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R04-009 RESOLUTION NO. R04- OOc[ A RESOLUTION OF THE CITY OF BOYNTON BEACH, FLORIDA, APPROVING THE AWARD OF RFQ #020- 2210-04/JA PROVIDING FOR MEDICAL DIRECTOR TO OVERSEE THE EMERGENCY MEDICAL SERVICES AS PROVIDED BY FIRE RESCUE/EMTS, PARAMEDICS AND LIEFEGUARDS TO DR. KENNETH SCHEPPKE, M.D.; AND PROVIDING AN EFFECTIVE DATE WHEREAS, on December 18, 2003, Procurement Sen, ices received and opened ~ne (10 RFQ, The sole applicant, Dr. Scheppke, has been our Fire Rescue Department's dedical Director for the past three years and it is the recommendation of staff that the LFQ be awarded to Kenneth A. Scheppke, M.D.; and WHEREAS, the City Commission, upon recommendation of staff, deems it to be n the best interests of the citizens and residents of the City of Boynton Beach to award lhis RFQ (#020-2210-04/JA), to Kenneth A Scheppke, M.D., providing for overseeing lhe Emergency Medical Services as provided by Fire Rescue/EMTS, Paramedics and Lifeguards, and to enter into an agreement betv¥'een the City of Boynton Beach and Kenneth A. Scheppke, M.D., in the amount of $24,504.00, a copy of which is attached lereto. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION DF THE CITY OF BOYNTON BEACH, FLORIDA, THAT: Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed as ~eing true and correct and are hereby made a specific part of this Resolution upon adoption hereof. Section 2. The City Commission of the City of Boynton Beach, Florida, upon ~:\CA\RESO~Agreements\Bid Awards\RFQ - Medical Director.doc kTTES'I-: ',commendation of staff, hereby approves the award of RFQ (#020-2210-04/JA), and to ~ter into an agreement between the City of Boynton Beach and Kenneth A. Scheppke, /I.D., in the amount of $24,504.00; authorizing the City Manager to execute a contract, a opy of which is attached hereto. Section 3. That this Resolution shall become effective immediately. PASSED AND ADOPTED THIS ~O_ day of January, 2004. CITY OF BOYNTON BEACH, FLORIDA ;:\CA\RESO~Agreements\Bid Awards',RFQ - Medical Director.doc EMERGENCY MEDICAL SERVICE DIRECTOR CONTRACT APPENDIX A THIS CONTRACT, entered into on January. 20~ 2004, between the CITY OF BOYNTON BEACH, Florida (hereinafter "City") and Kenneth A. Scheppke~ M.D,. (hereinafter "MEDICAL DIRECTOR") for Emergency Medical Services Director, is entered into subject to the following terms and conditions: The City of Boynton Beach and Kenneth A. Scheppke~ M.D. hereby agree that the terms of this Contract provide an outline of the working relationships and responsibilities of the CITY and the Medical Director for the City's Emergency Medical Services Program (EMS), which is a part of the CITY'S Municipal Fire Department. The items in this Contract in the following Sections are aimed at identifying the MEDICAL DIRECTOR'S general relationship with the CITY, his responsibility for supervising the direct medical related activities of the EMS program, and the MEDICAL DIRECTOR'S responsibility for local training and certification of the Paramedics. The Contract further supports the principle that the MEDICAL DIRECTOR will receive support from the Fire Department Administration and will direct his requests for equipment and equipment assignments; manpower and manpower assignments; and supplies of the Fire Department Administration and recognizes that assignments to the Paramedic Program will be made by the Fire Chief in accordance with the overall resources and needs of the Fire Department. 1. The CITY hereby contracts with the MEDICAL DIRECTOR and the MEDICAL DIRECTOR accepts this contract as MEDICAL DIRECTOR for the CITY OF BOYNTON BEACH Emergency Medical Services Program under the provisions of Section 401.46, Florida Statutes, and the applicable rules of any governmental agency implementing said Chapter or other established duties required to be performed by said MEDICAL DIRECTOR, or upon notice from the CITY that such additional duties have been established by the Florida Department of Health and Rehabilitative Services. It is recognized that the MEDICAL DIRECTOR'S contract with the CITY preserves MEDICAL DIRECTOR'S right to practice as an independent physician at all times. 2. The MEDICAL DIRECTOR shall accept responsibility for the medical performance of the Emergency Medical Technicians, Paramedics, Lifeguards and Certified Emergency Medical Dispatchers employed by the CITY and serving in the Emergency Medical Services Program of the City Fire Department, herein referred to as EMS. The Medical Director shall be responsible directly to the City Manager; however, nothing herein shall in any way authorize any limitations or restrictions by the City Manager on the professional acts or advice of the Medical Director. 3.The Fire Chief, through the Department staff and operation procedure, will establish Department policy for equipment and equipment assignment, and for supply purchase and use. The MEDICAL DIRECTOR, in conjunction with the Fire Chief.. shall establish dispatch procedures and priorities. The Fire Chief will establish Department policy for manpower assignment in conjunction with recommendations made by the MEDICAL DIRECTOR C1 4.The MEDICAL DIRECTOR shall perform all services required pursuant to Chapter 401, Florida Statues; Section 401.46, Florida Statutes; Chapter 64E-2, Florida Administrative Code; duties and regulations promulgated by the Florida Department of Health and Rehabilitative Services; and all present rules and regulations of any governmental agencies implementing said Chapter or other established duties required to be performed by said MEDICAL DIRECTOR. 5.The MEDICAL DIRECTOR shall serve as the Fire Department's physician for purposes of advising the Fire Chief on matters pertaining to occupational safety and health. MEDICAL DIRECTOR shall serve as the MEDICAL DIRECTOR for the City's Life Guards, who may be certified as Emergency Medical Technicians. 6. The MEDICAL DIRECTOR agrees to both directly and indirectly supervise and accept responsibility for the medical performance of Emergency Medical Technicians, Certified Emergency Medical Dispatchers, and Paramedic functioning for the EMS and shall have full authority to direct and supervise the medical activities in the field, in training and for certifications. Such supervision shall be accomplished by, but not limited to: A. Actual accompaniment of Paramedics and EMT's on rescue calls. B. Monitoring of radio transmissions to and from hospital emergency departments and related facilities. C. Review of incident reports and associated documentation, and D. Conference and/or meeting in both individual and group situations. E. Review of standard operating procedures and protocols involving multi-agency responses to medical emergencies. These duties will be performed periodically by the MEDICAL DIRECTOR at his/her convenience as often as is necessary to insure that proper medical standards and procedures are being followed. Cost for supplying necessary, in-service instruction material will be assumed by the CITY and the material will become the property of the CITY. Further the EMS Coordinator shall be the MEDICAL DIRECTOR'S agent for purpose of quality assurance pursuant to Florida State Statute. 7. The MEDICAL DIRECTOR shall have the services of the Departmental training program, facility and staff to assist in carrying out training requirements for the EMS. MEDICAL DIRECTOR shall participate in daily in-service training scheduled by the Fire Department. 8. The MEDICAL DIRECTOR shall be eligible as a member as defined under Section IV. Members of the Agreement between the City Of Boynton Beach and Florida as Municipal Liability Self-Insurance Program. Coverage under this agreement shall be limited to the scope of duties as MEDICAL DIRECTOR for the City Of Boynton Beach Fire Department as outlined in Florida Statute, Section 401.46 and Florida Administrative Code, Chapter 64E-2, as set forth in Exhibit "A" to this Agreement. The MEDICAL DIRECTOR shall provide the C2 Fire Chief with written reports as required by Fire Chief regarding efficiency, effectiveness, and general performance of the CITY's Emergency Medical Services System. The provider shall indemnify and save harmless the MEDICAL DIRECTOR from any and all liability for acts or omissions committed by the MEDICAL DIRECTOR while acting in the capability as Medical Director of the Boynton Beach Fire Department, but said indemnification shall be to the extent only of any amount due and owing from the MEDICAL DIRECTOR which exceed applicable insurance coverage maintained either by the MEDICAL DIRECTOR or by the CITY on behalf of the MEDICAL DIRECTOR. 10. The provider shall indemnify and save harmless the MEDICAL DIRECTOR from any and all liability incurred as a result of acts or omission of employees of the City Of Boynton Beach Fire Department. 11. The CITY will pay the MEDICAL DIRECTOR the sum of ($24~504.00) with the monthly rate being ($ 2~042.00) per month for twelve (12) months, payable at the end of each month for services outlined in this contract. 12. The CITY will provide portable radio communication and an Alpha Numeric or Digital Pager for the use of the MEDICAL DIRECTOR. 13. In matters of employee relations and concern, the MEDCIAL DIRECTOR, under the terms of this contract is considered to be a member of the administration and supervisory, division of the Fire Chief as the Fire Chief carries out grievance procedures, discipline, interviewing paramedics, paramedic school assignments, and union contract administrative requirements. The MEDICAL DIRECTOR will be expected to report to the Fire Chief his/her decisions relating to any employees for the Emergency Medical Services System such as discipline, de-certification or promotion in which the MEDCIAL DIRECTOR is involved. Bo The MEDICAL DIRECTOR agrees to participate as required at personnel hearing boards such as grievance procedures of the union contract, etc. as part of his Department administrative responsibilities of the Department without additional compensation. Co The MEDICAL DIRECTOR agrees to participate in the oral interview and skills test administered to all new firefighter applicants who have a paramedic certificate prior to their employment. The MEDICAL DIRECTOR retains the right to prevent the hiring of any such individual for the purpose of employment as a paramedic if he or she does not perform satisfactorily during the interview and/and or skills test. The content of the skills test will be in accordance with current standardized criteria set up by the American Heart Association and American College of Emergency Physicians. C3 D. The MEDICAL DIRECTOR agrees that anytime a firefighter employed by the City Of Boynton Beach wants to attend paramedic classes for purposes of becoming a licensed paramedic they must have written approval by the MEDICAL DIRECTOR prior to attending and/or enrolling in such classes. 14. From time to time the MEDICAL DIRECTOR will be expected to attend Department Administrative staff meetings so that he can give input to the Administrative staff on the needs and status of the EMS Program and so he can become involved and informed of Departmental Standard Operating Procedures relating to: A. Response procedures B. Equipment and personnel allocations C. Department priorities D. Departmental procedures for handling emergencies E. Working with other departments F. Emergency Medical Dispatching G. Infectious Disease Procedures 15. Any staffing changes that result in modifying the Department's current EMS response protocols must be cleared through the MEDICAL DIRECTOR. 16. Either party to this contract ma)', upon giving thirty (30) days written notice to the other part),, may terminate this contract for any reason whatsoever, and after the effective date of such notice all parties will be relieved of any further obligations under this contract. 17. The MEDICAL DIRECTOR will assure the continuous availability of at least one qualified physician as Director who shall serve as Acting MEDICAL DIRECTOR in the absence of the MEDICAL DIRECTOR. In addition, the MEDICAL DIRECTOR will notify the Boynton Beach Fire Rescue Department whenever he/she will be unavailable for whatever reason, and will attempt to provide twenty-four (24) hour prior notification of such unavailability except under emergency circumstances. The notification shall be given to the Office of the Fire Chief, and shall include the name and telephone numbers of the Acting MED1CAL DIRECTOR. 18. Upon request, the MEDICAL DIRECTOR will advise the Department on appropriate procedures to address incidents in which an employee of the Fire Department has been or ma), have been exposed to infectious diseases or hazardous materials. C4 19. MEDICAL DIRECTOR hereby agrees to perform those duties set forth in Exhibit "A" and in the Specifications for the position set forth in Exhibit "B". Exhibit "A" and "B" are attached hereto and incorporated herein by reference. 20. The term of this agreement shall be for three (3) years from the execution, with CITY having the option to renew on a yearly basis for two additional one years terms, by providing ~q'itten notice to the MEDICAL DIRECTOR at least twenty (20) days prior to the expiration of the term that the CITY intends to renew the contract for an additional year. The MEDICAL DIRECTOR shall indicate whether he or she wishes to remain a party, to the agreement prior to the expiration of the term. C5 IN WITNESS WHEREOF the parties hereto have caused these presents to be signed by their duly authorized officers and by the MEDICAL DIRECTOR on this 'Z~O day of ~_~o.~ ,2003. CITY OF BOYNTON BEACH, FLORIDA City Manager Medical Director Attest/Authenticated: Title Clerk Approved as to Form: (Corporate Seal) Authenticated: Office of the City Attorney Notary: C6 EXHIBIT "A" Be responsible for advising the ALS provider as to his assessment of the competence of each of the provider's paramedics and for making recommendations regarding the medical procedures which each paramedic should be authorized to perform. Such assessment should be made by utilizing responsible evaluative processes and techniques and should include at least one assessment of each paramedic's ability to: A. Appropriately evaluate emergency medical patients and determine proper priorities for emergency medical care: B. Communicate the findings of such evaluations to a physician who has agreed, in writing, to provide responsible supervision of that paramedic; C. Receive and understand proper orders from a physician providing direct supervision of the paramedic; D. Understand and properly apply any standing orders authorized by the Medical Director; Understand legal relationship between the paramedic, Medical Director, physician(s) under agreement to provide responsible supervision of the paramedic, and any other physician; F. Insure that any ALS performed by the paramedic is done with responsible physician supervision; and G. Perform the specific medical procedure(s) which the paramedic is specifically authorized by the Medical Director and by the ALS provider to perform. Continually evaluate the medical capability of the paramedics and the ALS provider and advise ALS provider regarding the appropriate level and standard of care which the ALS provider should seek to achieve. 3. Assist in identifying the specific medical skills and knowledge which paramedics must possess to achieve the desired level and standard of care. Assist in identifying the training and experience necessary for the paramedics to acquire the desired skills and knowledge and, in cooperation with approved educational programs, in assuring that each paramedic receives such training and experience as required. Develop and implement an appropriate process for periodic audit and review of medical procedures performed by paramedics. Such audit and review process must comply with such standards and requirements as may be set forth by the department from time to time. 6. Develop and authorize or review and authorize for use standing riders which allow the paramedics to properly manage certain medical emergencies when voice communications with the responsible physician is not available. Such standing orders must be specified and must at least provide for managing immediately life threatening emergencies though they are not required to be so comprehensive as to include all possible medical emergencies. Be responsible for the medical correctness of any standing order which he/she authorizes for use by the paramedics and for properly instructing the paramedics regarding the correct use of standing orders. 8. Assist the ALS provider in assuring continuous availability of at least one responsible physician. Determine the qualifications necessary for a physician to provide responsible supervision of the paramedics. Retain the ultimate authority to permit and/or prohibit any system paramedic to utilize ALS techniques. (Specific authority 401.35, 381.031 (1)(g),20.05(5)FS. Law implemental 401.46,401.47 FS. History NEW 9-10-7 EXHIBIT "B" SPECIFICATIONS FOR MEDICAL DIRECTOR TO OVERSEE THE EMERGENCY MEDICAL SERVICES AS PROVIDED BY FIRE RESCUE/EMTS, PARAMEDICS AND LIFEGUARDS Scope of Services: The City of Boynton Beach is seeking to employ a Medical Director to oversee the Emergency Medical Services as provided by Fire Rescue, Paramedics and Lifeguards, as well as other departmental administrative purposes and functions. The Medical Director will be an independent contractor supervising and accepting responsibility for the medical performance of Emergency Medical Technicians (EMTs), Paramedics, and first responders/Lifeguards, functioning in the Fire and Emergency Medical Services Department and the Parks and Recreation Department under applicable provisions of Florida Statutes. Related Responsibilities A. The Medical Director serves as the Fire Department's physician for the purposes of advising the Fire Chief on matters pertaining to occupational safety and health. B. The Medical Director serves as the Medical Director for the City's Lifeguards, who may be certified as Emergency Medical Technicians. Co The Medical Director agrees to both directly and indirectly supervise and accept responsibility for the medical performance of Emergency Medical Technicians and Paramedics functioning in the Fire and Emergency Medical Services Department and the Parks and Recreation Department. Such supervision shall be accomplished by, though not limited to: D. Actual accompaniment of Paramedics and EMTs on rescue calls; E. Monitoring of radio transmissions to and from hospital emergency departments and related facilities; F. Review of rescue incident reports and associated documentation; G. Conference and/or meetings in both individual and group situations; H. Review of Standard Operating Procedures and Protocols involving multi-agency responses to medical emergencies; I. Active participation in daily in-service training scheduled by the Fire Department. These duties will be performed periodically by the Medical Director at his/her convenience and as often as is necessary to insure that proper medical standards and procedures are being followed. The Medical Director shall provide the Fire Chief with written reports as required by the Fire Chief regarding efficiency and effectiveness and general performance of the City's Emergency Medical Services System. The Medical Director shall perform all services required of him/her pursuant to Chapter401, Florida Statutes, and the applicable rules of any governmental agency implementing said Chapter or other established duties required to be performed by said Medical Director, or upon promulgation of additional duties established by the Florida Department of Health. The Medical Director shall give necessary instructions to the City's Emergency Medical Technicians (EMTs), Paramedics and Lifeguards. The Medical Director will also supervise and arrange such in-service instructional sessions, and promulgate such rules and directives, as may be necessary to assure that all medical services performed by EMTs, Paramedics and Lifeguards are in accordance with proper medical standards and procedures. In addition, the Medical Director shall participate in general Paramedic staff meetings at a time and date mutually agreeable with the Medical Director and the Fire and Emergency Medical Services Department; provide sufficient didactic lecture and instruction to insure that standards of emergency medical care are maintained, review and comment on content and emphasis on in-service training and testing procedures; and shall initiate a review of all pre- hospital emergency medical service protocols and levels of personnel and equipment response at least every six months to determine their applicability and appropriateness with respect to currently accepted emergency procedures. Recommended revisions of said protocols or response procedures shall be furnished to the Fire Chiefi IV. Services and responsibilities: Ao The Medical Director will assure the continuous availability of a least one qualified physician as outlined in Section I, who shall serve as Acting Medical Director in the absence of the Medical Director. In addition, the Medical Director will notify the Boynton Beach Fire and Emergency Medical Services Department whenever he/she will be unavailable for whatever reason, and will attempt to provide 24hour prior notification of such unavailability except under emergency circumstances. The notification shall be given to the office of the Fire Chief, and shall include the name and telephone numbers of the Acting Medical Director. The Medical Director will provide liaison services as required and requested between the Fire and Emergency Medical Services Department of the City and other departments, divisions, boards and bodies of the City, County and the State of Florida, as well as educational, institutions, medical societies and other agencies or Co Ho institutions relating to the provision of Emergency Medical Services. The Medical Director will retain ultimate authority to permit or deny any Paramedic or EMT the utilization or advanced life support techniques, basic life support, patient assessment, or patient stabilization procedures. Upon request, the Medical Director shall advise the Fire Chief or the Director of Parks and Recreation, if appropriate, on disciplinary recommendations related to medical care. The Medical Director shall administer a protocol examination and/or practical test as he/she sees fit to determine the competence of all Emergency Medical Services personnel covered by this agreement. Upon request, the Medical Director will participate in the design and structure of selection procedures for entry level personnel for the City of Boynton Beach. Upon request, the Medical Director will consult with the Fire Chief regarding promotional testing criteria for incumbent personnel. Upon request, the Medical Director will advise the department on appropriate procedures to address incidents in which an employee of the Fire and Emergency Services Department or the Parks and Recreation Department's Life Guard unit, has been, or may have been, exposed to infectious diseases or hazardous materials. Upon request, the Medical Director will maintain data regarding the status of employees who have been, or may have been, exposed to the infectious diseases or hazardous materials. Upon request, the Medical Director will provide oversight and instruction to assist in the preparation of personnel in the Fire and Emergency Service Department in professional competitions which may be selected by the Department. At his/her election, the Medical Director may utilize the services of a Licensed Physician Assistant who shall be designated as a Deputy Medical Director to facilitate the delivery of the services enumerated in the Medical Director's contract. However, responsibility for the efficient delivery of these services shall remain with the physician selected as the Medical Director and no increase in the annual fee shall occur based on this election. K. The Medical Director will oversee and provide instruction during department scheduled in-service training, for a minimum of 6 hours per month. V. Consideration of the City of Boynton Beach Because the Medical Director may be subject to the risk of certain liabilities by entering into this agreement, the City will obtain and pay the annual premium on a medical malpractice insurance policy insuring the Medical Director against liability arising out of negligent acts or omissions of the Medical Director in the performance of his duties as Medical Director during the term of this Agreement. If this insurance policy provides coverage on a premium of this policy for a coverage period ending not less than four (4) years following termination of employment of the Medical Director, the provisions of this paragraph shall survive termination of this Agreement, regardless of whether termination is by the Medical Director or by the City, or by expiration of the term of this Agreement, until four (4) years after termination. VI. Appropriate communications equipment such as a portable radio, digital pager, cell phone, etc., may be provided to the Medical Director, if applicable, by the city. VII. The Medical Director shall be directly responsible to the Chief of the Fire and Emergency Medical Services Department of the City. The Fire and Emergency Medical Services Department will provide limited and department related administrative and secretarial support to the Medical Director through the Office of the Fire Chief. VIII. The Fire and Emergency Medical Services Department, through the Office of the Fire Chief and the Parks and Recreation Department, shall cooperate to the greatest possible extent in the delivery of competent emergency medical care, including implementation of the policies established by the Medical Director and approved by the Fire Chief. In consideration of the requirements and standards enumerated herein, I propose to perform these functions and duties for a fee of $2~042.00 per month. I am able to assume these responsibilities. Section 3 - Request for Qualifications Requirements Ko Standards to be met by the Medical Director Ao Co The Medical Director shall be a Florida State licensed physician; and Is an ACLS (Advanced Cardiac Life Support) provider with instructor certification, and is an ACLS affiliate faculty member of the American Heart Association; or Is a Board-Certified Emergency Physician, or is currently employed as an Emergency Department Physician in the State of Florida, or who has previously been an Emergency Department Physician in the State of Florida within the past (5) five years; D. Maintains official privileges and affiliation with one or more of the following medical facilities: Bethesda Memorial or John F. Kennedy Hospital. ATTACH COPIES OF ALL REQUIRED LICENSES, CERTIFICATIONS DOCUMENTATION OF PRIVILEGES AND AFFILIATIONS, A CURRICULUM VITAE, ALONG WITH OTHER CREDENTIALS OR INFORMATION YOU WISH TO HAVE CONSIDERED BY THE CITY AS PART OF THIS REQUEST FOR QUALIFICATIONS/SERVICES. IN ADDITION, ALL CURRENT AND ANTICIPATED CONTRACTUAL AGREEMENTS NAMING THE PHYSICIAN AS MEDICAL DIRECTOR FOR ANY OTHER GOVERNMENTAL AGENCY, BODY, INSTITUTION OR PRIVATE OR PUBLIC SERVICE SHALL BE IDENTIFIED AT THE TIME OF SUBMISSION OF THIS REQUEST FOR QUALIFICATION/SERVICES.