Resolution 299-1989
Commissioner John Stormont
RESOLUTION NO. 299-1989
A RESOLUTION OF THE BOARD OF COUNTY COMllIS-
SIONERS OF MONROE COUNTY, FLORIDA, AUTHORIZ-
ING THE MAYOR/CHAIRMAN OF THE BOARD TO
EXECUTE AN ADDENDUM TO THE MEMORANDUM OF
UNDERSTANDING ADOPTED BY RESOLUTION
NO. 673-1988 BETWEEN THE UPPER KEYS HEALTH
CARE TAXING DISTRICT AND BAPTIST HOSPITAL OF
MIAMI CONCERNING EMERGENCY TRAUMA-RELATED
HEALTH CARE.
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, that the Mayor/Chairman of the Board is
hereby authorized to execute an Addendum to the Memorandum of
Understanding between Monroe County and Baptist Hospital of Miami
adopted by Resolution No. 673-1988, a copy of same being attached
hereto and made a part hereof, concerning emergency trauma-
related health care.
PASSED AND ADOPTED by the Board of County Commissioners of
Monroe County, Florida, at a regular meeting of said Board held
on the~day of May, A.D. 1989.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By ff~W
Mayor airman
(Seal)
Attest: DANNY ~ KOLHAGE, perm
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ADDENDUM
TO
MEMORANDUM OF UNDERSTANDING
WHEREAS, the Board of County Commissioners of Monroe County,
on December 20, 1988, indicated, their desire to enter into a
Memorandum of Understanding with Baptist Hospital of Miami for
care of trauma related injuries from the Upper Keys Health Care
Taxing District, by affixing their signature to such Memorandum
of Understanding, and
WHEREAS, Baptist Hospital of Miami desires to add or clarify
certain wordings and paragraphs of that same Memorandum of
Understanding, and
WHEREAS, the Advisory Board of the Upper Keys Health Care
Taxing District has reviewed such recommendations and clarifica-
tions desired by Baptist Hospital of Miami, and
WHEREAS, the Upper Keys Health Care Taxing District Advisory
Board has recommended to the Board of County Commissioners,
sitting as the governing body of the Upper Keys Health Care
Taxing District that such additions and clarifications be at-
tached to and become a part of the Memorandum of Understanding
signed by the Board of County Commissioners on December 20, 1988,
therefore,
The following additions, deletions and corrections are made
and incorporated into the Memorandum of Understanding between the
Board of County Commissioners and Baptist Hospital of Miami.
I. Amend item 4, page 3, covering general terms of the
Memorandum of Understanding to read as follows:
"4. Pursuant to Baptist Hospital of Miami's request
that the Upper Keys Health Care Taxing District will
contact representatives of the State of Florida con-
cerning this relationship and any conflict with EMS
regulations and Florida Statutes to assure that this
relationship would be allowed to continue under recent-
ly enacted regulations, an attached Exhibit D certifies
that Trauma Transport Protocols and Access to Care are
the only issues which are under the jurisdiction of the
Office of Emergency Medical Services, State of Florida
Department of Health and Rehabilitative Services, and
that their indications are that the contract need not
contain language relating to trauma transport protocols
but that no agreement between the Upper Keys Health
Care Taxing District or Monroe County and any hospital
will negate or modify that the hospital's responsibil-
ity to comply with the Florida Statutes (F.S.l, partic-
ularly with reference to section 394.0142."
II. Pursuant to the above recommendation of the Office of
Emergency Medical Services, State of Florida Department of Health
and Rehabilitative Services, modify Section 5, Transfer From
On-Scene, subparagraph C, to read:
"C. Prior to contact with Baptist Hospital of
Miami Emergency Department, the on-scene paramedic will
verify at a minimum:
(a) That the patient has trauma score 12, coma score
10, or evidence of shock at the scene with systolic BP
90.
(2) Of that trauma victim has experienced amputation
proximal to the hand or foot.
(3) Any other trauma tria~e as may be required in -
trauma transport protocols."
III. Section 6, Paragraph E, is hereby added, to read:
"6. E. Baptist Hospital shall be entitled to
conclusively rely upon the signature of a Monroe County
official on the Certificate of Eligibility (attached as
Exhibit A) as being an authorized paramedic acting on
behalf of the Upper Keys Health Care Taxing District,
unless Baptist Hospital is furnished actual knowledge
otherwise. The Upper Keys Health Care Taxing District
shall provide a list of names of those authorized to
sign any Certificate of Eligibility. Under no circum-
stances shall the District be responsible for Baptist
Hospital's acceptance, under this agreement, of persons
2
admitted without said Certificate of Eligibility, or
signed by other than an authorized person as above."
IV. Amend the second paragraph of Section 9 to read:
"Where insurance or other coverage exists, or
those cases where assignments are normally accepted by ~
Baptist Hospital of Miami, Baptist Hospital of Miami
and its physicians will charge and collect payment from
those entities. Should health or liability insurance
coverage be less than 80% of the charges, the Upper
Keys Health Care Taxing District agrees to compensate
Baptist Hospital of Miami and its physicians for the
difference between collections and 80% of charges."
V. Add as the first paragraph of Section 11, Cancellation
of Agreement, the following:
"Either party may terminate this agreement, with
or without cause, upon thirty days written notice to
the other party." Then continue with section as
written.
VI. Add as a second paragraph in Section 12, Patient
Review/Case Management, the following:
"Acknowledging that this agreement is for trauma
care, this agreement also covers the acute recovery
phase of the patient's health care needs in circum-
stances when the patient is not yet able to be trans-
ferred to another facility. Through the efforts of the
Upper Keys Health Care Taxing District, our mutual
Social Services staff and a third party Utilization
Management consultant, Baptist Hospital and the Upper
Keys Health Care Taxing District agree to collaborate
on case review/management aimed toward the discharge
from Baptist Hospital and proper placement of the
patient when medically able to be transferred to a
facility accepting the patient. Individual case
discussions with representatives from Baptist Hospital,
its Medical Staff, the Upper Keys Health Care Taxing _
District, and the Utilization Management consultant
3:
will be used as a focal point to monitor and effect the
plans for discharge of each patient under this agree-
ment."
VII. Modify Section 13, Patient Transferability, paragraph
A, to read: .,..
"A. In certain cases under this agreement where
it becomes apparent that tqe patient is eligible for
certain health care benefits (e.g. Veteran's, welfare
or other), or to transfer to another facility, and that
it is apparent that such benefits/alternate facility
may be utilized by the patient, either party to this
agreement, upon notification to the other party, and
the concurrence of the patient or his representative,
the attending physician and the receiving facility, may
effect the transfer of the patient to the receiving
facility for such above benefits, and thereby terminate
obligations beyond those incurred as part of this
agreement at the time of transfer."
IN WITNESS WHEREOF, the parties below have caused this
Addendum to the Memorandum of Understanding dated December 20,
1988, to be executed by their undersigned officials as duly
authorized.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
Date
(SEAL)
Attest~
DANNY L. KOLHAGE, Clerk
BAPTIST HOSPITAL OF MIAMI
By
Title
Date
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Witnesses