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HomeMy WebLinkAboutAgenda - 01-21-2010 - 4hORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: January 21, 2010 Action Agen,+dah Item No. SUBJECT: EMS Medical Director Agreement Renewal DEPARTMENT: Emergency Services -EMS PUBLIC HEARING: (Y/N) No ATTACHMENT(S): Renewal Agreement Designation of Medical Director INFORMATION CONTACT: F.R. Montes de Oca, Emergency Services, 919-245-6100 Annette Moore, Staff Attorney, 919- 245-2317 Kim Woodward, Emergency Services, 919-245-6100 PURPOSE: To renew an agreement between Orange County and the University of North Carolina (UNC) Department of Emergency Medicine for the medical direction of Orange County's Emergency Medical Services (EMS) program. BACKGROUND: Orange County provides both Advanced and Basic Life Support (ALS & BLS) EMS transport service. Under state regulations, a county providing this service must function under the supervision of a Medical Director. The County receives medical direction through the UNC Department of Emergency Medicine and UNC Hospitals by Dr. Jane Brice and her assistants. The Medical Director's responsibilities include: • Providing training, monitoring and protocol development for the emergency medical dispatch program at 9-1-1. • Performs quality assurance reviews and approves telecommunicators for certification. • Establishes the level of medical practice for all first responders and has required that any practioner hold a state office of EMS credential in order to treat patients in Orange County. • Determines the standard of care and appropriate treatment protocols for paramedics and Emergency Medical Technicians (EMTs}. • Provides training, skill proficiency and evaluation of paramedic and EMT technical performance. The agreement with UNC also requires that the Medical Director have 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 for patient care issues and meets regularly with EMS staff to provide consultation and review of medical issues. Dr. Jane Brice serves as an emergency department staff physician at UNC. This agreement offsets the cost to the UNC Department of Emergency Medicine in providing physician coverage for her as she provides services to Emergency Services. This is a common practice among medical directors who also staff emergency departments. FINANCIAL IMPACT: The $47,000 cost of this agreement reflects a 4.4% increase over the current year. Emergency Services Department has $46,400 budgeted for FY 2009-2010 operating budget. The additional $600 will be transferred from an operating account to cover the shortage. The agreement is based on the County paying a percentage of the Medical Director's salary and benefit cost through UNC, and the increase is based on both an annual salary increase and increased benefit costs for UNC, including an increase in the medical liability premiums. RECOMMENDATION(S): The Manager recommends the Board: • Approve the agreement renewal; • Authorize the Chair to sign the agreement renewal; and • Direct staff to proceed with the necessary budget actions to fund this agreement. 3 AN AGREEMENT TO PROVIDE EMERGENCY MEDICAL DIRECTOR SERVICES THIS AGREEMENT dated January 21, 2010 between The University of North Carolina at Chapel Hill (the "University"), and the County of Orange (the "County") for provision of Emergency Medical Duector Services 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 Services which, as one of its functions, provided emergency medical care to the residents of the County; and Whereas, the County wishes to have associated with this program trained physicians 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 agrees as follows: The University agrees to provide a physician from the Department of Emergency Medicine to serve as Emergency 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, including Medical and First Responder, Basic Life Support, Advanced Life Support, and special events coverage, including the Emergency Medical Service personnel of any agency franchised to provide emergency services in Orange County. b. Develop, review, and periodically update medical treatment protocols in conjunction with the County Director of Emergency Services 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 4 personnel including, Medical and 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 Orange County 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 UNC Hospitals and receive complaints, comments, or questions from the hospital's medical. staff about out-of- hospital emergency medical issues and consult with the Director or their designee for resolution. f. Assist the Medical Affairs Officer for the County's Department of Emergency Services 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. g. Serve as the medical duector for the Emergency Medical Dispatch program and perform the same functions for Communications as noted in sub- paragraphs b, c and d. h. Review data about the EMS System in Orange County and analyze activity and trends through interpretation of various databases. i. Provide weekly administrative time at the Department of Emergency Services for consultation and review of medical issues with the Director. j. Relate to all patients and staff of the County in a professional manner. k. Provide medical consultation in accord with accepted methods and procedures. 1. 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 asback-up to the person named as 5 the Medical Director in the event the Medical Director is unavailable. The names of those designated shall, upon designation, be provided to the Director within 30 days of the start of this Agreement. 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 the 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 designation 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 Forty-Five Thousand Dollars ($45,000.00) per year for services provided from July 1 of each year through June 30 of the next year. The University shall invoice the County on or about July 1 sc of each year and the County shall provide payment within 30 days of receipt of invoice. 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. Both parties to this contract will adhere to local, state, and federal legal requirements regarding the confidentiality of medical records, and may enact other contracts or agreements stipulating the specific arrangements for achieving this compliance. 6 11. This Agreement shall run for a period of one year, from the 1st day of July, 2009 to the 30th day of June, 2010, and shall be renewable, upon the mutual written agreement of the parties. 12. This Agreement or its renewals may be terminated at any time and as provided in paragraph 4, without penalty by either party provided that written notice of such termination is furnished to the other party at least 90 days prior to termination. In the event of such termination any payment due shall be prorated to the date of termination. 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. . 13. Independent Contractor. The services rendered by the University and the they physicians appointed medical director pursuant to this Agreement are those of an independent contractor with respect to Orange County Government. For all purposes, the medical director is an employee of The University and not an employee of Orange County Government. Nothing contained in this Agreement shall be construed to create the relationship of principal and agent, or employer and employee, between The University and Orange County Government. 14. 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. 15. 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. 16. 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. 17. 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. 18. The laws of North Carolina shall govern the validity and interpretation of the provisions, terms, and conditions of the Contract. 19. No provision of this Agreement shall be construed or interpreted as creating a pledge of the faith and credit of the Orange County within the meaning of any constitutional debt limitation. No provision of this Agreement shall be construed or interpreted as creating a delegation of governmental powers nor as 7 a donation by a lending of the credit of Orange County within the meaning of the Constitution of the State of North Carolina. This Agreement shall and does not directly or indirectly or contingently obligate Orange County Government to make any payments beyond those appropriated in the sole discretion of Orange County for any fiscal year in which this Agreement shall be in effect. No deficiency judgment may be rendered against Orange County in any action for breach of a contractual obligation under this Agreement and the taxing power of Orange County is not and may not be pledged directly or indirectly or contingently to secure any monies due under this Agreement. IN WITNESS WHEREOF, the parties hereto have duly and validly authorized and executed this Agreement this the day of January, 2010. FOR AND ON BEHALF OF THE COUNTY OF ORANGE Valerie P. Foushee, Chair ATTEST: Donna Baker, Clerk to the Board Of Commissioners Approved as to legal form: Annette M. Moore, Staff 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 William L. Roper, MD, MPh Dean of School of Medicine Vice Chancellor for Medical Affairs 8 STATE OF NORTH CAROLINA ORANGE COUNTY DESIGNATION OF MEDICAL DIRECTOR The University of North Carolina at Chapel Hill (the "University") and Orange County, North Carolina (the "County") hereby agree as follows: WHEREAS, the University and the County have entered into that certain agreement for provision of EMS Medical Direction Services to the County dated as of the day of (the "EMS Medical Director Agreement"); and WHEREAS, the EMS Medical Director Agreement requires that the parties indicate their agreement to the designation of the EMS Medical Director and any other physicians who will provide back-up services under the EMS Medical Director Agreement; and WHEREAS, the parties have, and hereby do, agree to the designation of the EMS Medical Director and other physicians who will provide back-up services under the EMS Medical Director Agreement. NOW THEREFORE, the parties hereto agree that the physicians who will provide services under the EMS Medical Director Agreement shall be as follows: I. EMS Medical Director: II. First Back-Up Medical Director: III. Second Back-Up Medical Director: IN WITNESS WHEREOF, the parties hereto have duly authorized and entered into this agreement as of the day of , FOR AND ON BEHALF OF THE UNIVERSITY OF NORTH CAROLINA At CHAPEL HILL By: By: Name: TITLE: COUNTY OF ORANGE Chair, Board of Commissioners