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Collier County Emergency Services Deputy Medical Director Agreement THIRD AMENDMENT TO THE COLLIER COUNTY EMERGENCY SERVICES DEPUTY MEDICAL DIRECTOR AGREEMENT THIS THIRD AMENDMENT, made and entered into on this 224 J day of f pi- I 2025, by and between Douglas S. Lee, M.D., hereinafter referred to as DEPUTY MEDICAL DIRECTOR, and Collier County, a political subdivision of the State of Florida, (the "County") (collectively, the"Parties"): WHEREAS, on February 1, 2014 the County entered into the Collier County Emergency Services Deputy Medical Director Agreement (the "Agreement") with the Deputy Medical Director to provide professional Deputy Medical Director services in conjunction with the County's Medical Director in accordance with Chapter 401, Florida Statutes and Chapter 64-J-1, Florida Administrative Code, Rules of the Department of Health; and WHEREAS, on April 26, 2016 (Agenda Item No. 16.H.6),the County entered into the First Amendment to the Agreement, which extended the termination date of the Agreement to April 26, 2019, provided for a three-year renewal term, amended the scope of work, and adjusted the terms of compensation to Deputy Medical Director under the Agreement; and WHEREAS, on March 22, 2022 (Agenda Item No. 16.E.2) the County entered into the Second Amendment to the Agreement, which extended the termination date to April 26, 2025, and provided an adjustment to the compensation for services. WHEREAS, the Parties desire to further amend the Agreement through this Third Amendment to extend the termination date of the Agreement for up to one hundred and eighty days (180), replace the scope of work in its entirety to be consistent with that of the Medical Director, and provide for an adjustment to the compensation of services for the transition of the Deputy Medical Director to serve as the Interim Medical Director. NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, it is agreed by the Parties as follows: 1. ARTICLE 2- SCHEDULE AND RENEWAL, is hereby amended so that the termination date of the Agreement shall now be October 24, 2025, or until a Medical Director and Deputy Medical Director agreement have been approved by the County, whichever is sooner. 2. ARTICLE 4 -PAYMENTS TO DEPUTY MEDICAL DIRECTOR, is hereby amended so that the COUNTY shall pay the position as the Interim Medical Director the sum of $15,193.83 per month. The compensation shall become effective as of April 27, 2025. Words Straek—Through are deleted;Words Underlined are added 3. The parties agree that Exhibit A— Scope of Work be removed in its entirety and shall be amended as follows: Page 1 of 5 Third Amendment to Agreement# 13-6081 Douglas S.Lee,M.D. AO Exhibit A —Scope of Services * * * * * 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 online medical control. Notwithstanding anything to the contrary contained herein, INTERIM MEDICAL DIRECTOR may use reasonable discretion in determining the appropriateness of his response to calls. C. INTERIM 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, INTERIM MEDICAL DIRECTOR shall assist the COUNTY with obtaining patient outcome information from local hospitals. E. INTERIM MEDICAL DIRECTOR shall participate in regular Quality Assurance meetings with Dispatch personnel. F. INTERIM MEDICAL DIRECTOR shall review and participate in the development of the Dispatch Protocols followed by COUNTY EMS. G. INTERIM MEDICAL DIRECTOR shall participate in direct EMS Advanced Cardiac Life Support (ACLS) classes and shall assist the County and EMS Chief in arranging training to meet the needs of the community and the standards of care for the industry. The INTERIM MEDICAL DIRECTOR shall, upon request of the County Manager or designee, evaluate County EMT's and Paramedical personnel during training exercise. INTERIM MEDICAL DIRECTOR shall review and approve the content of EMS training form for medical correctness at the request of the County Manager or designee. H. INTERIM 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 INTERIM MEDICAL DIRECTOR which have been approved by the EMS Chief, will be recognized as part of the normal job duties of INTERIM MEDICAL DIRECTOR. I. As required under Chapter 401, Florida Statutes, and Chapter 64J-1, F.A.C., INTERIM 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 INTERIM MEDICAL Page 2 of 5 Third Amendment to Agreement# 13-6081 Douglas S. Lee,M.D. CAO 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 aeromedical personnel. INTERIM 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. INTERIM 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. INTERIM 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 INTERIM 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. INTERIM 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 INTERIM MEDICAL DIRECTOR to meet the obligations of this paragraph. Back-up physicians may be used in lieu of the INTERIM 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. INTERIM 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. INTERIM 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. INTERIM 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. INTERIM MEDICAL DIRECTOR shall receive prior approval from the County Manager or designee preceding any COUNTY communication with the media. Page 3 of 5 Third Amendment to Agreement# 13-6081 Douglas S. Lee,M.D. CAO 4. Except as amended herein, all other terms and conditions of the Agreement, which is incorporated herein by reference, shall remain unchanged. **Signature page to follow** Page 4 of 5 • Third Amendment to Agreement# 13-6081 Douglas S.Lee,M.D. CAO IN WITNESS WHEREOF, the Parties have executed this Third Amendment on the date and year first written above by an authorized person or agent. ATTEST: Crystal K. Kinzel, Clerk of the Circuit BOARD OF COUNTY COMMISSIONERS Court and Comptroller COLLIER COUNTY, FLORIDA By: � By: -l�•4— Burt L. Saunders, Chairman Dated: { 416 _ (SEAL) s J Attest as to Chaim:1 s signature only. INTERIM MEDICAL DIRECTOR: Witnesses: Douglas S. Lee M.D. ,edwara First Witness By: Min Kim Signature Douglas S. Lee TType/print witness nameT . opioril.06 TType/print signature and titleT Second Witness 3/26/25 Jacob Lee Date TType/print witness nameT pro ed as to F a Legality: .e.....tez_L Scott R. Teach, Deputy County Attorney Page 5 of 5 (? Third Amendment to Agreement# 13-6081 'AO Douglas S. Lee,M.D. AFFIDAVIT REGARDING LABOR AND SERVICES Effective July 1, 2024,pursuant to §787.06(13), Florida Statutes,when a contract is executed, renewed,or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services. Nongovernmental Entity's Name: Douglas S.Lee Address: 1635 Gordon River Lane, Naples, FL 34104 Phone Number: 646-391-5600 Authorized Representative's Name: Douglas S.Lee Authorized Representative's Title: Email Address: duglee@hotmail_com AFFIDAVIT I, Douglass.Lee (Name of Authorized Representative),as authorized representative attest that Douglass.Lee (Name of Nongovernmental Entity)does not use coercion for labor or services as defined in§787.06, Florida Statutes. Undty enalty of perjury,I declare that I have read the foregoing Affidavit and that the facts stated in it are true. ANQlet(-- Z, 7.0 Z�f (Signature of authorized representative) Date STATE OF. Y\(1 COUNTY OF CO 1,l Sworn to(or affirmed)and subscribed before me,by means of Vp.hysical presence or❑online notarizationthis day of Arc)C i t ,2025, by' kt.cc� C e (Name of Affiant),who produced their Of\tree ( i C-e V 5 e as iden 'fication or are rsonally known t'o me. /9 YOiANDAGUILE GARZA LNiRAGA N r Public +' :+ MY COMMISSION A�HH353225 ' %i�:',Q°, EXPIRES:Febma 14,2021 I oZ-1 _:�Oitt°n �Y Commission Expires Personally Known E 'OR Produced Identification a Type of Identification Produced: CONTRACT,RENEWAL,OR EXTENSION REQUEST FORM Version:2025.1 1