The Medical Director must: • Perform all services required pursuant to: Chapter 401, Florida Statutes https://www.flsenate.gov/Laws/Statutes/2021/Chapter401/All Chapter 64J Medical Direction, Florida Administrative Code (F.A.C.) https://www.flrules.org/gateway/ruleno.asp?id=64J-1.004. The applicable rules of any government agency implementing said chapter and any duties upon written notice from the Florida Department of Health that such additional duties are required of the Medical Director, or upon notice from the County that such additional duties have been established by the Florida Department of Health. • Attend local and State EMS Advisory Council meetings as needed. • Retain ultimate authority to permit any paramedic, EMT, or first responder to utilize basic life support or advanced life support, patient assessment, and patient stabilization. • Maintain and update medically correct standing orders or protocols which permit specified ALS/BLS procedures when communication cannot be established with a supervising physician or when any delay in patient care would potentially threaten the life or health of the patient. Seek input from CCFR employees regarding the protocols on an annual basis and before any protocol revision. • Provide continuous 24-hour-per-day, 7-day-per-week medical direction which shall include in addition to the development of protocols and standing orders, direction to personnel of the provider as to the availability of medical direction “off-line” service to resolve problems, system conflicts, and provide services in an emergency as defined by Section 252.34(4), F.S. https://m.flsenate.gov/Statutes/252.34 • Supervise and assume direct responsibility for the medical performance of the first responders, emergency medical technicians and paramedics of Citrus County Fire Rescue. • Visit BLS/ALS units, on site, for the purpose of riding, observing and evaluating, a minimum of fifteen (15) hours during each year, with a minimum of ten (10) hours per year being actual ride time on an engine per State Guideline 64E-2.004 https://www.flrules.org/gateway/ruleno.asp?id=64E-2.004 • Meet with a designated representative of CCFR to review medical issues that may arise regarding BLS/ALS issues on an as-needed basis. • Maintain and upgrade the patient care quality assurance system to assess the medical performance of paramedics and EMTs by way of performing a monthly audit. • Provide field response as needed, during mass casualty incidents at the request of CCFR. • Maintain and upgrade the system involving CCFR employees to evaluate new medications, equipment and treatment modalities for potential implementation, as well as the elimination of medications, equipment and treatment modalities that no longer serve the best interest of patients and/or CCFR. • Submit and maintain copies of current registration as a Medical Director, either individually or through a hospital, with the U.S. Department of Justice, Drug Enforcement Administration (DEA), to provide controlled substances to the provider. Registration must include addresses at which controlled substances are stored. All fees for licenses or certifications shall be paid by the Medical Director as contracted expense(s). • Ensure and certify that security procedures of the CCFR providers for medications, fluids, and controlled substances are in compliance with all applicable laws to include: Chapters 499 F.S. http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0499/0499.html Chapter 893 F.S. http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0800-0899/0893/0893.html Chapter 64F-12, F.A.C. https://www.flrules.org/gateway/ChapterHome.asp?Chapter=64F-12 • Create, authorize and ensure adherence to, detailed written operating procedures regarding all aspects of the handling of medications, fluids, and controlled substances by the provider. • Notify the department in writing of each substitution by the EMS provider of equipment or medication. • Provide or oversee periodic refresher training to Fire Rescue personnel and ensure their compliance with proper standards for preparing medical documentation of patient care rendered with emergency medical services. • Develop, implement, and participate in a patient care quality assurance system to assess the medical performance of paramedics and EMTs in conformance with: o F.S. Section 401.265(2) http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0401/Sections/0401.265.html o 64J-1.004(4)(b) F.A.C. https://www.flrules.org/gateway/ruleno.asp?id=64J-1.004 o provide quarterly performance reports to the Citrus County Fire Chief. • Obtain ten (10) hours of continuing medical education per year in topics concerning EMS, such as emergency medicine, critical care, trauma and pediatrics. • Assume direct responsibility for the use of an automatic or semi-automatic defibrillator by a Fire Rescue EMT/Paramedic, and use of all other items used in conformance with 64J-1.004(4)(g) https://www.flrules.org/gateway/ruleno.asp?id=64J-1.004 • Oversee and administer the automatic defibrillator program throughout County facilities. • Ensure that all EMTs and paramedics are trained in the use of the trauma scorecard methodologies as provided in Rule 64J-2.004, F.A.C. https://www.flrules.org/gateway/RuleNo.asp?ID=64J-2.004 for adult trauma patients and Rule 64J-2.005, F.A.C. https://www.flrules.org/gateway/RuleNo.asp?ID=64J-2.005 for pediatric trauma patients. • Develop and revise when necessary TTPs for submission to the department for approval. • Develop and implement policies and protocols to minimize exposure of Fire Rescue personnel to infectious diseases in compliance with State and Federal requirements. • Immediately report to the County the initiation of any legal action pertaining to the Medical Director, disciplinary procedure imposed on the Medical Director or investigation of the Medical Director by the State of Florida or any of its regulatory agencies. • Report to the Florida Bureau of EMS any EMT or paramedic who has had their privilege to provide patient care removed by the Medical Director and provide a report of disciplinary action to include a statement and documentation of specific acts and dates. • Set appropriate review/appeal mechanisms for the above action for any EMT or paramedic that has had their privileges suspended by the Medical Director. • Be knowledgeable of aeromedical requirements of patients. • Assure all aspects of the EMS system are developed to place the needs of the patients first. • Develop and maintain liaison with the medical community (hospitals, emergency departments, mental health agencies, physicians and other providers of EMS). • Be a member in good standing of at least one national emergency medicine constituency group and participate in national EMS organizations through attendance at conferences and other activities. • Interact with County, Regional, State and Federal EMS authorities, regulators and legislators to ensure standards, needs, and requirements are met and resource utilization is optimized. • Meet with Nature Coast EMS (NCEMS) medical director twice a year to ensure quality partnership between NCEMS and CCFR. • Participate in grant application process for system funding, expansion and research as determined by the CCFR. • Require education/testing/proficiency for all personnel involved in EMS (first responders, EMTs, paramedics and associate medical directors, if employed). • Provide a written report to the Citrus County Fire Chief of activities for the previous quarter to reflect the required services documented in the contract between CCFR and the Medical Director. Written report to be provided by the 15th of each month following the end of the quarter.
