HomeMy WebLinkAboutAgenda - 06-26-2003-8HORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 26, 2003
Action Agenda
Item No.
SUBJECT: Renewal of EMS Medical Director Contract
DEPARTMENT: Emergency Management-EMS PUBLIC HEARING: (Y/N) No
ATTACHMENT(S):
Summary of Changes in Contract
Medical Director Contract
INFORMATION CONTACT:
Nick Waters„ ext 3030
TELEPHONE NUMBERS:
Hillsborough
Chapel Hill
Durham
Mebane
732-8181
968-4501
688-7331
336-227-2031
PURPOSE: To consider renewing an agreement between Orange County and the UNC
Department of Emergency Medicine concerning medical direction of Orange County's
Emergency Medical Services (EMS) program.
BACKGROUND: Orange County provides both Advanced Life Support (ALS) and Basic Life
Support (BLS) EMS service. Under State regulations, a County providing that 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 approved telecommunicators for certification.
The Medical Director establishes the level of practice for the first responders and the training
requirements to operate automatic defibrillators. Each first responder must be annually trained
and tested in defibrillation.
The Medical Director will assist in the training and evaluations of the new Basic Life Support
personnel (EMTs) of the EMS Transportation Section
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 agreement with the University 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, on patient care issues. The Medical
Director meets weekly with EMS staff to provide consultation and review of medical issues.
In addition to a Medical Director, the UNC Hospitals also provide a nurse liaison whose 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 Department of Emergency Medicine provides limited 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. Jane Brice to be replaced in her
emergency department clinical rotations-from time to time. The funding for this agreement is to
help offset the costs incurred by the Department of Emergency Medicine in providing physician
coverage for Dr. Jane Brice.
A summary of changes between the current and proposed contract is attached.
FINANCIAL IMPACT: The amount of the contract under this renewal is $35,000. This
represents a $5,000 increase from the 2002-03 contract. Funding is available in the
recommended 2003-2004 Emergency Management departmental operating budget for this
agreement.
RECOMMENDATION(S): The Manager recommends that the Board approve the agreement
and authorize the Chair to sign it.
SUMMARY OF CHANGES IN MEDICAL DIRECTOR CONTRACT
(by part and subpart of the revised contract)
2(a). Clarified the scope of the Medical Director's oversight (formerly just "EMS System") to
specifically include all aspects of the EMS system: First Responders, BLS, ALS, and special
events, including those done by Orange EMS and Rescue Squad (OEMSRS).
2. Removed old clause (f) about serving on the EMS Advisory Council.
2(h). Reworded this clause to remove UNC support of county database (that was a provision
specific to services provided by previous medical director Dr. Greg Mears); databases are soon
to be a State Office of EMS function) but retain data analysis and interpretation responsibility.
6. Increased the annual stipend amount from $30,000 to $35,000 in recognition of UNC's
increased cost of providing Emergency Department coverage for the Medical Director during
her duties with EMS.
10. Added a new clause about confidentiality which allows a separate "Business Associate
Agreement" for HIPAA compliance.
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STATE OF NORTH CAROLINA
ORANGE COUNTY
THIS CONTRACT dated June 30, 2003 between The University of
North Carolina at Chapel Hill (the "University"), and the County of Orange (the
"County") for provision of EMS Medical Direction 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
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").
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 First Responder, Basic Life
Support, Advanced Life Support, and special events coverage
personnel, including the EMS personnel of Orange EMS & Rescue
Squad, Incorporated.
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 UNC Hospitals and receive
complaints, comments, or questions from the hospital's medical
staff about out-of-hospital emergency medical issues and consult
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with the Director for resolution.
f. 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.
g. 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.
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 Management 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 maybe 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 Five Thousand Dollars
($35,000.00) 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, 2003 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. Both parties to this contract will adhere to local, state, and federal legal
requirements regarding the confidentiality ofinedical records, and may
enact other contracts or agreements stipulating the specific arrangements
for achieving this compliance.
11. This Contract will be reviewed annually no later than June l 5 for renewal
effective the following July 1, and maybe renewed, modified, or amended
at that time, or any time, upon the mutual written agreement of the parties.
12. This Contract maybe 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.
13. The University shall be responsible for the negligence of its employees and
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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.
14. 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.
15. The University and the County hereby agree that, in their educational
and/or employment practices, each will comply with such non-
discrimination laws as maybe applicable to them in the performance of
this Contract.
16. 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.
17. The laws of North Carolina shall govern the validity and interpretation of
the provisions, terms, and conditions of the Contract.
IN WITNESS WHEREOF, the parties hereto have duly and validly authorized
and executed this Contract this day of , 2003.
COUNTY OF ORANGE
Margaret Brown, Chair
ATTEST:
Donna Baker, Clerk to the
Board of Commissioners
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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
Nancy D. Suttenfield
Vice Chancellor for Finance and Administration