MONROE COUNTY MEDICAL CONTROL
BOARD/AUTHORITY BY-LAWS
INDEX
ARTICLE I: Name
ARTICLE II: Affiliation
ARTICLE III: Purpose
ARTICLE IV: Goals
ARTICLE V: Membership
Qualification of the Medical Director
Duties of the Medical Director
Assistant Medical Director
Attendance
ARTICLE VI: Meetings
Committees of the Advisory Board
Continuous Quality Improvement Committee
Operations/Training Committee
E.M.S. Communications Committee (Ad Hoc)
Nominating Committee (Ad Hoc)
ARTICLE VII: Nominations
ARTICLE VIII. Conflict of Interest
ARTICLE IX: Conflict Resolution
ARTICLE X: Parliamentary Procedure
ARTICLE XI: Amendments to the By-Laws
ARTICLE XII: Extension, Withdrawal & Revocation of
Cooperation
ARTICLE XIII: Emergency Withdrawal of Cooperation
ARTICLE I
Name
The name of the organization shall be the Monroe County
Medical Control Authority - Advisory Board.
ARTICLE II
Affiliation
This Advisory Board is organized by approval of the Board of
Trustees of Mercy Memorial Hospital Corporation (MMH) and derives its authority from
Sections 10918 and 20919 (1) of Act No. 179, Michigan Public Acts of 1990, as amended, and
Regulations promulgated there under.
ARTICLE III
Purpose
The purpose of the Monroe County Medical Control Advisory
Board is to:
1. Promulgate medical protocols for all prehospital emergency
medical care rendered in Monroe County.
2. Assure that prehospital emergency medical care is provided
in accordance with applicable standards and regulations.
3. Monitor the human and fixed resources in the county to
provide for effective EMS services.
4. Support the organized delivery of Emergency Medical
Services (EMS) in the county.
The Advisory Board provides advice to the Medical Control
Authority in its responsibility to provide medical control supervision for Monroe County
prehospital providers.
ARTICLE IV
Goals
SECT. 1. Establish standard operating procedures, and
protocols that provide conformity and consistency at all levels of prehospital care.
SECT. 2. Develop a mechanism to review the standards of care
and, where necessary, investigate inappropriate patient care and recommend corrective
action to MMH Board of Trustees, and/or the Michigan Department of Consumer and Industry
Services EMS Division, as appropriate.
SECT. 3. Perform medical audits of prehospital life support
activities to evaluate conformance with, and the effectiveness of, promulgated standards
of care.
SECT. 4. Act as a resource for matters which require medical
consultation including inter-agency operations, dispatch guidelines, training programs and
community education.
SECT. 5. Facilitate the development of on-going training
programs for all personnel providing or supporting prehospital emergency medical care.
ARTICLE V
Membership
SECT. 1. The Membership of the Advisory Board shall consist
of a minimum of seventeen (17) persons. The members shall be qualified and selected in a
manner set forth in these By-Laws.
SECT. 2. The members shall be members of the Advisory Board,
a committee of the whole membership, and shall have and exercise all such other rights,
powers, duties and privileges as in the manner prescribed in these By-Laws.
SECT. 3. New members shall be appointed by the Advisory Board
based on the recommendation of the Nominating Committee. The terms of membership shall be
as noted commencing with the April meeting.
a. A minimum of two (2) Michigan licensed physicians (at
least one of whom shall be actively engaged in the practice of emergency medicine at MMH)
who shall hold the following offices:
1) Current EMS Medical Director.
Department physician from each participating
hospital (one of whom shall be designated as Assistant Medical Director).
b. Two (2) registered nurses from MMH Emergency Department
staff. (A.C.L.S. Certified)
1) Mercy Memorial Hospital, Director of Emergency Services.
2) RN designated as EMS Continuous Quality Improvement (CQI)
Coordinator
c Basic EMT (1 year)
d. EMT - Paramedic (ACLS Certified) (2 years)
e. Mercy Memorial Hospital Pharmacist
f. Monroe County Fire Association Representative/ Medical
First Responder (3 years)
g. Mercy Memorial Hospital Administration Representative
h. Monroe County Central Dispatch Director
i. Law enforcement officer (chosen from the law enforcement
chiefs in the county). (3 years)
j Citizen at large. (3 years)
k. Monroe County 911 Contracted Ambulance service
Representative
l. Monroe County Emergency Medical (Ambulance) Authority
Representative (1 year)
m. EMS Education Coordinator/EMT Instructor-Coordinator
n. Monroe County Health Department Representative
o. Emergency Management Division Representative
SECT. 4. Qualifications and Duties of the Authority Medical
Director
a. The EMS Medical Director shall be an appointee of the MMH
Board of Trustees Hospital Authority with the advice of the Medical Control Authority
Advisory Board.
b. Qualifications: Physician licensed in the State of
Michigan, Board certified in the provision of emergency medicine.
c. Duties
1. To serve as Chair and provide executive direction to the
Advisory Board.
2. To direct, in consultation with the Advisory Board, the
implementation of the actions of the Advisory Board that relate to minimum standards of
medical care, treatment protocols and operating procedures for their medical correctness.
3. To review training curricula and to assure that course
content is consistent with minimum standards of care and treatment protocols adopted by
the Authority and Advisory Board and approved by the EMS Division of the Michigan
Department of Consumer and Industry Services.
4. To direct the development of training programs to assure
the availability of continuing education at each level of prehospital care practiced in
Monroe County.
5. To be accountable for the security of all drugs and
restricted medical supplies assigned to field units.
6. To direct the establishment of procedures; to review
prehospital care and to determine whether the care rendered conforms with protocols and
standard operating procedures.
7. To enforce minimum standards of prehospital care, and,
where necessary, initiate disciplinary proceedings.
8. To provide for the emergency withdrawal of cooperation of
MMH and the Advisory Board from any individual(s), ambulances, firm and/or organization if
in the Medical Director's opinion such care poses a serious threat to the public's health,
safety or welfare.
d. Assistant EMS Medical Director
The Assistant EMS Medical Director shall carry out all
responsibilities of the EMS Medical Director in the EMS Medical Director's absence.
SECT. 5 Attendance
Any member who does not attend at least 75% of the meetings
of the Advisory Board or committee of the Advisory Board which he/she may be a member, or
who has more than two unexcused absences, may be removed from office by the members
sitting as the Advisory Board.
ARTICLE VI
Meetings
SECT. 1. There shall be an annual meeting of the Monroe
County Medical Control Advisory Board, for the purpose of approving nominations for
membership. This meeting shall be held in April of each year.
SECT. 2. The Advisory Board shall hold a routine meeting at
least every other calendar month. An Executive Committee meeting may be held on alternate
months in lieu of a full Advisory Board meeting or as otherwise needed. All meetings will
be held at a time and place designated by the EMS Medical Director unless otherwise voted
by the majority to cancel or postpone the meeting.
SECT. 3. One-half (50%) of the membership of the Medical
Control Advisory Board being present shall constitute a quorum for the transaction of
business, and the acts of a majority of the members present at any meeting at which there
is a quorum shall be the acts of the members of the Advisory Board, except as otherwise
provided by these By-Laws. A minimum of four (4) Executive Committee members shall
constitute an Executive Committee quorum.
SECT. 4. Special meetings may be called by the EMS Medical
Director when deemed necessary.
SECT. 5. The Medical Director or his designee shall preside
at meetings of the Advisory Board. The Medical Director shall have such powers and duties
as are vested in this position by these By-Laws and as may be determined by the Advisory
Board. In no regard may the Advisory Board nor the By-Laws interfere with the Medical
Director's authority and responsibility as defined by Michigan law.
SECT. 6. Committees of the Medical Control Advisory Board
A. The members of the Advisory Board may, at any meeting,
establish such committees as they deem necessary to consider and render advice on any
matters pertinent to the membership or to the Advisory Board.
B. The members of such committees shall be selected as
determined by the Advisory Board.
C. All such committees shall be directly responsible to the
Medical Director.
D. Standing Committees
1. The Executive Committee
It will be the responsibility of this Committee to act on
behalf of the Advisory Board to further the projects and plans of the whole Board. It may
take actions consistent with but not superceding the policies, procedures or planning
which the Advisory Board has set (with approval of the Hospital Authority). Written
minutes will be kept at all meetings and all actions taken must be reported to the Medical
Control Board at its next meeting. All Advisory Board members will be notified of, and may
participate in, the scheduled meetings of the Executive Committee.
The Committee shall consist of the following members:
a. EMS Medical Director (Chairperson)
b. CQI Coordinator
c. Mercy Memorial Hospital, Emergency Department Director
d. Mercy Memorial Hospital Administration Representative
e. Monroe County Central Dispatch Director
f. EMS Education Coordinator/EMT Instructor-Coordinator
g. One Advisory Board Member appointed by the Medical
Director
2. The Continuous Quality Improvement Committee
It will be this Committee's responsibility to review
prehospital care rendered within the Authority's jurisdiction and recommend actions
through the Mercy Memorial Hospital Administration to the Mercy Memorial Hospital Board of
Trustees regarding the extension, withdrawal and suspension of Medical Control Authority
cooperation.
The Committee shall consist of the following members:
a. EMS Medical Director (Chairman)
b. EMT-Paramedic
c. Mercy Memorial Hospital, Emergency Department, Director
d. Ambulance Service Representative
e. Mercy Memorial Hospital EMS CQI Coordinator
f. EMS Education Coordinator/EMT Instructor-Coordinator
All actions taken by the committee will be kept confidential
to the extent that it is consistent with the laws of the State of Michigan.
3. The Operations/Training Committee
This Committee shall be charged with the development,
implementation and modification of protocols and standard operating procedures. Areas to
be addressed by this Committee include, but are not limited to, standing orders, medical
protocols and treatment procedures, drugs and drug exchange, equipment and equipment
failure, methods of documentation as well as medical areas within operating procedures.
The Committee shall be responsible for reviewing the course
content of all training programs. In addition, this Committee shall facilitate the
development of on-going training programs for all personnel providing or supporting
prehospital emergency care.
The Committee shall consist of the following members:
a. EMS Medical Director (Chairman)
b. Mercy Memorial Hospital, Emergency Department, Director
c. Mercy Memorial Hospital Pharmacist
d. EMT
e. EMT Paramedic
f. Fire Association Representative
g. EMS Education Coordinator/Instructor-Coordinator
h. Ambulance Service Representative
I. EMS CQI COORDINATOR
4. The Communications Committee (Ad Hoc)
An Ad Hoc committee of the Advisory Board, the Committee
shall be responsible for the technological recommendation and modification of
communication equipment and procedures. Voice communication protocols between various
professionals within the EMS community will be undertaken and developed by
Operations/Training Committee.
The Ad Hoc Communications Committee shall consist of the
following members:
a. Monroe County Central Dispatch Director (Chairman)
b. Fire Association Representative
c. Mercy Memorial Hospital Administration Representative
d. Ambulance Service Representative
5. The Nominating Committee
The Committee shall consist of three members of the Advisory
Board appointed by the Medical Director.
SECT. 6. Meetings
Meetings of the Medical Control Board and its Committees are
subject to the Michigan Open Meetings Act.
ARTICLE VII
Nominations
The Nominating Committee will meet during January of each
year to develop a slate of candidates for each position. These recommendations will be
forwarded to the Advisory Board at the February meeting. All candidates will be voted on
at the April Annual Meeting. Special meetings of the Nominating Committee may be called by
the Medical Director to assist in recommending candidates to fill temporary vacancies.
ARTICLE VIII
Conflict of Interest
SECT. 1. The following provisions are designed to preclude
the use of membership on the Advisory Board or on any committee for purposes which are, or
give the appearance of being, motivated by private gain on the part of any individual:
a. Members of the Advisory Board or any of its organizational
units with conflicts of interest may participate in the discussion of a matter in which
they have an interest, but in no case shall be allowed to vote on that matter.
b. The applicant and/or guests will not participate in
discussions of the body considering a matter in which they have an interest unless
recognized or requested to do so by the Chair.
c. For purposes of applying the above rules as conflict of
interest, a conflict shall exist under the following conditions:
1. The organization member has, or within the twelve months
preceding the vote had, a substantial ownership, employment, medical staff, fiduciary,
contractual creditor or consultative relationship in regard to the matter to be
considered.
2. The organization member has a personal and direct monetary
and fiduciary interest in an agency, organization or institution which has an intent as
defined in number one above.
d. Prior to a matter being considered at a meeting, a written
disclosure of conflict of interest shall be made by persons having an interest as defined
in c(1) and c(2) above and such conflict of interest shall be announced at the meeting.
e. Questions regarding conflict of interest shall be settled
by majority vote of the Advisory Board.
ARTICLE IX
Conflict Resolution
The Medical Control Advisory Board shall develop, as an
operating procedure, a mechanism for conflict resolution. In the event of impasse, the MMH
Board of Trustees shall make a final determination. Because of the medical nature of the
decisions involved, the Medical Director and the Advisory Board will have an opportunity
to address the medical issues prior to the MMH Board of Trustees taking action. The
procedure for resolution of conflicts is outlined in Appendix B (Quality Review) and
Appendix F (Withdrawal of Cooperation).
ARTICLE X
Parliamentary Procedure
SECT. 1. Any question concerning procedure arising at any
Advisory Board or committee meeting shall be resolved by the Chairman in accordance with
these By-Laws, and in the case of a question not resolved by these By-Laws, the Chairman
shall resolve the question by reference to the latest edition of Robert's Rules of Order
Revised, and the meeting shall proceed in accordance with his/her decision based upon said
Rules.
ARTICLE XI
Amendments to the By-Laws
SECT. 1. Notice of any proposed change of the By-Laws must be
sent to the members, in writing, ten (10) days prior to the meeting and the proposed
changes must be set forth in full in the Notice.
SECT. 2. These By-Laws may be amended and supplemented with
provisions consistent with the objectives and purposes of the Monroe County E.M.S.
Authority by two-thirds vote of a majority of the Advisory Board.
SECT. 3. Any changes in By-Laws must be approved by the Mercy
Memorial Hospital Board of Trustees.
ARTICLE XII
Extension, Withdrawal &
Revocation of Cooperation
The Continuous Quality Improvement Committee shall make
recommendations to MMH Administration regarding the extension, withdrawal and revocation
of cooperation to basic, limited and advanced mobile emergency care services and
personnel. MMH Administration shall approve or disapprove all recommendations made by the
Advisory Board. Specific procedures are outlined in Appendix B and Appendix F.
ARTICLE XIII
Emergency Withdrawal of
Cooperation
Because of a need to maintain high quality prehospital care,
the Medical Director, acting in cooperation with Mercy Memorial Hospital Administration,
shall be empowered to temporarily withdraw cooperation from any basic, limited, advanced
mobile emergency care service or personnel, as authorized under Michigan Department of
Public Health Rule R325.23707, January 5, 1984, or as later amended.
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