1999-446AN ORDINANCE AUTHORIZING THE CITY MANAGER TO EXECUTE A PROFESSIONAL
SERVICES AGREEMENT WITH BAYLOR MEDICAL CENTER AT GRAPEVINE AND DR
JOHN ANSOHN TO PROVIDE MEDICAL CONTROL SERVICES FOR THE CITY OF
DENTON FIRE DEPARTMENT AS SET FORTH 1N THE CONTRACT, PROVIDING FOR THE
EXPENDITURE OF FUNDS THEREFORE, AND PROVIDING AN EFFECTIVE DATE (RFSP
2414 - PROFESSIONAL SERVICES CONTRACT FOR MEDICAL CONTROL SERVICES
AWARDED TO BAYLOR MEDICAL CENTER AT GRAPEVINE AND DR JOHN ANSOHN
IN THE AMOUNT OF $62,750)
THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS
SECTION I That the City Manager is hereby authorized to enter ~nto a professional service
contract with Baylor Medical Center at Grapewne and Dr John Ansohn for the Medical Centrol
Services, a copy of which is attached hereto and incorporated by reference herein
~ That the City Manager is authorized to expend funds as reqmred by the
attached contract
SECTION III That this orchnance shall become effective immediately upon its passage and
approval
PASSED AND APPROVED thls the ~/g/-'-~ dayof d~d~_,1999
ATTEST
JENNIFER WALTERS, CITY SECRETARY
APPROVED AS TO LEGAL FORM
HERBERT L PROUTY, CITY ATTORNEY
PSA 2414 -~ CONTRACTUAL FOR PROFESSIONAL SERVICES ORDINANCE
PROFESSIONAL SERVICES AGREEMENT
FOR MEDICAL CONTROL SERVICES
STATE OF TEXAS
COUNTY OF DENTON §
THIS AGREEMENT is made and entered into as of the q day of
~..~~_, 19 C~C~ , by and between the City of Denton, Texas, a Texas mummpal
corporation, with its pnnclpal office at 215 East McKmney Street, Denton, Denton County,
Texas 76201, hereinafter called "CITY" and BAYLOR MEDICAL CENTER AT GRAPEVINE,
a Texas non-profit corporation located at 1650 West College Street, Grapevine, Texas 76015,
hereinafter called "BAYLOR," acting herein, by and through their duly authonzed
representatives
WITNESSETH, that in consideration of the covenants and agreements herein contmned,
the parties hereto do mutually agree as follows
ARTICLE 1
EMPLOYMENT
The CITY hereby contracts with BAYLOR, as an independent contractor, and that
BAYLOR hereby agrees to perform the services herein in connection with the Project as stated
~n the sections to follow, with diligence and in accordance with the baghest professional
standards customarily obtained for such services m the State of Texas The professional services
set out herein are in connection with the following described project
Providing medical control services for the City of Denton Fire Department
ARTICLE 2
SCOPE OF SERVICES
The BAYLOR shall perform the following services in a professional manner
A
BAYLOR shall perform all those services as necessary and as described in the CITY's
RFSP #2414, which is attached hereto and made a part hereof as Exhibit "A" and as
descnbed in Baylor's Response to RFSP #2414, which is attached hereto and made a part
hereof as Exhibit "B" as if written word for word, to include but not limited to the
following
Off-hne EMS Medical director services as required by the Texas State Board of
Medical Examiners' EMS regulations for medical directors, 22 Tex Admm Code
§§ 197 1-1976 6,
On-hne medical control, as defined by Department regulations, 24 hours a day for
seven (7) days a week,
3
4
5
6
Formulation and review of EMS protocols,
Monthly scheduled meetangs to dascuss the operation of Emergency Servace and
Baylor's responsthflmes under thas Agreement,
Establash guadelanes and monator quahty assurance,
Coordanate sufficient eontanuang educataon to meet Department requirements as
set forth at 25 Tex Admm Code § 157 38,
By independent contract, Baylor will provade an EMS Medacal Darector (the
"Darector"), as defined by 22 Tex Admln Code § 197 2 who fulfills the
oblagataons and requarements of Chapter 197, Tex Admm Code, pertmmng to
EMS medmal dareetors The agreement between Baylor and the Darector to
prowde the EMS Medaeal D~reetor serrates as attached hereto as Exh~bat "D" and
aneorporated herean by reference,
Baylor wall sponsor up to three (3) EMS Examiners and three (3) EMS Instructors
from Emergency Servace, and
Baylor wall provade two (3) spemalty-type courses (BTLS, ACLS, and pedaatnc
course) for the CITY during the term of thas Agreement The classes wall be held
at Denton Fare Department an Denton, Texas The scheduling of these courses
wall be mutually agreed upon by CITY and BAYLOR
No more than thirty eaght (38) students may be enrolled an ACLS course
No more than thirty eaght (38) students may be enrolled an pedaatne course
No more than twenty sax (26) students may be enrolled an BTLS course
B
If there as any conflact between the terms of thas Agreement and the exhab~ts attached to
thas Agreement, the terms and cond~taons of thas Agreement will control over the terms
and condataons of the attached exhabats
ARTICLE 3
PERIOD OF SERVICE
Th~s Agreement shall become effective upon January 1. 2000 afier proper executaon by
the partaes, and shall remain an force for a period of one (1) year Thas Agreement may be
renewed for add~taonal one (1) year terms upon the giving of prior written not,ce by the CITY
before the anmversary date Thas Agreement may be sooner termanated m accordance wath the
provaslons hereof
ARTICLE 4
COMPENSATION
A COMPENSATION TERMS
In consaderataon for BAYLOR's provasaon of medacal control servaces under thas
Agreement, CITY wall pay to BAYLOR the fee set forth an Exhab~t "C" The fee shall be
prod to Baylor an quarterly anstallments, consastang of four equal anstallments as
determined an Exhablt "C", wath the first installment due on or before the tenth (10th) day
after the Commencement Date, wath each following ~nstallment due on or before the first
day of each (3rd) month followang CITY shall pay all fee anatallments to Baylor at the
address set forth an Article 10 hereof Any fee refunds shall only be made on a prorated
Pm,e 2
basis and in the event of termination of the Agreement ARer the expiration of the first
term of the Agreement and upon their mutual agreement, the parties may modify the
compensation to be prod Baylor by executing a new Exhibit "C' to the Agreement If
any new compensation ~s beyond the City Manager's authority then the change in
compensation shall go before the city council as an amendment to thts agreement
ARTICLE 5
INDEPENDENT CONTRACTOR
BAYLOR shall prowde services to CITY as an independent contractor, not as an
employee of the CITY BAYLOR shall not have or claim any right arising from employee
status Nothing m this Agreement shall be interpreted or construed so as to make BAYLOR an
employee, agent, or borrowed servant of the CITY Nothing In thru Agreement shall be
interpreted or construed so as to make the employees of the CITY the servants, agents, or
employees of BAYLOR CITY and the employees of the CITY shall not be ehgible for the
employment benefits, including health and unemployment ~nsurance, and worker's compensation
coverage, which are provided to employees of BAYLOR The part,es agree and acknowledge
that the D~reetor is an independent contractor physm~an, and nothing in thts Agreement shall be
interpreted or construed so as to make the Director an employee, servant or agent of BAYLOR
or the CITY CITY and BAYLOR acknowledge and understand that nothing ~n th~s Agreement
reqmres, and shall not be construed to reqmre (directly or indirectly, exphcitly or lmphcitly
CITY's use of BAYLOR or any other facility or service related to BAYLOR, or the admission or
referral of any persons or patients treated by CITY to BAYLOR or other famlmes related to
BAYLOR
ARTICLE 6
INDEMNITY AGREEMENT
BAYLOR shall tndemnify and save and hold harmless the CITY and its officers, agents,
and employees from and agmnst any and all habfl~ty, claims, demands, damages, losses, and
expenses, ~ncluding, but not hm~ted to court costs and reasonable attorney fees incurred by the
CITY, and including, without limitation, damages for bodily and personal injury, death and
property damage, resulting from the neghgent acts or omissions of BAYLOR or its officers,
shareholders, agents, or employees in the execution, operation, or performance of th~s
Agreement
To the extent permitted by law, CITY agrees and IS bound to hold harmless and
~ndemmfy BAYLOR against any and all claims for damages, costs, and expenses to persons or
property that may arise out of, or be occasioned by th~s contract or any of its acttwt~es or from
any act or omission of the CITY, its employees, representatives and agents, provided, however,
that ~t ~s not the tntention or purpose to create hablhty against the CITY unless such habfllty ~s
~mposed by law
Nothing in th~s Agreement shall be construed to create a habIhty to any person who is not
a party to th~s Agreement, and nothing here~n shall wmve any of the parties' defenses, both at
law or equity, to any claim, cause of action, or litigation filed by anyone not a party to this
Agreement, including the defense of governmental lmmumty, which defenses are hereby
expressly reserved
ARTICLE 7
INSURANCE
Dunng the performance of the services under this Agreement, BAYLOR shall maintain
the following insurance either as a self insured entity or w~th an insurance company licensed to
do business in the State of Texas by the State Insurance Commission or any successor agency
that has a rating with Best Rate Camers of at least an A- or above
A Professional Liability Insurance with hmlts of not less than $1,000,000 annual aggregate
ARTICLE 8
ARBITRATION AND ALTERNATE DISPUTE RESOLUTION
The parties may agree to settle any disputes under this Agreement by submitting the
dtspute to arbitration or other means of alternate dispute resolution, such as mediation No
arbitration or alternate dispute resolution arising out of or relating to th~s Agreement, involving
one party's d~sagmement, may include the other party to the d~sagreement without the other's
approval
ARTICLE 9
TERMINATION OF AGREEMENT
A
Notwithstanding any other provision of this Agreement, e~ther party may terminate by
g~vmg thirty (30) days' advance wntten notice to the other party
B
Th~s Agreement may be terminated in whole or in part in the event of either party
substantmlly failing to fulfill its obhgat~ons under this Agreement No such termination
will be affected unless the other party is given (1) written notme (delivered by cemfied
mall, return receipt requested) of ~ntent to terminate and setting forth the reasons
spemfymg the non-performance, and not less than thirty (30) calendar days to cure the
failure, and (2) an opportumty for consultation with the termmnatmg party prior to
termination
C
This Agreement shall terminate automatmally upon either party's loss of hcensum or
certification, or upon the effective date of any change m statute, ordinance, role or
regulation or action of governmental authority prohibiting this arrangement or the
services contemplated hereunder
ARTICLE 10
NOTICES
All notlces, communications, and reports reqmred or permitted under this Agreement
shall be personally delivered or marled to the respective parties by depositing same ~n the United
States marl to the address shown below, certffied marl, return receipt requested, unless otherwise
specified herein Mmled notices shall be deemed commumcated as of three (3) days' maflmg
To BAYLOR To CITY
Baylor Medmal Center of Grapewne
Attention Lelgh Anne Bednch
EMS Education Coordinator
1650 W College St
Grapewne, Texas 7605 l
City of Denton
Ross Chadwick, Fire Chief
212 West Sycamore
Denton, Texas 76201
All notices shall be deemed effective upon receipt by the party to whom such not,ce ~s
g~ven, or w~thln three (3) days' mailing
ART
ENTIRE AGREEMENT
Th~s Agreement, consist~ng of 8 pages and four (4) exhibits, constitutes the complete and
final expression of the agreement of the parties, and ~s intended as a complete and exclusive
statement of the terms of their agreements, and supersedes all prior contemporaneous offers,
promises, representatmns, negotmt~ons, d~scusslons, commumcat~ons, and agreements which
may have been made ~n connection w~th the subject matter hereof
ARTICLE 12
SEVERABILITY
If any prov~slon of this Agreement ~s found or deemed by a court of competent
junsdmt~on to be tnvahd or unenfomeable, ~t shall be considered severable from the remamnder of
th~s Agreement and shall not cause the remainder to be ~nvahd or unenfomeable In such event,
the pames shall reform this Agreement to replace such stricken provision with a valid and
enforceable provision which comes as close as possible to expressing the mtent~on of the stricken
provision
ARTICLE 13.
COMPLIANCE WITH LAWS
BAYLOR shall comply w~th all federal, state, and local laws, rules, regulatmns, and
ordinances apphcable to the work covered hereunder as they may now read or hereinafter be
amended
Pace ~
ARTICLE 14
DISCRIMINATION PROHIBITED
In performing the services reqmred hereunder, BAYLOR shall not dmcnm~nate against
any person on the bas~s of race, color, rehg~on, sex, national ongm or ancestry, age, or physical
hand~cap
ARTICLE 1 $
PERSONNEL
A
The BAYLOR represents that tt has or will secure, at its own expense, all personnel
reqmred to perform all the services reqmred under th~s Agreement Such personnel shall
not be employees or officers of, or have any contractual relations w~th the CITY
BAYLOR shall mfonn the CITY of any conflict of ~nterest or potential conflmt of
~nterest that may arise dunng the term of th~s Agreement
B
Except for the servmes prowded by the D~rector, services reqmred hereunder will be
performed by BAYLOR or under as supervision All personnel engaged ~n work shall be
qualified, and shall be anthonzed and penmtted under state and local laws to perform
such services
ASSIGNABILITY
Th~s Agreement shall apply to, and be b~ndmg upon, the part,es and their respective
successors and permitted assigns The part, es shall not assign any interest ~n thru Agreement,
and shall not transfer any interest m th~s Agreement (whether by assignment, novatmn, or
otherwise) w~thout the pnor written consent of the other party Any asmgnment attempted
without such consent shall be vmd
ARTICLE 17
MODIFICATION
No wmver or modfficatton ofth~s Agreement or of any covenant, condition, or hm~tat~on
hereto contained shall be vahd unless ~n writing and duly executed by the party to be charged
therewith, and no ewdence of any waiver or modfficat~on shall be offered or received m evidence
~n any proceeding arising between the parties hereto out of or affecttng this Agreement, or the
rights or obhgat~ons of the partxes hereunder, and unless such waiver or modification ~s ~n
writing and duly executed, and the part~es further agree that the pmws~ons of th~s section w~ll not
be waived unless as set forth herein
MISCELLANEOUS
A The following exhibits are attached to and made a part of th~s Agreement (hst exh;blts)
1 Extub~t "A" C,ty's Request for Sealed Proposal
2 Extubt "B" Baylor's Response to Request for Sealed Proposal
3 Exhibit "C" Compensation Exh,ba
4 Exbab~t "D" Baylor's Agreement with phys,caan
B
Venue of any stat or cause of action under th~s Agreement shall lie exclustvely in Denton
County, Texas This Agreement shall be construed in accordance with the laws of the
State of Texas
C
Force MaJeure Ne,ther party shall be in violation ofth~s Agreement ~f either party is, or
~f e~ther party reasonably determ,nes that it m, prevented from pel fonmng ~ts obligations
for any reason beyond its control, including without hm~tat~on, flood, storm, strikes, acts
of God or the pubhe enemy
D
The captions of this Agreement are for informational purposes only, and shall not m any
way affect the substantive terms or conditions ofth~s Agreement
IN WITNESS HEREOF, the C~ty of Denton, Texas has caused th, s Agreement to be
executed by its duly authorized City Manager, and BAYL~/3~as exeeuted,.thls Agreement
througih its duly authorized undersigned officer on this the /4t~ day of
2000
CITY OF DENTON, TEXAS
~ANAGER
ATTEST
JENNIFER WALTERS, CITY SECRETARY
APPROVED AS TO LEGAL FORM
HERBERT L PROUTY, CITY ATTORNEY
WITNESS
BAYLOR MEDICAL CENTER
AT GRAPEVINE
BY
Page 8
EXHIBIT "A"
CITY OF DENTON
RFSP # 2414
PROFESSIONAL SERVICES
CONTRACT FOR MEDICAL
CONTROL SERVICES
BID OPENING DATE: SEPTEMBER 23, 1999
NOTICE TO VENDORS
Proposals will be received by the City of Denton, Texas at the office of the Purchasing Agent pnor
to 2 00 pm,, SEPTEMBER 23. 1999 for the following
RSFP # 2414 - PROFESSIONAL SERVICES CONTRACT FOR MEDICAL
CONTROL SERVICES
Qualtfied prospective suppliers my obtain cop~es of the pwposal w~th mformat~on at the office of
the Purchasing Agent, located at 901-B Texas Street, Denton, Texas 76201 m the Service Center
complex
The C~ty of Denton, Texas reserves the nght to reject or accept any proposal and award to the most
advantageous proposal received
No officer or employee of the City of Denton shall have a f'mancml interest, chrect or ~ndlrect m any
contract w~th the City of Denton
Minority and small business vendors are encouraged to submit proposals
CITY OF DENTON, TEXAS
(940)349-7100
TOM D SHAW, C P M
PURCHASING AGENT
Ttus advertisement to run: SEPTEMBER 8 A~ND SEPTEMBER 15. 1999
RFSP 2414-STANDARD AD
REQUEST FOR PROPOSAL
The City of Denton is accepting Request for Proposals for a Pwfesslonal Services
Contract for medmal control services for the Denton Fire Department per the enclosed
requirements Two (2) copies of the proposal must be submitted by September 23, 19o9
in a sealed envelope w~th the following information marked plainly on the front
RFSP # 2414
CITY OF DENTON
90lB TEXAS STImuli'
DENTON, TX 76201
Questions regarding the attached spec:flcations may be directed to Greg Taylor, EMS
Program Manager, at 940/349-8132
Requirements
The requirements of the Medical Control provider fall into three categories as described
below
I. On-Line Medical Direction
A On-line sermces shall be provided as reqmred by the Texas State Board of
Medical Examiners' EMS regulations for medical directors in 22 TAC, § 197
B On-hne service via phone with two dedicated lines and fax/modem compatible
with Life-Pak 12s wdl be provided 24-hours, 7 days per week
C A relationship with a local Denton hospital for on-line medical control is
preferred
D Assistance will be provided in disasters and MCIs with dest~nation control and
bed availability
E Permanent audio recordings will be maintained of all on-hne medical
direction and copies provided to DFD upon request
II Off-Line Medical Direction
A Mechcal Control services shall be provided as required by the Texas State
Board of Medical Examiners' EMS regulations for medical directors, 22 TAC
§ 197
B The Medical Director will be a board certified Emergency Medicine physician
located in Denton, Dallas, Tarrant, or Colhn counties
C Protocols and SOPs will address basic and advanced life support procedures
D Continuous protocol development and review will be provided
E Quality Assurance guidelines wdl be estabhshed according to a systematic
plan and will Include the following
Written and slolls evaluations will be conducted at least annually as part of
a system to ascertain individual and system-wide proficiency and to satisfy
TDH recertfficatlon requirements
CQI summaries will be generated by the Medmal Control provider and
reported to the DFD EMS Program Manager on a monthly basis or as
requested
Field evaluations will be conducted by expenenced nurse/paramedms and
paramedic instructors Results will be reviewed voth the EMS Program
Manager and written summanes provided
Patient chart and system audits will be conducted monthly for the purpose
of complying with quality control provisions in accordance with the Texas
Department of Health
IlL Continuing Education
A The Medical Control provider will conduct both basic and advanced
continuing education in accordance with the Texas Department of Health
gmdehnes each contract year to employees of DFD Continmng education
classes will be offered at DFD fire stations at a date and time mutually
agreeable to the City and the provider
B Continmng education courses will be scheduled for each of the three shifts to
accommodate one-half of each shif~ per course, once per month on-site
C A multi-discipline approach to CE instruction will be used and should be
enhanced by video instruction, quahty ~mprovement r~vlews, and computer-
based trmnlng
D Skills and protocol review yell be incorporated into continuing education
curnculum
E. Provider will offer initial and recertfficatlon courses for DFD paramedics and
emergency medical technicians including a TDH approved pedmtnc course,
ACLS, and BTLS courses
F A written remediation plan will define procedures for DFD employees who
fall to meet minimum requirements of the evaluation tools used by the
Provider and Texas Department of Health
IV
Contents of Proposal
Proposals offered for consideration under this RFP will contain the followtng
A Cumculum Vitae on medical
instructors
B
C
D
director, program manager, and course
Statement of servxces to be performed
Current client base, size of total population served, and a client history
encompassing the last five years
Length of time in business
Software/hardware, computer configuration requirements m order to
implement program
Samples of CE evaluation tools, CQI reports, and other forms used in the
administration of the medical control program
A division of duties between the Medical Director and the DFD EMS Program
Manager will be clearly defined
Outline ofquahty assurance program
Implementation plan for integrating City of Denton Fire Department into
Provlder's present system
References
Documentation of certffications and licenses
A certificate of insurance or a statement from an agent/broker indicating that
medical malpractice coverage exists must be included Coverage limits,
policy term and name of agent/broker handling coverage must be included on
the documentation
V
Terms
In consideration of services rendered, such services shall receive compensation on
a contractual basis, with payment disbursed in quarterly amounts as specified in
the Contract subject to contractual limitations The Medical Director and the
Medical Control Pmvlder are responsible for providing their own insurance
including, but not limited to, medical malpractice insurance, and all other licenses
and certfficates necessary to carry out the job requirements The City shall
provide no additional compensation or reimbursement for such expenses The
Contract period will be for one year, with an option to renew the Contract
annually for additional one-year terms upon agreement of the parties Any such
renewal shall be subject to the written approval of the City of Denton Fire
Department
VI
Consideration of Proposals
Proposals shall be opened so as to not disclose the contents The C~ty of Denton
Fire Department may enter into negotiations with as many Proposers as have
submitted feasible proposals m order to amve at the best possible contract
Applicants may receive an invitation to appear before a panel of City of Denton
Fire Department personnel for an interview
The City of Denton Fire Department reserves the right to accept any proposal
deemed most advantageous to the City, to reject all proposals, and to negotiate the
specific terms of the contract with any selected proposer
VII. ProJected Time Table
The projected date for a Medical Control Prowder to be contracted IS November
1, 1999 Services would conunence muned~ately upon execution of the contract
VIII Indemmty or Hold Harmless Statement
Medical Control Provider agrees to defend, ~ndemmfy and hold the C~ty harmless
for any loss sustained by the C~ty as a result ora clmm or stat by a third party
claimant to the extent that such a loss ns the result ofneghgence, bad faith, or
default of Medical Control Provider The Medical Control Prowder further agrees
to perform the services w~th that standardof professional care, slnll and d~hgence
normally prowded ~n the performance ofhke or s~mdar services
CITY OF DENTON, TEXAS
DEMOGRAPHICS OF THE DENTON FIRE
DEPARTMENT'S EMERGENCY MEDICAL
SERVICE
The Denton Ftm Department operates the ~ ambulance servtce for the city of
Denton and our netghbonng communities in central and northwest Denton County We
have provided flus Advanced Life Support ambulance servtce since 1978 We serve a
population of over 125,000 m our response area
Today, we operate sxx (6) Mobile Intenmve Care Umts, three (3) fronthne and (3) reserve
These units are staffed by firefighter/paramedms When needed, the reserve MICUs are
manned from the crews of on-duty engine compames Due to our increasing call volume
a fourth, fronthne MICU will be added m early 2000
Over 70% of all the 8,000 plus calls that the Ftre Department receives each year are for
medical responses Wtth~n our cxty we have an average response ume of 5 09 mtnutes
The average response time tn the county ts I 1 52 minutes To get help to the county
residents sooner, the volunteer fire departments serve as first responders in their
communines and are an integral pa~ of our EMS dehvery system
When a 911 call is received a coordtnated response begtns The 911 dispatchers are
trained m providing pre-amval tnstmct~ons ~n First Atd and CPR until the responding
units get to the scene On every medtcal call both a fire engine and ambulance are
dispatched All of Denton's fire engines are manned by firefighter/paramedics and are
fully eqmpped to provxde Advanced Life Support If the engine amves before the MICU
they will beg~n treatment to stabilize the pattent The care of the patient ts then continued
by the firefighter/paramed;cs assigned to the MICU
We are fortunate m Denton to have two fine hospttals Both hospttals have Ftre
Department radios as well as dedicated phone hnes for EMS use The decxsion of which
hospital to use Is left to the patient If the patient has a preference, then we will transport
to that local hospttal If the pattent doesn't have a preference, is unable to tell us, or the
pattent's condmon warrants, then the patient ts transported to the closest hospttal that can
care for the patxent's injuries or illness
217 WEST McKINNEY STREET DENTON, TEXAS 76201
OFFICE (940) 349-8110 FAX (940) 349-8109
Page 2, Demographics of the Denton Fire Department Emergency Medical Service
The Denton Ftro Depaxtment ts dedicated to prowdmg our customers wtth the very best
EMS system posstble We made a decision several years ago to have all of our personnel
cross-tra~ned as paramedics Out oft. he 100 persons m operations over 70% are currently
paramedics W~th the projected growth of our city, the Department ts planmng on adding
approximately 40 firefighters and at least one new staUon wtthm the next three years All
of these new recrmt$ wtll recetve both firefighter and paramedic tra~mng
Recogmz~ng that our c~tizens are always the first care givers on a scene, the City is
current implementing a Pubhc Access &ED program We have begun plactng Automatic
Defibrillators m the Ctty facdmes The first umt wtll be placed tn the Semor Center The
program calls for an addlttonal 15-20 AEDs, as funding becomes avmlable
September 22, 1999
Tom Shaw, CPM
Oty of Denton
9018 Texas Street
Denton, Texas 76201
EXHIBIT "B"
~ F~4/('~xwd~r m~r
Dear Mr. Shaw
Enclosed are the ~ngredlents that were requested by your city for RFSP #2414 I
have described our services that are offered and hope that you find th~s bid
acceptable
We can provide the requested services for an annual fee of $S2,750.75
:Items that are not included in this pdce are ACLS ($100 per person), BTI~ ($125
per person), and pedlatflc course fees (price unknown at th~s Ume) These prices
would be determined on the number of prowders that Denton FD would be
sending to these type of classes. These fees are reported for budgeting
purposes. ACLS is a system requirement and all paramedics would be required to
obtmn this certification
A start up fee of $950.00 would be requ,red to purchase the necessary
protocol books and to teach the initial three New Paramedic Orientation courses
As DFD added new paramedics (alter the initial three courses), DFD would need
to budget $100 per paramedic. Again, this fee is reported for budgeting
purposes Attendance at a New Paramedic Orientation course ~s required for all
paramedics
I cannot think of any additional fees except for initial training courses for
paramedics, intermediates, and basics These fees would not be paid to Baylor
because DFD would send these students to other institutions. Baylor does not
teach these courses because of upcoming national and state requirements There
are many excellent schools In the area that can do this ~n accordance w~th the
upcoming state and federal changes.
If I can asmst you in any way, please contact me at (817) 329-2815
Sincerely,
Paul L Rosenberger, MPA, NREMT-P
EMS Coordinator
Bayior Meclical Cente~ at Grapewne
EMS Medical Control
Curriculum Vitae
For EMS Medical Director, EMS
Coordinator~ and Instructor Staff
MEDICAL SCHOOL
University of North Texas Health Science Center,
Texas College of Osteopathic Medmme, Forth Worth,
Texas, Graduated Cum Laude m May 1985
Student Memberships Student Government, National
Osteopathic Honor Society, Class Officer, Texas
Osteopathic Association, Texas Medical Association,
American Osteopathic Association, American
Academy ofFanuly Pracutmners
INTERNSHIP
Northeast Cornmumty Hospital, Bedford, Texas
Graduated July, 1986 Rotating
LICENSING EXAMS
American Osteopathic Boards Part I March 1983, Part 11
March 1985, Federal Licensing Exam (FLEX) June 1985,
Texas Medical Jurisprudence June 1985
BOARD CERTIFICATION
LICENSE
December 28, 1992 American College of Osteopatluc
Family Physlmans, American Osteopathic Board of Family
Phys~cians
State of Texas December 3, 1986, Texas License #H013
DEA #BA0534342
SOCIETY MEMBERSHIPS
Tan:ant County Medical Society, Texas Medical
Association, Texas Osteopathic Medical Association,
American Osteopathic Associntmn, American
Academy of Farmly Practitioners, American College
0f Osteopathic Family Practitioners, American College
Of Sports Medicine, American Osteopathic Academy of
Sports Medlcme, Association of Military Osteopathic
Phymcians and Osteopathic Physician and Surgeons,
American College of Emergency Physicians
Certifications
State of Texas Paramedic
State of Texas EMS Coordinator
State of Texas EMS Examiner
Advanced Cardiac L~fe Support Instructor
Advanced Cardm¢ Life Support Prowder
Basle Card~a¢ Life Support Instructor
Basle Card~a¢ Life Support Provider
Basic Trauma Life Support Instru or
Bas~¢ Trauma Life Support Prowder
Nationally Registered Emergency Medical Techmelan - Paramedze
Prehosp~tal Pediatric Prowder Course
Prehosp~tal Pedtatnc Provider Course Instructor
Lugene Bates Jr.
4502 Dorchester Ct.
Grapevine TX 760~1
19g6-Present C~ty of Grapevine
Job Duues Fu-efighterfParamed~c/F~eld Tram,ng Officer for the Ftre Deparunent
1996-Present Baylor Medical Crater of Orapewne
.lob DuU~ EMS Instructo~
1996-Present Tarrant Cotmty Stmwt College
Job Duties EMS Instructo~
Texas Commission of F~re Protection as Ftrefighter
Texas Comm~sston of Fire ProtecUou as Intermedmte Instructor
Texas Department of Health as Emergency Medical Techmc~apJParamed~c
Texas Deperlment of Health as Emergency Med~ca! Ser~ces Skills Examiner
Texas Department of Health as Emergency Medical Serwces lnslructor
American Heart Assoctatwn as Advanced Card~ac Life Support Prowder/Instructor
American Heart Aasoc~atwn as Bas~¢ Car&ac Life Support Prov~der/-mswactor
Basic Trauma Life Support InternaUonal aa BTLS Prowdet/Ins~ructor
rT~
°
¥92-7/93
87-5/92
86-12/86
85-6/86
volume Responsible for county w~de EMS, transfers, and assisting tn pubhe awareness of EMS
Sole BTLS certified medic ;n Okmulgee EMS Sole medm m Okmulgee EMS pursuing Paramed c
certification
Security Concepts of Tulsa, Tulsa, OK
Owner
R. espons~ble for sales, tel~ ritory development, inventory, and presentauon of home, personal, ara
auto security systems
Currently covering a tn-state area
Windsor Consultants Inc., Houston, TX
Dgta Processing Consultant
Kesponslble for cheat development, and recruiting of quahfied mdiv~duals for chents Responsible
for salary negoUatlon, reference verifications, and salary surveys Responsible for general
recruitment on regional and national basis Knowledgeable in salary and compensation, EEOC
prac~mes, and techmcal pracUces
Magnacon, Houston, TX
Consultant
Responsible for cheat development and recrmtment of mdiwduals for contract placement
Responstble for hourly rate negottataon and candidate compensation
Builders Square #1010, Houston, TX
Lnventorv Control Superxnsor
Responsible for 7-8 MM dollar inventory Responsible for entry of purchase orders and receixang
orders into systems Supennsed I to 2 employees dunng tenure
Exoenence (cont):
Six Flags Over Texas, Inc.
Lmergenc: Medical fechmctan May 1991-December 1991 Duties included
providing First Aid to the guests of S,x Flags Over Texas
Pat/, ~ervwe% April 1986-May 1991 Duties included manag,ng a crew of eight
personnel and ensunng the cleanliness of the park
Education
Tarrant County Jumor College, Fort Worth, Texas
Graduated December 1996 w~th an Associates Degree of Apphed Science tn Fire
Protection Technology
Texas A&M Umvemty, College Station, Texas
August 1989-May 1991 Studied courses m Aeronautical Engineering
Tnmty I-hgh School, Euless, Texas
Graduated v~th Honors in June 1989
Certlficat~ons
Texas Intermediate Flrefighter
Texas Intermediate Fire Instructor
TDH EMT-P
ACLS Provider
ACLS Instructor-expired January 1998
PHTLS Provider-expired October 1997
PPPC Provider
TDH EMS Instructor
TDH Skall Examiner
Awards:
Valedictonatt, Metrocrest Medical Semces, Inc Paramedic Class #10
Outstanding Scholastic Freshman, Infantry Band, Texas A&M Umversity
Eagle Scout
References:
Gee Randy Corbm, Fire Chief
Lew~svtlle F~re Department
188 North Valley Parkway
Lev, nsville, Texas 75067
972 219 3580
Steven Palmer
5932 Cimarron Trail
Ft. Worth, Texas 76148
(817)58 -0889
Oblecttve
To use my education and years of fire and emergency medmal expenence tn an admm~straUve
tratntng capac~y
Experience
Keller Fire Department - 137 Taylor Street, Keller, Texas 76248
July 1988 - Present
Job Trtle Lieutenant
Duties include EMS Officer for the department v~th responslbfl.,ty for mamtamg the
department's EMS training records, ordenng EMS supplies, mamtatng protocols, easurmg
compliance wrdh the CQI standards, prepamg the EMS budget, writing the specifications
for EMS equipment and vehicles, and easunng the department comphes wr,.h all Texas
Department of Health Rules, Superwsmn of daffy activities for stauon, flow testing
hydrants, conducting fire mspecuons of businesses, computer upgrades and mam~nance,
conducting personnel evaluations, super~nsmg fire training, assist m budget preparauoo,
conduct new hire mterwews, coordinate CPR for the all c~ty departments
Baylor Mechcal Ceater Grapevine - 1650 West College Street, Grapevine, Texas 76051
December 1995 - Present
Job Trde EMS Inz'auetor/Exanuner/EMS Web Master
DuUes include Instructing EMTs and Paramedics aa conttnutng education, Advanced
Card, an Life Support, Basic Trauma Life Support, CPR, and EMT schools
Developing, updating, and overseeing the EMS web page
Me&cai EducaUon Systems - P O Box 820702, North R~chland Hills, Texas 76182
July 1996 - Present
Job Trde Owuer
DuUes include Coordinate EMT cumculum, coordinate tnstructors, order equipment and
supphes, instruct classes, and ensure program qualrty
Education
Tarrant County College - Associate Degree m Emergency Me&cai Technology
(estLmated completion December 1998)
tn~eLf tht rtqutreme, nt~ for c~rtl, flcatlon
Imt~ctor
P. xptres 08/3112000
~el iD 14483
F....-~b~
· rb'vEN BRADLEY PALMER
6932 CIMARRON TR
FORT WORTH TX 76148
R~l~rt e~ tn =dtO'a= ~r t~lo~ntnt to
Texas ~ ,,fHealth
ii00 V/est 49th
Attain. TX 75'?$0.3199
1996-Current
1996-Current
1996-1999
1987-1996
1992-1995
Robert W. Potter
4941 Colonial Park Dr
Haitom C~ty, Texas 76117
817-577-4265
SUMMARY
I ha~ e dcdiceted thc last 12 )cars of my life to tho service of the cmzens of the State of
Texas, first as a pohce officer, and then as a fire fighter I have been involved in the medical
care of pcaple since 1991 as an EM'T, and then progressing to a Paramedic and finally as a
Registered Nurse My goal is to protect and service those around mc
WORK BISTORY
Fire Fighter/Paramedic Richland Hills Fire Department
Provide Fire and EMS serwce to a city of apprommately 8,500 people Duucs tncludc Fire
Suppression, Emergency Medical Se~,'aces ,aa MICU, and Fire/Arson Investtgauons
Emergency Room RN, ~Vorth HHIs Hospttal
Pre,ade care to paUents of all ages w~th rather mechcal problems or trauma injuries tn an
emergency department that has on average over 2200 pauents a month
Emergency Room RN/Trauma Coordinator, DFW Medtcal Center
Provide care tn the emergency room semng, as well as began the development of the Trauma
Center program for the hospital
Pubhc Safety Corporal II, Dl~V Alrport
Cross trained m Police, Fire and EMS Performed general Pohce and EMS duUes tn the
Patrol/Rescue Dixnmon and Fire Suppression duues tn the Aireraft/Ftre/Rescue Dl'as~on
wnuQATtON
Assoclatcs D~gree in lq'urstng, Tarrant County Junior College
UOERm & OIBllSR,qTIS
· CetUfied Police Officer, 1987
Ce~ F~ Ft~ter, 1988
~e~ N~, 1995
Em~gen~ M~ T~ct~-~c, 1994
L~ ~m~c, 1999
Tm~ N~ Co~ Co~, 1997
P~am~ ~ ~e Su~ 1996
Emer~n~ N~ P~a~c Co~, 1998
~o Sy~ ~e, ~e Co~, 1997
H~ ~ten~s T~c~ 1998
S~ Water ~ T~cz~ 1, 1993
S~ Wat~ ~c T~ 2, 1994
A~ ~ ~r, 1997
Bamc Poh~ ~cer l~or, 1995
Fzre & ~n ~tor B~c, 1997
F~ Co~sslon ~or Inter.ate, 1997
Te~ ~ ofH~ ~or & EYnmmcr 1999
S~t~ W~ ~dTa~ Sch~l, 1992
i¥1e(]lcal ~.enter au ~fapevlne
EMS MedIcal Control
Statement of services to be
performed
Baylor Medical Center currently offers EMS Med,cal Control Services to ten fire-
based EMS services In North Tarrant and South Denton Counties Our services
can be grouped into four basic categofles. The categories are on/off-hne medical
d~rection, continuing education, C(~! standards, and written protocols All are
offered to ensure the highest level of consistency i~ the clinical care arena
On-hne medical direction, in most cases, Is offered by Baylor Medical Center at
Grapewne through our emergency department (ED) The ED ~s staffed twenty-
four hours per day and seven days a week with a staff of nurses and physicians
These health care professionals are trained to answer our dedicated EMS
phones. We contract w~th EmCare to prowde physician servIces and to perform
the EMS on-line consultation and direction duties. The ED has double physioan
coverage from noon to midnight; this will reduce the chance of a doctor being
bed up w~th a critical patient and needing to talk to EMS at the same time
Other on-line medical d~rection sites are allowed when the requesting faohty
s~gns a contract and fulfills ~ts commitments to become a site. Currently, Harris
MethodiSt Hospital HEB has obtained this status Medical Center of Lewlswlle is in
the process of obtaining this status. Denton Community has expressed
interest, if Baylor Is awarded the bid.
Three dedicated phone lines, a fax, and a Phys,o-Control twelve lead receivIng
station iS located In an EMS work area This area also contains a recording dewce
for conversations between Baylor and the EMS service Disaster assistance ~s
available by activating the Baylor Emergency Response Team. Destination control
and bed ~ava~lablllty can be offered as best as possible when a disaster strikes
Off-hne medical control direction Is another area offered. Baylor contracts diredJy
w~th Dr .lohn Ansohn for his role as the EHS Medical Director Dr Ansohn works
for EmCare and Metroplex Emergency Physldan Association (MEPA) Wh~le
working for EmCare his services are provided at Baylor-Grapevine. When working
for MEPA, h~s services are provided to Denton Commumty Hospital. By reviewing
Dr Anscihn's resume, you w~ll see that he climbed the ladder to obtain h~s role as
a physician. As a result, he is very paramedic friendly and, most ~mportantiy, a
strong believer In the role that EMS plays In the continuum of care
~aylor ~lec]lcal center at ~apewne
EMS Medical Control
RF£P ~2~:14 ~Dem-~n FD~
Baylor trad~bonally offers CQT standards only These standards are developed by
the EMS CQT Sub-Committee and approved by the EMS Medical Control
Committee. The standards are implemented by the fire department by utilizing a
CQ! Officer and F~eld Training Officers Remedlabon and quality improvement
recommendations are usually developed by the agency (CQT Officer) and
approved by the EMS Hedlcal D~rector
The RFP submitted by Denton actually requests that medical control provide
sk~lls examination (once per year), chart audits, field evaluations, and CQ!
summaries These services are tradibonally conducted by the agency and
subject to inspection by the EivlS Medical D~rector These services are included
(with Baylor performing these duties) in the final quote
Baylor w~ll prowde an EMS Tnstructor e~ght hours per week (three weeks per
month) who w~ll come to Denton and conduct chart audits, field evaluations, and
CQ! summanes dunng th~s time The ~nstructor w~ll make every attempt from the
EMS Coordinator employed by the FD to obtain the charts, obtain who ~s to be
evaluated, and submit monthly summanes Sk~ll evaluabon/~nstrucbon can be
offered during this time Sk~ll testing will be offered on a testing case-by-case
bas~s and ~s not part of the b~d. Our current fees for TDH sk~lls tesbng are, EHT-
Basic $100 per person, EHT-Tntermedlate $130 per person, and EHT-Paramedlc
$150 per person Tn the past, the system (Baylor and fire departments) conduct
two EMS Skills testing dates to fulfill TDH cntena Admission ~s free for testing
candidates when the fire department submits a TDH Examiner
EMS Protocols are developed and written by the EMS Protocol Sub-Committee
and approved by EMS Medical Control Our ex~stmg protocols are researched and
based in national standards. Tn the sk~lls secbon, sk~ll levels are identified for
EHT-Bas~cs, EHT-Jntermedlates, and EHT-Paramed~cs The chapters of the
protocol book are Tntroduction, Card~ac, Medical, Pediatric, Trauma, Med~cabon
Reference, Skills Reference, and Hed~cal Control Pol~oes and Procedures An
original protocol book Is supplied to the fire department and the agency w~ll be
allowed to make as many copies needed A protocol book will be supphed to
each paramedic dunng orientation courses Updates and rews~ons are
commumcated through the agency's EMS Coordinator
~8ylor IVlea~c81 Lenter at brapev~ne
EMS Ned~cal Control
Length of time in business
The EMS Medical program was developed In 1993 as a joint endeavor between
Baylor-Grapevlne and the Cmttes of Colleyville, Flower Mound, Grapevine, Keller,
Southlake, and Trophy Club
The hospital property, in Grapevine, was bought by the Baylor Health Care
System in 1981 from a group of local physicians and became 8aylor Medical
Center at Grapevine Tn 1903, Texas Baptist Memorial Sanitanum was developed
and renamed Baylor Hospital m 1921 The health care system has operated ~n
North Texas since 1903
The system en]oys the strength, wealth of knowledge, and expertise that can
come from being part a historically world renowned health care system
uaylor ivlea~cal uen~er ac brapev~ne
EMS Ned~cal Control
Samples of CE evaluation tools,
rePorts, and other forms used in
the administration of the medical
control program.
Enclosed are copies of the CE Verification Form, CE Registration, PartIcipant
Evaluation Tool (student critique of instruction) Enclosed in the attached CQ!
Plan are the forms used ~n the CQ! process
Date
Course T~tle
EMS CE REGISTRATION
Course Locanon
Shn~
Content Area
Course Approval Number 100145
Instructor Name and ID Number
Coordinator Paul Roserk,~rger
Hours Awarded.
Lesson ID Number
Me&cal Control Use
o~y
Student Name Department ID Number Pass ~ Fad
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
Continuous Quality Improvement
Plan
Baylor Medical Center at Grapewne £MS Medtcal Control
Introduction:
Baylor Medtcal Center at Grapewne currently pro~ades medtcal control to several public based EMS prowders
Northeast Tm-rant and Southern Denton Counties EMS medical control ts provided to the ctttes of Colleyvtlle
Euless, Flower Mound, G-rapevme, Keller, Lewisvflle, Richland I-hlls, Roanoke, Southlake, and Trophy Club
The combined populatton for these Pane reties ts over 268,110 people Nmeteen fi~lly dedicated ambulances and
numerous Paramedtc Engme Compames (PEC) prowde h~gh quahty emergency medtcal serwces
The goal of the medical control system ts to md m the enhancement of emergency medtcal serwce and to prowae
access to medtcal control and educational opportumttes to agenmes pammpatmg tn the system Th~s goal ~s
accompltshed by Baylor Medtcal Center at C-rapevme prowdmg contmumg educatton, contmuous quaht7
~-nprovement (CQI), protocols, and on/off lme medical contrdl
CQI ts a comprehenstve pro,'am that rewews all aspects of EMS care and has multtple pammpants The CQI
program is composed of a data base, tn-field evaluattons, a patient follow-up process, pattent satisfaction
surveys, new paramedic onentatton courses, chart evaluattons, mctdent mvesttgat~on process, testmg standards,
and on-hne medtcal control pattent report rewew
The CQI process rehes on several dL~erent parttctpants to make tt effecttve Fteld Trapamg Officers ('FTO),
Officers, and the EMS Coordtnator and Medical D~rector are essentml to system review and tmprovement FTOs
are selected by the agency and approved by medtcal control The quahficattons that a FTO has are that he/she
paramedm m good standmg w~th thew respecttve a~ency and has completed a FTO course that ts hosted by
Baylor It ts recommended that a FTO ts a rankmg officer and ts cert~ed by the Texas Department of Health as
an Instructor and Exarmner, or ~s certified by the Texas Comnusston on Fire Protectton as a Bastc Ftre Instructor
or h~gher FTOs are responstble for conducting chart rewew, and conductmg m-field evaluations
The CQI Officer should be a rankmg offcer wtthm the agency or has been delegated the authority to implement
to CQI the process When tlus person ts not a ranlcpag officer, Medtcal Control will commumcate dtrectly to the
agency's EMS Coordmator for various tssues FTOs are directly accountable to the CQI Officer The CQI
Officer ts selected by the agency and approved by Medtcal Control The quahficattons that a CQI Officer
possesses are that he/she ts a paramedm tn good standmg w~th thetr agency and has completed a FTO course that
has been hosted,by Baylor It ts lughly recommended that the CQI Officer ts a ranYang Officer wth~n the agenc.~
It is recommended that the CQI Officer [s certified by the Texas Department of Health as an Instructor and
Exarmner or ts certified by the Texas Commission on Ftre Protection as a Bastc Ftre Instructor or h~gher CQI
Officers are responstble for all of the FTO roles and comptlatton, rewew, forwardtng of the data base
reqmrements, chart evaluation, and adrmpasterin$ the pattent satlsfactton survey
The EMS Coordmator ts employed by Baylor Medical Center at Grapevme EMS Medtcal Control The EMS
Coordinator ~s accountable to the EMS Medtcal D~rector The quahficattons that the EMS Coordmator possess
ts that he/she possess ~s certtfied by Texas Department of Health as an Instructor and Exarmner It is preferred
that the EMS Coordmator also possesses the Coordmator cert~ficatmn The EMS Coordtnator Is responsible for
oversight of the enttre EMS medtcal control pro,ram
((Responding to the Call of Excellence' 2
Baylor Medical Center at Grapewne EMS Medical Control
Organizational C~hart:
"Responding to the Call of Excellence" 4
Baylor Medical Center at Grapevine EMS Medical Control
In. Field Evaluation:
A Field Tra~mn$ Officer (new employees) or the mdl,adual's ran!OhS officer (current employees) vail conduct m-
field evaluatwn on each paramedic A field training officer or appropriate officer vail evaluate each primary
paramedic annually 1',lew paramedics m the system will have an evaluation at the s~x-month anniversary date and
at the one-year anmversary date These m-field evaluations should be mcorporated or utd~zed when conducting
an annual performance rewew for the EMS prowder
The paramedic must obtain a score of "Meets Expectations" or higher and satisfy all absolutes on the evaluation
When an improvement opportumty is identified, the CQI Officer and the EMS Coordinator will develop a plan of
action
The m-field evaluation form vail evaluate the follovang components of EMS duties
I Paramedic preparedness
H Interaction with other pubhc sennce enuties
Patient and family rapport
IV Shll techmque
V Protocol apphcatmn and unplemantation
VI Interaction vnth on-line medical control staff
VII Interacuon at the receiving faahty
"Responding to the Call of Excellence"
Overall Rating Score
FTO/CQI Officer Stgnature
EMS Provader Stgnature
FTO/CQI Officer should make comments ua the appropriate areas EMS Provaders should make
comments in the area below
III
Patient and family rapport
4 = Interactions are always professional and friendly No vahd complaints fi.om fanuly
or patient
3 = Interacttons are cons~ently professior~l and friendly Very few vahd cornplamts
from farmly or patient
2 = Interactions are us,,.lty professional and friendly May reqmre intervention,
complaints are considered todd m offense
1 = Interactions lack courtesy and profassmnabsn~ Intervention reqmred
0 = Commits an offense that ts grossly offensive to patient or ~hmdy
(sA) x (w) 15% =
Rating Justification
IV Skfl[q techmque
4 = Follows all skulls criteria and exhibits proficiency according to estabEshed
guidelines tn the Procedure Chapter of the protocol book
3 = Follows all skdl.q criteria and exhibits a moderate level of proficiency accordmg to
estabbshed gudehnes m the Procedure Chapter of the protocol book
2 = Adheres to most of the estabhshed gmdelmes m the Procedure Chapter of the
protocol book but exhtbits a nantmal level of proficiency
1 = Performs skdl-q but tn a manner or fastnon that ts inappropriate
0 -- Does not know skulls criteria as estabhshed in the Procedure Chapter of the
protocol book Not pwficient tn skills usage
Rating Justtfication
(SA) X (W) 25% =
Interaction at the receiwng facility
4 = Interactions are always professioml and lhendly Patient reports are conctse and
the appropmt¢ mformatlen is relayed
3 = Interactions are consistently professional and ihendly Patient reports are concise
and the appropriate reformation ~s relayed
2 -- Interactions are us~l!y professional and friendly Patient reports are not always
concise and/or the appropriate patient reformation ~s not relayed
1 = Interactions occasionally lack professlonaEsm or fi~endhness Patient reports are
not always concise and/or the appropriate patient re.formation is not relayed
0 = Patient reports are not concise and/or patient reformation is not relayed
(SA) X (W) 5% =
RatmgJustffi¢~lon
Baylor Medical Center at Grapevine EMS Medical Control
Patient Satisfaction Surveys:
Patient Satisfaction Surveys wall be totaled out by the agency on at least twenty- percent ofa~l EMS responses
When an unprovement opportumty ~s ~dent~fied, the CQI Officer and the EMS Coordinator wall be responsible
for developing a plan ofactxon
"Responding to the Call of Excellence"
P O Box 123
Beautiful C~ty USA 12345
......................... DETACH HERE
CITY OF BEA~
CUSTOMER SERVICE SATISFACTION SURVEY
Recently you had an occamon to contact the Beautiful Ctty Fmc/EMS
Department wnh a request regarding
PLEASE GRADE US!
HOW SATISFIED WERE YOU
Were the Fire/EMS personnel fair and non-dlscrimlnaton/? A B
Were the Mre/EMS persorlnel frlerldty and caring'~ A B
Were our fire/EMS personnel knowledgeable? A B .
Were you satisfied with the quallL"y of service we pmvldecP A
Were you satLefled with the Rre/EN$ personnel over all performance~ ¥¢s.
C ,D , F
C ,D F __
.C D __F __
C D__F__
C D F__
No
ADDITIONAL COMMENTS OR SUOGESTIONS YOU MIGHT HAVE AND WISH TO SI[ARE
New Paramedic Orientation
Day 1'
0800-0900
0900-1100
1100-1200
1200-1300
1300-1500
1500-1700
Why 12 Lead ECG
Cardiac Anatomy & Electrophystology
Lead Placement
Lunch
Charactensucs ora Normal 12 Lead ECG
Charactenstlcs of an Abnormal 12 Lead ECG
Day 2:
0800-1200
1200-1300
1300-1400
1400-1600
Protocol Rewew
a Introduction Chapter
b Cardmc Chapter
c Trauma Chapter
d Medical Chapter
e Pedmtnc Chapter
Lunch
Protocol Rewew
f Procedures Chapter
g Drug Information Chapter
Skfl!s Instruction and Testing
Implantabla Access Systems
b Intraosseous
c Percutaneous Au'way
d Pleural Decompression
1600-1700 WnRen Exammatmns
Name
New Paramedic Orientation Course
Course Completion Checkhst
Agency
Certification Level
Agency I D #
Slall Sheet
Implantable Access
Systems
Skall Sheet
Intraosseous Infusion
Skill Sheet
Cncothyrotomy
Skall Sheet
Pleural
Decompression
Written Examination
BCLS and ACLS are system requirements If you do not possess these certifications,
please notify your agencies EMS Coordinator
Candidates Name:
Baylor Medical Center at Grapevine
EMS Medical Control Program
lntrosseous Infusion Skill Sheet
Agency
of action to be undertaken
Locates site (Anterior aspect of the tibia 1-3 cm below the tibial tuberosity)
Preps area with aseptic technique, outward direction
Directs I0 needle mfenorly to avoid the eplphyseal plate
Verbalizes successful cannulatlon (Must verbal,ze at least one of the following Lack of
resistance aider needle passes through the bony center, needle stands upright without suppo'-
ability to aspirate bone marrow, or ~ree flow of the infusion wtthout significant subcutaneo',:s
infiltration)
Attaches ['v fluid
Secures needle with protect,~e dressing
Satisfies the above criteria
Comments
Signature of £xammer'
Medical Control Use Only*~
Date
Baylor Medical Center at Grapevine
EMS Medical Control
Pleural Decounpresslon $1oH Sheet
Candidate Naune:
Agency
Yes No Description of action to be t~k~.
Identifies the need for pleural decompression (Must verb~hTe two of the following s~gns or
syraptoms dyspnea, dmamashed breath sounds, hypotensmn, or d~tended neck veins)
Locates the second or tbard untercoastal space un the mad-clavicular line
Preps area wath aseptic techmque, outward techraque
Inserts the needle over the nb unto the pleural space
W~thdraws the needle fi.om the catheter and attaches the one-way flutter valve
Secures pleural decompression dewee
Contunuously mountors the breath sounds, resp~ratou rate and effort
Satisfies the above criterm
** Medical Control Use Only**
S~gnature of Exaunmer: -
Date'
Baylor Medical Center at Grapevine EMS Medical Control
Chart Evaluation:
The agency's CQI officer will oversee chart evaluation The agency will review a mimmum of flurry charts per
month (with available call volume) Each agency will rewew at least fifty percent of the following categories of
calls ALS calls, aeromedical support, CPR, pharmacological agent admimstratmn (excluding oxygen, and IV
therapy), and completion of a patient refusal form
Selected sections of the protocol book have a corresponding CQI Appropriateness of Care Standard that wll be
Utdlzed to evaluate ~mprovement opportumues On the back of these sheets are comment sections for flae EMS
prowder and the CQI officer or FTO Providers will respond to questions by the CQI Officer or FTO in a t~mel.x
fastuon
The goal for chart evaluation is to have mnety- percent compliance to the appropnate standard that apphes to a
g~ven medical condition and satisfy all absolute requirements The provtder will be required to treat and
document a patient report w~th comphanee to the CQI standard and protocol Deviations from the standard
should be explained on the patient care report
At the end of each month, the CQI Officer will submit a copy the Quality Management report to Medical
Control All charts are subject to inspection to Medical Control When an improvement opportumty is idenufied,
the CQI Officer and the EMS Coordinator will develop a plan of action
"Responding to the Call of Excellence" 10
below for each chart that does not standards
2
3
4
5
8
9
10
11
12
13
14
15
16
17
18
19
20
Improvement Actmn Codes = D~scussed ,oath Individ-aL 2 = ~eferred to Super'asor, 3 =
Referred to Medical ControL, = Departmemal pohcy ctmnged, 5 = Protocol rewew/change,
and/or 6 = Other, please specify
FTO/CQI Officer Observatmns 8; Quesuons
EMS Prowder Comments'
EMS Prowder Signature
Date
Baylor Mechcal Center at C-rapevme EMS Medical Control
** Confident,~d Information **
Medication A~tlon Approprmteness of Care Standard
Provader Name
Chart Number
Mechcatlon admumtratlon was m comphance w~h protocols or direct orders ***
given by Medical Control
Provides complete documentauon of the following ** *
route, t~me admmi.~tered, dosage, and the person aflmm~nterllag the
med,cation.
Prowdes complete documentation of the me&cared IV chap Name of
solution, amount of me&cation m solution and rate
Assesses change tn paUem condition after treatment
Documents allergies, when available
Are the Absolutes Satisfied9 Yes No
- - Score of Chart
Is the Score Greater Than 89%9 Yes No
If any of the absolutes are not sattsfied or the score ts not equal to or greater than 90%, the chart does not meet
the CQI standards Please make comments on the back oftl~s sheet EMS Prowders are reqmred to respond to
FTO/CQI Officer comments
FTO/CQI Officer Signature
Date
Baylor Mechcal Center at C-rapevme EMS Medical Control
** Confidentml Information **
Trauma Appropriateness of Care Standard
ProviderName
Chart Number
Provides clinical __
Obtains lustory and chlefcomplumt Provzdes time, mechemsm of injury, and
loss of consciousness
Assesses resptratory status Rate, symptoms ofdistxess, breath sounds, and
Provides a!~propnate itu-way control and oxygen therapy
Assesses v~tal s~gns l~re-trsn~rt, transport, or as d~rected by protocol
Provides continuous cardiac monitoring vath correct interpretation.
Assess neurological slatu.s
Provides full assessment of all body systems
Provides stabd~Tatlon
Provides IV therapy Lints rate, route, s~ze, s~te, fired, and person Imtmtmg IV
vnth the number of attempts
Performs advanced skills as mdlcated MAST, pleural decompression, or
other Ltsts the person imtlatmg the skill
Assesses change m patient conchtlon atter treatment
Contacts Medical (~ontrol
Resssesses patzent ~onditlon at recennng facility
Treats patient m c~mphance vath protocol
Scene time 10 minutes or less for major trauma
Are the Absolutes Satisfied? Yes No
Score of Chart
Is the Score Greater Than 89%9 Yes No
If any of the absolutes are not satisfied or the score ~s not equal to or greater than 90%, the chart does not meet
the CQI standards Please make comments on the back oftlus sheet EMS Providers are reqmred to respond to
FTO/CQI O~eer comments
FTO/CQI Officer Sxgneture
Date
Pro~der Name
Date of Inctdent
Baylor Medical Center at C-rapevme EMS Medical
** Confidentnd Information **
Adverse Incident/Sentinel Event/Chracal Comphant
Appropriateness of Care Standard
Chart Number
Pames Involved
Description o f Incident/Event'
Date Rewewed
Action Taken
Please attach any pertinent paperwork
Baylor Medical Center at Grapevine EMS Medical Control
Testing Standards:
TDH Evaluation Tool:
For the EMT or EMT-I to function vathln the medical control system, the EMT must obtain an overall score of
at least a seventy five percent The EMT-P must obtain an overall score of at least a seventy five percent and
actueve at least a seventy- percent in each subscale area
First Failure
If the pro,ader fails the TDH Evaluation Tool, the EMS Medical Director wll assign a probat,onary status and
the prowder vail be given the oppormmty to self-study The provider ~ continue to function at their s~ate
cenlfied level
The EMT or EMT-I vail be adrmmstered an evaluation tool, by Medical Control, which ~ cover the entire
course content of an EMT basic or EMT-I course, which ever is appropriate
The EMT-P vail retest the specific subscale that the prowder failed, up to three subscales If the lnchv~dual
four or more subscales or the overall score is below seventy-five percent, the EM'r-P vail retest the entire course
content of an EMT-P course These tests vail be adrmmstered by Medical Control
All testing vail be completed vathin ninety days
Second Failure
If the provider fails the TDH Evaluation Tool and the Medical Control ExarmnaUon, the prowder ~ continue
then' probationary status and study vath a FTC The probationary prowder must function under the FTO's d~rect
supemsion and cannot be responsible for patient treatment at any time The provider may perform skills only
when supervised by the FTC If the FTO's super~nslon is not provided, the prowder may only function at a level
below their certification A paramedic vail function at the EMT level
The EMT and EMT-I vail be admimstered another exarmnauon, by Medical Control, whch vall cover the entire
course content of an EMT or EMT-I course, whichever applies
The EMT-P will retest the specific subscale that the provider faded or the entn'e course content of an EMT-P
course, which ever applies according to the first failure criteria This test ~ be adrmmstered by Medical
Control
All testing vall be completed vathin mnety days of the EMS Medical Director receiving the test results from the
EMS Coordinator
"Responding to the Call of Excellence"
Baylor Medical Center at Grapevine EMS Medical Control
Second Fadure'
If the prowder fails xmtlal Protocol Exarmnat~on and the retest, the provtder will continue their probattonary
status and work and study w~th a FTC The probauona~ EMT-P must function under the FI'O's dxrect
supervision and cannot be responsible for patient treatment at any time The EMT-P may perform skalls only
when super.ased by the FTC If the FTC supervmon is not prowded, the prowder may only function at an EMT
level
The EMT-P wll retest the specific section that the EMT-P failed Medical Control or the CQI Officer
adrmmster the retest All testing vall be completed no sooner than fourteen days and no later than sixty days
Third Failure'
If the EMT-P fa~Is the lmtlal protocol exammauon and two retests, the prowder wdl receive a letter from the
EMS Medical Director that states that they are no longer ellg~ble to prowde any EMS care under the direction of
the EMS Medical Dtrector's authority A fire fighter status vall b~ the only recogmzed status If the EMT-P
wants to regain thew EMS status, they must attend a New paramedic Orientation Course After successful
completion oftlus course and the entire Protocol Exasmnntlon, the EMT-P status w~ll be reassigned A fire
fighter status w~H be assigned from the failure date of the retest to the date of successful completion of the New
Paramedic Onentatlon Course
Fourth Fadure'
After failure of the uutlal Protocol Exanunation, two retests, and the New Paramedtc Orientation Course, the
EMT-P will be considered a fire fighter only and subject to disc~plmary actions estabhshed by their respective
agencies
"Responding to the Call of Excellence"
14
Baylor Medical Center at Grapevine EMS Medical Control
Physician Competencles:
On/Offhne Medical Control Phystctans will be reqtured to complete an exercise that ts tntended to famdianze the
physician with medical control systems medicat~ons, procedures, and quahty assurance plan The exercise is m a
question and answer format The physician w~ll have two weeks to complete the exercise The exercise vall be
administered by the respectzve mechcal dtrector at each on-line medical control site and submitted to the EMS
Coordinator
"Responding to the Call of Excellence"
Your Name:
Date:
Please list the 28 drags that are earned by the paramedics on each EMS vehtcle Th~s can
be found m the Introduction or Drug Information Chapters
2
List the type of Intravenous Solution and sizes that are canned by the paramedics in the
EMS vehicles Th~s can be ~'ound in the Introduction Chapter
5 What does the term "Open" and "Closed" mean in the Transportation Guideline protocol*
6 In the event of an Adverse IncldenffSentmel EvenffChmcal Complaint where can the
reporting form be found* (ER. Departmental Pohcy)
7
Tbas form should be completed and mailed to
Baylor Medical Center at Grapevine
EMS Educauon-Attanuon Paul Rosenberger
1650 West College Street
Grapemne, TX 76051
8 Commems or Suggestions
In conslderaUon of the services provided m the attached Agreement, C~ty of Denton
will pay to Baylor the fee of $62,750 00 per year for each term of the Agreement City of
Denton shall pay the tee to Baylor ~n quarterly installments of $15,687 $0 per
installment
CONFIDENTIAL AND PROPRIETARY
I~ROPERTY Off BAYLOR HEALTH CARE SYSTEM
ALL PRIVILEC, E8 CLAIMED
EXHIBIT 'D'
MEDICAL DIRECTOR AGREEMENT
This Medical Director Agreement ("Agreement") is entered into effective as of the 1s* day of November,
1999 ("Effe~ve i~at~'), by and bet'~ean-~.ylor Me~o~ Ce-!er at C. wapevm~ ("Hoslmal'), a Te~a~
nonprofit corporation, and John Anschn, D O ("Physician")
RECITALS
Hospital operates an acute care general hospital located m Grapevine, Texas and requires ce~am
admimstrat~ve services for me&cai dlrec/aon and/or supervision of prchospital care by emergency medical
service ("EMS'~ personnel ("Medical Control"),
Hospital requires the sennces of a physician wgh speclahzed trammg and experience m emergency
medlcme to provide part-time professional and admmlstrative direction for EMS Medical Control, and
Physician poSsesses speclahzed training and experience in the area of Medical Control and is qualified to
provide such services, and
Hospital desires to engage Physician as pan*time Medical Director for EMS Me&cai Control, and
Physic~an desires to accept such engagement w~th Hospital and m that capacity to provide services under
the terms and conditions of this A~reement
AGREEMENT
NOW, THEREFORE, m consideration of the foregoing premises, and the mutual covenants and
con&tlons contained hereto, Hospital and Physician agree as follows
I EMPLOYMENT
Hospgal hereby employs Phystctan to serve as part-Ume Me&cai D~rector for EMS Me&cai
Control ("Me&cai Director") and Phys~aan hereby accepts such employment, all subject to the
terms and conditions of tins Agreement
2. TITLE.
Physic~an's t~le shall be Me&cai Director, EMS Me&cai Control
EMS MEDICAL CONTROL JOHN A~SOHN, D O
MEDICAL DIRECTOR AGREEMENT
This Medical Dtrector Agreement (#Agreement~) ~s entered rote effective as of the 1~ day of November,
1999 ("Effective Dste~), by and between Baylor Medical Center at Grapevine ("Hoslgtsl'L a Texas
nonprofit corporation, and l~dn Ansohn, D O ("Physician")
I~E~ITALS:
Hospital operates an acute care general hospital located m Grapevme, Texas and requires co,am
admm~rative eer,flcee for medical directlGn and/or supeFvls~on of prehosplral cam by emer~0ncy medical
semce ("EMS'~ personnel ("Mediesl Control"),
Hospital req~lree the selv~ces of' a I~h~slcum vflth sileclahzed irs'hms_and exll~nence m emer~i~cy
medtcme to provide pan-tone prot'ess~onal and admmlstrauve chrecuun for EMS Medtcal Control, and
Phys~cian possesses slpcclahzed training_and OXl~Onanco m the area of Medical Coatsol and ~s quahfied to
prowde such semces, and
[dospKal destree to eniii~e Phl/slclan as Ilart-time Me(heal D~rector for EMS Medical Control, and
Phystclan desires to accept such engagement with Hospital and m that capac~'y to pro3flda semces under
the terms and,cund~tiuns ofth~s Agreement
AGREEMENT:
NOW, THEREFORE, m consideration of the foreg.omg_llremlses, and the mutual covenants and
conditions contained hereto, Hospital end Phys~clan agree as follows
Hospital hereby employs Ph!/sl(llan to SOlVe lis part-time Meihcal D~rector for EMS Medical
Control ("Medicsl Director~) and Physician hereby accepts such employment, all subjeci to the
terms and condmuns ofth~s Agl~ement
2. TITLE.
Physician's t~le shall be Methcal Dlreaor, EMS Medical Control
EMS MEDICAL CONTROL - JOHlq AIqSOH~, D.O
~ BAYLOit HEALTH CAR~ SYS?RM 199~ PAGE 1 OF I?
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32
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DUTIES OF PHYSICL~I
Services Phxsician shall perform the Services (defined below) pursuant to the terms and
cond,uons of this Agreement, and shall serve the Hospital faithfully and diligently, according to
the best of his/her abilities Physician shall serve as the Medical Director for EMS Medical
Control and shall, in such role, have the following major areas of responslbdit,, (a) assisting
Hospital in defining the scope and characteristics of Me&cai Control services provided in the pre-
hospital emergency care of patients, (b) providing trmmng and consultation to EMS personnel as
required bm all applicable state and federal statutes, rules and regulations and as requested by
Hospital; and (c) momtonng the delivery of Medical Control serwces m the pre-hospital care of
pauents by EMS personnel In carting out such responslbfllues, Physician shall perform the
specific services set forth on ~ attached hereto and incorporated hereto bv reference (the
Services") The Services are administrative m nature and do not constitute the practice of
medicine
Hours Physician shall devote on average eleven (11) hours per week to the performance of
Services hereunder, with the exact dates and times to be coordinated by the Physician and the
Hospital in accordance ~th the needs of the Hospital, and subJeCt to approved absences,
prowded, hox~ever, that Physician shall not prowde and Hospital shall not be obligated to
compensate Phssician for more than five hundred seventy-six (576) hours of Services per each
one (I) ~ear term of tins Agreement
~ Physician shall provide Hospital v, ith written documentation of all
Services rendered hereunder Such documentation shall be submitted to Hospital on a periodic
basis as reasonably requested b) Hospital The documentaUon shall be in the form, and contain
the reformation, as ma~ be requested by Hospital from time to time to comply with apphcable
federal and state laws, regulations and rules, and with the physician compensation allocataon
requirements under the Medicare and Medicaid programs
~ Ph.~stclan shall report to (0 the Executive Director of Hospital with
respect to all administrative matters, and (ii) the Chief of the Medical Staff at Hospital or such
committee of~ the Medical staff as the Chief of the Medical Staff may, from time to Ume,
designate with respect to all chmcal, medical staff policy and plamung and professional matters
?h)sl¢lan also shall maintain effective halson with the medical directors of all clinical
departments In the Hospital for clinical and profasslnnal matters related to, as appropriate, chmcal
integration, quality improvement, patient care, research and teaching
4
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42
43
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REPRESENTATIONS, WARRANTIES AND CERTAIN COVENA2qT$ OF PHYSICL~N
Lmcnsurc ~d Ce~lficat~on Phx src~ represents ~d ~a~ ~at he/she is, ~d during ~c te~
of ~ls Agreement shall remain dun hcenscd, registered ~d m good st~dmg under ~c laws of
~c State of Tcx~ to engage m ~c unrcsmctcd practice of mcdimne ~d to a~m~stcr ~d
prescribe controlled subs~ccs, ~d Is possess ~c quahficat~ons for Medical Director (off-hnc)
~ set fo~ m ~c r~gulat~ons of ~c Tcx~ State B~rd of Medical Exa~ncrs, 22 ~ ~
CODE { 197 I et seq Ph*slct~ reprosents ~d wa~ts ~at ~s~er license to practice medmme
~d ce~ficatc to prescribe medtcattons ~d controlled subst~ces m ~e State of Tex~ or m ~y
other jurisdiction h~ never been dcmed, suspended, revoked, tcmmatcd, voluntarily rehnqmshed
under ~reat of or subject to dtsc~phnau action, probated, or rcsmctcd m ~y way Phys~ct~
~er represents ~d ~a~ts ~at h~shc ~ not been subject to &sc~ph~ or conecUvc
action by ~ hosp~l or hcensmg ~cnc~ or to exclusion or deba~ent ~om e~er ~e Mc&care
or Med~cmd progr~ Upon request, Ph~ssct~ shall prowdc to Hosptml ~srd-p~
documentation to cwdencc thc accurac~ of ~c foregoing reprcscnmUons ~d wa~txes ~
upon request, shall au~onze (m x~ntmg ff requested) Hospital to obmm verification ~rcctly ~om
~rd pames
Medical St~ff Membershm Ph)s~c~ represents ~d wa~ts ~t he/she h~ or wd[ obtain prior
to ~c ~ffect~ve Date, ~d dunng ~c te~ of ~s Agreement shall maintain, Hosptml mcdmal
staff membership ~d appropriate chmcal pnvdeges, m good s~dmg However, ~s Agreement
~s not, ~d shall not be construed as, ~ fo~ of guar~tce or ~su~cc by Hospital ~t
Ph~s~c~ ~xdl ob~n or rcmm medsc~ s~ff membership or appropriate chmcal privileges, since
such membership ~d pnvdegcs ~c governed solely by thc bylaws of Hospital ~d ~e bylaws of
· e medical smffat Hosptml as ~ended ~om t~mc to t~c
~ontmum~ Medmal Educatmn Ph)s~c~an represents ~d wa~ts ~at he/she ~s, ~d dunng ~c
tc~ offs Agreement s~ll ~mam, professionally ~med ~d experienced m cunent EMS Off-
Linc M~mal Control, ~d agrees to ~e all actions necessa~ to maintain such tra~ng ~d
experience as max be reqmred b~ ~c Tcx~ State Bo~d of Mcdmal Ex~mers ~d ~ neccssa~
to ab~de bx ~c reqmremcn~ of Phxs~cz~ s mcdzcal board specmlty, including, wl~out
hmt~tlO~ a~en~cc, at profcss~o~ convention, post-graduate seminars, contmmng med~l
educatmn semi.rs ~d coherences ~d ~nctmns of profcss~o~ socset~es CCME Act~wt~es")
CME Act~tses arc at ~e sole cost ~d expe~e of Phys~c~ ~lcss such expenses ~c accounted
for m ~e budget of~e Dep~ent ~Wor approved m advice by Exccuttvc D~rector
~ Ph~smmn shall complete ~d execute a Ba~lor Health C~e System
approved fo~ of Co~cts off ~tercst Statement idcnt~mg all ~own ~d ~ttc~patcd co~ic~
Physic~ or ~y of his or her f~fly members ~ ~th ~y ent~t) a~hated wxth Ballot Health
C~e S)stem At ~1 times dunng ~e Te~ of~ls Agreement, Physm~ shall be subject to ~d
comply wt~ ~c Baylor H~lth C~c Sy~em Co~lc~ of Interest Pohcv
CO~I:~gNTIA~ AND ~ROFR.I~TARY '1
PROPERTY Of' BAyLOR HEALTH CARE SYST F,M
ALL [~RIVILEGgS CLA~iED
~ Physician shall promptly (within three (3) da~s) notlS, Hospital m the event any
representation or ~arrant~ by Physician set forth m this Agreement shall no longer be true,
correct or complete
Comp|tahoe ~lth Hosoltal Policies Physician shall compl~ with all applicable bylaws, rules and
regulations of the me&cai staff at Hospital, and the policies and procedures of Hospital, as are in
eft'cci from time to time Physician shall work cooperanve[y with the personnel of Hospital, and
in particular, those persons working in or on behalf of Hospital
~[ILg~L~:l~ Physician shall participate in the EMS and Medical Control educational and
training programs conducted by Hospital, and shall perform such other teaching and training
functions within Hospital as Hospital reasonably requests Physician shall monitor developmants
and improvements tn the provision of medical services relating to Medical Control, and shall
~ork with Hospital in the implementation of developments in the service area
Etbacs and Professional Standards Physician shall comply with the etlucal and professional
standards of the American Medical Association, the Joint Commission on Accreditation of
Healthcare Organizations, the Health Care Financing Administration, the Texas Department of
Health, the Institutional Ethics Committee at Hospital and other relevant professional and
go~ermng bodias Physician shall comply with the Bavlor Health Care System Code °f C°nduct'
Clinical Ethics Guidelines and Business Ethics Guidelines
Lncummz Financial Obhlzatlon. Exoensas Physician mat not incur an~ financial obligation on
behalf of Hospital without the prior written approval of Hospital Physician ~lll be responsible
for all expenses incurred in providing Services under t.}us Agreement, unless such expenses are
approved in advance by Executive Director
~ Nothing contained herein shall prevent Physician from establishing and
maintaining a private medical practice Physician shall conduct his/her private medical practace
in a manner that permits fulfillment of his/her responsibilities under tins Agreement Physician
ma~ make such charges for services provided in Physician's private medical practice as he/she
shall determine, and may bill and collect all such charges, vathout pa~Tnant of any part of the
proceeds thereof to Hospital
Nc) Other Bavlor Relatwnshio Physician represents and warrants to Hospital that neither
Ph~ slclan nor any family member of Physician has an agreement or arrangement (whether oral Oo~
written) for the provision of items or services with Hospital, Baylor Health Care System or any
its affiliated organizations, other than as set forth on ~ attached hereto and incorporated
hereto by reference and/or as established by this Agreement
PROFESSIONAL LIABILITY INSURANCE
6
7
71
72
73
8
In thc event Ph~slcma maintains a private medical practice, Physicmn, at lus/her own cost and
expense, shall maintain, m full force and effect dunng the Term of this Agreement, professional
habdity insurance, issued b~ aa insurer acceptable to Hospital, covering Physic~nn against all
clmms arising out of the performance of services consUtutmg thc pracucc of medicine
( Malpractice Insurance ') MalpmcUce Insurance shall bcm amounts of coverage no less than
thc mtmmum required b~ Hospital to be a member of thc medical staff dunng an~ year The
insurance pohc~ shall require thc career to provide Hospital with written notice of an~
cancellanon or reduction of insurance coverage at least twenty (20) days in advance of such
cancellaUon or reduction On or before the Effective Date and thereafter upon request, Physician
shall promptl~ dchvery to Hospital certificates of insurance evidencing such coverage
I NDEMi"ffFICATION
Physician shall mdemm~ and hold harmless Hospital fi.om sad against any and all clmms,
liabilities, damages and expenses, incluthng without lumtauon reasonable attorneys' fees incurred
bv Hospital, its officers, threctors, employees or agents, arising out of or related to the acts or
onnssions (mcluthng the negligence) of Physician in connection with Physician's pmcUcc of
medicine
OWNERSHIP OF/ACCESS TO BOOKS AND RECORDS
GOvernment Access to Books and Records Physician shall comply with all applicable federal
and state la~s governing the maintenance of documentation to verify thc cost of Services
rendered under this Agreement Until the expiration of four (4) years after the fumislung of
Services pursuant to flus Agreement, Physician shall make available, upon written request of the
Secretary of the Department of Health and Human Services or the Comptroller General of the
United States, or any of their duly anthonzed representaUves, this Agreement, and books,
documents, and records of Physician that are necessary to eertl~ the nature and extent of such
COSTS
Notice to Hosmtal If Ph>sicmn receives a request or demand to disclose any books, documems
or records relevant to flus Agreement for the purpose of an autht or investigation, Physsciaa shall
immediately (within two (2) business days after receipt of such request or demand) noufy
Hospital in wnung of the nature and scope of such request or demand Physscian shall make
available to Hospital, upon wnt~an request of Hospital, all such books, documents or records
0x~nershio of Records All Hospital and Ivlcdical Control records shall be and remain the
property, of Hospital
FINANCIAL A. RRANGE~NTS
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In consideration of the performance by Phystclan of the Services sci forth m this Agreement,
upon submiss,on of thc reports and records required by this Agreement, and subject to thc
hmltat~ons of ~.LL0.R~, Hospital shall pay to Physician a salary at the rate set forth on ~
~ attached hereto and incorporated by reference herein, provided, however, that Hospital shall
not be obhgatcd to pa'~ Physician any salary unless this Agreement and all of tis terms and
conditions arc approsed bs the Executive Committee of thc Baslor Health Care System Board of
Trustees on or before December 3 l, 1999 Physician shall not bill an~ patients or tlurd-party
pasors for Services pros idcd pursuant to tlus Agreement
TI~RM AND TI~ILMINATION
T~rm of A~reement. Condition ~e ong:~ t~ of ~s A~eement s~ll be for a period of one
(1) yc~ co~encmg on ~c ~ffecttvc Date (~e "Original Term'3, ~lcss tc~t~tcd ~rhcr m
accor~cc ~ath ~e provisions of ~s Ag~cmcnt ~s Agreement s~l be auto~Bcally
extended for addttto~ successive one (1) ye~ ~s (~ch, a "Renewal Term") ~dcr ~c s~e
te~s ~d conditions unless ~e A~rcement ts o~e~zse te~t~ted pursuit to ~s ~ or
el~er p~ elects not w so renew by ~t~n8
~ No~vtt~ng ~tng hereto to ~c contr~, ~s Agreement is subj~
· c end of ~) te .... ._ ~ ..... ~ i~ce of ~c Baylor H~th
to ~d s~ll be con.ironed upon tis approvat oy
C~e S)stem Bo~d of T~tees, ~d, m ~e event tMt such Executive Co~t~ee does not
approve of~c ~re~ment on or before December 31, 1999, ~s Agreement shall be null ~d void
~d of no e~cct x~hatsoever
Tc~matton bx Mu~al Consent ~ts Agreement ~Y bc tc~tcd at ~y ttmc by mum~
wnsen agreement of ~e pa~tes
~ ~s Agreement ~Y be to.hated by either of ~c pa~tcs ~vt~out cause
by gxvmg thc other p~ mnety (90) ~ys' prior ~Ren noucc
~matc tMs Agreement tmmcdtatel) for breach of
~ ~tcn~ tc~ or conatuon et uxb...~___mc
Y ...... a --*bm ten il0) business ~ys ~cr
Breac~n~ Pa~ ~ notice of brach ~r ~s ~t~~ ~ble
~c~tnatton b~ ~0sDt~ ~ospl~ ~Y ~tnate ~ts Agreement, cffc~tvc i~cdtatcly upon
notice to physician, m ~c event of
a ~) te~atlon, suspc~wn, wl~awal under ~cat of ~sctpl~ a~ton,
probation, [tint.lion or reduction m Physician s s~ privileges at ~ospt~ or
~y o~cr hospt~l or hcal~ care facthW, or
.~R,,vcoa ax~.'m c,~u~ s~sax~ 1 .,999 p&og 6 or i_~
96
97
b an~ termination suspension probation, [imitation, revocation or lapse of
Physician's (a) license to practice medicine in the State of Texas, (b) state or
federal authorization to acLmimster or prescribe controUed substances, or
(c) quahRcauon under the Medicare or Medicaid programs, or
c charging or con~ lction of Physician by any federal or state agency or authority of
any crime lnvol~mg ~raud, moral turpitude or immoral conduct
Matters R¢latmc, to Medical Staff .Membershio and Duc Process Ivlcdical staff membership is a
condition to thc pert'ormancc of Services under this Agreement However, this Agreement is not,
and shall not be construed as, any form of guarantee or assuranc~ by Hospital that Physician
obtain or retain medical staff membership or cllmcal pn,nleges, those matters are governed solely
b~ the b.~laws, roles and regulations of the medical staff at Hospital as are m effect from time to
time The nonrenev~al or termination of this Agreement shall not affect the medical staff
membership or clinical privileges of Ph.%sician at Hospital, ~h,ch status shall be separately
gosemed b~ the bylax~s of the medical staff of Hosp,tal, although the event causing the
termination under this Agreement may also be grounds for action under such bylaws Any due
process or other requirements of Hospital or its medical staff bylaws, rules or regulations shall not
appl~ to the termination of this Agreement
Leitat Comohance If there Is a change in an,v law, regulation or rule, state or federal, which
affects this Agreement or the actl~ lties of either party under this Agreement, or any change in the
judicial or admlmstrativ¢ interpretation of an~ such law, regulation or rule or if any of the
pro~ lslons of this Agreement are found to be in violation of the laws ex. isling at the time of such
determination, and either party reasonably believes in good faith that the change, lnterpretaUon or
determination x~lll have a substantial adverse effect on that party's business operations or its
rights or obligations under this Agreement, then the party may, upon whiten notice, require the
other part~ to enter into good faith negotiations to renegottate the terms of this Agreement and to
take an~ action necessar'~ to maintain compliance with such laws, rules or regulations If the
parties are unable to reach an agreement concerning the modification of this Agreement within
the ca,her of fort'y-five (45) days a~er the date of the notice seeking renegotlation or the effective
date of the change, or if the change or determination is effective immediately, then either party
ma~ immediately termmata this Agreement by wntten notice to the other party
10 CONI~IDI~NTIALITY
Ph~sician acknowledges that in connection with this Agreement and the Services provided by
Phxsician under this Agreement, Phvslclan may be acquinng and making use of certain
confidential information of Hospital which includes, but is not limited to, management reports,
financial statements, internal memoranda, reports, patient information, and other materials or
records of a propnetar', nature (' Confidential Information") Therefore, in order to protect the
Confidential Information, physician shall not use such Confidential Information except in
~Ba¥1~oR ~LTII CARE SYSTEM 1999 pn~E 7 OF I~
CONi~DgNT~A.[. Avl} ~ROpRX~TARY
[~ROelLRTY OY BAyLOR [-~A LTH CARE SYST LM
ALL PRIV~---ee--st ~ CLAIblID
connecUon v~,th the performance of Phystctans duttes pursuant to tlus Agreement, or chvulge the
Confidential Information to an) thtrd party, unless Hosp,tal consents m writing to such use or
dtvulgence or d~sclosure ~s requtred by law Physician shall comply w~th the apphcable federal
and state laws and regulatzons govcmzn8 the confident,ahty of all paUent medical records and
peer review m~ormat~on la the event Phystctan receives a request or demand fi.om a third party
for the d~sclosure of Confidentml Informauon, Phys~cmn shall promptly (wzthm two (2) business
days a~er receipt of such request or demand) provtde wnuen nouce to Hospital of such request or
demand, including a copy of any written document of such request or demand Upon ternunaUon
of th~s Agreement, Phystc~an shall not take or retain, without prior written authonzatton from
Hospttal, any pauent records, other pattant chmcal dat~ or tnformauon, patient list, papers, fee
schedules, files, or other documents or cop~es thereof or other Confidential lnformaUon of any
kind belonging to HospitaJ pertsuung to l~tUents, business, sales, ~manctal con&tton, or products
of Hospital Wtthout hmmng other possible remedtes for the breach of thts covenant, the pames
agree that mjuncuve or other equitable rebel shall be avmlable to enforce this covenant, such
rebel to be ~thout the necesstty of pc)sung a bond, cash or otherwise
11
NOTICES
Nottccs or communicat~ons to be gtven under thts Agreement shall be provtded to the appropriate
party m ~ntmg etther by personal dehvery, overmght dehvery service, confirmed telefacsimde or
registered or cemfied mall, postage prepmd, as follows
To Hospital
Baylor Medical Center at Grapevine
1650 W College St
Grapevine, Texas 7605 l
Fax (817) 481-2962
AttenUon £xecutiv¢ Director
s~tth a cop~ to
BHCS Office of General Counsel
3600 Gaston Avenue
Suite I157, LB 83
Dallas, Texas 75246
Fax (214) 820-1535
If to Physician
John Ansohn, D 0
EM S % tED lCAL COtq't'ROL JoaW A,-~so~, D O
~'BA'~ LOR ~EALTT[ CARE SySTeM 1999 PAGE 8 OF 17
or at such other addresses and to such other persons as either part~ may fi.om time to time
designate by notice given as herein provided Such notices or commumcations shall be deemed
to have been given upon receipt if bm personal dehverv, three (3) business days after deposit in
the United States mail if sent by regular, registered or certified mall, postage prepaid, one (1)
business day after delivery if by an ovem,ght dehverv service, or upon transmassion confirmation
if by telefacsimde
12 GENERAL PROVISIONS.
12 I Entire A~reement. Reoreseatation. Construction Tl~s Agreement, any amendments or addenda
hereto, and an,, exhibits specifically mentioned herein constitute the entire agreement between the
parties regard,ne the subject mat~er hereof and supersede all prior or contemporaneous
discussions, representations, correspondence, offer letters, memoranda and agreements, whether
oral or written, pertaining thereto By executing this Agreement, the parties acknowledge that
they have been represented by independent counsel, and have had the opportumty to review and
consider its terms The language of this Agreement shall be construed as a whole according to its
fair and common meaning The various titles of the sections herein are used soleil, for
convenience and shall not be used for interpretation or construing any ~ord, clause, paragraph, or
subparagraph of this Agreement
12 2 ~ Tlus Agreement ma~, be executed in multiple counterparts, and each counterpart
shall be considered an original
12 3 ~ The parties each agree to cooperate fully with the other party to take such further
action and execute such other documents or instruments as necessary or appropriate to implement
this Agreement
12 4 ~ Tlus Agreement mas be amended only by a written instrument signed by Hospital
and Phvstman
12 5 ~ Physician may not assign or delegate the rights, duties and obhgntaons of Physicmn
under flus Agreement to any other person, group or professional association Hospital may not
assign or delegate the rights, duties or obligations of Hospital under this Agreement to any other
person or entity without prior written consent of Phvsiman, provided, ho~sever, that ttus
Agreement may be assigned to any corporation or other entity, succeeding to the business of
Hospital in connection with the merger, consohdat~on or Wansfer of all or substantially all of the
assets and business of Hospital or with a corporate reorganization involving Hospital Tlus
Agreement may also be assigned to any subsid~ary, parent corporation or other affiliate of
Hospital
RM$ %I~DICa2. CONTROl. .IOI1~ A~'~OI~, D O
~AYLOR E[~ALTH (~AP~ S¥~T~,N~ 1..999 pXOl~ 9 OF 17
I CONtqDE~ITL~.L .A.~D ~1~.O PR~'TARY
PROPgRT*~ OF BAyLoR HEA~TH CARE
~[.L t~R~VILEG~ CI.A~M ED ,,
12 6 NO Third Part~ Beneficiaries This Agreement shall be binding upon and inure to the benefit of
the parties hereto, their successors and pernutted assigns Nothing m this Agreement ts intended,
nor shall be deemed, to confer an~ benefits on any third party, including, without limitation any
pauents of the Hospital, nor shall such person or entity have an:, right to seek, enforce or recover
an~ right or remed.~ with respect hereto
127 Reorescntations and Warranties Physician acknowledges that Hospital is relying on
representations and warranties contained tn this Agreement m entering into this Agreement and
the transactions contemplated hereby
128 ~ If any term or prov~ston of this Agreement ts held illegal, mvahd or unenforceable
to any extent, the remmnder of this Agreement shall not be affected thereby and each term and
provision of this Agreement shall be valid and enforceable to the fullest extent pernutted by law,
and tn lieu of each such illegal, mvahd or unenforceable provision the parties shall use their best
efforts to add as a part of this Agreement a provision as sumlar m terms to such dlegal, invalid or
unenforceable provision as may be legal, vahd, and enforceable
129 Waiver Waiver by either party of a breach or violation of any provision of this Agreement shall
not operate as, or be construed to be, a waiver of any prior, concurrent or subsequent breach of
the same or stmdar provision None of the provisions of this Agreement shall be considered
x~atved by either party except x~hen such wmver ts g~ven tn x~'nting
1210 v L w V u This Agreement shall be construed and governed accordmg to the la~s
of the State of Texas, ~,athout gtvmg effect to tls eonfilct of laws prov~sions The parUes hereto
expressly agree that this Agreement ts executed and shall be performed m Tarrant County, Texas
and venue of all disputes, claams and lawsmts arising hereunder shall lie tn Tan'ant County,
Texas
12 Il Remedies The remedies prowded to the parties by this Agreement are not exclusive or
exhaustive, but are cumulative of each other and tn adtht~on to any other remedies the parties may
have
1212 Attorneys Fees If either party bnngs an acuon against the other to enforce any condttaon or
covenant of this Agreement, the prevailing party, m addmon to other rebel awarded by a court or
arbitrator, shall be entitled to recover from the other party its court costs and reasonable
attorney's fees recurred tn such action
1213 C0nfidentiaht,, of Aitreement Physician shall keep th~s Agreement and its contents confidential
and not chsclnse this Agreement or tls contents to any third partT other than his/her legal and
financial advisors, or otherwise as reqmred by law, w~thout the prior written consent of Hospital
12 14 Corporate Practice of Medicine Nothing contained herein is intended to (a) consvtute the usc of
a medical license for the practice of medicine by anyone other than a licensed physician, (b) md
Hospital or an., other corporation to practice medicine when in fact such corporation ts not
hcensed to practice medicine, or (c) constitute or result m any other ac~ or create any other
arrangements in violation of the Texas Med~eal Practice Act ('lEx REV CFc STAT AblN ~
4495b)
12 15 Fraud and Abuse Law and Texas H~lth & Safety Code The parUes enter rote this Agreement
with the intent of conducting their relationship In f~ll comphance with applicable stat~, local, and
federal law including tho Stark law, the Mc&care and Medicaid Anti-Fraud and Abuse law and
the Texas Health & Safot~ Code Illegal Remunerauon law Notvathstandmg any unanfaclpated
effect of any of tho prov~sions herein, neither party w~ll intentionally conduct itself under the ,
terms of tlus Agr~¢munt in a manner to constitute a wolat~on of the Medicare and Medic, md
Anti-Fraud and Abuse law or Texas Health & Safety Code Illegal Remuneration law provisions
12 16 ~L~q~L~/~gl~l Physlcmn acknowledges and understands that this Agreement does not
require, and shall not be construed to require (directly or m&rectly, explicitly or implicitly),
Physician's use of Hospital or any other facility or sevace related to Hospital, or the admission or
referral of any patients treated by Physlcmn to Hospital or other facilities related t~ Hospital
Tlus Agreement does not prohibit Physician from obtaining memberslup on the medical staff of
any other hospital or health tara entaty or from refemn$ patients to or utilizing the services of any
other hospital or health care entlt2,.
[Signature Page Follows]
COeI~II~T~A,L A,%'O I~OI~R~TA~Y
I~ROPERTY O1 BAYLOR H~ALTH CA~E SYSTLM
A~L I)RIVI~EGES CLAIMED
IN WITNESS WHEREOF, the pames hereto have duly executed th~s Agreement by their
respective duly authorized representatives as of the Effective Date first stated above
HOSPITAL
BAYLOR MEDICAL CENTER AT GRAPEVINE
Mark Hood
E~¢¢UtlV¢ Dtrector
PHYSICIAN
EMS % EIEOICA~. CO~O~, - Jo~ A~sO~, D O
~BAYLOR IIFALT~ CAI~ S¥~q~4 1~99 PAGE 12 O~ 17
I CO~IDI~r~IAL ~ I~ROI~J~TA~Y I
EXHIBIT A
ADMINISTRATIVE SERVICES
2
3
4
5
6
7
Provide off-line EMS Me,heal D~rec~or services as reqmred by the regulaUons of the Texas State
Board of Medrol Examiners for EMS ra~hcal &rectors, presently co&tiM at 22 T~x Admm
Code § 197 1 et seq for those EMS systems (Wl~ne EMS Systems") listed below and as may be
added from t~me to tm~e through contractual a~/eement with Hoep~tal
a
J
k
L
Colle~lle F~re Department,
Denton Fu~ De~artmant,
Euless FLre Department,
Flower Mound Fu~ Depnnm~ot,
Grapevine F~e Department,
Keller Ftre De~amnant,
Lake CtUes F~e Department,
La~et~x~kt F~ro
Pochland Hdls Fire Department,
Roanoke F~rz Department,
Southlake Department of Pubh¢ Safety,
Trophy Club Emerl~n¢~ M~hcal Serwces
Facthtete Contmuons Quahty Improvement (CQI) acttvtt~es at Hospital for the EMS Systems
Formulate and review emergency me&cai service protocols
Estabhsh gmdelmes and momtor quahty assurance for all Medical Control acUvmes
Coordinate suffioent contmumg education to meet Department of Health requirements as set
forth tn 25 Tex Admtn Code § 157 38
Pro.de training.and educ~on on EMS-feinted matters through Ho~al to EMS Systen~
R~q~rssent the Hosp~al on EMS-related nsanes before local, regional and state EMS and trauma
org~zauonal boards and authormes
Prowde and fncfl~te strategtc planning for Hospttet EMS Medical Control system
9
Attend and represent Hospr, al at medical control meetings and sub-commntee meatmgs as
needed
CO~/~DE,%rTIAL A,ql) ~R. OPRI~TARY
~:)ROP~RTY Or BAYI,OR ~LTI-I CARI
ALL ~,~I, ~O ~ C~En
10
11
Assist in enforcm$ the bylaws and the roles and regulations of thc Hospital's medical staff as well
a~ any other Hospital, medical ~ or patient cate pohcses and procedures
Perform other duties or special requests as may from tu~c to ume be reasonably requestcd by the
adm~mstration of Hospital or by the Hospital's Mcchcal Board or as may be rcqmred by thc
medical staff bylaws of Hospital
EMS ~,LKDZCAL COFTTROL - JOH~ A,~OH~, O O
~BAYLOR HY. ALTH CA.q~ SYSTEM 1999 PAGE 14 OF 17
I Coffll'TD e.',(TIA l, ~"~D ~l?.O P~r, TARY "1
~tOP~TY OF BAYL.OK [-[F~ LTH C.~i~ SYSTL~4
EXHIBIT B
OTHER BAYLOR RELATIONSHIPS
List all other contractual or financial relattonslups vath Hospital, BHCS or a/~hated entrees
Contractual relationship with Baylor Medical Center at Grapewne for provision of Medical
Director services to Hospital Utthzat~on Review and Quality Assurance Rewew programs
2 Employment relaraonship wgh Texas-EMI Me(hcal Scn~lces, P A, contractor to Baylor Me&cai
Center at Grapevine for Emersency Dep~u b.L,ont CoverSSe
EMS %IF. DICAL CONTROl, - JOIL~ A,~'SOHN, D O
~ BA~/.OR HF. ALTH CARE SYSTEM 1999 ~AGE IS OF 17
EXHIBIT C
COMPENSATION
Fee shall be based upon thc number of hours for which Physlcan provldes Mc&cai Director services, pard
at a rote of Sev~nt~-Fiv¢ and No/100 Dollars per hour ($75 00/hr) up to annual ma.vamums of 576 work
hours and Forty-Three Thousand, Two Hundred and No/100 Dollars ($43,200 00) compensation per year
Physician's compensauon fee shall be prod in monthly installments after receipt of Physician's reports
and documentatton of services for the previous month Physician shall mamtmn and provide to Hospaal a
monthly wnttan record, m form and in detml reasonably sausfactory to Hospttal, meeting the
requirements of this Agreement and documenting all tune devoted to Services under tlus Agreement