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Resolution 450-1987 Commissioner John Stormont RESOLUTION NO. 450 -1987 A RESOLUTION OF THE BOARD OF COUNTY COMMIS- SIONERS OF MONROE COUNTY, FLORIDA, AUTHORIZ- ING THE MAYOR TO EXECUTE, ON BEHALF OF MONROE COUNTY, FLORIDA A MEMORANDUM OF UNDERSTANDING WITH BAPTIST HOSPITAL OF MIAMI AND DIRECTING EMERGENCY MEDICAL SERVICES PERSONNEL TO EXECUTE PROTOCOLS WITH THE VARIOUS EMS SERVICE DISTRICTS TO AFFECT THE MEMORANDUM'S TEMPORARY RELATIONSHIP FOR SEVERE, TRAUMA- RELATED EMERGENCY HEALTH CARE IN MONROE COUNTY. WHEREAS, Monroe County, Florida finds itself unable to provide sufficient emergency trauma-related health care to its visitors and residents at certain time periods of the year, and WHEREAS, the Board of County Commissioners is continuing to attempt to address on-going severe trauma-related emergency health care on behalf of the public health, safety and welfare of its people by the establishment of an Emergency Medical Services Council, and has entered into agreement with the Health Council of South Florida to aid in determining solutions for such on- going severe trauma-related health care, and WHEREAS, the Key Largo Volunteer Ambulance Corps and certain County officials have, in parallel actions, held discussions with Baptist Hospital of Miami, having indicated its willingness to aid Monroe County in its on-going severe trauma-related emergency health care problems, and, WHEREAS, Mr. Lee S. Huntley, Vice President at Baptist Hospital of Miami, has indicated by letter of intent to Monroe County, Baptist Hospital of Miami's willingness and desire to enter into a temporary relationship with Monroe County for a period of sixty (60) days effective December 1, 1987, for accept- ing trauma patients from Monroe County on certain terms, to help alleviate seasonal pressures involving severe trauma-related emergency health care in Monroe County, Florida; now, therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, as follows: 1. The Mayor is hereby authorized to execute, on behalf of Monroe County, Florida, a Memorandum of Understanding between 11onroe County and Baptist Hospital of Miami, a copy of same being attached hereto; and 2. The Emergency Medical Services Coordinator of Monroe County is hereby directed to make available to and to implement the provisions of the Memorandum of Understanding with the Emergency medical Districts throughout Monroe County and their respective Medical Directors immediately and upon completion of signatures thereto attached. PASSED AND ADOPTED by the Board of County commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 1st day of December, A.D. 1987. BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Byg~'JL.? a a~rman (Seal) Attest :DANNY L. KOLRAGE, Clerk ~L,f/1:.1jJQ/ APPPlOI/ED AS TO FORti/! 4L ,<um~/rf cv. /) 11 P-~~"I <t' .."",', ~,,;,.- '-'1 L · ;]'1 t ') .... MEMORARDUM OF UNDERSTANDING WHEREAS, Monroe County, Florida, finds itself unable to provide sufficient emergency trauma-related health care to its visitors and residents at certain time periods of the year, and WHEREAS, the Board of County Commissioners is continuing to attempt to address on-going severe trauma-related emergency health care on behalf of the public health, safety and welfare of its people by the establishment of an Emergency Services Committee and has entered into agreement with the Health Council of South Florida to aid in determining solutions for such on-going severe trauma-related health care, and WHEREAS, the Key Largo Volunteer Ambulance Corps and certain county officials have, in parallel actions, held discussions with Baptist Hospital of Miami, having indicated its willingness to aid Monroe County in its on-going severe trauma-related emergency health care problems, and, WHEREAS, Mr. Lee S. Huntley, Vice President at Baptist Hospital of Miami, has indicated by letter of intent to Monroe County, Baptist Hospital of Miami's willingness and desire to enter into a temporary relationship with Monroe County for a period of sixty (60) days effective December 1, 1987, for accepting trauma patients from Monroe County on certain terms, to help alleviate seasonal pressures involving severe trauma-related emergency health care in Monroe County, A MEMORANDUM OF UNDERSTANDING is hereby entered into between the Board of County Commissioners of Monroe County, Florida, on Page-l- behalf of the people of Monroe County, and Baptist Hospital.of Miami as outlined in the November 25, 1987 letter of intent to describe a temporary relationship for severe trauma-related emergency health care, wherein both parties agree to the following: 1. Monroe County acknowledges that Baptist Hospital of Miami's primary function is to provide services for patients within its service area. 2. Baptist Hospital of Miami and its Medical Staff will do everything reasonably possible to make severe trauma-related emergency health care available to the visitors and residents of Monroe County, except that these same individuals acknowledge that, from time-to-time, demands for emergency or other critical services saturate Baptist Hospital of Miami's limited resources. At those times where Baptist Hospital of Miami's resources are s8turated so as to prohibit patient acceptance under this temporary relationship, Baptist Hospital of Miami will attempt to aid in placement of the patient in other facilities, with the understanding that Monroe County's participation under this temporary relationship would extend to that institution. 3. Under the provisions of 2. above, Baptist Hospital of Miami and selected members of its Medical Staff will accept trauma patients who are able to be transported by air or ground directly from the scene in such a Page-2- .. , . manner as to arrive within sixty (60) minutes of injury to Baptist Hospital of Miami's Emergency Department. 4. Monroe County on its part will contact representatives of the state of Florida concerning this relationship and any conflict with EMS regulations to assure that this relationship would be allowed to continue under recently enacted regulations. 5. Paramedics and EMS personnel operating in or on behalf of Monroe County will be required to contact Baptist Hospital of Miami Emergency Department physicians, from the scene, prior to transport, to review the condition of the patient and the availability of resources to accept the patient. 6. It is acknowledged that patients initially transported to Monroe County hospital facilities will be considered on a case-by-case basis for transfer to Baptist Hospital of Miami. 7. Prior to contact with Baptist Hospital of Miami Emergency Department, the on scene paramedic or EMS personnel will verify: a) Availability, if required, of Dade County Air-Rescue One, under Monroe County's agreement with Dade County, for transport of patient b) That the patient has trauma score 12, Coma score 10, or evidence of shock at the scene with systolic BP 90. Page-3- ~ , /( /. c) Trauma victim has been exposed to a hostile environment (e.g. hot, cold, or noxious fumes). d) Trauma victim has experienced penetrating trauma to the head, neck, chest or abdomen. e) Trauma victim has experienced amputation. f) Trauma victim has experienced major burns requiring treatment at a burn center, including 40% BSA, involvement of facial area, possible airway compromise. g) Paralysis, drowning or electrocution, or h) In extenuating circumstances where in the opinion of the paramedic or EMS personnel in charge, that the situation warrants air evacuation for reasons not specifically listed above, in which case the paramedic or EMS personnel may call for air evacuation at his discretion confirmed by the Medical Director or a member of the District medical Board of the service involved. i) In all events, the paramedic or EMS personnel on the scene will verify with the Medical Director involved the need for effecting this temporary relationship prior to contact with Baptist Hospital of Miami Emergency Department. 8. The relationship described is between Monroe County and Baptist Hospital of Miami and does not extend to Monroe County hospitals, that relationship Page-4- ~~ ,/ being considered to be beyond the scope of this temporary agreement. 9. All relations with Metro-Dade Air-Rescue One are to be handled at the scene by existing protocols utilized by Key Largo Fire Rescue/Metro-Dade Air Rescue. 10. Monroe County agrees to guarantee Baptist Hospital of Miami and the participating Hospital-based physicians 80% of reasonable charges for each patient. Where insurance coverage exists or the patient can defray such costs, Baptist Hospital of Miami and its physicians will bill and collect appropriately. Should circumstances dictate that these funds are not collectable within ninety (90) days of service, Monroe County agrees to compensate Baptist Hospital of Miami and its physicians 80% of those charges. Baptist Hospital of Miami and its physicians will, in turn, assign insurance benefits to Monroe County in a manner acceptable to both parties. Should health or liability insurance coverage be less than 80% of the charges, Monroe County agrees to compensate Baptist Hospital of Miami and its physicians for the difference between collections and 80% of charges. 11. Monroe County, to aid in the effectiveness of and as requirement for evaluation of this temporary relationship shall require its Medical Director of any Page-5- "- u_ .~ ~-- District involved to implement criteria and protocols included herein, not to exclude reporting of patient on-scene score report, Air-Rescue One or land transport report, disposition of patient and follow-up of hospital treatment logs and reports, to the County Administrator and Director of Emergency Medical Services for statistical and effectiveness determinations. 12. Monroe County hereby desires to include under the terms of this temporary relationship, the patient case of Linda Houston, previously transported at the request of Commissioner Stormont and authorized by the County Administrator. 13. Monroe County further desires to retain as designated appointees to further review the aspects of this temporary relationship and to discuss the content of a relationship extending beyond January 31, 1988 with Baptist Hospital of Miami the following individuals: G. Joey Elam and Douglas Cullen, both of Key Largo Volunte~r Ambulance Corps, J. Allison DeFoor II of the Monroe County EMS Council, Commissioner John C. Stormont, and Howard Anderson of Mariner's Hospital. IN WITBESS WHEREOF, the parties below have caused this Memorandum of Understanding to be executed by their undersigned officials as duly authorized. Page-6- . _.~ T __.<.,'''''''- ~,. -.~~.....--,_._, "~._.< .."."".......,...,."..",.-_.'..'~..",.. (SEAL) Attest: APPR VrD ..llS TO FORM Af1D f r.GAL S~FFlCIEfJC~;J. . rw .4.__ rt. ~A~'--L, .J AUomcy', om" ./ ( . Page-7- BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By: 4.~' ~, Mayor Date: D-- ( -8"7 BAPTIST HOSPITAL OF MIAMI By: Date: ~ BAPTIST HOSPITAL OF MIAMI lee S. Huntley Vice President November 25, 1987 John C. Stormont Monroe County Commissioner, Di.trict 5 163 Coconut Row Tavernier, Florida 33070 Dear Mr. Stormont: Please consider this as a letter of intent to describe a temporary relationship effect~ve December 1, 1987, for a period of sixty (60) days between Baptist Hospital, Monroe County and the Metro-Dade Fire Rescue Department and paramedic services operating in the Upper Keys. Baptist Hospital and selected me.bers of its Medical Staff will accept trauma patients from the Upper Keys and Card Sound Road (exact service area to be defined) who are able to be transported by air or ground directly from the scene. Patients to be accepted under this arrangement be transported in such a manner as to arrive within 60 minutes of injury to Baptist Hospital's Emergency Department. In offering this temporary relationship, Monroe County officials, residents and visitors acknowledge that Baptist Hospital's primary function is to provide services for patients within its service area. Baptist Hospital and its Medical Staff will do everything reasonably possible to make these services consistently available to the visitors and residents of Monroe County. However, these same individuals acknowledge that, from time-to-time, demands for emergency or other critical services saturate Baptist Hospital's limited resources. Monroe County's obligations under this agreesent are: . To contact representative. of the state of Florida, concerning this relationship and any possible conflict with 'EMS regulations, to assure that this relationship would continue under recently enacted regulations. To require paramedics operating in or on behalf of Monroe County to contact Baptist Hospital Eaergency Department physicians, from the scene, to review the condition of the patient and the availability of resources to accept the patient. It 18 acknowledged that patients initially transported to Monroe County facilities will be considered on a case-by-case basis for transfer to Baptist Hospital. The relationship between Baptist Hospital and Monroe County Hospitals is considered to be beyond the scope of this temporary agreement and should be discussed as an issue if this relationship is to continue beyond January, 1988. 8900 North Kendall Drive Miami. Fl 33176-1197 (05) S96 - 6503 . John C. Stormont Monroe County Commissioner Page 2 November 23, 1987 . Monroe County Commissioner aarees to work with Metro-Dade Air Rescue to grant the necessary approvals to land their aircraft at the scene of an accident, in compliance with regulations similar to those in place in Dade County. o Monroe County agrees to guarantee Baptist Hospital and the participating and Hospital-based physicians 80% of reasonable charges for each patient. ~lere insurance coverage exists, Baptist Hospital and its physicians will bill and collect from those insurance companies. Should circumstances dictate that these funds are Lot collectable within ninety (90) days of service, Monroe County agrees to compensate Baptist Hospital and its physicians 80X.of those charges. Baptist Hospital and its physicians will, in turn, assign insurance benefits to Monroe County in a manner acceptable to both parties. Should health or liability insurance coverage be less than 80% of the charges, Monroe County agrees to compensate Baptist Hospital and its physicians for the difference between collections and 80% of charges. Mr. Stormont, representatives and physicians from Baptist Hospital are willing to review the aspects of this temporary relationship and discuss the content of a relationship extending beyond January, 1988, with officials from Monroe County. We look forward to speaking with you further. Sincerely, ~<;\,\ Lee S. Huntley Vice President -_._~ LSH/ls -