Agenda Item Wording:
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Fire Department Medical Director Contract - Authorize the City Manager to enter into a medical director services contract with Chadi Kahwaji Incorporated for not to exceed $42,000 annually for one year, with the option to renew for 4 additional one-year terms for a total of 5 years.
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Deadline for Action: 5/5/2025
Submitting Department: Fire Department
Contact Name and Phone Number:
Ryan Munger, EMS Coordinator ryan.munger@visalia.city 713-4261;
Crissy Balderama, Sr. Administrative Analyst crissy.balderama@visalia.city 713-4513;
Dan Griswold, Fire Chief dan.griswold@visalia.city 713-4220
Department Recommendation:
Staff recommends City Council authorize the City Manager to enter into a medical director services contract with Chadi Kahwaji Incorporated for not to exceed $42,000 annually for one year, with the option to renew for 4 additional one-year terms for a total of 5 years, per request for proposal (RFP) 23-24-26.
Background Discussion:
Advanced Life Support (ALS) fire departments and private emergency medical service (EMS) agencies are required to have a medical director for medical treatment oversight and to be able to purchase and administer narcotic medications as required in their paramedic protocols. Additionally, the medical director is essential to ensure agencies are providing effective prehospital emergency medical care through confirming current, evidence-based best practices are utilized, incorporating continuous quality improvement, and prioritizing provider health and safety measures. The key deliverables of this contract are specified as follows:
1. Medical Leadership & Oversight
a. Provide strategic medical leadership for the City’s EMS program.
b. Ensure that emergency medical practices align with industry’s best practices and evidence-based medicine.
c. Work closely with the EMS Coordinator to implement department goals.
d. Participate in key EMS-related policy discussion and planning.
2. Protocol Review & Compliance
a. Conduct an annual review of EMS protocols, ensuring they comply with federal, state, and local regulations.
b. Implement updates to treatment protocols based on the latest research and technological advancements.
c. Monitor changes in EMS regulations and recommend modifications as needed.
3. Training & Education
a. Conduct at least four EMS training sessions annually for department personnel.
b. Provided one in-person lecture per year on advancements in emergency medical care.
c. Work with training officers to develop educational content, including hands-on skills assessments.
d. Guide new paramedics through probationary evaluations and competency assessments.
4. Controlled Substance & Equipment Oversight
a. Ensure compliance with state and federal laws regarding controlled substance handling and storage.
b. Monitor inventory and usage of medical prescription drugs and EMS supplies.
c. Establish policies to prevent drug diversion and misuse.
5. Quality Assurance & Continuous Improvement
a. Develop a data-driven EMS quality improvement program.
b. Review patient care reports (PCRs) and conduct case audits for high-risk calls.
c. Participate in root cause analysis for critical incidents and complaints.
d. Implement corrective action plans for performance improvement.
6. Field Observation & Hands-On Support
a. Participate in field ride-along to directly observe patient care delivery.
b. Provide real-time clinical feedback to EMT’s and paramedics.
c. Respond to select high acuity calls for direct medical oversight.
7. Collaboration & Advisory Role
a. Act as a medical advisor for the Fire Department’s Peer Support & Behavioral Health Program.
b. Attend regional EMS committee meetings and serve as a liaison between the City of Visalia and regulatory agencies.
c. Assist in developing new service models as desired or requested.
A summary of Dr. Kahwaji’s qualifications and related experience includes:
Chadi Kahwaji, MD/PhD, FACEP (Fellow of the American College of Emergency Physicians).
• Board Certification: American Board of Emergency Medicine
• EMS Experience: 15 years in EMS Leadership
• Current Hospital Affiliation: Kaweah Health Emergency Department
• Specializations: EMS
• Professional Associations:
o National Association of EMS Physicians (NAEMSP)
o Emergency Medical Services Directors Association of California (EMDAC)
o American College of Emergency Physicians (ACEP)
o American Academy of Emergency Medicine (AAEM)
o Central California Emergency Medical Services Agency (CCEMSA)
Bidding Process:
The City of Visalia issued a RFP (NO. 23-24-26) to solicit for the medical director services. The RFP closed on March 6, 2025 and staff received one (1) proposal from Chadi Kahwaji Incorporated in the amount of $3,100 per month. After reviewing the proposal and conducting reference checks, staff recommends the contract be awarded to Chadi Kahwaji Incorporated for not to exceed $42,000 annually for one year, with the option to renew for 4 additional one-year terms for a total of 5 years.
Fiscal Impact:
The medical director services contract will be funded by the EMS Budget in Measure N.
Prior Council Action: N/A
Alternatives: No Alternative
Recommended Motion (and Alternative Motions if expected):
recommendation
I move to authorize the City Manager to enter into a Medical Director Services contract with Chadi Kahwaji Incorporated for not to exceed $42,000 annually for one year, with the option to renew for 4 additional one-year terms for a total of 5 years for RFP 23-24-26.
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Environmental Assessment Status: N/A
CEQA Review: N/A
Attachments:
1. RFP 23-24-26 Medical Director Services.
2. RFP 23-24-26 Addendum 1.
3. Chadi Kahwaji Inc Proposal
4. Medical Director Services Contract