Backup Documents 04/22/2025 Item #16F2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 F 2
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office ) J
4. BCC Office Board of County
Commissioners (5$ k n'r( 5g25
5. Minutes and Records Clerk of Court's Office61-1 bi�fZ‘
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Staff Cherie DuBock/EMS Phone Number 239-252-3756
Contact/ Department
Agenda Date Item was 4/22/2025 Agenda Item Number 16.F.2
Approved by the BCC
Type of Document Amendment Medical Director Agmt. Number of Original 1
Attached Documents Attached
PO number or account PLEASE EMAIL TO
number if document is BRUCE.GASTINEAU@
to be recorded COLLIERCOUNTYFL.GOV
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? CD
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 1/2Z and all changes made N/A is not
during the meeting have been incorporated in t e attached document. The County SR.44h an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the saf f tt7 an option for
Chairman's signature. this line4
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
16F2
THIRD AMENDMENT TO THE COLLIER COUNTY EMERGENCY
SERVICES DEPUTY MEDICAL DIRECTOR AGREEMENT
THIS THIRD AMENDMENT, made and entered into on this 22" day of
Apr;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 Struck 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:
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Third Amendment to Agreement# 13-6081
Douglas S.Lee,M.D. C!'0
p!
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* * * * *
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
16F2
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.
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Third Amendment to Agreement# 13-6081
Douglas S. Lee,M.D.
CAO
16F2
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.
16F2
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
5 1 4
5
By• � '` B
y: /44..141...Aele4104—
Burt L. Saunders, Chairman
Dated: t 26
(SEAL) Attest as to Chairs
signature only.
INTERIM MEDICAL DIRECTOR:
Witnesses: Douglas S. Lee M.D.
,0"`raffw.
First Witness By:
Min Kim Signature
Douglas S. Lee
TType/print witness nameT
• TType/print signature and titleT
Second Witness
3/26/25
Jacob Lee
Date
TType/print witness nameT
pro ed as to F a71 Legality:
•Ctel.,/
Scott R. Teach, Deputy County Attorney
Page 5 of 5
Third Amendment to Agreement# 13-6081 AO
Douglas S. Lee,M.D.
1OF2..
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
1, Douglas S.Lee (Name of Authorized Representative),as authorized representative attest
that Douglas S.Lee (Name of Nongovernmental Entity)does not use coercion for labor or
services as defined in§787.06, Florida Statutes.
Und; .penalty of perjury,I declare that I have read the foregoing Affidavit and that the facts stated in it are true,
/iilec4— 2, 7aZ-3--------
(Signature of authorized representative) Date
STATE OF_ _ Y____
COUNTY OF ('()1,1 f i(
Sworn to(or affirmed)and subscribed before me,by means of 1physical presence or❑online notarization this
.._ day of Ac f i ' ,2025, byt)C 4c (...-t.e (Name of Affiant),who produced their by.tIrPY`s I i C'
as iden 'fication or are rsonally knownYo me.
N r Public , fi+ YOLANDAGISELLEGARZALARRAGA
,a;.,,` 1 1NYCOMMISSIONMHH35322s
r� .y ',',, NV EXPIRES:February 14,2021
. a i "`
Commission Expires
Personally Known Q'OR Produced Identification 0]
Type of Identification Produced:
CONTRACT,RENEWAL,OR EXTENSION REQUEST FORM Version:2025.1