HomeMy WebLinkAboutR-2021-059 Approving Agreement for Medical Director Services RESOLUTION NO. R-2021-059
A RESOLUTION APPROVING AN AGREEMENT FOR MEDICAL DIRECTOR
SERVICES
BE IT RESOLVED BY THE BOARD OF ALDERMEN OF THE CITY OF
RIVERSIDE, MISSOURI AS FOLLOWS:
THAT the Board of Aldermen approves the Medical Director Services and
HIPPA Business Associate Agreement, in substantially the form attached hereto, with
Steven M. Orr, M.D., and authorizes the Mayor to execute the Agreement on behalf of
the City; and
FURTHER THAT the Mayor, the City Administrator, the Fire Chief, and other
appropriate City officials are hereby authorized to take any and all actions as may be
deemed necessary or convenient to carry out and comply with the intent of this
Resolution and to execute and deliver for and on behalf of the City all certificates,
instruments, agreements and other documents, as may be necessary or convenient to
perform all matters herein authorized.
PASSED AND ADOPTED by the Board of Aldermen this-day of June 2021.
J4LA 1,4 If,d
Mayo athleen L. Rose
ATTEST: Tv
Robin Kincaid, City Clerk
MEDICAL DIRECTOR SERVICES
AND HIPAA BUSINESS ASSOCIATE AGREEMENT
THIS AGREEMENT, made and entered into this 151 day of July , 2021,
is entered into pursuant to Chapter 190 of the Missouri Revised Statutes, specifically
Section 190.103, and pursuant to HIPAA Regulations promulgated by the Secretary of
Health and Human Services under Title II, Subtitle F, of the Health Insurance Portability and
Accountability Act (Public Law 104-191), and between the City of Riverside, in its capacity
as an "Emergency Medical Response Agency' and as "Covered Entity' (hereinafter
"Agency"), and Steven M Orr M.D., in his/her capacity as the "Medical Director" and as
a "Business Associate" (hereinafter "Director") under the following terms and conditions:
WHEREAS,Agency desires to promote the general interest and welfare of the
Citizens of Riverside by participating in a program which promotes the services and skills of
the emergency medical personnel employed by Agency; and
WHEREAS, it is necessary for Agency to designate a medical director to review
ambulance reporting forms, develop ambulance protocols, certify license maintenance for
Emergency Medical Services providers, certify training programs for Emergency Services
providers, maintain federal and state drug licenses for purchase of medications, and all
other standards of care; and
WHEREAS,Agency desires to contract with Director for the purposes of serving as an
advisor to Agency on matters relating to emergency medical service delivery; and
coordinating educational and training sessions designed to provide for skills maintenance for
the employees of Agency who provide emergency medical services.
NOW,THEREFORE, in consideration of the promises and mutual covenants herein
set forth, it is hereby agreed as follows:
1. Qualifications and Designation. Director shall maintain a license to practice
medicine in the State of Missouri as set forth in Missouri State Regulation 19 CSR 30-
40.303 and hereby agrees to provide the medical direction services set out in
Chapter 190 to Agency. Director shall provide such services in a timely manner
according to the terms and conditions set forth herein; however, in the absence or
inability of Director to fulfill the obligations hereunder, Director shall designate
another qualified individual to provide such services to Agency on a temporary basis
during the absence or inability of Director to perform the functions prescribed
herein.
2. Scope of Work. Director agrees to provide medical direction services to Agency
through Agency's Fire Department, including the following;
Page 1 of 6
a. Perform consulting and advisory services on behalf of Agency with respect to
matters relating to or affecting the emergency medical services program of
Agency in accordance with the Regulations Governing Emergency Medical
Direction in the State of Missouri (DHHS), and other relevant regulations; and
b. Ensure that the personnel providing emergency medical services for Agency
are able to provide care, meeting established standards of care with
consideration for state and national standards as well as local area needs and
resources; and
C. Approve the level of pre-hospital care, which may be rendered locally by
each Agency emergency medical service provider, regardless of the
providers' level of state licensure at the time of hire and thereafter; and
d. Establish and develop triage, treatment and transport protocols, which may
include authorization for standing orders and define field performance
standards for Agency providers; and
e. Assist in the design and development of patient medical record forms for use
in the field; and
f. Review reporting forms and the operation of the emergency medical service
delivery program and make suggestions regarding appropriate emergency
medical care to employees of Agency; and
g. Review all critical calls as requested by Agency, including, but not limited to
cardiac respiratory arrest cases and AED uses; and
h. Serve as an advisor to Agency on matters relating to emergency medical
service delivery; and
i. Coordinate educational and training sessions to provide for skills
maintenance for the employees of Agency who provide emergency medical
services; and
j. Determine standards of pre-hospital care through protocols and standing
orders to ensure providers are qualified and competent to treat patients and
shall monitor compliance and establish goals; and
k. Assist the Agency in continuing to develop and improve the ongoing Quality
Assurance program; and
I. Authorize, supervise and approve the purchase of necessary medications for
pre-hospital use in accordance with the local protocol, Missouri Board of
Pharmacy; or, Missouri Department of Public Safety, and the Federal Drug
Enforcement Agency (DEA) regulations; and
Page 2 of 6
M. Ensure compliance with all Regulations promulgated by the Missouri
Department of Health for Emergency Medical Response Agencies; and
n. Maintain Medical Malpractice Insurance. Director shall provide Agency with
certificates of insurance evidencing the required coverage. Director shall not
cause or allow the required insurance coverage to lapse or be cancelled
during the term of this Agreement.
o. Indemnify and hold harmless Agency from any and all claims for damages
arising out of Director's performance, or failure to perform, any professional
duties on behalf of Agency.
3. Agency's Obligations. The Agency agrees to:
a. Communicate with and notify Director of training and operational concerns
and needs as determined and established by Department of Public Safety
protocols and standing orders; and
b. Provide to the Director a listing of the authorized personnel operating within
the system to include name, type of license, CME and re-certification records
and other clinical information as requested, and to assist the Director in
gathering other personnel information as desired; and
C. Respond in a timely manner to institute any change in operation needed to
affect improvement in patient care, or to correct violation of relevant laws
and regulations as suggested by the Director; and
d. Provide Director with copies of reporting forms for review on critical
responses cases as recommended by the Missouri Bureau of Emergency
Medical Services and set forth in Department of Public Safety Continuing
Quality Improvement Programs; and
e. Pay Director the sum of Four Thousand eight hundred Dollars($4,800.00) per
year for services rendered to Agency as herein provided, payable on a
quarterly basis as invoiced by Director; and
f. Reimburse Director for actual out of pocket expenses incurred for printing,
copying, postage and stationery as a direct result of performance under this
agreement. Itemized expenses shall be presented to the City for review and
approval.
4. Location of Services Provided. It is understood and agreed to by the parties that
some of Director's services will be rendered at its business office, but that Director
will from time to time come to Agency's Fire Department facilities in Riverside,
Missouri, or such other place as designated by Agency, to meet with employees of
Agency.
Page 3 of 6
5. Term. The parties hereby agree that the term of this Agreement shall be for a
period of one (1) year beginning on the 1St day of July ' 2021
and renewed for unlimited successive one-year terms by mutual agreement of the
parties unless sooner terminated as provided herein.
6. Termination. This Agreement may be terminated without cause by any party upon
thirty (30) days' written notice to the other party. This Agreement shall be
immediately terminated without notice in the event Director becomes unable to
practice medicine in the State of Missouri.
7. Independent Contractor. Director is an independent contractor performing a
service for Agency and shall not be considered an employee of Agency for any
purpose. In the performance of the services, the particular services and the hours
Director is to work on any given day will be entirely within Director's control and
Agency will rely upon Director to work such number of hours as are reasonably
necessary to fulfill the spirit and purpose of this Agreement.
8. Grievance Procedure. A grievance is a complaint by a customer/patient (hereinafter
"grievant") concerning emergency care services provided by the medical response
agency or ambulance service, personnel and the medical director. A grievance can
be initiated only by the grievant or his/her parent, if a minor, legal guardian or
conservator, attorney-in-fact or personal representative. The grievance must be
reduced to writing and presented to the Emergency Medical Response Agency Fire
Chief within seven (7) weekdays of the event giving rise to the grievance.
If the Fire Chief fails to resolve the grievance to the grievant's satisfaction, then the
grievant may, within three weekdays of the Fire Chief's decision, submit the same
written grievance to the City Administrator. On receipt of such written grievance,
the City Administrator or his/her designee shall as expeditiously as possible review
the grievance. If the City Administrator elects, a meeting may be held with the
grievant.
The decision of the City Administrator shall be final and no further administrative
review of the grievance will be afforded.
9. HIPAA Compliance. Additionally, it is agreed to as follows:
a. Agency may make available and/or transfer to Director certain confidential
information, in conjunction with services that are being provided by Director
to Agency. This information must be afforded special treatment and
protection.
b. Director will have access to and/or receive from Agency certain information
that can be used or disclosed only in accordance with this Agreement and the
Privacy Regulations of the U.S. Department of Health and Human Services.
Page 4 of 6
C. Director hereby agrees that it shall be prohibited from using or disclosing the
information provided or made available by Agency for any purpose other
than as expressly permitted or required by this Agreement.
d. The term of this contract shall commence as of the date executed (the
"Effective Date"), and shall expire when all the information provided by
Agency to Director is destroyed or returned to Agency.
e. Director shall be permitted to use and/or disclose information provided or
made available from Agency for the purposes stated in §§ 2.a. through 2.k.
and §§ 3.a. through 3.d., above.
f. Director is permitted to use information if necessary for the proper
management and administration of Director or to carry out legal
responsibilities of Director.
g. Director is permitted to disclose information received from Agency for the
proper management and administration of Director or to carry out legal
responsibilities of Director,provided that the disclosure is required by law; or
the Director obtains reasonable assurances from the person to whom the
information is disclosed that it will be held confidentially and used or further
disclosed only as required by law or for the purposes for which it was
disclosed to the person, the person will use appropriate safeguards to
prevent use or disclosure of the information, and the person immediately
notifies Director of any instance of which it is aware in which the
confidentiality of the information has been breached.
h. Director is also permitted to use or disclose information to provide data
aggregation services, as that term is defined by 45 C.F.R. § 164.501, relating
to the healthcare operations of Agency.
i. Director will establish and maintain appropriate safeguards to prevent any
disclosure of the information, other than as provided for by the contract.
j. Director hereby agrees that it shall immediately report to Agency any use or
disclosure of information not provided for or allowed by the contract.
k. Director hereby agrees that, any time information is provided or made
available to any subcontractors or agents, Director must enter into a
subcontract with the subcontractor or agent that contains the same terms,
conditions, and restrictions on the use and disclosure of information as
contained in this Agreement. Director must obtain Agency's approval prior
to entering into such agreements.
Page 5 of 6
I. Director hereby agrees to make available and provide right of access to
information by the individual in accordance with 45 C.F.R. § 164.524,
including substitution of the word "Agency' with "Director" where
appropriate.
M. Director agrees to make information available for amendment and to
incorporate any amendments to information in accordance with 45 C.F.R.
§ 164.526, including substitution of the word "Agency" with "Director"
where appropriate.
n. Director agrees to make information available as required to provide an
accounting of disclosures in accordance with 45 C.F.R. § 164.528, including
substitution of the word "Agency" with "Director" where appropriate.
o. Director hereby agrees to make its internal practices, books and records
relating to the use or disclosure of information received from, or created or
received by, Director on behalf of Agency, available to the Secretary of
Health and Human Services or the Secretary's designee for the purpose of
determining compliance with the Privacy Regulations.
P. At termination of the contract, Director hereby agrees to return or destroy all
information received from, or created or received by, Director on behalf of
Agency. Director agrees not to retain any copies of the information after
termination of the contract. If return or destruction of the information is not
feasible, Director agrees to extend protections of the contract for as long as
necessary to protect the information and to limit any further use or
disclosure. If Director elects to destroy the information, it shall certify to
Agency that the information has been destroyed.
q. Director agrees to have procedures in place for mitigating, to the maximum
extent practicable, any deleterious effect from the use or disclosure of
information in a manner contrary to the contract or the Privacy Regulations.
r. Director agrees and understands that it must develop and implement a
system of sanctions for any employee, subcontractor or agent who violates
this Agreement or the Privacy Regulations.
S. The information shall be and remain the property of Agency. Director agrees
that it acquires no title or rights to the information, including any de-
identified information, as a result of the contract.
t. Director agrees that Agency has the right to immediately terminate the
contract and seek relief under Paragraph v., if Agency determines that
Director has violated a material term of the contract.
Page 6 of 7
U. Any non-compliance by Director with the contract or the Privacy Regulations
will automatically be considered to be grounds for breach, if Director knew
and failed to immediately take reasonable steps to cure the non-compliance.
V. Notwithstanding any rights or remedies provided for in the contract,Agency
retains all rights to seek injunctive relief to prevent or stop the unauthorized
use or disclosure of information by Director or any agent, contractor or third
party that received information from Director.
10. Conflict of Interest. The Director warrants that he/she has no interest and shall not
acquire any interest, directly or indirectly, which would conflict in any manner or
degree with the performance of services required under this agreement.
11. Binding Effect.This Agreement shall be binding upon the parties hereto and upon
their respective successors and assigns.
12. Scope of Agreement. This Agreement contains the entire agreement of the parties,
and may not be modified orally, but only by an agreement in writing signed by the
parties hereto.
IN WITNESS WHEREOF,the parties have executed this Agreement the day and year
first above written.
CI"IY 01: RIVERSIDI:, MISSOURI
Kathlee I.. Rose Tll� I�Mnldkd
Title: Mayor Ala/ TkV I_tm
Dated: W1t
ATTI ST:
Robin Kincai , City Clerk
MEDICAL DIRECTOR
r
,-
-- ------------------
�trv�a
Page 7 of*7
U. Any non-compliance by Director with the contract or the Privacy Regulations
will automatically be considered to be grounds for breach, if Director knew
and failed to immediately take reasonable steps to cure the non-compliance.
V. Notwithstanding any rights or remedies provided for in the contract, Agency
retains all rights to seek injunctive relief to prevent or stop the unauthorized
use or disclosure of information by Director or any agent, contractor or third
party that received information from Director.
10. Conflict of Interest. The Director warrants that he/she has no interest and shall not
acquire any interest, directly or indirectly, which would conflict in any manner or
degree with the performance of services required under this agreement.
11. Binding Effect.This Agreement shall be binding upon the parties hereto and upon
their respective successors and assigns.
12. Scope of Agreement. This Agreement contains the entire agreement of the parties,
and may not be modified orally, but only by an agreement in writing signed by the
parties hereto.
IN WITNESS WHEREOF,the parties have executed this Agreement the day and year
first above written.
CITY OF RIVERSIDE, MISSOURI
By: �Ammdkd Kathlee . RoseJlu
Title: Mayor Mack -PW 1—?Im
Dated: VA W121
ATTEST:
Robin Kincai , City Clerk
MEDICAL DIRECTOR
M.D.
Page 7 of 7