08 EMS Medical Director AppointmentCITY COUNCIL AGENDA ITEM BRIEFING SHEET
Submittal Date: Originating Department: Presented By: Agenda Item No.:
03/13/2008 $
Council Date: E.M.S. Kent Klinkerman
03/24/2008
RECOMMENDED MOTION:
Motion to approve a Resolution accepting the resignation of Dr. Gleb Bourianoff as Medical Director of
the Emergency Medical Service of the City of Paris, appointing Dr. Eduardo Wilkinson to serve as
Medical Director and authorizing the City Manager to negotiate and execute all necessary documents.
POLICY ISSUE~S~:
Contract
BACKGROUND:
Dr. Bourianoff has served as EMS Medical Director since April 2002. He is moving out of town and
will no longer be available locally on a regular basis. Dr. Bourianoff has submitted his letter of
resignation effective April O 1, 2008.
Dr. Eduardo Wilkinson has agreed to serve as EMS Medical Director. He is an ER physician at Paris
Regional Medical Center. Dr. Wilkinson has previous experience as an EMS Medical Director in
Galveston, Texas.
BOARD~COMMISSION RECOMMENDATION:
EXHIBITS:
Contract
ACTION: BUDGET INFO:
^ Financial Report ^ Minute Order Expense $ 6,000
^ Department Report ®Resolution Budgeted Amt. $ 12,000
^ Presentation ^ Ordinance yTD Actual $ 4
500
,
^ Public Hearing ^ Other Acct. Name EMS Medical Director
Acct. Number 01-0350-54-00
FISCAL NOTES:
REVIEWED AND APPROVED BY:
® Administration ®City Clerk ^ Community Development ®EMS/IT ^ Finance ^ Fire
^ Municipal Court ®Legal ^ Library ^ Police ^ Eng./Public Works ^ Utilities
City of Paris Revised 2/04/08
DRAFT
attorney\reswork\current\EMS Med Dir Contract Res 2008
March 13, 2008
RESOLUTION NO.
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS,
TEXAS, ACCEPTING THE RESIGNATION OF DR. GLEB
BOURIANOFF AS MEDICAL DIRECTOR OF THE EMERGENCY
MEDICAL SERVICE OF THE CITY OF PARIS; APPOINTING DR.
EDUARDO WILKINSON TO SERVE AS MEDICAL DIRECTOR FOR
THE EMERGENCY MEDICAL SERVICE OF THE CITY OF PARIS;
APPROVING AND AUTHORIZING THE EXECUTION OF AN EMS
MEDICAL CONTROL AGREEMENT WITH DR. EDUARDO
WILKINSON; MAKING OTHER FINDINGS AND PROVISIONS
RELATED TO THE SUBJECT; AND DECLARING AN EFFECTIVE
DATE.
WHEREAS, in accordance with Chapter 773 of the Texas Health & Safety Code and
Title 25, Part 1, Chapter 157 of the Texas Administrative Code and Title 22, Part 9, Chapter 197
of the Texas Administrative Code, the Emergency Medical Services Department of the City of
Paris is required to contract with a licensed medical doctor to provide EMS medical direction to
the City's Emergency Medical Services Operation.
WHEREAS, Dr. Gleb Bourianoff has served as medical director since Apri18, 2002, and
has tendered his resignation effective April 1, 2008, and Dr. Eduardo Wilkinson has agreed to
serve as the new medical director; and,
WHEREAS, an EMS Medical Control Performance Agreement with Dr. Eduardo
Wilkinson, attached hereto and incorporated herein as Exhibit A, should, in all things be
approved, and the City Manager should be authorized to execute the same;
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF PARIS, TEXAS:
Section 1. That the findings set out in the preamble to this resolution are hereby in all
things approved.
Section 2. That the resignation of Dr. Gleb Bourianoff as Medical Director for the
Emergency Medical Service of the City of Paris be, and the same is hereby, accepted, with deep
appreciation for the invaluable service which he rendered the citizens of the city of Paris.
Section 3. That beginning April 1, 2008, Dr. Eduardo Wilkinson be, and he is hereby,
appointed as Medical Director for the Emergency Medical Service Department of the City of
Paris, and he is empowered to perform the duties and obligations enumerated by the laws of the
State of Texas and as also set forth in the Agreement attached hereto and incorporated herein as
Exhibit A.
Section 4. That an EMS Medical Control Agreement with Dr. Eduardo Wilkinson,
attached hereto as Exhibit A, be, and the same is hereby approved.
Section 5. That the City Manager be, and he is hereby, authorized and directed to
execute and the City Clerk to attest, on behalf of the City of Paris, the EMS Medical Control
Agreement, substantially in accordance with the terms and conditions and in the form shown in
Exhibit A, attached hereto.
Section 6. That this resolution shall be effective from and after its date of passage.
PASSED AND APPROVED this 24th day of March, 2008.
Jesse James Freelen, Mayor
ATTEST:
Janice Ellis, City Clerk
APPROVED AS TO FORM:
W. Kent McIlyar, City Attorney
EMS MEDICAL CONTROL
PERFORMANCE AGREEMENT
STATE OF TEXAS )
KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF LAMAR )
This Agreement is made and entered into the day of March, 2008, between CITY
OF PARIS EMERGENCY MEDICAL SERVICE, hereinafter referred to as "CITY," and
Eduardo Wilkinson, M.D., hereinafter referred to as "PHYSICIAN", (collectively "Parties").
WITNESSETH
WHEREAS, the CITY and the PHYSICIAN hereby agree that it would be of mutual
benefit to each party for the PHYSICIAN to provide EMS Medical Director services to the
Emergency Medical Services Department of the City of Paris as required by Chapter 773 of the
Texas Health and Safety Code, Title 25, Part 1, Chapter 157 of the Texas Administrative Code
and Title 22, Part 9, Chapter 197 of the Texas Administrative Code; and,
WHEREAS, CITY agrees to budget and pay PHYSICIAN $12,000 annually, payable in
equal monthly installments, for providing EMS Medical Control services.
NOW, THEREFORE, IN CONSIDERATION of the mutual covenants and
agreements contained herein and other good and valuable consideration, the parties agree as
follows:
I.
RESPONSIBILITIES OF MEDICAL DIRECTOR
A. Provide EMS Medical Director Services
1. PHYSICIAN shall provide EMS Medical Director Services for the Emergency
Medical Services Department of the City of Paris as defined in Chapter 773 of the
Texas Health and Safety Code, Title 25, Part 1, Chapter 157 of the Texas
Administrative Code and Title 22, Part 9, Chapter 197 of the Texas Administrative
Code.
2. Patient care policies, protocols, and procedures will be established and continually
upgraded by PHYSICIAN with collaboration and cooperation of the CITY
Administration, the CITY EMS DIRECTOR, and the CITY EMS Training
Coordinator.
Page 1 of 7
EXHIBIT.,Q..
3. Off-line Medical Control will be established by policies, protocols, and procedures.
On-line Medical Control will be coordinated with the on-duty Emergency Department
physician at Paris Regional Medical Center Hospital.
B. Provide Continuous Quality Improvement
1. PHYSICIAN shall direct, approve, and oversee all Quality Improvement activities.
Methods of Continuous Quality Improvement will include chart audits, EMS training
officer observations, exception reports, ED Physician feedback, educational
programs, protocol testing, skills testing, random surveys, and organized research
activities.
2. PHYSICIAN will develop immediate action plans for sentinel events which are
defined as resuscitation cases, no transports, patient or family complaints, high risk
procedures such as cricothyrotomy, chest decompression, intraosseous placement,
rapid sequence induction, narcotic administration, adverse outcomes, and
communication failures.
3. In addition, PHYSICIAN will see that 10% of each EMS certificant's patient charts
are audited bi-monthly. PHYSICIAN will arrange for assistance in Continuous
Quality Improvement gathering if calls run more than 75 days behind processing.
This assistance will be provided at no extra cost to PHYSICIAN.
4. PHYSICIAN will also oversee the operation of an ad hoc peer review committee
made up of three CITY paramedics, two first responders, and one ED Nurse.
C. Approve Continuing Education Programs
1. PHYSICIAN shall approve continuing education based on Continuous Quality
Improvement parameters and individual improvement programs. PHYSICIAN will
develop specialized programs and implement them as needed through the office of the
City of Paris EMS Training Coordinator.
D. Representation
1. PHYSICIAN will be required to attend the Ad Hoc Peer Review meetings when
scheduled. Periodic and special requested attendance will be required for Medical
Staff meetings at Paris Regional Medical Center, Emergency Department
Committees, and CITY Council meetings as well as any other matters requiring the
involvement of the Medical Director. PHYSICIAN will provide information on
Continuous Quality Improvement for local concern and customization of policies,
protocols, and procedures.
Page 2 of 7
E. Accountability
1. PHYSICIAN shall be responsible and accountable for all patient care protocols,
policies, and procedures and the extension, limitations of extension, or removal of
authority to provide medical care from any EMS provider in the CITY's Emergency
Medical Services System PHYSICIAN shall also understand this Agreement is a
Performance Contract.
2. PHYSICIAN must also carry medical malpractice insurance with policy limits and
coverage commensurate with current EMS Medical Directors in the State of Texas.
This insurance policy shall also name the City of Paris, Texas as an Additional
Insured on said policy. A copy of the malpractice insurance policy or a properly
signed Certificate of Insurance evidencing the required coverage shall be submitted to
the City's Emergency Medical Services Department prior to the execution of this
Agreement or any renewal thereof.
II.
RESPONSIBILITIES OF CITY
The CITY shall:
1. provide an EMS Training Coordinator to organize and carry out action plans of
continuous quality improvement and comprehensive and relevant continuing education
programs.
2. provide adequate notice for meetings and deadlines.
3. pay PHYSICIAN $12,000 annually for EMS Medical Control Services rendered herein,
payable in equal monthly installments of $1,000.
4. provide space at a City facility for the review of calls, development of protocols and
policies. Office functions such as printing, copying, mailing, email, office supplies shall
be supplied.
5. provide the EMS Medical Director with an official uniform with appropriate badge and
patches.
6. provide the EMS Medical Director a portable radio for communication with EMS
resources.
7. provide the EMS Medical Director with training funds for personal EMS Medical
Director development.
Page 3 of 7
8. pay annual association dues for PHYSICIAN to the Texas EMS Medical Directors
III.
TERM OF AGREEMENT
The initial term of this Agreement shall begin on April 1, 2008 and end on April 30,
2009. Thereafter, this Agreement may be renewed for successive twelve (12) month terms
beginning on May 1, 2009. Any renewals of this Agreement shall be subject to all other
provisions of the Agreement. This Agreement may be terminated at any time by either Parry by
giving written notice to the other Party ninety (90) days prior to termination. During any ninety
(90) days notice period pursuant to this Agreement, the Parties will continue to provide services
designated herein without any diminution of said services, and PHYSICIAN will cooperate with
any new provider to ensure the smooth transition of these services to the new provider.
PHYSICIAN will be entitled to remuneration in an amount equal to the then monthly sum
pursuant to this Agreement and any written extension hereof.
IV.
COPYRIGHT
All forms of public information and advertising, direct or indirect, utilized by
PHYSICIAN shall be approved in advance by mutual agreement of CITY and PHYSICIAN.
CITY shall not unreasonably withhold its approval of advertising or public relations programs
and materials developed by PHYSICIAN to promote his reputation, or to jointly promote the
goodwill and reputation of the System in the local and regional area. Promotion and publicity of
advertisements about the System shall represent the interests of CITY and the provision of
quality medical care by the System. Use of trademarks or information of CITY or PHYSICIAN
shall be only upon mutual agreement of the Parties, and such use shall not imbue the other Party
with any ownership rights of such trademarks and/or other information.
V.
ENTIRE AGREEMENT
This Agreement supersedes any and all other Agreements, either oral or in writing,
between the Parties hereto with respect to the subject matter hereof, and no other Agreement,
statement, or promise relating to the subject matter of this Agreement which is not contained
herein shall be valid or binding.
Page 4 of 7
VI.
ASSIGNMENT
Neither this Agreement nor any duties or obligations contained herein may be assigned or
delegated to another person or entity by PHYSICIAN without the prior approval of the Paris City
Council and written authorization by the Paris City Manager.
VII.
ATTORNEY'S FEES
If any action at law or equity is brought to enforce or interpret the provisions of this
Agreement, the prevailing Party shall be entitled to reasonable attorney's fees in addition to any
other relief to which the prevailing Party may be entitled.
VIII.
TEXAS LAW TO APPLY
This Agreement shall be construed under and in accordance with the laws of the State of
Texas, and all obligations of the parties created hereunder are performable in Lamar County,
Texas; therefore exclusive venue for any disputes arising from this Agreement shall be in Lamar
County, Texas.
IX.
AMENDMENT
This Agreement may be amended only by the mutual agreement of the parties hereto set
out in writing and signed by an authorized representative of each party.
X.
NONWAIVER CLAUSE
No waiver of the either Party's rights under this Agreement shall be deemed to have been
made unless expressed in writing and signed by an authorized representative of the Party.
XI.
LEGAL CONSTRUCTION
In case any one or more of the provisions contained in this Agreement shall, for any
reason, be held invalid, illegal, or unenforceable in any respect, such invalidity, illegality, or
unenforceability shall be construed as if such invalid, illegal, or unenforceable provisions has
never been contained herein.
Page 5 of 7
IN WITNESS WHEREOF, the Parties hereto have executed this Agreement in multiple
originals.
By:
ATTEST:
Janice Ellis, City Clerk
APPROVED AS TO FORM:
Kent McIlyar, City Attorney
STATE OF TEXAS }
COUNTY OF LAMAR }
CITY OF PARIS, TEXAS
Kevin Carruth, City Manager
PHYSICIAL/EMS MEDICAL DIRECTOR
Dr. Eduardo Wilkinson, M.D.
BEFORE ME, the undersigned authority, on this day personally appeared Kevin
Carruth, City Manager of the City of Paris, known to me to be the person whose name is
subscribed to the foregoing instrument, and acknowledged to me that he executed the same for
the purposes and consideration therein expressed and in the capacity therein stated.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of March, 2008.
Notary Public, State of Texas
STATE OF TEXAS }
COUNTY OF LAMAR }
Page 6 of 7
BEFORE ME, the undersigned authority, on this day personally appeared Dr. Eduardo
Wilkinson, known to me to be the person whose name is subscribed to the foregoing instrument,
and acknowledged to me that he executed the same for the purposes and consideration therein
expressed.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of April, 2008.
Notary Public, State of Texas
Page 7 of 7