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HomeMy WebLinkAboutContract 63603Docusign Envelope ID: 053DCDFE-B6BC-4A92-A11F-D07EB9B92EBD CSC No. 63603 CITY OF FORT WORTH ASSIGNMENT WHEREAS, the Metropolitan Area EMS Authority dba MedStar Mobile Healthcare ("Assignor") and Tarrant County Hospital District d/b/a JPS Health Network d/b/a John Peter Smith Hospital ("JPS") entered into a Program Letter Agreement, dated effective June 14, 2024 (the "PLA") concerning the rotation of the Emergency Medical Services Residency/Fellowship Program Physician Trainees from JPS to Assignor; WHEREAS, Assignor, the City of Fort Worth ("Assignee"), and JPS 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 JPS; NOW, THEREFORE, Assignor, Assignee, and JPS agree as follows: I. AMENDMENT The PLA is hereby amended as follows: Section VIII. D.., entitled "Liability Coverage" is hereby amended to include the following: "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 VIII. L., entitled "Notices" is hereby amended to replace the information referring to Assignor with information relevant to Assignee, as follows: 100 Fort Worth Trail Fort Worth, Texas 76102 With copy to City Attorney's Office The ALA is further amended such that all references to FACILITY or MedStar Mobile Healthcare shall refer to the City of Fort Worth. All other terms of the PLA remain in full force and effect. OFFICIAL RECORD CITY SECRETARY H. ASSIGNMENT FT. WORTH, Tx Assignor hereby assigns to Assignee all of its rights, duties, and obligations under the Contract, between Assignor and JPS. Assignee agrees to assume and perform all duties and obligations required of Assignor under the terms of the Contract, as amended. Assignment Page 1 of 5 Docusign Envelope ID: 053DCDFE-B6B0-4A92-A11F-D07EB9B92EBD 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 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 73Z�9b—__ 2025. Metropolitan Area EMS Authority dba MedStar Mobile Healthcare (Assignor) By:� Print: Frank s Title: Interim Chief Executive Officer Assignment Page 2 of Docusign Envelope ID: 053DCDFE-B6BC-4A92-A11F-DNE139692EBD City of Fort Worth (Assignee): VOL WAA--X-1- By: Valerie Washington (Jul2, 202510:50 CDT) ' Name: Valerie Washington Title: Assistant City Manager Date: 07/02/2025 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 Assignment 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. -Z By: �v Name: Dwayne Howerton Title: AD Office of Medical Director City Secretary: aQU aoFFORrka v°gig ° o9-w duo o=o �\�p�Cl;s�, 3dQn nEoAsabp CJ` By: Name: Jannette S. Goodall Title: City Secretary OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 3 of 5 Docusign Envelope ID: 053DCDFE-B6BC-4A92-A11F-D07EB91392EW NOTARY ACKNOWLEDGEMENT n the 2( day of jV,� 2025, personally appeared ho acknowledged to me that (s)he is the Interim Chief Executive Officer o etropolitan 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 Authority dba MedStar Mobile Healthcare By: Print: Frank Gre Title: Interim C lie Executive Officer SUBSCRIBED TO before me on this day of aw)e, , 2025. A'. MONICACRUZ # 12MB16 Notary Public in and for the Late of �,+(a S My Notary ID F iresMay20,2028 My commission Expires: "aL Aot'A0ap Assignment Page 4 of 5 Docusign Envelope ID: 053DCDFE-136BC-4A92-Ai 1 F-DUE1391392E13D CONSENT TO ASSIGNMENT Tarrant County Hospital District d/b/a JPS Health Network d/b/a John Peter Smith Hospital hereby consents to the assignment of the Program Letter of Agreement dated effective June 14, 2024, as amended by the Amendment executed concurrently herewith (collectively, the "Contract"), between Tarrant County Hospital District d/b/a JPS Health Network d/b/a John Peter Smith Hospital and Metropolitan Area EMS Authority dba MedStar Mobile Healthcare ("Assignor") to City of Fort Worth ("Assignee"). Tarrant County Hospital District d/bla JPS Health Network d/b/a John Peter Smith Hospital 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. Tarrant County Hospital District d/b/a JPS Health Network d/b/a John Peter Smith Hospital By: 5�ocu5igned by: 1661. fw6fft Name: -rr-1M't114'dit, m. D. Title: syp, Arademi rs anri Research Affairs Date:06/25/25 1 3:16 PM CDT .......... . Assignment rage 5 of S Docusign Envelope ID: 053DCDFE-86BC-4A92-AI IF-DO7EB9B92EBD PROGRAM LETTER OF AGREEMENT between Tarrant County Hospital District d/b/a JPS Health Network d/b/a John Peter Smith Hospital and Metropolitan Area EMS Authority d/b/a MedStar Mobile Healthcare This Program Letter of Agreement ("Agreement") sets forth the understanding between Tarrant County Hospital District d/b/a JPS Health Network d/b/a John Peter Smith Hospital ("JPS") and Metropolitan Area EMS Authority d/b/a MedS tar Mobile Healthcare ("FACILITY") regarding the education of resident/fellow physicians -in -training ("Residents/Fellows") in required assignments (the "Resident/Fellow Rotations") for JPS's residency/fellowship Program (defined below). JPS and FACILITY may be referred to individually as a "Party" to this Agreement, and they may be referred to collectively as the "Parties" to this Agreement. 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, JPS and FACILITY hereby agree to establish Resident/Fellow Rotations upon the following terms and conditions: L RESIDENCY/FELLOWSHIP PROGRAM: Emergency Medicine ("Program") The Parties shall establish a Resident/Fellow Rotation at FACILITY that will be affiliated with the Program at JPS, and participation in said Program by the Residents/Fellows is acknowledged as a bona fide Resident/Fellow Rotation for the Program. JPS, through its Program Director, and upon mutual agreement with FACILITY, will recommend, and FACILITY will accept, the number of Residents/Fellows that will participate in the Resident/Fellow Rotation. The Parties agree that the annual assignment of Residents/Fellows to FACILITY and the length of each assignment shall depend on the availability of such Residents/Fellows for assignments. The Parties agree that the terms "Resident" (or variations thereon, "Fellow" (or variations thereof), "Program", and "Rotation" in this Agreement shall refer to the particular Residents or Fellows (as applicable) participating in the particular Resident Rotation or Fellow Rotation (as applicable) for the particular Fellowship Program or Residency Program (as applicable), as described herein and in Exhibit "A". H, LOCATION OF RESIDENT/FELLOW ROTATION: Ambulance ride -outs originating from: McdStar Mobile Healthcare 2900 Alta Mere Dr. Fort Worth, Texas 76116 III. GOALS AND OBJECTIVES: See Competency Based Goals and Objectives, which are attached hereto as Exhibit "A" and incorporated herein by reference. PROGRAM LETTER OF AGREEMENT PAGE 1 Docusign Envelope ID: 053DCDFE-B66C-4A92-A11F-DWEBMWEBD IV. FACULTY: A. Jeffrey L. Jarvis, MD, MS, EMT-P, or such other physicians, paramedics, and other individuals on the staff at FACILITY as designated by JPS and approved by FACILITY from time to time, will provide clinical supervision for the Residents/Fellows. B. The FACILITY supervising faculty must: 1. Devote sufficient time to the Program to fulfill their supervisory and teaching responsibilities; 2. Administer and maintain an educational environment conducive to educating Residcnts/Fellows; and 3. Evaluate Resident/Fellow performance in a timely manner during each Resident/Fellow Rotation, document this evaluation at completion of the assignment in a form acceptable to the Program Director, and timely provide the Program Director with a copy of the evaluation. C. The JPS Program Director must: 1. Oversee Resident/FeIlow supervision and the quality of patient care; 2. Give clear guidelines to the supervising faculty; and 3. Oversee resources and administrative support for the educational mission. V. TERM AND TERMINATON: This Agreement shall remain in full force and effect for a term of five (5) years beginning September 1, 2023, and expiring August 31, 2028, unless this Agreement is earlier terminated by either Party in accordance with this Section V. A. Termination without Cause. Either Party, upon ninety (90) days prior written notice to the other Party, may terminate this Agreement without cause. B. Termination for Default. Either Parry may terminate this Agreement in the event of a material breach by the other Party which, in the sole discretion of the non -breaching Party, remains uncured after thirty (30) days written notice of the material breach to the breaching Party. C. Termination for Bankruptcy. In the event that a Party enters bankruptcy, takes an assignment for the benefit of creditors, becomes subject to receivership or is otherwise reasonably deemed insolvent, then this Agreement may be terminated at the option of the other Party. D. Annual Fiscal Condition Precedent. The Parties acknowledge and agree that JPS is a governmental entity subject to an annual budgetary process and restrictions on spending in conformity with that process and its approved budget. The Parties further PROGRAM LETTER OF AGREEMENT PAGE 2 Docusign Envelope ID: 053DCDFE-B68C-4A92-A99F-D07EB9B92EBD agree that, notwithstanding any other language or provision herein to the contrary, if for any reason funds are not budgeted expressly for this Agreement for JPS's fiscal years subsequent to that in which funds for this Agreement are first allocated, JPS may immediately and without penalty terminate this Agreement; provided, however, that in no event shall such a termination be effective earlier than the expiration of the last date for which funds have already been so allocated under an existing, finally approved budget. VI. FINANCIAL ARRANGEMENTS: JPS will continue to provide Resident/Fellow salary and benefits. VIL POLICIES AND PROCEDURES: A. Each Resident/Fellow assigned to FACILITY under this Agreement will adhere to the policies of FACILITY and to the policies of JPS and the JPS department sponsoring the Program. Any Resident/Fellow failing to comply with the above requirements may be terminated from the Resident/Fellow Rotation immediately by JPS. FACILITY will make readily available to the Residents/Fellows all policies which are applicable to their participation in the Resident/Fellow Rotation. B. The Resident/Fellow Rotation shall be operated according to the approved standards of the ACGME, CPME, or other applicable accreditation agency and the Programs Residency/Fellowship Review Committee and shall be approved by JPS's Program Director. Regarding the same, FACILITY and the FACILITY STAFF (defined below) supervising the Residents/Fellows shall familiarize themselves and comply with the ACGME, CPME, and/or other accreditation agency requirements as applicable to the particular Resident/Fellow being supervised. VIII. ADDITIONAL PROVISIONS: A. Supervision of Residents/Fellows. (1) By FACILITY. The Residents/Fellows assigned to the Resident/Fellow Rotation shall participate in the Program under the clinical supervision of the physicians, paramedics, and other individuals on the staff of FACILITY assigned by JPS to provide training and supervision of the Residents/Fellows ("FACILITY STAFF"). The FACILITY STAFF will be responsible for the general day-to-day supervision and the training of the Residents/Fellows, in coordination and cooperation with JPS's teaching staff during the Resident/Fellow Rotation. The FACILITY STAFF will be responsible for clinical supervision of the Residents/Fellows in compliance with applicable accreditation standards and in keeping with the Goals and Objectives and the policies and procedures specified in this Agreement; however, without limiting the foregoing, at all times during the term of this Agreement, each Resident/Fellow assigned to the Resident/Fellow Rotation shall remain a JPS "employee" (as such term is defined in the Texas Tort Claims Act) when the Resident/Fellow is providing care and treatment to patients within the course and PROGRAM LETTER OF AGREEMENT PAGE 3 Docusign Envelope ID: 053DCDFE-86BC-4A92-A11F-D07EB9B92E:BD scope of the Resident/Fellow Rotation and is acting within the course and scope of his or her employment as a Resident/Fellow of JPS. FACILITY STAFF will be bound by and comply with the terns of this Agreement for all times when the Residents/Fellows are participating in the Resident/Fellow Rotation. (2) By JPS. JPS will plan and determine the adequacy of the educational experience of the Residents/Fellows in background, basic skill, professional ethics, attitude and behavior and shall assign to the FACILITY only those Residents/Fellows who have satisfactorily completed the prerequisite requirements for participation in the Program and Resident/Fellow Rotation. Notwithstanding the clinical supervision requirements set forth in Section VIII.A.(1) above, JPS will retain ultimate responsibility for the education and assessment of the Residents/Fellows and, at all times during a Resident/Fellow Rotation, JPS shall have the authority and legal right to control the Residents'/Fellows' participation in the Program and Resident/Fellow Rotation, including the authority and legal right to appoint and terminate the Residents'/Fellows' participation in the Program and Resident/Fellow Rotation. JPS shall monitor and supervise the Residents'/Fellows' compliance with JPS policies and procedures, JPS Medical Staff Bylaws, rules and regulations, the JPS Graduate Medical Education Institutional Handbook, and any other requirements imposed by JPS for the Residents'/Fellows' participation in the Program. and Resident/Fellow Rotation. B. Oualifications of Sunervisina Staff. The FACILITY STAFF are subject to approval for participation in the Resident/FeIlow Rotation by FACILITY. All FACILITY STAFF shall possess all necessary qualifications, training, experience, and, as applicable, current licensure or certification in the State where the Resident/Fellow Rotation is located to perform the functions and duties of the particular FACILITY STAFF. Without limiting the foregoing, each FACILITY STAFF during the term of this Agreement shall remain, as applicable, duly licensed, registered, certified and in good standing under the laws of the State where the Resident/Fellow Rotation is located to engage in the practice or performance of the health care service or other service for which such FACILITY STAFF is licensed, registered and/or certified and, if applicable, to prescribe and administer controlled substances. FACILITY represents and certifies, to the best of its knowledge and belief, that no FACILITY STAFF has had his or her license to practice medicine (if applicable) or license, registration or certification to perform the health care service or other service for which he or she is licensed, registered or certified in the State where the Resident/Fellow Rotation is located or in any other jurisdiction denied, suspended, revoked, terminated, voluntarily relinquished under threat of disciplinary action, or otherwise restricted in any way. C. Resident/Fellow Participation in Care. While at FACILITY, the Residents/Fellows will only participate in the care and treatment of patients as provided herein. The Residents/Fellows may be involved in the care and treatment of patients only under the direction and supervision of the FACILITY STAFF. The FACILITY STAFF shall have primary responsibility for the care of FACILITY patients, but may delegate patient care duties (e.g., rounds), as deemed appropriate, to the Residents/Fellows; provided, PROGRAM LETTER OF AGREEMENT PAGE 4 Docusign Envelope ID: 0530CDFE-B66C-4A92-A11F-D07E1391392EBD however, the Residents/Fellows shall not have any primary, unsupervised patient care responsibility delegated to them by FACILITY STAFF. D. Liability Coverage. FACILITY recognizes that JPS is a county hospital district, created and operating under Chapter 281 of the Texas Health and Safety Code and is a unit of local government for purposes of Chapter 101 of the Texas Civil Practice and Remedies Code ("Texas Tort Claims Act"). JPS considers a Resident/Fellow to be a JPS "employee" (as such term is defined in the Texas Tort Claims Act) when the Resident/Fellow is providing care and treatment to patients within the course and scope of the Resident/FelIow Rotation and is acting within the course and scope of his or her employment as a Resident/Fellow of JPS. Residents/Fellows will be considered by JPS to be subject to the limits of liability under the Texas Torts Claim Act with respect to acts performed in the course and scope of the Resident's/Fellow's employment with JPS. As a general rule, with respect to acts performed in the course and scope of the Resident's/Fellow's employment with JPS for which governmental immunity has been waived under the Texas Tort Claims Act, the current limits on amount of liability under the Texas Torts Claim Act for employees acting in the course and scope of employment are $100,000 for each person and $300,000 for each single occurrence for bodily injury or death claims. FACILITY shall carry commercial general and professional liability insurance coverage on an occurrence basis covering its obligations under this Agreement, with limits of no less than $1,000,000 per occurrence and $3,000,000 general aggregate, and provide proof of such insurance coverage to JPS upon request. E. HIPAA Obligations. Both Parties acknowledge obligations and other regulations implementing the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. § 1320(d) ("HIPAA")). The Parties acknowledge that federal regulations set forth in HIPAA and the Health Information Technology for Economic and Clinical Health Act of 2009 (42 U.S.C. 17921-53) ("HITECH Act") relating to the confidentiality, integrity and accessibility of individually identifiable health information (whether created, maintained, accessed, stored or transmitted electronically or otherwise) require Covered Entities to comply with the privacy and security standards adopted by the U.S. Department of Health and Human Services as they may be amended from time to time, 45 C.F.R. parts 160 and 164, subparts A and E ("Privacy Rule") and 45 C.F.R. parts 160 and 164, subparts A and C ("Security Rule"). The Privacy Rule and Security Rule are collectively referred to herein as the "Privacy and Security Standards". The Privacy and Security Standards require a Covered Entity to ensure that those who receive, access, store, or transmit confidential information in the course of providing services on behalf of a Covered Entity 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. F. Texas Public Information Act. FACILITY and JPS acknowledge that both Parties are governmental bodies under Chapter 552 of the Texas Government Code, commonly PROGRAM LETTER OF AGREEMENT PAGE 5 Docusign Envelope ID: 053DCDFE-6613C-4A92-A11F-DUE59692EBD referred to as the Texas Public Information Act ("TPIA"), and each thereby acknowledges that information that is collected, assembled, or maintained in connection with the transaction of official business by a governmental body is considered public information potentially subject to disclosure pursuant to a valid TPIA request and each hereby assumes full responsibility for challenging any requests for information it considers confidential under the TPIA. JPS agrees to notify FACILITY, and FACILITY agrees to notify JPS, of any TPIA requests that seek disclosure of potentially confidential information under this Agreement; however, failure to notify by either Party shall not be deemed a material breach of this Agreement. G. No Boycott of Israel. In compliance with Section 2270.001 et seq. of the Texas Government Code, FACILITY warrants, represents, and by its execution of this Agreement hereby verifies that: (1) FACILITY does not boycott Israel; and (2) FACILITY will not boycott Israel during the term of this Agreement. For the purposes of this Agreement, and in compliance with the Texas Government Code, "boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict harm on, or limit commercial relationships specifically with Israel, or with a person or entity doing business in Israel or in an Israel -controlled territory, but does not include an action made for ordinary business purposes. H. No Enaaaement in Scrutinized Business Operations. In compliance with Section 2252.151 et seq. of the Texas Government Code, FACILITY warrants, represents, and by its execution of this Agreement hereby verifies that: (1) FACILITY does not engage in scrutinized business operations in Sudan; (2) FACILITY does not engage in scrutinized business operations in Iran; and (3) FACILITY does not engage in scrutinized business operations with designated foreign terrorist organizations. "Scrutinized business operations in Sudan" shall have the meaning ascribed to that tenn as set forth in Section 2270.0001 et seq. of the Texas Government Code. "Scrutinized business operations in Iran" shall have the meaning ascribed to that term as set forth in Section 2270.0101 et seq. of the Texas Government Code. "Scrutinized business operations with designated foreign terrorist organizations" shall have the meaning ascribed to that term as set forth in Section 2270.0151 et seq. of the Texas Government Code. Boycott of Enerav Companies Prohibited. In compliance with Section 2274.002 of the Texas Government Code (added by 87th Legislature, S.B. 13), FACILITY verifies that it does not boycott energy companies and will not boycott energy companies during the term of this Agreement. "Boycott energy company" is defined in Section 804.001(1) (added by 87th Legislature, S.B. 13) and means, without an ordinary business purpose, refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations with a company because the company: (A) engages in the exploration, production, utilization, transportation, sale, or manufacturing of fossil fuel -based energy and does not commit or pledge to meet environmental standards beyond applicable federal and state law; or (B) does business with a company described by subsection (A). PROGRAM LETTER OF AGREEMENT PAGE 6 Docusign Envelope ID: 053DCDFE-B6BC-4A92-A11F-1707EB9B92EBD J. Discrimination against Firearm Entities or Firearm Trade Associations Prohibited. In compliance with Section 2274.002 of the Texas Government Code (added by 87th Legislature, S.B. 19), FACILITY verifies that it does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and will not discriminate during the term of this Agreement against a firearm entity or firearm trade association. "Discriminate against a firearm entity or firearm trade association" is defined in Section 2274.001(3) (added by 87th Legislature, S.B. 19) and means, with respect to the entity or association, to: (i) refuse to engage in the trade of any goods or services with the entity or association based solely on its status as a firearm entity or firearm trade association; (ii) refrain from continuing an existing business relationship with the entity or association based solely on its status as a firearm entity or firearm trade association; or (iii) terminate an existing business relationship with the entity or association based solely on its status as a firearm entity or firearm trade association; the term does not include: (i) the established policies of a merchant, retail seller, or platform that restrict or prohibit the Iisting or selling of ammunition, firearms, or firearm accessories; and (ii) a company's refusal to engage in the trade of any goods or services, decision to refrain from continuing an existing business relationship, or decision to terminate an existing business relationship: (aa) to comply with federal, state, or local law, policy, or regulations or a directive by a regulatory agency; or (bb) for any traditional business reason that is specific to the customer or potential customer and not based solely on an entity's or association's status as a Eireann entity or firearm trade association. K. Governinsi Law and Venue. This Agreement shall be governed by the laws of the State of Texas without regard to its conflict of laws provisions. The venue of any litigation arising from this Agreement will be in the United States District Courts, Fort Worth Division of the Northern District of Texas if the litigation arises in Federal Court or in the District Courts of Tarrant County, Texas if the litigation arises in State Court. The venue of any dispute resolution activity shall be in Fort Worth, Tarrant County, Texas. L. Notices. All notices provided for by this Agreement shall be made in writing either (a) by actual delivery (e.g., personally, by commercial courier service, or by confirmed telefacsimile) of the notice, or (b) by the mailing of the notice by United States Postal Service certified or registered mail, return receipt requested, and addressed to the Party to be notified at the address set forth below (or at such other address as may be given for notice by a Party). The notice shall be deemed to be received (i) if by actual delivery, on the date of its receipt by the Party, or (ii) if by mail, on the second day on which mail is delivered following the date of deposit in the United States Postal Service, unless actually received sooner by mail. FACILITY: Metropolitan Area EMS Authority Attn: General Counsel 2900 Alta Mere Dr. Fort Worth, Texas 76116 JPS: Tarrant County Hospital District d/b/a JPS Health Network Attn: Academic Affairs 1500 South Main Street Fort Worth, Texas 76104 PROGRAM LETTER OF AGREEMENT PAGE 7 Docusign Envelope ID: 053DCDFE-B6BC-4A92-A1 1 F-D07EB9B92EBD M. Miscellaneous. 1. Use ofName: Advertising. Neither Party shall use the other's corporate or business name, trademark, service mark or logo, or any identifier which is reasonably Iikely to suggest that the two Parties are related, without first obtaining the written consent of the other Party. 2. Non -Assignment and Subcontracting. Neither Party shall assign, transfer or contract for the furnishing of services to be performed under this Agreement without the prior written approval of the other Party. 3. Entire Agreement. This Agreement (and its attachments, if any) constitutes the entire understanding between the Parties with respect to the subject matter hereof and may be modified only by a writing signed by both Parties. 4. Severability. Should any part, term, or provision of this Agreement be declared to be invalid, void, or unenforceable, all remaining parts, terms, and provisions hereof shall remain in full force and effect, and shall in no way be invalidated, impaired, or affected thereby. Each invalid provision shall be revised only to the extent necessary to bring it within the requirements of such law or regulation. 5. Waiver. The failure of either 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 either Party, whether written or oral, expressed or implied, of any rights under or arising from this Agreement shall be binding on any subsequent occasion; and no concession by either Party shall be treated as an implied modification of this Agreement unless specifically agreed in writing. 6. Attornev's Fees and Court Costs. If either Party brings an action against the other to enforce any condition or covenant of this Agreement, each Party shall be individually responsible for its own court costs and attorney's fees. 7. Relationship of the Parties. None of the provisions of this Agreement are intended to create, and none shall be deemed or construed to create any relationship between the Parties, other than that of independent contractors. This Agreement shall not create the relationship of employer -employee, agency, partnership, or joint venture between the Parties. Neither Party shall have the right or power in any manner to unilaterally obligate the other to any third party, whether or not related to the purpose of this Agreement. 8. Parties Affected. Nothing in this Agreement, whether express or implied, is intended to confer upon any individual or entity, other than the Parties hereto (and their respective heirs, representatives, successors, and permitted assigns), any rights or remedies hereunder or otherwise. Nothing in this Agreement is intended to relieve or discharge any liability of any Party hereto or any third party. No provision in this Agreement shall give any individual or entity any right of subrogation against any Party hereto. PROGRAM LETTER OF AGREEMENT PAGE 8 Docusign Envelope ID: 053DCDFE-B6BC-4A92-A11F-D07E69B92EB❑ 9. Subiect Headings. The subject headings of the sections, paragraphs, and subparagraphs of this Agreement are included herein solely for the purposes of convenience and reference, and shall not be deemed to explain, modify, limit, amplify, or aid in the meaning, construction, or interpretation of any of the provisions of this Agreement. 10. Bindiniz A>reement. The Parties hereto warrant and represent that upon execution hereof, this Agreement shall be a legal, valid and binding obligation on them and shall be enforceable against them in accordance with its terms. The Individuals signing this Agreement warrant and represent that they are duly authorized to sign this Agreement on behalf of the Parties hereto. 11. Modification. No supplement, modification, or amendment of any term, provision, or condition of this Agreement shall be binding or enforceable on either Party hereto unless in writing signed by both Parties. 12. 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, from acts of God, pandemics/epidemics, civil or military authority, labor disputes, or any similar cause beyond the reasonable control of the Parties. 13. 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. 14. No Waiver of Immunitv. Both Parties are a political subdivision of the State of Texas and under the constitution and laws of the State of Texas each possesses certain rights and privileges, is subject to certain limitations and restrictions, and only has such authority as granted to it under the constitution and laws of the State of Texas. Notwithstanding any other provision of this Agreement, nothing in this Agreement is intended to be nor shall it be construed to be a waiver of the sovereign immunity of the State of Texas, or the governmental immunity of either Party as a political subdivision thereof, nor a prospective waiver or restriction of any rights, remedies, claims and privileges of the State of Texas, or either Party as a political subdivision thereof. Remainder of page intentionally blank. Signatures on following page. PROGRAM LETTER OF AGREEMENT PAGE 9 Dowsign Envelope ID: 053DCDFE-B6BC-4A92-A11F-DUE89892EBD JPS: Tarrant County Hospital District d/b/a JPS Health Network d/b/a John Peter Smith Hospital FACILITY: Metropolitan Area EMS Authority d/b/a MedStar Mobile Healthcare By: �° By: Juff" b, �a.v S) h+J Name: Ryan Kirby, MD Name: Jeffrey L. Jarvis, MD, MS, EMT-P Title: JPS Program Director Title: Chief Medical Officer, Medical Director Date: 06-14-2023 1 12:15 PM CDT Date:06-14-2023 11:35 AM CDT By: fiV1(Aa f(,(6 f) At. V, By: 4In InA simps6v, Name: Tricia C. Elliott, MD, FAAFP Name: Kenneth J. Simpson Title: Designated Institutional Official Title: Chief Executive Director Date:06-14-2023 1 12:38 PM CDT Date:06-14-2023 1 12:13 PM CDT PROGRAM LETTER OF AGREEMENT PAGE 10 Docusign Envelope ID: 053DCDFE-666C-4A92-A11F-D07EB9B92EBD EXHIBIT "A" JPS Emergency Medical Services Rotation Service: • PGY1-3 • Maximum 7 ride -outs with MedStar in half -month block • Optional Longitudinal experience and/or elective block • Rotating assignment with select units; experience in Medical Direction & Oversight Contact: Jeffrey L. Jarvis, MD, MS, EMT-P, Chief Medical Officer, MAEMSA Medical Director (817-923-1500, JJarvisna medstar9l Lorz) Goals: Develop an understanding of pre -hospital interventions and protocols commonly used by EMS. Goals will be met through satisfactory completion of the following objectives under the direction of the Medical Director of MedStar who is a Physician licensed to practice in the State of Texas, is certified by his primary specialty board, and holds the appropriate appointment to carry out the duties typical of an EMS Medical Director within Tarrant County. Work an adequate number of hours to gain experience with the unique challenges that occur in the pre -hospital setting. Obiectives: 1. Medical Knowledge (MK) a. Acquire the skills to appropriately triage patients to a hospital that is capable of addressing their immediate medical needs. b. Acquire and apply the knowledge to make decisions regarding the optimal transport of patients based on level of acuity of the patient versus level of expertise available at a given hospital. c. Acquire and apply knowledge to provide appropriate therapeutic interventions on behalf of patients in the pre -hospital setting. 2. Patient Care (PC) a. Appropriately manage patients in the pre -hospital setting. b. Apply advanced resuscitation skills to patients in the pre -hospital setting. 3. Systems Based Practice and Learning (SBP) a. Advocate appropriate access to care for patients. PROGRAM LETTER OF AGREEMENT PAGE 1 Docusign Envelope ID: 053DCDFE-B6BC-4A92-A11F-D07EB91392EBD 4. Interpersonal Communication (ICS) a. Educate other members of the healthcare team regarding patients in the pre -hospital setting. b. Consultation with: EMS personnel Medical Director(s) Paramedics Hospital personnel 5. Professionalism (PROF) a. Develop and maintain professional behaviors. b. Demonstrate professional maturity with respect to prompt arrival to assigned duty stations. 6. Practiced Based Learning and Improvement (PBLI) a. EM didactics. b. Ongoing independent study. PROGRAM LETTER OF AGREEMENT PAGE 12