Agenda 04/26/2016 Item #16H 6 4/26/2016 16.H.6.
EXECUTIVE SUMMARY
Recommendation to consider requests from the County's Medical Director and Deputy Medical
Director for compensation modification pursuant to their respective contracts and the Interlocal
Agreement Between Collier County and the North Collier Fire Control and Rescue District.
OBJECTIVE: To maintain an exemplary pre-hospital emergency medical care system.
CONSIDERATIONS: The County's Medical Director and Deputy Medical Director provide EMS
medical direction under services contracts. Under the provisions of those contracts, Article 18 —
Modifications to Work states, in part,as follows:
"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 Medical Director/Deputy
Medical Director of the County's notification of a contemplated change, the Medical
Director/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 Medical Director's/Deputy Medical Director's ability to meet the completion
dates or schedules of this Agreement."
In accordance with this provision, the County Manager received a request (attached) for the below
modification as it relates to the duties and responsibilities of providing medical direction under the terms
of the recently approved Interlocal Agreement with North Collier Fire District.
Compensation for MEDICAL DIRECTOR:
$100,000 year one, $125,000 year two, $150,000 year three
Three year contract, renewable
Six month severance if County terminates without cause
Compensation for DEPUTY MEDICAL DIRECTOR:
$75,000 year one, $100,000 year two, $125,000 year three
Three year contract, renewable
Six month severance if County terminates without cause
The North Collier Fire District has endorsed this request(see letter attached).
As a point of reference,below is a compilation of the cost proposals received under the Request
for Proposals solicited in 2013.
Med Dir Deputy
Robert Tober, MD $ 75,000
James Augustine, MD $150,000
Richard Juda, MD $125,000 $125,000
Douglas Lee, MD $ 50,000
Jeffrey A Panozzo, DO $150,000 $100,000
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4/26/2016 16.H.6.
The Medical Director is currently serving the first of three potential one year renewal terms at the annual
rate of$81,529.80.
The Deputy Medical Director is currently serving the third year of an initial five-year term, with up to
three additional one-year renewal options at the annual rate of$54,600.
FISCAL IMPACT: The approximate impact of this modification is$220,000 over three years.
GROWTH MANAGEMENT IMPACT: There are no Growth Management Impacts associated with
this action.
LEGAL CONSIDERATIONS: In keeping with Dr Tober and Dr. Lee's request, the County Attorney
prepared proposed amendments to their respective agreements incorporating the requested changes, with
the exception that severance was reduced to the 20 week maximum allowed under Florida Statutes Sec.
215.425 which states in relevant part "On or after July 1, 2011, a unit of government that enters
into a contract or employment agreement, or renewal or renegotiation of an existing contract or
employment agreement, that contains a provision for severance pay with an officer, agent,
employee, or contractor must include the following provisions in the contract:
1. A requirement that severance pay provided may not exceed an amount greater than 20
weeks of compensation.
2. A prohibition of provision of severance pay when the officer, agent, employee, or
contractor has been fired for misconduct, as defined in s. 443.036(29) , by the unit of
government."
With that noted, this item is approved as to form and legality, and requires majority vote
for action. -JAK
RECOMMENDATION: That the Board of County Commissioners considers the compensation
modification request from the County Medical Director and Deputy Medical Director.
Prepared by: Len Golden Price,Administrative Services Department Head
Attachments:
1) Medical Director Agreement Renewal
2) Request for compensation modification
3) Letter North Collier FD
4) Medical Director Agreement-First Amendment
5) Deputy Medical Director-First Amendment
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.H.16.H.6.
Item Summary: Recommendation to consider requests from the County's Medical
Director and Deputy Medical Director for compensation modification pursuant to their
respective contracts and the Interlocal Agreement Between Collier County and the North Collier
Fire Control and Rescue District.
Meeting Date: 4/26/2016
Prepared By
Name: Bendisa Marku
Title: Operations Analyst, Senior,Administrative Services Department
4/19/2016 9:57:53 AM
Submitted by
Title: Operations Analyst, Senior,Administrative Services Department
Name: Bendisa Marku
4/19/2016 9:57:54 AM
Approved By
Name: Bendisa Marku
Title: Operations Analyst, Senior,Administrative Services Department
Date: 4/19/2016 10:20:44 AM
Name: PriceLen
Title:Department Head-Administrative Svc,Administrative Services Department
Date: 4/19/2016 12:55:39 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 4/19/2016 4:25:48 PM
Name: IsacksonMark
Title: Division Director-Corp Fin&Mgmt Svc, Office of Management&Budget
Date: 4/19/2016 5:06:03 PM
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4/26/2016 16.H.6.
Name: KlatzkowJeff
Title: County Attorney,
Date: 4/19/2016 5:08:20 PM
Name: CasalanguidaNick
Title: Deputy County Manager, County Managers Office
Date:4/19/2016 5:25:38 PM
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•
Administrative Services Department
Procurement Services Divisk)n
ber 22, 2015
Dr. Robert Boyd Tober, FACEP
2240 Southwinds Drive
Naples, FL 34102
FAX: 649-0343
/btmbarmd@yahoo.ccm •
RE: Contract Renewal for#13-G0B1 'Medical Director & Deputy Director"
Dear Dr. Tober:
Collier County would like to renew the above agreement under the same terms and conditions
for one (1) additional year in accordance wth the renewal clause in the agreement. This
renewal is contingent upon Pr jactManaQerapprova}.
|fyouare -"'-- please indicate your in��ntionsbyproviding the infnrn�g0onaurequested
beiow:
� anma0remab�to renewing the above ne�xenoe6contract under the
tmnm$erm*, conditions, and pricing as the existing contract. The
U tb provided fm���*/�n� ��e�hw� d�omr�omt�documentation ��nav � `
•
I am not agreeable to renewal of this contract.
By signature this contract will be in effect from January 28, 2016 until January 27, 2017.
Please take a moment,to review the Collier County Online Bidding System and refresh your
business profile information. Log into the County's site at: httolibid.ocria[govoet/bidt. select
My Profile and My Cornmodites, and review information and commothdes o ensure they
accurately reflect your businCss
"micr uxjo '/32' mr: " ~*~ ^4fi;~-= ' ' V•
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4/26/2016 16.H.6.
•
Page 2 of 2
RE: Contract Renewal for#13-6081 "Medical Director& Deputy Director'
Please return this letter to the Purchasing Department with your response at your earliest
convenience. If you have any questions you may contact Lissett De La Rosa at 239-252-6020,
email lissettuelarosanco`Iieraov.net or FAX 239-252-6592 or 239-732-0844.
Respectfully,
..iC,+ ?1.b1C MarkievVloZN . . <;..�`s/ `:
Director--• Procurement Sba\i:tces ..:.
Acceptance of contract Rent waf
Name of Company —
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April 15, 2016
Leo E. Ochs, Jr.,
County Manager
3299 East Tamiami Trail, Suite 202
Naples, FL 34112
Dear Mr. Ochs,
The recent settlement between the County and North Naples Fire District regarding the COPCN
and interlocal agreement, would represent a significant modification of work for both the
MEDICAL DIRECTOR and DEPUTY MEDICAL DIRECTOR. Per the requirements of Article
18- Modifications of Work, of the Medical Director and Deputy Medical Director Agreements-
this letter provides a detailed estimate of the expected increase in workload and cost for both the
MEDICAL DIRECTOR and DEPUTY MEDICAL DIRECTOR.
The citizens of Collier County deserve an exemplary pre-hospital care system. Medical direction
for such a diverse population requires a significant time and resource commitment on the part of
the physicians involved. Implementation of the stringent medical protocols, standards, training,
and certification/recertification requirements to the County-employed paramedics is a resource-
intensive task. Extending those standards to fire-based paramedics nearly doubles the number of
medical personnel under the supervision of the MEDICAL DIRECTOR and DEPUTY
MEDICAL DIRECTOR. Additionally, the interlocal agreement also mandates the supervision
of another physician, one who was not selected by the MEDICAL DIRECTOR and DEPUTY
MEDICAL DIRECTOR. These adjustments, along with the expansion in oversight of other fire
agencies, will translate into increased costs to the MEDICAL DIRECTOR/DEPUTY MEDICAL
DIRECTOR in the following ways:
1 Greatly increased liability and substantially increased workload requiring the need to re-
examine our malpractice exposure
2 Inability to utilize the CCEMS training staff as it relates to NNFD (per the Agreement)
3 Increased meetings with other fire agencies
4 Implementation of re-credentialing standards for NNFD by the Agreement
5 Need to develop a single patient care reporting system — something that does not currently
exist
6 Additional supervision and coordination of multiple fire agencies and EMS
7 Around the clock availability to provide direction and guidance to fire and EMS
These are just a few of the expanded requirements of the MEDICAL DIRECTOR and DEPUTY
MEDICAL DIRECTOR. Our commitment to providing the highest level of service to the public
will undoubtedly generate an increased workload with additional time constraints. We look
forward to taking on these challenges with the understanding that Collier County will provide the
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compensation necessary to implement these revisions.
We are asking the County for the following modifications to maintain and safeguard the integrity
of the positions of MEDICAL DIRECTOR and DEPUTY MEDICAL DIRECTOR:
Compensation for MEDICAL DIRECTOR:
$100,000 year one, $125,000 year two, $150,000 year three
Three year contract, renewable
Six month severance if County terminates without cause
Compensation for DEPUTY MEDICAL DIRECTOR:
$75,000 year one, $100,000 year two, $125,000 year three
Three year contract, renewable
Six month severance if County terminates without cause
If, either the MEDICAL DIRECTOR or ASSISTANT MEDICAL DIRECTOR is unable to
fulfill their role, and the full duties of medical direction fall on the other individual,the combined
compensation for both roles is paid to that remaining individual until a replacement can be
found.
We believe, these requests are more than reasonable in order to ensure that the MEDICAL
DIRECTOR and DEPUTY MEDICAL DIRECTOR can continue to advocate for the health of
the County's citizens.
Sincerely,
Robert Boyd Tober, M.D., FACEP
Medical Director, Collier County EMS
Douglas S. Lee, M.D., FACEP FAAEM
Deputy Medical Director, Collier County EMS
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NORTH COLLIER FIRE CONTROL AND RESCUE DISTRICT
BOARD OF FIRE COMMISSIONERS
Norman E. Feder,Chairman • Christopher L.Crossan,Vice Chairman • Margaret Hanson,Secretary-Treasurer
James Burke • Ramon E.Chao •Richard Hoffman • J.Christopher Lombardo • John O. McGowan
•
April 14, 2016
Donna Fiala,Commissioner, District 1
Collier County Board of Commissioners
3299 Tamiami Trail East, Suite 303
Naples, Florida 34112
Re: Increase in compensation for Dr. Robert Tober, Medical Director and Dr. Douglas Lee, Deputy
Medical Director
Dear Madam Chair:
The purpose of this letter is to request that the Board of Collier County Commissioners consider and
support an increase in compensation for Dr. Robert Tober, Medical Director,and Dr. Douglas Lee, Deputy
Medical Director.
Pursuant to the Interlocal Agreement dated March 23,2016,between the District and Collier County,both
doctors now serve as the District's Medical Director and Deputy Medical Director.
As such, they have taken on additional responsibilities that include training, quality assurance, and
medical guidance for the District's 200 EMTs and Paramedics. The additional responsibilities and
workload they have taken on should be acknowledged and compensated.
On behalf of the Board of Fire Commissioners of the North Collier Fire Control and Rescue Distict, I
respectfully request the Board of County Commission's full support and consideration of our
recommendation to increase the compensation for Dr.Tober and Dr. Lee.
With your support,we look forward to strengthening our existing resources and continuing to effectively
serve our community.
I look forward to your response. Thank you for your anticipated cooperation in this matter.
Respectfully,
72/
Norman E. Feder
Chairman, Board of Fire Commissioners
1885 Veterans Park Drive Naples, FL 34109•(239)597-3222• Fax(239)597-7082 r www.northcollierfire.com
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COLLIER COUNTY EMERGENCY SERVICES
MEDICAL DIRECTOR AGREEMENT
FIRST AMENDMENT
THIS AMENDMENT dated April 26, 2016, to the Collier County Emergency Services
Medical Director Agreement dated January 28, 2014 ("Agreement"), by and between ROBERT
BOYD TOBER, INC., hereinafter referred to as MEDICAL DIRECTOR, and COLLIER
COUNTY, FLORIDA,hereinafter referred to as the COUNTY.
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, ROBERT BOYD TOBER, M.D., 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 MEDICAL DIRECTOR are presently parties under a
Medical Director Agreement, a copy of which is set forth as Exhibit A, and wish to continue
their relationship under the terms and conditions set forth below;and
WHEREAS, on March 22, 2016, the COUNTY entered into an Interlocal Agreement
with the North Collier Fire Control and Rescue District ("District"), in which the MEDICAL
DIRECTOR was designated as the District's Medical Director; and
WHEREAS, the MEDICAL DIRECTOR has requested, and the Board of County
Commissioners agrees, to additional compensation and other modifications to the Agreement
resulting from these increased duties.
NOW THEREFORE, in consideration of the promises and mutual covenants hereinafter
set forth,the Agreement dated January 28,2014 between the parties is amended as follows:
ARTICLE 2 —SCHEDULE AND RENEWAL, is hereby amended so that the termination
date of the Agreement shall be April 26, 2019. Thereafter, the Agreement would be renewable
for three years on the same terms and conditions as set forth in the Agreement.
ARTICLE 3—SCOPE OF WORK, is hereby amended so that the MEDICAL DIRECTOR
shall assume the duties and responsibilities set forth in the March 22,2016 Interlocal Agreement
between the COUNTY and the North Collier Fire Control and Rescue District, a copy of which
is attached as Exhibit B.
ARTICLE 4 —PAYMENTS TO MEDICAL DIRECTOR, is hereby amended so that the
COUNTY shall pay to the MEDICAL DIRECTOR the sum of$100,000 per annum for the first
year, $125,000 for the second year, and $150,000 for the third year as full compensation for the
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services rendered herein and no other compensation. This change in compensation becomes
effective as of April 26,2016.
ARTICLE 6 — TERMINATION, is hereby amended so that the County shall pay the
MEDICAL DIRECTOR as severance damages a sum equal to 20 weeks salary if the termination
is without cause. In no event will this severance be paid if the MEDICAL DIRECTOR has been
fired for misconduct, as defined in Florida Statutes Sec. 443.036(29).
Except as specifically set forth herein, all other terms and conditions of the Agreement
remain in full force and effect.
IN WITNESS WHEREOF, the Board of County Commissioners of Collier County,
Florida, has made and executed this Amendment on behalf of the COUNTY and MEDICAL
DIRECTOR has hereunto set its hand the day and year above written.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK,Clerk COLLIER COUNTY,FLORIDA
By: By:
,Deputy Clerk DONNA FIALA,CHAIRMAN
WITNESSES: ROBERT BOYD TOBER,INC.
—
By: 50 eC7.00/i1 Ro bert Boyd Tober, sident
Print Name:
Print Name:
Approved as to form and legality:
Jeffrey A. Klatzkow,County Attorney
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EXHIBIT A 4/26/2016 16.H.6.
16K3
COLLIER COUNTY EMERGENCY SERVICES
MEDICAL DIRECTOR AGREEMENT
THIS. MEDICAL DIRECTOR AGREEMENT made this 2:2;Mr<day of
aexA-tucu , 2014, by and between ROBERT BOYD TOBER, INC., hereinafter
referred to asDICAL DIRECTOR, and COLLIER COUNTY, FLORIDA, hereinafter
referred to as the COUNTY.
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, ROBERT BOYD TOBER, M.D., 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 MEDICAL DIRECTOR are presently parties under a
Medical Consultant Contract, and wish to continue their relationship under 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-SERVICES
The MEDICAL DIRECTOR'S responsibility under this Agreement is to provide
professional services as 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 MEDICAL DIRECTOR shall commence services on the date first written above and
complete all services by two (2) years from 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 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.
ARTICLE 3—SCOPE OF WORK
This Agreement is personal to Dr. Tober, and as such the duties set forth herein cannot be
delegated or assigned except as expressly permitted by Chapter 401, Florida Statutes and
•
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Chapter 64-J-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 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.
ARTICLE 4—PAYMENTS TO MEDICAL DIRECTOR
The COUNTY shall pay to the MEDICAL DIRECTOR the sum of seventy-five thousand
($75,000) 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 MEDICAL DIRECTOR shall
not be eligible for any employee benefits other than this compensation. This sum shall be paid to
the MEDICAL DIRECTOR in twelve (12) equal monthly payments commencing with the
effective date of the Agreement,with each monthly payment being payable by the 101 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 employee, the MEDICAL
DIRECTOR'S base salary shall be modified to reflect the general wage adjustment granted to
other COUNTY employees. In addition,on each annual anniversary date during the term of this
Agreement, including any renewal terms,the 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 MEDICAL DIRECTOR shall report to the County Manager or designee for the
services as MEDICAL DIRECTOR as more specifically defined in this Exhibit A and as set
forth in Section 401.265,Florida Statutes.
The 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 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 MEDICAL DIRECTOR and the County Manager or designee and adopted prior to
October 1'of each year for implementation in the next year.
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:
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(a) 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) MEDICAL DIRECTOR violates law, ordinances,rules,regulations or any governmental
authority having jurisdiction;
(c) 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
$2,000,000 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 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 MEDICAL DIRECTOR,the Deputy Medical Director and 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.
D. The requirements contained herein are not intended to and shall not in any manner limit the
liabilities and obligations assumed by the 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.
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ARTICLE 10—CONFLICT OF INTEREST
MEDICAL DIRECTOR shall at all times act in the COUNTY'S best interest.Nothing in
this Agreement shall be interpreted as preventing the 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 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 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 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 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 MEDICAL DIRECTOR. The COUNTY agrees to notify the
MEDICAL DIRECTOR of its opinion by certified mail within thirty (30) days of receipt of
notification by the 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
MEDICAL DIRECTOR, the COUNTY will so state in the notification and the MEDICAL
DIRECTOR shall,at is 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
MEDICAL DIRECTOR under the terms of this Agreement.
Nothing in this Agreement shall be interpreted as preventing the 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 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 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 NCH,The Wound Care Center and The Neighborhood Clinic.
ARTICLE 11—DISCLOSURE AND OWNERSHIP OF DOCUMENTS
The 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 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,
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
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delivery of this Agreement and the consummation of the transactions contemplated hereby.
P Y
ARTICLE 12—INDEPENDENT CONTRACTOR RELATIONSHIP
The 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. All persons engaged in any of the work or services performed pursuant to this
Agreement shall at all times, and in all places, be subject to the MEDICAL DIRECTOR'S sole
direction, supervision,and control. The MEDICAL DIRECTOR shall exercise control over the
means and manner in which it and its employees, agents, subcontractors, Deputy Medical
Director and back-up physicians perform the work, and in all respects the MEDICAL
DIRECTOR'S relationship,and the relationship of its employees,agents,subcontractors,Deputy
Medical Director and back-up physicians, to the COUNTY shall be that of an Independent
Contractor and not as employees or agents of the COUNTY. The MEDICAL DIRECTOR, the
Deputy Medical Director and all back-up physicians shall comply with all COUNTY policies
concerning conduct and security when performing services hereunder. The 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 MEDICAL DIRECTOR for any reasonable legal
expenses and costs incurred by the MEDICAL DIRECTOR in the performance of his duties or
resulting from his holding of the Medical Director's position and title, including without
limitation 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 F.A.C.64 4-1,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 IS—AUTHORITY TO PRACTICE
The 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 of designee upon request. The MEDICAL
DIRECTOR further represents and warrants that he will continue to maintain the requisite
qualifications, knowledge and experience required of a medical director by Section 401.265,
Florida Statutes and Rule 643-1.004,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
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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 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 in the Medical Director's Exhibit A
Scope of Work, including alterations, reductions therein or additions thereto. Upon receipt by
the MEDICAL DIRECTOR of the COUNTY'S notification of a contemplated change, the
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 MEDICAL DIRECTOR'S ability to meet the completion dates or schedules of this
Agreement.
If the COUNTY so instructs in writing,the 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 MEDICAL DIRECTOR shall not commence work on any such change until
such written amendment is signed by the MEDICAL DIRECTOR and approved and executed by
the COUNTY Board of County Commissioners.
ARTICLE 19—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
And if sent to the MEDICAL DIRECTOR shall be mailed to:
ROBERT BOYD TOBER,INC.
Collier County Emergency Medical Services
8075 Lely Cultural Parkway,Suite 267
Naples,FL 34113
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ARTICLE 20-REGULATIONS;LICENSING REQUIREMENTS
i
The 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. 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.
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, has made and executed this Agreement on behalf of the COUNTY and MEDICAL
DIRECTOR has hereunto set its hand the day and year above written.
ATTEST: BOARD OF CO COMMISSIONERS
DWIGHT E.BROCK,Clerk COLLIER ' SUN , j LORIDA
By: gf,tekt; 4% " - t?C . B : 0 '1 -
AitO i.i�`��i.F' li`Deputy Clerk `0 M HENNING,C ,�,' •
sigtttl _-�
WITNESSiS:• '`` ROBERT BOYD TOBER,INC.
Print Name: Marj &at Mea4s
Ald,-_, deided_WZO- Ol..4.) By:
Robert Boyd Tober,Presid t `
Print N: ∎e:
r
App '44 0Vilii rL1and legality:
tab-all
Jeffrey A_r la I i' ow
County A it 1
Item* �
Agenda Date 1 -��t�
Date a_ao-ks-
Recd
t111
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Exhibit A
Scope of Work
A. Attend at least once quarterly a 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 meeting will be supplied by the County Manager or
designee.
B. Except during scheduled vacations or personal emergencies, when the Deputy Medical
Director or other approved back-up physician shall be available via radio or telephone
communication on a 24 hour a day, 7 day per week basis for on line medical control.
Notwithstanding anything to the contrary contained herein,MEDICAL DIRECTOR may use
reasonable discretion in determining the appropriateness of his response to calls.
C. 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, MEDICAL DIRECTOR shall assist the
COUNTY with obtaining patient outcome information from local hospitals.
E. MEDICAL DIRECTOR shall participate in regular Quality Assurance meetings with
Dispatch personnel.
F. MEDICAL DIRECTOR shall review and participate in the development of the Dispatch
Protocols followed by COUNTY EMS.
G. 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
MEDICAL DIRECTOR shall, upon request of the County Manager or designee, evaluate
COUNTY EMT's and Paramedical personnel during training exercises. MEDICAL
DIRECTOR shall review and approve the content of EMS training for medical correctness at
the request of the County Manager or designee.
H. 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 MEDICAL DIRECTOR which have been approved by
the EMS Chief, will be recognized as part of the normal job duties of MEDICAL
DIRECTOR.
I. As required under Chapter 401, Florida Statutes, and Chapter 64J-1, F.A.C., 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. As
required by Section 401.265, Florida Statutes, and Rule 64J-1.004, F.A.C, the MEDICAL
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DIRECTOR shall supervise and assume direct responsibility for the medical performance of
all EMT's and paramedics operating for COUNTY EMS, including both ground and aero
medical personnel. MEDICAL DIRECTOR shall develop any other protocols as required by
Chapter 401,Florida Statutes,or Chapter 64J-1,F.A.C.,as they may be amended from time
to time.
J. MEDICAL DIRECTOR shall supervise the 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,EMT's and Flight Medics.
K. MEDICAL DIRECTOR shall 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.A.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 shall
be available pursuant to and in accordance with Article 3,Paragraph M.
L. MEDICAL DIRECTOR shall provide the County Manager or designee with a quarterly
report generally describing activities performed, with reference to the requirements of this
Agreement. COUNTY shall provide administrative support in order for the MEDICAL
- DIRECTOR to meet the obligations of this paragraph. 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. 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 the
Deputy Medical Director or an approved back-up physician.
N. 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. 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. Medical Director shall receive prior approval from the County Manager or designee
preceding any COUNTY communication with the media.
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- INSTR 5243339 OR 5254 PG 803 RECORDED 3/24/2016 9:54 AM PAGES 10 4/26/2016 16.H.6.
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA
REC $86.50
EXHIBIT B
INTERLOCAL AGREEMENT
_
THIS INTERLOCAL AGREEMENT, dated this _ day of March, 2016, is entered
into as authorized by Ch. 163,Florida Statutes("Fla.Stat."),Intergovernmental Programs by and
between the North Collier Fire Control and Rescue District (hereinafter "District") and the
Collier County Board of County Commissioners(hereinafter"County").
WITNESSETH:
WHEREAS, Section 163.01, Fla. Stat., authorizes the joint exercise of any power,
privilege, or authority which the p , e •s '1... R• aerein share in common and which
each might exercise separately; :nH
WHEREAS, Distric fil d a 'aw it 1,inst t - Coun% i the litigation titled North
Collier Fire Control and Rescue D trict st ic' ' •I ,; o County Commissioners of
Collier County, Responde f II fendant (Case N.: 11-4115 tX 101871), pending in the
Twentieth Judicial Circuit in Col ounty,(hereinaft - - 4, . as the"Lawsuit");and
WHEREAS,the Parties ha - -n,._ , ' 1, , Fla. Stat., Governmental Dispute
C
process and have agreed to settle the litigation pursuant to the terms of this Interlocal Agreement
as specifically authorized by Sec. 164.1055(2), Fla. Stat., which provides for a joint public
meeting and mediation process;and
WHEREAS,District and the County,without either Party admitting any liability or fault,
desire to settle the Lawsuit and any and all disputes that arise from, relate or refer in any way,
whether directly or indirectly,known or unknown,to the incidents described or allegations made
in the Lawsuit;and
WHEREAS, District and the County desire to execute this Interlocal Agreement as
required by Sec. 164.1057, Fla. Stat., and so that it shall be binding upon them as well as their
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Oil 5254 PG 804 4/26/2016 16.H.6.
respective owners, principals, elected officials, officers, employees, ex-employees, agents,
attorneys,representatives,insurers,successors,assigns,and affiliates;and
NOW, THEREFORE, in consideration of the mutual covenants, promises and
consideration set forth in this Interlocal Agreement, and with the intent to be legally bound,
District and the County agree as follows:
i. District and the County adopt and incorporate the foregoing recitals, sometimes
referred to as"Whereas Clauses",by reference into this Interlocal Agreement.
2. The County shall iss gistroti ificate of public convenience and
necessity ("COPCN") to pro el' •vanced life sup S") non-transport services
throughout the boundaries of the •is .. t e i e Date .f t is Agreement subject to the
following terms and conditi ns:
a. The Distr c a ain e ' of " ..• ounty Medical Director to
serve as th ict's Medical Dire r: - =T1: 'er referred to as the County
Medical Direc .*P .,' Medic= 'ri '• by this Agreement with the
11E C
County for this service an. . ize the protocols and standards issued by
the County Medical Director/District Medical Director to govern the
provisions of advanced life support services authorized by the COPCN and
licensed by the State. There shall be no charge to the District for these
services. The District may employ an Associate Medical Director to assist the
District with the implementation of the protocols, standards, training, and
certification/recertification standards established by the County Medical
Director/District Medical Director relating to ALS services provided by the
District. The Associate Medical Director or any other medical professional
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dR 5254 PG 805 4/26/2016 16.H.6.
employee and/or volunteer of the District shall work under the supervision of
the County Medical Director/District Medical Director. It is acknowledged by
both Parties that the District does not, by this Agreement or any other
agreement or requirement, report to the Collier County Emergency Medical
Services ("EMS") Division or Collier County, and that all statutory and rule
requirements related to medical direction shall be made directly to the District
by the County Medical Director/District Medical Director. The County
Medical Director/U:2 u e'1 y 6. ctor and, if applicable, the Collier
County Dep � Director,ical Direct shaV�413,1y with the provisions of Ch.
119, Fla. to , t' - al ' Al e Po .•bil and Accountability Act
("HIPA• '), Ith i : i, •. fo Economic and Clinical
,r
Health re‘iik. , a • • • -:- fed —. .r .., . applicable laws relating to
records an•. •s" •nfdentiality of re-..d . yet at end, the County Medical
Director/Distric Vii' .1. Directs . •, • applicable, the Collier County
Deputy Medical Direc . , execute a HIPAA Business Associate
Agreement with the District. The County Medical Director/District Medical
Director may delegate any or all of his responsibilities under this Agreement
to the Collier County Deputy Medical Director.
b. The District shall operate under the emergency medical technicians("EMTs")
and paramedic credentialing and recredentialing standards issued by the
County Medical Director/District Medical Director, except, all current
credentialing shall be honored by the County Medical Director/District
Medical Director until December 31, 2017. The recredentialing standards
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used presently by the District shall remain in place through March 31, 2017.
The County Medical Director/District Medical Director shall develop, with
input from the District, the recredentialing standards for ALS non-transport
paramedics and EMTs on or before January 1,2017.
c. The District shall adhere to the paramedic and EMT credentialing and
recertification ride-time requirements as established by the County Medical
Director/District Medical Director. The District may meet its ride-time
requirements by ac n: .s.. •- t on the Collier County EMS ALS
transport fro • c- o hospital when V ot, service has been performed on
the patien pri• t. • 1 ans.o . `,wever, the oilier County EMS Chief,
District F re ( ;f a , e . fD n�. FJ i -ct. /District Medical Director
may iden p 'n .. ttin: •;etion—'. h+e time requirements. The
District a: -;42 •at any time a C. ' r EMS paramedic requests a
District parame• t, .• •mtan . ,.z: ''',. .n the Collier County EMS ALS
V
transport from scene to o •'Y -gardless of the level of service,the District
paramedic shall accompany the patient to the hospital.
d. The District shall have its own quality assurance program for District
paramedics and EMTs as established by the County Medical Director/District
Medical Director.The District's quality assurance program shall solely consist
of the County Medical Director/District Medical Director, the District's
Associate Medical Director and District staff. The District shall also
participate in a countywide Quality Assurance Committee as established by
the County Medical Director/District Medical Director, contingent upon all
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interested parties entering into a written mutually agreeable business associate
agreement to ensure compliance with the HIPAA requirements and any other
federal or state applicable laws.
e. The District shall adhere to the patient care reporting system requirements that
allows for view only access to patient care reports. The District will provide
to Collier County a one-user login account to a view only patient care report
dashboard of the District's Patient Care Reporting System to be used for
continuum of car � 'g r y .uality assurance and performance
benchmarkin L"' er County will p•i0. • the District a one-user login
account to a v e : pa - . : repo das board of Collier County's
Patient C.re ' -••rti : y e i • „ -• T•onti uum of care fora patient,
ul
quality . .a , , d • • - be ':r = The Parties agree that it
shall contr. .ccess and use to ST,, ' •,t rec.re reports. The District will
provide login • 01 . e Distri ' ' Care Reporting System to the
County Medical Direc • '-
Medical Director, with such access
protected from disclosure by the County Medical Director/District Medical
Director. Both Parties will work cooperatively to ensure that any necessary
third party providers,such as hospitals and emergency rooms,have view only
access to the District's patient care reports. The Parties will also work
cooperatively to implement a single consolidated patient care reporting system
as soon as practicable. The Parties shall use their best efforts to negotiate and
enter into any agreements that may be necessary to meet any and all lawful
requirements,including those related to HIPAA.
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3. This Interlocal Agreement shall take effect upon execution by the Parties
("Effective Date"). The term of the COPCN and this Interlocal Agreement shall be effective
through March 31,2017.
4. Should the District be found to have breached the terms of this Interlocal
Agreement or the COPCN in any way, all written complaints shall be investigated by both the
County staff and the District staff, and a report thereon made to both the Board of County
Commissioners and the District Board of Fire Commissioners, together with findings and
recommendations,within 15 days of s • a r lo!- ination of the Interlocal Agreement
or revocation, suspension or alt . of the COPCN ap at arranted, the Board of County
Commissioners shall give n• ice o :)•<-s'stric same wil be considered at a specific
commission meeting,provided •- r,at; .f t u : ,r 7:t be 1 s than five days from the
date of the notice. The Boa .11 .. y . i .',ers ". "h ..n consider the complaint
and either revoke or suspe 'c�'�;�•e COPCN, termI' 'e ��--rlocal Agreement, suggest
alternatives to the COPCN, or di A-,. r,: .m.lai i. , 1 standing,this procedure shall be
CIE _1gC
held in compliance with the County's COP • a . •nce No. 04-12, § 14,as amended.
5. Should the County or the County Medical Director/District Medical Director be
found to have breached the terms of this Interlocal Agreement or the COPCN in any way, all
written complaints shall be investigated by both the County staff and the District staff, and a
report thereon made to both the Board of County Commissioners and the District Board of Fire
Commissioners,together with findings and recommendations,within 15 days of such complaint.
If termination of the Interlocal Agreement or alteration of the COPCN or the Interlocal
Agreement appears warranted, the District shall give notice to the County that the same will be
considered at a specific commission meeting,provided the date of such meeting shall not be less
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than five days from the date of notice. The District Board of Fire Commissioners shall
thereupon consider the complaint and either terminate the Interlocal Agreement or suggest
alternatives to the COPCN or the Interlocal Agreement.
6. In consideration of the resolution of all disputes or claims arising from or
referring or relating in any way,whether directly or indirectly,to the Lawsuit,the District agrees
to dismiss the Lawsuit with prejudice.
7. In consideration of the resolution of the Lawsuit, and for other good and valuable
consideration,the receipt and adequa ,pf� h e• • acknowledged, the Parties, on behalf
of themselves, their attorneys, gin� r, representatives, in refs, heirs, successors and assigns,
hereby expressly releases a d f. ev ' har:- eac •ther, a. w- I as their elected officials,
officers, employees, ex-ernpl•, - •.e is I •, -,Ts.nta Ives, successors, assigns,
insurers and affiliates from; an. all c aims, •-i,an•s, cau:4 actions, damages, costs,
attorney's fees, expenses an
***.
ations of any ki' o .t9 whatsoever that they have
asserted or could have asserted in , • - ' •m or relate or refer in any way,
IrE CII-
whether directly or indirectly, to the Lawsuit or any incident, event or allegation referred to or
made in the Lawsuit.
8. Notwithstanding anything that may be to the contrary in this Interlocal
Agreement, District and the County agree that either of them (as well as any other persons or
entities intended to be bound) shall, in the event of any breach, retain the right to enforce the
terms and conditions of this Interlocal Agreement.
9. District and the County acknowledge and agree that this Interlocal Agreement is
intended to and shall be binding upon their respective owners, principals, officials, officers,
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•
employees, ex-employees, agents, attorneys, representatives, insurers, successors, assigns, and
affiliates.
10. District and the County recognize and acknowledge that this Interlocal Agreement
memorializes and states a settlement of disputed claims and nothing in this Interlocal Agreement
shall be construed to be an admission of any kind, whether of fault, liability, or of a particular
policy or procedure,on the part of either District or the County.
11. District and the County acknowledge and agree that this Interlocal Agreement is
the product of mutual negotiation an. -I:l.t tfO -.iguous language or provision in this
•
Agreement to be construed ag. y Party based up.. . :im that the Party drafted the
ambiguous provision or 1. gua:e t e was i en• d to be benefited by the
ambiguous provision or lan_uag•
O
12. This Interlo.n∎ : - en :y . ame-• . ." by a written instrument
specifically referring to thi 'CC T. ement and exec-11-4 • • e same formalities as this
Agreement. 0-C)'
7I-IE GIRC
13. In the event of an alleged • -. is Interlocal Agreement, District and the
County agree that all underlying causes of action or claims of District related to the September 8,
2015 denial of the District's COPCN, have been extinguished by this Agreement and that the
sole remedy for breach of this Agreement shall be for specific performance of its terms and
conditions or any damages arising from the breach. In this regard, District and the County
further agree that the sole venue for any such action shall be in the Twentieth Judicial Circuit in
and for Collier County,Florida in Naples, Florida.
14. This Interlocal Agreement shall be governed by the laws of the State of Florida.
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' OR 5254 PG 811 4/26/2016 16.H.6.
15. Either the County or District may terminate this Interlocal Agreement after
providing written notice of its intent to terminate at least thirty(30)days in advance of the date
of termination. The District's COPCN is revoked on the termination date of this Interlocal
Agreement without further action by the County. This Interlocal Agreement shall automatically
terminate if the District is notified by the Florida Department of Health that its license to provide
ALS service has been revoked under Ch. 401, Fla. Stat., and associated rules. Upon receipt of
such notification,the District shall inform the County in writing.
16. This Interlocal Agreem-- .t* ee r :::reement titled "Interlocal Agreement Al
Advanced Life Support Partne p etween Collier C.. 0-.. d Big Corkscrew Island Fire
Control and Rescue District" •ate ,,- 5, I '.
17. Prior to its e i ecf,- ess, i to 1 _ i,.n, sha I be filed with the Clerk of
Courts for the Circuit Cou • • ler •. t •''suan' • 63.01 (2), Fla. Stat.. The
County shall file said agree C 4 soon as practica a e,T)! oval and execution by both
parties. 1-
IN WITNESS WHEREOF, Dis n and the County have signed and sealed this
Interlocal Agreement as set forth below.
Date: aids + 11,
ATTEST: -,,:, ' `,7.;;r;,) BOARD OF COUNTY COMMISSIONERS
DWIGIyT'1;.BROCK,gierk COLLIER COUNTY,FLORIDA
By: t...• .1.9;4..
.1.: 'w i4.a By �-ri-16--/ c eit.
' �1 lw'.V% erk DONNA FIALA,CHAIRMAN '5Viz.Xmb
Appro I,, ,• o'rni and legality:
1a1 A
Jeffrey 1."Q'FI! ow
County I .• ,$ ey
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°** OR 5254 PG 812 *** 4/26/2016 16.H.6.
1
By: 1. ,A •
North Col,er Fire Control and Rescue District
DISTRICT
G
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EXHIBIT A
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 -SERVICES
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 64-J-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 10th 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 1.)IRECTOR 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 1$1 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
$2,000,000 each occurrence combined single limit
Coverage is afforded to the MEDICAL DIRECTOR and DEPUTY MEDIC.A.L
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 he 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. 64-1-1,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 19—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 he 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
executed,this Agreement which shall become effective as of the 1"day of February,2014.•ATTl f: . . BOARD OF COUNTY COMMISSIONERS
DWIGHT.E BROCK;Clerk COLLIER COUNTY,F 1 RIDA
`. - /
By:; .. ,,j `..,:: By. /AA
Atte sata Oha • lei) Actin*" TOM KENNING,CHAP,•AN•
signature ai y,
WITNF ES �,,r- ''
Print Name: tual- 0,-- OP
By:
2 t tgs,ici .�G, `ACIA -` -"-''7' Douglas . Lee,M.D.
Print Name: E 2A$C. N 01J N 1—‘1
Appr. i 'fir. '•rm and legality:
1111!:
Jeffre • , it-rkow
County tto .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.
EI. 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.
1. In the absence of the Medical Director, and as required under Chapter 401, Florida Statutes,
and Chapter 64J-1. FA.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 he 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 64J-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 EivlTs 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, EMT'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
643-1.004 F.A.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.
0. 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 DIRECTO.R shall receive prior approval from the County Manager or
designee preceding any COUNTY communication with the media.
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INSTR 5243339 OR 5254 PG 803 RECORDED 3/24/2016 9:54 AM PAGES 10 4/26/2016 16.H.6.
DWIGHT E. BROOK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA
REC $86.50
EXHIBIT B
INTERLOCAL AGREEMENT
THIS INTERLOCAL AGREEMENT, dated this og day of March, 2016, is entered
into as authorized by Ch. 163,Florida Statutes("Fla.Stat."),Intergovernmental Programs by and
between the North Collier Fire Control and Rescue District (hereinafter "District") and the
Collier County Board of County Commissioners(hereinafter"County").
WITNESSETH:
WHEREAS, Section 163.01, Fla. Stat., authorizes the joint exercise of any power,
privilege, or authority which the p ; e 't y: R'. =• .erein share in common and which
Q 1)„,
each might exercise separately;
WHEREAS, Distric fil:d a -aw 't •:.inst t Coun'. i the litigation titled North
Collier Fire Control and Re•cue a trict sic '1111 '� ` "7o-a d o County Commissioners of
Collier County, Responde r r fendant (Case N•. I I,t 15 t 101871), pending in the
•
Twentieth Judicial Circuit in , - ounty,(hereinafter - - • as the"Lawsuit");and
0 `S
WHEREAS, the Parties ha,- n' -• 'C t. . Fla. Stat., Governmental Dispute
process and have agreed to settle the litigation pursuant to the terms of this Interlocal Agreement
as specifically authorized by Sec. 164.1055(2), Fla. Stat., which provides for a joint public
meeting and mediation process;and
WHEREAS,District and the County,without either Party admitting any liability or fault,
desire to settle the Lawsuit and any and all disputes that arise from, relate or refer in any way,
whether directly or indirectly,known or unknown,to the incidents described or allegations made
in the Lawsuit;and
WHEREAS, District and the County desire to execute this Interlocal Agreement as
required by Sec. 164.1057, Fla. Stat., and so that it shall be binding upon them as well as their
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o1R 5254 PG 804 4/26/2016 16.H.6.
respective owners, principals, elected officials, officers, employees, ex-employees, agents,
attorneys,representatives,insurers,successors,assigns,and affiliates;and
NOW, THEREFORE, in consideration of the mutual covenants, promises and
consideration set forth in this Interlocal Agreement, and with the intent to be legally bound,
District and the County agree as follows:
1. District and the County adopt and incorporate the foregoing recitals, sometimes
referred to as"Whereas Clauses",by reference into this Interlocal Agreement.
2. The County shall iss - litsteittyti ifcate of public convenience and
At
necessity ("COPCN") to pro d, vanced life sup.. • S") non-transport services
throughout the boundaries of the b is—=-• t e • i e Date .f t is Agreement subject to the
following terms and conditicns: ?iv
t
a. The Dist Qs air e • � of � { ounty Medical Director to
serve as tht �ict's Medical Direr :T 'er referred to as the County
Medical Direc .*► ., Medic: + r- '► by this Agreement with the
CIE IR
County for this service an. • ' 1 ize the protocols and standards issued by
the County Medical Director/District Medical Director to govern the
provisions of advanced life support services authorized by the COPCN and
licensed by the State. There shall be no charge to the District for these
services. The District may employ an Associate Medical Director to assist the
District with the implementation of the protocols, standards, training, and
certification/recertification standards established by the County Medical
Director/District Medical Director relating to ALS services provided by the
District. The Associate Medical Director or any other medical professional
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dR 5254 PG 805 4/26/2016 16.H.6.
1
employee and/or volunteer of the District shall work under the supervision of
the County Medical Director/District Medical Director. It is acknowledged by
both Parties that the District does not, by this Agreement or any other
agreement or requirement, report to the Collier County Emergency Medical
Services ("EMS") Division or Collier County, and that all statutory and rule
requirements related to medical direction shall be made directly to the District
by the County Medical Director/District Medical Director. The County
Medical Director/D.: kotitite y i tor and, if applicable, the Collier
County Dep iv
A.• teal Director, sha T*sly with the provisions of Ch.
119, Fla. tat, t. al • .t- e Po :bil y and Accountability Act
("HIPA. '), c 1th : i� - it T fo Economic and Clinical
1• F+
Health rep ' , : • . fed- •r . • applicable laws relating to
records an., .^ •.nfidentiality of r'' d . et at end, the County Medical
Director/Distri 4111'' .1.. Direct. ,Le • applicable, the Collier County
HE IR
Deputy Medical Direc I , execute a HIPAA Business Associate
Agreement with the District. The County Medical Director/District Medical
Director may delegate any or all of his responsibilities under this Agreement
to the Collier County Deputy Medical Director.
b. The District shall operate under the emergency medical technicians("EMTs")
and paramedic credentialing and recredentialing standards issued by the
County Medical Director/District Medical Director, except, all current
credentialing shall be honored by the County Medical Director/District
Medical Director until December 31, 2017. The recredentialing standards
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used presently by the District shall remain in place through March 31, 2017.
The County Medical Director/District Medical Director shall develop, with
input from the District, the recredentialing standards for ALS non-transport
paramedics and EMTs on or before January 1,2017.
c. The District shall adhere to the paramedic and EMT credentialing and
recertification ride-time requirements as established by the County Medical
Director/District Medical Director. The District may meet its ride-time
requirements by ac .‘'4 An: • *� t on the Collier County EMS ALS
transport fro o hospital when�: Qt' service has been performed on
iii
the patien pri. t. • 1 :ns•o . ' .wever, the oilier County EMS Chief,
District F re t :f a e • 1.11910 : -as /District Medical Director
may iden i'i n itin: • 7.tion . -h'e time requirements. The
_j—
District a: t a t any time a C r • ®y EMS paramedic requests a
District parame.A* . .an : x ``S.n the Collier County EMS ALS
HE 'TR
transport from scene to o •'r -gardless of the level of service,the District
paramedic shall accompany the patient to the hospital.
d. The District shall have its own quality assurance program for District
paramedics and EMTs as established by the County Medical Director/District
Medical Director.The District's quality assurance program shall solely consist
of the County Medical Director/District Medical Director, the District's
Associate Medical Director and District staff. The District shall also
participate in a countywide Quality Assurance Committee as established by
the County Medical Director/District Medical Director, contingent upon all
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interested parties entering into a written mutually agreeable business associate
agreement to ensure compliance with the HIPAA requirements and any other
federal or state applicable laws.
e. The District shall adhere to the patient care reporting system requirements that
allows for view only access to patient care reports. The District will provide
to Collier County a one-user login account to a view only patient care report
dashboard of the District's Patient Care Reporting System to be used for
continuum of car- '• R le" • ality assurance and performance
L
benchmarkin!. iv: er County will p • ile. • the District a one-user login
account t• a e -• pa . ; repo das board of Collier County's
Patient C.re t •p•rti• : y e , • ,T•ont' uum of care for a patient,
I. r
quality as. a , .1 d • • • be yi The Parties agree that it
shall contr• •ccess and use to s� •:t. ttf .re reports. The District will
C
provide login . AP-. : e Distri ' '. Care Reporting System to the
County Medical Direc • ': Medical Director, with such access
protected from disclosure by the County Medical Director/District Medical
Director. Both Parties will work cooperatively to ensure that any necessary
third party providers,such as hospitals and emergency rooms,have view only
access to the District's patient care reports. The Parties will also work
cooperatively to implement a single consolidated patient care reporting system
as soon as practicable. The Parties shall use their best efforts to negotiate and
enter into any agreements that may be necessary to meet any and all lawful
requirements, including those related to HIPAA.
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• OR 5254 PG 808 4/26/2016 16.H.6.
3. This Interlocal Agreement shall take effect upon execution by the Parties
("Effective Date"). The term of the COPCN and this Interlocal Agreement shall be effective
through March 31,2017.
4. Should the District be found to have breached the terms of this Interlocal
Agreement or the COPCN in any way, all written complaints shall be investigated by both the
County staff and the District staff, and a report thereon made to both the Board of County
Commissioners and the District Board of Fire Commissioners, together with findings and
recommendations,within 15 days of s • . t la ct t' - ination of the Interlocal Agreement
or revocation, suspension or alt, - �. of the`C_OPCN ap•-ak-• arranted, the Board of County
Commissioners shall give n• ice o same wil be considered at a specific
commission meeting,provi•ed - at- •f u - Tt be 1-ss than five days from the
t. •.•
date of the notice. The Boa • •' •. ty •. i .'ers -,+r.0•on consider the complaint
and either revoke or suspe 1- •e COPCN, term • e -rlocal Agreement, suggest
alternatives to the COPCN, or di ,''•, t•: om•lai 6 standing, this procedure shall be
iHfE 'IRL
held in compliance with the County's COP , • .nce No.04-12, § 14,as amended.
5. Should the County or the County Medical Director/District Medical Director be
found to have breached the terms of this Interlocal Agreement or the COPCN in any way, all
written complaints shall be investigated by both the County staff and the District staff, and a
report thereon made to both the Board of County Commissioners and the District Board of Fire
Commissioners,together with findings and recommendations,within 15 days of such complaint.
If termination of the Interlocal Agreement or alteration of the COPCN or the Interlocal
Agreement appears warranted, the District shall give notice to the County that the same will be
considered at a specific commission meeting,provided the date of such meeting shall not be less
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• OR 5254 PG 809 4/26/2016 16.H.6.
than five days from the date of notice. The District Board of Fire Commissioners shall
thereupon consider the complaint and either terminate the Interlocal Agreement or suggest
alternatives to the COPCN or the Interlocal Agreement.
6. In consideration of the resolution of all disputes or claims arising from or
referring or relating in any way,whether directly or indirectly,to the Lawsuit,the District agrees
to dismiss the Lawsuit with prejudice.
7. In consideration of the resolution of the Lawsuit,and for other good and valuable
consideration, the receipt and adequa t ►ems acknowledged, the Parties,on behalf
of themselves, their attorneys, :l ' 1, representatives, in firs, heirs, successors and assigns,
hereby expressly releases a d f• ev har, eac ether, a w: I as their elected officials,
officers, employees, ex-e pl., :e t , s=nta Lives, successors, assigns,
insurers and affiliates from n an. all c arms, • *Lan•s, cau.ey f actions, damages, costs,
attorney's fees, expenses an• ations of any ki' o ,e9 whatsoever that they have
asserted or could have asserted in A • •m or relate or refer in any way,
E CIi
whether directly or indirectly, to the Lawsuit or any incident, event or allegation referred to or
made in the Lawsuit.
8. Notwithstanding anything that may be to the contrary in this Interlocal
Agreement, District and the County agree that either of them (as well as any other persons or
entities intended to be bound) shall, in the event of any breach, retain the right to enforce the
terms and conditions of this Interlocal Agreement.
9. District and the County acknowledge and agree that this Interlocal Agreement is
intended to and shall be binding upon their respective owners, principals, officials, officers,
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• OR 5254 PG 810 4/26/2016 16.H.6.
employees, ex-employees, agents, attorneys, representatives, insurers, successors, assigns, and
affiliates.
10. District and the County recognize and acknowledge that this Interlocal Agreement
memorializes and states a settlement of disputed claims and nothing in this Interlocal Agreement
shall be construed to be an admission of any kind, whether of fault, liability, or of a particular
policy or procedure,on the part of either District or the County.
11. District and the County acknowledge and agree that this Interlocal Agreement is
the product of mutual negotiation an. -• ;,•tftf o � guous language or provision in this
Agreement to be construed ag: y Party based up•, :im that the Party drafted the
ambiguous provision or la gua.e t e •• was i en' d to be benefited by the
ambiguous provision or Ian:uag;
l'
12. This Interlo•n :. en :y • `ame" •plr by a written instrument
.3
specifically referring to thi " -ement and exec.l-* • • 'e same formalities as this
Agreement. gp 1, "0'
CIE CI
13. In the event of an alleged • • is Interlocal Agreement, District and the
County agree that all underlying causes of action or claims of District related to the September 8,
2015 denial of the District's COPCN, have been extinguished by this Agreement and that the
sole remedy for breach of this Agreement shall be for specific performance of its terms and
conditions or any damages arising from the breach. In this regard, District and the County
further agree that the sole venue for any such action shall be in the Twentieth Judicial Circuit in
and for Collier County,Florida in Naples,Florida.
14. This Interlocal Agreement shall be governed by the laws of the State of Florida.
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oR 5254 PG 811 4/26/2016 16.H.6.
15. Either the County or District may terminate this Interlocal Agreement after
providing written notice of its intent to terminate at least thirty (30)days in advance of the date
of termination. The District's COPCN is revoked on the termination date of this Interlocal
Agreement without further action by the County. This Interlocal Agreement shall automatically
terminate if the District is notified by the Florida Department of Health that its license to provide
ALS service has been revoked under Ch. 401, Fla. Stat., and associated rules. Upon receipt of
such notification,the District shall inform the County in writing.
16. This interlocal Agreem wiltee reement titled "Interlocal Agreement
L Al
Advanced Life Support Partne• ill, etween Collier C.. . d Big Corkscrew Island Fire
Control and Rescue District" •ate, I-- 5, 1 ..
17. Prior to its a mt. a es , i I t 1. 1,n, sha 1 be filed with the Clerk of
Courts for the Circuit Cou ier '.' t ..` uan'.. „H 63.01 (2), Fla. Stat.. The
County shall file said agree : soon as practice a e oval and execution by both
parties. �� + S� CJ
4/E C3.RC'V
IN WITNESS WHEREOF, District and the County have signed and sealed this
Interlocal Agreement as set forth below.
Date: filitakl2eZ10140
ATTEST: - `.:;?t,, BOARD OF COUNTY COMMISSIONERS
DWIGI T'E.B OCK,e,Jerk COLLIER COUNTY,FLORIDA
Q' 'BY: .. .r, i .:*., By: �,■ erk DONNA FIALA,CHAIRMAN 3\Z2..\.`k...
Oi Appro .[�. of iii and legality:
Aligi 'i
Jeffrey r' "l1! ow
County 1,1 . I ey
Page 9 of 10
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• ' 1** OR 5254 PG 812 *** 4/26/2016 16.H.6.
By. 1
North Col er Fire Control and Rescue District
DISTRICT
Cpl ?'
(.2 CC °
y
1I1E, CII'S)
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