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2019-264 20200189 Asante
I CONSULTANT AGREEMENT FOR MEDICAL DIRECTORSHIP SERVICES This Consultant Agreement for Medical Directorship Services (the "Agreement") is entered into by and between Applegate Valley Rural Fire Protection # 9, the City of Ashland by and through Ashland Fire and Rescue, Butte Falls Volunteer Fire and Rescue, Greensprings Rural Fire District, Jackson County Fire District # 3, Jackson County Fire District # 4, Jackson County Fire District # 5, Jackson County Fire District # 6, City of Jacksonville by and through Jacksonville Fire Department, City of Medford by and through Medford Fire Department, Prospect Rural Fire Protection District, Rogue River Rural Fire Protection District, Medford Airport Fire Department, and Emergency Communications of Southern Oregon (dispatch center) (each individually referred to herein as an "Agency" and collectively referred to herein as the "Agencies") and Asante, an Oregon domestic nonprofit public benefit corporation ("Asante"), on July 1, 2019 (the "Effective Date"). RECITALS WHEREAS, the Agencies provide prehospital care to the residents of Jackson County and desire to provide high-quality state of the art care to the residents of Jackson County; WHEREAS, Asante provides medical care as a charitable, public benefit corporation to the residents of Jackson County; WHEREAS, the state of Oregon by Oregon Revised Statute ("ORS") § 682.062, has designated the duty to provide emergency prehospital services to counties, cities, and rural fire protection districts and exempted such regulation from liability under federal antitrust laws; WHEREAS, the state of Oregon by ORS Chapter 682, OAR Chapter 333 Division 265, and OAR Chapter 847 Division 35 requires a medical director (supervising physician) to oversee EMS providers; WHEREAS, the Agencies have determined that it is a matter of public interest, necessity, and requirements under Oregon law to engage the specialized services of a licensed physician in good standing with the Oregon Medical Board to provide medical directorship services to the Agencies; WHEREAS, the Agencies are unable to provide fair market value compensation to a medical director (supervising physician) and can only do so with the assistance of Asante; WHEREAS, Asante will designate a licensed physician in good standing with the Oregon Medical Board ("OMB") who is board certified in emergency medicine and employed with Asante in the emergency department at Asante Rogue Regional Medical Center pursuant to an employment agreement with Asante ("Consultant") to provide medical directorship services to the Agencies; WHEREAS, Asante desires to provide the services of Consultant to the Agencies to ensure the Agencies are able to provide this important community benefit to the residents of Jackson County; and 1 WHEREAS, the Agencies desire to contract with Asante for medical directorship services. AGREEMENT Now, therefore, the parties mutually agree as follows: 1. Professional Services. 1.1.1 Scope of Services. Asante will designate Kevin Kelleher, M.D. to act as the Consultant for the Agencies. Consultant will be the medical director (supervising physician) of the Agencies. Consultant will provide direct and indirect medical oversight and consultation for all clinical aspects of prehospital emergency services for the Agencies in coordination, and in a manner that promotes collaboration, with other Emergency Medical Services (EMS) leaders, for the effective planning and administration of EMS services provided by the Agencies. Consultant will perform the following services: (a) Issue, review, and maintain standing orders that are within the applicable scope of practice for each EMS provider; (b) Communicating the standing orders to the EMS provider; (c) Ensuring that all EMS providers are currently licensed and in good standing with the applicable governmental authority; (d) Providing monthly review to the EMS provider's practice by direct observation and indirect observation, which includes prehospital emergency care report review, prehospital communications tape review, mandating the presentation of reports by EMS providers, mandating EMS providers demonstrate required technical skills, and/or post-care patient or receiving physician interviews; (e) Providing or coordinating monthly case reviews of EMS providers. This review must include determining the specific issue presented, the actions taken, what actions could have been taken but were not, and identifying areas of improvement; (f) Providing or coordinating continuing education for the EMS providers and ensuring any continuing education sessions are taught by a qualified instructor; (g) Report in writing to the Oregon Health Authority's chief investigator any act or omission of an EMS provider that could be cause for disciplinary action under ORS Chapter 682; (h) Meet with each Agency individually for a minimum of two (2) hours per year; i (i) Foster and facilitate communications with other EMS medical directors (supervising physicians) and local emergency department physicians to coordinate the development of the standing orders; Page 2 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante i (j) Assist EMS administrators and personnel with review and development of emergency medical dispatch guidelines utilized by Emergency Communications of Southern Oregon to ensure continuity of care between pre-arrival instructions and clinical care guidelines followed by EMS providers; O k Attend quarterly Jackson County EMS Committee meetings , (1) Hold quarterly meetings with Jackson County Fire Agencies; 1 (m) Authorize administration and accountability of controlled I substances as required by Oregon Administrative Rule ("OAR") Chapter 333, Division 250; and 1 (n) Review and authorize additional EMS related programs requiring medical director oversight in order to deliver the other services required by this Agreement. 1.1.2 Standards. In performing the services required by this Agreement, Consultant shall exercise the ordinary care and skill required by a practitioner in Consultant's } profession acting under similar circumstances. 1.1.3 Consultant's Representations. Asante and Consultant represent and warrant the following: (a) Consultant is a physician licensed by and in good standing with the Oregon Medical Board (the "Board") and is Board certified or eligible to be Board certified in emergency medicine; { 1 (b) Consultant is qualified and approved as a medical director (supervising physician) by the Board pursuant to OAR Chapter 847, Division 35; (c) Consultant currently practices emergency medicine at, and is employed by, Asante Rogue Regional Medical Center. In the event that Consultant ceases his employment with Asame Rogue Regional Medical Center, then all parties agree to amend this Agreement in writing to reflect this change; (d) Consultant possesses the requisite knowledge and skills to perform the duties required by Oregon law of EMS medical directors (supervising physicians); l (e) If Consultant has less than thirty-six (36) months of experience as an EMS medical director, then Consultant must complete one of the following within one (1) year of assuming the role of EMS medical director for the Agencies: (i) completion of a one-day National Association of EMS Physicians Medical Direction overview course; (ii) completion of a three-day National Association of EMS Physicians National EMS Medical Directors Course and Practicum; or (iii) certification in an EMS specialty; (f) Meet continuing medical education requirements by completing one of the following every two (2) years: (i) attendance at an Oregon Health Authority ("OHA") supervising physician's forum; (ii) complete four (4) hours of EMS-related continuing medical education per year; or participation/maintenance of a certification in EMS. Page 3 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante 2. Duties of Agencies. Each Agency shall commit sufficient staff, resources, and other support to enable Consultant to carry out the services required by this Agreement, including, but not limited to, the following: (a) Provision of a designated agency liaison to provide single-point communication between the Agencies and Consultant; (b) Provide means and support for Consultant to carry out his record keeping and documentation duties required by this Agreement; (c) Provide timely responses to recommendations made by Consultant; (d) Assist Consultant in providing in-service training programs to help meet the recertification requirements of the EMS providers of the Agencies; (e) Maintain an effective quality assurance program for the operations of the Agencies; I (f) Agencies will obtain a DEA Registration in the name of Consultant and will comply with all applicable regulations and policies regarding the dispensing of controlled substances; ! (g) Provide to Consultant, free of cost to Consultant, necessary equipment, materials and resources for Consultant to perform the services required by this Agreement; and a (h) Maintain professional malpractice insurance for the Agencies EMS ! providers with coverage limits of not less than $1,000,000.00. I 3. Independent Contractor. Asante and Consultant will be independent contractors of the Agencies. Consultant will be an independent contractor of the Agencies. Asante and Consultant will be free from direction and control over the means and manner of providing the services required by this Agreement, except as set forth in this Agreement. 4. Term. The term of this Agreement shall commence on the Effective Date, July 1, 2019, as set forth in the preamble above and shall continue in full force and effect for five (5) years thereafter (the "Initial Term"). Any party may terminate this Agreement at any time and for any reason upon not less than ninety (90) days advance written notice to the other parties. 5. Compensation. 5.1.1 Compensation for Services. The Agencies will pay Asante in accordance with the compensation schedule set forth in Schedule 1, which is attached hereto and incorporated herein by this reference. The amount of the compensation will be set in advance and of fair market value. 5.1.2 Travel, Training, Education and Membership Reimbursements. The Agencies will reimburse Asante for reasonable out-of-pocket expenses incurred by Consultant in Page 4 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante I I I connection with the performance of the services required by this Agreement, upon Consultant's compliance with the reasonable expense reimbursement instructions, policies, and rules that the Agencies establish from time to time. Any reimbursement allowed by this Section shall be paid to Asante for Asante to provide to Consultant as set forth in Schedule 1 of this Agreement. 5.1.3 No Benefits. The Agencies will not provide any benefits to Consultant, and Consultant will be solely responsible for obtaining Consultant's own benefits, including but not limited to insurance, medical reimbursement, or retirement plans. 5.1.4 Compensation to Asante. All sums paid to Asante for the services of Consultant required by this Agreement shall pass through to Consultant pursuant to Consultant's Physician Services Agreement with Asante. Asante is solely responsible for ensuring the compensation it receives under this Agreement is reported correctly on any applicable tax form and to the IRS. 6. Intellectual Property. Asante and Consultant assign all rights to and interest in the "Creative Work" to the Agencies. "Creative Work" is defined as all data, information, reports, and any other document prepared by Consultant and furnished to the Agencies for the purpose of fulfilling Consultant's obligations under this Agreement. 7. Indemnification. Asante and Consultant shall indemnify, hold harmless, protect and defend the Agencies and its Commissioners, elected officials, trustees, officers, employees, agents, and representatives (the "Indemnified Agency Parties") for, from, and against any and all demands, claims, suits, damages, losses, liabilities, costs and expenses, including, but not limited to, court costs and attomeys' fees (the "Indemnified Matters"), of any nature whatsoever (including, but not limited to, damage to or loss of property, bodily injury or death), arising out of or in connection with the performance of Consultant's obligations under this Agreement. Asante's and Consultant's indemnification obligations shall not apply if the Indemnified Matters arise solely out of the fault or negligent acts or omissions of the Indemnified Agency Parties. The Agencies shall indemnify, hold harmless, protect and defend Consultant and Asante and its officers, employees, agents, and representatives (the "Indemnified Asante Parties") for, from, and against any and all Indemnified Matters of any nature whatsoever (including, but not limited to, damage to or loss of property, bodily injury or death), arising out of or in connection with the performance of the Agencies obligations under this Agreement. The Agencies' indemnification obligations shall not apply if the Indemnified Matters arise solely or in part out of the fault or negligent acts or omissions of the Indemnified Asante Parties. 8. Insurance. 8.1.1 Comprehensive General Liability Insurance. Asante shall carry, maintain, and keep in full force and effect, a Comprehensive General Liability Insurance Policy covering against any personal injury, death, loss or damage resulting from or arising out of the fault, the negligent acts or omissions of Asante or Consultant with minimum limits of $2,000,000 per occurrence and $4,000,000 in the aggregate. 8.1.2 Professional Liability Insurance. Asante shall carry, maintain, and keep in full force and effect, a Professional Liability Insurance Policy with respect to Consultant's Page 5 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante V services required by this Agreement with minimum limits of $2,000,000 per occurrence and $4,000,000 in the aggregate. 8.1.3 Additional Insured. Asante shall add the Agencies to applicable insurance policies as additional insureds. 9. Conflict of Interest. The Agencies acknowledge Consultant's position as an employed emergency department physician for Asante and has determined that the position does present a conflict of interest between Consultant and the Agencies. 10. General Provisions. 10. No Assignment. Neither party may assign or delegate any of its rights or obligations under this Agreement to any person without the prior written consent of the other party. 10. 1.2 Binding Effect. This Agreement will be binding on the parties and their respective heirs, personal representatives, successors, and permitted assigns, and will inure to their benefit. 10.1.3 Amendment. This Agreement may be amended only by a written document signed by the party against whom enforcement is sought. 10. 1.4 Notices. All notices or other communications required or permitted by this Agreement must be in writing and must be delivered to the parties at the addresses set forth below, or any other address that a party may designate by notice to the other party. Notices are considered delivered upon the following: (i) upon actual receipt if delivered personally, by fax, or by a nationally recognized overnight delivery service; or (ii) at the end of the third business day after the date of deposit, if deposited in the United States mail, postage pre-paid, certified, return receipt requested. Asante Legal Department Attn: Kristen Roy Mailing: 2650 Siskiyou Blvd, Suite 104, Medford, Oregon 97504 Fax: (541) 789-5393 Email: Kristen.Ro Asante or Agencies Applegate Valley Rural Fire Protection # 9 Attn: Mike McLaughlin Mailing: 1095 Upper Applegate Road Jacksonville, OR 97530 Fax: Email: mikem@applegatefd.com Page 6 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante City of Ashland by and through Ashland Fire and Rescue Attn: David Shepherd, Fire Chief - Ashland Fire & Rescue Mailing: 455 Siskiyou Boulevard, Ashland, Oregon 97520 Fax: (541) 488-5318 Email: david.shepherd@ashland.or.us Butte Falls Volunteer Fire and Rescue Attn: Shane Smith Mailing: P.O Box 268. Butte Falls, OR 97522 Fax: Email: EMS.buttefalls@gmail.com Greensprings Rural Fire District Attn: Gene Davies Mailing: 12915 OR-66 Ashland, OR 97520 Fax: Email: aa6n hu hes.net Jackson County Fire District # 3 Attn: Mike Hussey Mailing: 8383 Agate Road White City, OR 97503 Fax: 541-826-4566 Email: Mikeh@icfd3.com Jackson County Fire District # 4 Attn: Greg Winfrey Mailing: P.O. Box 1400 Shady Cove, OR 97539 Fax: 541-878-3172 Email: Gre 'cfd4.com Jackson County Fire District # 5 Attn: Charles Hanley Mailing: 5811 Pacific Hwy Phoenix, OR 97535 Fax: 541-535-4226 Email: Hanley@jcfd5.com Jackson County Fire District # 6 Attn: Travis Crume Mailing: 8677 E. Evans Creek Road Rogue River, OR 97537 Fax: Email: Travis evfire.or City of Jacksonville by and through Jacksonville Fire Department Attn: Derek Matchett Mailing: P.O. Box 7 Jacksonville, OR 97530 Fax: Email: dmatchett'acksonvilleor.us City of Medford by and through Medford Fire Department Attn: Fire Chief Mailing: 200 S Ivy, Medford, OR 97501 Fax: 541-774-2514 Email: Fire Cit ofMedford.or Page 7 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante Prospect Rural Fire Protection District Attn: Greg Shaffer Mailing: P.O. Box 32 Prospect, OR 97536 Fax: Email: Gregshaffer51@gmail.com Rogue River Rural Fire Protection District Attn: James Price Mailing: P.O. Box 1170 Rogue River, OR 97537 Fax: 541-582-3456 Email: iprice@logueriverfd.com Rogue Valley Airport Fire Attn: John Karns Mailing: 3650 Fire Station Spur Medford, OR 97504 Fax: Email: jkams@protectfire.com Emergency Communications of Southern Oregon (dispatch center) Attn: Margie Moulin Mailing: 400 Pech Road Central Point, OR 97502 Fax: Email: Mar 'e.Moulin ECS0911.com 10. 1.5 Waiver. No waiver will be binding on a party unless it is in writing and signed by the party making the waiver. A party's waiver of a breach of a provision of this Agreement will not be a waiver of any other provision or a waiver of a subsequent breach of the same provision. 10. 1.6 Severability. If a provision of this Agreement is determined by a court of competent jurisdiction to be unenforceable in any respect, the enforceability of the provision in any other respect and of the remaining provisions of this Agreement will not be impaired. 10. 1.7 Further Assurances. The parties will sign other documents and take other actions reasonably necessary to further effect and evidence this Agreement. These actions shall include Consultant amending his current Physician Services Agreement with Asante to reflect and account for the terms of this Agreement. 10.1.8 Termination. The termination of this Agreement, regardless of how it occurs, will not relieve a party of obligations that have accrued before the termination. 10.1.9 Survival. All provisions of this Agreement that would reasonably be expected to survive the termination of this Agreement will do so. 10. Attachments. Any exhibits, schedules, and other attachments referenced in this Agreement are part of this Agreement. 10. Remedies. The parties will have all remedies available to them at law or in equity. All available remedies are cumulative and may be exercised singularly or concurrently. Page 8 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante 10.1.12 Governing Law. This Agreement is governed by the laws of the State of Oregon, without giving effect to any conflict-of-law principle that would result in the laws of any other jurisdiction governing this Agreement. 10.1.13 Venue. Any action, suit, or proceeding arising out of the subject matter of this Agreement will be litigated in courts located in Jackson County, Oregon. Each party consents and submits to the jurisdiction of any local, state, or federal court located in Jackson County, Oregon. [This Agreement may be executed in counterparts] [Remainder ofpage left intentionally blank. Signature pages to follow.] Page 9 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante IN WITNESS WHEREOF, the parties have executed this Consultant Agreement for Medical Directorship Services, effective as of the Effective Date set forth above. ASANTE By: 5~ Printed Name: Z Title: Cc: O Date: CONSULTANT By: Printed Name: Kevin Kelleher, MD Title: Medical Director Date: ~~6 I APPLErGATTE VALLEY RURAL FIRE PROTECTION # 9 By: Pri nted Name: ,C L z' Of Title: i9c e4os c Date: Z{ 30~~ CITY OF ASHLAND By: - Printed Name: k-At", r~ Title: ci-t-i - u- t t Date: Page 10 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante BUTTE FALLS VOLUNTEER FIRE AND RESCUE By: Printed Name: Title: Date: GREENSPRINGS RURAL FIRE DISTRICT By: &2sg- Printed Name: f 12 ~ V I E:s Title: X712- 0% t1 ~-1= Date: fir - % _ / JACKSON COUNTY FIRE DISTRICT # 3 By. Printed Name: Title: Date: JACKSO COUNTY FIRE DISTRICT # 4 By- `7 Printed Name: R per W ~J t-e ` tt Title: R!C Date: Page I1 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante JACKSON COUNTY FIRE DISTRICT # 5 By: Printed Name: "Alv Vein Title: Date: JACKSON COUNTY FIRE DISTRICT # 6 B Printed Name: / ri,.,~ s GGw Title: Date: CITY OF JACKSONVILLE By: r?-Ad k) Printed Name: ff, eL. e./ tJ+;,.rf r Title: t' to- c-k r P Date: Y-1611Y CITY OF MEDFORD By: Printed Name: Title: Date: Page 12 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante PROSPECT RURAL FIRE PROTECTION DISTRICT By: Printed Name: C~/\19 Title: Date: RO UE RIVER RURAL FIRE PROTECTION DISTRICT By: - 0 Printe Name: j c-1-r-yn el~, tA, Title: C.A,,~-w Date: f i / ( MEDFORD AIRPORT FIRE DEPARTMENT By: G~ _ J=dL Printed Nam) Title: P: f fi C CHIEF Date: 7 5 / / EMERGENCY COMMUNICATIONS OF SOUTHERN OREGON By• Printed Name: ~iz ~c►i e u ~Za` r, Title: - i Rat lL Date:, o? I °1 Page 13 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante BUTTE FAL ~S VOLUNTEER FIRE AND RESCUE By: Printed Name: ~Te-4.c Go'PA.-C"i Title: Ck!e-c J-Irr.112'Cfu, Date: 5 -1 i -9011 GREENSPRINGS RURAL FIRE DISTRICT By: Printed Name: Title: Date: JACKSON COUNTY FIRE DISTRICT # 3 By: Printed Name: Title: Date: JACKSON COUNTY FIRE DISTRICT # 4 By: Printed Name: Title: Date: Page 11 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante Title: Date: JACKSON COUNTY FIRE DISTRICT # 6 By: Printed Name: Title: Date: JACKSONVILLE FIRE DEPARTMENT By: Printed Name: Title: Date: CITY OF MED IFORD By: I AM tl~-- Printed Name: Brian Sjothun Title: City Manager Date: August 21, 2019 PROSPECT RURAL FIRE PROTECTION DISTRICT By: Printed Name: Title: Date: Page 12 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante Schedule 1 Compensation Agency Com ensation Applegate Valley Rural Fire Protection # 9 $1,875.00 City of Ashland by and through Ashland Fire and Rescue $9,350.00 Butte Falls Volunteer Fire and Rescue $900.00 Greens rings Rural Fire District $900.00 Jackson County Fire District # 3 $8,000.00 Jackson County Fire District # 4 $2,000.00 Jackson County Fire District # 5 $4,800.00 Jackson County Fire District # 6 $900.00 Jacksonville Fire Department $1,075.00 City of Medford by and through Medford Fire Department $17,900.00 Prospect Rural Fire Protection District $900.00 Rogue River Rural Fire Protection District $4,500.00 Medford Airport Fire Department $900.00 Emergent Communications of Southern Oregon $0 TOTAL $54,000.00 Page 14 of 14: Agreement for Medical Directorship Services: Jackson County Agencies/Asante Purchase Order Fiscal Year 2020 Page: 1 of 1 THib i,d , fik3 Ft ~iU (AI'pEA? 0 _N ALL ! B City of Ashland jwoic Es. AND SHIPPING DOCUMENTS. 1 L 20 E. Main ATTN: Accounts Payable Purchase L Ashland, OR 97520 Order# 20200189 T Phone: 541/552-2010 O Email: payable@ashland.or.us V H C/O Fire and Rescue Department E ASANTE 1 455 Siskiyou Blvd N 2650 SISKIYOU BLVD Ashland, OR 97520 D MEDFORD, OR 97504 P Phone: 4/1/482 2770 0 T Fax: 541/488-5318 R 0 David She herd 10/04/2019 68 FOB ASHLAND OR/NET30 Cit Accounts Pa able Medical Directorship Services 1 Medical Directorship Services 1 $9,350.0000 $9,350.00 consultant Agreement for Medical Directorship Services - Effective date. July 1, 2019 (5-year multi-agency agreement) YEAR 1 - $9,350.00 Project Account: 2 YEAR 2 - $9,350.00 1 $0.0100 $0.01 Project Account: 3 YEAR 3 - $9,350.00 1 $0.0100 $0.01 Project Account: 4 YEAR 4 - $9,350.00 1 $0.0100 $0.01 Project Account: 5 YEAR 5 - $9,350.00 1 $0.0100 $0.01 Project Account: GL SUMMARY************* 071200 - 604100 $9,350.04 By:'~ Date ) d ; ' Authorized Signature = $9,350.04, RI~I#3 • CITY OF FO ASHLAND REQUISITION ate of request: 09/18/2019 Required date for delivery: Vendor Name Asante Address, City, State, Zip 2650 Siskiyou Blvd, Medford, OR 97504 Contact Name & Telephone Number Kristen Roy 541-789-5393 Email address Kristen. Roy@Asante.org SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached Attach co of council communication _(If council approval required, attach co of CC ❑ Small Procurement ❑ Request for Proposal Cooperative Procurement Not exceeding $5,000 Date approved by Council: ❑ State of Oregon ❑ Direct Award _(Attach copy of council communication) Contract # ❑ Verbal/Written bid(s) or proposal(s) ❑ Request for Qualifications (Public Works) ❑ State of Washington Date approved by Council: Contract # -Attach co of council communication ❑ Other government agency contract Intermediate Procurement Sole Source Agency GOODS & SERVICES Applicable Form (#5, 6, 7 or 8) Contract # Greater than $5,000 and less than $100,000 ~ ritten quote or proposal attached Intergovernmental Agreement ❑ (3) Written bids & solicitation attached Form #4, Personal Services $5K to $75K Agency PERSONAL SERVICES ❑ Special Procurement ❑ Annual cost to City does not exceed $25,000. Greater than $5,000 and less than $75,000 ❑ Form #9, Request for Approval Agreement approved by Legal and approved/signed by ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached City Administrator. AMC 2.50.070(4) ❑ (3) Written proposals & solicitation attached Date approved by Council: ❑ Annual cost to City exceeds $25,000, Council ❑ Form #4, Personal Services $5K to $75K Valid until: Date approval required. (Attach copy of council communication) Description of SERVICES Total Cost Consultant Agreement for Medical Directorship Services for 5 years (FY20, FY21, FY22, FY23, FY24). $9,350 a year for a total of $46,750 $ 9,350 earl x 5 ears Item # Quantity Unit Description of MATERIALS Unit Price Total Cost Per attached quotelproposal TOTAL COST $ 9,350 Project Number _ _ _ _ _ _ _ Account NumberQ 71 2~- j 0?11- L(/ Account Number Account Number "Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support -Yes / No By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. 919 Employee: Department Head: a to or greater than $5,000) Department Manager/Supervisor: City Administrator: 1 (Equal r greate than $25,000) Funds appropriated for current fiscal year JY'E / NO Deputy Finance Director- (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition CITY OF FORM #4 -ASHLAND DETERMINATIONS TO PROCURE PERSONAL SERVICES $5,000 to $75,000 To: Kelly Madding, City Administrator From: David Shepherd, Fire Chief Date: August 28, 2019 Re: DETERMINATIONS TO PROCURE PERSONAL SERVICES In accordance with AMC 2.50.120(A), for personal services contracts greater than $5,000, but less than $75,000, the Department Head shall make findings that City personnel are not available to perform the services, and that the City does not have the personnel or resources to perform the services required under the proposed contract. Backl4round Ashland Fire & Rescue (AF&R) is required by state law to have both a medical director for oversight of the ambulance service and a supervising physician for oversight of our paramedics. Both titles may be filled by a single physician. ORS Chapter 682, OAR Chapter 333 Division 265 and OAR Chapter 847 Division 35 outline the duties of a medical director and supervising physician. Some of the services provided include: Issuing of standing orders, insuring EMTs are licensed and in good standing, providing monthly case reviews and coordinating continuing education. AF&R shall pay Asante the sum of $9,350 a year for services as defined under the associated contract. The term of the contract will be five years. Either party may terminate the agreement with 90 days written notice. The supervising physician contract details all scope of services. Pursuant to AMC 2.50.120(A), has a reasonable inquiry been conducted as to the availability of City personnel to perform the services, and that the City does not have the personnel and resources to perform the services required under the proposed contract? Yes, the city does not employ a physician that meets the needed requirements as outlined above. Requested by: r % Date: A o? ~ art ea Approved by: Date: Z`i 1 Kelly Madding, inistrator Comments: Form #4 - Department Head Determinations to Procure Personal Services, Page 1 of 1, 8/29/2019 FORM #7 CITY OF ASHLAND SOLE-SOURCE DETERMINATION AND WRITTEN FINDINGS PERSONAL SERVICES Less than $75,000 To: Kelly Madding, City Administrator From: David Shepherd, Fire Chief Date: August 16, 2019 Re: Sole Source Determination and Written FindinjZs for Personal Services In accordance with AMC 2.50.090(F), the Department Head shall determine in writing that there is only one provider of a product or service of the quality and type required available. Estimated total value of contract: $46,750 over a five-year period ($9,350 yearly) Project name: Supervising Physician Description of project: Supervising Physician Services for EMS Background: Ashland Fire & Rescue (AF&R) is required by state law to have both a medical director for oversight of the ambulance service and a supervising physician (SP) for oversight of our paramedics. Both titles may be filled by a single physician. ORS Chapter 682, OAR Chapter 333 Division 265 and OAR Chapter 847 Division 35 outline the duties of a medical director and SP. Some of the services provided include: Issuing of standing orders, insuring EMTs are licensed and in good standing, providing monthly case reviews and coordinating continuing education. The term of the contract will be five years. Either party may terminate the agreement with 90 days written notice. The SP contract titled "Consultant Agreement for Medical Directorship Services" details all scope of services. AF&R seeks a sole source determination due to the specialized nature of needed service. The Rogue Valley Fire Chiefs Association (RVFCA) has been working on finding a replacement SP for over a year now. The applicant pool was extremely small to begin with and as the SP is needed to give oversight to 13 agencies, we were eventually left with only one candidate who was willing to take on this responsibility. Form #7 - Sole Source -Personal Services - Less than $75,000, Page 1 of 2, 9/18/2019 Findings: Our current SP had announced his intention to retire in 2019. A subcommittee of the RVFCA was formed to begin the process of searching for a new SP. Initial meetings showed that our current SP (Dr. Paul Rostykus) was greatly underpaid as compared to other SPs around the state. As many of the 13 RVFCA agencies are smaller volunteer departments, with limited budgets, we needed to explore other avenues to help keep cost down. One of the suggested options was to partner with a local hospital group so that we may share the cost. The only other SP in our area was a physician working for Providence Medical Group (the SP for Mercy Flights). To keep a balance in the EMS system the RVFCA felt it would be best to search out a SP from the other big hospital in the area, Asante Rogue Regional. Asante was willing to take on this project and was able to assign one of their Emergency Department (ED) Physicians, Pursuant to ORS 27913.075 (2)(c): Provide findings supporting your determination that the goods or services are for use in a pilot or an experimental project. For many years the department has contracted with an individual SP. While Dr. Rostykus provided us great service it became problematic when he no longer was employed by a local hospital. By establishing a contract with a local health care provider instead of an individual physician, we have created a pilot project that will hopefully provide the needed service for years to come. As our contract is with Asante, not an individual SP, Asante will be able to assign the task to various ED physicians. As ED physicians have a tendency to come and go, we will not be scrambling every couple of years to find someone to fill the role. Additionally, by creating this new partnership program, the local fire agencies are saving about $38,000 a year in cost. Form #7 - Sole Source -Personal Services - Less than $75,000, Page 2 of 2, 9/18/2019 A`~ CERTIFICATE OF LIABILITY INSURANCE D07/31(/2019D/YYVV) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA INC. NAME: 111 S.W. COLUMBIA A/~ No EXt : A/C No FIFTH FLOOR E-MAIL PORTLAND, OR 97201 ADDRESS: Attn: Melody.Drangstveit@marsh.com; (503) 248-4877 INSURERS AFFORDING COVERAGE NAIC # CN102294793-STND-GPX-17-20 INSURERA: Southern Oregon Insurance, Inc. 12184 INSURED ASANTE INSURER B : Endurance American Specialty Insurance Company 41718 DBA: ASANTE HEALTH SYSTEM INSURER C : 2650 SISKIYOU BOULEVARD INSURER D : MEDFORD, OR 97504 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-003624467-01 REVISION NUMBER: 5 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN SD WVD POLICYNUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY S010002017 1010112017 0110112020 EACH OCCURRENCE $ 1,000,000 REM SES ti occur RENTED $ 100,000 X CLAIMS-MADE F7 OCCUR PDAMAGE To MED EXP (Any one person) $ NONE PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY 1 PRO- ❑ LOC PRODUCTS - COMP/OP AGG $ 3,000,000 X JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB OCCUR HLClOO12007200 10/31/2017 0110112020 EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DIED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in Ni E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A PROFESSIONAL LIABILITY S010002017 1010112017 0110112020 ANNUAL AGGREGATE 3,000,000 "Claims-Made" EACH MEDICAL INCIDENT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The following agencies are included as additional insureds as it pertains to EMS Medical Director Duties pursuant to terms of the Consultant Agreement for Medical Directorship Services. SEE ATTACHED CERTIFICATE HOLDER CANCELLATION Asante SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Dba: Asante Health System THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2650 Siskiyou Blvd. ACCORDANCE WITH THE POLICY PROVISIONS. Medford, OR 97504 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Lorie Larsen-Denning ycow., -4-:-Jr @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN102294793 LOC Portland A~oRO ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA INC. ASANTE DBA:ASANTE HEALTH SYSTEM POLICY NUMBER 2650 SISKIYOU BOULEVARD MEDFORD, OR 97504 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Applegate Valley Rural Fire Protection #9 Ashland Fire and Rescue Butte Falls Volunteer Fire and Rescue Emergency Communications of Southern Oregon Greensprings Rural Fire District Jackson County Fire District #3 Jackson County Fire District #4 Jackson County Fire District #5 Jackson County Fire District #6 Jacksonville Fire Department Medford Fire Department Prospect Rural Fire Protection District Rogue River Rural Fire Protection District Medford Airport Fire Department ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ENDORSEMENT NO. 18 - Revised This endorsement, effective 12:01 AM: 7/1/19 Forms a part of policy no.: SOI 0002017 Issued to: Asante, dba Asante Health System By: Southern Oregon Insurance, Inc. ADDITIONAL INSURED ENDORSEMENT It is agreed the coverage provided underthe Coverage Part(s) indicated by an `x' below is amended by adding the following as Additional Insureds but only with respect to any claim or suit arising out of the conduct of your business: X HEALTHCARE PROFESSIONAL LIABI LITY COVE RAG E PART X HEALTHCARE GENERAL LIABILITY COVERAGE PART Applegate Valley Rural Fire Protection # 9 Ashland Fire and Rescue Butte Falls Volunteer Fire and Rescue Emergency Communications of Southern Oregon Greensprings Rural Fire District Jackson County Fire District# 3 Jackson County Fire District# 4 Jackson County Fire District # 5 Jackson County Fire District # 6 Jacksonville Fire Department Medford Fire Department Prospect Rural Fire Protection District Rogue River Rural Fire Protection District Medford Airport Fire Department Perthe terms of the Consultant Agreement for Medical Directorship Services, effective 7/1/2019, the above Agencies are added as Additional Insureds as it pertains to EMS Medical Director Duties as outlined in the contract. All otherterms, conditions and exclusions of the policy remain unchanged. SOII Primary Policy (10/17) Page 52 of 53 SO 11 0002017 Legal Department Review DOCUMENT TRANSMITTAL AND CONTROL This form will accompany the document through the drafting, review, and signature processes, and will be kept with the City's final executed copy of the document. Required fields are indicated in gray scale. Document: Supervising Physician/Medical Director for Ashland Fire & Rescue (Include names ofparties to the document) Type of Document: Contract R Lease ❑ Easement ❑ Deed ❑ IGA ❑ Other (specify) Dept Contact: David shepherd ACTION REQUESTED: Dept: Fin Phone: Ext 2219 ❑ Review Draft Date submitted to Legal: 12/06/2018 Approve final and forward to: Draft due by: (Unless indicated, Legal will return document to you) Return Requested by: Needs to be done by 06/01/2019 Complete this section ONLY the first time this form is filled out. Has this document been previously worked on by the Legal Dept Staff. 8 No ❑ Yes If yes, by whom? LEGAL DEPT First Date Received by Legal Date: 191-1119 By: USE ONLY Returned to Dept. for Revision Date: By: Received for additional review by Legal Date: By: Returned to Dept. for Revision Date: By: Received for additional review by Legal Date: By: Returned to Dept. for Revision Date: By: Received for Additional Review by Legal Date: By: Returned to Dept for Revision Date: By: Final Logged out b Legal Date: B : Comments from LEGAL to DEPARTMENT: Comments from DEPARTMENT to L G . ❑ See Attached. The current contract between AF&R and Dr. Rostykus will expire as of June 30, 2019. We are currently in talks with =SLi Asante to provide us a Supervising Physician/Medical Director beginning July 1, 2019. We have asked that the Asante legal team contact Katrina to begin formulating an C5 te d d agreement. Return original executed document to Ci es this document need to be recorded? Recorder for safekeeping? El No Yes D No ❑ Yes CITY ADMINISTRATOR / DEPARTMENT HEAD Please do not sign the attached document until this for h' been oved by the Legal De t below: y FINAL LEGAL DEPARTMENT APPROVAL: ~4 _ - Date: