HomeMy WebLinkAboutExhibit 2ATTACHMENT "A"
MEDICAL DIRECTOR'S CONTRACT
TRUST shall provide medical direction services under a four (4) tier system as follows:
Tier 1: Medical Director: TRUST shall designate an individual who will act as Medical
Director and who shall have the following responsibilities, at a minimum:
1. Supervise and provide medical oversight for the medical performance of the CITY's
paramedics and emergency medical technicians (EMT's), as required in Florida Statute §401;
2. Supervise and prescribe medical oversight to the CITY's Public Access Defibrillation (PAD)
Program. This shall include the issuance of Prescriptions for any AED that is installed under
the PAD Program.
3. Select the physicians described in Tier 2 and Tier 3 for 24 hour on-line medical control;
4. Ensure the satisfactory performance of Tier 2 and Tier 3 physicians;
5. Bar from further participation in the performance of medical direction services resulting from
this RFP any lower tier physicians who fail to perform in a manner commensurate with the
expectations of the CITY upon appropriate notice from the CITY;
6. Develop and sign medically correct standing orders (treatment protocols) for Advance Life
Support (ALS) and Basic Life Support (BLS) care, and medically -related policies and
procedures, and subsequently review such policies and procedures to ensure correctness at
least every 2 years;
7. Be available (or designate an alternate physician during periods of unavailability) 24 hours a
day, 365 days a year, to answer system questions of an emergent or immediate nature that are
beyond authority of the Tier 2, 3and Tier 4 physicians;
8. Provide medical oversight for and participate as a member of the CITY's Quality
Management Program (QMP) and Continuous Quality Improvement (CQI) Committee for
medically -related issues. Such participation will require attendance at a minimum of 40
meetings per year (average duration is 2 hours);
9. Participate as a member of the Medical Priority Dispatch System's (MPDS) Steering
Committee, and attend its meetings. MPDS Committee has 4-6 meetings per year, each with
an average duration of 2-3 hours;
10. Provide medical oversight for the CITY's MPDS Quality Assurance Program (QAP) which
monitors the dispatching of EMS units;
11. Attend and actively participate in a majority of the State of Florida's Quarterly EMS
Meetings, particularly those meetings regarding the development of State policies and
procedures, legislation and proposed legislation review, etc. Issue a report to the CITY on
issues relevant to it;
12. Participate in an ongoing program of Protocol Testing of all system paramedics;
13. Participate in the Infection Control Program and aid in the development of the program's
policies and procedures;
14. Provide prescriptions and authorization for all medications and medical equipment, including
controlled substances;
15. Obtain and maintain a Drug Enforcement Agency (DEA) license for a City of Miami's
Department of Fire -Rescue;
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16. Develop and revise, when necessary, Trauma Transport Protocols to comply with the State of
Florida requirements;
17. Evaluate and approve continuing education hours for re -certification of paramedics, EMT's,
and Emergency Medical Dispatchers (EMD's);
18. Consult with Department on medically -related issues for EMS personnel (e.g. legal issues,
policy development on issues such as Dive Team or Hazardous Materials Team medical
evaluations, etc.) on an as needed basis; and
19. Perform such other duties as may be negotiated or required.
20. Duties relating to the Village of Key Biscayne: The Village of Key Biscayne receives its
Medical Direction Services from the CITY of Miami. Therefore, the Medical Director shall
have additional responsibilities relating to the needs of the Village of Key Biscayne's
Department of Fire -Rescue. Medical Director must perform all services to Key Biscayne in
the same manner as provided to the CITY, in addition to the following responsibilities:
1. Review 100% of ALS incidents (report review and crew remediation if necessary)
and completion of the Quality Assurance Form;
2. Review 25% of all BLS incidents (report review and crew remediation if necessary);
3. Meet monthly with EMS Captain or Department's designee (2 hours per month);
4. Meet bi-annually with the Deputy Fire Chief (2 hours each meeting);
5. Publish a quarterly newsletter; and
6. Develop new programs (2 hours per month).
Minimum Qualifications for Medical Director: The Medical Director must satisfy the
following minimum qualifications:
♦ Florida licensed Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.);
• Board certified or Board qualified in Emergency Medicine preferred, or Board
certified or Board qualified in Internal Medicine or Family Practice with a minimum
of 2 years experience as a physician in an Emergency Department in the past 5 years;
• Advanced Cardiac Life Support (ACLS) and Advanced Trauma Life Support (ATLS)
provider certification, with instructor certification in at least one of them;
♦ Primary residence and work location within standard portable radio range of the
CITY's radio system, in order to monitor calls as needed (i.e., not to exceed 20 miles
in any direction from the Main transmitter located at 111 NW 1st Street, Miami, F1);
• Shall possess education and/or experience in EMS education;
• Possess a minimum of two (2) years experience as an EMS Medical Director in the
State of Florida; and
♦ DEA licensed for Schedule II, IV, and V controlled substances.
Tier 2: Primary Response Phvsicians' Group (on-line Medical Advisors):
responsibilities of the Primary Response Physicians' Group are as follows:
1. Report to the Medical Director;
2. Monitor City of Miami Medical Channel radio traffic on a 24 hour per day, 365 days per year
basis, either through direct radio response to each EMS call (no matter what the destination
hospital), or by monitoring the Tier 3 physicians response. Tier 2 Physicians shall have
The
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responsibility to immediately override any advice given by Tier 3 physicians that is not in
accord with departmental protocols or standard of care for EMS;
3. Act in accordance with CITY EMS protocols, and medical policies and procedures;
4. Maintain a current knowledge of CITY EMS protocols and medical policies and procedures
to the satisfaction of the Medical Director;
5. Ride with an EMS crew for a minimum of 4 hours prior to assumption of duties;
6. Train with the Medical Director for the period designated by the Medical Director prior to
assumption of duties;
7. Develop knowledge in the operation of the CITY's EMS system prior to assumption of
duties; and
8. Develop knowledge of the CITY's EMS protocols (standing orders) prior to assumption of
duties.
Minimum Qualifications of the Primary Response Physicians' Groun: The Primary
Response Physicians must satisfy the following minimum qualifications:
1. Be a Florida licensed M.D. or D.O.
2. Be an Advanced Cardiac Life Support (ACLS) Provider.
3. Possess Active medical staff privileges at a hospital, within the corporate limits of the CITY
of Miami.
Tier 3: First Response Radio Physician Group: The responsibilities of First Response Radio
Physician Group are as follows:
1. Monitor and respond to City of Miami Medical Channel radio traffic on a 24 hour per day,
365 days per year basis, with medically appropriate orders, and be available by radio to on -
scene EMS personnel as a resource for treatment and/or transportation questions of an
immediate nature;
2. Train with the Medical Director prior to assumption of duties;
3. Be available during a tour of duty at a hospital within the jurisdiction of the City of Miami to
answer questions from, and interact with, City of Miami Fire -Rescue EMS crews in reference
to their duties;
4. Maintain a current knowledge of CITY EMS protocols and medical policies and procedures
to the satisfaction of the Medical Director;
5. Develop knowledge in the operation of the CITY's EMS system prior to assumption of
duties; and
6. Develop knowledge in the CITY's EMS protocols (standing orders) prior to assumption of
duties.
Minimum Qualifications of First Response Radio Physician Groun: The First Response
Radio Physicians must satisfy the following minimum qualifications:
1. Possess active medical staff privileges, if individually licensed, or residency in good standing
with an accredited training program, at a hospital within the corporate limits of the City of
Miami,
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2. Possess a M.D. or D.O. with either an individual Florida Medical License or licensed under a
hospital license for physicians in an accredited residency training program. Physicians in
residence must have entered at least their 2nd year of residency.
Tier 4: Associate Medical Director: The Medical Director working with MFR through a
committee process will select an Associate Medical Director who shall have the following
responsibilities at a minimum:
1. Report to EMS Medical Director;
2. Maintain familiarity with all equipment and medications carried on ALS units;
3. Maintain familiarity with all EMS protocols and policies;
4. Maintain familiarity with federal, state, and local laws and administrative codes as they apply
to EMS;
5. Maintain knowledge and skills in Disaster Management and in local, federal, and state
disaster response plans; participate in MCI drills with MFR;
6. Serve as acting Medical Director in the Medical Director's absence;
7. Respond to EMS scenes with EMS crews for training and quality management;
8. Review and approve EMT recertification course content;
9. Investigate new EMS equipment or treatments for adoption by MFR;
10. Participate in ALS classroom teaching (lectures or procedural skills) and course development;
11. Participate in development and revision of EMS medical protocols;
12. Participate in education and evaluation of new recruits during their probationary period;
13. Participate in medical control radio coverage at JMH;
14. Develop an EMS research project with the .EMS Medical Director;
15. Develop Tactical EMS protocols;
16. Assist QM officers with periodic QM newsletter;
17. Participate in Hazardous Materials response planning;
18. Work an average of 8 hours per week over an annual period;
19. Attend majority of meetings for:
a. EMS Equipment Committee.
b. Region 7 WMD committees (primarily EMS).
c. Miami -Dade County OEM meetings for hospitals and/or EMS; and
d. MFR Curriculum Committee.
20. Attend the following meetings periodically:
a. MFR CQI Committee meetings.
b. FOAM-D EMS Subcommittee; and
c. Area hospital meeting.
21. Assist the EMS Medical Director with the following:
a. Liaison to local Emergency Departments on EMS issues;
b. Participation in Continuous Quality Improvement program;
c. Protocol re -testing of paramedics;
d. Attendance and participation at State Bureau of EMS meetings;
e. PAD Program;
f. Orientation and assistance for Tier 3 radio physicians (residents); and
g. Emergency Medical Dispatch oversight;
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Minimum Qualifications for Associate Medical Director: The Associate Medical Director
must satisfy the following minimum qualifications:
• Florida licensed Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.);
• United States residency -trained and board certified in his/her specialty
1. Advanced Cardiac Life Support (ACLS) certified and either Advanced Trauma
Life Support (ATLS) or Pediatric Advanced Life Support (PALS) certified, with
instructor certification in at least one of those fields.
2. Minimum of 2 years experience in EMS -related duties.
a. Be acceptable to the City of Miami and MFR.
OTHER DUTIES: In addition to the foregoing, TRUST shall have the responsibility to:
1. Remunerate the Medical Director and the physicians described in Tiers 2, 3 and Tier 4;
2. Schedule Tier 2 and Tier 3 physicians to ensure adequate coverage, and, prior to the 1st of
every month, supply the CITY with a work schedule of the Tier 2 physicians for that month;
3. Document and supply education, training, and quality management for all physicians
described in Tier 2, 3 and Tier 4;
4. Provide such other administrative support, including office space, to Medical Director as may
be required to perform the medical direction services.
5. To the extent appropriate, support legal services such as limited case review as may be
required by the Medical Director in the performance of his/her responsibilities.
6. Comply with the following and all applicable HIPAA requirements as they pertain to Miami
Fire -Rescue ("MFR") patients and those patient's medical records. TRUST, including his/her
agents, servants, subcontractors and employees, shall carry out its obligations under this
Agreement in compliance with the privacy regulations of the Health Insurance Portability
and Accountability Act of 1996 (HIPAA) as amended from time to time, and the regulations
promulgated therein, in order to protect the privacy of all individually identifiable protected
health information (PHI) that is created, received, collected, processed or learned as a result
of the services provided pursuant to this RFP. In conformity therewith, TRUST agrees that
he/her and his/her agents, servants, subcontractors, and employees shall:
a. Not use or further disclose PHI except as permitted under this Agreement or required by
law;
b. Use appropriate safeguards to prevent use or disclosure of PHI except as permitted by
this Agreement and shall not use or further disclose PHI in a manner that would violate
HIPAA's requirements if done by Miami Fire -Rescue;
c. As soon as reasonably practical, report to MFR any use or disclosure of PHI not provided
for by this Agreement of which TRUST becomes aware, and mitigate, to the extent
possible, any harmful effect of such use or disclosure of PHI;
d. Ensure that any business associates, agents or subcontractors, to whom TRUST provides
PHI, or who have access to PHI, agree to the same restrictions, terms, and conditions that
apply to TRUST with respect to such PHI;
e. Make PHI available to MFR and to individuals who have a right of access to information
under HIPAA;
f. Incorporate any amendments to PHI in accordance with HIPAA when notified to do so
by MFR;
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g. Provide an accounting to the CITY's authorized representative of all uses or disclosures
of PHI made by TRUST, in accordance with HIPAA, within sixty (60) days;
h. At the termination or expiration of any Agreement, TRUST shall return to MFR all PHI
received from, or created or received by TRUST on behalf of MFR that TRUST still
maintains in any form and shall not retain copies of such information. If such return is not
feasible, TRUST shall continue to protect such PHI in accordance with this Agreement
and HIPAA, and must limit further uses and disclosures of such PHI for those purposes
that made the return of such PHI not feasible.
i, Except as otherwise limited in an Agreement, TRUST may use or disclose PHI to
perform functions, activities, or services for, or on behalf of, the CITY as specified in the
Agreement, provided that such use or disclosure would not violate HIPAA's
requirements if done by MFR;
j, TRUST may, if necessary, use and disclose PHI for the proper management and
administration of TRUST or to carry out the legal responsibilities of TRUST. However,
in order to disclose PHI;
i. The disclosure must be required by law; or
ii. TRUST must obtain reasonable assurances from the person to whom the information
is disclosed that it will be held confidentially and used or further disclosed only as
required by law or for the purpose for which it was disclosed to the person; and
iii, The person must notify TRUST of any instances of which it is aware in which the
confidentiality of the information has been breached.
7. Shall protect, defend, reimburse, indemnify, and hold CITY, its' agents, employees and
elected officers, harmless from and against all claims, liability, expense, loss, cost, penalties,
damages or causes of action of every kind or character, including attorney's fees and costs,
whether at trial or appellate levels or otherwise, arising as a result of any disclosure of
protected health information due to the actions or inactions of TRUST.
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