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RESOLUTION AUTHORIZING THE COUNTY MAYOR OR COUNTY MAYOR�S DESIGNEE TO EXECUTE AND EXERCISE THE PROVISIONS SET FORTH IN A NO-COST MEMORANDUM OF UNDERSTANDING BETWEEN MIAMI-DADE COUNTY, THROUGH THE MIAMI-DADE FIRE RESCUE DEPARTMENT (�MDFR�), AND THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FOR THE PROVISION OF ADVANCE TACTICAL MEDICAL TRAINING TO ALL MDFR PARAMEDICS, FOR A TERM OF FIVE YEARS WITH TWO FIVE-YEAR OPTIONS TO RENEW

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WHEREAS, this Board desires to accomplish the purposes outlined in the accompanying memorandum, a copy of which is incorporated herein by reference,

NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MIAMI-DADE COUNTY, FLORIDA, that this Board:

Section 1. Incorporates and approves the foregoing recital, as if fully set forth herein.

Section 2. Authorizes the County Mayor or County Mayor�s designee to execute a Memorandum of Understanding, in substantially the form attached hereto and incorporated herein as Exhibit A, between Miami-Dade County, through the Miami-Dade Fire Rescue Department, and the Public Health Trust of Miami-Dade County, Florida for the provision of Advance Tactical Medical (�ATM�) Training at the Ryder Trama Center. All MDFR paramedics including members of the Urban Search and Rescue Florida Task Force 1 and those assigned to the Office of the Miami-Dade Sheriff�s Special Response Team will participate in ATM Training, which includes classroom education, cadaver workshops, and hands-on patient care. The no-cost Memorandum of Understanding shall be for a five-year term with two options to renew, each for an additional five-year term.

Section 3. Authorizes the County Mayor or County Mayor�s designee to exercise the provisions set forth in the Memorandum of Understanding and execute amendments, provided that any such amendments do not alter the purpose or extend the term or renewal periods of the Memorandum of Understanding.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MIAMI-DADE COUNTY, FLORIDA, that:

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Date:

To: Honorable Chairman Anthony Rodriguez
and Members, Board of County Commissioners

From: Daniella Levine Cava
Mayor

Subject: Resolution approving a Memorandum of Understanding
between Miami-Dade County through the Miami-Dade
Fire Rescue Department and the Public Health Trust
of Miami-Dade County, Florida

STAFF RECOMMENDATION
Summary
This item seeks approval of a Memorandum of Understanding (MOU), attached to and incorporated in the accompanying resolution as Exhibit A, between Miami-Dade County through the Miami-Dade Fire Rescue Department (MDFR) and The Public Health Trust of Miami-Dade County, Florida (Trust), which operates Jackson Health System (JHS), including Ryder Trama Center (RTC) for the purpose of educating and training all MDFR paramedics to enhance their skillsets through the Advance Tactical Medical (ATM) Training program. Priority will be given to members of MDFR�s Urban Search and Rescue Florida Task Force 1 (USAR FL-TF1) and MDFR paramedics assigned to the Miami-Dade Sheriff�s Office Special Response Team (SRT) and trained as tactical paramedics. This no-cost MOU is for a five-year term with two options to renew each for an additional five-year term.

MDFR seeks to formally establish a partnership with the Trust to provide its paramedics with clinical training opportunities that expose them to the latest technology and best practices in patient care. This training will better prepare paramedics for trauma care and high acuity medicine in the expeditionary setting. By training at a Level I Trauma Hospital, paramedics will have opportunities to improve their clinical and surgical acumen and save lives when they are in the field.

The Administration extends its sincere appreciation to the Public Health Trust for its continued support and commitment to this joint mission. The Trust�s dedication to fostering high-quality clinical training opportunities plays a vital role in strengthening the County�s emergency medical response capabilities and ensuring the highest standard of care for our community.

Recommendation
It is recommended that the Miami-Dade Board of County Commissioners (Board) approve the attached resolution authorizing the County Mayor or County Mayor�s designee to execute the MOU between Miami-Dade County, through MDFR, and the Trust. It is further recommended that this Board authorize the County Mayor or County Mayor�s designee to exercise the provisions set forth in the MOU and execute amendments, provided that any such amendments do not alter the purpose or extend the term or renewal periods of the MOU.

Scope
The service provided is countywide.

Delegation of Authority
The County Mayor or County Mayor�s designee has delegated authority to exercise the provisions set forth in the MOU and execute amendments thereto, during the initial and any renewal terms, provided that such amendments do not alter the purpose or extend the term or renewal periods of the MOU.

Fiscal Impact/Funding Source
There is no fiscal impact to the County.

Track Record/Monitor
The MOU will be monitored by a designated MDFR Division Chief or other supervisory personnel.

Background
MDFR seeks to formally establish a partnership with the Trust, to provide its paramedics, including members of USAR FL-TF1 and SRT, with clinical training opportunities that will expose them to the latest technology and best practices for treatment of trauma patients.

Currently there are limited opportunities to provide paramedics with sufficient clinical and tactical medical experience to meet the core competencies necessary to effectively and efficiently treat immediate life-threatening traumatic injuries that they encounter on the job. This is especially true for paramedics who are members of SRT, which is a full-time special weapons and tactics unit responsible for: (1) serving high-risk search warrants; (2) the resolution of barricaded subjects and hostage rescue incidents; (3) aircraft, vessel, and train hijackings; (4) felony-armed subject searches; and (5) dignitary protection details.

The ATM Training will emphasize and build upon participants� core medical skills and knowledge, with the ultimate goal of expanding each individual�s knowledge base and enhancing their hands-on clinical skills. To accomplish these goals, the training will consist of the following components.

1. Classroom Didactic Education: All participants of the ATM Training course will undergo classroom lectures using a variety of multimodality tools. These lectures will cover not only basic anatomy and physiology that paramedics are required to know but will also highlight the physiology and treatment of traumatic injuries such as pneumothorax, hemothorax, and pericardial tamponade. This will enable the paramedics to administer higher quality medical treatment. An overview and demonstration of the proper use of common equipment will be covered in these sessions as well as a workshop on suturing wounds and other modalities of bleeding control.

2. Cadaver Workshop: After the didactic component of the training course, the focus will shift to hands-on skills training using cadaveric models. The ATM Training course will partner with the military Advance Surgical Skills for Exposure in Trama (ASSET) course that is offered at RTC on Tuesdays and Wednesdays of most months. The cadaver training, in addition to further development of some of the classroom skills such as suturing, will expose the paramedics to skills such as cricothyroidotomy and simple and tube thoracostomy.
3. Hands-on Development of Skills: Finally, after classroom and cadaver training, the ATM paramedics will complete 4-6 shifts (day or night) at RTC with the trauma teams. These trauma teams are composed of trauma attending surgeons, trauma fellows, and residents who provide care within the trauma resuscitation area. The ATM paramedics will participate in all aspects of trauma patient care under the direct supervision of the trauma attending surgeon and the trauma fellows. All procedures will be directly supervised and will only include those that were taught in the classroom and thoroughly practiced on cadavers.

ATM Training expands the skillset of paramedics and increases their ability to better serve the community and the likelihood of more successful outcomes for patients.

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Arnold Palmer
Chief of Public Safety