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02-G EMS Medical Dir ContractDRAFT F:kAttorney\LisakResolutions\CURRENT\EMS Med Dir Contract Res 2003.wpd April 17, 2003 RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS, PARIS, TEXAS, REAPPOINTING GLEB BOURIANOFF 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. GLEB BOURIANOFF; MAKING OTHER FINDINGS AND PROVISIONS RELATED TO THE SUBJECT; AND DECLARING AN EFFECTIVE DATE. WHEREAS, in accordance with the Amended Agreement between the City of Paris, L.P. McCuistion Community Hospital, and St. Joseph's Hospital and Health Center, dated September 10, 1990, the City of Paris is responsible for the appointment of one or more physicians, from either or both of the staffs of the respective hospitals, to serve as medical director or co-medical directors for the Emergency Medical Service of the City of Paris; and, WHEREAS, Dr. Gleb Bourianoffhas served as medical director since April 8, 2002, and has agreed to continue serving; and, WHEREAS, an EMS Medical Control Performance Agreement with Dr. Gleb Bourianoff, attached hereto as Exhibit A, should, in all things be approved, and the Mayor should be authorized to execute the same; NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PARIS, PARIS, TEXAS: Section 1. That the findings set out in the preamble to this resolution are hereby in all things approved. Section 2. That Dr. Gleb Bourianoffbe, and he is hereby, reappointed to serve as medical director for the Emergency Medical Service of the City of Paris, and he is empowered to perform the duties and obligations enumerated in the laws of the State of Texas. Section 3. That an EMS Medical Control Agreement with Dr. Gleb Bourianoff, attached hereto as Exhibit A, be, and the same is hereby, approved. Section 4. That the Mayor 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, under the terms and conditions and in the form shown in Exhibit A, attached hereto. Section 5. That this resolution shall be effective from and after its date of passage. PASSED AND APPROVED this 28th day of April, 2003. ATTEST: Michael J. Pfiester, Mayor Mattie Cunningham, City Clerk APPROVED AS TO FORM: Larry W. Schenk, City Attorney EMS MEDICAL CONTROL PERFORMANCE AGREEMENT STATE OF TEXAS COUNTY OF LAMAR KNOW ALL MEN BY THESE PRESENTS: This Agreement is made and entered into the 28th day of April, 2003, between CITY OF PARIS EMERGENCY MEDICAL SERVICE, hereinafter referred to as "CITY," and GLEB BOURIANOFF, M.D., hereinafter referred to as "Dr. Bourianoff", (collectively "Parties"). WITNESSETH WHEREAS, it is agreed by the aforementioned Parties to be of mutual interest and advantage that Dr. Bourianoffwill provide EMS Medical Direction to CITY as defined and required in Chapter 773 of the Health Code of the State of Texas, Texas Administrative Code Chapter 197, and Texas Administrative Code Chapter 157; and, WHEREAS, CITY agrees to provide $9,000.00 annually of funding, payable monthly, to Dr. Bourianoff for providing EMS Medical Control services. THEREFORE, Dr. Bourianoff on this date effects the following agreement with CITY to obtain funding to provide CITY with EMS Medical Control. RESPONSIBILITIES OF DR. BOURIANOFF A. Provide EMS Medical Direction Dr. Bourianoff shall provide EMS Medical Direction for the City of Paris as defined in Chapter 773 of the Health and Safety Code of the State of Texas, Texas Administrative Code Chapter 197, and Texas Administrative Code Chapter 157. Patient care policies, protocols, and procedures will be established and continually upgraded by Dr. Bourianoffwith collaboration and cooperation of the CITY Administration, the CITY EMS Advisory Board, and the CITY EMS Training Coordinator. 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 CHRISTUS St. Joseph's Hospital's north and south campuses. EXHIBIT A B. Provide Continuous Quality Improvement Dr. Bourianoffshall direct, approve, and oversee all Quality Improvement activities. Methods of Continuous Quality Improvement will include chart audits, EMS training officer observations, exception reports, ED Nurse feedback, educational programs, protocol testing, skills testing, random surveys, and organized research activities. Dr. Bourianoffwill 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. In addition, Dr. Bourianoff will see that 10% of each EMS certificant's patient charts are audited bi-monthly. Dr. Bourianoff 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 Dr. Bourianoff. Dr. Bourianoffwill 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 Dr. Bourianoffshall approve continuing education based on Continuous Quality Improvement parameters and individual improvement programs. Dr. Bourianoffwill develop specialized programs and implement them as needed through the office of the City of Paris EMS Training Coordinator. D. Representation Dr. Bourianoff will be required to attend the CITY EMS Advisory Board Meetings on a quarterly basis. Periodic and special requested attendance will be required for Medical Staff meetings at CHRISTUS St. Joseph's Hospital's north and south campuses, Emergency Department Committees, and CITY Council meetings as well as any other matters requiring the involvement of the Medical Director. Dr. Bourianoff will provide information on Continuous Quality Improvement for local concern and customization of policies, protocols, and procedures. E. Accountability Dr. Bourianoff is accountable and responsible for all patient care protocols, policies, and procedures and the extension, limitations of extension, or removal of authority to any EMS provider in the CITY EMS System to provide emergency medical care. Dr. Bourianoffwill also understand this Agreement is a Performance Contract. Dr. Bourianoffmust carry standard malpractice insurance at a rate commensurate with current Medical Doctors in the State of Texas. Dr. Bourianoff will be covered under the CITY's liability insurance policy for duties detailed in this contract that are strictly related to EMS Medical Direction. ii. RESPONSIBILITIES OF CITY The CITY shall: provide an EMS Training Coordinator to organize and carry out action plans of continuous quality improvement and comprehensive and relevant continuing education programs. B. provide adequate notice for meetings and deadlines. provide $9,000 in funding annually, payable monthly in equal installments of $750.00, for EMS Medical Control. iii. RESPONSIBILITIES OF CITY AND DR. BOURIANOFF CITY and DR. BOURIANOFF shall: A. Agree on the amount of annual funding, with the ultimate decision being that of CITY. Agree to customize protocols, policies, and procedures based on local emphasis and patient need. IV. TERM OF AGREEMENT This Agreement shall be effective on May 1, 2003, and end on April 30, 2004; provided that this Agreement shall renew annually on May 1 of each year upon written agreement signed by both Parties which sets the compensation amounts. If no changes in compensation are necessary, no such written agreement will be required, and this Agreement will be automatically renewed for the next ensuing year of service. Any renewals hereof shall be subject to all other provisions of this Agreement. This Agreement may be terminated at any time by either Party 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 Dr. Bourianoffwill cooperate with any new provider to ensure the smooth transition of these services to the new provider. Dr. Bourianoff will be entitled to remuneration in an amount equal to the then monthly sum pursuant to this Agreement and any written extension hereof. COPYRIGHT All forms of public information and advertising, direct or indirect, utilized by Dr. Bourianoff shall be approved in advance by mutual agreement of CITY and Dr. Bourianoff. CITY shall not unreasonably withhold its approval of advertising or public relations programs and materials developed by Dr. Bourianoff to promote its 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 Dr. Bourianoff 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. VI. 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. VII. ASSIGNMENT Neither this Agreement nor any duties or obligations hereunder shall be assignable by Dr. Bourianoff. VIII. 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. 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. AMENDMENT This Agreement shall be amended by the mutual agreement of the parties hereto in writing to be attached to and incorporated into this Agreement. 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. IN WITNESS WHEREOF, the Parties hereto have executed this Agreement in multiple originals. CITY OF PARIS, PARIS, TEXAS ATTEST: By: Michael J. Pfiester, Mayor Mattie Cunningham, City Clerk APPROVED AS TO FORM: Larry W. Schenk, City Attorney DR. BOURIANOFF Gleb Bourianoff, M.D. STATE OF TEXAS COUNTY OF LAMAR } BEFORE ME, the undersigned authority, on this day personally appeared Michael J. Pfiester, Mayor 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 28th day of April, 2003. STATE OF TEXAS } COUNTY OF LAMAR } BEFORE ME, the undersigned Notary Public, State of Texas authority, on this day personally appeared Dr. Gleb Bourianoff, 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 2003. __ day of Notary Public, State of Texas