HomeMy WebLinkAboutCity of Tamarac Resolution R-2009-137Temp. Reso. # 11702
September 29, 2009
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CITY OF TAMARAC, FLORIDA
RESOLUTION NO. 2009- 197
A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF
TAMARAC, FLORIDA APPROVING THE AGREEMENTS AND
AUTHORIZING THE APPROPRIATE CITY OFFICIALS TO
EXECUTE MEMORANDA OF AGREEMENT BETWEEN THE CITY
AND THE BROWARD COUNTY HEALTH DEPARTMENT AND
THE STATE OF FLORIDA DEPARTMENT OF HEALTH
PROVIDING FOR THE H1 N1 VACCINATION PROGRAM;
PROVIDING FOR CONFLICTS; PROVIDING FOR
SEVERABILITY; AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, the Health and Human Services Secretary Michael O. Leavitt issued
a Declaration for the Use of the Public Readiness and Emergency Preparedness Act
(PREP ACT) dated January 26, 2007, and amended on November 30, 2007 and
October 17, 2008, with respect to certain avian influenza viruses; and
WHEREAS, on April 26, 2009 Acting HHS Secretary Charles Johnson
determined that a nationwide Public Health Emergency existed with potential to national
security; and
WHEREAS, following her confirmation by the senate as Secretary of HHS, on
July 24, 2009 Secretary Kathleen Sebelius renewed the Public Health Emergency
declaration of April 26, 2009; and
WHEREAS, the Florida Department of Health has developed an H1 N1 Swine Flu
Mass Vaccination Campaign; and
WHEREAS, City Officials have been working with the Department of Health to
develop contingency plans relative to the storage, dispensing and administration of the
H1 N1 Flu vaccine; and
Temp. Reso. # 11702
September 29, 2009
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WHEREAS, the City Manager recommends that authority be delegated to the
appropriate City Officials to execute those agreements required by the Florida
Department of Health and the Broward County Health Department providing for City
participation in the H1N1 Campaign attached hereto as Exhibit 1, Exhibit 2 and Exhibit
3; and
WHEREAS, the City Commission finds it to be in the best interest of the citizens
and residents of the City of Tamarac to authorize the appropriate City Officials to
execute the prerequisite agreements between the City and the Florida Department of
Health and the Broward County Health Department.
NOW THEREFORE BE IT RESOLVED BY THE CITY COMMISSION OF THE
CITY OF TAMARAC, FLORIDA:
SECTION 1: The foregoing "WHEREAS" clauses are hereby ratified and
confirmed as being true and correct and are hereby made a specific part of this
Resolution. All exhibits attached hereto are incorporated herein and made a specific
part of this resolution.
SECTION 2: The City Commission of the City of Tamarac hereby approves the
agreements and further authorizes the appropriate City Officials to execute the
agreements between the City of Tamarac and the Florida Department of Health and the
Broward County Health Department attached hereto as Exhibit 1, Exhibit 2, and Exhibit
3.
SECTION 3: All resolutions or parts of resolutions in conflict herewith are hereby
repealed to the extent of such conflict.
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Temp. Reso. # 11702
September 29, 2009
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SECTION 4: If any clause, section, other part or application of this Resolution is
held by any court of competent jurisdiction to be unconstitutional or invalid, in part or
application, it shall not affect the validity of the remaining portions or applications of this
Resolution.
SECTION 5: This resolution shall become effective upon its passage and
adoption.
PASSED, ADOPTED AND APPROVED this day of AIAW , 2009.
ATTEST:
MARION SWEN ON, CM
CITY CLERK
I HEREBY CERTIFY that
I have approved this
RESOLUTION as to form.
EC S. GOREN
'ATTORNEY
B H FLANS MUM- ALABISCO
MAYOR
RECORD OF COMMISSION
MAYOR FLANSBAUM-TALABISCO
DIST 1: COMM BUSHNELL OZ
DIST 2: VM ATKINS-GRAD
DIST 3: COMM, GLASSER
DIST 4: COMM. DRESSLER 41e
MEMORANDUM OF AGREEMENT FOR ENTITIES OPERATING
PUBLIC POINTS OF DISPENSING (PODS) J
THIS MEMORANDUM OF AGREEMENT made this day of October, 2009 by and between the
State of Florida, Department of Health, Broward County Health Department (BCHD) and the City of Tamarac
(ENTITY).
WHEREAS, Health and Human Services (HHS) Secretary Michael O. Leavitt issued a Declaration for the
Use of the Public Readiness and Emergency Preparedness Act (PREP ACT) dated January 26, 2007 and
amended on November 30, 2007 and October 17, 2008 with respect to certain avian influenza viruses; and,
WHEREAS, on April 26, 2009, Acting HHS Secretary Charles Johnson determined that a nationwide Public
Health Emergency existed with potential to national security; and,
WHEREAS, on June 11, 2009 the WHO Director, General Dr. Margaret Chan, issued a statement raising the
level of pandemic influenza alert to Phase 6, beginning the 2009 Influenza Pandemic; and,
WHEREAS, on June 19, 2009 the Secretary issued a PREP Act declaration identifying the pharmaceutical
Tamiflu and Relenza as "covered countermeasures" to address the threat of or actual human influenza that
results from the infection of humans with highly pathogenic avian influenza A viruses including the swine
H 1 N 1 virus; and,
WHEREAS, on June 25, 2009 the HHS Secretary issued a PREP Act declaration similarly identifying the
2009 HIN1 vaccines as a "covered countermeasure" for that same purpose; and,
WHEREAS, on July 14, 2009 the Food and Drug Administration issued an Emergency Use Authorization
letter expanding uses of Tamiflu for treatment and prophylaxis of influenza; and,
WHEREAS, following her confirmation by the Senate as Secretary of HHS, on July 24, 2009 Secretary
Kathleen Sebelius renewed the Public Health Emergency declaration of April 26, 2009,
NOW, THEREFORE, in consideration of the mutual covenants herein and other good and valuable
consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties hereby agree as
follows:
I. RECITALS
The Parties mutually agree that the foregoing Whereas clauses are true and correct and are incorporated by
reference.
II. PURPOSE
To provide the "covered countermeasure" 2009 H1N1 vaccines to Broward County residents and visitors.
This Memorandum of Agreement establishes the terms, conditions and responsibilities of the parties for the
administration of the vaccine, which vaccine will be delivered into Florida by the federal government and its
agents.
III. LEGAL AUTHORITY
a. Sections 381.0011(5), (11), Florida Statutes, Duties and Powers of the Department of Health
b. Section 381.003(1)(d),(1)(e), Florida Statutes, Communicable Diseases and AIDS Prevention and
Control
IV. DEFINITIONS
a. Administration or Administer — the obtaining and giving of single doses of vaccine by a legally
authorized person to a patient. Sec. 465.003(1), Florida Statutes.
b. CDC — Centers for Disease Control
c. Florida SHOTS — the centralized online immunization registry described at Sec. 381.003(1)(e),
Florida Statutes and Rule 64E-3.046(6)-(8), Florida Administrative Code.
d. PPE — Personal Protective Equipment
e. Vaccine — the 2009 influenza A (HIND monovalent vaccine distributed for the US Department of
Health and Human Services and the CDC.
f. POD- Point of Dispensing
V. INTENDED BENEFICIARIES. NO PRIVATE RIGHT CREATED.
This Memorandum of Agreement is binding on the parties, their heirs -at -law, and their assigns and successors
in interest as evidenced by their signatures and lawful executions below, and does not create or confer any
right or benefit on any other person or party, private or public. Nothing in this Memorandum of Agreement is
intended to restrict the authority of either signatory to act as provided by law or regulation, or to restrict any
agency from enforcing any laws within its authority or jurisdiction.
VI. BCHD RESPONSIBILITIES
a. Shall provide Public Health experts to ENTITY, as needed, to resolve technical questions either by
telephone or onsite as applicable.
b. Shall assist ENTITY, as BCHD deems appropriate, with H1N1 flu vaccination sites and activities
related to the administration of the vaccine.
c. Shall provide ENTITY with the Influenza A (H1N1) 2009 monovalent vaccine, necessary vaccination
supplies and PPE as recommended by the CDC. Should options be offered by the CDC, the BCHD
shall in its sole discretion select the appropriate option.
d. Shall schedule vaccination sites and advertise their locations and times of operation. Nothing
precludes the ENTITY from advertising locations and times of operation provided; however, the
ENTITY locations and hours of operation are not changed without first providing three days advance
written notice to Broward County Health Department.
e. Shall provide ENTITY with medical, nursing, and support staff as BCHD deems appropriate to work
with assigned ENTITY volunteers at the identified sites.
f. Shall provide training to ENTITY POD staff as required.
g. Shall determine, in its sole discretion, the number of vaccination stations required at the PODs based
upon the availability of BCHD staff, ENTITY staff and volunteers, all of whom must be qualified and
appropriately licensed.
h. Shall provide the ENTITY the storage and handling requirements set forth by the federal government
and/or the manufacturer including compliance with cold chain requirements.
VII. ENTITY RESPONSIBILITIES
a. Acknowledges that it is acting independently as a health care entity and has executed the 2009
Influenza A (HIN1) Monovalent Vaccine -Vaccine Provider Agreement (Provider Agreement) and the
Memorandum of Agreement for Immunization by Paramedics (MOA/Paramedic), copies of which are
attached hereto and incorporated herein as if set forth in full.
b. Shall provide air conditioned structures that can serve no less than 10 vaccination stations (or other
mutually agreed upon number of stations) which shall be referred to as Points of Dispensing (PODS)
and shall be compliant with CDC standards.
c. Shall provide an administrative area within the POD to process both incoming and outgoing recipients
of the vaccine.
d. Shall provide secured air conditioned storage and/or an electrical supply source sufficient to operate
refrigeration units to store the vaccine, and necessary vaccination supplies, consistent with the storage
and handling requirements set forth by the federal government and/or the manufacturer including
compliance with cold chain requirements at or within the POD site.
e. Shall not deny services to any person regardless of their place of residence.
f. Shall not charge recipients, health insurance plans, or other third party payers for the vaccine, the
syringes or the needles as these are provided at no cost.
g. Shall not sell or use outside the direction of the BCHD the HIN1 vaccine, syringes or needles.
h. Shall provide clerical and administrative support staff to assist BCHD staff with the proper
documentation of the immunization during the hours of operation of the ENTITY POD.
i. Shall provide a sufficient number of law enforcement officers, security staff, and other necessary
personnel to assure the orderly processing of people seeking the vaccine prior to the opening the POD
and during and subsequent to the closing of the POD as deemed appropriate by the ENTITY.
j. Shall provide electric service sufficient to operate vaccination stations for each site within ENTITY's
jurisdiction.
k. Shall provide an EMS unit assigned to the POD during the hours of operation.
VIII. FEDERAL IMMUNITY
The PREP Act sets forth the immunity for "covered persons" from tort claims related to, in this case, "covered
countermeasure" for the Swine HIN1 Virus. For the purposes of this Agreement, ENTITY is a covered person;
a "Program Planner of countermeasure (i.e., individuals and entities involved in planning and administering
programs for distribution of a countermeasure)..." appears in CDC Public Readiness and Emergency
Preparedness Act Questions and Answers, 42 USC §247d-6d(i)(7)-(7)(A)(ii). As a covered person, ENTITY
shall be immune from suit and liability under Federal and State law with respect to all claims for loss caused
by, arising out of, relating to, or resulting from the administration to or the use by an individual of a covered
countermeasure...". 42 U.S.C. § 247d-6d(a)(1).
IX. INDEMNIFICATION
Each party who is a state agency or subdivision, as defined in Section 768.28, Florida Statutes, agrees to be
fully responsible only to the extent provided by Section 768.28, Florida Statutes, for its sole negligent acts or
omissions or tortuous acts of its own employees, agents or principals which result in claims or suits against the
other party (parties), and agrees to be liable for any damages proximately caused by said acts or omissions or
torts. Nothing herein is intended to serve as a waiver of sovereign immunity by any party to which sovereign
immunity applies. Nothing herein shall be construed as consent by a state agency or subdivision of the State of
Florida to be sued by third parties in any matter arising out of this MOA. No state agency or subdivision
indemnifies any other party or person beyond the extent permitted under the law, no matter what the
circumstances.
X. INSURANCE
Each Party, to the extent applicable, shall maintain at its sole expense ordinary property and liability insurance.
XI. WAIVER
No failure of any party to enforce any term hereof shall be deemed to be a waiver.
XII. DISPUTE RESOLUTION
Any dispute arising from this MOA is to be resolved according to Florida law. Such disputes may be resolved
only in the courts of the Seventeenth Judicial Circuit of Florida or the Southern District Federal Court. In any
such legal action, venue lies in Broward County, Florida.
XIII. TERMINATION AT WILL
This Memorandum of Agreement may be terminated by either Party upon no less than five (5) days written
notice to the other Party, without cause, unless a lesser time is mutually agreed upon in writing by both Parties.
XIV. MODIFICATION
Modification of provisions of this Memorandum of Agreement shall only be valid when they have been
reduced to writing and duly signed by both parties.
XV. TERM
The term of this Agreement is for one (1) year from the stated effective date unless extended by mutual
agreement of the parties.
XVI. STATUS OF PARTIES
The Parties expressly intend that as to this Memorandum of Agreement, the Parties shall be independent
contractors, have no relationship other than the one created by this Memorandum of Agreement, and shall not
receive any benefits other than those expressly provided herein. Further, the Parties expressly intend that no
agent, contractor, employee of one party shall be deemed to be an agent, contractor or employee of the other
Party.
XVII. NOTICE
When any of the parties desire to give notice to the other, such notice must be in writing, sent by Certified U.S.
Mail, postage prepaid, addressed to the party for whom it is intended at the place last specified or in person
with proof of delivery. The place for giving notice shall remain such until it is changed by written notice in
compliance with the provisions of this paragraph. For the present, the parties designate the following as the
respective places for giving notice:
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For BCHD:
Paula M. Thagi, MD, MPH
Director
780 SW 24rh Street
Fort Lauderdale, Florida 33315
For Entity:
Jeffrey L. Miller
City Manager
City of Tamarac
7525 NW 88`h Avenue
Tamarac, Florida 33321
XVIII. CONSTRUCTION
This Memorandum of Agreement shall be construed as if it were jointly prepared by both parties and there
shall be no presumption that any ambiguity in this Agreement shall be taken, interpreted, or construed against
either party.
XIX. SEVERABILITY
If any provision of this MOA is determined by settlement or by judgment of a court of competent jurisdiction
to be invalid or unenforceable, the remaining provisions shall continue in full force and effect notwithstanding.
IN WITNESS THEREOF the Parties hereto have caused this 5 page Memorandum of Agreement to be
executed by their duly authorized officials.
For Broward County Health Department:
Paula M. Thagi, MD, MPH
Director
780 SW 24tn Street
Fort Lauderdale, Florida 33315
/JGJ 114 VV 00 t1vG11uG
Tamarac, Florida 33321
2009 Influenza A(H1 N1) Monovalent Vaccine
Vaccine Provider Agreement
This Agreement made this _ day of October, 2009 by and between the State of Florida, Department of
Health, Broward County Health Department (BCHD) and the City of Tamarac (hereinafter "Applicant or
Immunization Provider")
L. Scott Ulin, MD Florida License: ME0040245
H1N1 Immunization Provider Names and applicable medical/nursing licensure numbers
of City of Tamarac
Facility Name
7525 NW 88th Ave, Tamarac, FL 33321
Address of primary facility
Tamarac Fire Rescue, 6000 Hiatus Rd, Tamarac, FL 33321
Address for receipt of vaccine
Your participation in the 2009 Influenza A(H1N1) monovalent vaccine vaccination effort is greatly
appreciated as a vital service that will protect individuals and the public against 2009 H1 N1 influenza. The
2009 Influenza A(H1N1) monovalent vaccine has been purchased by the federal government as a means
of protecting the public against 2009 H1 N1 influenza. It is being made available to immunization providers
working in partnership with state and local public health departments to vaccinate individuals for whom
the vaccine is recommended. This Provider Agreement specifies the conditions of participation in the
2009 Influenza A(H1N1) monovalent vaccine vaccination effort in the U.S. and must be signed and
submitted to the immunization program prior to receipt of the vaccine.
In consideration of the mutual covenants herein and other good and valuable consideration, the receipt
and sufficiency of which is hereby acknowledged, the Parties agree as follows:
The BCHD agrees to:
1. Provide the 2009 Influenza A(H1N1) monovalent vaccine distributed for the U.S. Department of
Health and Human Services and the Centers for Disease Control to Immunization Provider.
The Immunization Provider agrees to:
1. Administer the 2009 Influenza A(H1N1) monovalent vaccine according to the recommendations
of CDC's Advisory Committee on Immunization Practices as adopted by the Centers for Disease
Control and Prevention.
2. Store and handle the vaccine in accordance with the package insert provided with the vaccine
including in compliance with cold chain requirements.
3. Provide a current Vaccine Information Statement to each individual before vaccination, and
answer questions about the benefits and risks of vaccination, including different indications for
live versus inactivated vaccines.
4. Record in the patient's medical record or in an office log the date of administration, the site of
administration, the vaccine type and lot number, and the name of the immunization provider for
each individual vaccinated. The record must be kept for a minimum of three years following
vaccination.
5. Report moderate and severe adverse events following vaccination to the Vaccine Adverse Event
Reporting System (1-800-822-7967, http://vaers.hhs.gov/contact.htm ).
In addition, the Provider:
6. Can not charge patients, health insurance plans, or other third party payers for the vaccine, the
syringes or the needles as these are provided at no cost to the provider. The provider/facility is
also prohibited from selling H 1 N 1 vaccine, syringes or needles.
7. May charge a fee for the administration of the vaccine to the patient, their health insurance plan,
or other third party payer. The administration fee cannot exceed the regional Medicare vaccine
administration fee. If the administration fee is billed to Medicaid, the amount billed cannot exceed
the state Medicaid administration fee.
8. May either administer the 2009 Influenza A (H1 N1) monovalent vaccine for free to individuals
who cannot afford the administration fee, or refer these individuals to a public health department
clinic or affiliated public health provider for vaccination.
9. Must report the number of doses of 2009 Influenza A (H1 N1) monovalent vaccine administered to
individuals as requested by the state or local public health department.
10. Must report to the state health department the number of doses of vaccine that were not able to
be used because the vaccine expiration date was exceeded or the vaccine was wasted for other
reasons. These doses must be disposed of in accordance with Rule 64E-16, F.A.C. (Biomedical
Waste).
11. Are strongly encouraged to provide an immunization record card to the vaccine recipient or
parent/guardian to provide a record of vaccination, to serve as an information source if a Vaccine
Adverse Event Reporting System report is needed, and to serve as a reminder of the need for a
second dose of vaccine (if necessary). Immunization cards will be included in each shipment of
vaccine.
12. U.S. Code - Public Readiness and Emergency Preparedness Act
42 USC Sec. 247d — 6d
42 USC Sec. 247d — 6e
Note: The PREP Act immunizes "covered persons" from a wide list of tort claims (does not create
a long list of immunized persons). The immunity is immunity from suit — much stronger than the
sovereign immunity under Florida Statutes.
The definition of a "covered person" is broad. Covered persons include the federal government,
manufacturers, distributors, program planners, entities such as hospitals, and people such as
physicians qualified to administer the countermeasure. 42 U.S.C. § 247d-6d(i)(7)-(7)(A)(ii).
Therefore, physicians, nurses and anyone else who administers the vaccine at the direction of a
physician are "covered persons" for purposes of federal PREP Act immunity.
"[The] covered person shall be immune from suit and liability under Federal and State law with
respect to all claims for loss caused by, arising out of, relating to, or resulting from the
administration to or the use by an individual of a covered countermeasure. . . .". 42 U.S.C. §
247d- 6d(a)(1).
IN WITNESS THEREOF the Parties hereto have caused this Agreement to be executed by their duly
authorized representatives.
For Broward County Health Department: For Immunization Provider:
Paula M. Thagi, MD, MPH
Director
780 SW 24th Street
Fort Lauderdale, Florida 33315
�
Je r I-iller
City Manager
City of Tamarac
7525 NW 88th Avenue
Tamarac, Florida 33321
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L.Scott Ulin, MD
EMS Medical Director
Tamarac Fire Rescue
6000 Hiatus Rd
Tamarac, FL 33321
MEMORANDUM OF AGREEMENT FOR IMMUNIZATION BY PARAMEDICS
MEMORANDUM OF AGREEMENT
BETWEEN
BROWARD COUNTY HEALTH DEPARTMENT
AND
CITY OF TAMARAC
This Agreement made and entered into by and between the Broward County Health
Department (hereinafter referred to as the "BCHD") and the city of Tamarac (hereinafter referred
to as the "PROVIDER") is for the administration of vaccines (hereinafter "vaccine"), as approved
by the Broward County Health Department to the members of the public.
WHEREAS, pursuant to Section 401.272, Florida Statutes, paramedics may administer
immunizations in a nonemergency environment, within the scope of their training, and under the
direction of a medical director;
WHEREAS, the PROVIDER employs or contracts with a physician qualified pursuant to rule 64J
- 1.004, Florida Administrative Code, to be its Medical Director; and
WHEREAS, the Medical Director verifies and documents that paramedics have sufficient
training and experience to administer vaccinations. WHEREFORE, IN CONSIDERATION of the
mutual terms, conditions, promises, and covenants hereinafter set forth, the parties agree as
follows:
ARTICLE I
BCHD RESPONSIBILITIES
(1) Advise the PROVIDER of BCHD's protocol for the administration of immunizations.
(2) The BCHD Executive Medical Director shall review the PROVIDER's Medical Director's
written Operating Procedures regarding all aspects of the handling of vaccines.
(3) Provide copies of all forms, immunization records, and other materials necessary in
order for the PROVIDER to successfully administer the vaccination program consistent
with the terms set forth herein and all applicable laws, regulations and policies.
(4) Provide information and education regarding vaccine administration, vaccine storage,
handling, and appropriate references to all applicable employees.
(5) Provide instruction and assistance, upon request, subject to availability of Broward
County Health Department staff, to ensure PROVIDER enters all information about the
administration of the vaccine into the SHOTS program database.
ARTICLE II
PROVIDER RESPONSIBILITIES
(1) Assure that individuals administering the vaccine are licensed with the Department of
Professional Regulation and have no infractions against their license.
(2) Maintain an up to date list of all employees who have completed the required training.
(3) Ensure that the Medical Director is a Florida licensed Medical Doctor (M.D.) or a Doctor
of Osteopathic Medicine (D.O.). The Medical Director's name is: L. Scott Ulin, MD and
his/her license number is: State of Florida ME0040245.
(4) The Medical Director shall create, authorize and ensure adherence to detailed written
Operating Procedures regarding all aspects of the handling of vaccines.
(5) The Medical Director shall verify that each paramedic authorized to administer
immunizations has completed training consistent with that of other staff giving
immunizations in the BCHD as required by the BCHD Medical Director on a BCHD form,
a copy of which is attached as Exhibit A and titled "Authorization, Agreement and
Certification of Training". Completed forms must be maintained at PROVIDER'S location
and made available to BCHD on request.
(6) Store and handle the vaccine in accordance with the package insert provided with the
vaccine in compliance with cold chain requirements.
(7) Provide a current Vaccine Information Statement to each individual before vaccination,
and answer questions about the benefits and risks of vaccination, including different
indications for live versus inactivated vaccines.
(8) Cooperate with the BCHD to ensure proper recording in any required database. Data
shall include the name of the patient and completion of all other relevant data fields.
(9) Report moderate and severe adverse events following vaccination to the Vaccine
Adverse Event Reporting System (1-800-822-7967, http://vaers.hhs.gov/contact.htm).
(10) PROVIDER must report to Ethel Edwards, Assistant Nursing Director,
Immunizations, at (954) 467-4947 or ethel_edwards@doh. state. fl.us the number of
doses of vaccine that were not able to be used because the vaccine expiration date was
exceeded or the vaccine was wasted for other reasons. These doses must be disposed
of in accordance with state regulations for biological waste.
(11) PROVIDER agrees to provide an immunization record card to the vaccine
recipient or parent/guardian to provide a record of vaccination, to serve as an
information source if a Vaccine Adverse Event Reporting System report is needed, and
to serve as a reminder of the need for a second dose of vaccine (if necessary).
Immunization cards will be included in each shipment of vaccine.
(12) PROVIDER shall maintain confidentiality of all data, files, and records, including
client records related to the services provided pursuant to this Agreement and shall
comply with state and federal laws, including, but not limited to, Sections 384.29,
381.004, 392.65, and 456.057, Florida Statutes. Procedures must be implemented by
the PROVIDER to ensure the protection and confidentiality of all confidential matters.
These procedures shall be consistent with the Department of Health Information Security
and Privacy Policy 2007, which is incorporated herein by reference and the receipt of
which is acknowledge by the PROVIDER upon execution of this Agreement. The
PROVIDER shall adhere to any amendments to the BCHD's security requirements
provided to it during the period of this Agreement. The PROVIDER must also comply
with any applicable professional standards of practice with respect to client
confidentiality.
(13) PROVIDER agrees to assess each client's need for the vaccine by using a
screening questionnaire supplied by the BCHD. The screening questionnaire will assist
the paramedics to assess each client's health status, allergies, and reactions to previous
immunizations.
(14) Health Insurance Portability Act of 1996 (HIPAA).
a. Where applicable, the parties shall comply with HIPAA as well as all regulations
promulgated thereunder (45 CFR Parts 160, 162, and 164.)
b. Where applicable, the parties incorporate by reference the operative obligations of
the respective parties specified in 45 CFR §§ 164.502(e) and 164.504 (e, f, and g,
and subdivisions thereunder applicable) of HIPAA privacy regulations, only insofar as
either individual party is a business associate as defined in 45 CFR §160.103 for
purposes of this Agreement. This provision for HIPAA business associate obligations
shall remain in effect as long as the business associate has possession of protected
health information received from the other party. This HIPAA business associate
provision survives termination of this Agreement.
ARTICLE III
INDEMNIFICATION
BCHD and PROVIDER each agree to be fully responsible for its own respective acts of
negligence, or its employees' and/or agents' acts of negligence when acting within the scope of
their employment or agency, and BCHD and PROVIDER each respectively agree to be liable for
any damages resulting from its own negligence to the extent and limits permitted by Section
768.28, Florida Statutes. Nothing herein is intended to serve as a waiver of sovereign immunity
by any provider to whom sovereign immunity may be applicable. Nothing herein shall be
construed as consent by either party to be sued by third parties arising out of any contract.
ARTICLE IV
RELATIONSHIP
Nothing herein shall create to be construed to create an employer -employee, agency, joint
venture, or partnership relationship between the parties.
ARTICLE V
MODIFICATION AND AMENDMENT
No modification, amendment or alteration in the terms or conditions contained herein shall be
effective unless contained in a written documents prepared with the same or similar formality as
this Agreement and executed by an authorized representative of both parties.
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ARTICLE VI
ALL TERMS AND CONDITIONS INCLUDED
This Agreement contains all the terms and conditions agreed upon by the parties.
There are no provisions, terms, conditions, or obligations other than those contained herein,
and the Agreement shall supersede all previous communications, representations, or
agreements, either verbal or written, between the parties. if any term or provision of the
Agreement is found to be illegal or unenforceable, the remainder of the Agreement shall
remain in full force and effect and such term or provision shall be stricken.
ARTICLE VII
TERM AND TERMINATION
(1) The term of this Agreement shall begin on the date it is fully executed by both parties
and shall continue for a period of one (1) year from that date and shall be
automatically renewed for a one (1) year consecutive term unless either party
requests in writing a change of the termination date of this Agreement.
(2) This Agreement may be terminated by either party by submitting notice of such
intent in writing to the individuals and addresses identified below at least 30 days in
advance.
In witness thereof, the parties hereto have caused this 5 page Agreement to be executed
by their undersigned officials as duly authorized.
BROWARD COUNTY HEALTH
DEPARTMENT
By:
Paula M. Thagi, MD, MPH
Director
780 SW 24th Street
Fort Lauderdale, Florida 33315
Date:
CITY OF TAMARAC
By: (.
Je L. Uiller
City Manager
City of Tamarac
7525 NW 88th Avenue
Tamarac, Florida 33321
Date:��2�
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Exhibit A
STATE OF FLORIDA
DEPARTMENT OF HEALTH
BUREAU OF EMERGENCY MEDICAL SERVICES
CERTIFICATION OF TRAINING
as medical director of
a Florida licensed EMS provider,
hereby verify that the following paramedics have been trained to administer immunizations in
accordance with the requirements of Section 401.272(2)(b), Florida Statutes and 64J-1.004(5) Florida
Administrative Code:
Name
1
2.
3.
4.
5.
6.
7.
Signature.
Florida Medical License number
STATE OF FLORIDA
COUNTY OF
Certification Number
Sworn to (or affirmed) and subscribed before me this day of ,
20 , by . Personally Known OR
Produced Identification
(Seal) My Commission Expires
Type of Identification.
Signature of Notary
DH 1256, 12/08