HomeMy WebLinkAboutContract 63567Docusign Envelope ID: ACA6E9F7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract ID# FY2025-GME2-01344.1-NP
CSC No. 63567
CITY OF FORT 'WORTH
ASSIGNMENT
WHEREAS, the Metropolitan Area EMS Authority dba MedStar Mobile Healthcare ("Assignor")
and The University of Texas Southwestern Medical Center ("UTSW") entered into a Program
Letter Agreement, dated effective July 1, 2023 (the "PLA") concerning the rotation of the
Emergency Medical Services Fellowship Program Physician Trainees from UTSW to Assignor;
WHEREAS, Assignor, the City of Fort Worth ("Assignee"), and UTSW have agreed to amend
the PLA as set forth herein; and
WHEREAS, Assignor desires to assign, and Assignee desires to assume, the PLA, as amended
(collectively, the "Contract"), with the consent of UTSW;
NOW, THEREFORE, Assignor, Assignee, and UTSW agree as follows:
I. AMENDMENT
The PLA is hereby amended as follows:
Section III. B.S. is hereby amended and restated in its entirety and will hereafter be read as follows:
"Maintain in force during the term of this Agreement, and provide proof of such upon
reasonable request, general liability insurance. Alternatively, Facility may, at its discretion,
elect to self -insure provided that such self-insurance meets the applicable statutory
requirements and guidelines set forth by state law, including but not limited to chapter 2259
of the Texas Government Code."
Section IV. B. entitled "Term and Termination" is hereby amended and restated in its entirety and
will hereafter be read as follows:
"This Agreement shall become effective on July 1, 2023 and continue in effect until June
30, 2026 unless terminated earlier by either party in accordance with this Article W.B."
Section V. G., entitled "Notices" is hereby amended to replace the information referring to
Assignor with information relevant to Assignee, as follows:
Jeffrey L. Jarvis, MD, S, EMT-P
Supervising Faculty Member
100 Fort Worth Trail
Fort Worth, Texas 76102
Attention: Laura Long
OFFICIAL RECORD
With copy to: City Attorney's Office CITY SECRETARY
City Hall FT. WORTH, TX
100 Fort Worth Trai I
Fort Worth, Texas 76IO2
Assignment Page 1 oC5
Docusign Envelope ID: ACA6E9F7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract ID# FY2025-GME2-01344.1-NP
The PLA is further amended such that all references to Facility shall refer to the City of Fort Worth.
All other terms of the PLA remain in full force and effect.
II. ASSIGNMENT
Assignor hereby assigns to Assignee all of its rights, duties, and obligations under the
Contract, between Assignor and UTSW. Assignee agrees to assume and perform all duties and
obligations required of Assignor under the terms of the Contract, as amended.
This Assignment constitutes the entire agreement between Assignor and Assignee with
respect to the subject matter hereof. No modification of any provision of this Assignment shall be
Assignment Page 2 of
Docusign Envelope ID: ACA6E9F7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract ID# FY2025-GME2-01344.1-NP
effective unless in writing and signed by Assignor and Assignee. This Assignment shall inure to
the benefit of and be binding upon Assignor and Assignee and their respective successors and
assigns. This Assignment shall be governed by the laws of the State of Texas, without application
of principles of conflicts of law.
This Assignment may be executed in one or more counterparts each of which shall be
deemed an original but all of which together shall constitute one and the same instrument. Signed
signature pages may be transmitted by facsimile or e-mail, and any such signature shall have the
same legal effect as an original.
Dated the day of —ij i� 2025.
Metropolitan Area EMS Authority dba MedStar
Mobile Healthcare
(Assignor)
By. /
Print: Franc Gresh
Title: Interim Chief Executive Officer
Assignment Page of
Docusign Envelope ID: ACA6E9F7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract IN FY2025-GME2-01344.1-NP
City of Fort Worth (Assignee):
kv, Awl
By:
Valerie Washington (Jun 30, 2025 09:31 CDT)
Name: Valerie Washington
Title: Assistant City Manager
Date: 06/30/2025
CITY OF FORT WORTH INTERNAL ROUTING PROCESS:
Approval Recommended:
By:
Name: Jeffrey Jarvis
Title: EMS Chief Medical Officer
Approved as to Form and Legality
By:
Name:
Taylor Paris
Title:
Assistant City Attorney
Contract Authorization:
M&C:
N/A
Contract Compliance Manager:
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.
By:
Name: Dwayne Howerton
Title: AD Office of Medical
Director
4 vovnu a
' o�FORt�d�a
Boa
c° l.a Op-I�d
City Secretary:
oA 000 00 4�
By.
Name: Jannette S. Goodall
Title: City Secretary
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page 4 of 5
Docusign Envelope ID: ACA6E9F7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract ID# FY2025-GME2-01344.1-NP
NOTARY ACKNOWLEDGEMENT /
On the (e7 day of Yj N 4 2025, personally appeared
Z4 6665h , who acknowledged to me that (s)he is the Interim Chief Executive Officer
of Metropolitan Area EMS Authority dba MedStar Mobile Healthcare ("Assignor"), and that (s)he
executed this document for the purposes and consideration contained herein.
Metropolitan Area EMS Autho ' db e Sta obile
Healthcare
By:
Print: Frank Gresl ��
Title: Interim Chief Executive Officer
SUBSCRIBED TO before me on this day of -ZTuV1 e 72025.
MONICACRUZ
*= My Notary ID # 126504816
"F Expires May 20, 2028
Notary ublic in and ouhto f
My commission Expires: 1?
Assignment tames of5
Docusign Envelope ID: ACA6E9F7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract ID# FY2025-OME2-01344.1-NP
CONSENT TO ASSIGNMENT
The University of Texas Southwestern Medical Center hereby consents to the assignment
of the Program Fetter of Agreement dated effective July 1, 2023, as amended by the Amendment
executed concurrently herewith (collectively, the "Contract"), between The University of Texas
Southwestern Medical Center and the Metropolitan Area EMS Authority dba MedStar Mobile
Healthcare ("Assignor") to City of Fort Worth ("Assignee"). The University of Texas
Southwestern Medical Center acknowledges and agrees that Assignee shall assume all rights,
duties, and obligations of Assignor under the Contract, as amended, provided that Assignee
complies with all terms of the Contract.
The University of Texas Southwestern
Medical Center
k6A� Signed bby:
By: i 1 NLv
Name: Sherry C—.Y4Ufff g,`PLD.
Title: Vice Provost and Senior Associate Dear
For Education - U'1'SW Medical School
Date: 5/21/2025
DoeuSigned by:
5
""':"K
r`C:fi7RAdna
Kathy Rinnert, M.D.
Program Director
FSigned by,
A,U� �4�
'1v' AF7e aA2:!
Michael Green, M.D.
Designated Institutional Official
Assignment Page 6 of 5
Docusign Envelope ID: ACABE9F7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract Ibf0ar-I�?-01344-NP
PROGRAM LETTER AGREEMENT FOR GRADUATE MEDICAL EDUCATION
This Program Letter Agreement for Graduate Medical Education ("Agreement") is made and
entered into to be effective as of July 1, 2023 ("Effective Date") by and between The University
of Texas Southwestern Medical Center, an agency of the State of Texas and institution of higher
education located at 5323 Harry Hines Blvd., Dallas, TX 75390 ("Sponsoring Institution"), and
The Metropolitan Area EMS Authority dba Medstar Mobile Healthcare Medstar, a
governmental administrative agency created by the interlocal agreement of its member cities
under Title 7, Chapter 791 of the Texas Government Code, located at 2900 Alta Mere Dr., Fort
Worth, TX 76116 ("Facility"). This Agreement sets forth the responsibilities of each party in the
clinical education of trainees enrolled in Graduate Medical Education in the Sponsoring
Institution's Emergency Medical Services Fellowship program ("Program").
Whereas, Sponsoring Institution trains physicians in its Program ("Trainees");
Whereas, Facility participates in the training of Trainees by providing residents and/or fellows in
the Program with a clinical educational experience utilizing appropriate facilities and personnel;
Whereas, the Accreditation Council for Graduate Medical Education ("ACGME") requires the
Sponsoring Institution to be responsible for the duality of all educational experience and to retain
authority over Trainees' activities;
Now, therefore, for and in consideration of the mutual covenants and conditions herein contained,
and for other good and valuable consideration, the receipt and sufficiency of which is hereby
acknowledged by, the parties hereby agree to the terms and conditions as follows:
I. DESIGNATED OFFICIALS
The Sponsoring Institution's Program Director and the faculty member assuming both educational
and supervisory responsibilities for Trainees (the "Supervising Faculty Member") are designated on
the attached Exhibit A, which is incorporated herein by reference.
II. POLICIES AND PROCEDURES
A. Supervision of Trainees. Trainees will function under supervision of a designated
Supervising Faculty Member according to the defined goals and objectives of the Program
provided in the attached Exhibit A, and as applicable accreditation standards require. Tile
Supervising Faculty Member will be solely responsible for direct clinical supervision of
the Trainees and shall control the details of the medical tasks performed by the Trainees in
compliance with applicable accreditation standards.
B. Compliance with Protocols. Both parties hereto agree that, to the extent applicable,
Trainees will comply with the policies and procedures of Sponsoring Institution. While
on the premises of Facility, Trainees will comply with the applicable policies and
procedures of Facility. Due process procedures will be followed by Sponsoring
Institution.
C. Exclusive Control. Facility will retain the exclusive control of its prerises, operations, and all
aspects of its patient services, other than the practice of medicine by the faculty and Trainees.
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Ill. RESPONSIBILITIES
In order to accomplish the goals and objectives of the Program provided in the attached Exhibit and
according to the policies and procedures described in Article II above, the parties agree as follows:
A. Sponsoring Institution agrees to:
1. Plan, implement, and administer the curriculum of the Program.
2. Provide a program director (the "Program Director") to act as liaison between
Sponsoring Institution and facility and to coordinate the academic and clinical experience
of Trainees. The Program Director will have ultimate responsibility and final authority for
the educational content of the Program and the assignment of Trainees.
Contact the Facility at reasonable intervals to evaluate the Trainees and to determine if the
Facility is fulfilling its obligation to the Trainees.
4. Provide an appropriate instrument(s) for evaluation of the clinical experience of Trainees
("Evaluation Forms"),
5. Maintain in force during the term of this Agreement for any incidents occurring during the
term of this Agreement professional medical liability coverage for Trainees in an amount
of $500,000 per occurrence and $1,500,000 aggregate, pursuant to The University of Texas
System Professional Medical Malpractice Self -Insurance Plan and under authority of
Section 59.01, Texas Education Code.
6. To the extent authorized by the Constitution and the laws of the State of Texas, indemnify
and hold harmless facility, its directors, officers, agents, and employees against any and
all claims, demands, damages, liabilities, and costs incurred by Facility which directly or
indirectly result from, or arise in connection with, any negligent acts or omissions of
Sponsoring Institution, its Trainees, faculty, agents, or employees in performing
Sponsoring Institution's obligations hereunder. Nothing in the provision shall otherwise
limit or waive any other immunity available to Sponsoring Institution or its agents and
employees.
B. Facility agrees to:
1. Designate one member of its medical staff as the Supervising Faculty Member who will
assume administrative, educational, and supervisory responsibility for the Trainees
in the Program while at the Facility. The Supervising Faculty Member for the Program
will complete the Evaluation Form at the conclusion of the rotation for each Trainee and
provide such Evaluation Form to Sponsoring Institution.
2. Provide opportunities for specified clinical experiences under appropriate physician
supervision and in areas where Trainees are assigned.
3. Obtain and maintain all licenses required for Facility and assure that all Facility personnel
are appropriately licensed. Provide sufficient staff and related resources necessary to
implement the clinical learning experiences of the Trainees.
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U1' Southwestern Contract I�dT`UT6.1 �F� 01344-NP
4. Assist the Program Director in coordination of (a) orientation of the Trainees to the
Facility; (b) planning of clinical and learning experiences; and (c) orientation of and
supervision by faculty at the Facility.
5. Maintain in force during the term of this Agreement, and provide proof of such upon
reasonable request, general liability insurance.
6. Indemnify and hold harmless The University of Texas System Board of Regents,
Sponsoring Institution, its Trainees, directors, officers, agents, and employees against any
and all claims, demands, damages, liabilities, and costs incurred by Sponsoring
Institution which directly or indirectly result from, or arise in connection with, the
negligent acts or omissions of Facility, its Supervising Faculty Member or other faculty,
agents, or employees of Facility, in performing Facility's obligations hereunder. Nothing
in the provision shall otherwise limit or waive any other immunity available to Facility
or its agents and employees.
C. Sponsoring Institution and Facility shall mutually agree to:
1. Identify the number of Trainees assigned to the Facility for clinical rotations and the
dates of assignment of Trainees for clinical rotations.
2. Inform each other of changes in personnel actively involved in the Program.
3. Decide to discontinue the clinical rotation term of a Trainee for cause following
consultation between appropriate representatives of both parties, including the Program
Director and Supervising Faculty Member. Ultimately Facility may require permanent
withdrawal of any Trainee from the clinical educational experience if and when it
determines, in its sole discretion and judgment there is cause to do so.
IV. DURATION OF GRADUATE MEDICAL EDUCATIONAL EXPERIENCE
A. Duration of Rotation. Duration of the Trainees' rotation with Facility is set forth on
Exhibit A, subject to the terms and conditions set forth below in Article IV.
B. B. Term and Termination. This Agreement shall become effective on July 1, 2023 and
continue in effect until June 30, 2033 unless terminated earlier by either party in
accordance with this Article W.B.
Termination without Cause. Either party upon ninety (90) days advance written
notice to the non -terminating party may terminate this Agreement without cause.
If such notice is given, this Agreement shall terminate either (a) at the end of such
ninety (90) days; or (b) after all Trainees assigned to a rotation at the time such
notice is given have completed their respective rotations, whichever event occurs
last.
2. Termination for Default. Either party may terminate this Agreement effective
immediately and without penalty if and when it determines, in its sole discretion
and judgment, that the other party is not complying with terms of this Agreement.
3. Automatic Termination. In the event that either party enters bankruptcy, takes an
assignment for the benefit of creditors, becomes subject to receivership, or is
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LIT Southwestern Contract l��01�t1�4'r1 �'"o I344-NIA
otherwise reasonably deemed insolvent, then this Agreement shall terminate at the
option of the other party.
V. MISCELLANEOUS
A. Privacv and Securitv Obligations. The parties acknowledge, understand, and agree that
this Agreement may be subject to (1) obligations and other regulations implementing the
Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), the
administrative regulations and/or guidance which has been issued or may in the future be
issued pursuant to HIPAA, including but not limited to federal regulations relating to the
confidentiality, integrity, and accessibility of individually identifiable health information
(whether created, maintained, accessed, stored or transmitted electronically or otherwise)
requiring covered entities to comply with the privacy and security standards adopted by
the U.S. Department of Health and Hurnan Services, 45 C.F.R. parts 160 and 164, subparts
A and E ("Privacy Rule") and 45 C.F.R. parts 160, 162, and 164 subpart C ("Security
Rule"), and Texas state laws pertaining to medical privacy (collectively, "Privacy
Laws") and (2) the requirements of the Health Information Technology for Economic and
Clinical Health Act of 2009 ("HITECH Act").
B. Compliance with Privacv and Securitv Obliaations. The Privacy and Security Rules
require covered entities to ensure that business associates who receive, access, store, or
transmit confidential information in the course of providing services on behalf of covered
entities comply with certain obligations regarding the confidentiality, integrity, and availability
of health information as defined in the aforementioned regulations. Accordingly, the parties
agree to comply with those regulations as they may apply in the course of providing services
hereunder. The parties agree to (1) comply with all Privacy Laws and the HITECH Act, as
applicable to this Agreement, and (2) to negotiate in good faith and to execute any amendment
to this Agreement that is required for the terms of this Agreement to comply with applicable
Privacy Laws and/or the HITECH Act. In the event the parties are unable to agree on the terms
of an amendment to this Agreement pursuant to this paragraph within thirty (30) days of the
date the amendment request is delivered by one party to the other party (the "Renegotiation
Period"), this Agreement may be terminated by either party upon written notice to the other
party.
C. Discrimination. The Program and all related activities shall be conducted in a manner that does not
discriminate against any person on a basis prohibited by applicable law, including but not
limited to: race, color, national origin, religion, sex, sexual orientation, age, veteran status, or
disability.
D. Assignment. Neither party hereto may assign this Agreement without the prior written
approval of the non -assigning party.
E. Entire Agreement; Amendment. This Agreement and any attached Exhibit(s) hereto supersede
all prior agreements, written or oral, between Sponsoring Institution and Facility and will
constitute the entire understanding between the parties with respect to the subject matter hereof.
This Agreement and each of its provisions will be binding upon the parties and may not be
waived, modified, nor amended unless reduced to a writing signed by an authorized
representative of each party.
F. Captions. The caption of sections and subsections in this Agreement are for convenience only
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UT Southwestern Contract I�TFT'LJI'-CiM-UT3.T NFL"01344-NP
and will not be considered or referred to in resolving questions of interpretation or construction.
G. Notices. Except as otherwise provided by this Section, all notices, consents, approvals,
demands, requests or other communications provided or permitted under this Agreement will
be in writing and sent via certified snail, hand delivery, overnight courier, facsimile
transmission (to the extent a facsimile number is set forth below), or email (to the extent an
email address is set forth below) as provided below, and notice will be deemed given (i) if
delivered by certified mailed, when deposited, postage prepaid, in the United States mail, or
(ii) if delivered by hand, overnight courier, facsimile (to the extent a facsimile number is set
forth below) or email (to the extent an email address is set forth below), when received:
If to Sponsoring Institution: The University of Texas Southwestern Medical Center
5323 Harry Hines Blvd. Dallas,
TX 75390-9013
Attention: Executive VP for Business Affairs
with copy to: The University of Texas Southwestern Medical Center
5323 Harry Hines Blvd.
Dallas, TX 75390-9056
Attention: Director, Legal Contract Services
Fax:214-648-0845
Email: contracts((i)utsouthwestern.edtr
If to Facility: Jeffrey L. Jarvis, MD, MS, EMT-P
Supervising Faculty Member
2900 Alta Mere Drive
Fort Worth, TX 76116
Attention: Laura Long
with copy to: MedStar Mobile Healthcare
2900 Alta Mere Dr.
Fort Worth, TX 76116
Attention: General Counsel
Email: ComnlianceO.inedstar9l lore
or other person or address as may be given in writing by either party to the other in
accordance with this Section.
H. Governing Law and Venue. This Agreement shall be governed by the laws of the State of Texas
without regard to its conflict of laws provisions.
1. Breach of Contract Claims,. To the extent that Chapter 2260, Texas Govel-nmew Code, is
applicable to the Agreement and is not preempted by other applicable law, the dispute
resolution process provided for in Chapter 2260 and the related rules adopted by the Texas
Attorney General pursuant to Chapter 2260, will be used by Sponsoring Institution and Facility
to attempt to resolve any claim for breach of contract made by Facility that cannot be resolved
in the ordinary course of business. The chief business officer of Sponsoring Institution will
examine Facility's claim and any counterclaim and negotiate with Facility in an effort to resolve
such claims. The parties specifically agree that (i) neither the execution of the Agreement by
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Docusign Envelope ID: ACA6EgF7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract I6 Fyj('2g"f`M (� :fit` l�'-0I144-NP
Sponsoring Institution nor any other conduct, action or inaction of any representative of
Sponsoring Institution relating to the Agreement constitutes or is intended to constitute a
waiver of Sponsoring Institution's or the state's sovereign immunity to suit; and (d) Sponsoring
Institution has not waived its right to seek redress in the courts.
Public Information. Sponsoring Institution strictly adheres to all statutes, court decisions and
the opinions of the Texas Attorney General with respect to disclosure of public information
under the Texas Public Infor-mation Act ("TPIA"), Chapter 552, Texas Government Code. I n
accordance with Section 552.002 of TPIA and Section 2252.907, Texas Government Code, and
at no additional charge to Sponsoring Institution, Facility will make any information created
or exchanged with Sponsoring Institution pursuant to the Agreement (and not otherwise exempt
from disclosure under TPIA) available in a format reasonably requested by Sponsoring Institution
that is accessible by the public.
K. Press Releases. Facility will not make any press releases, public statements, advertisement, or
other promotional materials using the name or logo of Sponsoring Institution or the name of
any Sponsoring Institution employee, or referring to the Agreement, without the prior written
approval of Sponsoring Institution. Requests for prior written approval of any such releases,
public statements, advertisements, or other promotional materials must be directed to
Sponsoring Institution's Executive Vice President - Institutional Advancement. Sponsoring
Institution will not make any press releases, public statements, advertisement, or other
promotional materials using the name or logo of Facility or the name of any Facility employee,
or referring to the Agreement, without the prior written approval of Facility. Requests for prior
written approval of any such releases, public statements, advertisements, or other promotional
materials must be directed to Facility's Chief Strategic Integration Officer.
L. Severability. In case any provision of this Agreement will, for any reason, be held invalid or
unenforceable in any respect, the invalidity or unenforceabllity will not affect any other
provision of this Agreement, and this Agreement will be construed as if the invalid or
unenforceable provision had not been included.
M. Waiver. The failure of any party to exercise any of its rights under this Agreement for a breach
thereof shall not be deemed to be a waiver of such rights, and no waiver by any party, whether
written or oral, expressed or implied, of any rights under or arising from the Agreement shall
be binding on any subsequent occasion; and no concession by any party shall be treated as an
implied modification of the Agreement unless specifically agreed in a writing signed by
authorized representatives of both parties.
N. Force Maieure. Neither party shall be liable or deemed to be in default for any delay or failure
in performance under this Agreement or interruption of service resulting, directly or indirectly,
due to causes beyond its reasonable control, including but not limited to: acts of God, strikes,
epidemics, war, riots, flood, tire, sabotage, or any other circumstance of like character.
0. Counterparts. This Agreement may be executed in multiple counterparts, each of which shall
be deemed an original for all purposes and all of which shall constitute one and the same
instrument for all purposes.
P. Limitations. THE PARTIES ARE AWARE THAT THERE ARE CONSTITUTIONAL AND
STATUTORY LIMITATIONS ON THE AUTHORITY OF SPONSORING INSTITUTION (A STATE
AGENCY) TO ENTER INTO CERTAIN TERMS AND CONDITIONS THAT MAY BE PART OF THE
AGREEMENT, INCLUDING, BUT N91- LIMITED TO, THOSE -IYRN S AND M UTIONS RELATING TO
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UT Southwestern Contract l34a-NP
LIENS ON SPONSORING INSTITUTION'S PROPERTY; DISCLAIMERS AND LIMITATIONS OF
WARRANTIES; DISCLAIMERS AND LIMITATIONS OF LIABILITY FOR DAMAGES; WAIVERS,
DISCLAIMERS AND LIMITATIONS OF LEGAL RIGHTS, REMEDIES, REQUIREMENTS AND
PROCESSES; LIMITATIONS OF PERIODS TO BRING LEGAL ACTION; GRANTING CONTROL OF
LITIGATION OR SECCLFIVENT TO ANOTI-IER PARTY; LIABILITY FOR ACTS OR OMISSIONS OF THIRD
PARTIES; PAYMENT OF ATTORNEYS' FEES; DISPUTE RESOLUTION; INDEMNITIES; AND
CONFIDENTIALITY (COLLECTIVELY, THE "LIMITATIONS"), AND TERMS AND CONDITIONS
RELATED TO THE LIMITATIONS WILL NOT BE BINDING ON SPONSORING
INSTITUTION EXCEPT TO THE EXTENT AUTHORIZED BY THE LAWS AND
CONSTITUTION OF THE STATE OF TEXAS.
IN WITNESS WHEREOF, authorized representatives of Sponsoring Institution and Facility have
executed this Agreement as of the Effective Date.
Sponsoring Institution:
THE UNIVERSITY OF TEXAS
SOUTHWESTERN MEDICAL CENTER
FDocuSigned by:
tauk c,s fit.. Giv slo oa )
cry•cic
Charles M. Gri,ns�cuurgy,V.D.
Vice Provost and Senior Associate
Dean for Education
UT Southwestern Medical School
Facility:
METROPOLITAN AREA EMS AUTHORITY
ko. FDocuSignnd by:
I 5IoArsbv,
K nnefi`'"nimpson
Chief Executive Ofhcer-
MAEMSA
FA
,�DacuSigned by��n �vu
�at2�e�ss�6F i a
Michael Green, MD
Interim Designated Institutional Official
DacuSigned by:
Iefii`e`�` y"Jar�rs MD M5 EMT-P
Facility Medical Director
Supervising Faculty Member
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UT Southwestern Contract Ib-`'5+� o'3aa-rrP
EXHIBIT A
Emergency Medical Services Fellowship Program Agreement
1. Persons Responsible for Education and Supervision.
Sponsoring Institution -Program Director: Kathy Rinnert, MD
Facility -Supervising Faculty Member: Jeffrey L. Jarvis, MD, MS, EMT-P
The above -mentioned people are responsible for the education and supervision of the Trainees
while rotating at Facility.
2. Responsibilities.
The Supervising Faculty Member at Facility must provide appropriate supervision of Trainees
in patient care activities and maintain a learning environment conducive to educating the
Trainees in the ACGME competency areas. The Supervising Faculty Member must evaluate
Trainee performance in a timely manner during each rotation or similar educational assignment
and document this evaluation at completion of the assignment.
The Supervising Faculty Member responsible for supervising the Trainees will:
I. Supervise Trainees doing clinical rotations at the Facility.
2. Provide educational objectives and goals for the rotations.
3. Evaluate Trainee performance at mid -rotation as well as end of rotation.
3. Content and Duration of the Educational Experiences.
Identifier PY Level Duration
Fellow PY1 8 weeks
The content of the educational experiences has been developed according to ACGME
Residency/Fellowship Program Requirements, and include the following goals and objectives:
Goals and Obiectives: Please see attachment.
Sponsoring Institution: Facility:
bo., cu5igned by: bacu5igned by:
ttn In t V1� r�
Kathy J. Rinnert, MD Jef�i'ey L. Jarvis, MD, MA EMT-P
Program Director Supervising Faculty Member
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Docusign Envelope ID: ACA6E9F7-72D2-4A34-A74D-4DFF90054330
UT Southwestern Contract loci Vi&gl `dMH"a' 4-.yl4W--01344dJP
Emergency Medical Services Fellowship Program
OVERALL EDUCATIONAL OBJECTIVES - PY1
PATIENT CARE AND PROCEDURAL SKILLS
Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the
treatment of health problems and the promotion of health.
Fellows must demonstrate competence in the practice of patient evaluation and treatment of patients
of all ages and genders requiring emergency medical services by:
1) Gathering accurate, essential information in a timely manner.
2) Evaluating and comprehensively treating acutely ill and injured patients in the pre -hospital setting.
3) Prioritizing and stabilizing multiple patients in the pre -hospital setting while performing other
responsibilities simultaneously.
4) Properly sequencing critical actions for patient care.
5) Integrating information obtained from patient history, physical examination, physiologic recordings,
and test results to arrive at an accurate assessment and treatment plan.
6) Integrating relevant biological, psychosocial, social, economic, ethnic, and familial factors into the
evaluation and treatment of their patients; and,
7) Planning and implementing therapeutic treatment, including pharmaceutical, medical device,
behavioral, and surgical therapies.
Fellows must be able to perform all medical, diagnostic, and surgical procedures considered essential
for the area of practice.
Fellows must demonstrate competence in the practice of technical skills for patients of all ages and
genders requiring emergency medical services by performing physical examinations relevant to the
practice of emergency medical services and performing the following KEY INDEX PROCEDURES:
(minimum requirements are in parenthesis)
1) Participate in a mass casualty/disaster triage at an actual event or drill (1).
2) Participate in a sentinel event investigation (1).
3) Conduct a quality management audit (1).
4) Participate in a mass gathering medical plan and its implementation (1).
5) Participate in the revision or development of an emergency medical services protocol (1).
6) Obtain vascular access in the prehospital setting (5).
7) Manage cardiac arrest in the pre -hospital setting (5).
8) Mange a compromised airway in the pre -hospital setting (5).
9) Provide direct medical oversight on -scene, or by radio or phone (100).
10) Participate in hazardous materials response training (1).
11) Participate in tactical EMS training (1).
12) Participate in confined space, technical rescue, or collapse/trench training (1); and,
13) Participate in vehicle rescue/extrication training (1).
MEDICAL KNOWLEDGE
Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological,
and social -behavioral sciences, as well as the application of this knowledge to patient care.
Fellows must demonstrate competence in their knowledge of the following:
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EMS Program Requirement N.A.I.
Docusign Envelope ID: ACA6E9F7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract
1) Clinical manifestations and management of acutely ill and injured patients in the pre -hospital setting.
2) Disaster planning and response.
3) Evidence -based decision making.
4) Procedures and techniques necessary for the stabilization and treatment of patients in the pre -
hospital setting.
5) Provision of medical care in mass gatherings.
6) Public safety answering points, dispatch centers, emergency communication centers' operation, and
medical oversight.
7) Experimental design and statistical analysis of data related to emergency medical services clinical
outcomes and epidemiologic research.
8) Models, function, management, and financing of emergency medical services systems.
9) Principles of quality improvement and patient safety; and,
10) Principles of epidemiology and research methodologies in emergency medical services.
PRACTICE -BASED LEARNING AND IMPROVEMENT
Fellows must demonstrate the ability to investigate and evaluate their care of patients, to appraise and
assimilate scientific evidence, and to continuously improve patient care based on constant self -
evaluation and lifelong learning.
Fellows must demonstrate competence in the following:
1) Systematic analysis of practice using quality improvement methods and implement changes with the
goal of practice improvement.
2) Locate, appraise, and assimilate evidence from scientific studies related to their patients' health
problems; and,
3) Demonstrate proficiency in the critical assessment of medical literature, medical informatics, clinical
epidemiology, and biostatistics.
INTERPERSONAL AND COMMUNICATION SKILLS
Fellows must demonstrate interpersonal and communication skills that result in the effective exchange
of information and collaboration with patients, their families, and health professionals.
Fellows must demonstrate competence in the following:
1) Ability to relate, with compassion, respect, and professional integrity, to patients and their families,
as well as other members of the health care team, sensitive issues, or unexpected outcomes,
including diagnostic findings, end of life issues and death, and medical errors;
2) Ability to work effectively as a member or leader of a health care team or other professional group.
3) Effective teaching techniques include teaching peers, emergency medical services personnel, other
health professionals, and patients.
4) Maintaining comprehensive, timely, and legible medical records; and,
5) Oral and written communication skills.
PROFESSIONALISM
Fellows must demonstrate a commitment to professionalism and an adherence to ethical principles.
Fellows must demonstrate:
1) A commitment to ethical principles pertaining to the provision or withholding of clinical care,
confidentiality of patient information, informed consent, and business practice.
re
EMS Program Requirement W.A.I.
Docusign Envelope ID: ACA6E9F7-72D2-4A34-A74D-4DFF9005133D
UT Southwestern Contract I�01�s
2) A commitment to lifelong learning and an attitude of caring derived from humanistic and
professional values.
3) High standards of ethical behavior, including maintaining appropriate professional boundaries and
relationships with other physicians, and avoiding conflicts of interest.
4) Respect, compassion, and integrity towards patients and other members of the health care team; and,
5) Sensitivity and responsiveness to a patient's culture, age, gender, and disabilities.
SYSTEM -BASED PRACTICE
Fellows must demonstrate an awareness of and responsiveness to the larger context and system of
health care, including the social determinants of health, as well as the ability to call effectively on other
resources to provide optimal health care.
Fellows must demonstrate competence in:
I ) Advocating for quality patient care and optimal patient care systems.
2) Appropriate resource allocation and utilization.
3) Cooperative interactions with other care providers
4) Interprofessional team participation for the enhancement of patient safety and the improvement of
patient care quality; and,
5) Leadership skills in the coordination and integration of care across a variety of disciplines and
provider types.
EMS Program Requirement W.A.I.