City keeps Mark Fox as medical officer

May 12—The Crossville City Council will consider changes to its agreement with Dr. Mark Fox for medical services to its fire department after a motion to terminate its current contract failed.

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 direction of the county's EMS department.

"It's hard to have two medical directors," Mayor James Mayberry said during a special-called meeting May 3.

Mayberry read from the agreement with the county for the first-responder program of the Crossville Fire Department. As first responders, fire department personnel respond to medical calls within the city of Crossville to provide initial medical intervention until ambulance personnel arrive.

Firefighter personnel include individuals with emergency medical technician and paramedic certifications, as well as trained first responders. When responding to medical calls, they are to follow the medical protocols and procedures established by the county's EMS medical director.

Mayberry moved to rescind its independent contractor agreement with Fox, supported by Councilman R.J. Crawford.

Councilman Scot Shanks said, "I believe we have a really good set up with the city right now."

Mayberry said, "We operate under EMS, period. The medical director they [the county] have selected is over us."

Mayberry said the city could develop a new agreement with Fox. City Manager Greg Wood suggested a title of chief medical officer.

"That would be a whole other contract," Mayberry said.

Fox is a general surgeon with Crossville Medical Group and has worked with the city fire department for many years. In 2020, the city agreed to furnish a vehicle to allow Fox to respond to emergency scenes and to pay for an additional medical liability insurance policy.

The cost of the insurance premium and the $200 monthly stipend paid to Fox comes to about $4,800 a year, plus maintenance for the vehicle.

Crawford said he had talked to the Cumberland County and Putnam County EMS directors.

"To have two medical directors, we would be the only one in the state who would have that," Crawford said. "We need to have one medical director over the county EMS. If you want to change that, call it a different name and change some of the responsibilities ..."

Fox said he served as the fire department medical director before a first-responder program was established.

"There are a lot of things that go on within the fire department that do not fall under the auspices of the county EMS medical director," Fox said. "The county EMS director is the signature on the line that allows the Crossville Fire Department first-responder program to proceed."

Fox said he could assist with programs involving care of the firefighters, including the cancer surveillance program, the city's AED program, workplace safety training or returning firefighters after medical conditions.

"Those things need oversight that is out of the purview and the responsibility of the county EMS medical director," Fox said.

Fox said he could respond with the fire department on a mutual-aid call in a neighboring county to assist with rescue of an injured hiker, for example, and the firefighters could administer advanced care. That would fall outside the first responder program, he said.

"Whether you call it a Crossville Fire Department medical director, Crossville Fire Department chief medical officer, I truly believe there's the reason and justification for having someone in that position," Fox said.

Fox does sometimes respond to a scene where medical care is being administered.

"I'm not responding as a first responder. I'm the most advanced responder. I'm not responding under the auspices of the county EMS medical director. I'm a standalone 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'd be a standalone entity," Ridley said. "You can still provide first-responder services. You just have to do it subject to the county medical director's guidance and protocols."

Fox said, "My services would not be classified as first responder services ... When I respond, it's not as a first responder."

The city's agreement with Fox is separate from the county's medical program, Ridley said. It includes conducting annual trainings for fire and EMS employees of the city and performing administrative, supervisory and educational functions associated with the medical director position.

Shanks said, "We've got someone with incredible talent who wants to do this, is highly supported by the fire department, is paid practically nothing to do it."

Crawford expressed concerns about potential liability for the city and possible confusion with two medical directors.

Councilman Rob Harrison asked if the city could change its contract, with a new title and new responsibilities. As for confusion on the county and city medical director, he said, "That was my reaction at the beginning — who's going to make the call. But they've worked together in the emergency room for decades probably," Harrison said. "I'm satisfied 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 2-3 vote. Voting in favor of rescinding the current contract were Mayberry and Crawford. Opposed were Shanks, Harrison and Councilman Art Gernt.

Shanks then suggested another motion to change the contract. Ridley said the council could direct him to draft a new contract to be considered next month. That did not require a motion.

During Tuesday's regular council meeting, the council approved its agreement with Cumberland County EMS to continue the first responder program with city personnel.

In other business, the council approved the following consent agenda items:

—third and final reading of a budget amendment to fund replacement of the maintenance building roof

—third and final reading removing an ordinance that prohibited fortune telling in the city

—third and final reading of a budget amendment to replace a high mast light pole and traffic light

—second reading of a budget amendment for the purchase of a utility maintenance truck

—second reading of a budget amendment to purchase non-budgeted items

—second reading of a budget amendment for the Three Star grant and engineering services for a pedestrian bridge over the Little Obed River

Heather Mullinix is editor of the Crossville Chronicle. She covers schools and education in Cumberland County. She may be reached at hmullinix@crossville-chronicle.com.