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HomeMy WebLinkAboutAgenda - 06-21-1999 - 8oOrange County 1 Board of Commissioners Date: June 21, 1999 Action Agenda Item No _ 8 & Subject: EMS Medical Director Contract Renewal Department: Emergency Management - EMS Public Hearing Yes F-� No Attachment(s): Information Contact: Nick Waters 1) Contract Extension Number: 3030 Telephone Number: Hillsborough 732 -818 -1 Chapel Hill 968 -4501 Mebane 336 -227 -2031 Durham 688 -7331 Purpose: To consider renewing an agreement between Orange County and UNC Hospitals concerning medical direction of Orange County's Emergency Medical Services (EMS) program. Background Orange County provides an Advanced Life Support (ALS) EMS service. Under State regulations, a County providing that level of service must function under a Medical Director at the sponsor hospital. The County receives medical direction through UNC Hospitals by Dr. Greg Mears. The role of the medical director has changed dramatically in the past two years. The Medical Director's responsibilities include providing training, monitoring and protocols for the emergency medical dispatch program at 9 -1 -1. The Medical Director performs quality assurance reviews and approves telecommunicators for certification. The Medical Director establishes the level of practice for the first responders and the training requirements for them to operate automatic defibrillators. Each first responder must be annually trained and tested in defibrillation. The Medical Director determines the standard of care and appropriate treatment protocols for the paramedics. The Medical Director must provide training, skill proficiency and evaluation of technician performance for the Initial Response Paramedics. The agreement with the Hospital also requires that the Medical Director has an appropriate number of assistant medical directors to assure availability at all times. The Medical Director serves as a consultant for the Paramedics in the field, on patient care issues. The Medical Director meets weekly with EMS staff to provide consultation and review of medical issues. 2 In addition to a Medical Director, the Hospital also provides a nurse liaison who's primary function is to facilitate skill evaluations, special training sessions, technician review with staff training officer, and assist in writing the required two year training program for state approval. The Hospital provides computer support for the EMS database which includes patient medical records, and analytical programs with interpretation of data. Performing the duties of medical director requires Dr. Greg Mears to be replaced in his emergency department clinical rotations from time to time. The funding for this agreement is to help off -set the costs of the Hospital providing physician coverage for Dr. Greg Mears. The contract is proposed for renewal in 1999 -2000 at the current rate of $30,000. Adequate funding to cover the contract has been included in the 1999 -2000 recommended budget. Financial Impact The $30,000 cost of this contract is included in the departmental operating budget. Recommendation The Manager recommends that the Board approve the agreement and authorize the Chair to sign it. S STATE OF NORTH CAROLINA ORANGE COUNTY THIS CONTRACT dated June 30, 1999 between The University of North Carolina at Chapel Hill (the "University'), and the County of Orange (the "County ") for provision of an EMS Medical Director to Orange County. WITNESSETH Whereas, the County and the University have historically cooperated and worked jointly on matters of mutual concern and interest; and Whereas, the County operates and maintains a Department of Emergency Management which, as one of its functions, provides emergency medical care to citizens of the County; and Whereas, the County wishes to have associated with this program a trained physician specializing in emergency medicine to provide guidance and support; and Whereas, the University, through its Department of Emergency Medicine, wishes to provide this service for the County; and Whereas, performance of the activities described herein is consistent with the University's goals of research, teaching, education and public service. NOW THEREFORE, in consideration of the premises and the mutual covenants and conditions set forth below, the County and the University agree as follows: 1. The University agrees to provide a physician from the Department of Emergency Medicine to serve as EMS Medical Director to the County (hereafter "the Medical Director "). 2. The duties of the Medical Director shall include the following: a. Provide medical direction for the emergency medical services program of Orange County. b. Develop, review, and periodically update medical treatment protocols in conjunction with the County Director of Emergency Management or designee (hereafter "the Director "). C. Provide medical treatment supervision of personnel by randomly responding to EMS calls and observing the approach, demeanor, relationships, and medical treatment provided to the patient and others by all responding personnel including, First Responders, Fire, Law Enforcement, Rescue, and EMS. d. Facilitate a program of total quality management of patients addressing compliance to protocol, standards of care, technician proficiency, appropriate patient management, effectiveness of treatments and protocols, evaluation for positive patient outcomes and other components of the EMS system that occur from access through 911 to delivery through the Emergency Department at the University of North Carolina Hospitals. Provide ongoing recommendations to the Director of system needs and changes necessary to implement and operate the patient total quality management program. e. Serve as the contact person for the sponsor hospital and receive complaints, comments, or questions from the hospital's medical staff about out -of- hospital emergency medical issues and consult with the Director for resolution. f. Serve on the Orange County Medical Services Council. g. Assist the Medical Affairs Officer for the County's Department of Emergency Management in general medical issues for HazMat, Fire, Rescue, Law Enforcement, and others in providing coverage for special events, planning for mass casualty, and other activities outside the routine EMS tasks. h. Serve as the medical director for the Emergency Medical Dispatch program and perform the same functions for Communications as noted in sub - paragraphs b, c and d. i. Assist with maintaining and supporting the EMS database for Orange County Emergency Management to include updating forms and programs as needed, developing reports and providing analytical interpretation of data. Provide weekly administrative time at the Department of Emergency Management for consultation and review of medical issues with the Director. k. Relating to all patients and staff of the County in a professional manner. 1. Providing medical consultation in accord with accepted methods and procedures. 6 m. Other duties as may be requested and necessary in assuring a quality EMS program for Orange County. 3. The department head of the University's Department of Emergency Medicine, with the advice and consent of the Director, shall designate the physician who will serve as the Medical Director and the name of any physician or physicians who will provide services under this Contract as back -up to the person named as the Medical Director in the event the Medical Director is unavailable. The names of those designated shall, upon designation, be provided to the Director. a. Any change in the persons designated will be agreed upon by the head of the University's Department of Emergency Medicine and the Director. b. The University and the County shall indicate their agreement to the designation of the Medical Director and any other physicians involved as described above by signing the "Designation of Medical Director" attachment to this Contract. 4. In the event that the Medical Director and back -up physicians become unwilling or unable to perform the duties required by this Contract, the University shall, with the advice and consent of the Director, designate replacements. If agreement on designations is not achieved, then this Contract shall terminate. 5. The University shall be responsible for ensuring that any physicians providing services under this Contract maintain current registration and licensure and shall provide evidence of such to the County upon request. 6. The County shall compensate the University for the services provided pursuant to this Contract in the amount of Thirty Thousand Dollars ($30,000.00) per year for services provided from July 1 of each year through June 30 of the next year. Payment shall be made on or about July 1, 1999 and on or about July 1 of each year thereafter. 7 The County and the University shall each designate one person as its official contact person for purposes of implementing and administering this Contract. 8. Nothing contained therein is intended to alter or abridge the employment relationship between the University and its employees or the County and its employees. 9. Any University staff providing services under this Contract to the County shall be provided with the University's medical and hospitalization benefits and insurance and be covered by Worker's Compensation insurance or self insurance. 10. This Contract will be reviewed annually no later than June 15 for renewal effective the following July 1, and may be renewed, modified, or amended at that time, or any time, upon the mutual written agreement of the parties. 11. This Contract may be terminated as provided in paragraph 4 and, without the fault of either party, at any time by either party giving 90 days notice to the other party in writing. If either party defaults in its obligations and does not cure such default within ten (10) days of receipt of notice of such default, the non - defaulting party may immediately terminate the Contract. The University shall refund a pro rata portion of the compensation received by it for any portion of a Contract year in the event of a termination of this Contract not the result of a default by the County. 12. The University shall be responsible for the negligence of its employees and agents to the extent of the North Carolina Tort Claims Act. Further, the University, in consultation as to amount with the County, shall provide adequate professional liability insurance for the University personnel who provide the services described in this Contract. The insurance limits will be stated in a Certificate of Insurance or other written evidence of insurance submitted to the County at the time the Contract is commenced. 13 No transfer or assumption of liability for the acts of the employees or agents of either party is intended by the parties to this Contract. 14 The University and the County hereby agree that, in their educational and/or employment practices, each will comply with such non- discrimination laws as may be applicable to them in the performance of this Contract. 15 This Contract contains the entire understanding of the parties and shall not be altered, amended, or modified, except by an agreement in writing executed by the duly authorized officials of both parties. 16 The laws of North Carolina shall govern the validity and interpretation of the provisions, terms, and conditions of the Contract. IT The laws of North Carolina shall govern the validity and interpretation of the provisions, terms, and conditions of the Contract. 10 IN WITNESS WHEREOF, the parties hereto have duly and validly authorized and executed this Contract of this day of July, 1999. COUNTY OF ORANGE Alice M. Gordon, Chair ATTEST: Beverly A. Blythe, Clerk to the Board of Commissioners Approved as to form: County Attorney "This instrument has been preaudited in the manner required by the Local Government Budget and Fiscal Control Act." Orange County Finance Director FOR AND ON BEHALF OF THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL Wayne R. Jones, Vice Chancellor Business and Finance ORIGINAL STATE OF NORTH CAROLINA ORANGE COUNTY THIS CONTRACT dated June 30, 1999 between The University of North Carolina at Chapel Hill (the "University "), and the County of Orange (the "County ") for provision of an EMS Medical Director to Orange County. WITNESSETH Whereas, the County and the University have historically cooperated and worked jointly on matters of mutual concern and interest; and Whereas, the County operates and maintains a Department of Emergency Management which, as one of its functions, provides emergency medical care to citizens of the County; and Whereas, the County wishes to have associated with this program a trained physician specializing in emergency medicine to provide guidance and support; and Whereas, the University, through its Department of Emergency Medicine, wishes to provide this service for the County; and Whereas, performance of the activities described herein is consistent with the University's goals of research, teaching, education and public service. NOW THEREFORE, in consideration of the premises and the mutual covenants and conditions set forth below, the County and the University agree as follows: The University agrees to provide a physician from the Department of Emergency Medicine to serve as EMS Medical Director to the County (hereafter "the Medical Director "). F t� 4 2. The duties of the Medical Director shall include the following: a. Provide medical direction for the emergency medical services program of Orange County. b. Develop, review, and periodically update medical treatment protocols in conjunction with the County Director of Emergency Management or designee (hereafter "the Director "). C. Provide medical treatment supervision of personnel by randomly responding to EMS calls and observing the approach, demeanor, relationships, and medical treatment provided to the patient and others by all responding personnel including, First Responders, Fire, Law Enforcement, Rescue, and EMS. d. Facilitate a program of total quality management of patients addressing compliance to protocol, standards of care, technician proficiency, appropriate patient management, effectiveness of treatments and protocols, evaluation for positive patient outcomes and other components of the EMS system that occur from access through 911 to delivery through the Emergency Department at the University of North Carolina Hospitals. Provide ongoing recommendations to the Director of system needs and changes necessary to implement and operate the patient total quality management program. Serve as the contact person for the sponsor hospital and receive complaints, comments, or questions from the hospital's medical staff about out -of- hospital emergency medical issues and consult with the Director for resolution. f. Serve on the Orange County Medical Services Council. g. Assist the Medical Affairs Officer for the County's Department of Emergency Management in general medical issues for HazMat, Fire, Rescue, Law Enforcement, and others in providing coverage for special events, planning for mass casualty, and other activities outside the routine EMS tasks. h. Serve as the medical director for the Emergency Medical Dispatch program and perform the same functions for Communications as noted in sub - paragraphs b, c and d. i. Assist with maintaining and supporting the EMS database for Orange County Emergency Management to include updating forms and programs as needed, developing reports and providing analytical interpretation of data. j. Provide weekly administrative time at the Department of Emergency Management for consultation and review of medical issues with the Director. k. Relating to all patients and staff of the County in a professional manner. 1. Providing medical consultation in accord with accepted methods and procedures. m. Other duties as may be requested and necessary in assuring a quality EMS program for Orange County. 3. The department head of the University's Department of Emergency Medicine, with the advice and consent of the Director, shall designate the physician who will serve as the Medical Director and the name of any physician or physicians who will provide services under this Contract as back -up to the person named as the Medical Director in the event the Medical Director is unavailable. The names of those designated shall, upon designation, be provided to the Director. a. Any change in the persons designated will be agreed upon by the head of the University's Department of Emergency Medicine and the Director. b. The University and the County shall indicate their agreement to the designation of the Medical Director and any other physicians involved as described above by signing the "Designation of Medical Director" attachment to this Contract. 4. In the event that the Medical Director and back -up physicians become unwilling or unable to perform the duties required by this Contract, the University shall, with the advice and consent of the Director, designate replacements. If agreement on designations is not achieved, then this Contract shall terminate. 5. The University shall be responsible for ensuring that any physicians providing services under this Contract maintain current registration and licensure and shall provide evidence of such to the County upon request. 6. The County shall compensate the University for the services provided pursuant to this Contract in the amount of Thirty Thousand Dollars ($30,000.00) per year for services provided from July 1 of each year through June 30 of the next year. Payment shall be made on or about July 1, 1999 and on or about July 1 of each year thereafter. 7 The County and the University shall each designate one person as its official contact person for purposes of implementing and administering this Contract. 8. Nothing contained therein is intended to alter or abridge the employment relationship between the University and its employees or the County and its employees. 9. Any University staff providing services under this Contract to the County shall be provided with the University's medical and hospitalization benefits and insurance and be covered by Worker's Compensation insurance or self insurance. 10. This Contract will be reviewed annually no later than June 15 for renewal effective the following July 1, and may be renewed, modified, or amended at that time, or any time, upon the mutual written agreement of the parties. 11. This Contract may be terminated as provided in paragraph 4 and, without the fault of either party, at any time by either parry giving 90 days notice to the other parry in writing. If either parry defaults in its obligations and does not cure such default within ten (10) days of receipt of notice of such default, the non - defaulting party may immediately terminate the Contract. The University shall refund a pro rata portion of the compensation received by it for any portion of a Contract year in the event of a termination of this Contract not the result of a default by the County. 12. The University shall be responsible for the negligence of its employees and agents to the extent of the North Carolina Tort Claims Act. Further, the University, in consultation as to amount with the County, shall provide adequate professional liability insurance for the University personnel who provide the services described in this Contract. The insurance limits will be stated in a Certificate of Insurance or other written evidence of insurance submitted to the County at the time the Contract is commenced. 13 No transfer or assumption of liability for the acts of the employees or agents of either party is intended by the parties to this Contract. 14 The University and the County hereby agree that, in their educational and/or employment practices, each will comply with such non- discrimination laws as may be applicable to them in the performance of this Contract. 15 This Contract contains the entire understanding of the parties and shall not be altered, amended, or modified, except by an agreement in writing 9 executed by the duly authorized officials of both parties. 16 The laws of North Carolina shall govern the validity and interpretation of the provisions, terms, and conditions of the Contract. ,h �t; �� .�. ... .. 10 IN WITNESS WHEREOF, the parties hereto have duly and validly authorized and executed this Contract of this -Z day of July, 1999. COUNTY OF ORANGE �� 1 U V�l Alice M. Gordon, Chair ATTEST: Beverly A. Bl e, Clerk to the Board of Commissioners Approved as to form: ty A ey "This instrument has been preaudited in the manner required by the Local Government Budget and Fiscal Control Act." e� range County Finance Director FOR AND ON BEHALF OF THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL ' RR 5okn T. Evans Interim 1,1m CkanccfforforFiiuiruc a,uf dministw on