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2022-159
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2022-159
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Last modified
8/30/2022 3:13:46 PM
Creation date
8/30/2022 3:00:44 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Memorandum of Understanding
Approved Date
08/16/2022
Control Number
2022-159
Agenda Item Number
15.A.3.
Entity Name
Florida Dept. of Health, Indian River Health Dept. &
Indian River County Emergency Services District
Subject
Memorandum of Agreement to Provide Routine Immunization Services
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Memorandum of Agreement <br />Between State of Florida, Florida Department of Health, Indian River Health Department ("the <br />Department") and the Indian River County Emergency Services District ("the District"). <br />PARTIES <br />This memorandum of agreement addresses the collaborative efforts of the Department and the District. <br />01 Mor%cc <br />The purpose of this agreement is to provide routine healthcare services to employees of the District. These <br />services will be provided by the Department at an agreeable time and place suitable to both parties. <br />Department agrees to: <br />1. Provide covered services reference in the applicable product attachment (ATTACHMENT 1) to Fire <br />Rescue employees with the same degree of care and skill as customarily provided, within the scope of the <br />Department employees' license and in accordance with generally accepted standards of Department <br />practice and regulatory requirements. <br />2. Invoice the District for services provided to its employees in accordance with the Department <br />Compensation Fee Schedule (ATTACHMENT II). The brand name and prices for vaccines and testing <br />services are subject to change based on the maker of the vaccine and availability of the brand names in <br />stock. <br />3. Submit an invoice to the District within fifteen (15) days following the month of service. <br />District agrees to: <br />1. Implement a relationship with the Department for the Fire Rescue employee's vaccination <br />program under direction of the County's Medical Director. <br />2. Process physician's orders and assist in setting up blood draws and vaccination <br />appointments with the Department <br />3. Recognize and abide by Health Insurance Privacy and Accountability Act (HIPAA) <br />Regulations and Florida Department of Health Information Security Policies (DOHP 50- <br />10.1-16). <br />4. Keep all appointments except in case of an emergency and will attempt to notify the <br />Department of cancellations at least 24 hours prior to the appointment. <br />5. Will have all required documentation needed for employees: <br />a. Authority for Evaluation and Treatment - Initiation of Service <br />b. Health and Medication History (if necessary). <br />C. Notice of Privacy Practice Acknowledgment Form <br />
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