Catharine Ryan Keay, MD 4/7/2026

Temporary Medical Oversight Services Agreement This Agreement is made as of date of last signature below by and between: • City of Everett (hereinafter “Fire Department” or "Client"), with a principal place of business at 2801 Oakes Avenue, Everett, WA 98201 and • Dr. Catharine Ryan Keay (hereinafter "Physician" or “Provider”), with a principal place of business/residence at 16110 East Shore Drive, Lynnwood, WA 98087. Client engages Provider to perform EMS medical delegate oversight services under the terms herein. 1. Scope of Services Physician agrees to perform the following specific medical delegate oversight services (the "Services") in a professional and competent manner: Duties that accord with WAC 246-976-920(3)(a), 4(a) (c), and (d), 5(a), (e), and (f), 6(a) –(c) and (e), 7(a) – (d) and (f), that are delegated or otherwise assigned by the Snohomish County Medical Program Director to the Physician (“Services”), including the following deliverable • Provide medical control and direction of EMS certified personnel in their medical duties. This is done by oral or written communication; • Follow and comply with policies as directed by the Client to include a policy for storing, dispensing, and administering controlled substances. Policies must be in accordance with state and federal regulations and guidelines; • Participate with Snohomish County and North Region EMS/TC councils and SCEMSA to develop and revise (i) regional patient care procedures; (ii) Snohomish County operating procedures, when applicable; and (iii) recommendations for improvements in medical control communications and EMS system coordination; • Work within the parameters of the approved regional patient care procedures and the regional plan; • Provide oversight of instructors and supervise training of all EMS providers; • Approve providers to perform IV and IO starts on artificial training aids; • Approve a certified advanced emergency medical technician or a paramedic to function at a lower level of certification; • Access patient care records and reports in the statewide electronic EMS data system for EMS services under their oversight; • Audit the medical care performance of EMS providers in accordance with the MPD quality improvement plan; • Perform counseling and assign remediation regarding the clinical practice of EMS providers; • Approve equipment and medications used to provide medical care by EMS personnel; • Make recommendations for corrections for EMS services that are out of compliance with the regional plan to the department in accordance with WAC 246-976-400; and 2. Term of Agreement The initial term of this Agreement shall commence on March 1, 2026 and shall continue until September 30, 2026 (the "Term. The Physician and the Everett Fire Chief may agree in writing, without formal amendment to this Agreement, to further extend the Term of this Agreement to a date not later than December 31, 2026. Either party may terminate this Agreement before the end of the Term by 30-days prior written notice to the other party. 3. Compensation