R01-005RESOLUTION R 01- O~
A RESOLUTION OF THE CITY COMMISSION OF THE
CITY OF BOYNTON BEACH, FLORIDA, RATIFYING
THE EMERGENCY MEDICAL SERVICE DItLECTOR
CONTRACT BETWEEN THE CITY OF BOYNTON
BEACH AND KENNETH A. SCHEPPKE, M.D; AND
PROVIDING AN EFFECTIVE DATE.
WltEREAS, although this matter was approved by the City Commission at the
December 5, 2000 Commission meeting, there have been minor modifications made to
the Agreement; and
WHEREAS, this modified agreement is now brought before you for ratification;
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION
OF THE CITY OF BOYNTON BEACH, FLORIDA, THAT:
er Section 1. The City Commission of the City of Boynton Beach, Florida does
h eby ratify the Emergency Medical Service Director Contract between the City of
B~ynton Beach and Kenneth A. Scheppke, M.D., a copy of said Contract being attached
hereto as Exhibit "A".
Section 2. This Resolution will become effective immediately upon passage.
PASSED AND ADOPTED this I~ day of January, 2001.
Com-"'rr~sioner
ATTEST:
~lerk
EMERGENCY MEDICAL SERVICE DIRECTOR CONTRACT
THIS CONTRACT, entered into on ,2000, 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
re!ationship 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.
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, Flodda Statutes, and the applicable rules of any govemmental
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 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.
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.
The MEDICAL DIRECTOR shall perform all services required pursuant to Chapter
401, Florida Statutes; Section 401.46, Florida Statutes; Chapter 64E-2, Florida
Administrative Code; duties and regulations promulgated by the Flora 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.
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.
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 Paramedics
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 EMTs 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.
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.
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
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 Flodda Statute, Section 401.46 and Florida
Administrative Code, Chapter 64E-2, as set forth in Exhibit "A" to this Agreement.
10.
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12.
13.
MEDICAL DIRECTOR shall provide the Fire Chief with wdtten 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 capacity 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 MEDICAL DIRECTOR which exceed applicable insurance
coverages maintained either by MEDICAL DIRECTOR or by the CITY on behalf
of MEDICAL DIRECTOR.
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.
The CITY will pay the MEDICAL DIRECTOR the sum of Twenty-One Thousand
Dollars $21,000 per year (with the monthly rate being Seventeen hundred and
Fifty Dollars ($1,750.00) dollars per month for twelve (12) months, payable at the
end of each month for services outlined in this contract.
The CITY will provide portable radio communications and an Alpha Numeric or
Digital Pager for the use of the MEDICAL DIRECTOR.
tn matters of employee relations and concern, the MEDICAL DIRECTOR, under
the terms of this contract is considered to be a member of the administration and
supervisory division of the Fire Department and will be expected to aid the Fire
Chief as the Fire Chief carries out grievance procedures, discipline, interviewing
paramedics, paramedic school assignments, and union contract administrative
requirements.
Ac
The MEDICAL DIRECTOR will be expected to report to the Fire Chief the
circumstances relating to any employee decisions for the Emergency Medical
Services System such as discipline, de-certification or promotion in which the
MEDICAL DIRECTOR is involved.
The MEDICAL DIRECTOR agrees to participate as required at personnel
hearing boards such as the Civil Service Board, grievance procedures of the
union contract, etc. as a part of his Department administrative responsibilities
of the Department without additional compensation.
The MEDICAL DIRECTOR agrees to participate in the oral interview and
skills test administered to all new firefighter applicants who have a paramedic
certificate pdor to their employment. 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/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.
14.
15.
16.
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l!8.
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.
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 that he
can become involved in 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
Any staffing changes that result in modifying the Department's current EMS
response protocols must be cleared through the MEDICAL DIRECTOR.
Either party to this contract may, upon giving thirty (30) days written notice to the
other party, 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.
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
pdor 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.
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 may have been exposed to infectious diseases or
hazardous materials.
19.
20.
MEDICAL DIRECTOR hereby agrees to perform those duties set forth in Exhibit
"A" and in the Specifications (as set forth in the RFP) for the position set forth in
Exhibit "B." Exhibit "A' and "B" are attached hereto and incorporated herein.
The term of this agreement shall be for twelve (12) months effective January 1,
2001, through December 31,2001.
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 -8 ~']~
WITNESS: CITY OF BOYNTON BEAC..%I, FLORIDA
WITNESS:
MEDICAL DIRECTOR
PRINT NAME
ATTEST:
EXHIBIT "A"
1. 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 reasonable evaluative processes and techniques and should include at least assessment
. of each paramedic's abilityto: .
Appropriately evaluate emergency medical patients and determine proper priorities for
emergency medical care;
B. i Communicate the findings of such evaluation to a physician who has agreed, in writing, to
i provide responsible supervision of that paramedic;
C. I Receive and understand proper orders from a physician providing direct supervision of the
paramedic;
D. I Understand and properly apply any standing orders authorized bythe Medical Director;
E. i Understand legal relationship between the paramedic, Medical Director, physician(s) under
. agreement to provide responsible supervision of the paramedic and any other physician;
F. i Insure that any ALS performed by the paramedic is done with responsible physician supervision;
i and
G. iPerform the specific medical procedure(s) which the paramedic is specifically authorized by the
i Medical Director and by the ALS provider to perform.
2. iCont~nuallly evaluate the medical capab~hty of the paramedics and the ALS provider and advise
i the ALS provider regarding the appropriate level and standard of care which the ALS provider
ishould seek to achieve.
3. iAssist in identifying the specific medical skills and knowledge which paramedics must possess
i o achieve the desired level and standard of care.
4. iAssist in identifying the training and experience necessary for the paramedics to acquire the
~tesired skills and knowledge and, in cooperation with approved educational programs, in
~ssuring that each paramedic receives such training and experience as required.
5. Develop and implement an appropriate process for periodic audit and review of medical
Procedures performed by paramedics. Such audit and rexTiew process must comply with such
~tandards and requirements as may be set forth by the Department from time to time.
Develop and authorize or reviexv and authorize for use standing r/ders ~vhich allo~v 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 authorizes for use by
the paramedics and for properly instructing the paramedics regarding the correct use of standing
orders.
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
I techniques. (Specific authority 401.35, 381.03 l(1)(g), 20.05(5) FS. Law implemented 401.46,
i401.47 FS. History New 9-10-78).
"EXHIBIT "B"
SPECIFICATIONS
FOR
MEDICAL DIRECTOR TO OVERSEE THE EMERGENCY MEDICAL SERVICES AS
PROVIDED BY FIRE RESCUEFEMTS, PARA~IEDICS AND LIFEGUARDS
Scope of Services
The City of Boynton Beach is seeking to employ a Medical Director to oversee the Emergency
M~dical 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 Tec. hnicians (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.
I. Related Responsibilities
The Medical Director serves as the Fire Department's physician for the purposes of
advising the Fire Chief on matters pertaining fo occupational safety and health.
The Medical Director serves as the Medical Director for the City's Lifeguards, who
may be certified as Emergency Medical Technicians.
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;
Monitoring of radio transmissions to and fi.om 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;
Review of Standard Operating Procedures and Protocols involving multi-agency
responses to medical emergencies;
[. Active participation in daily in-service training scheduled by the Fire Department.
These duties ~vill 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 ~vith 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 ali services required of him pursuant to Chapter 401,
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 Hcalth.
The Medical Director shall give necessary instructions to the City's Emergency Medical
Technicians (EMTs), Paramedics and Lifeguards. The Medical D/rector will also supervise
and arrange such in-service insm~ctional 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-
iservice 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
~mergency procedures. Recommended revisions of said protocols or response procedures shall
be furnished to the Fire Chief.
Services and responsibilities:
A. 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 24 hour prior notification of such unavailability except under emergency
mrcumstances. The notification shall be given to the office of the Fire Chief, and shall include
Be name and telephone numbers of the Acting Medical Director.
B. 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 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. Upoa request, the Medical Director shall
ad,Ase 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 an&'or practical test as
he/she sees fit to detennine the competence of alt Emergency Medical Services personnel
covered by this agreement.
G-o
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 D/rector 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 ass/st in the
preparation of persormel 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 Me. dical Director will oversee and provide bastmction during department scheduled
m-servme training, for a minimum of 6 hours per month.
Consideration of the City of Boynton Beach
Because the Medical Director may be subject to the risk of certain liabilities by entering into
!his 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.
VI.
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 tkis 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 alter termination.
Appropriate communications equipment such as a portable radio, distal pager, cell phone,
etc., may be provided to the Medical Director, if applicable, by the city.
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.
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 mad approved by the Fire Chief.
In consideration of the requirements and standards emimerated herein, I propose to perform
these functions and duties for a fee of .$1,750 00 per month I am able to assume these
responsibilities.
Request for Qualification Requirements
X. Standards to be met by the Medical Director
A. The Medical Director shall be a Florida State licensed physician; and
Co
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 Physic/an, 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;
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 i ADDITION, ALL CURRENT AND ANTICIPATED CONTRACTUAL AGREEMENTS
NAMING TIlE PHYSICIAN AS MEDICAL DIRECTOR FOR ANY OTHER GOVERNM]ENTAL
A(~ENCY, BODY, INSTITUTION OR PRIVATE OR PUBLIC SERVICE SHAJ_J., BE
IDENTIFIED AT THE TIME OF SUBMISSION OF THIS REQUEST FOR
QUALIFICATION/SERVICES.
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