Item C30 C30
BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE Mayor Craig Cates,District 1
The Florida Keys Mayor Pro Tern Holly Merrill Raschein,District 5
Michelle Lincoln,District 2
James K.Scholl,District 3
m' David Rice,District 4
Board of County Commissioners Meeting
September 20, 2023
Agenda Item Number: C30
2023-1455
BULK ITEM: Yes DEPARTMENT: Fire Rescue
TIME APPROXIMATE: STAFF CONTACT: James K. Callahan
N/A
AGENDA ITEM WORDING:
Approval of a one (1)year contract extension with Professional Emergency Services, Inc. for a Medical
Director with a five percent (5%) increase from $55,000 to $57,750 for air ambulance medical direction
and an increase from $58,000 to $60,900 for ground ambulance medical direction for a total contract
amount of$118,650.
ITEM BACKGROUND:
Monroe County Fire Rescue's (MCFR's) existing contract with Professional Emergency Services, Inc.
for a Medical Director of Monroe County Fire Rescue will expire on September 30, 2023. In
accordance with the Purchasing Policy, MCFR is requesting BOCC approval for exemption from the
competitive bidding process and BOCC approval for a one (1)year contract extension. The proposed
contract extension is for the period commencing on October 1, 2023 through September 30, 2024.
This contract is pursuant to the exemption from the competitive bidding process for professional
services under Chapter 4 of the Purchasing Policies and Procedures. In accordance with Chapter 4
Purchase of Professional Services, because differences in price may only be a minor concern compared
to qualitative considerations, as can be the case with medical services, these professional services may
be exempted by the BOCC from the competitive bidding process.
PREVIOUS RELEVANT BOCC ACTION:
On June 8, 2011, sealed bids were opened for the professional services of a physician to
provide medical direction for Monroe County Fire Rescue. Professional Emergency Services,
Inc. was chosen by a selection committee consisting of seven (7) members on July 13, 2011.
On October 16, 2013, the BOCC (Item C.34) and BOG (Item G.2) granted approval for execution
of the 1st Renewal Option of the Contract between the BOCC, the BOG, and
Professional Emergency Services, Inc. effective October 1, 2013 expiring September 30, 2015.
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On September 16, 2015, the BOCC (Item C.47) and BOG (Item G.5) approved and exercised the
2nd and Final Renewal Option of the contract between the BOCC, the BOG, and
Professional Emergency Services, Inc. to provide Medical Direction for Monroe County Fire
Rescue pursuant to Chapter 401, F.S. and Chapter 64J-1, FAC, resulting in the contract
being extended and a new expiration date of September 30, 2017.
On July 19, 2017, the BOCC (Item C.10) and BOG (Item H.2) granted approval for an
amendment and extension to the existing agreement with Professional Emergency Services, Inc.,
to include additional medical oversight in the expansion of the Trauma Star secondary air
transport ambulance with a new expiration date of September 30, 2020.
On August 19, 2020, the BOCC (Item C.10) and BOG (Item H.2) granted approval for an
amendment and extension to the existing agreement with Professional Emergency Services, Inc.
with a new expiration date of September 30, 2021.
On September 15, 2021, the BOCC (Item C.8) and BOG (Item H.1) granted approval for a contract with
Professional Emergency Services, Inc. for a 2 year initial term effective October 1, 2021 and an
expiration date of September 30, 2023.
CONTRACT/AGREEMENT CHANGES:
Additional one (1)year contract term with a 5% increase in both air and ground services.
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Professsional Emergency Services, Inc. - Medical Director -Expires 9-30-2023.pdf
Professional_Emergency_Services_Inc._-_First_Addendum_Expires_09.30.2024_Signed_Version.pdf
FINANCIAL IMPACT:
Effective Date: 10/01/2023
Expiration Date: 09/30/2024
Total Dollar Value of Contract: $118,650 over the one year contract term
Total Cost to County: $118,650
Current Year Portion: $118,650
Budgeted: Yes
Source of Funds: 141-11500 and 101-11001
1600
CPI: Five percent(5%) increase for one year contract extension
Indirect Costs: N/A
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Kevin Madok, CPA
Clerk of the Circuit Court$ Comptroller—Monroe County, Florida
DATE: September 22, 2021
TO: Cheri Tamborski
Fire Rescue
FROM: Sally M. Abrams, D.C.
SUBJECT: September 15th BOCC Meeting
Attached is an electronic copy of Item C8, a two (2) year contract with Professional Emergency Services,
Inc., for a Medical Director of Monroe County Fire Rescue with an increase from $54,000 to $55,000 per
year for air ambulance medical direction, the same annual cost of$58,000 for ground ambulance medical
direction and the option to renew for two (2) additional 2-year periods at an increase in cost of up to five
percent (5%). This contract is pursuant to the exemption from the competitive bidding process for
professional services under Chapter 4 of the purchasing policies and procedures.
Should you have any questions, please feel free to contact me at ext. 3550. Thank you.
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY PKIROTH BUILDING
500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road
Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070
305-294-4641 305-289-6027 305-852-7145 305-852-7145 1 602
CONTRACT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
AND
THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1
AND
PROFESSIONAL EMERGENCY SERVICES,INC.
FOR MEDICAL DIRECTION FOR MONROE COUNTY FIRE RESCUE
THIS CONTRACT is made and entered into this 15th day of September 2021, by and
between the Hoard of County Commissioners, The Board of Governors of Fire and Ambulance
District I of Monroe County, Florida,hereinafter collectively referred to as the "COUNTY,"and
Professional Emergency Services,Inc.,hereinafter referred to as"MEDICAL DIRECTOR'.
WITNESSETH:
WHEREAS,COUNTY provides fire and/or emergency medical services pursuant to Chapter
401,F.S.and Chapter 641-1,FAC;and
WHEREAS,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 Emergency Medical Services (EMS) and pre-hospital care experience, or a
business entity that employs or contracts with similarly qualified physicians; and
WHEREAS, COUNTY has determined it to be in the best interests of the residents of and
visitors to Monroe County to contract with MEDICAL DIRECTOR for the purpose of providing
direction to the Fire and Emergency Medical Services;and
WHEREAS, MEDICAL DIRECTOR desires to provide professional services according to
the terms and conditions stated herein.
NOW THEREFORE, in consideration of the mutual understandings and Contracts set forth
herein, COUNTY and MEDICAL DIRECTOR agree as follows:
1. Term
This Contract shall became effective on October 1, 2021, and shall run through September 30,
2023(Initial.Term),and shall be renewable thereafter at the option of COUNTY fortwo additional
two(2)-year periods.
Upon expiration of the Initial Term, COUNTY may renew the contract for up to two additional
two (2)-year periods at an increase in the compensation-rate of up to five percent(51/6) over the
prior Initial Term,unless otherwise agreed by the parties.
2. Compensation
2.1 Ground Ambulance
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MEDICAL DIRECTOR shall be paid at a rate of $58,000.00 annually to provide ground
ambulance medical direction. Payments shall be made monthly in arrears by COUNTY pursuant
to the Florida Local Government Prompt Payment Act after receipt of proper invoice submitted by
MEDICAL DIRECTOR.
2.2 Air Ambulance
MEDICAL DIRECTOR shall be paid at d rate of$55,000.00 annually to provide air ambulance
medical direction. Payments shall be made monthly in arrears by COUNTY pursuant to the
Florida Local Government Prompt Payment Act after receipt of proper invoice by MEDICAL
DIRECTOR.Note: This payment is contingent upon COUNTY's decision to continue to operate
air ambulance services under its ALS license, and 1� for any reason, COUNTY decides not to
continue to operate air ambulance EMS service under its ALS license, then MEDICAL
DIRECTOR shall have no responsibility to serve as MEDICAL DIRECTOR for the air ambulance
service and COUNTY shall have no liability for this portion of MEDICAL DIRECTOR's
compensation.
2.3
Physician"peer to peer"services for collection of denied medical claims will be paid,subject to
administrative review, at a rate of$250.001hour in order to collect funds that would otherwise be
unpaid.
2.4
COUNTY will reimburse MEDICAL DIRECTOR for any direct expenses associated with
meetings required by COUNTY or Monroe County Sheriffs Office. For the purpose of this
paragraph,the term "direct expenses"means per diem or subsistence allowances, transportation
costs or mileage allowances, and miscellaneous travel expenses, as those terms are defined by
Section 112.061,Florida Statutes. All compensation shall be according to County Ordinance and
State law.
2..5
a.MEDICAL DIRECTOR will be provided a county phone and any other equipment required as
approved by the Chief of Fire Rescue.
b. COUNTY will reimburse MEDICAL DIRECTOR for the yearly application fee required for
renewal of the County's Drug Enforcement Administration (DEA) certificate, if the MEDICAL
DIRECTOR has paid the application fee in advance on behalf of the COUNTY.
2.5
Invoices received from MEDICAL DIRECTOR shall be reviewed and approved by COUNTY
Fire Chief or his designee, indicating that services have been rendered in conformity with the
Contract,and then will be sent to the Finance Department for payment.
2.7
In order for both parties to close their books and records, MEDICAL DIRECTOR must clearly
state"FINAL INVOICE"on 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
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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 MEDICAL DIRECTOR
2.8
Nothing in this Contract prohibits MEDICAL DIRECTOR from billing any third party for medical
services rendered outside the scope of this Contract that may arise during or after the term of this '
Contract.
3. Ruripose
The purpose of this Contract is to assure compliance of COUNTY in Medical Direction of Monroe
County Fire Rescue in accordance with the provisions of F.S.,Chapter 401,and FAC Chapter 64J-
1.004.
4. Duties and Responsibilities.
4.1
MEDICAL DIRECTOR shall be responsible to Monroe County Fire Rescue and report directly to
the Fire Chief,and/or his/her designee.
4.2
MEDICAL DIRECTOR shall adhere to the responsibilities as set forth in Chapter 401,F.S.,and
Rule 641-1.004,FAC;the applicable rules of any goiernment agency implementing said chapter;
and any duties upon writtednotice from the Florida Department of Health that such additional
duties are required of .MEDICAL DIRECTOR. These include supervising and accepting
responsibility for the medical performance of all certified/license response personnel functioning
within the scope of their official duties while on duty with Monroe County Fire Rescue(MCFR),
including,but not limited to,members of volunteer fire department under contract with COUNTY
and/or Monroe County Fire and Ambulance District 1. While these duties will typically occur
within the geographical Borders of unincorporated Monroe County and the'City of Layton, they
also include duties performed at the Key West International Airport, during mutual performed
during mutual aid to requesting municipalities outside those geographical borders and while
transporting patient to out ofcounty medical facilities. For the purpose of this Contract,Dr.Sandra
Schwemmer is the individual who meets the licensing and registration requirements of Chapter
401,F.S.and FAC Chapter 64J-1.004.
4.3
MEDICAL DIRECTOR shall be knowledgeable with the standards set by National Fire Protection
Association,and in particular; Standard!582: Standard on Comprehensive Occupational Medical
Program for Fire Departments.
4.4 Standards of Care
MEDICAL DIRECTOR shall establish and maintain standards of care for EMS providers. '
4.4.1
MEDICAL DIRECTOR shall gather agency input in the review and development of standards of
care on an annual basis and establish and revise agency performance standards as necessary.
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4.4.2
Develop pre-hospital practice parameters for Fire Rescue Personnel of all levels. The parameters
shall Abe developed with consideration to budgetary and staffing limitations and the fiscal impact
on MCFR and the citizens of Monroe County.
4.5 Patient Advocate
MEDICAL DIRECTOR shall be a patient advocate in the fire rescue system and shall ensure that
all aspects of the EMS systems are developed to place the needs of the patient first.
4.6 Protocols and Standing Orders.
4.6.1
MEDICAL DIRECTOR shall develop, revise, implement, and maintain basic and advanced life
support protocols and standing orders under which MCFR personnel will function under medical
control.
4.6.2
MEDICAL DIRECTOR shall review and revise existing protocols and standing orders to ensure
that they meet nationally accepted standards of practice for use by all system providers, which
permit specified ALS and BLS procedures when communication cannot be established with a
supervising physician,or when any delay in patient care would threaten the life or health of the
patient, These standards include,but are not limited to,Advanced Cardiac Life Support(ACLS),
Basic Trauma Life Support(BTLS),and Pediatric Advanced Life Support(PALS). In addition to
medical treatment,protocols shall address determination of patient destination.
4.6.3
MCFR shall publish and distribute,at its own cost,all protocols and standing orders. The protocols
and standing orders shall be published in a form consistent with agency Standard Operating
Procedures. Copies of the protocols and standing orders will be maintained on all MCFR
ambulances (air and ground) and ALS engines, and will be distributed to certified/licensed
response personnel. Personnel copies may be provided electronically. MCFR shall obtain and
retain a receipt from each personnel member verifying receipt of the protocols and any changes.
These receipts may be electronic, and shall state clearly that each person is individually
accountable and obligated to follow all rules,regulations and protocols. All protocols and standing
orders shall become public domain upon implementation,
4.6.4
MEDICAL DIRECTOR shall develop, review, and revise, when necessary, Trauma Transport
Protocols (TTP) for submission to the Florida Department of Health, Bureau of Emergency
Medical Services for approval in accordance with Rule 64d-2,FAC.
4.6.5
MEDICAL DIRECTOR shall develop enhanced protocols for specialty procedures or services
including but:not limited to aeromedical(Trauma Star)transport.
4.6.6
MEDICAL DIRECTOR shall conduct an on-going review of all protocols and standing orders as
may be necessary to ensure reliable service delivery,appropriate patient care,and the maintenance
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of the current standard of care. This shall include,at a minimum,a comprehensive annual review
and written approval of all protocols and standing orders. While conducting the annual review,
MEDICAL DIRECTOR shall take into consideration the results of quality assurance reviews,
review of current medical literature,and input from MCFR response personnel. Changes shall be
developed with consideration to budgetary Iimitations and the fiscal impact on MCFR and the
citizens of Monroe County. The annual review shall be completed, and all proposed changes
forwarded to the Fire Chief,prior to the end of each Fiscal Year.
4.6.7
MEDICAL DIRECTOR shall ensure that appropriate training for new protocols and standing
orders is conducted prior to implementation;shall ensure compliance with protocols and standing
orders by all MCFR personnel; and ensure that additional training is conducted for any identified
needs.
4.1 Availability.
MEDICAL DIRECTOR or hiAer previously approved designee shall be available twenty-four
(24) hours a day, seven (7) days a week for medical direction to MCFR personnel in order to
resolve problems,system conflicts, and provide services in an emergency as that term is defined
in Section 252.34(3),F.S.
4.8 Trauma Scorecard Methodologies.
MEDICAL DIRECTOR shall ensure that all certified/licensed response personnel are trained in
the use of the trauma scorecard methodologies,as provided in Chapter 64l-2.004,FAC, for adult
trauma patients and 64J-2.005,FAC,for pediatric trauma patients.
4.9 Aeromedical Operations
4.9.1
MEDICAL DIRECTOR shall participate in Trauma Star safety and quality assurance committees,
and shall attend quarterly meetings to review safety policies, procedures, unusual occurrences,
safety issues,and audit compliance with safety policies and procedures.
4.9.2
Be knowledgeable with aeromedical requirements of patients and evaluate each patient in person,
by telephone, or by delegated written protocol prior to each interfacility transfer flight for the
purpose of determining,that the aircraft,flight and medical crew,and equipment meet the patient's
needs.
4.10 Oversight of Medical Qualifications And Proficiency of MCFR Personnel
A M 1
MEDICAL DIRECTOR shall ensure initial and continued medical qualifications and proficiency
of MCFR personnel.
4.10.2
MEDICAL DIRECTOR shall establish and periodically update the minimum personnel training
standards and certification requirements for all MCFR personnel who provide emergency medical
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care. Such standards shall include the requirements for orientation and initial training, continuing
medical education,standards for professional conduct and evaluation standards and procedures.
4.10.3
MEDICAL DIRECTOR shall ensure that all field personnel meet the initial requirements and
continuously comply with established standards to attain and maintain approval to operate within
the MCFR system.
4.10.4
MEDICAL DIRECTOR shall establish procedures for issuance, renewal, suspension, and
revocation of practice privileges for MCFR personnel in concert with the Fire Chief,to include a
process for remediation. The procedures shall contain due process provisions and all such
provisions,shall be approved,in advance,by the Fire Chief.
4.10.5
MEDICAL DIRECTOR shall provide for direct observation of field level providers while
performing their duties that meets or exceeds Section 401.265,F.-S.,and Rule 64J-1.004,FAC.
4.11 Quality Assurance
4.11.1
MEDICAL DIRECTOR,in coordination with MCFR,shall develop,implement, and maintain an
effective patient care Quality Assurance System to assess the medical performance of all
certified/licensed MCFR response personnel.
4.11.2
MEDICAL DIRECTOR shall develop, implement, and supervise a formal patient care Qualify
Assurance System in accordance with Section 401.265(2), F.S. and Rule 64J-1.004, FAC, to
include the formation and supervision of a quality assurance committee.
4.11.2.1
The purpose and tone of the quality assurance review process shall be positive and educational;
however, MEDICAL DIRECTOR may, at any time and without limitation, conduct a quality
assurance review investigation or audit to ensure that MCFR personnel comply with the Protocols
and Standard of Care.
4.11.2.2
The method and extent of the investigation employed during any given quality assurance review
shall be determined by MEDICAL DIRECTOR in consultation with the Fire Chief. As a result of
said investigation, MEDICAL DIRECTOR may require remedial training of MCFR personnel
and/or revocation of practice privileges. Remedial training may be conducted by MEDICAL
DIRECTOR,MCFR personnel,or other personnel at MEDICAL DIRECTOR's discretion.
4.11.3
MEDICAL DIRECTOR or designee may also conduct special audits in response to observations
or customer feedback provided by patients, family members, caregivers, bystanders,
crewmembers,physicians and hospital personnel.
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4.11.4
MEDICAL DIRECTOR may also develop procedures far routine auditing of EMS system
performance and adherence to protocols on individual EMS incidents and overall EMS,system
compliance.
4.11.5
MEDICAL DIRECTOR or designee shall review, in conjunction with MCFR battalion chiefs or
their designees,patient care reports on an ongoing basis;review all protocol deviations and initiate
or recommend corrective action. MEDICAL DIRECTOR or designee shall review at least 40
patient care reports per month.MCFR shall provide electronic copies of patient care reports.
4.11.6
MEDICAL DIRECTOR shall periodically visit and communicate with the hospital emergency
departments to exchange information and review the quality of care provided by the MCFR
personnel.
4.11.7
MEDICAL DIRECTOR shall participate in field activity and system monitoring to include the
following;
4.11.7.1
Ride along and observe field activity as a crewmember on a rescue as needed.
System monitoring shall include visiting fire stations when needed to discuss issues with MCFR
personnel.
4.11.8
MEDICAL DIRECTOR shall document in a quarterly status report to the Fire Chief, evidence of
the following required activities:
4.11.8.1
Reporting on issues identified with MCFR personnel; and
4.11.8.2
Communicating with hospital emergency department staff, and other medical and public safety
personnel for quality assurance and education activities.
4.12 Educational Programs
4.12.1
KAPTUCAL DIRECTOR shall participate in educational programs at all levels, to include sII
certified/licensed response personnel.
4.12.2
MEDICAL DIRECTOR or designee shall oversee a minimum of ten (10) -hours a year of
continuing medical education related to pre;hospital care or teaching or a combination of both.
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4.12.3
MEDICAL. DIRECTOR shall actively participate in the development and presentation of EMS
continuing education programs by identifying educational topics, presenting lectures and
providing other educational opportunities for the enhancement of the fire rescue system. MCFR
shall pay the actual direct cost of any course materials, instructors, and certificates.
4.12.3.1
Education should be geared to reach the specific needs of the audience. As some providers are
volunteers,consideration shall be given to scheduling some training on nights or weekends.
4.12.3.2
Course content should include system-specific issues and items resulting from audit and review.
4.12.4
Where MEDICAL DIRECTOR is not the presenter,and training services are conducted by other
COUNTY personnel and/or are subcontracted to an outside provider,MEDICAL DIRECTOR will
ensure the quality of the Continuing Medical Education (CME) training provided to EMS
personnel by:
4.12.4.1
Reviewing and approving all curriculum and courses for continuing education units(CEU's)prior
to MCFR personnel being trained;
4.12.4.2
Monitoring and auditing at least one (1) class session of every CME course held in which
MEDICAL DIRECTOR is issuing CME; and
4.12.4.3
Evaluating the educational effectiveness of instruction,courses and programs in consultation with
the CME contractor.
4.12.5
MEDICAL DIRECTOR shall maintain necessary and appropriate instructor certifications and
participate as Medical Director for educational programs sponsored by MCFR such as ACLS,
PALS,6TLS,etc,
4.12.6
Upon proof of completion, MEDICAL DIRECTOR shall sign documents and approve CME to
those-EMT's and EMT-Ps that have completed a minimum of 30 hours or the required hours for
biannual recertification training,as set forth in Section 401.2715,F.S.
4.13 Agency Liaison
4.13.1
MEDICAL DIRECTOR shall participate in interagency discussions about specific issues or
problems as necessary.
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4.13.2
MEDICAL DIRECTOR shall notify MCFR of any pertinent concerns regarding patient care raised
by other agencies and provide advice on a resolution. MEDICAL DIRECTOR shall also notify
other agencies of any concerns regarding patient care, raised lay either MCFR or MEDICAL
DIRECTOR.
4.13.3
MEDICAL DIRECTOR shall develop and maintain liaisons with the local medical community:
hospitals, emergency departments, mental health agencies, physicians, providers, ambulance
services,and other agencies impacting MCFR.
4.13.4
MEDICAL DIRECTOR shall assist in resolution of problems involving the delivery of pre-
hospital care and other services in accordance with Rule 64]-1.004,FAC.
4.13.5
MEDICAL DIRECTOR shall interact with and inform local government officials on an as needed
basis.
4.13.6
MEDICAL DIRECTOR shall participate in the Florida EMS Medical Director's Association or a
statewide physician's group involved in pre-hospital care.
4.13.7
MEDICAL DIRECTOR shall be an active member of at least one national emergency medicine
constituency group such as the National Association of EMS Physicians,the American College of
Emergency Physicians, etc.
4.13.8
MEDICAL DIRECTOR shall interact with county, regional, state, and federal authorities,
regulators and legislators .to ensure standards, needs, and requirements are met, and resource
utilization is optimized when necessary.
4.13.9
MEDICAL DIRECTOR shall participate in grant application process for system funding,
expansion,and research.
4.14 Stress Management Programs,
MEDICAL DIRECTOR shall participate in stress management programs for providers within the
system,as needed.
4.15 Community Access to Healthcare Initiatives.
MEDICAL DIRECTOR, in conjunction with MCFR, shall coordinate community access to
healthcare initiatives as needed.
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4.16 EMT Oversight.
4.16.1
In accordance with Rules 64d-1004(g)and(h),FAC,assume direct responsibility for:the use of
an automatic or semi-automatic defibrillator;the use of a glucometer;the administration of aspirin;
the use of any medicated auto injector; the performance of airway patency techniques including
airway adjuncts,not to include endotracheal intubation;and on routine interfacility transports,the
monitoring and maintenance of non-medicated I.V.s by an EMT.
4.16.2
MEDICAL DIRECTOR shall ensure that all EMTs are trained to perform these procedures;.shall
establish and/or maintain written protocols for performance of these procedures;and shall provide
written evidence to the Florida Department of Health documenting compliance with provisions of
these administrative rules.
4.17 Disaster Assistance and Planning
4.17.1
MEDICAL DIRECTOR shall be available for consultation and/or response during a disaster
situation occurring in Monroe County.
4.17,2
MEDICAL DIRECTOR shall function as a liaison between field EMS operations, hospitals, and
public health agencies during disaster situations.
4.17.3
MEDICAL DIRECTOR shalI provide specific information to assist in the mitigation of the EMS
aspects during a disaster situation.
4.17.4
MEDICAL DIRECTOR.shall cooperate in planning,updating, and following applicable sections
of the Monroe County Comprehensive Emergency Management Plan, including, but not limited
to,participation in disaster drill and emergency management drills.
4.18 Controlled Substances,Medical Equipment and Supplies.
4.18.1
In accordance with F.S., Chapter 401 and Rule 64J-1.004(4)(c), FAC, MEDICAL DIRECTOR
shall possess proofof current registration as a medical director with the U.S.Department of Justice,
DEA, to provide controlled substances to an EMS provider. The DEA registration shall include
each address at which controlled substances are stored. Proof of such registration shall be
maintained on file with MCFR,which shall maintain the copies and make them readily available
for inspection. MCFR will forward all renewal documents as received from DEA to MEDICAL
DIRECTOR in order to ensure continuous registration and will reimburse MEDICAL DIRECTOR
for the cost of such registration. Copies of physician license and registrations must be provided to
MCFR.
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4.18.2
MEDICAL. DIRECTOR shall formulate and ensure adherence to detailed written procedures to
cover the purchase, storage, use, and accountability for medications, fluids, and controlled
substances used by MCFR personnel, in accordance with Chapters 499 and 893, F.S., and Rule
641-1.021,FAC,
4.18.3
MEDICAL DIRECTOR shall ensure and certify that security procedures of all MCFR providers
for medications, fluids and controlled substances are in accordance with Chapters 499 and 893,
F.S.,and Rule 64J-1.021,FAC.
4.18.4
MEDICAL DIRECTOR shall approve a list of mandatory equipment, medications and medical
supplies that must be-on board a Rescue or ALS Engine for it to respond to EMS incidents.
4.18.5
MEDICAL DIRECTOR shall advise MCFR on appropriate staffing, structural requirements,
equipment and supplies necessary to ensure that the air ambulance-complies with Rule 64J-1.005,
FAC,and Section 441.251(4), F.S.
4.18.6
MEDICAL DIRECTOR shall conduct an on-going and comprehensive review of all EMS medical
equipment, medications and medical supplies as may be necessary to ensure reliable service
delivery in the fire rescue System and excellence in patient-care when requested.
4.18.6.1
In conducting the review, MEDICAL DIRECTOR shall take into consideration the results of
Quality Assurance Reviews, review of medical literature, input flom interested physicians, and
MCFR personnel.
4.18.6,2
MEDICAL DIRECTOR, in conjunction with MCFR, shall assist in the comprehensive review of
all EMS System medical supplies and equipment and present the proposed changes to the Fire
Chief for approval prior to the end of each Fiscal Year,
4.18.7
MEDICAL DIRECTOR shall ensure that the following criteria are met prior to activating new
medical equipment or supplies within the EMS System:
4.183.1
Proposed medical equipment or supplies have been thoroughly researched,supported by medical
literature,a field evaluation completed when applicable,and the analysis of'available system data;
4,18.7.2
All Protocols related to the medical equipment or supplies have been evaluated and updated as
appropriate,to ensure consistency and accuracy;and
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4.18.7.3
Protocols, supporting documents and implementation instructions are distributed to MCFR
personnel prior to training or-implementation,and training has-been completed,if necessary,prior
to implementation.
4.19 Infectious Disease Control Policy
4.19.1
MEDICAL DIRECTOR shall formulate, monitor, evaluate and update as necessary, a policy
complying with all applicable laws and rules necessary to control exposure of MCFR personnel to
infectious diseases. This policy shall cover protective measures to be taken on incidents,
inoculation procedures and recommendations,record keeping,follow up care recommendations as.
well as storage and disposal policies for contaminated materials.
4.19.2
MEDICAL DIRECTOR shall be available, in conjunction with the MCFR Infection Control
Officer, for consultation from field personnel to determine the significance of any body fluid
exposure and suggest appropriate action for-such an exposure in accordance with Monroe County
Fire Rescue's existing Workers' Compensation policies and procedures.
4.20
This Contract is a professional services contract based on the qualifications of Dr. Sandra
Schwemmer and the services required hereunder shall be performed by Professional Emergency
Services Inc.or under his/her supervision. Any additional personnel necessary for the fulfillment
of the services required under this Contract shall be secured at MEDICAL DM=OR's sole
expense and such personnel shall be fully qualified and,if required,authorized,or permitted under
State and local law to perform such services.
5. Iusurans�
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 Professional and General Liability certificate will specify coverage for 'EMS
oversight/medical direction".
COUNTY will provide certificate or proof of such insurance to MEDICAL DIRECTOR on an
annual basis.Medical Director will be provided thirty(30)days'notice of cancellation,change in
policy limits, and/or any restrictions placed on coverage of the insurance.provided by COUNTY
during the term of this Contract. COUNTY will be responsible for the payment of any deductible
and/or self-insured retention in the event of a claim.
The Contractor shall be responsible for all necessary Workers' Compensation and Vehicle
Liability insurance coverage. Certificates of Insurance must be provided to Monroe County within
fifteen-(15) days after award of contract,with Monroe County BOCC listed as additional insured
as indicated. Policies shall be written by insurers admitted and licensed to do business in the State
of Florida and having an agent for service of process in the State of Florida. Companies shall have
an A.M.Best rating of VI or better. The required insurance shall be maintained at all times while
Respondent is providing service to County.
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Prior to commencement of work governed by this contract,the CONTRACTOR must obtain:
Worker's Compensation Insurance with limits sufficient to respond to applicable state statutes.
In addition, the Respondent must obtain Employer's Liability insurance with limits of not less
than:
$500,000 Bodily Injury by accident,
$500,000 Bodily Injury by Disease policy limits,
and$500,000 Bodily Injury by Disease,each employee.
Coverage must be maintained throughout the entire term of the contract.
Prior to commencement of work governed by this contract,the CONTRACTOR must obtain:
Vehic]e Liability Insurance which shall cover owned,non-owned and hired vehicles. The
minimum acceptable limits shall be$300,000 Combined Single Limit(CSL). If split limits are
provided,the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$50,000 Property Damage
Monroe County Board of County Commissioners shall be named as an Addidonal.insured
on Vehicle Liability policies.
6. Termination
6.1 Early termination may occur as follows:
A. This Contract may be terminated by MEDICAL DIRECTOR,with or without cause,upon
not less than ninety(90)days written notice delivered to COUNTY.
B. COUNTY may terminate this Contract in whole or in part and without cause,upon not less
than ninety(90)days written notice,delivered to MEDICAL DIRECTOR.
C. COUNTY may terminate this Contract immediately in the event that MEDICAL
DIRECTOR fails to fulfill any of the terms,understandings or covenants of this Contract.
6.2 At such time as this Contract is terminated, whether at the natural ending date or at an
earlier time,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 performance of the work.
C. Transfer all work in process,completed work,and other materials related to the terminated
work to COUNTY.
D. Continue and complete all parts of that work which have not been terminated, if any.
7. Payments
Payments shall be made by COUNTY pursuant to the Florida Local Government Prompt Payment
Act after the completion of the rendered services and proper invoicing by MEDICAL DIRECTOR.
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S. Contineencv
COUNTY's performance and obligation to pay under this Contract is contingent upon an annual
appropriation by the Board of County Commissioners.
9. Sec_tion_HeadinU
Section headings have been inserted in this Contract as a matter of convenience of reference only,
and it is agreed that such section headings are not a part of this Contract and will not be used in
the interpretation of any provision of this Contract.
10. Ownership of The Project Document
Any documents submitted by MEDICAL DIRECTOR for this professional services contract
belong to COUNTY and may be.reproduced and copied without acknowledgement or permission
of MEDICAL DIRECTOR.
11. Successors and Assigns
MEDICAL DIRECTOR shall not assign its right hereunder,except its right to payment,nor shall
It delegate any of its duties hereunder without the written consent of COUNTY. Subject to the
provisions of the immediately preceding sentence, each party hereto binds itself, its successors,
assigns and Iegal representatives to the other and to the successors, assigns and legal
representatives of such other party.
12. Na Third P
Nothing contained herein shall create any relationship,contractual or otherwise,with or any rights
in favor of,any third party.
13. Public Entities Crimes
13.1
A person or affiliate who has been placed on the convicted vendor list following a conviction for
public entity crime may not submit a hid on contracts to provide any goods or services to a public
entity, may not submit a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real property to public entity,
may not be awarded or perform work as a contractor, supplier, subcontractor, or MEDICAL
DIRECTOR 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 of the F.S.,for CATEGORY
TWO for a period of 36 months from the date of being placed on the convicted vendor list.
13.2
By signing this Contract, MEDICAL DIRECTOR represents that the execution of this Contract
will not violate the Public Entity Crimes Act (Section 287.133, F.S.). Violation of this section
shall result in termination of this Contract and recovery of all monies paid hereto,and may result
in debarment from COUNTY's competitive procurement activities.
13.3
In addition to the foregoing, MEDICAL DIRECTOR further represents that there has been no
determination,based on an audit,that it or any SUBCONTRACTOR has committed an act defined
by Section 287.133,F.S.,as a"public entity crime"and that it has not been formally charged with
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committing an act defined as a"public entity crime"regardless of the amount of money involved
or whether CON[3SULTANT has been placed on the convicted vendor list.
13.4
MEDICAL DIRECTOR will .promptly notify COUNTY if MEDICAL DIRECTOR or any
subcontractor is formally charged with an act defined as a"public entity crime"or has been placed
on the convicted vendor list.
14. Records
MEDICAL DIRECTOR shall maintain all books, records, and documents directly pertinent to
performance under this Contract 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 all reasonable times, to all the other party's books, records, correspondence,
instructions,receipts,vouchers and memoranda(excluding computer software)pertaining to work
under this Contract for the purpose of conducting a complete independent fiscal audit. MEDICAL
DIRECTOR shall retain all records required to be kept under this Contract for a minimum of five
years,and for at least four years after the termination of this Contract. Storage of medical records
required by Federal or State statute in excess of the times stated herein and subsequent to the
termination of this Contract shall be revisited by the parties at such time as any transition period
is established to accommodate the termination of this Contract. MEDICAL DIRECTOR shall
keep such records as are necessary to document the provision of services under this contract and
expenses as incurred, and give access to these records at the request of 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 accounting 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.
15. Governing Law,Venue,Interpretation
This Contract shall be governed by and construed in accordance with the laws of the State of
Florida applicable to contracts made and to be performed entirely in the State.
In the event that any cause of action or administrative proceeding is instituted for the enforcement
or interpretation of this Contract, COUNTY and MEDICAL DIRECTOR agree that venue shall
lie in Monroe County, Florida, in the appropriate court or before the appropriate administrative
body. The Parties waive their rights to a trial by jury. This Contract is not subject to arbitration.
1& Severability
If uqterm, covenant, condition or provision of this Contract (or the application thereof to any
circumstance or person) shall be declared invalid or unenforceable to any extent by a court of
competent jurisdiction,the remaining terms,covenants,conditions and provisions of this Contract,
shall not be affected thereby;and each remaining torm, covenant,condition and provision of this
Contract shall be valid and shall be enforceable to the fullest extent permitted by law unless the
enforcement of the remaining terms,covenants,conditions and provisions of this,Contract would
prevent the accomplishment of the original intent of this Contract. COUNTY and MEDICAL
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DIRECTOR agree to reform the Contract to replace any stricken provision with a valid provision
that comes as close as possible to the intent of the stricken provision.
17. Attorney's Fees and Costs
COUNTY and MEDICAL DIRECTOR agree that in the event any cause of action or
administrative proceeding is initiated or defended by any party relative to the enforcement or
interpretation of this Contract,the prevailing party shall be entitled to reasonable attomey's fees,
court costs, investigative, and out-of-pocket expenses, as an award against the non-prevailing
parry,and shall include attorney's fees,courts costs, investigative,and out-of-pocket expenses in
appellate proceedings. Mediation proceedings initiated and conducted pursuant to this Contract
shall be in accordance with the Florida Rules of Civil Procedure and usual and customary
procedures required by the cinruit court of Monroe County.
18. Binding Effect
The terms,covenants,conditions,and provisions of this Contract shall bind and inure to the benefit
of COUNTY and MEDICAL DIRECTOR and their respective legal representatives, successors,
and assigns.
19. Authority
Each party represents and warrants to the other that the execution, delivery and performance.of
this Contract have been duly authorized by all necessary County and corporate action,as required
by law.
20. Claims for Federal or State Aid
MEDICAL DIRECTOR and COUNTY agree that each shall be, and is,empowered to apply for,
seek, and obtain federal and state funds to further the purpose of this Contract; provided that all
applications,requests, grant proposals, and funding solicitations shall be approved by each party
prior to submission.
21. Adiudication of DisRutes
COUNTY and MEDICAL DIRECTOR agree that all disputes shall be attempted to be resolved
by meet and confer sessions between:representatives of each of the parties. 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 or remedy as may be provided by this Contract or by Florida law.
22. Cooperation
In the event any administrative or legal proceeding is instituted against either party relating to the
formation, execution, performance, or breach of this Contract, COUNTY and MEDICAL
DMECTOR 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 Contract or
provision of the services under this Contract. COUNTY and MEDICAL DIRECTOR specifically
agree that no party to this Contract shall be required to enter into any arbitration proceedings
related to this Contract.
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23. Nondiscrimination
MEDICAL DIRECTOR and COUNTY agree that there will be no discrimination against any
person, and it is expressly understood that upon a determination by a court of competent
jurisdiction that discrimination has occurred, this Contract automatically terminates without any
further action on the part of any party, effective the date of the court order. MEDICAL
DIRECTOR and COUNTY agree to comply with all Federal and F.S.,and all local ordinances,as
applicable,relating to nondiscrimination. These include but are not limited to: 1)Title VII of the
Civil Rights Act of 1964(PL 88-352), which prohibit discrimination in employment on the basis
of rare,color,religion,sex,and national origin;2)Title IX of the,Education Amendment of 1972,
as amended(20 USC §§ 1681-1683,and 1685-1686),which prohibits discrimination on the basis
of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC § 794), which
prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as
amended(42 USC§§ 6101-6107),which prohibits discrimination on the basis of age;5)The Drug
Abuse Office and Treatment Act of 1972(PL 92-255),as amended,relating to nondiscrimination
on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention,
Treatment and Rehabilitation Act of 1970(PL 91616),as amended, relating to nondiscrimination
on the basis of alcohol abuse or alcoholism;7)The Public Health Service Act of 1912,§§523 and
527(42 USC§§690dd-3 and 290ce-3),as amended,relating to confidentiality of alcohol and drug
abuse patient records; 8)Title VIII of the Civil Rights Act of 1968 (42 USC §§ 3601 et seq.),as
amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The
Americans with Disabilities Act of 1990 (42 USC §§ 12101), as amended from time to time,
relating to nondiscrimination in employment on the basis of disability; 10)Monroe County Code
Chapter I4, Article II, which prohibits discrimination on the basis of race, color, sex, religion,
national origin, ancestry, sexual orientation,gender identity or expression,familial status or age;
and 11)any other nondiscrimination provisions in any federal or state statutes which may apply to
the parties to,or the subject matter of,this Agreement.
24. Covenant of No Interest
MEDICAL DIRECTOR and COUNTY covenant that neither presently has any interest, and shall
not acquire any interest,which would conflict in any manner or degree with its performance under
this Contract, and that only interest of each is to perform and receive benefits as recited in this
Contract.
25. Code of Ethics
MEDICAL DIRECTOR agrees that officers and employees of COUNTY recognize and will be
required to comply with the standards of conduct for public officers and employees as delineated
in Section t 12,313, F.S., 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 or use of certain information.
26. No Solicitation/Payment
MEDICAL DIRECTOR and COUNTY warrant that, in respect to itself, it has neither employed
nor retained any company or person, other than a bona fide employee working solely for it, to
solicit or secure this Contract and that it has not paid or agreed to pay any person, company,
corporation, individual, or firm, other than a bona fide employee working solely for it, any fee,
commission,percentage,gift, or other consideration contingent upon or resulting from the award
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or making of this Contract. For the breach or violation of the provision, MEDICAL DIRECTOR
agrees that COUNTY shall have the right to terminate this Contract without liability and,at its
discretion, to offset from monies owed, or otherwise recover, the full amount of such fee,
commission,percentage,gift,or consideration.
27. Public Access
MEDICAL DIRECTOR and COUNTY shall allow and permit reasonable access to,and inspection
of,all documents,papers,letters or other materials in its possession or under its control subject to
the provisions of Chapter 119, F.S., and made or received by MEDICAL DIRECTOR and
COUNTY in connection with this Contract; and COUNTY shall have the right to unilaterally
cancel this Contract upon violation of this provision by MEDICAL DIRECTOR.
28. Non-Waiver of Immunity
Notwithstanding the provisions of Section 768.28, F.S., the participation of MEDICAL
DIRECTOR and COUNTY in this Contract and the acquisition of any commercial liability
insurance coverage,self-insurance coverage,or local government liability insurance pool coverage
shall not be deemed a waiver of immunity to the extent of liability coverage,nor shall any contract
entered into by COUNTY be required to contain any provision for waiver.
29. Privileges and Immunities
All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules
and pensions and relief, disability,workers' compensation, and other benefits which apply to the
activity of officers,agents, or employees of any public agents or employees of COUNTY, when
performing their respective functions under this Contract within the territorial limits of COUNTY
shall apply to the same degree and extent to the performance of such functions and duties of such
officers,agents,volunteers,or employees outside the territorial limits of COUNTY.
30. Legal Obligations and Responsibilities
This Contract is not intended to,nor shall it be construed as,relieving any participating entity from
any obligation or responsibility imposed upon the entity by law except to the extent of actual and
timely performance thereof by any participating entity, in which case the performance may be
offered in satisfaction of the obligation or responsibility. Further,this Contract is not intended to,
nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of
COUNTY,except to the extent permitted by the Florida constitution, state statute,and case Iaw.
31. Non-Reliance by Non-Par ii
No person or entity shall be entitled to rely upon the terns, or any of them, of this Contract to
enforce or attempt to enforce any third-party claim or entitlement to or benefit of any service or
pram contemplated hereunder, and MEDICAL DIRECTOR MEDICAL DIRECTOR and
COUNTY agree that neither MEDICAL DIRECTOR nor COUNTY or any agent, officer, or
employee of either 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 Contract separate and apart, inferior to, or superior to the community in general or for the
purposes contemplated in this Contract.
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32, Attestations and Truth in Negotiation
MEDICAL DIRECTOR agrees to execute such documents as COUNTY may reasonably require,
including a Public Entity Crime Statement, an Ethics Statement, and a Drug-Free Workplace
Statement, Signature of this Contract by MEDICAL DIRECTOR shall act as the execution of a
truth in negotiation certificate stating that wage rates and other factual unit costs supporting the
compensation pursuant to the Contract are accurate, complete, and current at the time of
contracting.
33. No Personal Liahil_i
No,covenant or Contract contained herein shall be deemed to be a covenant or Contract of any
member,officer,agent or employee of COUNTY in his or her individual capacity,and no member,
officer,agent or employee of COUNTY shall be liable personally on this Contract or be subject to
any personal liability or accountability by reason of the execution of this Contract.
34. Execution of Counterparts
This Contract may be executed in any number of counterparts,each of which shall 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 Contract by signing any such counterpart.
35. Amendments and Assignments.
No amendment or assignment of this Contract shall be valid without the prior written consent from
COUNTY.
36. Indnende t Contractor.
At all times and for all purposes hereunder,MEDICAL DIRECTOR is an independent contractor
and not an employee of the Hoard of County Commissioners of Monroe County. No statement
contained in this Contract 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 entitled to none of the rights, privileges or
benefits of employees of Monroe County.
37. Compliance with Law.
In-carrying out its obligations under this Contract, MEDICAL DIRECTOR shall abide by all
statutes, ordinances, rules and regulations pertaining to or regulating the provisions of this
Contract, including those now in effect and hereafter adopted. Any violation of said statutes,
ordinances,rules or regulations shall constitute a material breach of this Contract and shall entitle
COUNTY to terminate this Contract immediately upon delivery of written notice of termination
to MEDICAL DIRECTOR.
------------
38. Licensing and Perm
MEDICAL DIRECTOR shall have,prior to commencement of work under this Contract and at all
times during said work, all required licenses and permits whether federal, state, county or
municipal.
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39. Signatures of Parties Required.
THIS CONTRACT 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.
40. Quaty
By execution hereof the signer below hereby certifies that signer is duly authorized to execute this
Contract on behalf of tho COUNTY.
41. Fed oral and State Tax.
COUNTY is exempt from payment of Florida State Use and Sales Taxes. COUNTY will sign an
exemption certificate submitted by MEDICAL DIRECTOR. MEDICAL DIRECTOR will not be
exempted from paying state sales tax to its suppliers for materials used to fulfill contractual
obligations with COUNTY, nor is MEDICAL DIRECTOR authorized to use COUNTY's Tax
Exemption Number in securing such materials.
42. Notice -Any notice of other communication from either party to the other pursuant to this
agreement is sufficiently given or communicated if sent by registered mail, with proper postage
and registration fees prepaid,addressed to the party for whom intended,at the following addresses:
For County: For Medical Director:
County Administrator Dr. Sandra Schwemmer
1100 Simonton Street 10 High Point Road
Key West,FL 33040 PO Box 379
And Tavernier,FL 33070
Monroe County Attorney's Office
111.1 12th St.,Suite 408
Key West,FL 33040
or to such other address as the party being given such notice shall from time to time designate to
the other by notice given in accordance herewith.
THE REMAINDER OF THIS PAGE HAS BEEN INTENTIONALLY LEFT BLANK.
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s
IN WITNESS WHEREOF,each party hereto has caused this wntrwt to be excwted.by its
acrthorized repremtative.
SBAL} BOARD OF COUNTY COMMNSIONERS
OF MONROE COUNTY,FL
A T: KEVIN MADOV.,CLERK _
By: l ��r6 Ely:
As D Clerk j.J Z 9 G I yor arrman
BOARD OF GOVERNORS OF
IROS ►PAN �o��r FIItE AND AMBULANCE DISTRICT 1,
r%/� OF MONROE iTNTY,Fw
ASS NW ATTORNEY By:
DMe 9/17/21 Mayor/Chairman
PROFESSIONAL CY
WTrNFSSES: SERVICES,INC.
4-r—Q&W)/ -
Witness Dr, as Schwcmmer
of iA rr--[ 1�10120��
Print Name d TW
Date;
By.
hipt Nqme and Titic
Date:
n C7
xI
1623
SECTION TWO;
FORMS
Attachment A Public Entity Crime Statement
Attachment D Drug Free Workplace Form
Attacbment C Lobbying&Conflict of Interest Clause Sworn Statement under Ordinance
No. 10-1990(Ethics Clause)
Attachment D Indemnification and Hold EWmless
Attachment E Insurance Documents
u
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Attachment A
PUBLIC ENTITY 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 proposal on a contract to provide any goads or services
to a public entity,may not submit a proposal on a contract with a public entity for the
construction or repair of a public building or public work,may not submit proposals on leases of
real property to public entity,may not be awarded or perform work as a bidder,supplier,
subbidder,or RESPONDENT under a contract with any public entity,and may not transact
business with any public entity in excess ofthe threshold amount provided in Section 287.017,
Florida Statutes,far CATEGORY TWO for a period of 36 months from the date of being placed
on the convicted vendor list"'
By executing this form,F acknowledge that Iltny company is in compliance with the above.
STATE OF 0VJL Ax
(Sifinatun of Respondent)
COUNTY OF �(Aljn �04k ` 11)-t f zin t
Date
PERSONALLY APPEARED BEFORE ME,the undersigned authority,
r ,
6 �� who,after first being sworn by me,(name of
in"dual signing)affixed his/her signature in the space provided above on this
day of �
expires: U"q p-1 Boa
NOTARY PUBLIC Stan unr sanmr;•w,�],qY
LPt6tt, ,r u:1.,lw pa
dP dlea�pS-,n4gd,t►e v
vsnowstni
23
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Attachment B
DRUG-FREE lWOMI ACE FOAM
The unders' ad dentin ante with Flori a Statute 287.087 hereby certifies that:
l�
(Name of Busine
1. Publishes a statement nodfyiag employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace and
specifying the actions that will be taken against employees for violations of such prohibition.
Z. Informs employees about the dangers of drag abuse in the workplace,the business's policy of
maintaining a drug-free workplace, any available drug counseling rehabilitation, and employee
assistance programs, and the penalties that may be imposed upon employees for drug abuse
violations.
3. Gives each employee engaged in providing the commodities or contractual services that are
under proposal a copy of the statement gmdfYed In subsection(1).
4, In the statement specified in subsection (11 notifies the employees that, as a condition of
worldog on the commodities or contractual services that are under proposal, the employee will
abide by the terms of the statement and will notify the employer of any conviction of,or plea of
guilty or polo contersdre to,any violation of Chapter 893 ('Florida Statutes)or of any controlled
substance law of the United States or any state,for a violation occurring in the workplace no later
than five(5)days after such conviction.
S. Imposes a sanction on.or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is
so convicted.
6. Makes a good faith effort to continue to maintains a drug-free workplace through implementation
of this section.
As the person authorized to sign statement,I certify thatthis firm complies fully with the above
requirements.
Restfond&d Signature
/G;z ea Z"j-
Date
OMB—MCP FORM 05
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Attachment C
LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO.104990
MONROE COUNTY,FLORIDA
ETHICS CLAUSE
warrants that he11t has not employed,retained or
otherwise had act on his f any former County officer or employee in violation of Section
2 of Ordinance No. 10-1990 or any Pounty officer or employee in violation of Section 3 of
Ordinance No. 1 D-1990. For breach or violation of this provision the County may,in Its
discretion,terminate this contract without liability and may also,in its discretion,deduct from
the contract or porch or erwise recover,the fiill amount of any fee,commission,
percentage,gift,or do 'd to the farmer County ofaeer or employee.
(Signature)
Date:_ k'yf
STATE OF. -f�L;t ��
COUNTY OF
PERSONALLY APPEARED BEFORE ME,the undersigned authority,
�;u 4{6,3 al M air _whop after first being sworn by me,affixed his/her
Signature(name of individual signing)in the space provided above on this day of
20;\
f4OTAAY PUBLIC
My commission expires: ,.nt{� . �•
031®-M,[:P FORM#4 Naerr
25
1627
Attachment D
MONROE COUNTY,FLORIDA
RUSK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADAIN ST ATION
MANUAL
Indemnification and Hold Harmless
The Medical Director covenants and agrees to indemnify and hold harmless the Monroe County
Board of County Commissioners, its servants,agents and employees from any and all claims for
bodily injury(includin death),personal injury,and property damage Qincludin8 property owned
by Monroe County)and any other losses,damages,add expenses((ino u ng attorney's fees)which
arise out o�in connection with or by reason of services provided by the Medical Director or any
of its employees,subcontractors,or agents,in any tier,and occasioned by the negligence,errors,
or other wrongful actor omission of the Medical Director,its employees,subcouUmors or agents,
in any tier.
The extent of liability is in no way limited to,reduced,or lessened by the insurance requirements
contained elsewhere within thus Contract.
pondent's Signature
ail
Date
Zb
1628
Attachment E
VEHICLE LTABILITY
INSURANCE REQU RENENTS
FOR
CONTRACT MEDICAL DIRECTOR
BETWEEN
MONROE COUNTY,FLORIDA
AND
PROFESSIONAL EMERGENCY SERVICES,INC.
Recoga mo*that the work governed by this contract requires the use of vehicles,the Medical
Director,prior to the commencement of work,shall obtain Vehicle Liability Insurance.
Coverage shall be maintained throughout the life of the contract and include`as a minimum,
liability coverage for:
11 Owned,Non-Owned,and Mired Vehicles
The minimum limits acceptable shall be:
$300,000 Combined Single Limit(CSL)
If split limits are provided,the minimum limits acceptable shall be:
$100,000 per Person
$300,800 per Occurrence
$50,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on
all policies issued to satisfy the above requirements.
V 2
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1629
Attachment E
WORKERS'COMPENSATION
INSURANCE REQUHZEMENTS
FOR
CONTRACT MEDICAL DIRECTOR
BETWEEN
MONROE COUNTY,FLORIDA
AND
PROFESSIONAL EM EREGENCY SERVICES,INC.
Prior to the commencement of work governed by this contract,the Medical Director shall obtain
Workers'Compensation Insurance with limits sufficient to respond to the applicable state statutes.
In addition,the Medical Director shall obtain Employers'Liability Insurance with Iimits of not less
than:
$50%000 Bodily injury by Accident
$500,000 Bodily Injury by Disease,policy limits
$500,000 Bodily Injury by Disease,each employee
Coverage shall be maintained throughout the entire term of the contract.
Cov shall be provided by a company or companies authorized to transact business in the
state
If the Medical Director has been approved by the Florida's Department of Labor, as an authorized
setf-insurer, the County shall recognize and honor the Medical Director's status. The Medical
Director may be required to submit a Letter of Authorization issued by the Department of Labor
and a Certificate of Insurance, providing details on the Medical Directors Excess Insurance
Program.
If the Medical Director participates in a self-insureace Rind, a Certificate of Insurance will be
required. In addition,the Contractor may be required to submit updated financial statements from
the hind upon request from the County_
WCS
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FIRST ADDENDUM TOAGREEMENT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS;
THE BOARD OF GOVERNORS OF MONROE COUNTY
FIRE &AMBULANCE DISTRICT 1,
AND
PROFESSIONAL EMERGENCY SERVICES, INC.
FOR MEDICAL DIRECTION FOR MONROE COUNTY FIRE RESCUE
THIS FIRST ADDENDUM TO AGREEMENT("Addendum") is entered into upon the
date below written by and between Monroe County, Florida, acting through its Board of County
Commissioners ("BOCC"), a political subdivision of the State of Florida, whose main business
address is 1100 Simonton Street, Key West, Florida 33040; the Board of Governors of Monroe
County Fire & Ambulance District 1 (collectively "County") and Professional Emergency
Services, Inc. ("Contractor").
WHEREAS, the County entered into a Professional Services Agreement ("Agreement")
with Professional Emergency Services, Inc. on September 15, 2021 for a period beginning October
1, 2021 and continuing through September 30, 2023 ("Initial Term") to provide professional
Medical Director services to Monroe County Fire Rescue; and
WHEREAS,the Agreement allows the parties to extend the employment term; and
WHEREAS, the Contractor has satisfactorily performed her duties therefore the parties
desire to update several terms and extend the term of the contract for a period of one year,
becoming effective on October 1, 2023 and terminating September 30, 2024; and
NOW THEREFORE, in consideration of the mutual promises contained herein, the
County and Contractor mutually agree as follows:
1. Paragraph 1 of the Agreement is amended to read as follows: This Contract shall
become effective on October 1,2023, and shall run through September 30,2024("Initial
Term"), and shall be renewable thereafter at the option of County for four additional
one-year periods.Upon expiration of the Initial Term,County may renew the contract for
up to four additional one-year periods at an increase in the compensation rate of up to
five percent (50/o), for each air and ground, at the discretion of the Fire Chief, over the
prior Initial Term,unless otherwise agreed bythe parties.
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2. Paragraph 2.1 of the Agreement is amended to read as follows to reflect a 5% pay
increase for the 2023-2024 term: In return for performance ofthe duties set forth in the
Agreement, including but not limited to specific duties assigned by MCFR from time
to time, Contractor shall be paid at a rate o f $60,900 annually to provide ground
ambulance medical direction. Payments shall be made monthly in arrears by County
pursuant to the Florida Local Government Prompt Payment Act after receipt of proper
invoice submitted by Medical Director.
3. Paragraph 2.2 of the Agreement is amended to read as follows to reflect a 5% pay
increase for the 2023-2024 term: In return for performance ofthe duties set forth in the
Agreement, including but not limited to specific duties assigned by MCFR from time
to time, Contractor shall be paid at a rate of$57,750 annually to provide air ambulance
medical direction. Payments shall be made monthly in arrears by County pursuant to
the Florida Local Government Prompt Payment Act after receipt of proper invoice
submitted by Medical Director. Note: This payment is contingent upon County's
decision to continue to operate air ambulance services under its ALS license, and if, for
any reason, County decides not to continue to operate air ambulance EMS services
under its ALS license, then Medical Director shall have no responsibility to serve as
Medical Director for the air ambulance service and County shall have no liability for
this portion ofMedical Director's compensation.
All other terms and conditions ofthe Initial Agreement dated September 15, 2021, not inconsistent
herewith, shall remain in full force and effect
(signatures on next page)
1632
IN WITNESS WHEREOF, the parties have set their hands and seals, in the County of
Monroe, Florida this day of : 2023.
MONROE COUNTY FIRE RESCUE
James Callahan, Fire Chief
WITNESS: PROFESSIONAL FAWRGENCY
SERVICES, IN
By-
By:
Professional Emergency Services, Inc;
Dr, Sandra Schwemmer
(SEAL) BOARD OF COUNTY
ATTEST: KEVIN MADOK, CLERK COMMISSIONERS
By:
As Deputy Clerk By:
Mayor
MONROE COUNTY ATTORNEY BOARD OF GOVERNORS OF FIRE
Approved as to form and content: AND AMBULANCE DISTRICT 1 OF
MONROE COUNTY, FLORIDA
By: By:
Assistant County Attorney Mayor I Chairperson
------------
AlTroved as to form and legal sxutfucvency
Monroe County Attorney s.Office
Christina Con,,Assistant County Attom y
Date:8.31.23
1633
YAp
PROFESSIONAL EMERGENCY SERVICES
August 28, 2023
To Whom It May Concern:
Professional Emergency Services, Inc. is not required to purchase Worker's Compensation
Insurance per FL Statutes (less than 4 employees).
Professional Emergency Services Inc. does not have commercial vehicles and does not carry
general liability insurance.
Please contact me should you have any questions.
Sincerely,
Sandra Schwemmer, D.O., FACOEP-D, FACEP, FAAOE, HCRM
President,
Professional Emergency Services, Inc.
1634
M
tG
2018 E idon
MONROE COUNTY, FLORIDA
REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS
It is requested that the insurance requirements, as specified in the County's Schedule of Insurance
Requirements,be waived or modified on the following contract.
ContractorNendor: Professional Emergency Services
Project or Service
ContractorNendor
Address&Phone#: Dr.Schwemmer-Medical Director
General Scope of Work: Medical Director
Reason for Waiver or Waive Additional Insured on Auto Liabililty, Dr Schwemmer,
Modification: Prefessional Emergency Services,does not own any commercial vehicles
Policies Waiver or
Modification will apply to: Auto Liability
Signature of CvntractorNendor, ' a„ e✓
Date 8/30/23 Approved Not Approved
. ,..., ....... � ....
Risk Management Signature
v
Date:.....,....8. .3.012Q2.3.
County Administrator appeal:
Approved: w Not Approved
Date.
Board of County Commissioners appeal:
Approved Not Approved.
Meeting Date:
Administrative Instruction 7500.7
104