Agenda 02/09/2016 Item #16E 5 2/9/2016 16.E.5.
EXECUTIVE SUMMARY
Recommendation to increase the compensation of the County Deputy Medical Director by 5% in
accordance with the Collier County Emergency Services Deputy Medical Director Agreement.
OBJECTIVE: To provide a 5%increase as requested by the County Deputy Medical Director.
CONSIDERATIONS: The Deputy Medical Director Agreement was approved by the Board on
February 11, 2014, Agenda Item 16.K.3. Article 4 — Payments to Deputy Medical Director
allows for a 5% annual increase at the request of the Deputy Medical Director and subsequent
approval by the Board of County Commissioners, to be retroactive to the first day after the
annual anniversary date.
FISCAL IMPACT: The 5% increase would total $2,600.00 for FY16 and would be paid from
the EMS operating budget Fund 490.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is
approved as to form and legality, and requires majority vote for approval. -JAK
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting
from this action.
RECOMMENDATION: That the Board of County Commissioners approve the 5% increase to
the Deputy Medical Director's annual pay.
PREPARED BY: Artie Bay, Supervisor, Emergency Medical Services Admin.
Attachment: Medical Director Agreement
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.E.16.E.5.
Item Summary: Recommendation to increase the compensation of the County Deputy
Medical Director by 5% in accordance with the Collier County Emergency Services Deputy
Medical Director Agreement.
Meeting Date: 2/9/2016
Prepared By
Name: BayArtie
Title: Supervisor-Accounting,Administrative Services Department
1/22/2016 11:45:51 AM
Approved By
Name: KopkaWalter
Title: Chief-Emergency Medical Services,EMS Operations
Date: 1/22/2016 11:52:48 AM
Name: PriceLen
Title: Department Head-Administrative Svc,Administrative Services Department
Date: 1/22/2016 2:00:21 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 1/28/2016 4:17:45 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 1/28/2016 4:27:48 PM
Name: WellsLaura
Title:Management/Budget Analyst, Senior, Office of Management&Budget
Date: 1/28/2016 4:32:31 PM
Name: CasalanguidaNick
Title: Deputy County Manager, County Managers Office
Date: 1/31/2016 12:34:55 PM
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COLLIER COUNTY EMERGENCY SERVICES
DEPUTY MEDICAL DIRECTOR AGREEMENT
THIS DEPUTY MEDICAL DIRECTOR AGREEMENT is by and between
DOUGLAS S. LEE, M.D., hereinafter referred to as DEPUTY MEDICAL DIRECTOR, and
COLLIER COUNTY, FLORIDA, hereinafter referred to as the COUNTY, and shall become
effective as of the 1St day of February,2014.
WITNESSETH:
WHEREAS, the COUNTY is responsible for emergency services in Collier County,
Florida;and
WHEREAS, Section 401.265, Florida Statutes, requires the COUNTY as a basic and
advanced life support service provider to employ a medical director; and
WHEREAS, the COUNTY desires to employ a deputy medical director in order aid the
medical director in carrying out the duties of the office; and
WHEREAS, Douglas S. Lee, is a duly licensed physician in the State of Florida who is
specially trained in the field of emergency medicine; and
WHEREAS, the COUNTY and the DEPUTY MEDICAL DIRECTOR wish to enter into
this contract for employment subject to the terms and conditions set forth below.
NOW THEREFORE, in consideration of the promises and mutual covenants hereinafter
set forth,the parties hereto agree as follows:
ARTICLE 1 -SERVIC.ES
The DEPUTY MEDICAL DIRECTOR'S responsibility under this Agreement is to
provide professional services in conjunction with the Medical Director for COUNTY in
accordance with Chapter 401,Florida Statutes and Chapter 64-J-1,Florida Administrative Code.
Rules of the Department of Health, as more specifically set forth in the Scope of Work and
specifications detailed in Article 3.
ARTICLE 2—SCHEDULE AND RENEWAL
The DEPUTY MEDICAL DIRECTOR shall commence services on the date first written.
above and complete all services by five (5) years from the date written above. This Agreement
may be renewed for up to three additional one (1) year terms by the Board of County
Commissioners based on satisfactory performance,mutual acceptance and determination that the
contract is in the best interest of the COUNTY. The DEPUTY MEDICAL DIRECTOR shall be
given one hundred-twenty days (120)notice of the COUNTY'S intent to renew the contract or to
allow the contract to expire without. renewal. Any renewal will be subject to appropriation of
funds by the Board of County Commissioners.
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ARTICLE 3—SCOPE OF WORK
This Agreement is personal to Dr. Lee, and as such the duties set forth herein cannot be
delegated or assigned except as expressly permitted by Chapter 401, Florida Statutes and
Chapter 644-1,Florida Administrative Code, Rules of the Department of Health or as otherwise
provided in this Agreement. Exhibit A outlines the specific scope of work and responsibilities of
the DEPUTY MEDICAL DIRECTOR. This does not limit duties to the following requirements,
which may be subject to revision/addition/deletion upon written agreement by both parties.
The scope of services for the DEPUTY MEDICAL DIRECTOR, as outlined in Exhibit A,
shall be in support of and to further the duties of the Medical Director. If for any reason the
Medical Director is unavailable whether by termination of his contract, scheduled vacation or
personal emergency, the DEPUTY MEDICAL DIRECTOR shall assume the duties of the
Medical Director until further notice. Article 18 may be utilized if an increase in duties is
necessary for more than 31 days:
ARTICLE 4—PAYMENTS TO DEPUTY MEDICAL DIRECTOR
The COUNTY shall pay to the DEPUTY MEDICAL DIRECTOR the sum of fifty
thousand ($50,000) per year, as :full compensation for the services rendered herein and no other
compensation. The COUNTY will pay the cost of the professional liability insurance and
reasonable and necessary legal services as set forth below. The DEPUTY MEDICAL
DIRECTOR shall not be eligible for any employee benefits other than this compensation. This
sum shall be paid to the DEPUTY MEDICAL DIRECTOR in twelve (12) equal monthly
payments commencing with the effective date of the Agreement, with each monthly payment
being payable by the 10`h of each month. On the date that general wage adjustments (i.e., cost of
living adjustments, special study pay adjustments, etc.) are granted generally to COUNTY
employees, the DEPUTY MEDICAL DIRECTOR'S base salary shall be modified to reflect the
general wage adjustment granted to COUNTY employees. In addition, on each annual
anniversary date during the term of this Agreement, including any renewal terms, the DEPUTY
MEDICAL DIRECTOR will be entitled to a 5%annual increase upon the written notification to
County Manager fifteen (15) days prior to the annual anniversary date and subsequent approval
by the Board of County Commissioners, with any increase to be retroactive to the first day after
the annual anniversary date.
ARTICLE 5—REPORTING/ANNUAL CONTRACTOR EVALUATION
The DEPUTY MEDICAL DIRECTOR shall report to the County Manager or designee
for the services as DEPUTY MEDICAL DIRECTOR as more specifically defined in this Exhibit
A and as set forth in Section 401.265,Florida Statutes.
The DEPUTY MEDICAL DIRECTOR will submit a contractor self-assessment along
with proposed goals for the next year on an annual basis to the County Manager or designee no
later than the first day of June. The County Manager or designee will review the DEPUTY
MEDICAL DIRECTOR's self-assessment and may request an independent evaluation and
recommendations from a Board authorized Advisory Board. Any performance issue will be
taken to the Board of County Commissioners. An updated contractor evaluation plan may be
developed in good faith between the DEPUTY MEDICAL DIRECTOR and the County Manager
or designee and adopted prior to October IS`of each year for implementation in the next year.
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ARTICLE 6—TERMINATION
This Agreement is subject to termination without cause by either party to this Agreement
upon sixty (60) days written notice. Such notice shall be forwarded by certified mail to the
addresses set forth in Article 19.
This Agreement is subject to immediate termination for cause in the event:
(a) DEPUTY MEDICAL DIRECTOR fails or refuses to prosecute the Scope of Work or any
severable part, with the diligence that will insure its completion within the time specified
by the COUNTY;
(b) DEPUTY MEDICAL DIRECTOR violates law, ordinances, rules, regulations or any
governmental authority having jurisdiction;
(c) DEPUTY MEDICAL DIRECTOR materially breaches any of the provisions of this
Agreement.
ARTICLE 7—AVAILABILITY OF FUNDS
The COUNTY'S performance and obligation to pay under this Agreement is contingent
upon an annual appropriation for its purpose by the Board of County Commissioners.
ARTICLE 8—INSURANCE
A. Coverage is afforded under the COUNTY'S SELF-INSURED RETENTION PLAN and
SPECIFIC EXCESS INSURANCE POLICY as follows:
SELF-INSURED RETENTION PLAN
$300,000 each occurrence
SPECIFIC EXCESS INSURANCE POLICY
52,000,000 each occurrence combined single limit
Coverage is afforded to the MEDICAL DIRECTOR and DEPUTY MEDICAL
DIRECTOR by endorsement. Coverage for back-up physicians shall be subject to the
prior approval of the COUNTY's insurance underwriters.
B. Additional Malpractice Coverage shall also be afforded by the COUNTY hereunder as has
been historically provided by COUNTY to DEPUTY MEDICAL DIRECTOR for activities
while riding as crew member of EMS vehicle as required by this Agreement and by State
Law.
C. The COUNTY reserves the right, but not the obligation, to purchase separate liability
insurance on behalf of the DEPUTY MEDICAL DIRECTOR and any back-up physicians in
lieu of providing the coverage as mentioned.above. Such insurance will be limited to those
matters arising out of this Agreement.
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D. The requirements contained herein are not,intended to and shall not in any manner limit the
liabilities and obligations assumed by the DEPUTY MEDICAL DIRECTOR under this
Agreement.
ARTICLE 9—REMEDIES
This Agreement shall be governed by the laws of the State of Florida. Any and all legal
action necessary to enforce the Agreement shall be held in.Collier County.
ARTICLE 10—CONFLICT OF INTEREST
DEPUTY MEDICAL DIRECTOR shall at all times act in the COUNTY'S best interest.
Nothing in this Agreement shall be interpreted as preventing the DEPUTY MEDICAL
DIRECTOR from operating any other business or being similarly employed with any other
emergency medical service which is lawfully licensed by the COUNTY (within Collier County,
Florida) and the State. However the DEPUTY MEDICAL DIRECTOR shall not accept any
employment or enter into any contractual relationship which would create a conflict between
such interest and the performance of its duties hereunder. To that end,the DEPUTY MEDICAL
DIRECTOR shall promptly notify the COUNTY'S representative, in writing, by certified mail,
of all other prospective employment, business association, interest or other circumstance which
DEPUTY MEDICAL DIRECTOR plans to engage in throughout the term of this Agreement.
Such written notification shall identify the prospective business association, interest or
circumstance, the nature of work that the DEPUTY MEDICAL DIRECTOR may undertake and
request an opinion of the COUNTY as to whether the association, interest or circumstance
would, in the opinion of the COUNTY, constitute a conflict of interest if entered into by the
DEPUTY MEDICAL DIRECTOR. The COUNTY agrees to notify the DEPUTY MEDICAL
DIRECTOR of its opinion by certified mail within thirty (30) days of receipt of notification by
the DEPUTY MEDICAL DIRECTOR. If in the opinion of the COUNTY, the prospective
business association, interest or circumstance would not constitute a conflict of interest by the
DEPUTY MEDICAL DIRECTOR, the COUNTY will so state in the notification and the
DEPUTY MEDICAL DIRECTOR shall, at his option, enter into said association, interest or
circumstance and it shall be deemed not a conflict of interest with respect to services provided to
the COUNTY by the DEPUTY MEDICAL DIRECTOR under the terms of this Agreement.
Nothing in this Agreement shall be interpreted as preventing the DEPUTY MEDICAL
DIRECTOR, a contractual employee of the COUNTY, from being employed in any other
capacity, including, but not limited to the operation of a medical practice, the employment as a
staff member of any hospital, or the serving as a DEPUTY MEDICAL DIRECTOR for any other
emergency medical service which is lawfully licensed by the COUNTY(if located within Collier
County) and the State. Nor shall anything in this Agreement be interpreted as preventing the
DEPUTY MEDICAL DIRECTOR from continuing with any employment or other work in
which he was already engaged at the time this Agreement was entered, which employment or
work includes without limitation employment and work with Lee Memorial Hospital/Lee
Memorial Health System and the Neighborhood Clinic.
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ARTICLE 11—DISCLOSURE AND OWNERSHIP OF DOCUMENTS
The DEPUTY MEDICAL DIRECTOR shall deliver to the COUNTY'S representative
for approval and acceptance, and before being eligible for final payment of any amounts due, all
documents and materials prepared by and for the COUNTY under this Agreement.
The COUNTY and the DEPUTY MEDICAL DIRECTOR shall comply with the
provisions of Chapter 119, Florida Statutes (Public Records Law), HIPAA, HITECH, HIPAA
Regulations, and any other applicable law relating to records and/or confidentiality of records.
To that end, DEPUTY MEDICAL DIRECTOR shall execute the COUNTY's standard Business
Associate Agreement,
All covenants, agreements, representations and warranties made herein, or otherwise
made in writing by any party pursuant hereto, including but not limited to any representations
made herein relating to disclosure or ownership of documents, shall survive the execution and
delivery of this Agreement and the consummation of the transactions contemplated hereby.
ARTICLE 12—INDEPENDENT CONTRACTOR RELATIONSHIP
The DEPUTY MEDICAL DIRECTOR is, and shall be, in the performance of all work
services and activities under this Agreement, an Independent Contractor,and not an employee, or
servant of the COUNTY. The DEPUTY MEDICAL DIRECTOR and all back-up physicians
shall comply with all COUNTY policies concerning conduct and security when performing
services hereunder. The DEPUTY MEDICAL DIRECTOR does not have the power or authority
to bind the COUNTY in any promise, agreement, or representation other than specifically
provided for in this Agreement.
ARTICLE 13—LEGAL EXPENSES OF THE MEDICAL DIRECTOR
The. County agrees to reimburse the DEPUTY MEDICAL DIRECTOR for any
reasonable legal expenses and costs incurred by the DEPUTY MEDICAL DIRECTOR in the
performance of his duties as set forth herein, including without limitation any expenses and costs
associated with legal opinions or assistance needed in the interpretation, application and
compliance with statutes, ordinances and administrative regulations, e.g., Chapter 401, Chapter
119 and I.A.C. 64-J-1, and litigation expenses.
ARTICLE .14—ENFORCEMENT COSTS
If any legal action or other proceeding is brought for the enforcement of this Agreement,
or because of an alleged dispute, breach, default or misrepresentation in connection with any
provisions of this Agreement, each party shall bear its own attorney's fees and costs.
ARTICLE 15—AUTHORITY TO PRACTICE
The DEPUTY MEDICAL DIRECTOR hereby represents and warrants that he has and
will continue to maintain all licenses and approvals required to conduct his business, and that he
will at all times conduct his business activities in a reputable manner. Proof of such licenses and
approvals shall be submitted to the County Manager or designee upon request. The DEPUTY
MEDICAL DIRECTOR further represents and warrants that he will continue to maintain the
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requisite qualifications, knowledge and experience required of a medical director by Section
401.265, Florida Statutes and Rule 64J-1.004, F.A.C., and any other applicable laws and
regulations.
ARTICLE 16—SEVERABILITY
If any term or provisions of this Agreement, or the application thereof to any person or
circumstances shall, to any extent, be held invalid or unenforceable, the remainder of this
Agreement, or the application of such terms or provisions to persons or circumstances other than
those as to which it is held invalid or unenforceable, shall not be affected, and every other term
and provision of this Agreement shall be deemed valid and enforceable to the extent permitted
by law.
ARTICLE 17—ENTIRETY OF CONTRACTUAL AGREEMENT
The COUNTY and the DEPUTY MEDICAL DIRECTOR agree that this Agreement sets
forth the entire agreement between the parties, and that there are no promises or understandings
other than those stated herein. None of the provisions, terms and conditions contained in this
Agreement may be added to, modified, superseded or otherwise altered, except by written
instrument executed by the parties hereto.
ARTICLE 18—MODIFICATIONS OF WORK
The COUNTY reserves the right to make changes to Exhibit A Scope of Work, including
alterations, reductions therein or additions thereto. Upon receipt by the DEPUTY MEDICAL
DIRECTOR of the COUNTY'S notification of a contemplated change, the DEPUTY MEDICAL
DIRECTOR shall, in writing: (1)provide a detailed estimate for the increase or decrease in cost
due to the contemplated change, (2) notify the COUNTY of any estimated change in the
completion date, and (3) advise the COUNTY if the contemplated change shall affect the
DEPUTY MEDICAL DIRECTOR'S ability to meet the completion dates or schedules of this
Agreement.
If the COUNTY so instructs in writing, the DEPUTY MEDICAL DIRECTOR shall
suspend work on that portion of his duties affected by a contemplated change, pending the
COUNTY'S decision to proceed with the change.
If the COUNTY elects to make the change, the COUNTY shall initiate an Agreement
Amendment and the DEPUTY MEDICAL DIRECTOR shall not commence work on any such
change until such written amendment is signed by the DEPUTY MEDICAL DIRECTOR and
approved and executed by the COUNTY Board of County Commissioners.
ARTICLE .9—NOTICE
All notices required in this Agreement shall be sent by certified mail, return receipt requested,
and if sent to the COUNTY'S representative shall be mailed to:
Leo E. Ochs, Jr.,County Manager
3299 East Tamiami Trail, Suite 202
Naples, FL 34112
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And if sent to the DEPUTY MEDICAL DIRECTOR shall be mailed to:
Douglas S.Lee,M.D.
1635 Gordon River Lane
Naples,Florida 34104
ARTICLE 20-REGULATIONS; LICENSING REQUIREMENTS
The DEPUTY MEDICAL DIRECTOR shall comply with all laws, ordinances and
regulations applicable to the services contemplated herein,to include those applicable to conflict
of interest and collusion. DEPUTY MEDICAL DIRECTOR is presumed to be familiar with all
federal, state and local laws, ordinances, codes and regulations that may in any way affect the
services offered. DEPUTY MEDICAL DIRECTOR shall keep all required licenses and
corporate records current throughout the term of this Agreement, and shall on request provide
proof thereof.
IN WITNESS WHEREOF, the Board of County Commissioners of Collier County,
Florida, on behalf of the COUNTY, and the DEPUTY MEDICAL DIRECTOR has made and
ex.ecuted.this Agreement which shall become effective as of the 1$`day of February,2014.
ATT&f BOARD OF COUNTY COMMISSIONERS
I: W1 HT`E:JBR4CI(;G3erk COLLIER COUNTY,F RIDA
�� By: . 1., yA, By_ _
Ate` �i to-0,149011.:I ep '» " "-Tom HENNING,CHAI. • AN
signntute antyr
wITNF ES: L.--------'
Print Name: ik-At - 4 j`-'
By:
l tg ` " o'°`'.4" Douglas . Lee,M.D.
Print:Name: 51-4 2.A3G. C.0ia N‘1-1-\"/
Appr•- o''.rm and legality:
1 tom._._
Jeffre ' . . .i atzkow
County tt ey
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Exhibit A
Scope of Work
A. When the Medical Director is unavailable, the DEPUTY MEDICAL DIRECTOR must
attend the quarterly scheduled emergency medical services meeting where discussions will
involve patient care, quality, mandated Paramedic and EMT training, Paramedic
requirements, addition or deletion of equipment available to Paramedics and EMT's. Ample
notice for all such meetings will be supplied by the County Manager or designee.
13. Be available as back-up, as needed, during times when the Medical Director is absent due to
a scheduled vacation or personal emergency or schedule and ensure that an approved back-up
physician is available.
C. DEPUTY MEDICAL DIRECTOR shall ride as a crew member on an EMS vehicle a
minimum of ten (10) hours annually or as otherwise expressly required by state law to
evaluate the skills and maintain a working relationship with EMT's, assigned Paramedics,
and probationary Paramedics.
D. As part of the quality assurance committee, DEPUTY MEDICAL DIRECTOR shall assist
the COUNTY with obtaining patient outcome information from local hospitals.
E. DEPUTY MEDICAL DIRECTOR shall participate in regular Quality Assurance meetings
with Dispatch personnel.
F. DEPUTY MEDICAL DIRECTOR shall review and participate in the development of the
Dispatch Protocols followed by COUNTY EMS.
G. DEPUTY MEDICAL DIRECTOR shall participate in and direct EMS Advanced Cardiac
Life Support (ACLS) classes, and shall assist the County and EMS Chief in arranging
additional training to meet the needs of the community and the standards of care for the
industry. The DEPUTY MEDICAL DIRECTOR shall, Upon request of the County Manager
or designee, evaluate COUNTY EMTs and Paramedical personnel during training exercises.
DEPUTY MEDICAL DIRECTOR shall review and approve the content of EMS training for
medical correctness at the request of the County Manager or designee.
H. DEPUTY MEDICAL DIRECTOR shall be physically present in the COUNTY EMS
Administrative Offices on as needed basis; in order to confer with the EMS Chief and other
designated staff. All official meetings attended by the DEPUTY MEDICAL 'DIRECTOR
which have been approved by the EMS Chief, will be recognized as part of the normal job
duties of DEPUTY MEDICAL DIRECTOR.
I. In the absence of the Medical Director, and as required under Chapter 401,Florida Statutes,
and Chapter 64J-1, F.A.C., the DEPUTY MEDICAL DIRECTOR shall develop, review and
authorize use of ALS and BLS protocols which allow personnel to properly manage medical
emergencies. Such protocols shall be specific in nature and shall provide for managing
immediately life-threatening medical emergencies. In the absence of the Medical Director,
and as required by Section 401.265, Florida Statutes, and Rule 647-1.004, F.A.C, the
DEPUTY MEDICAL DIRECTOR shall also supervise and assume direct responsibility for
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the medical performance of all EMTs and paramedics operating for COUNTY EMS,
including both ground and aero medical personnel.
J. DEPUTY MEDICAL DIRECTOR shall assist the Medical Director in the supervision,
implementation and maintenance of a quality assurance program as required by Section
401.265, Florida Statutes and Rule 64J-1.004 F.A.C., to include spot-checking medical
reports for completion and correctness. The quality assurance program must cover dispatch,
field paramedics, E.MT's and Flight Medics.
K. DEPUTY MEDICAL DIRECTOR may review and provide written affirmation of
recertification training of COUNTY EMS EMT and Paramedic personnel in accordance with
Section 401.2715(3), Florida Statutes.
It is understood and agreed between the parties to this Agreement that all of the legal duties
and responsibilities of a medical director as set forth in Chapter 401, Florida Statutes, Rule
64J-1.004 F.:i.C., and any other applicable laws and regulations, shall remain with the
Medical Director at all times except during scheduled vacations or personal emergencies,
when the DEPUTY MEDICAL DIRECTOR or other approved back-up physician is
available pursuant to and in accordance with Article 3,Paragraph M.
L. Back-up physicians may be used in lieu of the Medical Director and/or DEPUTY MEDICAL
DIRECTOR upon approval of the County Manager or designee. Back-up physicians, when
used, shall meet all of the qualifications for a medical director as set forth in.Section 401.265,
Florida Statutes,and shall be at no additional cost to the COUNTY.
M. In the absence of the Medical Director, the DEPUTY MEDICAL DIRECTOR will
coordinate the provision of coverage at all times not available during the term of this
Agreement,during such times,backup coverage may include an approved back-up physician.
N. In support of the Medical Director, the DEPUTY MEDICAL DIRECTOR shall perform all
other services required of a medical director, and assume all legal duties and responsibilities
of a medical director, as provided by Section 401, Florida Statutes, Chapter 64J-1 F.A.C.,
and any other applicable laws and regulations, all as may be amended from time to time.
O. DEPUTY MEDICAL DIRECTOR shall be available for consultation with the Director of
Emergency Management during activations of the County's Emergency Operations Center or
eminent emergency situation to assist in a public health emergency, disaster, pandemic, or
mass medical event. Such efforts shall be in coordination with the Public Health Director and
not in conflict with public health statutory authority.
P. DEPUTY MEDICAL DIR.ECTO.R shall receive prior approval from the County Manager or
designee preceding any COUNTY communication with the media.
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