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To: Michael R. Couzzo, Village er
From: James M. Weinand, Fire Chie
Date: September 25, 2003
Subject: Medical Director Agreement
Attached you will find a revised Medical Director Agreement
with Dr. Don T. Tanabe. The original Agreement took effect
on October l, 1994, and has been mutually extended every
year since 1994.
Florida Statutes, Section 401.265, requires that any
emergency medical services system, which utilizes
parantedics to perform advanced life support procedures,
must employ or contract with a Medical Director.
The Medical Director has a variety of duties to perform under
this Contract and by state law. I'm happy to report that Dr.
Tanabe has done an outstanding job on fulfilling these
obligations and is well like by the firefighters and
paramedics.
The reason this Agreement needs to be modified is to assure
compliance with new state and federal laws. For example, in 1996
the Congress passed a landmark law known as "HIPAA" which stands
� for Health Insurance Portability and Accountability Act. HIPAA
is a complex regulation that requires standardization and
efficiency in the health care industry.
The Village of Tequesta is required to be in compliance
with this new federal law by October 16, 2003, and we must
ensure the protection of our patient's health care information.
Therefore, this contact needs to be modified to reassure proper
protection for the Village.
This item service was not bid-out as per our purchasing policy.
Dr. Tanabe has done outstanding job as Medical Director for
the Village, is well liked by all and I see no reason to
change Medical Directors.
If you see fit, pleas� forward this Agreement to the Village
Council for consideration at their next meeting.
M:\Administration Documents\Village Manager\2003 Medical Director Agreement.doc
RESOLUTION NO.
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A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE OF
TEQUESTA, PALM BEACH COUNTY, FLORIDA, APPROVING THE MEDICAL
DIRECTOR AGREEMENT WITH DON T. TANABE, M.D., AND AUTHORIZING
THE MAYOR TO EXECUTE THE SAME ON BEHALF OF THE VILLAGE OF
TEQUESTA.
NOW, THEREFORE, BE IT RESOLVED BY THE VILLAGE COUNCIL OF THE VILLAGE OF
TEQUESTA, PAI,M BEACH COUNTY, FLORIDA, AS FOLLOWS:
Section 1. The Medical Director Aqreement between the Village of
Tequesta and Don T. Tanabe, M.D., attached hereto as Exhibit "A" and
incorporated by reference as a part of this Resolution, is hereby
approved and the Mayor of the Village is hereby authorized to execute
the same on behalf of the Village of Tequesta.
THE FOREGOING RESOLUTION WAS OFFERED BY Council Member
, who moved its adoption. The motion was
seconded by Council Member , and upon being
put to vote, the vote was as follows:
FOR ADOPTION AGAINST ADOPTION
'S1�e Mayor ther�eupon declared the Resolution duly passed and adopted this
� d,ay ca�' A. D. 2003 .
MAYOR OF TEQUESTA
Edward D. Resnik, Mayor
ATTEST:
Mary Wolcott
Village Clerk
MEDICAL DIRECTOR AGREEMENT
THIS AGREEMENT, made and entered into this 9th day of
October, 2003, by and between the VILLAGE OF TEQUESTA, a
municipal corporation under the laws of the State of
Florida (hereinafter referred to as "Village"), and DON
TANABE, M.D., a Florida licensed physician (hereinafter
referred to as "Medical Director").
W I T N E S S E T H:
WHEREAS, emergency medical services are provided by
the Village of Tequesta by and through its Department of
Fire-Rescue Services which employs paramedics to perform
advanced life support; and
�
WHEREAS, Section 401.265, Florida Statutes, requires
that any emergency medical services system which utilizes
par�.medics to perform advanced life support procedures must
�mpl.oy or contract with a medical director; and
WHEREAS, the aforementioned statute and Chapter 64E-2
of th� Flarida Administrative Code set out certain criteria
and xec�uircments for said medical director; and
WH�REAS, the Villa e desires to em lo a lic n
g p y e sed
physician to serve as medical director and to provide
m�dical direction to the employees of the Village of
Tequesta Department of Fire-Rescue Services to insure
appropriate patient care and consistency.
IN:�Administration Documents\Proposals & Contracts 1
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NOW, THEREFORE, in consideration of the mutual promises
and covenants set forth herein, the parties agree as
follows:
I. DESIGNATION OF MEDICAL DIRECTOR
The Village does hereby engage Don Tanabe, M.D., a licensed
physician in the State of Floricla, as Medical Director for
the Village's Emergency Medical Service System.
II. DUTIES AND RESPONSIBILITIES
The Medical Director shall:
A. Be the Medical Director for the Village of
Tequesta Emerg�ncy Medical Service System. For
the purposes of this agreement, the Village of
Tequesta Emergency Medical Service System shall
include emergency medical technicians,
paramedics, captains, lieutenants, firefighters
and volunteer firefighters working for or
providing services for the Village of Tequesta
Department of Fire-Rescue Services;
B. Supervise and accept responsibility for the
medical performance of the emergency medical
technicians, paramedics, captains, lieutenants,
firefighters and volunteer firefighters working
for or providing services to the Village of
Tequesta Department of Fire-Rescue Services;
C. Develop and authorize, or review and authorize
for use, medically correct standing orders and/or
protocols that permit specified ALS procedures
M:�Administration Documents\Proposals & Contracts 2
when communication cannot be established with a
supervising physician or when any delay in
patient care would have potential life or limb
threatening consequences. Standing orders and
protocol shall insure that patients are
transported to facilities that offer a type and
level of care appropriate to the patient's
medical condition. The Medical Director or his
appointee shall provide continuous twenty-four
(24) hour per day availability of Medical
Director "off-line" service for potential
problems, system conflicts and disaster events;
D. Audit the performance of the Village's Department
of Fire-Rescue Services personnel by use of a
quality assurance program to include, but not be
limited to, a prompt review of run reports,
direct observation, and comparison of performance
standards for drugs, equipment, and established
protocols and procedures
E. Be responsible for participating in quality
assurance programs developed by the Department of
Health and Rehabilitation Services;
F. Ensure and certify that security procedures for
medications, fluids and controlled substances are
in compliance with Chapter 499, Florida Statues,
and Chapter 893, Florida Statutes;
G. Specify medication substitutions in writing;
H. Submit to the Department of Health and
Rehabilitation Services, within thirty (30) days
of any deviation from the approved trauma
transport protocols, a copy of the run report and
a written explanation regarding the deviation;
M:�Administration Documents\Proposals & Contracts 3
I. Conduct one (1) meeting per month of not less
than two (2) hours for the purpose of training
and educating the Village's personnel in the
Department of Fire-Rescue Services;
J. Assist in identifying the specific medical skills
and knowledge which the Village's personnel
within the Department of Fire-Rescue Services
must possess to achieve the desired level and
standard of care;
K. Assist in providing the necessary training in the
special medical skills and knowledge which the
Village's personnel within the Department of
Fire-Rescue Services must possess to achieve the
desired level and standard of care;
L. Provide a minimum of eight (8) hours per month
attendance at the Fire-Rescue headquarters to
participate in monthly quality assurance planning
meetings, to deliver monthly in-service training
with department personnel, perform physician
level call review on random medical reports and
participate as a crew member on the response
unit;
M. Be responsible for complying with Florida
Statutes Section 401.265 (2003), as amended from
time to time, all laws and administrative
regulations promulgat,ed in accordance with
Chapter 401, Florida Statutes (2003), as amended
from time to time, and all rules of the
Department of Health and Rehabilitation Services
and shall perform all duties enumerated in
Section 64E-2.004, Florida Administrative Code
(2003), as amended from time to time.
M:�Administration Documents\Proposals & Contracts 4
III. DUTIES OF THE VILLAGE
A. In consideration for the services provided
by Medical Director, the Village hereby
agrees to pay Medical Director Nine Hundred
and Twenty-Five Dollars ($925.00) per month,
payable monthly, during the term of the
agreement.
i. If the contract is extended in
accordance with Section V (CONTRACT
TERM), the Nine Hundred and Twenty-Five
Dollars ($925.00) per month
compensation shall be considered the
Base Amount.
ii. Each year thereafter, the Base Amount
shall be adjusted up or down from the
compensation rate from the previous
contract year by annual indices from
the Bureau of Labor Statistics
Southeastern Regional offices for May,
utilizing the Consumer Price Index
(CPI) for all Urban Consumer-South to
arrive at the new compensation rate for
the next fiscal year. In the event that
during the term ot this Agreement the
above-referenced indices are no longer
published, then the parties hereto
agree to substitute therefore a
mutually agreeable new index.
B. The Village shall provide the Medical Director
insurance coverage for medical malpractice with
M:�Administration Documents\Proposals & Contracts 5
liability limits of $1,000,000.00 for claims
arising out of the scope and performance of
activities specified in this agreement, and
specifically as Medical Director for the Village
af Tequesta.
C. The Village will provide Medical Director with a
pager and/or cell phone to assure communications
with personnel if needed, to perform his duties
as Medical Director for the Village of Tequesta.
IV. INDEPENDENT CONTRACTOR RELATIONSHIP
A. The Medical Director is an independent contractor
who will be responsible for payment of federal
withholding tax and social security
contributions. Furthermore, the Medical Director
sha11 not be entitled to any fringe benefits
normally provided to Village Employees such as
worker's compensation, unemployment compensation,
retirement, disability leave and any leave with
PaY•
B. To the extent that some of the services provided
by the Medical Director may cause the Medical
Director to be defined as a Business Associate
under 45 CFR Parts 160 and 164 issued under the
Health Insurance Portability and Accountability
Act of 1996 (the "Privacy Rule") and the Village
of Tequesta Fire-Rescue Department in its
capacity as a Covered Entity, as defined in the
Privacy Rule, is required to comply with Sections
164.504 (2)(ii) of the Privacy Rule, the Medical
Director shall:
M:�Administration Documents\Proposals & Contracts 6
a. Not use or further disclose Protected Health
Information ("PHI"), other than as permitted
or required by this Agreement or as required
by law;
b. Use appropriate safeguards to prevent use or
disclosure of PHI other than as provided for
in this Agreement;
c. Report to the Village any use or disclosure
of PHI by Medical Director, employees or
agents other than as permitted by this
agreement of which Medical Director becomes
aware;
d. Ensure that any agents of Medical Director,
including a subcontractor, to whom Medical
Director provides PHI received from, or
created or received by Medical Director on
behalf of Village, agrees to the same
restrictions and conditions that apply to
Medical Director with respect to such
Protected Health Information.
e. To the extent applicable to Medical
Director, make available PHI in accordance
with Section 164.524 of the Privacy Rule;
f. To the extent applicable to Medical
Director, make available PHI for amendment
and incorporate such amendments to PHI in
accordance with Section 164.526 of the
Privacy Rule;
g. To the extent applicable to Medical
Director, make available information
required to provide an accounting of
M:�Administration Documents\Proposals & Contracts �
disclosures in accordance with Section
164.528 of the Privacy Rule;
h. Make Medical Director's internal practices,
books, and records related to use and
disclosure of PHI received from, or created
or received by Medical Director on behalf of
Village available to the Secretary of Health
and Human Services for purposes of
determining Customer's compliance with this
Section 29.
i. At termination of this Agreement, if
feasible, return or destroy all PHI received
from, or created or received by Medical
Director on behalf of the Village that the
Medical Director still maintains in any form
and retain no copies of such information,
or, if such return or destruction is not
feasible, extend the protections of this
Agreement of the information and limit
further uses and disclosure to those
purposes that make the return or destruction
of the PHI infeasible.
� j. Medical Director agrees to comply with
Security Provisions as outlined within the
HIPAA Privacy and Security Rules for the
electronic storage and use of PHI.
k. In the event that the Medical Director
breaches any of the foregoing conditions
regarding the Health Insurance Portability
and Accountability Act, the Village may
terminate this Agreement.
M:�Administration Documents\Proposals & Contracts 8
V. CONTRACT TERM
The Village agrees to retain the Medical Director and the
Medical Director agrees to be so retained in an independent
contractor relationship for a period of one (1) year
beginning October l, 2003. This agreement shall
automatically renew each year unless written notice of
intent to terminate is given by either party sixty (60)
days prior to the expiration date.
VI. TERMINATION
This agreement is subject to cancellation with or without
cause by either party to this agreement at any time during
the contract period, including renewals thereof, by
providing sixty (60) days prior written notice to the
party. Such notice shall be forwarded by registered mail
to the last known address of the'other party.
VII. AUTHORITY
A. The Medical Director is not authorized to
obligate the expenditure of Village funds.
B. The Medical Director shall retain the ultimate
authority to permit and/or prohibit any paramedic
or EMT working for the Village's Department of
Fire-Rescue Services to utilize advance life
support and/or basic life support techniques and
shall immediately notify the Village Manager or
his designee of the change of eligibility of any
paramedic or EMT to perform emergency medical
care.
M:�Administration Documents\Proposals & Contracts 9
C. The operation and administrative control of the
Village's Emergency Medical Services will be
vested in the Village Manager or his designee and
the Medical Director shall be responsible to the
Village Manager or his designee.
VIII. INTERPRETATION AND BINDING EFFECT
, Except as herein otherwise provided, this agreement shall
inure to the benefit of and shall be binding upon the
parties hereto, their personal representatives, successors,
heirs and assigns.
IX. INVALIDITY OR UNENFORCEABTLITY
Tnvalidity or unenforceability of any provision hereof
shall in no way affect the validity or enforceability of
any other provisions.
X. GOVERNING LAW
This agreement shall be governed and construed in
a�cQrdanc� with the laws of the State of Florida.
X�. ENTIRE AGREEMENT
Th�� agreement contains the entire understanding between
the parties and may not be changed or modified except by an
agreement in writing signed by all the parties.
M:�Administration Documents\Proposals & Contracts 10
IN WITNESS WHEREOF, the parties have signed this agreement.
The date of this agreement shall be the date first written
above.
Signed, sealed and delivered
In the presence of:
VILLAGE OF TEQUESTA:
By:
Edward D. Resnik, Mayor Witness
MEDICAL DIRECTOR:
Don T. Tanabe, M.D. Witness
�TTEST:
Mary Mi1es, Village Clerk Witness
M:�Administration Documents\Proposals & Contracts 11
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=.Y: ;'�9�1�ge �fiTequesta
Medical Qirector Ac�reement
c�ur File No, 13153.1
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t���a� reviewed the agreement re(ating to the Medica) !]il'ector which yau e-mailed to
���Lfi �fawkins. Pleasc be ad�ised that I approve of the agreement as #a legal farm �nd
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`='���se na�e, howvever, that I have penned in places where I have located typographicai
�r� s. in addition, ( have added a sEntence to paragraph 6 relating t4 termina#ion.
'= �� ���!��tever b�:nefit it may have, I am also providing you with a copy of a�imilar
- ��^� ;t fQr t���� Toi�m of Palm Beach which may include I�nguage that Tequesi� may
� ; � ���h�s �s� �ncorP�rate in ifis agreement.
�T� �-�.w� �ao r�pt he.sitate fio contact me i� yau have any comments ar questions,
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.� �°;`�'.��, F E�t, JoHNST4[d & STUBBS, P.A.
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