HomeMy WebLinkAbout17-119-FIR-007 Interlocal Agreement COA#17-119-FIR-007
Clinical Site Agreement
By and Between City of Anacortes,Anesthesiologist,and Island Hospital
The parties to this Agreement are Skagit County Public Hospital District No. 2 d/b/a Island
Hospital, Jeffrey S. Hambleton, MD with privileges at Island Hospital (IH), and City of Anacortes
(hereinafter Anacortes). Anacortes is responsible for overall supervision of the training Fire Department
employees as mobile intensive care paramedics (hereinafter the Paramedics). IH desires to provide an
opportunity for the Paramedics to obtain supervised experience of specific skills necessary for
recertification within the limitations established by IH. In consideration of the promises and of the
mutual covenants and agreements hereinafter set forth,the parties agree as follows:
1. Services:
IH agrees that those Paramedics approved by IH pursuant to Section 4 of this Agreement may,
for skill maintenance requirements, utilize operating and recovery rooms at IH for the training of
the Paramedics, subject to supervision by an anesthesiologist during a pre-scheduled time
acceptable to IH.
IH and the Anacortes intend that the Paramedics shall not render treatment to patients except
as may be necessary for them to obtain or maintain state certification.The Paramedics may only
render patient care consistent with their training and ability under IH Anesthesia provider's
supervision and authorization. In rendering patient care,the Paramedics shall comply with all
laws, rules, regulations and standards applicable to their area of certification and applicable
bylaws, rules, regulations, policies and procedures of IH, copies of which bylaws, rules,
regulations, policies and procedures IH shall provide to participating Paramedics. IH reserves the
right to limit the patient care activities of the Paramedics in the interest of patient care.
2. Relationship:
IH and Anacortes agree that this Agreement does not create the relationship of agent, servant,
employee, partnership,joint venture,or association between IH and Anacortes or between the
Hospital and the Paramedics. IH shall be under no obligation to compensate the Paramedics for
any services performed pursuant to this Agreement.
3. Supervision:
The Paramedics shall be subject to scheduling,control,and direction of management, nursing
personnel, and anesthesia providers of the operating and recovery rooms while performing
services in the IH pursuant to this Agreement.The Paramedics may initiate patient care activities
only under direct one-to-one physician supervision.
COA#17-119-FIR-007
4. Scheduling:
IH agrees to permit the Paramedics to perform services in the operating and recovery rooms
only at times which are pre-scheduled with the Surgical Services Director.Anacortes is
responsible for scheduling clinical times through the Operating Room delegate. No more than
one Paramedic will have access to the operating and recovery rooms at one time. Only
Washington State certified Paramedics will be scheduled for these purposes.
5. Approval:
Those Paramedics whose names appear in the current continuing medical education tracking
system maintained by Anacortes may schedule clinical time in IH facilities. Paramedics must
complete a brief orientation to the operating and recovery rooms prior to approval,to be
arranged through the Operating Room Charge Nurse. Paramedics must comply with IH
Employee Health immunization and Tuberculosis testing requirements listed in table in
Paragraph 10.
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6. Island Hospital Responsibility: A''°'-Lffr
The patients for intubation are to be selected by-WE along with informed consent of the patient
for the procedure,for anesthesia and for a Paramedic to perform the intubation. Patient
consent will be obtained prior to the Paramedics having access to patient identifiable health
care information.The Paramedics will not attempt intubation in IH on patients who have not
specifically consented to have a paramedic perform their intubation. Hospital shall identify
patients to whom the Paramedics shall provide services under this Agreement. IH shall have a
staff member designated to act as a liaison to the paramedic education program.All
communication from Anacortes will be provided to that liaison. IH will provide physician
preceptors who will directly supervise and delegate to the Paramedics the endotracheal
intubation, along with the pre-and post-intubation management techniques of the patient,as
determined appropriate by the Physician.The Paramedic will function as the agent of the
physician when performing these skills under the physician's direct supervision.A maximum of
two(2) intubation attempts per patient shall be performed by the paramedic.
The Physician preceptor will provide evaluation feedback of the Paramedic's performance in the
operating and recovering room to the Paramedic and,through the designated liaison,to the Fire
Department Training Coordinator. IH will coordinate,with Anacortes Fire Department's
Emergency Medical Services Officer,the development of an evaluation/checklist for the
evaluation of the Paramedic's performance in the Operating Room.
• COA#17-119-FIR-007
7. Anacortes Fire Department Responsibilities:
Anacortes agrees to cooperate fully with IH to ensure that all Paramedics performing services at
IH meet the requirements of their positions and that IH can timely provide documentation to
applicable regulatory agencies or Accreditation Agency to demonstrate such requirements to
have been met. Anacortes provide the following information if requested by IH:
a. A job description maintained by the fire department for any personnel performing services
at IH;
b. A signed IH confidentiality statement;
c. Current copies of any licensure or certification, including CPR if applicable, required for the
position;
d. Criminal History reports made with the Washington State Patrol pursuant to RCW 43.43.830
through 43.43.840;
e. Copies of vaccination record, laboratory titer results,TB skin testing results pertaining to all
immunization or testing listed under Section 10.
8. Insurance Indemnity:
During the term of this Agreement,Anacortes shall maintain public liability and malpractice
insurance coverage in the amount of at least one million dollars($1,000,000) per occurrence
and three million dollars($3,000,000) in the aggregate. As evidence of such coverage,
Anacortes shall furnish IH with a Certificate of Insurance for each one of the Paramedics before
each individual may have access to IH. Anacortes shall notify IH within 10 days of the
cancellation of said insurance.
Anacortes shall indemnify and hold harmless IH and the IH's contracted anesthesia provider and
any anesthesiologist supervising a Paramedic under this Agreement from liability, including
attorney's fees and costs of defense, with respect to negligent acts of the Paramedics.
The State of Washington provides liability protection for physicians teaching clinical to EMS
providers.This requires that the physician be designated an EMS teaching physician by the
county medical program director.The EMS medical program director will contact the IH
anesthesiologist annually to update the list of teaching physicians on file with the Washington
Department of Health and ensure that they have been appropriately designated.
COA#17-119-FIR-007
9. Confidentiality:
All Paramedics working under this Agreement will sign a confidentiality agreement with Island
Hospital.. No patient identifiable information is to leave the premises or be transmitted orally or
in written format to Anacortes or other third party.Any breach of confidentiality is grounds for
dismissal of the Paramedic from the training experience and the facility Liaison and the Fire
Department EMS Officer will take other appropriate action as deemed necessary.
10. Immunization/Qualifications:
Measles: Documentation of two doses of live virus vaccine administered on or after
the first birthday,with the second dose administered at least 1 month after
the first dose or laboratory evidence of past measles (rubeola) infection.
Mumps: Documentation of two doses of live virus vaccine administered on or after
the first birthday, With the second dose administered at least 1 month after
the first dose or laboratory evidence of past mumps infection or
documentation of past mumps infection.
Rubella: Documentation of one dose of live virus -vaccine administered on or after
the first birthday or laboratory evidence of past rubella infection or titer
showing immunity.
Varicella: Documentation of chickenpox disease in child/adulthood or laboratory
evidence confirming past infection or two doses of live virus vaccine
administered on or after the first birthday with the second dose administered
at least 1 month after the first dose or a lab titer performed for proof of
immunity.
Tetanus, Documentation of one dose of TDAP vaccine received in adulthood.
Diphtheria,
Pertussis (Tdap):
Tuberculosis Documentation of screening via two- step skin testing using Mantoux
screening: method completed within last 12 months, or chest x-ray and physician
documentation if known positive history.
Hepatitis B: All staff at risk for exposure to blood or body fluids are required to be
immunized with the 3 vaccine series and antibody tested,provide proof of
immunity, or provide a signed declination.
Seasonal Flu Documentation of one seasonal flu vaccine each year or physician
Vaccine: supported medical declination.
COA#17-119-FIR-007
11. Access:
IH shall have the right,as it is sole option,to deny access to IH facilities, equipment, personnel
and patients to any of the Paramedics who violate IH policies and procedures or who conduct
themselves in a manner inappropriate to the operation of IH's facilities.This agreement assumes
the complementary participation of Island Hospital anesthesia personnel and lH cannot
guarantee the continued cooperation of the anesthesia providers.
12. Equipment:
Anacortes shall be responsible for all costs incurred relative to their replacement and/or repair
of any of IH's equipment that is broken, damaged or destroyed due to acts and omissions of the
Paramedics. In requesting replacement or repair of equipment or reimbursement for the same,
IH shall provide documentation sufficient to allow Anacortes to know the basis for the claim.To
the extent that the parties disagree as to responsibility or the amount required to repair or
replace the equipment,they shall diligently cooperate in a dispute resolution process so that the
claim is resolved promptly.
13. Term:
The term of this Agreement shall commence on October 10, 2017. This Agreement shall be
renewed automatically each agreement year, unless either party gives notice to the other party
of its intention not to renew this Agreement 60 days prior to the end of the current term. For
the purposes of this agreement the term "Agreement Year"shall mean an annual period
commencing January 1 and ending the following December 31.The Parties shall notify each
employer of the Paramedics of each renewal of this Agreement.
14. Termination:
Either party may terminate this Agreement by 60 days prior written notice to the other party. IH
shall have the right, as its sole option and discretion,to immediately terminate this Agreement
in the event that any Paramedics violates the terms of this Agreement to such an extent as to
jeopardize the health and care of IH's patients.
15. Agreement:
This writing constitutes the complete understanding between the Hospital and the Anacortes
and thus supersedes any and all prior communication, oral,or written. Any amendment to this
Agreement must be in writing by both parties hereto.This Agreement does not pertain to any
functions provided by the Paramedics during performance of their standard operations for
Emergency Medical Services as authorized by the Anacortes Fire Department Medical Program
Director.
COA#17-119-FIR-007
Island Hospital Anacortes Fire Department Anesthesiologist
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