Agenda 09/10/2024 Item #16F3 (Agreements with David Lawrence Mental Health Center, Inc. (DLC) and Collier Health Services, Inc. to allow EMS to work cooperatively for the delivery of Medication-Assisted-Treatment (MAT))16.F.3
09/ 10/2024
EXECUTIVE SUMMARY
Recommendation to approve and authorize the Chairman to execute two Agreements on behalf of
Collier County with David Lawrence Mental Health Center, Inc., and Collier Health Services, Inc.,
d/b/a Healthcare Network regarding treatment of Opioid Use Disorder for Collier County
Emergency Medical Services to work cooperatively with these agencies to provide timely access to
education, prevention, and Medication -Assisted -Treatment (MAT)
OBJECTIVE: To approve Agreements with David Lawrence Mental Health Center, Inc. (DLC) and
Collier Health Services, Inc., d/b/a Healthcare Network (HN) to allow EMS to work cooperatively for the
delivery of Medication -Assisted -Treatment (MAT) to promote lifesaving and life -changing behavioral
healthcare services and assist in the emergency community induction program for individuals with Opioid
Use Disorders.
CONSIDERATION: Collier County EMS, David Lawrence Mental Health Center, Inc. and Collier
Health Services, Inc., d/b/a Healthcare Network ("HN") share core objectives of disrupting opioid use
disorders and promoting recovery. A partnership between the organizations makes natural sense as their
missions and resources complement each other and EMS and will facilitate access to substance use
disorder evidence -based treatment and services. EMS will provide MAT at the point of care in compliance
with standing orders addressing immediate needs and connecting patients with resources to support
recovery. EMS has adopted strategies to ensure around -the -clock access to initial treatment, continuity of
care, and unrestricted support to long-term treatment and access to peer services. The Agreements with
the agencies provide that when treating patients with Opioid Use Disorder, Collier County EMS will serve
as a referring entity to DLC and HN. In turn, the agencies will accept a Warm Hand Off and work with
the patients to secure additional needed services.
FISCAL IMPACT: There is no cost to the County.
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this
item.
LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires majority vote
for approval. - CMG
RECOMMENDATION: To approve and authorize the Chairman to execute two Agreements on behalf
of Collier County with David Lawrence Mental Health Center, Inc., and Collier Health Services, Inc.,
d/b/a Healthcare Network regarding treatment of Opioid Use Disorder for Collier County Emergency
Medical Services to work cooperatively with these agencies to provide timely access to education,
prevention, and Medication -Assisted -Treatment (MAT)
Prepared By: Bruce Gastineau, Chief of Emergency Medical Services
ATTACHMENT(S)
1. DLC-EMS CORE Agreement DLC Signed (PDF)
2. Agreement w HealthCare Network (PDF)
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16.F.3
09/10/2024
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.17.3
Doc ID: 29756
Item Summary: Recommendation to approve and authorize the Chairman to execute two Agreements on behalf of
Collier County with David Lawrence Mental Health Center, Inc., and Collier Health Services, Inc., d/b/a Healthcare
Network regarding treatment of Opioid Use Disorder for Collier County Emergency Medical Services to work
cooperatively with these agencies to provide timely access to education, prevention, and Medication -Assisted -
Treatment (MAT)
Meeting Date: 09/10/2024
Prepared by:
Title: — Emergency Medical Services
Name: Cherie DuBock
08/20/2024 2:14 PM
Submitted by:
Title: — Emergency Medical Services
Name: Bruce Gastineau
08/20/2024 2:14 PM
Approved By:
Review:
Emergency Medical Services
Emergency Management
County Attorney's Office
Office of Management and Budget
Office of Management and Budget
County Attorney's Office
Corporate Business Operations
County Manager's Office
Board of County Commissioners
Bruce Gastineau EMS Chief Review
Michael Choate Executive Director Review
Colleen Greene Level 2 Attorney Review
Debra Windsor Level 3 OMB Gatekeeper Review
Agnieszka Chudy OMB Reviewer
Jeffrey A. Klatzkow Level 3 County Attorney's Office Review
Jennifer Reynolds OMB Reviewer
Amy Patterson Level 4 County Manager Review
Geoffrey Willig Meeting Pending
Completed 08/20/2024 3:30 PM
Completed 08/26/2024 10:11 AM
Completed 08/30/2024 10:46 AM
Completed 08/30/2024 11:02 AM
Completed 08/30/2024 11:26 AM
Completed 08/30/2024 11:39 AM
Completed 09/03/2024 9:07 AM
Completed 09/03/2024 3:29 PM
09/10/2024 9:00 AM
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1 6.F.3.a
AGREEMENT REGARDING OPIOID USE DISORDERS
BETWEEN
DAVID LAWRENCE MENTAL HEALTH CENTER, INC. (DLC)
AND
COLLIER COUNTY
This Agreement is entered into and made effective , 2024, by and between David
Lawrence Mental Health Center, Inc. with its primary place of business at 6075 Bathey Lane, NTaples, FL,
34116 ("DLC"), and Collier County with its principal address at 3299 Tamiami Trail East, Suite 300,
Naples FL 34112, on behalf of its Collier County Emergency Medical Services, having its principal office
at 8075 Lely Cultural Parkway, 9267, Naples, FL 34113 ("EMS"), (individually a "Party" and collectively
the "Parties").
RECITALS
WHEREAS, David Lawrence Mental Health Center, Inc. is a not -for -profit entity located in
Collier County, Florida, whose mission is to provide life-saving and .life -changing behavioral health care
through education, prevention, intervention, and treatment available to all; and
WHEREAS, DLC provides Addiction Medicine/Psychiatric Evaluation, Medication -Assisted
Treatment ("MAT") (e.g., Induction, Maintenance), Detoxification/withdrawal management, and a full
continuum of substance use disorder evidence -based treatment services; and
WHEREAS, DLC desires to provide timely access to care and services to Collier County
Emergency Medical Services ("EMS") to support and assist in its emergency community induction
program for individuals with Opioid Use Disorders; and
WHEREAS, Collier County agrees to work with DLC pursuant to the terms of the this Agreement
to accept such services.
AGREEMENT
NOW, THEREFORE, the parties hereto enter this Agreement in accordance with the following
terms and conditions and statement of purpose:
1. RESPONSIBILITIES OF COLLIER COUNTY EMS:
A. Referrals. Collier County EMS may refer individuals with Opioid Use Disorders who
receive emergency medical interventions in the community (e.g., Narcan overdose reversal) and
have agreed to start Medication -Assisted Treatment induction (e.g., Buprenorphine) to DLC.
B. Induction. Collier County EMS may provide buprenorphine induction using the Collier
County EMS practitioner buprenorphine induction protocol to individuals who consent prior to
referral to DLC.
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1 6.F.3.a
C. Release of Information. Collier County EMS will attempt to obtain a Health Insurance
Portability and Accountability Act ("HIPAA") Release of Inforination from the individual to
facilitate the coordination of care between the identified patient/referral and DLC.
D. Notification of Referrals. Collier County EMS will attempt to notify the DLC Medication -
Assisted Treatment referral team when a patient in their care requires an urgent appointment to
facilitate continued Medication -Assisted Treatment services.
2. RESPONSIBILITIES OF DLC:
A. Warm Hand -Off. DLC shall support a warm hand-off from EMS to DLC services with
the purpose of providing Medication -Assisted Treatment using evidence -based practice standards
and transitioning Warm Hand -Off patients from induction to stabilization and follow-up
maintenance within the DLC MAT services continuum.
B. Access to Services. DLC shall coordinate access to timely Addiction Medicine Evaluation
by a licensed practitioner and/or admission to the DLC Crossroads withdrawal management
program for additional assessment and stabilization.
C. Level of Care Determination. DLC shall provide access to direct admission to the
appropriate level of care (i.e., withdrawal management program for referred patients needing
withdrawal management and/or inpatient induction).
(1) DLC inpatient services may include clinical triage, nursing assessment, physical
examination, case management, referral and linking, peer recovery support.
(2) DLC outpatient MAT services may include clinical triage, nursing intake, Addiction
Medicine Evaluation, Medication Management, urinalysis drug testing, case management,
peer recovery support, individual and/or group therapy, and referral and linking to other
levels of care.
D. Cost to Patients. DLC will be responsible for assisting the patient with the cost of
evaluation, treatment, and medications while the patient is actively in DLC's care through
financial screening and identification of funding sources in accordance with agency policies and
procedures.
3. DATA SHARING. DLC and Collier County EMS will collect and share data to evaluate the program
efficacy and outcomes. Data elements collected will include:
A. Data Collected via EMS:
(1) Demographic data of referred patients.
(2) Number of overdose reversals by naloxone conducted by EMS.
(3) Number of MAT referrals from EMS to DLC.
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1 6.F.3.a
(4) Of the total number of patients induced by EMS, the breakdown of referrals to all
agencies, (e.g., DLC Inpatient Detox, DLC Outpatient MAT Services, Healthcare
Network, NCH Healthcare, Physicians Regional Healthcare System, etc.
(5) The average length of time between EMS induction and the first DLC
appointment/admission date.
B. Data Collected via DLC:
(1) Of the total number of patients induced by EMS who are referred to DLC MAT
services, the number of patients who link with or are admitted by DLC to Detox or to
Outpatient MAT.
(2) Of the total number of patients induced by EMS who are admitted to DLC
Outpatient MAT or admitted to Detox:
(a) Total number who completed Detox.
(b) Of the total number of patients referred by EMS and admitted to DLC detox,
the total number of patients who subsequently link to DLC Outpatient MAT
and/or other levels of care.
(3) Total number who participated in at least 1 DLC MAT appointment.
(a) Of the total number of patients referred by EMS admitted to the DLC MAT
program, the percentage of patients who successfully linked with the DLC MAT
Program (as evidenced by attending up to three recommended appointments).
C. Confidentiality. Where applicable the parties will comply with the Health Insurance
Portability and Accountability Act as well as regulations promulgated thereunder (45 CFR Parts
160, 162, and 164).
4. INSURANCE.
a. DLC, at its sole cost and expense, shall obtain, keep in force, and maintain during the term of this
Agreement such professional liability and general liability insurance coverage to cover the acts or
omissions of the Party and its employees in the course of the Program pursuant to this Agreement, but
in no event shall such coverage at any time be less than one million dollars ($1,000,000.00) per covered
person or event or three million dollars ($3,000,000.00) in the aggregate. In the event that this
insurance is in the form of claims made, the Party shall obtain a full extended reporting endorsement
("Tail") to cover any event that may have occurred during the Agreement. The Parry shall notify the
other Party immediately upon receiving notice of the cancellation, expiration or non -renewal of any
insurance required hereunder.
b. Pursuant to Section 768.28, Fla. Stat., Collier County is self -insured.
S. INDEMNIFICATION. To the maximum extent permitted by Florida law, DLC shall defend,
indemnify and hold harmless Collier County, its officers and employees from any and all liabilities,
damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals'
fees, whether resulting from any claimed breach of this Agreement by DLC, any statutory or regulatory
violations, or from personal injury, property damage, direct or consequential damages, or economic
loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the
DLC or anyone employed or utilized by DLC in the performance of this Agreement. This
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1 6.F.3.a
indemnification obligation shall not be construed to negate, abridge or reduce any other rights or
remedies which otherwise may be available to an indemnified party or person described in this
paragraph.
This section does not pertain to any incident arising from the sole negligence of Collier County
The duty to defend under this Article 13 is independent and separate from the duty to indemnify, and
the duty to defend exists regardless of any ultimate liability of DLC, County and any indemnified party.
The duty to defend arises immediately upon presentation of a claim by any party and written notice of
such claim being provided DLC. DLC's obligation to indemnify and defend under this section will
survive the expiration or earlier termination of this MOU until it is determined by final judgment that
an action against the County or an indemnified party for the matter indemnified hereunder is fully and
finally barred by the applicable statute of limitations.
6. PATIENT RECORDS; DISCLOSURE OF PROTECTED HEALTH INFORMATION;
CONFIDENTIAL INFORMATION. Both parties agree to follow all applicable laws, rules, and
regulations regarding confidentiality of information, including, but not limited to, HIPAA, 42 CFR
Part Two, and 45 CFR. Further, each parry shall not use or disclose to any unauthorized person any
information relating to the business or affairs of the other party or of any qualified individual, except
pursuant to the express written consent of the other party or the qualified individual, as applicable, by
court order, or as required by law, rule, or regulation. Collier County is a political subdivision of the
State of Florida and required to comply with Florida's Public Records Law, Ch. 119, Florida Statutes.
7. IF DAVID LAWRENCE CENTER HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE DAVID LAWRENCE CENTER'S
DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT Division of Communications, Government &
Public Affairs, 3299 Tamiami Trail East, Suite 801, Naples, FL 34112 email
publierecordsreguestLa) colliercounh,fl."-ov.
DLC shall comply with public records laws, specifically to:
A. Keep and maintain public records required by the public agency to perform the service.
B. Upon request from the public agency's custodian of public records, provide the public
agency with a copy of the requested records or allow the records to be inspected or copied
within a reasonable time at a cost that does not exceed the cost provided in this chapter or
as otherwise provided by law.
C. Ensure that public records that are exempt or confidential and exempt from public
records disclosure requirements are not disclosed except as authorized by law for the
duration of the contract term and following completion of the contract if the contractor
does not transfer the records to the public agency.
D. Upon completion of the contract, transfer, at no cost, to the public agency all public
records in possession of the contractor or keep and maintain public records required by the
public agency to perform the service. If the contractor transfers all public records to the
public agency upon completion of the contract, the contractor shall destroy any duplicate
public records that are exempt or confidential and exempt from public records disclosure
requirements. If the contractor keeps and maintains public records upon completion of the
4
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1 6.F.3.a
contract, the contractor shall meet all applicable requirements for retaining public records.
All records stored electronically must be provided to the public agency, upon request from
the public agency's custodian of public records, in a format that is compatible with the
information technology systems of the public agency.
8. TERM and TERMINATION. This Agreement shall begin on the date on which it has been signed
by both parties and will remain in effect until modified or terminated by the signatories. This
Agreement may be modified and enforceable only if signed by both parties. Either party may terminate
this Agreement at any time with thirty (30) days' written notice.
9. FORCE MAJEURE. Either Party shall be excused from any delay or failure in performance
hereunder caused by reason of any occurrence or contingency beyond its reasonable control, including,
but not limited to, acts of God, acts of war, terrorism, fire, insurrection, labor disputes, riots,
earthquakes, or other acts of nature.
10. SEVERABILITY. If any provision of this Agreement is held to be illegal, invalid, or unenforceable
under present or future laws effective during the term hereof, such provision shall be fully severable
and the remainder of this Agreement shall be enforced to the fullest extent permitted by law.
11. GOVERNING LAW. This Agreement shall be subject to and governed by the laws of the State of
Florida. The Parties agree that any dispute, claim, and/or action arising out of or relating in any way
to this Agreement or the relationship between the Parties must and shall be brought exclusively in a
state or federal court located in the State of Florida.
12. BINDING EFFECT. This Agreement shall be binding upon and inure to the benefit of the Parties
hereto and their respective successors and assigns. Assignment is subject to the prior written approval
of the parties.
13. NOTICES. All notices, requests, demands, or other communications hereunder must be in writing
and must be given and shall be deemed to have been given upon receipt if delivered by a national
overnight courier service, on the date of delivery if delivered in person, or three (3) days after mailing
if sent by certified or registered mail with first-class postage prepaid, as follows:
If to Collier County EMS:
Bruce Gastineau, Chief, Collier County EMS
8075 Lely Cultural Parkway, Suite: #267
Naples, FL 34113
Bruce.Gastineaugi',colliercountyfl. gov
If to DLC:
David Lawrence Mental Health Center, Inc.
Attn: Scott Burgess, CEO
6075 Bathey Lane
Naples, FL 34116
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1 6.F.3.a
With copy to:
David Lawrence Mental Health Center, Inc.
Nancy Dauphinais, COO
6075 Bathey Lane
Naples, FL 34116
14. ENTIRE AGREEMENT; MODIFICATIONS; AMENDMENTS. This Agreement, along with its
Exhibits, contains all the terms and conditions agreed upon by the Parties regarding the subject matter
of this Agreement and supersedes any prior agreements, oral or written, and all other communications
between the Parties relating to such subject matter. This Agreement may be amended or modified at
any time by written consent of the authorized representatives of both Parties. This Agreement is
nonexclusive. The Parties reserve the right to enter into similar agreements with other institutions.
IN WITNESS WHEREOF, the parties hereto by and through their duly authorized representatives, whose
signatures appear below, have caused this MOU to be executed as of the date first written above.
FOR DAVID LAWRENCE MENTAL
HEALTH CENTER INC.
David Lawrenc M tal Health Center, Inc.
By: _
co Bur ss, C O
FOR THE COUNTY
ATTEST:
CRYSTAL K. KINZEL, Clerk of the
Circuit Court and Comptroller
, Deputy Clerk
Approved as to form and legality:
Colleen M. Greene
Managing Assistant County Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
go
CHRIS HALL, Chairman
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