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Agenda 03/25/2014 Item #16E7 3/25/2014 16.E.7. EXECUTIVE SUMMARY Recommendation to approve and authorize the Chairman to execute an Interlocal Agreement for an Advanced Life Support Partnership between Collier County and the Big Corkscrew Island Fire Control and Rescue District. OBJECTIVE: To provide quality and cost effective fire rescue and emergency medical services to the residents of the Big Corkscrew District and Collier County. CONSIDERATIONS: In accordance with the Board's direction at their January 28, 2014 regular meeting to enhance emergency medical services and response time, enhancements to the County's partnership with the Big Corkscrew Fire District were proposed. The Agreement attached to this item provides for Big Corkscrew District firefighter/paramedics or Firefighter/ Emergency Medical Technicians to work and train with a County paramedic/firefighter with ALS and/or basic life support EMT duties and for a County Paramedic/Firefighter to work and train on a Big Corkscrew Fire-Rescue unit providing Firefighting and Paramedic duties. FISCAL IMPACT: The FY14 cost to add personnel for 24 hour coverage is $132,200. Recurring costs in future years is approximately $265,000 plus any budgeted salary and/or benefits increases. LEGAL CONSIDERATIONS: The Agreement is substantially identical to the recent Board approved ALS Interlocal agreements with exception that paragraphs related to District personnel working on County apparatus were removed because that is not the proposed arrangement. This item has been approved for form and legality and requires a majority vote. -JAB GROWTH MANAGEMENT IMPACT: None. RECOMMENDATION: That the Board of County Commissioners approves and authorizes the Chairman to execute an Interlocal Agreement for an Advanced Life Support Partnership between Collier County and the Big Corkscrew Island Fire Control. Prepared By: Maria Franco, Administrative Assistant,Emergency Medical Services Attachments: Interlocal Agreement Packet Page -1356- 3/25/2014 16.E.7. COLLIER COUNTY Board of County Commissioners Item Number: 16.16.E.16.E.7. Item Summary: Recommendation to approve and authorize the Chairman to execute an Interlocal Agreement for an Advanced Life Support Partnership between Collier County and the Big Corkscrew Island Fire Control and Rescue District. Meeting Date: 3/25/2014 Prepared By Name: FrancoMaria Title: Administrative Assistant,EMS Operations 3/12/2014 10:22:40 AM Approved By Name: KopkaWalter Title: Chief-Emergency Medical Services,EMS Operations Date: 3/12/2014 10:44:51 AM Name: SummersDan Title: Director-Bureau of Emergency Services,Bureau of Emergency Services Date: 3/12/2014 12:04:53 PM Name: PriceLen Title: Administrator-Administrative Services,Administrative Services Division Date: 3/12/2014 3:05:32 PM Name: PriceLen Title: Administrator-Administrative Services, Administrative Services Division Date: 3/12/2014 5:41:52 PM Name: BelpedioJennifer Title: Assistant County Attorney, CAO General Services Date: 3/13/2014 2:24:52 PM Name: KlatzkowJeff Title: County Attorney, Date: 3/13/2014 3:14:36 PM Packet Page-1357- 3/25/2014 16.E.7. Name:PryorCheryl Title: Management/Budget Analyst, Senior, Office of Management&Budget Date: 3/13/2014 4:27:23 PM Name: OchsLeo Title: County Manager, County Managers Office Date: 3/14/2014 4:08:49 PM Packet Page-1358- 3/25/2014 16.E.7. INTERLOCAL AGREEMENT ADVANCED LIFE SUPPORT PARTNERSHIP BETWEEN COLLIER COUNTY AND BIG CORKSCREW ISLAND FIRE CONTROL AND RESCUE DISTRICT THIS INTERLOCAL AGREEMENT, made and entered into this 25'h day of March 2014, by and between the Collier County, a political subdivision of the State of Florida, (hereinafter "COUNTY") and the BIG CORKSCREW ISLAND FIRE CONTROL AND RESCUE DISTRICT, an Independent Special District of the County of Collier, State of Florida, created under Chapter 61-2032, Laws of Florida, and Chapter 191, Florida Statutes, (hereinafter "BIG CORKSCREW"). PURPOSE The purpose of this Interlocal Agreement is to provide quality and cost effective fire rescue and emergency medical services to the persons residing within the boundaries of BIG CORKSCREW district and Collier County. The recognition and utilization of existing and future personnel skills, qualifications and resources is in the interest and benefit of both agencies and the public we serve. WITNESSETH WHEREAS, BIG CORKSCREW and COUNTY seek to enhance emergency service further through a continued partnership; and WHEREAS, this Agreement provides for an Advanced Life Support (hereinafter "ALS") partnership where a BIG CORKSCREW Firefighter/Paramedic or a Firefighter/Emergency Medical Technician will work and train with a COUNTY Paramedic/Firefighter with ALS and/or basic life support EMT duties; and WHEREAS, the ALS partnership also provides for a COUNTY Paramedic/Firefighter to work and train on a BIG CORKSCREW Fire-Rescue unit providing firefighting and paramedic duties; and WHEREAS, BIG CORKSCREW and COUNTY work cooperatively to assure appropriate response of sufficient emergency medical resources, NOW, THEREFORE, In consideration of the above premises, and the mutual covenants, terms, and provisions contained herein,the COUNTY and BIG CORKSCREW agree as follows: SECTION I: DEFINITIONS 1.1 ALS means treatment of life-threatening medical emergencies through the use of techniques such as endotracheal intubation, the administration of drugs or intravenous fluids, cardiac monitoring, and cardiac defibrillation by a qualified person, pursuant to rules of the COUNTY Medical Director(hereinafter"OMD"). 1.2 BLS "Basic life support"means treatment of medical emergencies by a qualified person through the use of techniques such as patient assessment, cardiopulmonary resuscitation (CPR), splinting, obstetrical assistance, bandaging, administration of oxygen, application of medical Packet Page-1359- Page 1 of 9 3/25/2014 16.E.7. antishock trousers, administration of a subcutaneous injection using a premeasured auto injector of epinephrine to a person suffering an anaphylactic reaction, and other techniques described in the Emergency Medical Technician Basic Training Course Curriculum of the United States Department of Transportation. The term "basic life support" also includes other techniques which have been approved and are performed under conditions specified by rules of the department or the OMD. 1.3 BCC refers to the Collier County Board of Commissioners. 1.4 OA/OI means Quality Assurance/ Quality Improvement which is the Medical Director approved program which assesses and monitors the medical performance of Paramedics and Emergency Medical Technicians. 1.5 PCR means the Patient Care Record which chronicles the medical treatment of the patient. 1.6 Permitted means a non-transporting ALS fire apparatus and rapid response vehicle operating under the ALS license issued to COUNTY Emergency Medical Services Department (hereinafter "EMS")for the purpose of enhancing 911 medical responses. 1.7 Non-Permitted refers to any response vehicle that is not required by State Statute to be licensed,but is authorized by the OMD. 1.8 OMD refers to the Collier County Office of the Medical Director. ,SECTION II: COUNTY'S RESPONSIBILITY The following specific services, duties, and responsibilities will be the obligation of the COUNTY: 2.1 The COUNTY will provide through the County's Emergency Medical Services (EMS) Department and the OMD; medical direction, medical protocols, training and quality assurance on a countywide basis. 2.2 The COUNTY, as a licensed provider of advanced life support under Chapter 401, Fla. Stat. and Chapter 64J, Fla.Admin. Code, will permit a minimum of one (1), BIG CORKSCREW fire apparatus or response vehicles as non-transporting ALS vehicle(s) under the COUNTY EMS license for the purpose of enhancing 911 medical responses. 2.3 The COUNTY will permit additional vehicles as non-transporting ALS vehicles, as identified in 2.2 and mutually agreed upon, under the COUNTY EMS license during the term of this Interlocal Agreement. 2.4 The COUNTY EMS Department will provide one (1) Paramedic/Firefighter to BIG CORKSCREW 365 days per year, 24 hours per day to be utilized on fire apparatus vehicle(s) located in BIG CORKSCREW and permitted as an ALS non transporting unit under the Board of County Commissioner's authority pursuant to Chapter 401, Fla. Stat. and Chapter 64J, Fla. Admin. Code. These unit(s) will be designated within the County Sheriffs Office Computer Aided Dispatch (CAD) program to automatically respond to medical incidents with, or in place of, an ALS transport unit committed to a previous medical, rescue or fire operation in accordance with the COUNTY's Emergency Medical Dispatch protocol as an emergency medical response and/or fire suppression vehicle. 2.5 Pursuant to Chapter 401, Fla. Stat. and Chapter 64J, Fla Admin. Code, BIG CORKSCREW may operate any of their permitted and/or non- permitted ALS vehicles or apparatus as a BLS responder when a paramedic does not staff the vehicle. Packet Page -1360- Page 2 of 9 (2) 3/25/2014 16.E.7. 2.6 The COUNTY will maintain all medical run reports in an OMD approved records system and will handle them in a manner consistent with County operating guidelines, Federal, and State laws. 2.7 The COUNTY shall be responsible for providing and replacing expendable medical supplies and for the cost of repair and maintenance of all ALS equipment supplied by the COUNTY. SECTION III: BIG CORKSCREW'S RESPONSIBILITY The following specific services, duties, and responsibilities will be the obligation of BIG CORKSCREW: 3.1 BIG CORKSCREW will provide through BIG CORKSCREW Fire Rescue District; Incident Command, incident safety direction, fire rescue standard operating guidelines and training on a regional basis. 3.2 BIG CORKSCREW will ensure all BIG CORKSCREW personnel providing medical care maintain all state and federally required licensure. Records shall be maintained by BIG CORKSCREW and available to the COUNTY upon request. SECTION IV:MUTUAL CONVENANTS 4.1 The COUNTY and BIG CORKSCREW will provide each other's department employees' similar training and internship programs as would be provided for a COUNTY or BIG CORKSCREW employed Firefighter/Paramedic or Firefighter/EMT. 4.2 Necessary qualifications for both BIG CORKSCREW and COUNTY Firefighter/Paramedics will be cooperatively developed and defined within the ALS Operational Plan. 4.3 The COUNTY and BIG CORKSCREW will work cooperatively to identify and request appropriate grants in order to improve the operations and service capabilities of both departments. 4.4 The operational decision to change the location of either apparatus assignment may be changed by mutual written consent between the Chief of BIG CORKSCREW or his/ her designee and COUNTY's County Manager or his/her designee(e.g. Chief of EMS). 4.5 NOTIFICATION OF EXPOSURE TO INFECTIOUS DISEASES: In the event that Collier County EMS Department is notified of an exposure to infectious disease, EMS shall notify BIG CORKSCREW Infectious Control Officer so they may take appropriate action. Upon notification, the treatment procedures shall be the responsibility of BIG CORKSCREW In the event that BIG CORKSCREW is notified of an exposure to infectious disease, BIG CORKSCREW shall notify the EMS Infectious Control Officer or Battalion Chief 82 so they may take appropriate action. SECTION V: OPERATING PROCEDURES 5.1 The COUNTY EMS Department Paramedic/Firefighters will meet the same requirements and perform under the same fire specialized response protocols, standard operating procedures and chain of command as employees of BIG CORKSCREW. 5.2 The ALS Operational Plan, Attachment A, may be revised by mutual written consent between Packet Page-1361- Page 3 of 9 3/25/2014 16.E.7. the Chief of the BIG CORKSCREW Fire Rescue and COUNTY's County Manager or his designee (e.g. Chief of EMS). Such revisions must not conflict with the terms and standards set forth in this Agreement. 5.3 BIG CORKSCREW and COUNTY EMS will recognize the respective ranks and abilities of assigned personnel. 5.4 All discipline and investigations leading to discipline will be handled by the respective employing agency. 5.5 BIG CORKSCREW and COUNTY will utilize Command Staff and assets for logistical, support, and operational needs for national, state and local emergencies. 5.6 The State of Florida recognized Incident Management System (1MS) is the standard for emergency operations. BIG CORKSCREW shall assume command and control of all incidents where BIG CORKSCREW is the Authority Having Jurisdiction. In all instances where BIG CORKSCREW has established command, COUNTY EMS shall assume responsibility for, and be in charge of, patient care. 5.7 The COUNTY and BIG CORKSCREW will share statistical data. SECTION VI:RESOLUTION OF CONFLICTS 6.1 If the two governing entities' standard operating procedures, chain of command or any other unforeseen circumstances come into conflict, issues will immediately be decided in the following manner; 1. First and foremost by the medical needs of the patient and responder safety. 2. The COUNTY will have jurisdiction of medical issues concerning appropriate patient care. 3. BIG CORKSCREW will have jurisdiction of fire/rescue issues concerning operations and safety. 4. Conflicts involving patient care issues will be resolved through a QA/QI process. 5. Should conflicts arise that are irresolvable, the chain of command within each department will come together in an attempt to resolve those issues at the equivalent levels of each department and in unison move up the chain of command as necessary. ,SECTION VII:AGREEMENT TERM 7.1 The Interlocal Agreement shall remain in full force and effect from the date first above written and shall terminate after written notice of termination. 7.2 This Interlocal Agreement shall be reviewed and renegotiated as necessary after three (3) years. Absent termination or amendment to this Interlocal Agreement, the term of this Interlocal Agreement will automatically renew in (3) three year periods. Nothing within this Agreement shall preclude review and amendment of any provision within the three (3) year period or successive renewal periods when such amendment is mutually agreed to in writing by the COUNTY and BIG CORKSCREW. 7.3 Either the COUNTY or BIG CORKSCREW may terminate this Interlocal Agreement after providing written notice of its intent to terminate at least ninety (90) days in advance of the date Packet Page-1362- Page 4 of 9 3/25/2014 16.E.7. of termination. In the event that the COUNTY determines that the BIG CORKSCREW failure to fulfill any of the obligations under this Agreement adversely affects or may adversely affect the medical needs of the patient and/or responder safety, EMS may provide written notice to BIG CORKSCREW of its intent to recommend that the BCC terminate this Agreement. BCC consideration of termination of this Agreement must occur at the next available regular meeting of the BCC. Advance notice of the BCC meeting date and agenda item must be provided to the Medical Director and BIG CORKSCREW. Unless otherwise determined by the BCC at the meeting, the notice of intent to recommend that the BCC terminate this Agreement shall be deemed to be fully sufficient and to have commenced the (90) ninety day notice period. In the alternative, the BCC at the meeting may, after receiving information from the Medical Director and BIG CORKSCREW, terminate this Agreement without further action or notice to BIG CORKSCREW. Nothing in this Agreement shall limit the authority of the Medical Director as set forth in the Florida Statutes and the Florida Administrative Code. In the event that the DISTRICT's Fire Chief determines that EMS failure to fulfill any of the obligations under this Agreement adversely affects or may adversely affect the needs of the BIG CORKSCREW citizens and/or responder safety, BIG CORKSCREW may provide written notice to COLLIER COUNTY of its intent to recommend that the Big Corkscrew Board of Fire Commissioners (hereinafter `BCIFR") terminate this Agreement. BCIFR consideration of termination of this Agreement must occur at the next available regular meeting of the BCIFR. Advance notice of the BCIFR meeting date and agenda item must be provided to the EMS Chief and Collier County. Unless otherwise determined by the BCIFR at the meeting, the notice of intent to recommend that the BCIFR terminate this Agreement shall be deemed to be fully sufficient and to have commenced the (90) ninety day notice period. In the alternative, the BCIFR at the meeting may, after receiving information from the Fire Chief and BCIFR, terminate this Agreement without further action or notice to COLTER COUNTY. Nothing in this Agreement shall limit the authority of the Fire Chief as set forth in the Florida Statutes and the Florida Administrative Code. 7.4 The terminating party must also provide the non-terminating party's representatives with an opportunity to consult with the terminating party's representatives regarding the reason(s) for termination during the notice periods provided in Section 7 of this Agreement. SECTION VIII: INSURANCE 8.1 BIG CORKSCREW and COUNTY shall maintain insurance in the minimum amounts and types required by Florida State Statutes. 8.2 BIG CORKSCREW and COUNTY agree that either party may be self-insured on the condition that all self-insurance must comply with all State laws and regulations and must meet with the approval of the other party to this Interlocal Agreement. 8.3 To the extent permitted by law and as limited by and pursuant to the provisions of Florida Statutes, Section 768.28, BIG CORKSCREW and COUNTY agree to hold harmless the other, their employees and agents against any and all claims and/or damages by or behalf of any person, employee or legal entity arising from their respective negligent acts pursuant to this agreement that allows employees of the other to occupy and ride in each other's vehicles. Nothing is intended to alter either party's immunity in tort or otherwise impose liability on BIG CORKSCREW or the COUNTY when it would not otherwise be responsible. Packet Page-1363- Page 5 of 9 3/25/2014 16.E.7. SECTION IX: MISCELLANEOUS 9.1 This Interlocal Agreement shall be governed by and construed under the laws of the State of Florida. In the event any litigation is instituted by way of construction or enforcement of the Interlocal Agreement, the party prevailing in said litigation shall be entitled to collect and recover from the opposite party all court costs and other expenses, including reasonable Attorney's fees. 9.2 It is understood that this Interlocal Agreement must be executed by both parties prior to BIG CORKSCREW and COUNTY commencing with the work, services, duties and responsibilities described heretofore. 9.3 Prior to its effectiveness, this Interlocal Agreement and any subsequent amendments shall be filed with the Clerk of Courts for the Circuit Court for Collier County pursuant to Section 163.01 (2), Fla Stat. The COUNTY shall file said agreement as soon as practicable after approval and execution by both parties. IN WITNESS WHEREOF, the parties hereto have caused this Interlocal Agreement to be executed by their appropriate officials, as of the date first above written. ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E.BROCK, CLERK COLLIER COUNTY, FLORIDA BY: , Deputy Clerk Tom Henning, Chairman Approved as to form and legality k Jennifer A. Belpedio Assistant County Attorney 3!t 3 I r`t ATTEST: BIG CORKSCREW FIRE CONTROL AND RESCUE DISTRICT BY: /::02: Packet Page -1364- Page 6 of 9 3/25/2014 16.E.7. ATTACHMENT A COLLIER COUNTY EMERGENCY MEDICAL SERVICES I FIRE DEPARTMENT AND BIG CORKSCREW FIRE CONTROL AND RESCUE DISTRICT ALS OPERATIONAL PLAN REFERENCE: ALS Program Interlocal Agreement, v 2 014 PURPOSE: To provide quality and cost effective fire rescue and emergency medical services to the residents of BIG CORKSCREW and Collier County (COUNTY). The recognition and utilization of existing and future personnel skills, qualifications and resources is in the interest and benefit of both agencies and the public we serve. I. QUALIFICATION REQUIREMENTS a. COUNTY Paramedic/Firefighters utilized on designated fire apparatus must maintain the following valid and current qualifications: i. Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards(Firefighter II); ii. Florida Bureau of Emergency Medical services and Community Health Resources Paramedic Certification; iii. Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter 64J; iv. Collier County OMD Paramedic credentialing; v. Collier County Fire Chiefs' Association Firefighter Cross Training Certification. b. At least one BIG CORKSCREW Firefighter utilized on permitted BIG CORKSCREW ALS apparatus or vehicle must maintain the following valid and current qualifications; i. Florida Bureau of Emergency Medical services and Community Health Resources Emergency Medical Technician (EMT) or Paramedic Certification and; II. SCHEDULING AND POSITION ASSIGNMENTS i. The COUNTY Battalion Chief 82 and BIG CORKSCREW Captain 10 (or designee) will consult openly in order to assure continuity and efficiency. ii. The COUNTY will continuously provide BIG CORKSCREW with one [1] COUNTY Paramedic/Firefighter as qualified within Section I. a. for use on a Packet Page-1365- Page 7 of 9 3/25/2014 16.E.7. designated ALS apparatus or vehicle. iii. Program participants will participate in appropriate on-duty training, station duties and unit assignments in accordance with assignment and rank. iv. It is recognized by COUNTY and BIG CORKSCREW that harmonious and productive relationships between all personnel are necessary. Teamwork and cooperation is encouraged and expected. v. Applicable COUNTY and/or BIG CORKSCREW policies, practices, procedures, standard operating guidelines, general orders, protocols and/or applicable Bargaining Unit Contract language will be observed. III. COMMUNICATION AND DISPATCH a. COUNTY and BIG CORKSCREW staff will assure all personnel operate on the appropriate radio frequency, unit identifier dispatch and zone coverage protocol in accordance with Computer Aided Dispatch (CAD) and the CCFCA Communications Manual Designated assignments are outlined as follows: i. Medical Director approved Emergency Medical Dispatch (EMD) Models shall be designed to assure the initial response of appropriate ALS permitted apparatus. ii. COUNTY and BIG CORKSCREW chief officers will utilize available BIG CORKSCREW permitted resources to assure ALS coverage is continuously maintained within BIG CORKSCREW. iii. If requested, COUNTY and BIG CORKSCREW chief officers will assure permitted ALS assets will respond to out-of-district emergencies or coverage. b. Applicable COUNTY and/or BIG CORKSCREW policies, practices, procedures, standard operating guidelines, general orders, protocols and/or applicable Bargaining Unit Contract language will be observed. IV. DOCUMENTATION Before the end of shift, an accurate and complete OMD approved electronic report (E- PCR) will be transmitted for each patient contact 100% of the time by the COUNTY paramedic/ firefighter. All medical procedures performed by the personnel assigned to the response will be fully documented. ii. Prior to 0900hrs, or as call volume permits, the BIG CORKSCREW Lieutenant with a carbon copy to Captain 10 or designee must fax or email a complete ALS Staffing Report to Battalion Chief 80's office. If staffing changes are made during the shift, an updated report will be provided to Battalion Chief 80 prior to or at the end of shift to reflect staffing changes. Battalion Chief 80 will provide a complete EMS Staffing report to the BIG CORKSCREW Lieutenant's office with a carbon copy to Captain 10. V. QUALITY ASSURANCE Patient care concerns may be found outside of report monitoring and may be reported by either agency or allied personnel such as hospital staff, deputies, etc. Concerns should be made in writing to a QA Committee member via the Quality Assurance Review Form whenever possible and including pertinent specific details. Packet Page-1366- Page 8 of 9 3/25/2014 16.E.7. ii. The OMD will review all potential malpractices and make recommendations for follow up with call participants and future treatment or training guidelines. Feedback will be provided to both the complainant and the treating paramedic by the QA committee upon the resolution of the issue. VI. TRAINING i. BIG CORKSCREW personnel are allowed to attend EMS sponsored in-service training classes. ii. If requested by BIG CORKSCREW the COUNTY Paramedic/Firefighter(s) may instruct BIG CORKSCREW firefighter paramedics or EMTs Medical Director approved in- services,certifications,classes,etc.utilizing preapproved curriculum iii. Any curriculum taught by the COUNTY Paramedic/Firefighter(s)must be submitted with a complete student roster to the OMD in order to qualify for COUNTY accreditation. In addition, EMS Paramedic/Firefighter will accurately record continuing education hours of any personnel completing their training and provide those records to the COUNTY on the conclusion of training. iv. BIG CORKSCREW will provide to the COUNTY appropriate approved fire training documentation for recognized State approved fire classes. Packet Page -1367- Page 9 of 9 3/25/2014 16.E.7. Packet Page-1368-