HomeMy WebLinkAboutAgenda - 06-24-2008-4uORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 24, 2008
Action Agenda
Item No. ~°~{' ~" :~~~
SUBJECT: EMS Medical Director Contract Renewal
DEPARTMENT: Emergency Services -EMS PUBLIC HEARING: (YIN) No
ATTACHMENT(S):
Contract
Designation of Medical Director
INFORMATION CONTACT:
Frank Monies De Oca, 245-3030
Kim Woodward, 245-3030
PURPOSE: To consider renewing a contract between Orange County and .the University of
North Carolina (UNC) Department of Emergency Medicine concerning 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 service. Under state regulations, a county providing service must function under the
medical 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 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 to operate automatic defibrillators and glucose monitoring checks. 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 provides training, skill proficiency and evaluation of
technician performance for the Initial Response Paramedics.
The contract 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. The Medical Director meets
weekly with EMS staff to provide consultation and review of medical issues. Performing the
duties of Medical Director requires Dr. Jane Brice to be replaced in her emergency department
clinical rotations from time to time. The funding for this contract is to help offset the costs of the
Department of Emergency Medicine in providing physician coverage for Dr. Brice.
The amount of the contract is projected to be $45,000 annually, a 4.6% increase from the
previous year. Funding is available in the FY2008-2009 proposed budget for this agreement.
FINANCIAL IMPACT: The $45,000 cost of this contract, a 4.6% increase over the current year,
is included in the proposed departmental operating budget. The contract 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 that the Board approve the contract
renewal and authorize the Chair to sign.
STATE OF NORTH CAROLIl~A
ORANGE, COUNTY
THIS CONTRACT dated Tune 4, 2008 between The University of
North Car•alina at Chapel Hill (the "CTniversity'~, and the County of'Orange (the
"County") for provision of'EMS Medical Direction Services to th•ange County,
WTTNESSETH
Whereas, the County and the Univer•siry 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•Emer•gency Medicine, wishes
to provide this service foz• 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:
l.. The University agrees to provide a physician from the Department af'
Emergency Medicine to serve as EMS Medical Director to the County (hereafter "the
Medical Director").
2.. The duties of'the Medical Du•ector shall include the following:
a.. Provide medical direction for the emexgency medical services
program of'Orange County, including First Responder, .Basic Life
Support, Advanced Life Support, and special events coverage
personnel, including the EMS personnel of Orange County Rescue
Squad and South Orange Rescue Squad..
b. Develop, review, and periodically update medical treatment
protocols in conjunction with the County Director of Emergency
Management or• designee (hereafter "the Du•ector"):
e.. Provide medical tz•eatment supervision of'personnel by randomly
responding to EMS calls and observing the approach, demeanor,
relationships, and medical tx•eatment 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'car•e, technician
proficiency, appropriate patient management, effectiveness of
treatments and protocols, evaluation for positive patient
outcomes and other components of'the EMS system that occur'
fiom access through 911 to delivery through the Emergency
Department at the University ofNorth 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 ITNC Hospitals and receive
complaints, comments, ox questions from the hospital's medical
staff' about out-of-hospital emergency medical issues and consult
with the Du~ectar for resolution_
f'. Assist the Medical Affaiz~s Officer far the County's Department
of Emergency Management in general medical issues for HazMat,
Fine, 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 du~ector for• the 1/mezgency 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 intezpretation of'various databases.
i.. Pz~ovide weekly adnrzinistrative time at the Department of
Emergency Management for consultation and review of'medical
issues with. the Diz~ector~
j.. Relate to all patients and staff'ofthe County in a professional
mannez~,
k. Provide medical consultation in accord with accepted methods
and procedures.,
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'pmexgency
Medicine, with the advice and consent of the Direector•, 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'Ernergency 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 Duectox" attachment to this Contract.,
4, In the event that the Medical Director and back-up physicians become
unwilling or unable to perform the duties x~equix~ed 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
The University shall be responsible for ensuring that any physicians
providing services undez• this Contract maintain current registration and
`7
licensure and shall provide evidence of'such to the County upon request.
6. The County shall compensate the Univezsity for the sezvices provided
puz~suant to this Contract in the amount of'Forty--Five Thousand Do11az•s
($45,000.,00} per year for sezvices provided from .Tu1y 1 of each year
through .Tune 30 of'the next ,year Payment shall be made on or about
,Tiny 1 of each year.
7 The County and the University shall each designate one pez~son as its
official contact person foz~ puzposes of'implementing and adtninisteting
this Contract„
Nothing contained therein is intended to alter or abzidge the employment
relationship between the Uxuvez~sity and its employees or the County and
its employees.
9.. Any Univezsity 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 patties to this contract will adhere to local, state, and fedezal legal
xequirements regarding the confidentiality of'medical records, and may
enact athez~ contracts or agreements stipulating the specific arrangements
for achieving this compliance,
11. Thus Contract will be reviewed annually na later than ,Tune 1 for renewal
effective the following .Tiny 1, and may be renewed, modified, or amended
at that time, or anytime, upon the mutual written agreement of'the patties.
12.. This Contract may be terminated as provided in paragraph 4 and, without
the fault of either patty, at any time by either panty giving 90 days notice
to the other patty in writing., If' either patty defaults in its obligations and
does not cure such default within ten (10) days of'z•eceipt of'notice of'such
default, the non-defaulting patty may immediately tezminate the Contract.
The University shall z'efand a pro rata portion of'the compensation
received by it for any poztion of~ a Contract year in the event of a
termination of'this Contract not the result of'a default by the County.
13. The University shall be responsible for the negligence of'its employees and
agents to the extent of'the Nozth Carolina Tort Claims Act., ~ Fuzther~, the
University, in consultation as to amount with the County, shall provide
adequate pz•ofessional liability insurance for the University pezsonnel who
provide the sezvices described in this Contr•act.• The insurance ]units will
be stated in a Certificate of Insuz•ance oz' other wzitten evidence of
insurance submitted to the County at the time the Contr•aet is commenced.
14. No tr•ansfez• or assumption of'liability for the acts of'the employees or
agents of either party is intended by the parties to this Contract.
15 , The University and the County hereby agree that, in thew educational
and/oz• employment practices, each will comply with such non-
disczimination laws as maybe applicable to them in the pexfozmance of
this Contract.
16 This Contract contains the entize undez•standing of'the parties and shall
not he altered, amended, or modified, except by an agreement in wziting
executed by the duly authorized officials of'both parties
17. The laws of North Carolina shall govern the validity and intezpretation of
the pI'OV151ons, terlnS, and conditions of'the Contract.
IN WITNESS WHEREOF, the parties hez~eta have duly and validly authorized
and executed this Contract of~this day of Tune, 2008,
COUNTY OF ORANGE
Barry.Ta.CObs, Chain'
Arr>;sT:
Donna Baker, Clerk to the
Board of Commissionezs
Approved as to foam:
County Attozney, Geoff Gledhill
"This instrument has been preaudited in the manner requiz~ed by the Local Government
Budget and Fiscal Control Act."
Ozange County Finance Diz•ectar
FOR AND ON BEHALF OF THE
UNIVERSITY OF NORTH CAROLINA
AT CHAPEL HILL
G~
William RapE •, MD, MP ~,~D~
Dean o ,hoo of'Medicin
Vice Chancell r foz• Medical Affairs
i~
~;~
~.
STATE OR NORTH CAROLINA
ORANGE COUNTY
DES~GNAT~QN OF MEDICAL DYliECTUR
The Uxtiversity of'I+Iorth Camlintt at Chapat $i11 ~tlta `2Tuivexsity'~ and e
County, North C.sralzna the "t;aurtty'~ hereby arc as fiillaws:
WHEREAS, tbe'[7nive¢sity asulthe Coctnty hate ezitexed into that ~certairF
agxeeuient fcrrp;ovisian offiMS Medical Dilaetiom Sexvi.aes to the Coutzty ~atad as of the
• 4th dayaf June 2008..x(the"EMS h!ts~'LCalDireattnTAgie~neXlt"~~
a~
WHEREAS, #hc EMS Medical Director Agreernent requires that the paztieg
--------------indicatc~ha9r.agrcemeurt.tQtlx~desigt~atian_oi'tttc.:SIStCS.M"edie~.tD~tor a~tst-atty a~ter_-- -.-. -- -- ,- - - -- -- -- - .
ph~iaiaus who will pxavxde track-xtp asrvices un~3cr the EIaiS h+iediat~ Dir~ctoa~ - .
AreeemenE; an+d• .
T
WHp~REAS, the.~arti.es bav~, cad hereby do, ~e ~#+o. ttta deszgtiatian of the
Medicaa. l]irecta~r a~cl otherphysicia~as wl~ will provado bacl~ up sczvices u~i~oic •
Medical Dix~atar Agreexuent. ~ .
N{?W T~:~Ol the parfiics Ixeieiv agtea:#hat then pl~ysaciarss ~trho wall gravida .
seCYices uncles the M Medical Directcne Agreenaea~t ahaU be as foilovw3,
I, EMS Medial D.txeator.
II. FjtstBaclc Y7p MadicatlD9raatax:
Jane Brice
Brent . Mpeis ,
III. SsCOUd Back-Il'p Medical I~ireCtoz~ Pau 1 H i n c h e y ...__.._.__.__ __
lN' ~I"1'~ES3 yiT~EREi,~F, the parties hexeto have ~da1y auth~xi~ed au8 entered
into this agreement as of the __._._____ +~ of_...._.:~..,._ - ..
FQR AN}7 tJI+T FEHA5.:f1 OF Z'IdE
tJNNE12SITX' 4F NCJ7RTH ~LIl~IA
A,t C.Ei'A~EL ~L
By.
Namo:
for lYledicaE Affaiws
C4t.TNTY OF ORAI~'tl•E
B3'=
tom, Board of Coxumissioaers
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