Agenda 09/13/2016 R Item #16E 4 16.E.4
09/13/2016
EXECUTIVE SUMMARY
Recommendation to approve and authorize the Chairman to execute the attached HIPAA Business
Associate Agreement as required pursuant to the terms of the Interlocal Agreement between the
Collier County Board of County Commissioners and the North Collier Fire Control and Rescue
District(dated March 22,2016).
OBJECTIVE: To approve and authorize the Chairman to execute a HIPAA Business Associate
Agreement with the North Collier Fire Control and Rescue District.
CONSIDERATIONS: The Board of County Commissioners entered into an Interlocal Agreement with
the North Collier Fire Control and Rescue District ("North Collier") on March 22, 2016 (Agenda Item
10A). The Interlocal Agreement served to settle the litigation between the Parties regarding the North
Collier COPCN. Pursuant to Paragraph 2(d), of the Interlocal Agreement,the Parties are required to enter
into a HIPAA Business Associate Agreement to ensure compliance with with the HIPAA (Health
Insurance Portability and Accountability Act) requirements and any other federal or state applicable laws.
The attached Agreement was approved and signed by the North Collier Board on or about June 6, 2016.
Pursuant to the terms of the Interlocal Agreement, the County is required to enter into this HIPAA
Business Associate Agreement.
FISCAL IMPACT: None.
GROWTH MANAGEMENT IMPACT: There is no impact to the Growth Management Plan from this
action.
LEGAL CONSIDERATIONS: This item has been approved as to form and legality and requires
majority vote for approval. -CMG
RECOMMENDATION: For the Board to approve and authorize the Chairman to execute the attached
HIPAA Business Associate Agreement as required pursuant to the terms of the Interlocal Agreement
between the Collier County Board of County Commissioners and the North Collier Fire Control and
Rescue District(dated March 22,2016).
PREPARED BY: Tabatha Butcher, Chief Collier County EMS
Colleen M. Greene,Assistant County Attorney
ATTACHMENT(S)
1.HIPAA Agreement (PDF)
2. Item 10A-March 22 2016-Cover Memo Signed Se (PDF)
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16.E.4
09/13/2016
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.4
Item Summary: Recommendation to approve and authorize the Chairman to execute the attached
HIPAA Business Associate Agreement as required pursuant to the terms of the Interlocal Agreement
between the Collier County Board of County Commissioners and the North Collier Fire Control and
Rescue District(dated March 22,2016).
Meeting Date: 09/13/2016
Prepared by:
Title: Administrative Assistant—Administrative Services Department
Name: Maria Franco
08/18/2016 10:48 AM
Submitted by:
Title: Department Head-Administrative Svc—Administrative Services Department
Name: Len Price
08/18/2016 10:48 AM
Approved By:
Review:
Emergency Medical Services Tabatha Butcher Level 1 Sim.Reviewer 1-8 Completed 08/18/2016 10:58 AM
Administrative Services Department Len Price Level 1 Division Reviewer Skipped 08/18/2016 4:19 PM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 08/18/2016 4:26 PM
County Attorneys Office Colleen Greene Level 2 Attorney Review Completed 08/19/2016 3:45 PM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 08/19/2016 3:54 PM
Office of Management and Budget Laura Wells Level 3 OMB 1st Reviewer 1-4 Completed 08/19/2016 4:30 PM
County Attorney's Office Jeffrey A.Klatzkow Level 3 County Attorney's Office Review Completed 08/22/2016 12:54 PM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 08/28/2016 10:49 AM
Board of County Commissioners MaryJo Brock Meeting Pending 09/13/2016 9:00 AM
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16.E.4.a
COMBINED HIPAA PRIVACY BUSINESS ASSOCIATE,
HIPAA SECURITY RULE, HITECH
ACT COMPLIANCE AND
CONFIDENTIALITY AGREEMENT
THIS AGREEMENT is entered into by and between the North Collier Fire Control and
Rescue District, an independent fire control and rescue district operating pursuant to Chapter
2015-191, Laws of Florida, by and through its Board of Fire Commissioners, whose address is
1885 Veterans Park Dr.,Naples,Florida 34109(hereinafter"North Collier"),and Collier County,
a political subdivision of the State of Florida,by and through its Board of County Commissioners,
whose address is 3299 Tamiami Trail East, Naples, FL 34112 (hereinafter "Collier County"),
collectively hereinafter referred to as the"parties." The parties have entered into this Agreement c"
in compliance with the terms of the Interlocal Agreement dated March ?2, 2016 and for the E
purpose of satisfying the Business Associate contract requirements of the regulations at 45 CFR
Section 164.502(e) and 164.504(e), issued under the Health Insurance Portability and
Accountability Act of 1996 ("HIPAA"), the Security Rule, codified at 45 C.F.R Part 164,
Subparts A and C. (the"Security Rule"), the Health Information Technology For Economic and a.
Clinical Health Act, enacted in Pub. L. No. 111-05 H.R., 111th Cong. (2009), Title XIII (the
"HITECH Act"), as well as the confidentiality requirements contained in Section 401.30, Florida v
Statutes. This Agreement is intended to provide reciprocal obligations between and among the z
parties as required by law when one party is acting as the Business Associate and the other party
is acting as the Covered Entity. co
Section 1. Definitions
Terms used but not otherwise defined in this Agreement shall have the same meaning as those
terms in 45 CFR Sections 160.103 and 164.501, and in the HITECH Act, Subtitle D.
a.
(a) "Business Associate" has the same meaning as the term `Business associate" in 45 CFR
160.103 and shall include North Collier when acting as Business Associate of Collier County,and
Collier County when acting as Business Associate of North Collier.
(b) "Covered Entity" has the same meaning as the term "Covered entity" in 45 CFR 160.103 and Q
shall include North Collier when acting as Covered Entity and Collier County is its Business
Associate, and Collier County when acting as Covered Entity and North Collier is its Business
Associate.
(c) "Individual" has the same meaning as the term "individual" in 45 CFR Section 164.501 and
shall include a person who qualifies as a personal representative in accordance with 45 CFR
Section 164.502(g).
(d)"Privacy Rule"means the Standards for Privacy of Individually Identifiable Health Information
at 45 CFR Part 160 and part 164, Subparts A and E.
(e) "Protected Health Information"is defined at 45 CFR Section 160.103 and in the HITECH Act.
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For purposes of this Agreement,the term refers only to that Protected Health Information received
directly or indirectly from, or received or created on behalf of, the Covered Entity.
(f) "Secretary" means the Secretary of the U.S. Department of Health and Human Services or
designee.
(g) "Security Incident" means any event resulting in computer systems, networks, or data being
viewed, manipulated, damaged, destroyed or made inaccessible by an unauthorized activity. Sec
National Institute of Standards and Technology (NIST) Special Publication 800-61, "Computer
Security Incident Handling Guide," Revision 2 or subsequent revision for more information.
Section 2. Collier County's Obligations and Activities When Acting as Business Associate
and North Collier's Obligations When Acting as Covered Entity 1E
E
A. Obligations and Activities of Collier County acting as Business Associate Regarding
Protected Health Information Q
(a) Collier County agrees to not use or further disclose Protected Health Information other than a_
as permitted or required by Subsections B.,D.and E.of this Section 2, or as required by applicableen
federal or laws of the State of Florida. v
z
(b) Collier County agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement. co
(c) Collier County agrees to mitigate, to the extent practicable, any harmful effect that is
known to Collier County of a use or disclosure of Protected Health Information by Collier County
CD
in violation of the requirements of this Agreement.
(d) Collier County agrees to report to North Collier any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware. Collier County a.
will report to North Collier any Security Incident of which Collier County becomes aware that is
(1) a successful unauthorized access, use or disclosure of any Electronic Protected Health
Information; or (2) a successful major(a) modification or destruction of any Electronic Protected
Health Information or(b) interference with system operations in an information system containing
any Electronic Protected Health Information. Upon North Collier's request, Collier County will d
report any incident of which Collier County becomes aware that is a successful minor (a)
modification or destruction of any Electronic Protected Health Information or(b)interference with
system operations in an information system containing any Electronic Protected Health
Information.
(c) Collier County agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Collier County on
behalf of North Collier, agrees to the same restrictions and conditions that apply through this
Agreement to Collier County with respect to such information.
(f) Collier County agrees to provide access, at the request of North Collier or an Individual,
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I6.E.4.a
and in a prompt and reasonable manner consistent with the HIPAA regulations,to Protected Health
Information in a designated record set,to North Collier in order to meet the requirements under 45
CFR Section 164.524.
(g) Collier County agrees to make any amendment(s) to Protected Health Infouuation in a
designated record set that the North Collier or an Individual directs or agrees to pursuant to 45
CFR Section 164.526, in a prompt and reasonable manner consistent with the HIPAA regulations.
(h) Collier County agrees to make its internal practices,books, and records, including policies
and procedures and Protected Health Information, relating to the use and disclosure of Protected
Health Information received from, or created or received by Collier County on behalf of North
Collier available to North Collier, or at the request of North Collier, to the Secretary in a time and
manner designated by North Collier or the Secretary, for purposes of the Secretary determining
North Collier's compliance with the Privacy Rule. E
(i) Collier County agrees to document disclosures of Protected Health Information and
information related to such disclosures as would be required for North Collier to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in o.
accordance with 45 CFR Section 164.528.
u_
0) Collier County agrees to provide to North Collier or an Individual an accounting of
disclosures of Protected Health Information in accordance with 45 CFR Section 164.528, in a c•,
prompt and reasonable manner consistent with the HIPAA regulations.
(k) Collier County certifies that it is in compliance with all applicable provisions of HIPAA a
standards for electronic transactions and code sets, also known as the Electronic Data Interchange
(EDI) Standards, at 45 CFR Part 162; and the Annual Guidance as issued by the Secretary pursuant
to the HITECH Act, Section 13401. Collier County further agrees to ensure that any agent,
including a subcontractor, that conducts standard transactions on its behalf, will comply with the
EDI Standards and the Annual Guidance. a
(1) Collier County agrees to determine the minimum necessary type and amount of Protected E'
Health Information required to perform its services and will comply with 45 CFR Sections
164.502(b) and 514(d).
B. Permitted or Required Uses and Disclosures by Collier County as Business Associate
(a) Collier County acknowledges and agrees that Protected Health Information is confidential
under State of Florida laws.
(b) Except as expressly permitted in writing by North Collier,Collier County shall not divulge,
disclose, or communicate Protected Health Information or confidential information of North
Collier employees to any third party for any purpose not in conformity with this Agreement except
in accordance with North Collier policies and procedures and without prior written approval from
North Collier.
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16.E.4.a
(c) Except as otherwise limited in this Agreement, Collier County may use Protected Health
Information to provide data aggregation services to North Collier as permitted by 45 CFR Section
164.504(e)(2)(i)(B).
(d) Collier County may use Protected Health Information to report violations of law to
appropriate Federal and State authorities, consistent with 45 CFR Section 164.502(j) (1).
C. Obligations of North Collier as Covered Entity to Inform Collier County of
North Collier's Privacy Practices, and any Authorization or Restrictions
(a) North Collier shall provide Collier County with the notice of privacy practices that North
Collier produces in accordance with 45 CFR Section 164.520, as well as any changes to such
notice. ami
E
(b) North Collier shall provide Collier County with any changes in, or revocation of,
authorization by Individual or his or her personal representative to use or disclose Protected Health a
information, if such changes affect Collier County's uses or disclosures of Protected Health
information. a.
(c) North Collier shall notify Collier County of any restriction to the use or disclosure of
Protected Health Information that North Collier has agreed to in accordance with 45 CFR Section z
164.522, if such changes affect Collier County's uses or disclosures of Protected Health
Information. co
D. Confidentiality under State Law and Computer Use by Collier County as Business
Associate
(a) Generally. In addition to the HIPAA privacy requirements, Collier County agrees to
observe the confidentiality requirements of Section 401.30, Florida Statutes. In general, the
referenced statute provides that records of emergency calls that contain patient examination or a.
treatment information are confidential and exempt from the provisions of Section 119.07(1),
Florida Statutes, and may not be disclosed without the consent of the person to whom they pertain
unless otherwise statutorily prescribed. Any person who willfully, knowingly, and without
authorization discloses or takes data, programs, or supporting documentation, including those
residing or existing internal and external to North Collier's computer system, commits an offense
in violation of Section 815.04, Florida Statutes.
Confidentiality requirements protect more than unlawful disclosure of documents. The
confidentiality requirements protect the disclosure of all records and information of North Collier,
in whatever foam, including the copying or verbally relaying of confidential information.
As it relates to computer equipment and systems, Collier County agrees that it will not:
i. Operate or attempt to operate any North Collier computer equipment without
specific authorization from the North Collier.
ii. Disclose any portion of North Collier's computerized system or data with
unauthorized individuals.
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I6.E.4.a
iii. Permit any individual to review, examine, or make copies of any report(s) or
document(s) in its care, custody or control.
Collier County agrees that it will access computer systems, equipment and functions only as
required for the performance of its duties and responsibilities for North Collier and that it has an
up-to-date anti-virus software and firewall running on its computers. In the event Collier County's
password is disclosed, Collier County will immediately contact the District's Deputy Chief of
Emergency Medical Services and Training at (239) 597-3222 to report the incident and request a
new password. Collier County shall remove any North Collier access software before disposing
of any computer.
(b) Receipt of a Subpoena. If Collier County is served with subpoena requiring the production
of North Collier's records or information, Collier County shall immediately contact the District's
Deputy Chief of Emergency Medical Services and Training at (239) 597-3222.
A subpoena is an official summons issued by a court or an administrative tribunal, which requires Q
the recipient to do one or more of the following:
a_
i. Appear at a deposition to give sworn testimony, and may also require that certain
records be brought to be examined as evidence. u.
ii. Appear at a hearing or trial to give evidence as a witness, and may also require that z
certain records be brought to be examined as evidence.
iii. Furnish certain records for examination, by mail or by hand-delivery. co
(c) Employees and Agents. Collier County acknowledges that the confidentiality
requirements herein apply to all its employees,agents and representatives. Collier County assumes
responsibility and liability for any damages or claims, including state and federal administrative
co
proceedings and sanctions, against North Collier, including costs and attorneys' fees, resulting
from the breach by Collier County of the confidentiality requirements of this Agreement. cd
o.
E. Permissible Requests by North Collier as Covered Entity
North Collier shall not request Collier County to use or disclose Protected Health Infounation in
any manner that would not be permissible under HIPAA, the Privacy Rule, the HITECII Act, or
the laws of the State of Florida, if done by North Collier. t
F. HIPAA Security Rule
(a) Security of Electronic Protected Health Information. Collier County will develop,
implement, maintain, and use administrative, technical, and physical safeguards that reasonably
and appropriately protect the confidentiality, integrity, and availability of Electronic Protected
Health Information (as defined in 45 CFR Section 160.103)that Collier County creates, receives,
maintains, or transmits on behalf of the North Collier consistent with the Security Rule.
(b) Compliance Date. The parties to this Agreement will comply with this subsection F. by
the last date set forth in the signature blocks below.
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16.E.4.a
C. HITECH Act Compliance
In the event of any inconsistency or conflict between requirements of HIPAA, HIPAA Security
Rule and HITECH Act,the more stringent provision shall apply.
(a) Collier County shall make a good faith effort to identify and report any use or disclosure
of Protected Health Information not provided for in this Agreement.
(b) Reporting to North Collier. Collier County will report to the North Collier,within ten(10)
business days of discovery, any use or disclosure of Protected Health Information not provided for
in this Agreement of which the Collier County is aware.Collier County will report to North Collier,
within twenty-four (24) hours of discovery, any Security Incident of which Collier County is
aware. A violation of this paragraph shall be a material violation of this Agreement. Such notice
shall include the identification of each individual whose unsecured Protected Health Information
has been, or is reasonably believed by Collier County to have been, accessed, acquired, or Q
disclosed during such breach. ct
a
(c) Reporting to Individuals. In the case of a breach of Protected Health Information
discovered by Collier County,Collier County shall first notify North Collier of the pertinent details
of the breach and upon prior approval of North Collier shall notify each individual whose z
unsecured Protected Health Information has been, or is reasonably believed by Collier County to
have been, accessed, acquired or disclosed as a result of such breach. Such notification shall be in co
writing by first-class mail to the Individual (or the next of kin if the individual is deceased) at the
last known address of the individual or next of kin,respectively,or, if specified as a preference by a)
the individual, by electronic mail. Where there is insufficient, or out-of-date contract information
(including a phone number, email address, or any other form of appropriate communication) that
precludes written (or, if specifically requested, electronic) notification to the individual, a
substitute form of notice shall be provided, including, in the case that there are ten (10) or more
Individuals for which there is insufficient or out-of-date contact information, a conspicuous °'
posting on the Web site of North Collier involved or notice in major print of broadcast media,
including major media in the geographic areas where the individuals affected by the breach likely E
reside. In any case deemed by Collier County to require urgency because of possible imminent ._
misuse of unsecured Protected Health Information, Collier County may also provide information
to individuals by telephone or other means, as appropriate.
(d) Reporting to Media. In the case of a breach of Protected Health Information discovered by
Collier County where the unsecured Protected Health Information of more than five hundred(500)
persons is reasonably believed to have been, accessed, acquired, or disclosed, after prior approval
by North Collier, Collier County shall provide notice to prominent media outlets serving Collier
County.
(e) Reporting to Secretary of Health and Human Services. Collier County shall cooperate with
North Collier to provide notice to the Secretary of Health and Human Services of unsecured
Protected Health Information that has been acquired or disclosed in a breach. If the breach was
with respect to five hundred (500) or more Individuals,such notice must be provided immediately.
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I6.E.4.a
if the breach was with respect to less than five hundred (500) Individuals, Collier County may
maintain a log of such breach occurring and annually submit such log to North Collier so that it
may satisfy its obligation to notify the Secretary of Health and Human Services documenting such
breaches occurring in the year involved.
(f) Content of Notices. All notices required under this Agreement shall include the content
set forth in Section 13402(1),Title XIII of the American Recovery and Reinvestment Act of 2009.
(g) Financial Responsibility. Collier County shall be responsible for all costs related to the
notices required under this Agreement.
(h) Mitigation. Collier County shall mitigate,to the extent practicable, any harmful effect that
is known to Collier County of a use or disclosure of Protected Health Information in violation of
this Agreement.
Section 3. North Collier's Obligations and Activities When Acting as Business Associate
and Collier County's Obligations When Acting as Covered Entity ¢�
A. Obligations and Activities of North Collier acting as Business Associate Regarding o.
Protected Health Information
a
(a) North Collier agrees to not use or further disclose Protected Health Information other than
as permitted or required by Subsections B.,D., and E.of this Section 2,or as required by applicable c"
federal or laws of the State of Florida. o
(b) North Collier agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement.
(c) North Collier agrees to mitigate,to the extent practicable, any harmful effect that is known
to North Collier of a use or disclosure of Protected Health Information by North Collier in violation
of the requirements of this Agreement. a
x
(d) North Collier agrees to report to Collier County any use or disclosure of the Protected
Health Infotuiation not provided for by this Agreement of which it becomes aware. North Collier
will report to Collier County any Security Incident of which North Collier becomes aware that is
(1) a successful unauthorized access, use or disclosure of any Electronic Protected Health
Information; or(2) a successful major (a) modification or destruction of any Electronic Protected
Health Information or(b) interference with system operations in an information system containing
any Electronic Protected Health Information. Upon Collier County's request, North Collier will
report any incident of which North Collier becomes aware that is a successful minor (a)
modification or destruction of any Electronic Protected Health Information or(b)interference with
system operations in an information system containing any Electronic Protected Health
Information.
(c) North Collier agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by North Collier on
behalf of Collier County, agrees to the same restrictions and conditions that apply through this
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16.E.4.a
Agreement to North Collier with respect to such information.
(f) North Collier agrees to provide access, at the request of Collier County or an Individual,
and in a prompt and reasonable manner consistent with the HIPAA regulations,to Protected Health
Information in a designated record set, to Collier County in order to meet the requirements under
45 CFR Section 164.524.
(g) North Collier agrees to make any amendment(s) to Protected Health Information in a
designated record set that the Collier County or an Individual directs or agrees to pursuant to 45
CFR Section 164.526, in a prompt and reasonable manner consistent with the HIPAA regulations.
(h) North Collier agrees to make its internal practices, books, and records, including policies
and procedures and Protected Health Information, relating to the use and disclosure of Protected
Health Information received from, or created or received by North Collier on behalf of Collier
County available to Collier County, or at the request of Collier County, to the Secretary in a time
and manner designated by Collier County or the Secretary, for purposes of the Secretary
determining Collier County's compliance with the Privacy Rule.
a.
(i} North Collier agrees to document disclosures of Protected Health Information and
information related to such disclosures as would be required for Collier County to respond to a v
request by an Individual for an accounting of disclosures of Protected Health Information in 2
accordance with 45 CFR Section 164.528.
oo
(j) North Collier agrees to provide to Collier County or an Individual an accounting of
disclosures of Protected Health Information in accordance with 45 CFR Section 164.528, in a
prompt and reasonable manner consistent with the HIPAA regulations.
a)
(k) North Collier certifies that it is in compliance with all applicable provisions of HIPAA
standards for electronic transactions and code sets, also known as the Electronic Data Interchange
(EDI) Standards,at 45 CFR Part 162; and the Annual Guidance as issued by the Secretary pursuant
to the HITECH Act, Section 13401. North Collier further agrees to ensure that any agent,
including a subcontractor, that conducts standard transactions on its behalf, will comply with the a
EDI Standards and the Annual Guidance.
U
fC
a-.
(1) North Collier agrees to determine the minimum necessary type and amount of Protected ¢
Health Information required to perform its services and will comply with 45 CFR Sections
164.502(b) and 514(d).
B. Permitted or Required Uses and Disclosures by North Collier as Business Associate
(a) North Collier acknowledges and agrees that Protected health Information is confidential
under State of Florida laws.
(b) Except as expressly permitted in writing by Collier County,North Collier shall not divulge,
disclose, or communicate Protected Health Information or confidential information of Collier
County employees to any third party for any purpose not in conformity with this Agreement except
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I6.E.4.a
in accordance with Collier County policies and procedures and without prior written approval from
Collier County.
(c) Except as otherwise limited in this Agreement, North Collier may use Protected Health
Information to provide data aggregation services to Collier County as permitted by 45 CFR Section
164.5 04(e)(2)(i)(B).
(d) North Collier may use Protected Health Information to report violations of law to
appropriate Federal and State authorities, consistent with 45 CFR Section 164.502(j) (1).
C. Obligations of Collier County as Covered Entity to Inform North Collier of
Collier County's Privacy Practices, and any Authorization or Restrictions
(a) Collier County shall provide North Collier with the notice of privacy practices that Collier
County produces in accordance with 45 CFR Section 164.520, as well as any changes to such
a)
notice. c(
(b) Collier County shall provide North Collier with any changes in, or revocation of, a.
authorization by Individual or his or her personal representative to use or disclose Protected Health
0
Information, if such changes affect North Collier's uses or disclosures of Protected Health
Information. z
(c) Collier County shall notify North Collier of any restriction to the use or disclosure of co
Protected Health Information that Collier County has agreed to in accordance with 45 CFR Section
164.522, if such changes affect North Collier's uses or disclosures of Protected Health Information. a
D. Confidentiality under State Law and Computer Use by North Collier as Business a�
Associate
(a) ct
Generally. In addition to the HIPAA privacy requirements,North Collier agrees to observe °'
p � q � g
the confidentiality requirements of Section 401.30, Florida Statutes. In general, the referenced
statute provides that records of emergency calls that contain patient examination or treatment
information are confidential and exempt from the provisions of Section 119.07(1),Florida Statutes,
and may not be disclosed without the consent of the person to whom they pertain unless otherwise
statutorily prescribed. Any person who willfully, knowingly, and without authorization discloses
or takes data, programs, or supporting documentation, including those residing or existing internal
and external to Collier County's computer system, commits an offense in violation of Section
815.04, Florida Statutes.
Confidentiality requirements protect more than unlawful disclosure of documents. The
confidentiality requirements protect the disclosure of all records and information of Collier
County, in whatever form, including the copying or verbally relaying of confidential information.
As it relates to computer equipment and systems,North Collier agrees that it will not:
i. Operate or attempt to operate any Collier County computer equipment without
specific authorization from the Collier County.
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I6.E.4.a
ii. Disclose any portion of Collier County's computerized system or data with
unauthorized individuals.
iii. Permit any individual to review, examine, or make copies of any report(s) or
document(s) in its care, custody or control.
North Collier agrees that it will access computer systems,equipment and functions only as required
for the performance of its duties and responsibilities for Collier County and that it has an up-to-
date anti-virus software and firewall running on its computers. In the event North Collier's
password is disclosed, North Collier will immediately contact Collier County's Administrative
Secretary/Record Custodian, Collier County Emergency Medical Services, at (239) 252-3740.
North Collier shall remove any Collier County access software before disposing of any computer.
(b) Receipt of a Subpoena. If North Collier is served with subpoena requiring the production
of Collier County's records or information, North Collier shall immediately contact Collier E
County's Administrative Secretary/Record Custodian, Collier County Emergency Medical
Services at (239)252-3740. Q
A subpoena is an official summons issued by a court or an administrative tribunal, which requires a.
the recipient to do one or more of the following:
i, Appear at a deposition to give sworn testimony, and may also require that certain
records be brought to be examined as evidence. M
ii. Appear at a hearing or trial to give evidence as a witness, and may also require that o0
certain records be brought to be examined as evidence.
iii. Furnish certain records for examination, by mail or by hand-delivery.
E
(c) Employees and Agents. North Collier acknowledges that the confidentiality requirements
herein apply to all its employees,agents and representatives. North Collier assumes responsibility
and liability for any damages or claims, including state and federal administrative proceedings and qq
sanctions, against Collier County, including costs and attorneys' fees,resulting from the breach by
North Collier of the confidentiality requirements of this Agreement.
E. Permissible Requests by Collier County as Covered Entityca
Collier County shall not request North Collier to use or disclose Protected Health Information in
any manner that would not be permissible under HIPAA, the Privacy Rule, the HITECH Act, or
the laws of the State of Florida, if done by Collier County.
F. HIPAA Security Rule
(a) Security of Electronic Protected Health Information. North Collier will develop,
implement, maintain, and use administrative, technical, and physical safeguards that reasonably
and appropriately protect the confidentiality, integrity, and availability of Electronic Protected
health Information (as defined in 45 CFR Section 160.103) that North Collier creates, receives,
maintains, or transmits on behalf of the Collier County consistent with the Security Rule.
[04-EMG-01149/1255599/1.] Page 10 of 16
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(b) Compliance Date. The parties to this Agreement will comply with this subsection F. by
the last date set forth in the signature blocks below.
C. IIITECI-1 Act Compliance
In the event of any inconsistency or conflict between requirements of HIPAA, HIPAA Security
Rule and HITECH Act,the more stringent provision shall apply.
(a) North Collier shall make a good faith effort to identify and report any use or disclosure of
Protected Health Information not provided for in this Agreement.
(b) Reporting to Collier County. North Collier will report to Collier County, within ten (10)
business days of discovery, any use or disclosure of Protected Health Information not provided for
in this Agreement of which the North Collier is aware. North Collier will report to the Collier
County, within twenty-four (24) hours of discovery, any Security Incident of which North Collier
is aware. A violation of this paragraph shall be a material violation of this Agreement. Such notice
shall include the identification of each individual whose unsecured Protected Health Information
has been, or is reasonably believed by North Collier to have been, accessed, acquired, or disclosed o-
during such breach. _
u.
(c) Reporting to Individuals. In the case of a breach of Protected Health Information z
discovered by North Collier, North Collier shall first notify Collier County of the pertinent details cs,
of the breach and upon prior approval of Collier County shall notify each individual whose 00
unsecured Protected Health Information has been, or is reasonably believed by North Collier to
have been, accessed, acquired or disclosed as a result of such breach. Such notification shall be in a
writing by first-class mail to the Individual (or the next of kin if the individual is deceased) at the
last known address of the individual or next of kin, respectively, or, if specified as a preference by
the individual, by electronic mail. Where there is insufficient, or out-of-date contract information
(including a phone number, email address, or any other form of appropriate communication) that
precludes written (or, if specifically requested, electronic) notification to the individual, a a
substitute faun of notice shall be provided, including, in the case that there are ten (10) or more
Individuals for which there is insufficient or out-of-date contact information, a conspicuous
posting on the Web site of Collier County involved or notice in major print of broadcast media, •
including major media in the geographic areas where the individuals affected by the breach likely
reside. In any case deemed by North Collier to require urgency because of possible imminent
misuse of unsecured Protected Health Information, North Collier may also provide information to
individuals by telephone or other means, as appropriate.
(d) Reporting to Media. In the case of a breach of Protected Health Information discovered by
North Collier where the unsecured Protected Health Information of more than five hundred (500)
persons is reasonably believed to have been, accessed, acquired, or disclosed, after prior approval
by Collier County, North Collier shall provide notice to prominent media outlets serving Collier
County.
(e) Reporting to Secretary of Health and Human Services. North Collier shall cooperate with
Collier County to provide notice to the Secretary of Health and Human Services of unsecured
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Protected Health Information that has been acquired or disclosed in a breach. If the breach was
with respect to five hundred(500)or more Individuals, such notice must be provided immediately,
If the breach was with respect to less than five hundred (500) Individuals, North Collier may
maintain a log of such breach occurring and annually submit such log to Collier County so that it
may satisfy its obligation to notify the Secretary of Health and Human Services documenting such
breaches occurring in the year involved.
(f) Content of Notices. All notices required under this Agreement shall include the content
set forth in Section 13402(f),Title XIII of the American Recovery and Reinvestment Act of 2009.
(g) Financial Responsibility. North Collier shall be responsible for all costs related to the
notices required under this Agreement.
(h) Mitigation. North Collier shall mitigate, to the extent practicable, any harmful effect that
is known to North Collier of a use or disclosure of Protected Health Information in violation of
this Agreement.
Section 4. Term and Termination a.
2
(a) Term. The Term of this Agreement shall begin on the last date set forth on the signature uC'.
blocks below and shall terminate on March 31, 2017 unless otherwise extended by both parties in Z
-hJriting. M
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(b) Termination for Cause. Without limiting any other termination rights the parties may have,
upon party acting as Covered Entity's knowledge of a material breach by party acting as Business
Associate of a provision under this Agreement, Covered Entity shall provide an opportunity for
Business Associate to cure the breach or end the violation. If the Business Associate does not cure
the breach or end the violation within the time specified by Covered Entity, the Covered Entity a
shall have the right to immediately terminate the Agreement. If neither termination nor cure is
feasible, Covered Entity shall report the violation to the Secretary. a.
(c) Return or Destruction of Protected Health Information upon Termination. Within sixty
(60) days after termination of the Agreement for any reason, or within such other time period as
mutually agreed upon in writing by the parties, party acting as Business Associate shall return to
party acting as Covered Entity or destroy all Protected Health Information maintained by Business
Associate in any form and shall retain no copies thereof Business Associate also shall recover,
and shall return or destroy with such time period, any Protected Health Information in the
possession of its subcontractors or agents. Within fifteen (15) days after termination of the
Agreement for any reason, Business Associate shall notify Covered Entity in writing as to whether
Business Associate intends to return or destroy such Protected Health Information. If Business
Associate elects to destroy such Protected Health Information, it shall certify to Covered Entity in
writing when and that such Protected Health Information has been destroyed. If any subcontractors
or agents of the Business Associate elect to destroy the Protected Health Information, Business
Associate will require such subcontractors or agents to certify to Business Associate and to
Covered Entity in writing when such Protected Health Information has been destroyed. If it is not
feasible for Business Associate to return or destroy any of said Protected Health Infotivation,
Business Associate shall notify Covered Entity in writing that Business Associate has determined
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I6.E.4.a
that it is not feasible to return or destroy the Protected Health Information and the specific reasons
for such determination. Business Associate further agrees to extend any and all protections,
limitations, and restrictions set forth in this Agreement to Business Associate's use or disclosure
of any Protected Health Information retained after the termination of this Agreement, and to limit
any further uses or disclosures to the purposes that make the return or destruction of the Protected
Health Information not feasible. If it's not feasible for Business Associate to obtain, from a
subcontractor or agent, any Protected Health Information in the possession of the subcontractor or
agent, Business Associate shall provide a written explanation to Covered Entity and require the
subcontractors and agents to agree to extend any and all protections, limitations, and restrictions
set forth in this Agreement to the subcontractors' or agents' uses or disclosures of any Protected
Health Information retained after the termination of this Agreement, and to limit any further uses
or disclosures to the purposes that make the return or destruction of the Protected Health
Information not feasible.
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Prior to destroying any records hereunder, Business Associate shall obtain written confirmation
from the Covered Entity that such actions will not violate the State of Florida's or the Covered
Entity's record retention policies.
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Section 5. Regulatory References =
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A reference in this Agreement to a section in the Privacy Rule,the Security Rule or the HITECH z
Act means the section as in effect or as amended, and for which compliance is required. N
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Section 6. Amendment
Upon the enactment of any law or regulation affecting the use or disclosure of Protected Health
Information, Standard Transactions, the security of Health Information, or other aspects of
HIPAA-AS or the HITECH Act applicable or the publication of any decision of a court of the
United States or any state relating to any such law or the publication of any interpretive policy or
opinion of any governmental agency charged with the enforcement of any such law or regulation, a.
either party may, by written notice to the other party, amend this Agreement in such manner as
such party determines necessary to comply with such law or regulation. If the other party disagrees
with such amendment, it shall so notify the first party in writing within thirty (30) days of the E
notice. If the parties are unable to agree on an amendment within thirty(30) days thereafter, then
either of the parties may teiminate the Agreement on thirty (30) days written notice to the other
party-
Section 7. Survival
Each party agrees that its obligations under this Agreement with regard to Protected Health
Information and all other provisions in this Agreement that expressly or customarily survive the
termination or expiration of the Agreement shall continue in effect after the Agreement is
terminated or expires.
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I6.E.4.a
Section 14. Waiver
Unless otherwise specifically provided by the terms of this Agreement, no delay or failure to
exercise a right resulting from any breach of this Agreement shall impair such right or shall be
construed to be a waiver thereof, but such right may be exercised from time to time and as often
as may be deemed expedient.Any waiver shall be in writing and signed by the party granting such
waiver. If any representation, warranty or covenant contained in this Agreement is breached by
any party and thereafter waived by another party, such waiver shall be limited to the particular
breach so waived and shall not be deemed to waive,either expressed or impliedly,any other breach
under this Agreement.
Section 15. Severability
In the event any provision of this Agreement shall, for any reason, be determined invalid, illegal
or unenforceable in any respect the parties hereto shall negotiate in good faith and agree to such
amendments,modifications or supplements to this Agreement or such other appropriate actions as Q
shall, to the maximum extent practicable in the light of such determination implement and give
effect to the intentions of the parties as reflected herein,and the other provisions of this Agreement, n.
as amended, modified, supplemented or otherwise affected by such action, shall remain in full
force and effect. a'
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[SIGNATURE PAGE FOLLOWS] E
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I 6.E.4.a
IN WITNESS WHEREOF, the parties have executed this combined HIPAA Privacy Business
Associate, HIPAA Security Rule, HITECH Act Compliance and Confidentiality Agreement, on the
date(s) set forth below.
NORTH COLLIER FIRE CONTROL
AND RESCUE DISTRICT
eird A-11442e_
Print Name and Title
Date:
a.
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ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA
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By: By:
, Deputy Clerk DONNA FIALA, CHAIRMAN
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/Approved as to form and legality:
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,,t1Leffrey A. Klatzkow
County Attorney
[04-EMQ-01149/1255599/1] Page 16 of 16
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MEMORANDUM
Date: April 1, 2016
To: Jeff Klatzkow, County Attorney
Collier County Attorney's Office
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From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
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Re: Interlocal Agreement between the North Collier Fire Control &
Rescue District and Collier County Board of County Commissioners co
C)
Attached for your records is a copy of the agreement referenced above, (Item #10A)
approved by the Board of County Commissioners on Tuesday,March 22, 2016.
The original has been held by the Minutes and Records Department for the Official
Records of the Board. o
If you have any questions, please contact me at 252-8406.
Thank you.
dd
Attachment
Packet Pg. 1774
(NSTRRECpRDED 5243339 OR 5254 PG 803
3/24/2016 9 54 AM PAGES 10 I6.E.4.b
1 t ,16‘
DWIGHT E.BROCK, CLERK OF7HE
COLLIER COUNTY FLORIDA CIRCUIT COURT
REC$86.50
INTERLOCAL AGREEMENT
THIS INTERLOCAL AGREEMENT, dated this day of March, 2016, is entered
into as authorized by Ch. 163, Florida Statutes ("Fla. Stat."), Intergovernmental Programs by and
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between the North Collier Fire Control and Rescue District (hereinafter "District") and the E
as
as
Collier County Board of County Commissioners (hereinafter"County"). as
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WITNESSETH: a
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WHEREAS, Section 163.01, Ha. Stat., authorizes the joint exercise of any power, o
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privilege, or authority which the public agencies involved herein share in common and which c"
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each might exercise separately; and
a)
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WHEREAS, District filed a lawsuit against the County in the litigation titled North
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a)
Collier Fire Control and Rescue District, District/Plaintiff,v. Board of County Commissioners of i'n
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Collier County, Respondent/Defendant (Case No. 11-2015-CA-001871), pending in the a
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Twentieth Judicial Circuit in Collier County, (hereinafter referred to as the"Lawsuit");and
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c.)
WHEREAS, the Parties have engaged in the Ch. 164, Fla. Stat., Governmental Dispute
to
0
process and have agreed to settle the litigation pursuant to the terms of this Interlocal Agreement N
N
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as specifically authorized by Sec. 164.1055(2), Fla. Stat., which provides for a joint public
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meeting and mediation process; and
WHEREAS, District and the County, without either Party admitting any liability or fault,
a)
desire to settle the Lawsuit and any and all disputes that arise from, relate or refer in any way, ;
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whether directly or indirectly, known or unknown, to the incidents described or allegations made E
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in the Lawsuit; and
WHEREAS, District and the County desire to execute this Interlocal Agreement as
required by Sec. 164.1057, Fla. Stat., and so that it shall be binding upon them as well as their
Page 1of10
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16.E.4.b
IOA
respective owners, principals, elected officials, officers, employees, ex-employees, agents,
attorneys,representatives, insurers, successors, assigns, and affiliates;and
NOW, THEREFORE, in consideration of the mutual covenants, promises and
consideration set forth in this Interlocal Agreement, and with the intent to be legally bound,
District and the County agree as follows:
I. District and the County adopt and incorporate the foregoing recitals, sometimes a
referred to as "Whereas Clauses", by reference into this.interlocal Agreement.
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2. The County shall issue the District a certificate of public convenience and z
necessity ("COPCN") to provide advanced life support ("ALS") non-transport services 00
a)
throughout the boundaries of the District on the Effective Date of this Agreement subject to the c%
following terms and conditions: a
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a. The District shall retain the services of the Collier County Medical Director to
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serve as the District's Medical Director(hereinafter referred to as the County
Medical Director/District Medical Director) by this Agreement with the U
County for this service and shall utilize the protocols and standards issued by o
the County Medical Director/District Medical Director to govern the _c
provisions of advanced life support services authorized by the COPCN and
licensed by the State. There shall be no charge to the District for these
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services. The District may employ an Associate Medical Director to assist the
District with the implementation of the protocols, standards, training, and a'
certification/recertification standards established by the County Medical
ns
Director/District Medical Director relating to ALS services provided by the
District. The Associate Medical Director or any other medical professional
Page 2 of 10
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16.E.4.b
10 A
employee and/or volunteer of the District shall work under the supervision of
the County Medical Director/District Medical Director. It is acknowledged by
both Parties that the District does not, by this Agreement or any other
c
agreement or requirement, report to the Collier County Emergency Medical
Services ("EMS") Division or Collier County, and that all statutory and rule
requirements related to medical direction shall be made directly to the District
a.
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by the County Medical Director/District Medical Director. The County
v
Medical Director/District Medical Director and, if applicable, the Collier
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County Deputy Medical Director, shall comply with the provisions of Ch. ;°
119, Fla. Stat., the Health Insurance Portability and Accountability Act uz
a>
("HIPAA"), Health Information Technology for Economic and Clinical
in
Health requirements, and any other federal or state applicable laws relating to
records and/or confidentiality of records. To that end, the County Medical iv
0
Director/District Medical Director, and, if applicable, the Collier County
Deputy Medical Director, shall execute a HIPAA Business Associate 0
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Agreement with the District. The County Medical Director/District Medical
L j
Director may delegate any or all of his responsibilities under this Agreement
to the Collier County Deputy Medical Director.
b. The District shall operate under the emergency medical technicians ("EMTs") °'
and paramedic credentialing and recredentialing standards issued by the
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County Medical Director/District Medical Director, except, all current
credentialing shall be honored by the County Medical Director/District
Medical Director until December 31, 2017. The recredentialing standards
Page 3 of 10
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16.E.4.b
10A
used presently by the District shall remain in place through March 31, 2017.
The County Medical Director/District Medical Director shall develop, with
input from the District, the recredentialing standards for ALS non-transport
paramedics and EMTs on or before January 1,2017.
c. The District shall adhere to the paramedic and EMT credentialing and
recertification ride-time requirements as established by the County Medical Q
Director/District Medical Director. The District may meet its ride-time
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requirements by accompanying a patient on the Collier County EMS ALS
transport from scene to hospital when any ALS service has been performed on
a)
the patient prior to the transport. However, the Collier County EMS Chief,
a)
District Fire Chief and the County Medical Director/District Medical Director er)
in
may identify in writing any exceptions to the ride time requirements. The
District agrees that any time a Collier County EMS paramedic requests a
0
District paramedic to accompany a patient on the Collier County EMS ALS
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transport from scene to hospital regardless of the level of service, the District
N
paramedic shall accompany the patient to the hospital.
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d. The District shall have its own quality assurance program for District 2
paramedics and EMTs as established by the County Medical Director/District
E
Medical Director.The District's quality assurance program shall solely consist
of the County Medical Director/District Medical Director, the District's
Associate Medical Director and District staff. The District shall also
participate in a countywide Quality Assurance Committee as established by
the County Medical Director/District Medical Director, contingent upon all
Page 4 of 10
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16.E.4.b
10 A
interested parties entering into a written mutually agreeable business associate
agreement to ensure compliance with the HIPAA requirements and any other
federal or state applicable laws.
e. The District shall adhere to the patient care reporting system requirements that E
a)
allows for view only access to patient care reports. The District will provide
to Collier County a one-user login account to a view only patient care report
o.
dashboard of the District's Patient Care Reporting System to be used for
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continuum of care for a patient, quality assurance and performance z
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benchmarking. Collier County will provide to the District a one-user login o
account to a view only patient care report dashboard of Collier County's
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Patient Care Reporting System to be used for continuum of care for a patient, a,
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quality assurance, and performance benchmarking. The Parties agree that it
shall control the access and use to such patient care reports. The District will 2
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provide login access to the District's Patient Care Reporting System to the v
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County Medical Director/District Medical Director, with such access
protected from disclosure by the County Medical Director/District Medical
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Director. Both Parties will work cooperatively to ensure that any necessary
third party providers, such as hospitals and emergency rooms, have view only o
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access to the District's patient care reports. The Parties will also work
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cooperatively to implement a single consolidated patient care reporting system
as soon as practicable. The Parties shall use their best efforts to negotiate and
enter into any agreements that may be necessary to meet any and all lawful
requirements, including those related to HIPAA.
Page 5 of 10
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I6.E.4.b
IOA
3. This Interlocal Agreement shall take effect upon execution by the Parties
("Effective Date"). The term of the COPCN and this Interlocal Agreement shall be effective
through March 31, 2017.
4. Should the District be found to have breached the terms of this Interlocal
E
Agreement or the COPCN in any way, all written complaints shall be investigated by both the
County staff and the District staff, and a report thereon made to both the Board of County
a.
Commissioners and the District Board of Fire Commissioners, together with findings and
0
a_
recommendations, within 15 days of such complaint. If termination of the Interlocal Agreement
N
or revocation, suspension or alteration of the COPCN appears warranted, the Board of County00
Commissioners shall give notice to the District that the same will be considered at a specific
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a)
commission meeting,provided the date of such meeting shall not be less than five days from the
date of the notice. The Board of County Commissioners shall thereupon consider the complaint o
and either revoke or suspend the COPCN, terminate the Interlocal Agreement, suggest
alternatives to the COPCN, or dismiss the complaint. Notwithstanding, this procedure shall be
held in compliance with the County's COPCN Ordinance No. 04-12, § 14,as amended.
N
5. Should the County or the County Medical Director/District Medical Director be s
found to have breached the terms of this Interlocal Agreement or the COPCN in any way, all 2
written complaints shall be investigated by both the County staff and the District staff, and a
report thereon made to both the Board of County Commissioners and the District Board of Fire
Commissioners, together with findings and recommendations, within 15 days of such complaint.
s
If termination of the Interlocal Agreement or alteration of the COPCN or the Interlocal
Agreement appears warranted, the District shall give notice to the County that the same will be
considered at a specific commission meeting, provided the date of such meeting shall not be less
Page 6 of 10
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16.E.4.b
10 A
than five days from the date of notice. The District Board of Fire Commissioners shall
thereupon consider the complaint and either terminate the Interlocal Agreement or suggest
alternatives to the COPCN or the Interlocal Agreement.
6. In consideration of the resolution of all disputes or claims arising from or
referring or relating in any way,whether directly or indirectly,to the Lawsuit, the District agrees a1
to dismiss the Lawsuit with prejudice.
7. In consideration of the resolution of the Lawsuit, and for other good and valuable
u.
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consideration, the receipt and adequacy of which is hereby acknowledged, the Parties, on behalf
of themselves, their attorneys, agents, representatives, insurers, heirs, successors and assigns,
a>
hereby expressly releases and forever discharge each other, as well as their elected officials, -c
officers, employees, ex-employees, agents, attorneys, representatives, successors, assigns,
in
0
insurers and affiliates from any and all claims, demands, causes of actions, damages, costs, E
a)
2
attorney's fees, expenses and obligations of any kind or nature whatsoever that they have a)
0
asserted or could have asserted in the Lawsuit or that arise from or relate or refer in any way,
whether directly or indirectly, to the Lawsuit or any incident, event or allegation referred to or N
N
made in the Lawsuit.
8. Notwithstanding anything that may be to the contrary in this Interlocal
Agreement, District and the County agree that either of them (as well as any other persons or
E
entities intended to be bound) shall, in the event of any breach, retain the right to enforce the
terms and conditions of this Interlocal Agreement.
9. District and the County acknowledge and agree that this Interlocal Agreement is
intended to and shall be binding upon their respective owners, principals, officials, officers,
Page 7 of 10
Packet Pg. 1781
1 6.E.4.b
1OA
employees, ex-employees, agents, attorneys, representatives, insurers, successors, assigns, and
affiliates.
10. District and the County recognize and acknowledge that this Interlocal Agreement
_
memorializes and states a settlement of disputed claims and nothing in this Interlocal Agreement E
shall be construed to be an admission of any kind, whether of fault, liability, or of a particular
policy or procedure,on the part of either District or the County. a
s
11. District and the County acknowledge and agree that this Interlocal Agreement is
U
the product of mutual negotiation and no doubtful or ambiguous language or provision in this
N
ooAgreement to be construed against any Party based upon a claim that the Party drafted the
ambiguous provision or language or that the Party was intended to be benefited by the
ambiguous provision or language.
12. This Interlocal Agreement may be amended only by a written instrument
CD2
specifically referring to this Agreement and executed with the same formalities as this
Agreement.
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13. In the event of an alleged breach of this Interlocal Agreement, District and the cw
cvCounty agree that all underlying causes of action or claims of District related to the September 8, 5
L �
2015 denial of the District's COPCN, have been extinguished by this Agreement and that the
sole remedy for breach of this Agreement shall be for specific performance of its terms and
E
conditions or any damages arising from the breach. In this regard, District and the County
further agree that the sole venue for any such action shall be in the Twentieth Judicial Circuit in
and for Collier County, Florida in Naples, Florida.
14, This Interlocal Agreement shall be governed by the laws of the State of Florida.
Page 8 of 10
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1 6.E.4.b
IOA
15. Either the County or District may terminate this Interlocal Agreement after
providing written notice of its intent to terminate at least thirty (30) days in advance of the date
of termination. The District's COPCN is revoked on the termination date of this interlocal
c
Agreement without further action by the County. This Interlocal Agreement shall automatically °'
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a.)
m
terminate if the District is notified by the Florida Department of Health that its license to provide a,
ALS service has been revoked under Ch. 401, Fla. Stat., and associated rules. Upon receipt of Q
a_
such notification,the District shall inform the County in writing. a
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16. This Interlocal Agreement supersedes the agreement titled "Interlocal Agreement z
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Advanced Life Support Partnership Between Collier County and Big Corkscrew Island Fire °o
a)
Control and Rescue District"dated March 25,2014. v;
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17. Prior to its effectiveness, this Interlocal Agreement shall be filed with the Clerk of a>
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Courts for the Circuit Court for Collier County pursuant to Sec. 163.01 (2), Fla. Stat.. The F
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County shall file said agreement as soon as practicable after approval and execution by both
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parties. 0
to
IN WITNESS WHEREOF, District and the County have signed and sealed this N
Interlocal Agreement as set forth below. N
Date: y t� _(�" L
g
ATTEST: BOARD OF COUNTY COMMISSIONERS g
DWIGHT'E. I3ROCK,C4erk COLLIER COUNTY,FLORIDA
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t . — . • aer-rse.--/ /�
WO��.r,1t !r. y a)
1 erk DONNA FIALA, CHAIRtiIAN 3V2.2. t,o
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Appro frx ,•'form'and legality.
Ccts
OUNTY_Jeffrey ". ow
County j'neY
11
Page 9 of 10
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16.E.4.b
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,,,„By:
NorthCollher Fire Control and Rescue District
DISTRICT a
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Page 10 of 10
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16.E.4.b
ORIGINAL DOCUMENTS CHECKLIST & ROUTING ATO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT T
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.
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. c
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3. County Attorney Office County Attorney Office .JAB .C.1-5 3/24/16 ai
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4. BCC Office Board of County �D I=. C a
Commissioners vtf/7 31z..4 (t-,
5. Minutes and Records Clerk of Court's Office 3i2,4116 50,
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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 el
addressees above,may need to contact staff for a ditional or missing information. co
Name of Primary Staff Dan Summer ,Director,Bureau of 252-3600
Contact/Department Emergency rvices / in
Agenda Date Item was 3/22/16 Agenda Item Number 10-A J m
Approved by the BCCc
Type of Document CORN-North Collier Number of Original Onecn—
Attached ef,en4 t'T Documents Attached o
PO number or account n/a E
number if document is 2
to be recorded ,13
INSTRUCTIONS& CHECKLIST o
Initial the Yes column or mark"N/A".in the Not Applicable column,whichever is Yes N/A(Not U
appropriate. (Initial) Applicable) co
1. Does the document require the chairman's original sigma TAMP OK JAB N
2. Does the document need to be sent to another agency for ad. '•nal signa•.es? If yes, JAB cv
provide the Contact Information(Name;Agency;Address;Phone •• • attached sheet. _
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAB u
signed by the Chairman,with the exception of most letters,must be reviewed and signed c
by the Office of the County Attorney. • , •
4. All handwritten strike-through and revisions have been initialed by the County Attorney's JAB c
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 JAB • E
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 • JAB c
signature and initials are required. • E
7. In most cases(some contracts are an exception),the original document and this routing slip JAB
should be provided to the County Attorney Office at the time the item is input into SIRE. • ce
Some documents are time sensitive and require forwarding to Tallahassee within a certain Q
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was apjroved by the BCC on 3/22/16 and all changes made during the JAB
meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the Q0-5BCC,all changes directed by the BCC have been made,and the document is ready for the
Chairman's signature.
1: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
Packet Pg. 1785
1 6.E.4.b
IOA
MEMORANDUM
4-
Date: March 28, 2016.
CD
To: Kathy Heinrichsberg, Executive Secretary
Bureau of Emergency Services
a.
From:
Ann Jennejohn, Deputy Clerk
Board Minutes & Records Department
N
Re: North Collier Fire Control & Rescue District
Certificate of Public Convenience and Necessity (Permit)
Attached for the District's further use, is the original certificate referenced above
(Item#10A),approved by Collier County Board of County Commissioners on
Tuesday, March 22, 2016.
> ;
If you have questions or if I can be of any additional assistance, please feel
free to call me at 252-8406. CD
N
Thank you. N
N
. i
Ctl
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Attachment
Packet Pg. 1786
I6.E.4.b
10 A
COLLIER COUNTY FLORIDA
Renewal of Class "3"COPCN
This Permit is effective March 22,2016 and
Expires March 31,2017
Name of Service: North Collier Fire Control and Rescue District("District")
E
Name of Owner: North Collier Fire Control and Rescue District a
Principle Address of Service: 1885 Veterans Park Drive,Naples, FL 34109
Business Telephone: (239)597-3222 a_
Description of Service: Non-Transport Advanced Life Support o
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Number of Ambulances: N/A Z
N
See attached Exhibit"A" for list of permitted vehiclesco
This permit, as provided by Ordinance No. 2004-12, as amended, shall allow the above
named Non-Transport ALS Service to operate within the North Collier Fire Control and -
Rescue District response boundary and pursuant to the Interlocal Agreement, dated
March 22, 2016, between Collier County and District ("Agreement") and any mutual aid
or auto aid agreement for fire and rescue service within Collier County in which the
District is a party until the expiration date hereon,except that this permit may be revoked a
by the Board of County Commissioners of Collier County at any time the service named 2
herein shall fail to comply with any local, state or federal laws or regulation application (0
to the District in accordance with the Agreement. 'o
This Permit is conditioned on the District complying with Agreement and shall
automatically expire upon the termination of the Agreement. N
N
Issued and approved this 22n1,. day ofckx-cS.-- ,2016
caATTEST: BOARD OF COUNTY COMMISSIONERS a
DWIGHT E.BROCK, CLERK CO IER COUN Y,FLORIDA
r 4
r,
Skinature ty C erk Donna Fiala,Chairman
Approved as to form and leIity:
w, Ng,,,,yy�� •irk
Jenniftr A. Belpedio .. sistant County Attorney
3 a4�tca
Packet Pg. 1787
16.E.4.b
1 0 A
EXHIBIT A
North Collier Fire Control and Rescue District Vehicles
Year Type VIN#
2006 Pierce Quantum 4PICUO1HX6A006078 (T044)
c
12010 Pierce Quantum 4PI CUO1 E3AA010553 (RE45)
1
o
2002 Pierce Quantum 4P1CT02S02A002256 (EN46) a,
Q
2004 Pierce Quantum 4P1CT02S93A003679 (EN40) Q
a.
1998 Pierce Quantum 4P1CT02S5WA000816 (LA47) _
0
2006 Pierce Quantum 4PICU01S36A006032 (LA43) U
z
2005 Ford Expedition 1 FMPU 16545LA78469(SQ44) M
00
2005 Ford 450 1 FDAF56P95ED24543 (HZ41)
a>
v�
2012 Ford 350 1FT8W3BT6CEC562 I I (SQ40) a
c '
2013 Pierce IMPEL 4P 1CJ01 A8EA014108(E 44) a)
in
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2013 Pierce IMPEL 4P1CJ01A8EA014125 (E 48) E
m :
a '
2005 International MEDTEC 1 HTMNAAM67H460580(SQ45) �-
a)
0
2005 Pierce Contender 4P1CC01M65A004732 (Reserve) c.>
u)
2016 Pierce IMPEL 4PIBAAFF7GA015968(EN 42) c
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2006 Sutphen S2- 1S9AIBLD961003100(EN 12) as
2006 Sutphen S2- 1 S9A1 BLD261003097 (EN 10.) c
2013 Ford F550 I FDOX5HTXDEA80905 (AT. 10) E
a3
2015 Ford F550 1FDOX5HT2FEB71542 (AT. 12) —
c
2006 Ford Expedition 1 FMPU16506LA97618(Lt.41 Training) E
2013 Chevy Tahoe 1 GNSK2E03DR326603 (Capt.410) cz
I
C
Packet Pg. 1788
16.E.4.b
10A
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1'-- NORTH COLLIER FIRE CONTROL AND RESCUE DISTRICT a
=
CERTIFICATE OF'PUBLIC CONVENIENCE AND NECESSITY i'
!�
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WHEREAS, the NORTH COLLIER FIRE.CONTROL.AND RESCUE UIS ERIC"T(hereinafter"District")wishes to
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,,'i provide non transport Advanced Life Support("ALS')services;and, ',, N
WHEREAS, it has been demonstrated that there is a need for the District to provide non-transport ALS service to the Qp
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�,` citizens of this County within the District's response boundary and pursuant to Interlocal Agreement, !I i1 i.,
dated March 22,2016,between County and District("Agreement"), and any mutual aid or auto aid t f tF f)
`.',.. i agreement for fire and rescue service within Collier County in which the District is a party;and, 'r3
f,•
d
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WHEREAS, the District has indicated that it will comply with all requirements of Chapter 401,Florida Statutes, C
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governing emergency medical telecommunications and transportation, the Board of County it :I to
Commissioners of COLLIER COUNTY hereby issues a Certificate of Public Convenience and Necessity i.r o
jr \‘‘,.,i;,:::.
to the District for non-transport ALS service with an expiration date of March 31,2017. In issuing this I `'j i'' E
certificate, it is understood that the District will meet the requirements of Ordinance 2004-12, as•
,- amended,applicable laws and regulations,comply with the Agreement,and provide service on a 24 hour i t' - "
,l >
1 tom.; , basis. 1'. O
i� .
t'" s., , ' " U
Al TEST, B)ARD OF COUNTY COMMISSIONERS
I UWIC,H f.f: BROC.$,CLE,JtK C SLIER COUN Y,FLORIDA ` tp
L 1Cs
.
� I)e ut Clerk GV
1 t� 45t as f`ki i i.1 , P y ruts •is a,Chairman fV
4 t l Appreigna ILL sodFand legality ... l -
' Date Signed -- %E l i
1 i
Jennifer .Belpedio r.,,
\,'i I Assistant County.Attorney .,,�,> t t c.
I,, .�11 Q
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1" Effective Date:March 22,2016 r
r" ` I 1�1I
f i'` 'I 1 Expiration Date Mauch 21 2017 .. r E
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Packet Pg. 1789