HomeMy WebLinkAboutResolutions - 1988.09.22 - 17689PUBLIC SERVICES COMMITTEE
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September 22, 1938
MISCELLANEOUS RESOLUTION # 88252
BY : Public Services Committee, Richard Kuhn, Chairperson
PUBLIC SERVICES DEPARTMENT -
IN RE: EMS AND EMERGENCY MANAGEMENT DIVISION - OAKLAND COUNTY COUNCIL FOR
EMERGENCY MEDICAL SERVICES (OAKEMS) BYLAWS REVISIONS
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS:
Mr. Chairperson, Ladies and Gentlemen:
WHEREAS the Oakland County Board of Commissioners established the
Oakland County Council for Emergency Medical Services (per Miscellaneous
Resolution #6490); and
WHEREAS the Oakland County Council for Emergency Medical Services
functions as the Medical Control Authority; and
WHEREAS Public Law 79 of 1981 requires a Medical Control Authority
to be administered by a "system of hospitals" and that an application be
completed for approval;
WHEREAS the "system of hospitals" developed an application for the
Medical Control Authority consistent with state law which was approved by the
Michigan Department of Public Health on May 24, 1988;
WHEREAS OAKEMS will be advisory to the Medical Control Board and
will no longer be the Medical Control Authority; and
WHEREAS it is deemed to be in the best interest of Oakland County
that the Oakland County Council for Emergency Medical Services continues to
serve in an advisory capacity to the Oakland County Board of Commissioners.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of
Commissioners approves the attached Bylaws of the Oakland County Council for
Emergency Medical Services excluding Articles IX, X and XI.
BE IT FURTHER RESOLVED that Oakland County assumes no responsibility
for the Medical Control Board, its agents, and employees, including the
Project Medical Director.
BE IT FURTHER RESOLVED that this Resolution supersedes Miscellaneous
Resolution Nos. 81196 and 84236.
Mr. Chairperson, on behalf of the Public Services Committee, I move
the adoption of the foregoing resolution.
BACKGROUND
The State, through the Michigan Department of Public 'Health has mandated changes
in the Emergency Medical Services organization in Oakland County. Given those
mandated changes, the issue before us is how can we, the Hospitals and the
County, continue to work together to further pre-hospital patient care.
How did we get to where we are now? Some background information may be useful:
1. State taw and rules are the basis for E.M.S. (see attachment A for relevant
sections).
2. MPH determined that a reapplication for Medical Control Authority must be
submitted by all counties.
3. Our initial reapplication was rejected on the grounds that the relationship
of the Medical Control Authority (Hospitals) was too close to the County.
Specific concerns were that the County Board of Comissioners appointed the
members of the proposed Medical Control Board, and approved bylaw changes
(see attachment B).
4. Extensive discussions were held on how best to rectify concerns at the
county level with concerns at MPH.
5. Finally, a reapplication was made and was approved by MOPH. The features of
this reapplication are as follows.
a. The organization is streamlined (see attachment C) this is important,
especially from the point of view of the physician, who are all
voluntary and contribute substantial time.
b. Quality Assurance is established as a function this is important because
although we believe we deliver excellent care, we need to prove that and
to look for avenues toward further improvement.
c. To satisfy the State, Medical Control, the patient care aspect of the
organization, was taken out of OAKEMS and established in a Medical
Control Board (see page 6 of amended Bylaws).
What are the implications of the proposed amendments to the OAKEMS bylaws?
Clearly, the answer is interpretable, however certain issues are evident:
I. For OAKEMS to remain intact, the amended bylaws, or relevant portions, need
to be approved first by OAKEMS Council, then by the Board of Commisioners.
a. If approval is forthcoming, the changes in the relationship between the
County and OAKEMS must be explored.
b. If approval is not forthcoming, a summable will ensue. Although the
Medical Control Board has patient care responsibilities, other and
important state mandated functions are reserved to OAKEMS. These
include communications, consumer input, and disaster planning.
2. Assuming approval of the amended bylaws is forthcoming, where are the
potentials for change in the relationship between the County and OAKEMS?
There are two major arenas, legal and financial.
Page 2
a. Legal - the changes proposed put the Hospitals at greater risk in that
they appoint the members of the Board and are responsible for Quality
Assurance. Legal exposure may still be shared to some degree as the
Hospitals and the County remain partner, overall, in pre-hospital care.
b. Financial - there are two areas where the County currently provides
financial support.
i. Communication - this is an expense which has been shared by the
Hospitals and the County. The split is approximately 50:50.
ii. Staff and Support - space for OAKEMS, meetings, secretarial support,
xeroxing and mailing and the like has been provided by the County.
It would be reasonable to expect continued support for the strictly
OAKEMS functions, and it would be desirable, to preserve the smooth
operation and cohesiveness of the organization as a whole, to have
the Division of EMS and Disaster Control continue to support what is
now the Medical Control Board.
In summary, it can be said that although we were compelled by the state to
dissect a well functioning organization, in the end the changes made may provide
for improvements in service in a streamlined, more efficient manner. Certainly,
it would be hoped that the cooperative environment the County and the Hospitals
have heretofore enjoyed will not be destroyed in the process of change.
AGW:jm
MEDICAL CONTROL
Public Law 479
Sec. 20705(2)
"Medical control" means a department approved
organization of authority to assure medical accountability
within an emergency medical services system through the
promulgation of minimum standards of medical care, protocols,
and operating procedures approved by the department, which
is administered by a licensed hospital or system of
hospitals, and which is'under the direction of i licensed
physician designated is project medical director by a
licensed hospital or a system of licensed hospitals. -
Note: Michigan Law is explicit in Medical Control of
emergency medical services being under the direction
of the physlcimn.
State Rule 325.23702 -
Medical Control Board; Requirements
Rule 702
To be eligible for-department approval almedical
control board shalt comply with all of the following
requirements:
(1) Be jointly appointed and administered by a
hospital or system of hospitals under the direction of a
projsct medical director jointly designated by the hospital
or system of hospitals.
Note; State Rule is again explicit in hospital appointed
and physician directed medical control.
State Rule 325.23704 -
Promulgation of minimum emergency care standards; review by
the department.
Rule 704.
(1) The medical control board shall prepare minimum
standards. of medical care, protocols, and operational
procedures for all advanced, limited advanced, and basic
mobile emergency care services and all personnel associated
with those services within the authorized region of
authority of the medical control board. These minimum
standards of medical care, protocols and operational
procedures shall include all of the following:
page2
(a) Patient treatment protocols.
(b) Patient care quality review procedures.
(c) Procedures to assure the availability and
efficacy of training and continuing education programs.
(d) System telecommunications procedures.
(e) Agreement for the coordination of services.
(f) In medical control regions where advanced or
limited advanced mobile emergency care services are
provided, procedures for the elective withdrawal and
restoration of hospital cooperation with such services
when necessary to assure compliance with minimum standards
of medical care, protocols and operational procedures or
to rpotect the public health, safety, or welfare.
(g) In medical control regions where advanced or
limited advanced mobile emergency care services are
provided, procedures for pharmaceutical security, control,
and exchange.
(h.). Procedures for voluntary enforcement of minimum
standards of medical care, protocols, and dperational
procedures, including procedures for issuing notices of
noncompliance and for the conduct of informal hearings
when such notices are appealed.
(2) Before adopting any minimum standards of medical
care, protocols, and operational procedures, the medical
control board shall submit the proposed minimum standards
of protocols and operational procedures to the department
for review.
Note: State Rule delegates standards for the authority
and accountability to emergency medical services.
Resolution # 88252 Septeber 22,-1988
_22.nd this tember 1.08
ALLEN, County Clerk/Register of De
'day of
LYW
Moved by R. Kuhn supported by Luxon the resolution be adopted.
AYES: Rewold, Rowland, Skarritt, Aaron, Caddell, Calandro, Crake,
Doyon, Gosling, Hobart, Jensen, R. Kuhn, S. Kuhn, Lanni, Luxon, McDonald,
A. McPherson, R. McPherson, Moffitt, Page, Pernick. (21)
NAYS: None. (0)
A sufficient majority having voted therefor, the resolution was adopted.
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
1, Lynn D. Allen, Clerk of the County of Oakland and having a seal,
do hereby certify that I have compared the annexed copy of the attached
resolution adopted by the Oakland County Board of Commissioners at their regular
meeting held on Septe_mber- 22, 1988
with the original record thereof now remaining in my office, and
that it is a true and correct transcript therefrom, and of the
whole thereof.
In Testirony Whereof, I have hereunto set my hand and affixed the
seal of said County at Pontiac, Michigan
HEALTH
48909
Directof
STATE OF MICHIGAN
JAMES J. BLANCHARD, Governor
DEPARTMENT OF PUBLIC
3500 N. LOGAN
P.O BOX 30035. LANSING. mICH/GAN
GLORIA R. SMITH. PhD,. MPH., F.A.A N
EMS
OS I.
DISPkSit pirtbaPPOL
August 20, 1986
Sanford H. Foltonew, M.D., Project Medical Director
Medical Control Board of Oakland County
1200 North Telegraph
Pontiac, NU 48053
Dear Doctor Koltonow:
As you may know, one of the concerns that the Advanced Life. Support Technical
Committee of the Governor's Statewide EMS Advisory Council expressed regarding
the Oakland Cbunty application for medical control was the interrelationship
with the county board of commissioners. The structure, as proposed, allowed
the commissioners to administer, organize, appoint, and/or otherwise control
the medical control authority/board. The Advanced Life Support Technical
Committee felt this was inconsistent with the law and rules governing the
establishment and operation of a medical control authority, and conveyed their
concerns to the contact person listed on your application, Mt. Paul Phelps.
Mr. Phelps notified me by telephone that, since there is no definition for
"system of hospitels", a term used in Section 20705 (2), P.A. 368 of 1978, as
amended, it would be the choice of the Medical Control Board of Oakland
County to interpret this portion of the law to /man that a "system of hospitals"
legitimately includes a county lyaard of commissioners. He further indicated
:klat no changes would be made in the application and that it stands as submitted.
I relayed the content of this conversation to the ranced Life Support Technical
Cbrrmittee for their consideration. They asked, at their August 12, 1986 reetine,
that I relay to you their determination that a "system of hospitals" does not
include a county board of commissioners, unless the county board of commissioners
is the owner or legally responsible party for one or more of the hospitals
within the "system of hospitals". In that case, the county board of commissione4s
could legitimately make decisions on behalf of the facility/facilities they
own or are legally responsible for, but meld not act on behalf of the
facilities with other ownership.
In the event that questions or concerns arise that you would like to discuss
further, please feel free to contact the co-chairpersons of the Advanced Life
Support Technical Committee, Daniel Hatton, Ph. D. (517/894-3796) and Robert
Aranosian, D.O. (313/225-8446).
thia Butcfier, R.N.
Nurse COnsultant
Division of Ebergency Nedical Services
Aligust 20, 1986
Sanford H. Koltonow, M.D.
page two
Sincere regards,
cc: Advanced Life Support Technical COmmittee
Wayne McKenna
4..rau1 Phelps
qt COMMUNICATIONS DISASTER DPERATIONS
TRAINiNG ALS COORDINATORS I
OAKLAND COUNTY
BOARD OF
COMMISSIONERS
MICHIGAN DEPARTMENT
OF PUBLIC HEALTH
OAK EMS
COUNCIL
-Information Advice-
BOARD PROJECT MEDIC-A2
DIRECTOR
CONSUMER
I NFORMATI 0 QUALITY
ASSURANCE
I
EXECUTIVE
COMMUNICATIO DI SASTE
OAKLAND COUNTY
PARTICIPATING HOSPITAL
EMS
OPERATIONS'
COMMITTEE STRUCTURE
OAKLANO COUN71
BOARD OF
COMMISSIONERS
Bylaws changes ratification
OAK EMS COUNCIL
auStort
CONSUMER INFORMATION I I MEDICAL CONTROL
1
REVIEW AND AUDIT.'
1 QUALITY ASSURANCEINOTE: SEE NEXT •
BASIC LIFE SUPPORT AND FIRST RESPONDER
1-17
OAKLAND COUNTY COUNCIL FOR EMERGENCY MEDICAL SERVICES
BY-LAWS
ARTICLE!
• NAME
The Council shall be known as the Oakland County Council for Emergency Medical
Services (OAKEMS).
ARTICLE II
STATEMENT OF PURPOSE
ToaLlisfst'Ithe Oakland County Board of Commissionere and the County Executive in
addressiFig those areas related to the Oakland County Emergency M :.(licrei Services
System.
Section 3 To provide a program of community information and education designed to increase
awareness of emergency medical services within Oakland County.
Section 4 To assist in the provision of training, communications, and technological equipment to
facilitate the efficacious delivery of emergency medical services to Oakland County
residents.
ARTICLE in
STATEMENT OF GOALS
Section 1 To assist In efforts to maintain and enhance an Emergency Medical Services System
which is comprehensive, coordinated, appropriate, accessible financially, physically
and socially acceptable, available, effective and efficient in providing high quality
service to every citizen and visitor to Oakland County.
Section 2 To assist governmental and private units to improve and expand emergency medical
services programs where appropriate.
Section 3 To establish, coordinate, and maintain an integrated emergency medical services
communication system throughout Oakland County,
Section 4 To the Medical Control Board in promoting and coordinating an integrated
emergency response and transportation system, utilizing proper vehicles, equipment
and trained personnel throughout Oakland County.
Section 5 To provide incentives for coordination and cooperation among local governments,
private agencies, and other agencies delivering emergency medical services within
Oakland County.
Section 6 • To assist in developing and updating, as necessary, an emergency medical services plan
for Oakland County that addresses manpower, training, communications,
transportation, hospital emergency facilities, critical care units, public safety
agencies, consumer participation, accessibility to care, transfer of patients, standard
medical record keeping, consumer Information and education, evaluation, disaster and
mutual aid agreements, and evaluates these components based upon cost effeativeness.
Section 7 To maintain a management organization for assisting In Implementing and evaluating a
county-wide emergency medical system.
5283/AGLIAKWA1023M/052787
Section 1 To act in an, _fadvisory capacitycto the Medical Control Board of Oakland County (the
"Medical Con-l-F•rei-i•
Section 2
Section 3 To assist the Medical Control Board's Operation, Committee in promoting an
educational system which will increase the knowledge and effectiveness of ae
personnel involved in providing emergency medical services.
Section 9 To assist in the development of a public information and education subsystem which
emphasizes basic first aid/cardiopulmonary resuscitation practices and provides
information on the effective and efficient use of the Emergency Medical Services
System.
Section 10 To assist the Medical Control Board regarding a timely coordinated response to
medical emergencies by competent and qualified professional personnel with
appropriate equipment organized so as to provide a high quality of emergency medical
care as defined by standards of operation.
Section 11 To assist the Medical Control Board's Operations Committee in the training of persons
providing emergency medical care Services to a level consistent with their roles and
responsibilities.
Section 12 To assist the Disaster Committee and the Medical Control Board in developing the
capability at all levels and in all subsystems to respond quickly, efficiently and
effectively to the medical needs of areas stricken with or threatened by major
disasters.
Section 13 To monitor federal and state legislation, Health Systems Agency actIvities, and
potential funding sources; advise the Oakland County Board of Commissioners
regarding recommendations to procure grant funds; and review and comment upon
grants or proposals as may be assigned by regional, state, or federal agencies.
Section 14 To assist the Medical Control Board in maintaining liaison with or act as the advisory
body to other agencies responsible for emergency medical services activities at state,
regional, and local levels.
Section 15 To assist the Medical Control Board in providing for a mechenism to receive
information from the community relative to the quality of the emergency medical
services system In Oakland County.
ARTICLE IV
COUNCIL MEMBERSHIP
Section 1 COMPOSITION
The members of the Council shall be appointed by the Chairperson of the Board of
Commissioners with the approval of the Board of Commissioner,. The Council shall be
composed of members who shall be representative of the following categories:
(A) HOSPITAL REPRESENTATION (9)*
One representative from each hospital categorized as an emergency center or
department. At least two .(2) members of this category shall be physicians.
FIRE DEPARTMENT REPRESENTATION (1)
A representative from a non-advanced life support provider fire department,
to be recommended by the Oakland County Fire Chief's Association.
(C) POLICE DEPARTMENT REPRESENTATION (1)
A representative from the law enforcement community, to act as liaison
between OAKEMS and the respective police chiers association within
Oakland County.
(D) PUBLIC SAFETY REPRESENTATION. (1)
Numbers indicated are representative as of June, 1984.
(El)
5263/AGL/AKWA1023M/052787
3
- I
A representative from a Public Safet y Department.
(B) COMMUNICATIONS REPRESENTATION (I)
A representative from the Oakland Count y Fre quency Advisory Committee.
(F) BOARD OF COMMISSIONERS REPRESENTATION (2)
Two (2) representatives from the Oakland County Board of Commissioners
.(one from the majority part y and the other from the minorit y party).
(G) EMERGENCY NURSES ASSOCIATION REPRESENTATION (1)
A representative from the Oakland Count y Chapter of the Emergency
Department Nurses Association.
(I) CONSUMER REPRESENTATION (3)
(I) MUNICIPAL ADVANCED LIFE SUPPORT SERVICES REPRESENTATION (6).
One representative from each of the municipalities currentl y providing
Advanced Life Support Services, one of whom must be an Advanced
Emergency Medical Technician.
(J) PRIVATE AMBULANCE SERVICES REPRESENTATION (4)*
One representative from each of the private ambulance services providing
Advanced Life Support Services within Oa'eland County, one of whom must t:
an Advanced Emergency Medical Technician. However, no more than two I_
representatives ma y be appointed from an y organization that has an
overlappin g Board of Directors.
(K) BASIC LIFE SUPPORT SERVICES REPRESENTATION (1)
One representative from a volunteer organization whom must be a Basic
Emergency Medical Technician.
Section 2 LENGTH OF SERVICE
Council members shall be appointed bi-annuall y by the Chairperson of the Oakland
County Board of Commissioner-s. Such appointments shall be for two years. Upon the
recommendation of the Council, names will be submitted prior to the last Board of
Section 3
Commissioners meeting of the even years.
VACANCIES
Any vacancy that shall occur durin g the term ma y be filled by the Chairperson of the
Board of Commissioners who ma y appoint a new member from the cate gory which is
vacant with the approval of the Board of Commissioners. Recommendai ions ma y be
made by the Council.
Section 4 TERMINATION
Any person may terminate his/her membership b y submitting a written resi gnation to
the Chairperson of the Council. Participation b y Council members will be reviewed by
the Council as a condition of reappointment.
Section 5 OFFICERS
(A) CHAIRPERSON - The Chairperson of the Council shall be a ph ysician
member, to be appointed b y the Chairperson of the Board of Commissioners
for a term of two years or until a successor is appointed.
(1) Duties - The Chairperson shall preside at all meetings of the Council,
and perform such other duties as prescribed b y the By-Laws and, from
time to time, as assigned to him/her b y the Council membership under
Parliamentary authority adopted by the Council. He/She shall appoint
members of the Council to represent the organization of the Regionai
5263/AGUARWA1023M/052787
•
1
Emergency Medical Services bodies. Such appointments are subject to
the approval of the Council.
VICE-CFIAIRPERSON - The Council shall have a Vie Chairperson who
appointed by the Chairperson of the Oakland County Board c
Commissioners. He/She shall serve a term concurrent with the Chairpersor.
or until his/her successor is appointed.
(1) Duties - The Vice-Chairperson shall act instead of the Chairperson at
any time when the Chairperson is absent or unable to perform his/her
duties. He/She shall perform other duties assigned to him/her from
time to time by the Chairperson.
Section 5 ALTERNATES
Each member may appoint an alternate to appear and vote at a meeting cf the Courcfl
when that member's attendance is impossible. The alternate shall hmve tre sam--
voting power as the regular member. Alternates shall be from the saris categnity as
the regular member and may be required to present written documentation that heis!-.e
is authorized to vote on behalf of the absent member. Said alternate shaii be name:
and appointed at the next scheduled meeting of the Council following the appointment
of the regular member.
Section 7 ATTENDANCE
A member and alternate shall be replaced if combined they miss more than two
regularly scheduled meetings in a calendar year.
ARTICLE V
MEETINGS
Section 1 COUNCIL
The Council shall hold bi-monthly meetings in the third week of the month. Additional
Council meetings may be called at the discretion of the Chairperson or by written
request from at least five Council members.
Section 2 NOTICES
Notices of all regular and special meetings of the Council and/or all committees shall
be given in writing preceding the date of the proposed meeting.
Section 3 gm:mum
A quorum for a Council meeting shall be a majority of the members appointed.
(B)
ARTICLE VI
COMMITTEES
Section 1 COMMITTEES
Committees shall be established in each of the following functional areas;
(A) CONSUMER INFORMATION.
(11) COMMUNICATIONS.
(C) DISASTER.
The committees shall meet at least bi-monthly to conduct business, if agenda items
warrant.
Section 2 COMMITTEE MEMBERS-RIP
Committees shall be composed of members as appointed by the Chairperson of the
AGLAKWA1023M/052787
4
Council. subject to the approval of the Council. Each committee shall have at least
one member sitting on the Council. Chairperson of the Medical Control Committee
must be a member of Council.
• Section 3 VOTING PRIVILEGES
All committee members shall have voting privileges at committee meetings.
Section 4 ALTERNATES
Committee members may appoint alternates from the same category as the regelar
member and shall have the same voting power.
Section 5 COMMITTEE OFFICERS
The Chairperson and Vice-Chairperson of each committee shall be appointed by tn-z
Chairperson of the Ceuncit with the ratification of the Council. The Chalepere.e.
should be a member of alternate of the Council.
Section 8 SPECIAL COMMITTEE -
(A) Special committee of the Council may be appointed by the Council
Chairperson with the ratification of the Council.
(B) Duties and responsibilities of all special committees of the Council shall be
stipulated by the council Chairperson with the approval of the Council.
Section 7 QUORUM
A quorum for a committee meeting shall be a majority of the members appointed.
Section 8 ATTENDANCE
Attendance guidelines for individual committees shall be drafted by the committees
and subject to approval by the Council.
ARTICLE VII
PROCEDURES
Section 1 MAJORITY
An affirmative vote of a majority of members or alternates present and voting shalt
control any issue except amendments to the By-Laws, which shall require an
affirmative vote by two-thirds of those members present and voting.
Section 2 PARLIAMENTARY AUTHORITY
Rules contained in Robert's Rules of Order shall govern the Council and all committees
which they are applicable and in which they are not inconsistent with these By-Laws or
any standing rules for the conduct of business.
Section 3 CONFLICT OF IN'TEREST
A conflict of interest is considered to exist if the outcome of the vote could benefit
the voting member or the employer oF the voting member. Any potentTel conflicts
must be declared by the member and shall be ruled upon by the Chairperson at the
time of vote and if a conflict is deemed to exist, the involved party be banned from
that particular vote. An appeal of a decision of the Chair shalt be consistent wite
those rules established by Robert's Rules of Order.
Section 1
ARTICLE VIII
STANDING RULES FOR THE CONDUCT OF BUSINESS
The Council than provide the Standing Rules for the Conduct of Business.
5263/AGLAKWA1023M/052787
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ARTICLE IX
Section 1 AUTHORITY.
A system of licensed hospitals participating in the emergency medics! system in
Oakland County hereby assumes the authority and shall appoint and administer the
medical control authority for Oakland County, which shall be known as the Medical
Control Board of Oakland County (the "Board").
Section 2 PURPOSE.
The Board shall act as the Michicran_aapertment of Public Health (the ,"Deoartmentn
appro%red authority to assure medical accountability within the emergency medics,.
services syStern in Oakland County, through the promulgation of minimum standards of
medical care, protocols, and operating procedures approved by the Department.
Section 3 RESERVATION OF AUTHORITY
All matters of patient care or medical policy shall be reserved exclusively to the
province of the Board. The question of whether any matter is a patient care or
medical policy issue shall be raised and discussed at a session of the Boar. which shall
then vote thereon. A vote of two-thirds of the voting Board members shall be
necessary to declare any matter a patient care or medical policy issue.
Section 4 COMPOSITION.
Board shall be composed of:
One Emergency Department Physician from each participating hcspitah
Five representatives from the entities providing emergency medical services
in Oakland County, which shall include the Chairman of the EMS Operations
Committee, who shall also serve as the representative from one of the
following categories and one additional representative selected from each of
the categories remaining thereafter:
from the private entities providing advanced emergency service:
(a) one licensed paramedic
(b) one administrative representative
(ii) from the municipal entities providing advanced emergency service:
(a) one licensed paramedic
(b) one administrative representative
(iii) from the entities providing basic life support services:
(a) one representative
(C) The Project Medical Director,
Section 5 APPOINTMENT.
Each participating hospital will appoint its Emergency Department Physician Director
or his designee and the EMS Operations Committee will nominate the representatives
to the Board from the pre-hospita.1 community which nominations shall be endo,-sed and
appointed, as made, by the participating hospital representatives on the Board. All
subsequent elections of representatives under Section 4.8, shall be performed in such a
manner as to maintain the structure outlined In that Section.
5263/AOL/AKWA1023M/052787
6
a
The
(A)
(B)
(I)
Section TERM.
Members of the Board shall hold office for two year terms. The terms. of Board
members shall be staggered so that the terms of approximately or.e-haif Me} of !re
Board members shall expire each year. The terms of the members of the initial Board
shall be selected by lot at the first Board meeting 50 that one-naif serves a one year
term and one-half serves a two year term. Board members may be reappointed !'er an':
number of successive terms. A Board member may be removed from the Board, fcr
cause, by. a vote of two-thirds of the voting Board members.
Section? VACANCIES.
Vacancies due to death, removal resignation or other cause shall be flied in
accordance with the procedures described in Section 4 above. The new member azall
serve for the remainder of the term.
Section 8 MEETINGS.
(A) Regular. The Board shall hold regular meetings as deemed necessary by •-ee
Board but no less than sour times a calendar year at locations dmgeued
Chairman.
(13) Special. Special meetings may be requested by any member, but may only be
called by the Chairman.
Section 9 NOTICE OF BOARD MEETING.
A written agenda for regular and a written notice of special meetings of the Board
shall be mailed by first class mail or delivered to each Board member at least five (51
calendar days before the date of the meeting. In the ease of special treetinga, the
notice shall state generally the nature of the business to be taken up at the meeting.
Section 10 PUBLIC NOTICE.
Meetings of the Board and public notices of regular or special meetings shall be given
and shall comply with the terms of the Open Meetings Act, Public Act No. 267, P.A.
1976, as amended.
Section 11 DESIGNATION OF OFFICERS.
The officers shall be a Chairman, a Vice Chairman and a Secretary and such other
officers as the Board may elect, whose duties shell be as follows;
(A) Chairman Of The Board. The Chairman of the Board shall be a physician
elected by the Board. The Chairman shall preside at all meetinge. The
Chairman shall have and exercise general charge and supervision of the
affairs of the Board and shall do and perform such other duties as may be
assigned by the Board.
(B) Vice :Chairman he Vice Chairman shall be a Board member elected by the
tioard. the vice-Chairman, at the request of the Chairman or in the event of
his absence, shall perform the duties of the Chairman. Upon request of the
Cha(rman, the Vice Chairman shall perform other dunes as assi;elec.
(C) Secretary. The Secretary shall be a Board member elected by the Board a: e
shall act as Secretary of the Board; shall send appropriate notices or waivers
of notice regarding meetings of the Board; shall prepare agendas and other
materials for all meetings of the Board: and shall perform such other duties
as are customarily performed or required of organizational secretaries.
Term And Remove'. Officers shall serve a term of two years which than
expire on the final day of the month in which they were elected. Off:cers
may be removed by vote of the Board.
5263/AGL/AKWA11J23M/052787
Section 12 (D)
Section 13 STANDING COMMITTEES.
The following committees shall be established by and report to the Board:
(A) QUALITY ASSURANCE COMMITTEE
• (B) EMS OPERATIONS COMMITTEE
(C) EXECUTIVE COMMITTEE.
Section 14 QUALITY ASSURANCE COMMITTEE.
The Quality Assurance Committee shall he composed of physician members and the
Project Medical Director. This Committee shall be responsible for organization,
implementation and coordination of the quality assurance programs.
Section 15 EMS OPERATIONS COMMITTEE.
The EMS Operations Committee shall be composed of one representative from each
advanced life support. basic life support and first responder agency operating witMn
Oakland County. The EVES Operations Committee shall be responsible for review and
comment on matters designated by the Board. The EMS Operations Committee shalt
forward motions to the Board for Board action. Nothing contained in this paragrapn
shall be construed to preclude Board action on any matter.
Section 18 EXECUTIVE COMMITTEE.
The Executive Committee shall be composed of the Project Medical Director two
additional physician members of the Board elected by the Board, and the Chairman or
of the Operations Committee. The Executive Committee shall be responsible for
conducting emergency sessions of the Board and for such other activities as shall be
designated by the Board.
Section 17 SPECIAL COMMITTEES.
(A) The Board may appoint such special committees as it deems necessary.
(I3) The assigned responsibilities of all special committees shall be stipulated and
shall exist until the committee's mandate has been fulfilled.
Section 18 VOTING.
Each member of the Board, except the Project Medical Director, shall have one vote.
Each member of a committee shall have one vote.
Section 19 MAJORITY.
An affirmative vote of a majority of a quorum shall control any issue except
amendments to the By-Laws, which shall require an affirmative vote by two-thirds
(2/3) of the Board members.
Section 20 QUORUM.
A quorum shall be the majority of the Board or committee members appointed, except
that a quorum for purposes of the EMS Operations CornInittee shall consist of nine
members thereof so long as at least one of the members present is a representative or
a basic life support agency.
Section 21 MEETING PROCEDURES.
The agenda should include copies of all correspondence directed to the Board or its
Chairman for information or action.
Section 22 PARLIMENTART PROCEDURES.
Basic rules of parlimentary procedure adopted by the Board shall govern the Board and
all committees to which they are applicable, provided that they are not inconsistent
with applicable By-Laws or any standing rules for the conduct of business.
5263/AGUAKWA1023M/052787
Section 23 CONFLICT OF INTEREST.
A conflict of interest is consideFed to exist if the outcome of any vote could benefit
the voting member or the employer of the voting member. Any potential conflicts
must be declared by a member and shall be ruled upon by the Chairman at the ti rne of
vote and if a conflict is deemed to exist, the involved party may not vote. Any appeal
of any decision shall be to the entire Board.
ARTICLE X
PROJECT MEDICAL DIRECTOR
Section I ELECTION.
The Project Medical Director shall be a physician elected by the Board.
Section 2 TERM.
The Project Medical Director's term of office shall be two Years.
Section 3 DUTIES.
The Project Medical Director shall be the Director of the Board and shall have such
other duties and responsibilities as shall be prescribed by the Board consistent with the
Public Health Code and the rules promulgated thereunder. • The Pro;ect Medical
Director sits on the Board and gives direction to the Board. The Project Medical
Director is responsible for day-to-day operations consistent with the policies and
pr)cedures of the Board. The Project Medical Director does not vote in Board or
Committee proceedings.
Section 4 REPORTS.
The Project Medical Director shall provide reports to the Board.
Section 5 REMOVAL
The Project Medical Director may be removed from office by a two-thirds vote of the
voting members of the Board.
Section 6 SUPPORT STAFF,
The Board may provide for the provision of administrative support to the Project
Medical Director at its discretion.
ARTICLE XI
Section 1
Section 2
Section 3
AM END ME NTS
Proposed amendments to the By-Laws, except Articles IX and X, may be made by
twenty percent of the current members of the Council or by any special committee
appointed by the Chairperson or the Council. Any proposed amendments to Articles IX
arid X of these ay-Laws must be made by 20% of the current members of the Medical
Control Board.
Proposed amendments must be presented in written form to the Council at least
twenty days in advance of the meeting in which the amendments are to be voted
upon. Amendments must be approved by a two-thirds vote of those members of the
Council present and voting, except that proposed amendments to Articles IX or .X must
be approved by an affirmative vote of two-thirds of the Medical Control Board
members, plus the vote of one additional Medical Control Board member.
Proposed amend. tents shall become effective upon ratification by the Board of
Commissioners, provided that no amendment to Articles iX or X of the By-Laws shall
become effective unless that amendment is approved by a 2/3's vote of the Medical
Control Board members, plus the vote of one additional Medical Control Board
member.
5263/AGUAKWAI023M/652737
AGREEMENT
This Agreement made and entered into this first day of January, 1988, by and
between the COUNTY OF OAKLAND, a Michigan Constitutional Corporation, whose
principal address is 1200 N. Telegraph Road, Pontiac, Michigan, 48053,
hereinafter referred to as "COUNTY", and Sinai Hospital of Detroit, a nonprofit
corporation, whose principal address is 6767 West Outer Drive, Detroit, Michigan,
48235, hereinafter referred to as "HOSPITAL".
WHEREAS, the Oakland County Emergency Medical Services Communications
Coordinating Center, hereinafter referred to as "0"COM, is an E.M.S. radio
communications system wherein all medical communications activities are
integrated through a single spectrum management facility which facilitates,
through coordination activities, the maximum utilization of available
frequencies; and
WHEREAS, THE "0"CO1 functions are mandated by the Public Health Code, Act No
368, Public Acts of 1978, as amended, to provide the coordination of
interregional medical control telecommunications in order to provide advanced
mobile emergency care services; and
WHEREAS, the HOSPITAL provides the Oakland County Emergency Medical Services
System with advanced mobile emergency care services by using the "0"COM
functions; and
WHEREAS, the COUNTY owns and maintains the "0"COM communications equipment; and
WHEREAS, it is the recommendation of the Oakland County Council for Emergency
Medic. R.1 Services (OAKS ) that the COUNTY and the HOSPITALS enter into an
agreement effective January 1, 1988, for the sharing of costs of the "0"CO1
Center whereby the HOSPITALS pay for all personnel costs and the COUNTY to
continue to pay for all operational costs (depreciation of radio equipment,
leased radio communication lines, radio maintenance) and to pay for commodities
(office supplies, etc.); and
WHEREAS, it is the mutual intention of the parties hereto and for good and
valuable consideration to effectuate an agreement outlining their respective
duties and liabilities.
Page 1 of 5
NOW THEREFORE IT IS AGREED by and between the COUNTY and the HOSPITAL hereto as
follows:
A. DEFINITIONS
1. ADVANCED MOBILE EMERGENCY CARE SERVICES means a person or a
governmental entity which provides, for profit or otherwise, the
licensed personnel, vehicles, and other equipment required to perform
advanced emergency medical techniques at the scene of an emergency as
defined by Public Health Code, Act No. 368, Public Acts of 1978, as
amended.
2. HOSPITALS means the participating hospitals in the Oakland County
Emergency Medical Services System identified as: William Beaumont in
Troy and Royal Oak; Botsford General in Farmington; Crittenton in
Rochester; Oakland General in Madison Heights; Pontiac General,
Pontiac Osteopathic, and St. Joseph Mercy in Pontiac; Providence in
Southfield; Sinai Hospital of Detroit, and Huron Valley in Milford.
3, OPERATIONAL COSTS means depreciation of radio communications
equipment, leased radio communication lines between the base station
sites and "0"CO1, radio maintenance, office supplies, printing, or
other commodities associated with the operation of "0"CO1 as
established by the Oakland County Board of Commissioners.
4. PERSONNEL COSTS means salaries, wages, fringe benefits, liability
insurance, or other compensation for County Employees as established
by the Oakland County Board of Commissioners.
B. The COUNTY shall locate "0"COM in the Oakland County Division of Emergency
Medical Services and Disaster Control offices and agrees to provide the
following:
1. Staffing
a. A Communications Coordinator will be assigned as
Supervisor/Liaison Officer for purposes of relating all elements
of the Communications system to the appropriate committees of
the Oakland County Council for Emergency Medical_ Services.
b. Appropriately trained personnel will be assigned the primary
function of routing and monitoring emergency medical services
communications on a 24-hour day, 7-day week basis.
2. Facility
a. Specifications:
(1) Floor Space: Minimum of 400 square feet of dedicated
floor space.
Page 2 of 5
(2) Noise Level: Ambient noise level shall not exceed 40
decibels.
(3) Temperature:
(4) Humidity:
(5) Lighting:
(6) Ventilation:
720 + 4° Fahrenheit.
50% + 5% at 72° Fahrenheit.
Variable lighting intensity.
Minimum of 5 cubic feet per minute for
each designated person in the area.
(7) Electrical Power: Adequate electrical power so as to
allow for 24-hour continuous operation
of the communications facility.
(8) Emergency Power: Sufficient for sustaining normal
operations for a minimum of 14 days.
b. Provide adequate security to protect the integrity of the space
allocated, including, but not limited to, controlled access to
the coordinating center and protection against adverse weather
conditions.
c. Facility will meet local fire codes.
d. A 10 pound CO2 or 10 pound dry chemical fire extinguisher will
be available within the coordinating center.
e. Provide furniture (1 e., tables, chairs) necessary for the
efficient operation of the communications coordinating center.
f. Provide for the mounting of microwave dishes that provide line
of site coverage to one of the major communication sites.
C. The COUNTY further agrees:
1. To provide for monthly review and audit of the operation of the
coordinating center in conformance with criteria as established by
the Oakland County Council for Emergency Medina] Services and the
Oakland County Emergency Medical Services/Disaster Control Division.
2. To cooperate in collecting and analyzing data necessary for a
continuing evaluation of prehospital care systems operating in
Oakland County.
3. That instructions and assignments will be issued entirely upon stated
protocols and objective analyses of various situations.
4. That no institutional or commercial advantage will be gained through
the use of such instructions or assignments.
5. To provide liability coverage and workman's compensation coverage for
an personnel involved with the communications coordination center.
6. That advertisement of the selection for the site for the
communications coordinating center designation is prohibited.
Page 3 of 5
7. To be an equal-opportunity employer.
8. To adhere to emergency medical services communications criteria as
developed by the Oakland County Council for Emergency Medical
Services and the Oakland County Emergency Medical Services/Disaster
Control Division.
9. To pay for the depreciation of radio, leased radio communication
lines, radio maintenance, and commodities costs associated with the
operation of "0"COM.
10. That the HOSPITAL will be held harmless from any liability arising
out of the operation of "0"CO1 by reason of any negligence of COUNTY,
its agents, servants, employees, or other persons acting under the
direction of the COUNTY, its agents, servants, or employees.
D. The HOSPITAL agrees:
1. To pay for all of the personnel costs associated with the operation
of "0"CO1 in accordance with the HOSPITALS mutually agreed upon cost-
sharing criteria, attached to this Agreement as Attachment A, and
incorporated by reference with the Agreement.
2. That the COUNTY will be held harmless from any liability arising out
of the operation of "0"CO1 by reason of any negligence of the
HOSPITAL, its agents, servants, employees, or other persons acting
under the direction of the HOSPITAL, its agents, servants, or
employees.
3. To adhere to emergency medical services communications criteria as
developed by the Oakland County Council for Emergency Medical
Services and the Oakland County Emergency Medical Services/Disaster
Control Division.
E. Terms and Conditions of the Agreement:
1. The COUNTY retains title to any and all radio comfmanications
equipment purchased by the COUNTY.
2. The HOSPITAL understands and agrees that the HOSPITAL is one of the
participating hospitals, and that any changes, renegotiations, or
allegations of breach or default of this agreement is subject to the
unanimous agreement of the other HOSPITALS and the COUNTY.
3. Personnel associated with "0"COM are employees of the COUNTY and are
not employees of the HOSPITAL for any purpose whatsoever.
4. The HOSPITAL shall be billed on a monthly basis by the COUNTY in
accordance with COUNTY billing procedures.
Page 4 of 5
BY:
WITNESS
WITNESS
5. The length of this Agreement shall be for one (1) year from its
effective date and shall be reviewed annually. It shall
automatically remain in effect unless modified. Notice of
termination shall be given in writing six (6) months prior to the
effective date of terminations
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed by
their respective duly authorized officers on the date and year first above
written.
OaNTY OF OAKLAND
WITNESS
Jii,"4q/ HOSPITAL
Page 5 of 5
ATTACHMENT A
"0" COM PERSONNEL COST SHARING CRITERIA
1. All personnel costs associated with the operation of "0" COM shall be shared by
the HOSPITALS on a 50% fixed and a 50% variable Cost formula. The variable is
ADVANCED LIFE SUPPORT (ALS) PATIENT ARRIVALS.
HA . a. Y2d c/Hi
NH A
b. C = Total costs
N 7.: Number
H Hospital
HA Hospital ALS Patient Arrivals
HA i = Individual Hospital ALS Patient Arrivals
A ALS Patient Arrivals
Hi Individual Hospital
2. ADVANCED LIFE SUPPORT (ALS) PATIENT ARRIVALS means the arrival of an
ALS patient to one of the HOSPITALS by which the MEDCOM communications
system (UHF radio frequencies) or telephonic telemetry system for medical
direction were utilized.
3. The Oakland County Division of EMS and Disaster Control will record the ALS
Patient arrivals.
4. The previous year's statistics will be used for the subsequent year cost sharing
assessments.
5. a. In the event a HOSPITAL terminates their cost sharing agreement, the
remainder HOSPITALS will convene, renegotiate, and agree on a cost
sharing method.
b, The HOSPITAL understands that termination of their cost sharing
agreement will result in the termination of the utilization of MEDCOM
communications system.
GROVELAN
R C f FK1 A
TOWNSHIP
-tf0,
FouNinc0
$35
4695 GRANGE HALL ROAD
HOLLY, MICHIGAN 48442
(3 L3) 634-4152
JUL 14 P1 :07
aaaaaaTowNSnP OF GROVELAND
" u";1.n.'of`4IYY OF OAKLAND
STaTE OF MICHIGAN
WHEREAS, Paramed, Inc. has offered to install E911 equipment that
would enable the 0 ,kland County DisPatch, designated as the
Primary Public Safety Answering Point, to utilize Paramed,
Inc. ea the Secondary Public Safety Answering Point; and
WHEREAS, the new E911 equipment would allow Groveland the option of
transferring calls for emergency medical service directly to
Paramed, Inc.'s communication center for pre-arrival
instructions; and
WHEREAS, after careful review it is the recommendation of the
Groveland Township Board that Paramed, Inc. be named
Secondary Public Safety Answering Point to Groveland's
commnnication system;
NOW, THEREFORE, THE TOWNSHIP BOARD OF THE TOWNSHIP OP GROVELAND
RESOLVES
That the Groveland Township Board does hereby authorize
Paramed, Inc., 486 Opdyke, Pontiac, Michigan 48341, to be
designated as Secondary Public Safety Answering Point to
Groveland's systems and approve the installation of E911
equipment and putting the program into operation.
And that the Township Clerk be and hereby is directed to
send a copy of this resolution to Thomas R. Gahan, President
, of Paramed, Inc; the Oakland County Clerk and the Groveland
Township Fire Chief.
I, Beth Steele, Groveland Township Clerk, do hereby certify that the
foregoing is a true and complete copy of a resolution adopted by the
Groveland Township Board by a vote of 5 to 0, at the regular meeting
held on Monday, June 8, 1992.
Beth J. Steele
Clerk
Groveland Township
I If