Crossville City Council will consider changing its agreement with Dr. Mark Fox for medical services for its fire department after a failed motion to terminate his current contract.
The decision comes after Cumberland County last month hired a new medical director to oversee its emergency medical services. The city operates a first responder program under the county’s EMS department.
“It’s hard to have two medical directors,” Mayor James Mayberry said at a special meeting called May 3.
Mayberry read the agreement with the county for the Crossville Fire Department’s first responder program. As first responders, fire department personnel respond to medical calls within the city of Crossville to provide initial medical response until paramedics arrive.
Firefighter personnel include individuals with Emergency Medical Technician and Paramedic certifications, as well as trained first responders. When responding to medical calls, they must follow medical protocols and procedures established by the county EMS Medical Director.
Mayberry offered to cancel his independent contractor contract with Fox, supported by Councilman RJ Crawford.
Councilor Scot Shanks said: ‘I think we have a very good set up with the town at the moment.
Mayberry said: “We operate under EMS, period. The medical director they [the county] have chosen is upon us.
Mayberry said the city could develop a new deal with Fox. City manager Greg Wood suggested a title of chief medical officer.
“That would be a whole different deal,” Mayberry said.
Fox is a general surgeon at Crossville Medical Group and has worked with the city’s fire department for many years. In 2020, the city agreed to provide a vehicle for Fox to respond to emergency scenes and pay for an additional medical liability insurance policy.
The cost of the insurance premium and $200 monthly stipend paid to Fox comes to about $4,800 per year, plus vehicle maintenance.
Crawford said he spoke to EMS directors in Cumberland County and Putnam County.
“To have two medical directors, we would be the only ones in the state to have that,” Crawford said. “We need a medical director for the county EMS. If you want to change that, call it a different name and change some of the responsibilities…”
Fox said he was the fire department’s medical director before a first responder program was established.
“There are a lot of things going on within the fire department that are not the responsibility of the EMS county medical director,” Fox said. “The County EMS Director is the signing on the line that allows the Crossville Fire Department’s first responder program to continue.”
Fox said he could participate in programs involving firefighter care, including the cancer surveillance program, the city’s AED program, workplace safety training or returning firefighters from medical conditions.
“These things require oversight that is outside of the jurisdiction and responsibility of the EMS County Medical Director,” Fox said.
Fox said he could respond with firefighters to a call for assistance in a nearby county to help rescue an injured hiker, for example, and that firefighters could administer advanced care. That wouldn’t fall under the first responder program, he said.
“Whether you call him Medical Director of the Crossville Fire Department, Chief Medical Officer of the Crossville Fire Department, I truly believe there is reason and justification to have someone in that position” , Fox said.
Fox sometimes responds to a scene where medical treatment is being administered.
“I’m not responding as a first responder. I am the most advanced responder. I do not respond under the auspices of the EMS County Medical Director. I am an autonomous entity,” he said.
City Attorney Will Ridley said Fox would be subject to the first responder program and medical protocols if he responded to a scene as a representative of the city of Crossville.
“I agree with most of what he said, except I don’t believe he would be a standalone entity,” Ridley said. “You can still provide first aid services. You only need to do so subject to the guidelines and protocols of the county medical director.
Fox said, “My services wouldn’t be classified as first responder services…When I respond, it’s not as a first responder.”
The city’s deal with Fox is separate from the county’s medical program, Ridley said. This includes conducting annual trainings for the city’s fire and EMS employees and performing administrative, supervisory, and educational duties associated with the position of medical director.
Shanks said: ‘We have someone with incredible talent who wants to do this, is heavily supported by firefighters, gets paid next to nothing to do this.’
Crawford expressed concerns about the city’s potential liability and possible confusion with two medical directors.
Councilman Rob Harrison asked if the city could amend his contract, with a new title and new responsibilities. As for the confusion over the county and city medical director, he said, “That was my reaction at first – who’s going to make the call. But they probably worked together in the emergency room for decades,” Harrison said. “I’m confident they can make it work.”
The county’s medical director is Dr. James Wojcik, who is now retired but previously worked in the emergency department at Cumberland Medical Center. He is board certified in internal medicine and emergency medicine.
Mayberry’s motion failed with a vote of 2-3. Mayberry and Crawford voted to cancel the current contract. Shanks, Harrison and Councilman Art Gernt were opposed.
Shanks then suggested another motion to change the contract. Ridley said the board could ask him to draft a new contract to review next month. It didn’t require a motion.
At Tuesday’s regular council meeting, the council approved its agreement with Cumberland County EMS to continue the first responder program with city staff.
In other matters, the board approved the following consent agenda items:
• third and final reading of a budget amendment to finance the replacement of the roof of the maintenance building
• third and final reading removing an ordinance that prohibited divination in the city
• third and final reading of a budget amendment to replace a lighting mast and a traffic light
• second reading of a budget amendment for the purchase of a utility maintenance truck
• second reading of a budget amendment to purchase unbudgeted items
• second reading of a budget amendment for the three-star grant and engineering services for a pedestrian bridge over the Little Obed River