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Agenda 11/12/2013 Item #16E11EXECUTIVE SUMMARY Recommendation to approve and authorize the Chairwoman Agreement for an Advanced Life Support Partnership between East Naples Fire Control and Rescue District. 11 /12/2013 16. E.11. to execute an Interlocal Collier County and the OBJECTIVE: To provide quality and cost effective fire rescue and emergency medical services to the residents of the East Naples District and Collier County. CONSIDERATION: In an effort to enhance emergency medical services through a continued partnership between Collier County and the East Naples Fire Control and Rescue District, this Agreement allows for East Naples District Firefighter/Paramedics or Firefighter/ Emergency Medical Technicians to work and train on a County Advanced Life Support Transport Unit providing Paramedic/Firefighter duties and/or basic life support EMT duties. In addition provides for a County Paramedic/Firefighter to work and train on an East Naples Fire Rescue unit providing Firefighter and Paramedic duties. FISCAL IMPACT: There is no Fiscal Impact associated with this action. LEGAL CONSIDERATIONS: This item has been approved as to form and legality and requires majority vote for approval. -CMG GROWTH MANAGEMENT IMPACT: None. RECOMMENDATION: That the Board of County Commissioners approves the Interlocal Agreement between Collier County and the East Naples Fire Control and Rescue District for an Advanced Life Support Partnership and authorizes the Chairwoman to execute the Agreement. PREPARED BY: Maria Franco, Administrative Assistant, Emergency Medical Services — Admin. Attachment: Interlocal Agreement Packet Page - 2935 -. 11 /12/2013 16. E.11. ^ COLLIER COUNTY Board of County Commissioners Item Number: 16.16.E.16.E.11. Item Summary: Recommendation to approve and authorize the Chairwoman to execute an Interlocal Agreement for an Advanced Life Support Partnership between Collier County and the East Naples Fire Control and Rescue District. Meeting Date: 11/12/2013 Prepared By Name: FrancoMaria Title: Administrative Assistant, EMS 10/21/2013 9:34:15 AM Approved By Name: KopkaWalter ^ Date: 10/21/2013 10:17:19 AM Name: pochopinpat Title: Administrative Assistant,Facilities Management Date: 10/21/2013 11:01:23 AM Name: SummersDan Title: Director - Bureau of Emergency Services, Date: 10/22/2013 6:24:28 AM Name: GreeneColleen Title: Assistant County Attorney,County Attorney Date: 10/22/2013 10:28:58 AM Name: PriceLen Title: Administrator, Administrative Services Date: 10/24/2013 10:38:08 AM Name: KlatzkowJeff Title: County Attorney Date: 10/24/2013 3:33:53 PM Packet Page -2936- Name: PryorCheryl Title: Management/ Budget Analyst, Senior,Office of Manag Date: 10/28/2013 1:54:37 PM Name: OchsLeo Title: County Manager Date: 11/2/2013 9:54:56 AM Packet Page -2937- 11/12/2013 16. E.11. 11 /12/2013 16. E.11. INTERLOCAL AGREEMENT n ADVANCED LIFE SUPPORT PARTNERSHIP BETWEEN COLLIER COUNTY AND EAST NAPLES FIRE CONTROL AND RESCUE DISTRICT THIS INTERLOCAL AGREEMENT, made and entered into this day of 2013, by and between the Board of County Commissioners, Collier County, Florida, a political subdivision of the State of Florida, (hereinafter "COUNTY ") and the EAST NAPLES 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 its successors, (hereinafter "EAST NAPLES "). PURPOSE The purpose of this Interlocal Agreement is to provide quality and cost effective fire rescue and emergency medical services to the residents of the EAST NAPLES 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, EAST NAPLES and COUNTY seek to enhance emergency service further through a continued partnership; and WHEREAS, the Advanced Life Support (hereinafter "ALS ") partnership provides for an EAST NAPLES Firefighter/Paramedic or a Firefighter/ Emergency Medical Technician to work and train n on a COUNTY Advanced Life Support Transport Unit providing Paramedic/Firefighter duties and /or basic life support EMT duties; and WHEREAS, The ALS partnership provides for a COUNTY Paramedic/Firefighter to work and train on an EAST NAPLES Fire- Rescue unit providing firefighting and paramedic duties; and WHEREAS, EAST NAPLES 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 EAST NAPLES 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 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. Page i of li Packet Page -2938- 11/12/2013 16. E.11. 1.3 FTO means a Field Training Officer; a certified paramedic recognized by the OMD as having sufficient skill and experience to train and direct medical providers in working under the approved medical protocols. 1.4 OA/ ()I 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 MOU refers to a Memorandum of Understanding between agencies. 1.7 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. 1.8 Non- licensed refers to any response vehicle that is not required by State Statute to be licensed, but is authorized by the OMD. 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 will maintain at least one (1) ALS transport unit staffed by EAST NAPLES and the COUNTY under the Board of Commissioners' authority pursuant to the current Chapter 401. Fla. Stat. and Chapter 64J, Fla. Admin. Code at EAST NAPLES Station 23 as a first -due apparatus on all medical, rescue and fire incidents. 2.3 The COUNTY, as a licensed provider of advanced life support under Chapter 401, Fla. Slat. and Chapter 64J, Fla. Admin. Code, will license a minimum of two (2), EAST NAPLES fire apparatus or response vehicles as non - transporting ALS vehicle(s) under the COUNTY EMS license for the purpose of enhancing 911 medical responses. 2.4 The COUNTY will license additional vehicles as non - transporting ALS vehicles, as identified in 2.3 and mutually agreed upon, under the COUNTY EMS license during the term of this Interlocal Agreement. 2.5 The COUNTY EMS Department will provide one (1) Paramedic/Firefighter to EAST NAPLES 365 days per year, 24 hours per day to be utilized on fire apparatus vehicle(s) located at EAST NAPLES Station 23 and licensed 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. Pursuant to Chapter 401, Fla Stat. and Chapter 64J, Fla. Admin. Code, EAST NAPLES may operate any of their licensed and/or non - licensed ALS vehicles or apparatus as a BLS responder when a paramedic does not staff the vehicle. Packet Page -2939- Page 2 of ii E) 11/12/2013 16.E.11. SECTION III: EAST NAPLES' RESPONSIBILITY A*—,*, The following specific services, duties, and responsibilities will be the obligation of EAST NAPLES: 3.1 EAST NAPLES will provide through EAST NAPLES' Fire Rescue Department; Incident Command, incident safety direction, fire rescue standard operating guidelines and training on a regional basis. 3.2 EAST NAPLES will maintain a minimum of two (2) ALS apparatus, permitted by the COUNTY, as referenced in Section 2.3. 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. 3.3 EAST NAPLES will comply with medical protocol, equipment standards, and will fully participate in medical training and quality assurance programs in accord with the COUNTY. 3.4 EAST NAPLES 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. 3.5 EAST NAPLES will ensure all EAST NAPLES personnel providing medical care maintain all state and federally required licensure. Records shall be maintained by EAST NAPLES and available to the COUNTY upon request. 3.6 EAST NAPLES will provide one (1) Firefighter/Paramedic or Firefighter/ Emergency Medical Technician to the COUNTY 365 days per year, 24 hours per day to be utilized on the ALS transport unit assigned to COUNTY Station 23. 3.7 EAST NAPLES will provide at least one liaison as an Emergency Medical Care Coordinator (hereinafter "EMCC "), approved by the OMD to function as a Training Officer / Supervisor n for EAST NAPLES Paramedic and EMT training. The EMCC shall work with COUNTY EMS Training staff to enhance the BLS and First Responder Program by assisting in teaching per the annual published in- service schedule. If the EAST NAPLES cannot logistically attend ESC training, they may teach OMD approved curriculum at remote sites provided: • The OMD approved EMCC attends all in- service classes taught at the ESC in order to insure the training liaison is kept up to date on protocol changes, trends in local treatment, case reviews, etc. and can more effectively communicate the material in context to their agency's personnel. • The EMCC use only curriculum pre- approved by the OMD for medical training. In the case of regularly scheduled County in- service, the approved curriculum will be provided the month after the conclusion of scheduled in- services at ESC. 3.8 EAST NAPLES will designate an OMD approved representative as a Quality Assurance member to participate in Quality Assurance. 3.9 EAST NAPLES may provide additional non - licensed ALS vehicles when paramedic staffing permits. 3.10 EAST NAPLES may provide additional medical equipment and advanced service with the approval of the COUNTY. 3.11 EAST NAPLES shall be responsible for replacing expendable medical supplies and for the cost of repair and maintenance of all ALS equipment supplied by the COUNTY, not on County staffed vehicles. 9 Packet Page -2940- Page 3 of 11 11/12/2013 16. E.11. SECTION IV: MUTUAL CONVENANTS 4.1 The COUNTY and EAST NAPLES will provide each other's department employees similar training and internship programs as would be provided for a COUNTY or EAST NAPLES employed Firefighter/Paramedic or Firefighter/EMT. 4.2 Necessary qualifications for both E A S T NAPLES and COUNTY firefighter /paramedics will be cooperatively developed and defined within the ALS Operational Plan, and OMD's Paramedic Qualification/Certification Matrix. 4.3 The COUNTY and EAST NAPLES 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 EAST NAPLES or his designee and COUNTY's County Manager or his 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 EAST NAPLES Infectious Control Officer or EMCC so they may take appropriate action. Upon notification, the treatment procedures shall be the responsibility of EAST NAPLES In the event that EAST NAPLES is notified of an exposure to infectious disease, the EAST NAPLES shall notify the EMS Infectious Control Officer or EMSCOMM so they may take appropriate action. 5.1 EAST NAPLES Firefighter/Pararnedics and Firefighter/ Emergency Medical Technicians will meet the same requirements and perform at the appropriate medical protocol as defined by the OMD, standard operating procedures, quality assurance program, general orders and chain of command as employees of the COUNTY EMS Department. 5.2 EAST NAPLES Firefighter/Paramedics shall be certified to perform as ALS Engine Paramedics under current medical protocol. The COUNTY EMS Medical Director shall regularly evaluate the skills of EAST NAPLES Paramedics for consideration of expanding the medical protocol under which they perform. 5.3 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 EAST NAPLES. 5.4 The ALS Operational Plan, Attachment A, may be revised by mutual written consent between the Chief of the East Naples 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. 5.5 Licensed and non - licensed ALS vehicles, programs personnel or details may be developed and implemented by joint agreement and in cooperation between EAST NAPLES and COUNTY. Such resources may not conflict with the standards set forth in this agreement. 5.6 EAST NAPLES and COUNTY EMS will recognize the respective ranks and abilities o f a s s i g n e d personnel. 5.7 All discipline and investigations leading to discipline will be handled by the respective employing agency. 5.8 EAST NAPLES and COUNTY will utilize Command Staff and assets for logistical, Packet Page -2941- Page 4 of li °I 11 /12/2013 16. E.11. support, and operational needs for national, state and local emergencies. 5.9 The State of Florida recognized Incident Management System (IMS) is the standard for emergency operations. EAST NAPLES shall assume command and control of all incidents where EAST NAPLES is the Authority Having Jurisdiction. In all instances where EAST NAPLES has established command, COUNTY EMS shall assume responsibility for, and be in charge of, patient care. 5.10 The COUNTY and EAST NAPLES will share statistical data. 6.1 If the two governing entities' standard operating procedures, chain of command or any other unforeseen chumstances 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. EAST NAPLES 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. 7.1 This Interlocal Agreement supersedes the agreement titled Interlocal Agreement Advanced Life Support Engine Partnership, between EAST NAPLES and COUNTY, dated June 26, 2007. 7.2 The Interlocal Agreement shall remain in full force and effect from the date first above written and shall terminate after written notice oftetmination. 7.3 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 EAST NAPLES. 7.4 Either the COUNTY or EAST NAPLES may terminate this Interlocal Agreement after providing written notice of its intent to terminate at least ninety (90) days in advance of the date of termination. In the event that the COUNTY's Medical Director determines that the EAST NAPLES 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 EAST NAPLES 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 EAST NAPLES. 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 EAST NAPLES, �9 Packet Page -2942- Page 5 of 11 11/12/2013 16.E.11. terminate this Agreement without further action or notice to EAST NAPLES. Nothing in this Agreement shall limit the authority of the Medical Director as set forth in the Florida Statutes and the Florida Administrative Code. 7.5 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 VII of this Agreement. SECTION VIII: INSURANCE 8.1 EAST NAPLES and COUNTY shall maintain insurance in the minimum amounts and types required by Florida State Statues. 8.2 EAST NAPLES 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 EAST NAPLES 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 EAST NAPLES or the COUNTY when it would not otherwise be responsible. 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 EAST NAPLES and COUNTY corrrnencing with the v"k services, dories and responsibilities described her etofore. 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. [Remainder of page intentionally left blank, signature page to follow] N Page 6 of 11 Packet Page -2943- 11/12/2013 16.E.11. 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: DWIGHT E. BROCK, CLERK ,Deputy Clerk Approved as to form and legality t County Attorney ATTEST: BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA BY: Georgia A. Hiller, Esy Chairwoman EAST NAPLES FIRE RESCUE DISTRICT BY: klid Packet Page -2944- Page 7 of 11 11/12/2013 16. E.11. ATTACHMENT A COLLIER COUNTY EMERGENCY MEDICAL SERVICES I FIRE DEPARTMENT AND EAST NAPLES FIRE AND RESCUE DEPARTMENT ALS OPERATIONAL PLAN REFERENCE: ALS Program Interlocal Agreement, 2013 PURPOSE: To provide quality and cost effective fire rescue and emergency medical services to the residents of EAST NAPLES (ENFD) 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 Medical Director's Paramedic Certification /Qualification Matrix Rescue Paramedic and; V. Collier County Fire Chiefs' Association Firefighter Cross Training Certification. b. ENFD Firefighters utilized on the County Medic unit must maintain the following valid and current qualifications: i. Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards (Firefighter In; ii. Department of Health Emergency Medical Services Emergency Medical Technician or Paramedic Certification; iii. Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter 64J and; iv. Collier County Medical Director's Orientation, as referenced in the Collier County Medical Director's Paramedic Certification/Qualification Matrix. Page 8 of 11 Packet Page -2945- 11 /12/2013 16. E.11. C. At least one ENFD Firefighter/Paramedic utilized on licensed ENFD ALS apparatus or vehicle must maintain the following valid and current qualifications; i. Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards (Firefighter Il)• ii. Florida Bureau of Emergency Medical services and Community Health Resources Paramedic Certification and; Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter 64J and; iv. Collier County Medical Director's Paramedic Certification/Qualification Matrix Engine Paramedic Certification or above. d. ENFD Firefighter/Paramedics utilized in non - licensed apparatus or assignments must maintain the following valid and current qualifications; i. Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards (Firefighter ED; ii. Florida Bureau of Emergency Medical services and Community Health Resources Paramedic Certification and; iii. Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter n 64J and; iv. Collier County Medical Director's Paramedic Certification/Qualification Matrix Engine Paramedic Certification or above. e. SCHEDULING AND POSITION ASSIGNMENTS i. The COUNTY and ENFD Chiefs or their designee, must approve all Exchange Program participants. ii. The COUNTY Battalion Chief 80 and ENFD Battalion Chief 20 will consult openly in order to assure continuity and efficiency. The COUNTY will continuously provide ENFD with one [1] COUNTY Paramedic/Firefighter as qualified within Section I. a. for use on a designated ALS apparatus or vehicle. iv. ENFD will continuously provide the COUNTY with one [1] ENFD Firefighter Paramedic or a Firefighter/ Emergency Medical Technician as qualified within Section I. b. for use on the appropriate designated apparatus or vehicle. V. Exchange Program participants will participate in appropriate on-duty training, station duties and unit assignments in accordance with assignment and rank. vi. It is recognized by COUNTY and ENFD that harmonious and productive relationships between all personnel are necessary. Teamwork and cooperation is encouraged and expected. ^ vii. Applicable COUNTY and/or EAST NAPLES policies, practices, procedures, standard operating guidelines, general orders, protocols and/or applicable Bargaining Unit Contract language will be observed. Page 9 of 11 Packet Page -2946- II. III 11/12/2013 16. E.11. COMMUNICATION AND DISPATCH a. COUNTY and ENFD 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: L Medical Director approved Emergency Medical Dispatch (EMD) Models shall be designed to assure the initial response of appropriate ALS licensed apparatus. ii. COUNTY and ENFD chief officers will utilize available ENFD licensed resources to assure ALS coverage is continuously maintained within EAST NAPLES. iii. COUNTY and ENFD chief officers will assure licensed and non - licensed ALS assets will respond to out -of- district emergencies or coverage when identified by CAD as the closest available ALS unit. Applicable COUNTY and/or EAST NAPLES policies, practices, procedures, standard operating guidelines, general orders, protocols and/or applicable Bargaining Unit Contract language will be observed. DOCUMENTATION i. The first arriving licensed and non - licensed ALS unit will document each patient contact in an OMD approved Patient Care Report (PCR). Collier EMS utilizes electronic reporting as its primary PCR system but in the event the EAST NAPLES does not have on scene electronic reporting capability, handwritten reports may be utilized until electronic reporting can be completed. The PCR must record any notations from on -scene patient treatment, patient identifying data completed and collected prior to transfer of patient care, AR number, Dispatch times, and crew signatures with State paramedic or EMT license numbers. Some specific call types may require additional documentation (such as Release /Competency forms for patient sign outs) as specified by protocol and EMS documentation standards. When ALS units arrive at the same time, the PCR will be completed by the transporting unit. Shift PCRs are to be collected in a secured envelope with completed coversheet and submitted to the appropriate EMS representative daily. ii. 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. All medical procedures performed by the personnel assigned to the response will be fully documented. "CHART" format with documented "BSI" is required. iii. Prior to 0900hrs, or as call volume permits, the EAST NAPLES Battalion Chief or designee must fax or email a complete ALS Staffing Report to EMSCOMM's office. If staffing changes are made during the shift, an updated report will be provided to EMSCOMM prior to or at the end of shift to reflect staffing changes. EMSCOMM will provide a complete EMS Staffing report to the EAST NAPLES Battalion Chief s office. Page 10 of li Packet Page -2947- 11/12/2013 16.E.11. IV. QUALITY ASSURANCE EAST NAPLES will appoint an OMD approved "Quality Assurance (QA) member to participate on the ALS Non - Transport Quality Assurance Committee, and will be granted privileges to enable them to review their department's PCRs. EAST NAPLES will adhere to QA standards of the OMD and provide quarterly reports reflecting the monitoring guidelines employed by the County. iii. 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. iv. 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. V. At the discretion of the OMD or designee, routine or informational QA Review with EAST NAPLES personnel may be handled entirely by the EAST NAPLES member. The member shall review and complete all paperwork with the EAST NAPLES personnel and return all necessary documentation to the ALS Non - Transport QA Committee within thirty [30) calendar days. vi. In the event the OMD orders remediation, the QA member shall be present understanding that confidential medical information will be discussed. If a significant issue is identified by the QA Committee, the EMT or Paramedic may be immediately prohibited from providing patient care until all processes are completed. V. TRAINING i. The EAST NAPLES Training person(s) is qualified to instruct EAST NAPLES firefighter paramedics or EMTs Medical Director approved in- services, certifications, classes, etc. utilizing preapproved curriculum ii. Any curriculum taught by the EAST NAPLES EMS Training person(s) must be submitted with a complete student roster to the OMD in order to qualify for COUNTY accreditation. In addition, the EMS Training Officer will accurately record continuing education hours of any personnel completing their training and provide those records to the COUNTY quarterly. EAST NAPLES will provide to the State Fire College appropriate approved training documentation for recognized State approved fire classes. VI. MUTUAL COVENANT i. EAST NAPLES will provide a Firefighter / Paramedic at least fifty percent (50 %) of shifts to staff an EMS ambulance. The remaining shifts will be staffed by an EAST NAPLES Firefighter / Emergency Medical Technician. H. EAST NAPLES Firefighters / Paramedics will staff an EMS ambulance for a 24 hour shift at least every forty-five (45) calendar days. W. Monthly reports will be provided to the COUNTY by EAST NAPLES which reflects EAST NAPLES personnel, dates and hours in which they staffed an EMS ambulance. Page 21 of 11 Packet Page -2948-