninety (SO) days written noUee delivered to the COUNTY. (b) The COUNTY may terminate this Contract in whole or in part and without cause, upon not less than ninety (90) days written notice, delivered to the MEDICAL DIRECTOR. (c) The COUNTY may term irate this Contract immediately In the event that MEDICAL DIRECTOR fails to fulfill any of the terms, understandings or covenants of this Contract. 13.2 . At such time as this agreement is terminated, whether at the natural ending date or at an earlier tIme under paragraph 13.1 above, the MEDICAL DIRECTOR shall: (a) Stop work on the date and to the extent specified. (b) Terminate and settle all orders and subcontracts relating to the perfonnance of the work. Cc) Transfer all work in' process, completed work, and other materials related to the terminated work to the COUNTY. (d) Continue and complete all parts of that work which have not been terminated, If any. 14. GENERAL PROVISIONS. 14.1 Amendments and Asslanments. No amendment or assignment of this Agreement shall be valid without the prior written consent from the County. 14.2 Entire Atlreement. The entire agreement between the parties with respect to the Subject matter hereof Is contained in this Agreement, the Request for Qualifications and response thereto. Unless contradicted by the terms of this agreement, the partIes shall be bound by the provisions of the RFQ and Response. To the extent the RFQ and response are contradicted by the language In this Agreement, this Agreement supersedes all prior oral and written proposals and communications related to this Agreement between the parties. No provision of this Agreement shall be deemed waived, amended or modified by either party unless such waiver, amendment or modification is in writing and signed by the party against whom the waiver, amendment or modification is claimed. This Agreement shall be binding upon and inure to the benefit of the parties hereto, their permitted successors and assigns. 14.3 Severabllltv. If any term, covenant, condition or prOViSion of this Agreement shall be declared Invalid or unenforceable to any extent by a court of competent JurisdIction, the remaining terms, covenants, conditions and provisions of ihis Agreement shall not be affected thereby; and each remaining tenn, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaIning terms, covenants, conditions and provision of this Agreement would prevent the accomplishment of the original intent of this Agreement. The parties agree to reform the Agreement to replace any stricken provision with a valid provision that comes as crose as possible to the intent of the stricken provision. 14.4 CaDtfQn!. The captions set forth herein are for convenience of reference only and shalf not define, modify, or limit any of the terms hereof. 14.5 Governlna Law and Venue. This Agreement shall be governed by and construed In accordance with the laws of the State of Florida. Venue for any legal action which may arise out of or under this agreement shall be In Monroe County, Florida. 14.5.1 Conflicts in Interoretatlon. The parties agree that, In the event of conflicting interpretations of the terms or a term of this Agreement by or between them, the issue shalf be submitted to mediation prior to the instrtution of any other legal proceeding. 14.5.2 Adludlcatlon of DlsDutes and Dlsaoreements. The parties agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of the parties. tf no resolution can be agreed within thirty (30) days after the first meet and confer session, the Issue or Issues shall be discussed at a public meeting of the Board of County Commissioners. If the issue or issues are still not resolved to the satisfaction of the parties. then any party shall have the right to seek such relief 85 may be provided by this Agreement or by Fldrida law. 14.5.3 CooDeration, In the event any administrative or legal proceeding is instituted against either party relating to the fonnatlon, execution, performance, or breach of this Agreement, the parties agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement. The parties agree that neither party shall be required to enter into any arbitration proceedings related to this Agreement or any Attachment or Addendum to this Agreement. 14.5.4 Least Obllaatlons and ResDonslbiJities; Non-deleaatlon of ConstltutlQnal or Statutory Duties. This Agreement Is not intended to relieve, nor shall it be construed as relieving, any party from any obligation or 'responsibllity imposed upon the party by law except to the extent of actual and timely performance thereof by the other party, in whIch case the performance may be offered In satIsfaction of the obligation or responsibility. Further this Agreement is not Intended to authorize, nor shall It be construed as authorizing, the delegation of the constitutional or statutory duties of the County, except to the extent permitted by the Florida Constitution, state statutes. case law, and. specifically. the provisions of Chapter 125, FlorIda Statutes. 14.6 Attornev's Fees and Cosw. In the event any cause of action is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, court costs, Investigative, and out-of-pocket expenses, .as an award 8galnst the non-prevailing party, and shall include reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the circuit court of Monroe County. 14.7 Records. MEDICAL DIRECTOR shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles. Upon ten (10) business days written notice to the other party, representatives of either party shall have access, at al/ reasonable tfmes, to all the other party's books, records, correspondence, instructions, receipts, vouchers and memoranda (excluding computer software) pertaining to work under this Agreement for the purpose of conducting a complete Independent fiscal audit. MEDICAL DIRECTOR shall retain all records required to be kept under this agreement for a minimum of fIVe years, and for at least four years after the termination of this agreement. Storage of medical records required by Federal or State statute in excess of the times stateCf herein and subsequent to the termination of this Agreement shall be revls[ted by the partIes at such time as any transition period [s established to accommodate the termination of this Agreement. MEDICAL DIRECTOR shall keep such records as are necessary to document the provision of services under this agreement and expenses as incurred, and give access to these records at the request of the County. the State of Florida or authorized agents and representatives of said government bodies. It is the responsibility of MEDICAl DIRECTOR to maintain appropriate records to insure a proper accountfng of all collections and remittances. MEDICAl DIRECTOR shall be responsible for repayment of any and all audit exceptions whIch are identified by the Auditor General for the State of Florida, the Clerk of Court for Monroe County, the Board of County Commissioners for Monroe County, or their agents and representatives. , ,1- . " 14.7.1 Public Access. The pa(ties shall allow and permit reasonable access to and inspection of, all documents, papers, letters, or other materials subject to the Florida Public Records Law, as provided in Chapter 119. Florida Statutes, and made or received by the parties, unless speclflcally exempted by State or pre-emptive Federal Statute. 14.8 Ethics Clause. MEDICAL DIRECTOR warrants that it has not employed, retained or otherwise had act on its behalf any former County officer or employee In violation of Section 2 or Ordinance No. 10-1990 or any County officer or employee In violatIon of Section 3 of Ordinance No. 10-1990. For breach or violatlon of the provision the County may, at its discretion tennlnate this agreement without liability and may also, at its discretion, deduct from the agreement or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former or present County officer or employee. County employees and officers are required to comply with the standards of conduct delineated in Section 112.313, Florida Statutes, regarding, but not limited to. solicitation or acceptance of gifts. doing business with one's agency, unauthorized compensation, misuse of public position, conflicting employment or contractual relationship, and disclosure of certain Information. 14.9 Authorl~. MEDICAL DIRECTOR warrants that he or sha Is authorized by law to engage in the performance of the activitIes encompassed by the project herein described. Each of the signatories for MEDICAL DIRECTOR below certifies and warrants that the Contractor's name in this agreement is the full name as designated In its corporate; they are empowered to act and contract for MEDICAL DIRECTOR, and this agreement has been approved by the Board of Directors of MEDICAL DIRECTOR or other appropriate authority. 14.10 Public Entltv Crime Statement. 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 an agreement to provide any gOOds or services to a public entity, may not submit a bid on a agreement 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, sUb.oContractor, or consultant under a agreement with any publiC entity. and 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 of 36 months from the date of being placed on the convicted vendor list. 14.11 Antl-klekback. The Grantee warrants that no person has been employed or retained to solicit or secure this agreement upon an agreement or understanding for a commission, percentage. brokerage or contingent fee, and that no employee or officer of the County or TOe has any interest, financially or otherwise, In the said funded project, except for general membership. For breach or violation of this warranty. the Grantor shall have the right to annul this agreement without liability or, in its discretion. to deduct from the agreement price or consideration, the full amount of such commission. percentage, brokerage or contingent fee. 14.12 Modifications and Amendments. Any and all modifications of the terms of this agreement shall be only amended in writIng and executed by the Board of County Commissioners for Monroe County and MEDICAL DIRECTOR. 14.13 IndeDendent Contractor. At all times and for all purposes hereunder, MEDICAL DIRECTOR Is an independent contractor and not an employee of the Board of County CommissIoners of Monroe County. No statement contained in this agreement shall be construed as to find MEDICAL DIRECTOR or any of its employees, contractors, servants or agents to the employees of the Board of County Commissioners of Monroe County, and they shall be entltted to none of the rights, privileges or benefits of employees of Monroe County. : 14.14 Comollanc9 with Law. 'In carrying out its obligations under this agreement, MEDICAL DIRECTOR shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provisions of this agreement, including those now in effect and hereafter adopted. Any violation of said statutes, ordInances, rules or regulations shall constitute a material breach of this agreement and shall entitle the County to tenninate this agreement immediately upon delivery of written notice of termination to MEDICAL DIRECTOR. 14.15 Licensing and Permits. MEDICAL DIRECTOR shall have, prior to commencement of work under this agreement and at all times during said work, all required licenses and pennlts whether federal. state, County or City. 14.16 Non-Discrimination. MEDICAL DIRECTOR shall not discriminate, in its employment practices and In providing services hereunder, on the basis of race, color, sex, religion, disability, national origin, ancestry, sexual orientation, gender Identity or, expressIon, familial status or age, and shall abide by all federal and state laws regarding nonoodlscrimlnation. Upon a detennlnation by a court of competent jurIsdictIon that such discrimination has occurred. this Agreement automatIcally terminates without any further action by the County, effective the date of the court order. 14.17 Claims for State or Federal Ald. The parties agree that each shall be. and is. empowered to apply for, seek, and obtain federal and state funds to further the purpose of thIs Agreement, provided that all applications, requests, grant proposals, and funding solicitations shall be approved by each party prior to submission, and which approval shalf not be unreasonable withheld. 14.18 Non~R.llance bv Non-Partles. No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any thlrd..party claim or entitfement to or benefit of any service or program contemplated hereunder, and the parties agree ihat neIther the County nor MEDICAL DIRECTOR or any officer, agent, or employee of each shall have the authority to inform, counsel, or otherwise Indicate that any particular Individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart. Inferior to, or superior to the community In general or for the purposes contemplated under this Agreement. 14.19 Attestations. MEDICAL DIRECTOR agrees to execute such documents as the County may reasonable require, InclUding a Drug-Free Workplace Statement, and a Public Entity Crime Statement. 14.20 Signatures of Parties Reaulred.. THIS AGREEMENT SHALL NOT BE EFFECTIVE UNTIL EXECUTED BY BOTH PARTIES AND RECEIVED IN FINAL EXECUTED FORM BY AN AUTHORIZED REPRESENTATIVE OF MEDICAL DIRECTOR AT ITS PRINCIPAL PLACE OF BUSINESS. 14.21 County Authorltv. By execution hereof the signer below hereby certifies that signer Is duly authorized to execute this Agreement on behalf of the Court. 14.22 No Personal Llabllltv. No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of the Board Of County Commissioners of Monroe County in his or her individual capacity and no member, officer, agent or employee of the Board Of County Commissioners of Monroe County shall be liable personally on this Agreement or be subject to any personal Ilablflty or accountability by reason of the execution of this Agreement. 14.23 execution In Counteroarts. This Agreement may be executed in any number of counterparts. each of which shqll be regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by signing any such counterpart. MEDICAL DIRECTOR'S signature on this Agreement shall act as the execution of the truth-In-negotiatIon certificate certifying that wage rates and costs used to determine the compensation provided under this Agreement are accurate. complete and current as of the date of the Agreement, and are no higher than those charged the MEDICAL f?IRECTOR'S most favored customer for the same or substantially similar service. 14.24 T'V~h In Neaotlatlon Certificate. Signature of this Agreement by MEDICAL DIRECTOR shall act as the execution of the truth-In-negotiatIon certificate certifying that the wage rates and costs used to determine the compensatIon provided In this Agreement are accurate, complete and current as of the date of the Agreement and no higher than those charged the MI;DICAL DIRECTOR's most favored customer for the same or substantially similar service. 14.25 Federal and State Tax. The COUNTY Is exempt from payment of Florida State Use and Sales Taxes. The COUNTY will slgn an exemptIon certificate submitted by MEDICAL DIRECTOR. The MEDICAL DIRECTOR will not be exempted from paying state sales tax to Its suppliers for materials used to fulfill contractual Obligations with the COUNTY, nor Is the MEDICAL DIRECTOR authorized to use the County's Tax Exemption Number in securing such materials. 14.26 Notice. All notices required in this Agreement shall be sent by mail. return receipt requested. and shall be sent to the followIng: For MEDICAL DIRECTOR: For COUNT'(; Sandra Schemmer, 0.0., FACOEP ,FACEP Clark Martin, Fire Chief 160 Kev Hei~hts Drive 490 63rd Street (Ocean) Tavernier, FL 4~O37 Marathon, Fl. 33050 and Richard Collins, County Attorney P.O. Box 1026 Key West. Fl. 33041-1026 . d.. , IN Wff~ES~ WHEREOF, the parties hereto have caused this MEDICAL DIRECTOR Contract to be ~ect:ltad 'the day and year first above ~Jtten. (SEAL) Board of County Commissioners of ~Iot;j. b . . OE CuuNTY ATTORNEY /. DAVID 'p, RICE OVED~ VICE~CHAIRMAN UZANNE A. HUTTON ~d. ~ t.1r4?f'SSISTAN~~>>?RNEfrofesslon Witness / ~Q-LU 2ALV~ Sa d Schwemmer, 0.0., FACOEP ,FACEP Witness . " LOBBYING.AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010.1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE PROFESSIONAL EMERGENCY SERVICES J INC warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 1O~1990. For breach or violation ofthis provision the County may, in its discretion, terminate this contract 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 C // .,' j (signature) %fi;f Date: STATE OF \=- \O{ : (\A COUNTY OF Y f::\.. \ M bt: A('.h PERSONALLY APPEARED BEFORE ME, the undersigned authority, 5~~ S ~- who, after first being sworn by me, affixed hi~ signature (name of individual signing) in t~e space provided above on this ~. -t~. day of ~~ , 20 Dl.\ . \ \~~U__Lu.. 9: riA ~ )CX-4) NOTARY PUBUC My commission expires: .f""'~ Ter&nta Edwards OMB . MCP FORM tf4 \.'1.) My CommiSSion D0127724 Of '" EJ.:plres JUI1ft 20. 2006 <. . \ PUBLIC ENTITY CRIME STATEMENT "A person or affiliate who has been placed on the convicted vendor list following a convi~tion 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 ofreat 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, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CA TEGOR Y TWO for a period of 36 months from the date of being placed on the convicted vendor list. II