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<br /> <br />7 <br /> <br />EXHIBIT A <br /> <br />SCOPE OF SERVICES <br /> <br />Duties that accord with WAC 246-976-920(3)(a), 4(a) (c), and (d), 5(a), (e), and (f), 6(a) –(c) and <br />(e), 7(a) – (d) and (f), that are delegated or otherwise assigned by the Snohomish County <br />Medical Program Director to the Physician (“Services”), including the following: <br /> <br />1. Provide medical control and direction of EMS certified personnel in their medical duties. <br />This is done by oral or written communication; <br />2. Establish policies as directed by the department to include a policy for storing, <br />dispensing, and administering controlled substances. Policies must be in accordance <br />with state and federal regulations and guidelines; <br />3. Participate with Snohomish County and North Region EMS/TC councils to develop and <br />revise (i) regional patient care procedures; (ii) Snohomish County operating procedures , <br />when applicable; and (iii) recommendations for improvements in medical control <br />communications and EMS system coordination; <br />4. Work within the parameters of the approved regional patient care procedures and the <br />regional plan; <br />5. Provide oversight of instructors and supervise training of all EMS providers; <br />6. Develop or approve an intensive airway management program and approve providers to <br />take the program if live intubations cannot be obtained ; <br />7. Approve providers to perform IV and IO starts on artificial training aids ; <br />8. Develop an evaluation form for a procedure or skill if one is not provided by the <br />department; <br />9. Develop an integration process to evaluate and determine competency of an applicant's <br />knowledge and skills in accordance with department policies; <br />10. Recommend denial of certification to the Secretary for any applicant whom the Medical <br />Program Director (“MPD”) can document is unable to function as an EMS provider, <br />regardless of successful completion of training, evaluation, or examinations; <br />11. Approve a certified advanced emergency medical technician or a paramedic to function <br />at a lower level of certification; <br />12. Adopt an MPD quality improvement plan that describes how quality improvement <br />activities are conducted by the MPD. The plan must meet the minimum standards of <br />the department;