CONTRACT 6424 Professional Services AgreementAgreement No. 6424
PROFESSIONAL SERVICES AGREEMENT
BETWEEN
m THE CITY OF EL SEGUNDO AND
MARC R. COHEN, MD, A PROFESSIONAL
CORPORATION
This AGREEMENT is made and entered into this 1st day of July, 2022 (the
"Effective Date"), by and between the CITY OF EL SEGUNDO, a municipal corporation
and general law city ("CITY") and MARC R. COHEN, MD, A
PROFESSIONAL CORPORATION, a California S-Corp ("Consultant"). The parties
agree as follows:
1. CONSIDERATION.
A. As partial consideration, CONSULTANT agrees to perform the work listed
in the SCOPE OF SERVICES, below;
B. As additional consideration, CONSULTANT and CITY agree to abide by the
terms and conditions contained in this Agreement;
C. As additional consideration, CITY agrees to pay CONSULTANT a sum not
to exceed fifty-four thousand dollars ($54,000) each fiscal year for
CONSULTANT's services. CITY may modify this amount as set forth below.
Unless otherwise specified by written amendment to this Agreement, CITY
will pay this sum as specified in the attached Exhibit "A," which is
incorporated by reference.
2. SCOPE OF SERVICES,
A. CONSULTANT will perform the Emergency Medical Services ("EMS")
Medical Director services listed in the attached Exhibit 'A," which is
incorporated by reference.
B. CONSULTANT will, in a professional manner, furnish all of the labor,
technical, administrative, professional and other personnel, all supplies and
materials, equipment, printing, vehicles, transportation, office space and
facilities, and all tests, testing and analyses, calculation, and all other means
whatsoever, except as herein otherwise expressly specified to be furnished
by CITY, necessary or proper to perform and complete the work and provide
the professional services required of CONSULTANT by this Agreement.
3. PERFORMANCE STANDARDS. While performing this Agreement, CONSULTANT
will use the appropriate generally accepted professional standards of practice existing at
the time of performance utilized by persons engaged in providing similar services. CITY
will continuously monitor CONSULTANT's services. CITY will notify CONSULTANT of
any deficiencies and CONSULTANT will have fifteen (15) days after such notification to
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Agreement No. 6424
cure any shortcomings to CITY's satisfaction. Costs associated with curing the
deficiencies will be borne by CONSULTANT.
4. PAYMENTS. For CITY to pay CONSULTANT as specified by this Agreement,
CONSULTANT must submit a detailed invoice to CITY which lists the hours worked and
hourly rates for each personnel category and reimbursable costs (all as set forth in Exhibit
"A") the tasks performed, the percentage of the task completed during the billing period,
the cumulative percentage completed for each task, the total cost of that work during the
preceding billing month and a cumulative cash flow curve showing projected and actual
expenditures versus time to date.
5. NON -APPROPRIATION OF FUNDS. Payments due and payable to CONSULTANT
for current services are within the current budget and within an available, unexhausted
and unencumbered appropriation of the CITY. In the event the CITY has not appropriated
sufficient funds for payment of CONSULTANT services beyond the current fiscal year,
this Agreement will cover only those costs incurred up to the conclusion of the current
fiscal year.
6. FAMILIARITY WITH WORK,
A. By executing this Agreement, CONSULTANT agrees that it has;
Carefully investigated and considered the scope of services to be
performed;
Carefully considered how the services should be performed; and
iii. Understands the facilities, difficulties, and restrictions attending
performance of the services under this Agreement.
B, If services involve work upon any site, CONSULTANT agrees that
CONSULTANT has or will investigate the site and is or will be fully
acquainted with the conditions there existing, before commencing the
services hereunder. Should CONSULTANT discover any latent or unknown
conditions that may materially affect the performance of the services,
CONSULTANT will immediately inform CITY of such fact and will not
proceed except at CONSULTANT's own risk until written instructions are
received from CITY.
7. TERM. The term of this Agreement will be from the Effective Date through June 30,
2023. Thereafter, this Agreement will automatically renew annually for a one year period
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Agreement No. 6424
beginning July 1, 2023. Unless otherwise determined by written amendment between the
parties, this Agreement will terminate in the following instances:
A. Completion of the work specified in Exhibit "A";
B. Termination as stated in Section 15.
8. TIME FOR PERFORMANCE,
A. CONSULTANT will not perform any work under this Agreement until:
CONSULTANT furnishes proof of insurance as required under
Section 22 of this Agreement; and
i. CITY gives CONSULTANT a written notice to proceed.
B. Should CONSULTANT begin work on any phase in advance of receiving
written authorization to proceed, any such professional services are at
CONSULTANT's own risk.
9. TIME EXTENSIONS. Should CONSULTANT be delayed by causes beyond
CONSULTANT's control, CITY may grant a time extension for the completion of the
contracted services. If delay occurs, CONSULTANT must notify the Manager within forty-
eight (48) hours, in writing, of the cause and the extent of the delay and how such delay
interferes with the Agreement's schedule. The Manager will extend the completion time,
when appropriate, for the completion of the contracted services.
10.CONSISTENCY. In interpreting this Agreement and resolving any ambiguities, the
main body of this Agreement takes precedence over the attached Exhibits; this
Agreement supersedes any conflicting provisions. Any inconsistency between the
Exhibits will be resolved in the order in which the Exhibits appear below:
A. Exhibit: A: Scope of Work and Fees ("El Segundo Fire Department Provider
Agency Medical Director Services")
11. CHANGES. CITY may order changes in the services within the general scope of this
Agreement, consisting of additions, deletions, or other revisions, and the contract sum
and the contract time will be adjusted accordingly. All such changes must be authorized
in writing, executed by CONSULTANT and CITY. The cost or credit to CITY resulting from
changes in the services will be determined in accordance with written agreement between
the parties.
12.TAXPAYER IDENTIFICATION NUMBER. CONSULTANT will provide CITY with a
Taxpayer Identification Number.
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Agreement No. 6424
13. PERMITS AND LICENSES. CONSULTANT, at
maintain during the term of this Agreement, all
certificates that may be required in connection with
this Agreement.
its sole expense, will obtain and
necessary permits, licenses, and
the performance of services under
14. WAIVER. CITY's review or acceptance of, or payment for, work product prepared by
CONSULTANT under this Agreement will not be construed to operate as a waiver of any
rights CITY may have under this Agreement or of any cause of action arising from
CONSULTANT's performance. A waiver by CITY of any breach of any term, covenant, or
condition contained in this Agreement will not be deemed to be a waiver of any
subsequent breach of the same or any other term, covenant, or condition contained in
this Agreement, whether of the same or different character.
15.TERMINATION.
A. Except as otherwise provided, CITY may terminate this Agreement at any
time with or without cause. Termination will be effective upon CITY's
provision of written notice to CONSULTANT of termination.
B. CONSULTANT may terminate this Agreement at any time with CITY's
mutual consent. Notice will be in writing at least thirty (30) days before the
effective termination date.
C, Upon receiving a termination notice, CONSULTANT will immediately cease
performance under this Agreement unless otherwise provided in the
termination notice. Except as otherwise provided in the termination notice,
any additional work performed by CONSULTANT after receiving a
termination notice will be performed at CONSULTANT's own cost; CITY will
not be obligated to compensate CONSULTANT for such work.
D. Should termination occur, all finished or unfinished documents, data,
studies, surveys, drawings, maps, reports and other materials prepared by
CONSULTANT will, at CITY's option, become CITY's property, and
CONSULTANT will receive just and equitable compensation for any work
satisfactorily completed up to the effective date of notice of termination, not
to exceed the total costs under Section 1(C).
E. Should the Agreement be terminated pursuant to this Section, CITY may
procure on its own terms services similar to those terminated.
F. By executing this document, CONSULTANT waives any and all claims for
damages that might otherwise arise from CITY's termination under this
Section.
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16.OWNERSHIP OF DOCUMENTS. All documents, data, studies, drawings, maps,
models, photographs and reports prepared by CONSULTANT under this Agreement are
CITY's property. CONSULTANT may retain copies of said documents and materials as
desired but will deliver all original materials to CITY upon CITY's written notice. CITY
agrees that use of CONSULTANT's completed work product, for purposes other than
identified in this Agreement, or use of incomplete work product, is at CITY's own risk.
17. PUBLICATION OF DOCUMENTS. Except as necessary for performance of service
under this Agreement, no copies, sketches, or graphs of materials, including graphic art
work, prepared pursuant to this Agreement, will be released by CONSULTANT to any
other person or public CITY without CITY's prior written approval. All press releases,
including graphic display information to be published in newspapers or magazines, will
be approved and distributed solely by CITY, unless otherwise provided by written
agreement between the parties.
18.INDEMNIFICATION.
A. CONSULTANT agrees to the following:
L Indemnification for Professional Services. CONSULTANT will
save harmless and indemnify and at CITY's request reimburse
defense costs for CITY and all its officers, volunteers,
employees and representatives from and against any and all
suits, actions, or claims, of any character whatever, brought for,
or on account of, any injuries or damages sustained by any
person or property resulting or arising from any negligent or
wrongful act, error or omission by CONSULTANT or any of
CONSULTANT's officers, agents, employees, or
representatives, in the performance of this Agreement, except
for such loss or damage arising from CITY's sole negligence or
willful misconduct.
ii. Indemnification for other Damages. CONSULTANT indemnifies
and holds CITY harmless from and against any claim, action,
damages, costs (including, without limitation, attorney's fees),
injuries, or liability, arising out of this Agreement, or its
performance, except for such loss or damage arising from
CITY's sole negligence or willful misconduct. Should CITY be
named in any suit, or should any claim be brought against it by
suit or otherwise, whether the same be groundless or not,
arising out of this Agreement, or its performance,
CONSULTANT will defend CITY (at CITY's request and with
counsel satisfactory to CITY) and will indemnify CITY for any
judgment rendered against it or any sums paid out in settlement
or otherwise.
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B. For purposes of this section "CITY" includes CITY's officers, officials,
employees, agents, representatives, and certified volunteers.
C. It is expressly understood and agreed that the foregoing provisions will
survive termination of this Agreement.
D. The requirements as to the types and limits of insurance coverage to be
maintained by CONSULTANT as required by Section 22, and any approval
of said insurance by CITY, are not intended to and will not in any manner
limit or qualify the liabilities and obligations otherwise assumed by
CONSULTANT pursuant to this Agreement, including, without limitation, to
the provisions concerning indemnification.
19.ASSIGNABILITY. This Agreement is for CONSULTANT's professional services.
CONSULTANT's attempts to assign the benefits or burdens of this Agreement without
CITY's written approval are prohibited and will be null and void.
20.INDEPENDENT CONTRACTOR. CITY and CONSULTANT agree that
CONSULTANT will act as an independent contractor and will have control of all work and
the manner in which it is performed. CONSULTANT will be free to contract for similar
service to be performed for other employers while under contract with CITY.
CONSULTANT is not an agent or employee of CITY and is not entitled to participate in
any pension plan, insurance, bonus or similar benefits CITY provides for its employees.
Any provision in this Agreement that may appear to give CITY the right to direct
CONSULTANT as to the details of doing the work or to exercise a measure of control
over the work means that CONSULTANT will follow the direction of the CITY as to end
results of the work only.
21.AUDIT OF RECORDS. CONSULTANT will maintain full and accurate records with
respect to all services and matters covered under this Agreement. CITY will have free
access at all reasonable times to such records, and the right to examine and audit the
same and to make transcript therefrom, and to inspect all program data, documents,
proceedings and activities. CONSULTANT will retain such financial and program service
records for at least three (3) years after termination or final payment under this
Agreement.
22.INSURANCE.
A. Before commencing performance under this Agreement, and at all other
times this Agreement is effective, CONSULTANT will procure and maintain
the following types of insurance with coverage limits complying, at a
minimum, with the limits set forth below:
Type of Insurance Limits
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Commercial general liability: $2,000,000
Professional Liability $1,000,000
Business automobile liability $1,000,000
Workers compensation Statutory requirement
B. Commercial general liability insurance will meet or exceed the requirements
of the most recent ISO-CGL Form. The amount of insurance set forth above
will be a combined single limit per occurrence for bodily injury, personal
injury, and property damage for the policy coverage. Liability policies will be
endorsed to name CITY, its officials, and employees as "additional
insureds" under said insurance coverage and to state that such insurance
will be deemed "primary" such that any other insurance that may be carried
by CITY will be excess thereto. Such endorsement must be reflected on
ISO Form No. CG 20 10 11 85 or 88, or equivalent. Such insurance will be
on an "occurrence," not a "claims made," basis and will not be cancelable
or subject to reduction except upon thirty (30) days prior written notice to
CITY.
C, Professional liability coverage will be on an "occurrence basis" if such
coverage is available, or on a "claims made" basis if not available. When
coverage is provided on a "claims made basis," CONSULTANT will continue
to renew the insurance for a period of three (3) years after this Agreement
expires or is terminated. Such insurance will have the same coverage and
limits as the policy that was in effect during the term of this Agreement and
will cover CONSULTANT for all claims made by CITY arising out of any
errors or omissions of CONSULTANT, or its officers, employees or agents
during the time this Agreement was in effect.
D. Automobile coverage will be written on ISO Business Auto Coverage Form
CA 00 01 06 92, including symbol 1 (Any Auto).
E. CONSULTANT will furnish to CITY duly authenticated Certificates of
Insurance evidencing maintenance of the insurance required under this
Agreement and such other evidence of insurance or copies of policies as
may be reasonably required by CITY from time to time. Insurance must be
placed with insurers with a current A.M. Best Company Rating equivalent
to at least a Rating of "A:VII."
F. Should CONSULTANT, for any reason, fail to obtain and maintain the
insurance required by this Agreement, CITY may obtain such coverage at
CONSULTANT's expense and deduct the cost of such insurance from
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payments due to CONSULTANT under this Agreement or terminate
pursuant to Section 155.
23. USE OF SUBCONTRACTORS. CONSULTANT must obtain CITY's prior written
approval to use any consultants while performing any portion of this Agreement. Such
approval must approve of the proposed consultant and the terms of compensation.
24.INCIDENTAL TASKS. CONSULTANT will meet with CITY monthly to provide the
status on the project, which will include a schedule update and a short narrative
description of progress during the past month for each major task, a description of the
work remaining and a description of the work to be done before the next schedule update.
25. NOTICES. All communications to either party by the other party will be deemed made
when received by such party at its respective name and address as follows:
If to CONSULTANT:
Marc R. Cohen, MD
A Professional Corporation
346 Manhattan Ave
Hermosa Beach, CA 90254
Attention: Marc R. Cohen, MD
Phone: 310-908-6460
Email: emsdoc9ll@hotmail.com
If to CITY:
City of El Segundo
350 Main Street
El Segundo, CA
Attention: Deena Lee, Fire Chief
Phone: 310-524-2219
Email: dlee@elsegundo.org
Any such written communications by mail will be conclusively deemed to have been
received by the addressee upon deposit thereof in the United States Mail, postage
prepaid and properly addressed as noted above. In all other instances, notices will be
deemed given at the time of actual delivery. Changes may be made in the names or
addresses of persons to whom notices are to be given by giving notice in the manner
prescribed in this paragraph.
26. CONFLICT OF INTEREST. CONSULTANT will comply with all conflict of interest laws
and regulations including, without limitation, CITY's conflict of interest regulations.
27. SOLICITATION. CONSULTANT maintains and warrants that it has not employed nor
retained any company or person, other than CONSULTANT's bona fide employee, to
solicit or secure this Agreement. Further, CONSULTANT warrants that it has not paid nor
has it agreed to pay any company or person, other than CONSULTANT's bona fide
employee, any fee, commission, percentage, brokerage fee, gift or other consideration
contingent upon or resulting from the award or making of this Agreement. Should
CONSULTANT breach or violate this warranty, CITY may rescind this Agreement without
liability.
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28.THIRD PARTY BENEFICIARIES. This Agreement and every provision herein is
generally for the exclusive benefit of CONSULTANT and CITY and not for the benefit of
any other party. There will be no incidental or other beneficiaries of any of
CONSULTANT's or CITY's obligations under this Agreement.
29.INTERPRETATION. This Agreement was drafted in and will be construed in
accordance with the laws of the State of California, and exclusive venue for any action
involving this agreement will be in Los Angeles County.
30.COMPLIANCE WITH LAW. CONSULTANT agrees to comply with all federal, state,
and local laws applicable to this Agreement.
31. ENTIRE AGREEMENT. This Agreement, and its Exhibit(s), sets forth the entire
understanding of the parties. There are no other understandings, terms or other
agreements expressed or implied, oral or written. This Agreement will bind and inure to
the benefit of the parties to this Agreement and any subsequent successors and assigns.
32. RULES OF CONSTRUCTION. Each Party had the opportunity to independently
review this Agreement with legal counsel. Accordingly, this Agreement will be construed
simply, as a whole, and in accordance with its fair meaning; it will not be interpreted strictly
for or against either Party.
33.SEVERABILITY. If any portion of this Agreement is declared by a court of competent
jurisdiction to be invalid or unenforceable, then such portion will be deemed modified to
the extent necessary in the opinion of the court to render such portion enforceable and,
as so modified, such portion and the balance of this Agreement will continue in full force
and effect.
34.AUTHORITY/MODIFICATION. The Parties represent and warrant that all necessary
action has been taken by the Parties to authorize the undersigned to execute this
Agreement and to engage in the actions described herein. This Agreement may be
modified by written amendment.
35.ACCEPTANCE OF ELECTRONIC SIGNATURES. The Parties agree that this
Agreement, agreements ancillary to this Agreement, and related documents to be entered
into in connection with this Agreement will be considered signed when the signature of a
party is delivered by electronic (pdf) or facsimile transmission. Such electronic or
facsimile signature will be treated in all respects as having the same effect as an original
signature.
36. CAPTIONS. The captions of the paragraphs of this Agreement are for convenience of
reference only and will not affect the interpretation of this Agreement.
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37.TIME IS OF ESSENCE. Time is of the essence for each and every provision of this
Agreement.
38. FORCE MAJEURE. Should performance of this Agreement be prevented due to fire,
flood, explosion, acts of terrorism, war, embargo, government action, civil or military
authority, the natural elements, or other similar causes beyond the Parties' reasonable
control, then the Agreement will immediately terminate without obligation of either party
to the other.
39.STATEMENT OF EXPERIENCE. By executing this Agreement, CONSULTANT
represents that it has demonstrated trustworthiness and possesses the quality, fitness
and capacity to perform the Agreement in a manner satisfactory to CITY. CONSULTANT
represents that its financial resources, surety and insurance experience, service
experience, completion ability, personnel, current workload, experience in dealing with
private consultants, and experience in dealing with public agencies all suggest that
CONSULTANT is capable of performing the proposed contract and has a demonstrated
capacity to deal fairly and effectively with and to satisfy a public CITY.
[Signatures on next page]
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Agreement No. 6424
IN WITNESS WHEREOF the parties hereto have executed this Agreement the
day and year first hereinabove written.
CITY OF EL SEGUNDO
Darrell George,
City Manager
ATTES :
Trac We er„
-12
City Clerk
APPROVED AS TO FORM:
MARK D. HENSLEY, CITY ATTORNEY
Joaq i Vazquez,
Depu City Attorney
'X
City of El Segundo Professional Services
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COMPANY NAME
Marc R. Cohen, MD
A Professional Corporation
Taxpayer ID No. 20-3372220
Agreement No. 6424
"Exhibit A"
El Segundo Fire Department
Provider Agency Medical Director Services
Position Summary:
• EMS Medical Director is responsible for performing professional level work in planning
and training activities and programs with health and medical components; providing
direction for fire service medical issues; providing medical consultation to major support
functions; and providing on -scene medical oversight and patient care on selected
incidents.
Minimum Qualifications:
Education and Certifications:
1. Medical Doctor (MD) or Doctor of Osteopathy (DO)
2. Completion of an accredited emergency medicine residency program
3. Continuing ABEM Emergency Medicine Board certification
4. Continuing ABEM EMS Subspecialty Board certification
5. Active engagement in the clinical practice of emergency medicine
6. Active engagement in EMS medical direction and EMS education with a minimum of 5
years professional experience in an EMS Provider Agency leadership role
7. Meets the requirements, roles, and responsibilities outlined in the Los Angeles County
Department of Health Services Prehospital Care Policy Reference 411— Provider Agency
Medical Director.
Licenses and certification
1. California Physicians and Surgeons License (active and valid without restriction)
2. Drug Enforcement Agency License (active and valid without restriction)
3. California Driver's License (active and valid without restriction).
Agreement No. 6424
Scope of Services:
• In consultation with the Fire Chief, EMS Coordinator, and Nurse Educator, provides
medical oversight and expertise to EMS Operations, including providing medical
oversight and information to planning and operations personnel.
• Assists on operations training topics with EMS, medical and health components; provides
medical oversight and assists Nurse Educator(s) with EMS education curriculum
development; provides direct EMS classroom and skills instruction and indirect education
and briefings.
• Conducts research, evaluates case studies, interprets data and formulates reports relative
to the provision, delivery, evaluation, and management of the EMS Program.
• Oversees the purchasing, storing, and distributing controlled drugs for the provider
agencies in accordance with County of Los Angeles' Department of Health Services
Reference No. 702, Controlled Drugs Carried on ALS Units. This includes:
o Assisting in maintaining written controlled drug policies.
o Providing input into disciplinary actions that have controlled drug implications.
o Meeting with the medical community to ensure that the practices of the agencies
and its personnel are satisfactorily meeting their needs relative to the handling
pharmaceuticals and controlled drugs.
• Provides medical oversight and expertise to continuous quality improvement (CQI)
programs by reviewing and analyzing EMS effectiveness, system trends, and needs in an
effort to ensure EMS system excellence.
• Develops and assists in the formulation of policies and procedures.
• Participates in call reviews with nurse educators, firefighter/paramedics, and
firefighter/EMT's.
• Evaluates the adherence of ESFD paramedics to medical policies, procedures and
protocols of the Los Angeles County EMS Agency in collaboration with the EMS
Coordinator and Nurse Educator. Reviews incidents with unusual or adverse patient
outcomes and complaints related to the delivery of medical care. Assists in the review of
incidents with medical care issues by reviewing incidents and ensuring appropriate
actions are taken Evaluate compliance with the legal documentation requirements of
patient care in collaboration with the Nurse Educator and EMS Coordinator.
• Serves as an ESFD representative and liaison with medical directors and administrators
of the Los Angeles County EMS Agency, base hospitals, regional trauma centers,
paramedic receiving hospitals, acute care facilities, paramedic training institutions and
professional medical groups.
• Attends EMS Agency administrative and oversight committee meetings such as Medical
Advisory Committee, Provider Agency Advisory Committee, Base Hospital Committee.
• Reviews results and provides input following the annual ESFD survey conducted by the
Los Angeles County EMS Agency.
• Participates in direct observation of field responses and provides medical direction during
a field response per Los Angeles County EMS Agency Policy 411 as needed.
• Assists EMS Coordinator/Designated Officer with decisions involving risk assessment,
postexposure prophylaxis and treatment of occupational infectious disease exposures;
assists Risk Management/Safety Officer/Respiratory Program Manager with medical and
Agreement No. 6424
health components of OSHA Respiratory Protection Standard; provides input to Safety
and Occupational Health Project Team with regard to firefighter safety and health issues.
• Provides expert medical expertise and information to the Hazardous Materials Response
Team and Hazardous Materials Support Services on issues of environmental and clinical
toxicology in administration, planning, training and operations.
• Reviews and recommends to the EMS Agency Medical Director any new medical
monitoring devices or procedures under consideration and ensures compliance with State
and local regulations.
• Provides medical duties within the ICS Medical Unit or as Medical Unit Leader on
extended incidents to provide medical care and rehabilitation of firefighters on scene of
extended incidents.
• Serves as the Medical Director for any Emergency Medical Dispatch (EMD) program
and review and approves the medical components of the dispatch system including
medical dispatch strategies and pre -arrival instructions.
• Assists Public Information Officer (PIO) as a technical specialist on emergency services
medical and health issues.
• Provides medical standing orders to the EMS Coordinator for administration of flu
vaccines and other orders as needed.
• Supports the ESFD and City in development and execution of projects directed at
improving care for low acuity 911 users, high utilizers of 911 services, at -risk seniors,
patients struggling with mental illness or substance addiction, homeless patients, or other
selected patient populations as needed.
• Assists ESFD in identifying patient populations where EMS is well positioned to mitigate
care needs and improve prehospital system efficiency. Maintains a record of ESFD how
utilizes and develops approaches to improve their care and linkage to services. Works
with internal and external health service experts to elicit guidance on measuring and
optimizing patient linkage to follow up services, including medical and non -medical
resources.
• Analyzes ESFD EMS patient care data to assess needs, assists with EMS system
planning, assists with prehospital performance improvement, and promotes increased
system efficiency.
• Meets with hospital based providers and administrators to promote ESFD projects and
community integration.
• Interfaces with EMS medical directors of similar programs around the county and
country to compile and implement best practices.