HomeMy WebLinkAboutContract 56661 CSC No.56661
DocuSign Envelope ID:997A818F-27CE-4FE0-6471-5A151 FB31A4D
MEMORANDUM OF UNDERSTANDING
REGARDING SHARING AND PROTECTION OF PATIENT CARE DATA
This Memorandum of Understanding("MOU")sets forth the understanding regarding the sharing of patient care
data between the Metropolitan Area EMS Authority(hereinafter"MAEMSA")and its Medical Director,located at 2900
Alta Mere Dr.Fort Worth,TX 76116, and the City of Fort Worth(hereinafter"City"),the First Responding Organization
("FRO"), located at 505 W.Felix Street Fort Worth,TX 76115.
WHEREAS,under the state rules and the Restated Interlocal Cooperative Agreement("RICA"), City is obligated
to provide patient care data to the Medical Director as requested for purposes including but not limited to: certification of
personnel; establishing equipment requirements for first responder vehicles;and monitoring the quality of patient care; and
WHEREAS,MAEMSA is required to maintain such data in compliance with state and federal law;
NOW THEREFORE,the parties state their shared understandings at to such matters as follows:
I. PURPOSE
This Memorandum of Understanding delineates the responsibilities of each party with regard to the sharing of patient care
data collected by City. The purpose is to provide assurances to City regarding MAEMSA's compliance with patient care
data confidentiality,privacy, and security with the requirements of the HIPAA Rules and Texas state law.
II. JOINT ACKNOWLEDGEMENTS
The parties recognize that under the RICA and 22 TAC § 197.2(a),Dr. Veer Vithalani is the System Medical Director for
City,MedStar, and all EMS FROs in the EMS system and is therefore responsible for all aspects of the operation of the
EMS system concerning the provision of medical care. The Medical Director requires access to the records of all
medically related aspects of the operation of the EMS system in order to perform his statutory duties.
As the Medical Director for all EMS providers in the system,under 22 TAC § 197.3(A),he must be actively involved in
(1)the training and/or continuing education of all MAEMSA system EMS personnel under his direct supervision, at their
respective levels of certification, and(2)the medical audit,review,and critique of the performance of EMS personnel
under his or her direct supervision.
Under 22 TAC § 197.3(B),he is required to: (1)direct an effective system audit and quality assurance program; (2)
develop and implement a comprehensive mechanism for management of patient care incidents,including patient
complaints,allegations of substandard care, and deviations from established protocols and patient care standards; and(3)
determine standards and objectives for all medically related aspects of the operation of the EMS system,including the
inspection, evaluation, and approval of the system's performance specifications.
M. RESPONSIBILITIES OF CITY
City agrees to provide the MAEMSA Medical Director with all data related to the medical aspects of its EMS operations,
including but not limited to patient care provided by City under the delegation, direct or standing medical orders of the
Medical Director,including the protocols thereof. Such data shall include but is not limited to electronic patient care
reports ("ePCR"),paper patient care reports,patient care worksheets,any and all patient information collected by City
during patient care and while performing medical evaluation(s).
IV. RESPONSIBILITIES OF MAEMSA
MAEMSA agrees and understands that patient care data provided by City is protected health information("PHI")as defined
by 45 CFR § 160.103. MAEMSA shall comply with the Health Insurance Portability and Accountability Act of 1996
("HIPAA") and the implementing standards for privacy and security of identifiable health information, located at 45 CFR
§ 160 and§164, Subparts A and E(the"Privacy Rule")and Part§ 164, Subparts A and C(the"Security Rule");as amended
by the Health Information,Technology for Economic and Clinical Health(HITECH)Act,Title XIII of Division A and Title
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
DocuSign Envelope ID:997A818F-27CE-4FE0-B471-5A151FB31A4D
IV of Division B of the American Recovery and Reinvestment Act of 2009 ("ARRA"), and the HIPAA Omnibus Final
Rule, 78 Fed.Reg. 5566(Jan.25,2013)(collectively the"HIPAA Rules").
V. PERMITTED USES AND DISCLOSURES
MAEMSA shall only use and disclose PHI obtained from City for those purposes permitted for a Covered Entity(as defined
by 45 CFR § 160.103) or required under the RICA or state law, and only in a manner that is consistent with 25 TAC §
157.14, the RICA, this MOU, and the HIPAA Privacy Rule and Security Rule. MAEMSA may use and disclose de-
identified PHI at its sole discretion if the de-identification is in compliance with 45 CFR§ 164.502(d),and the de-identified
health information meets the standard and implementation specifications for de-identification under 45 CFR§ 164.514(a)
and(b).
VI. TERMINATION
This MOA shall remain in effect and govern the relations of the parties unless and until either MAEMSA or City gives the
other thirty(30)days written notice that this MOU no longer reflects its understanding and that it wishes to withdraw
from this MOU.
[signature page follows]
DocuSign Envelope ID:997A818F-27CE-4FE0-B471-5A1 51 FB31A4D
Agreed to on this Day of 2021 the effective date.
CITY OF FORT WORTH: METROPOLITAN AREA EMS
AUTHORITY:
DoeuSigned by:
By:valerieW I
Name: Valerie Washington By: Stl%r lit,
Title: Assistant City Manager Name: Kenneth J. Simpson
Nov 12 2021 Title: Chief Executive Officer
Date:
DoeuSigned by:
By:
Name:
Title: MAEMSA Medical Director
11/4/2021
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ame: James E. Davis ame: RonalGonzales K���EXpSoap
itle: Chief, Fort Worth Fire Department itie: Acting City Secretary
CONTRACT COMPLIANCE MANAGER:
Approved as to Form and Legality: By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract,
including ensuring all performance and reporting
requirements.
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ame: Christopher Austria By:Ma rk Ra uscher(N ov 15,202109:17 CST)
itle: Assistant City Attorney Name:Mark Rauscher
Title:Assistant Fire Director
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX