BEFORE THE ADMINISTRATIVE HEARING COMMISSION STATE OF MISSOURI Missouri Department of Health ) and Senior Services ) Bureau of Emergency Medical Services) 920 Wildwood Drive ) Jefferson City, Missouri 65102-0570, ) ) Petitioner, ) ) v } Case No. : ) License No. EMT-Basic 72355 ) Dominic Biscari ) 550 W 43rd St ) Kansas City, MO 64111, ) ) Respondent. ) SETTLEMENT AGREEMENT ‘The parties, Dominic Biscari (hereinafter “Biscari”), represented by Louie ‘Wright, and the Missouri Department of Health and Senior Services’ Bureau of Emergency Medical Services (hereinafter “Department”), represented by Brenda Rackers, announce they are entering into the following Settlement Agreement in order to discipline Biscari’s EMT-Basic license. Biscari and the Department jointly stipulate and agree that a final disposition of this matter, as detailed below, is authorized under sections 621.045, RSMo, (2016) and 190.172, RSMo, (2016). ‘The parties understand that this Settlement Agreement is in lieu of Biscati's right to a hearing before the Administrative Hearing Commission, 1, Biscari acknowledges that he understands the various rights and privileges afforded by law, the right to a hearing of the allegations against him; the right to appear and be represented by legal counsel; the right to have all charges against him provenupon the record by competent and substantial evidence; the right to cross-examine any witnesses appearing at the hearing against him; the right to present evidence on his own behalf; and the right to a decision based upon the record by a fair and impartial administrative hearing commissioner concerning the allegations pending against him. Biscati acknowledges that he understands his rights under the law and that he knowingly and voluntarily waives each and every one of these rights and freely enters into this Settlement Agreement and agrees to abide by the terms of this document as they pertain to him, 2. Biscari acknowledges that pursuant to section 190.172, RSMo, (2016) the agency shall submit a copy of this Settlement A greement signed by all of the parties within fifteen days after signature to the administrative hearing commission for determination ‘that the facts agreed to by the parties to the settlement constitute grounds for disciplining Biscari’s EMT-Basic license. Further, pursuant to section 190.172, RSMo, (2016) any person who is directly harmed by the specific conduct for which the disefpline is ght may submit a written impact statement to the administrative hearing commission for consideration in connection with the commission’s review of the settloment agreement. 3. Biscari acknowledges that pursuant to section 621.045.4(4), RSMo, (2016) he has been informed of his right to consult legal counsel in this matter. 4, Biscati also acknowledges that pursuant to section 621.045.5, RSMo, (2016) that any Settlement Agreement submitted to the administrative hearing commission shall not be effective and final unless and until findings of fact and conclusions of law are entered by the administrative hearing commission that the facts agreed to by the parties to the settlement constitute grounds for denying or disciplining the license of the licensee.5. The parties stipulate and agree that the order regarding the discipline of Biscari's EMT-Basic license in Part I] is based only on the facts and law set out in Part 1 6. Biscari understands and agrees that the Department will maintain this Settlement Agreement as an open record of the Department. PartI Based on the foregoing, Biscari and the Department jointly stipulate to the following: JOINT FINDINGS OF FACTS 1, The Bureau of Emergency Medical Services is a program with the Missouri Department of Health and Senior Services, an agency of the State of Missouri. 2. Biscari was licensed with the Department as an EMT-Basic, license number B- 72355, on February 20, 2020, Biscari’s E! {T-Basic license expires on February 28, 2028. 3. On or about February 21, 2023, an Information was filed against Biscari in the Circuit Court of Jackson County Missout in case number 2316-CR00810-01 stating, in pertinent part, as follows: Count I. Involuntary Manslaughter-2nd Degree (565.027- 001'7202009990) The Prosecuting Attomey of the County of Jackson, State of Missouri, upon information and belief, charges that the defendant, in violation of | Section 565.027, RSMo, committed the class E felony of involuntary ‘manslaughter in the second degree, punishable upon conviction under Sections 558.011 and 558.002, RSMo, in that on or about December 15, 2021, in the County of Jackson, State of Missouri, the defendant caused the death of Jennifer San Nicolas by crashing a Pierce Impel fire apparatus into a Honda CRV being operated by Jennifer San Nicolas and did so with criminal negligence in that thedefendant entered an intersection against a red traffic control signal without braking or ensuring that it was safe to exercise a negative right of way. Count Il, Involuntary Manslaughter-2nd Degree (565.027-001Y202009990) The Prosecuting Attomey of the County of Jackson, State of Missouri, upon information and belief, charges that the defendant, in violation of Section 565.027, RSMo, committed the class felony of involuntary manslaughter in the second degree, punishable upon conviction under Sections 558.011 and 558.002, RSMo, in that on or about December 15, 2021, in the County of Jackson, State of Missouri, the defendant caused the death of Michael J Elwood by crashing a Pierce Impel fire apparatus into a Honda CRV in which Michael J. Elwood was a passenger and did so with criminal negligence in that the defendant entered an intersection against a red traffic control signal without braking or ensuring that it was safe to exercise a negative right of way. Count III. Involuntary Manslaughter-2nd Degree (565.027-001Y202009990) ‘The Prosecuting Attorney of the County of Jackson, State of Missouri, upon information and belief, charges that the defendant, in violation of Section 565.027, RSMo, committed the class E felony of involuntary manslaughter in the second degree, punishable upon conviction under Sections 558.011 and 558.002, RSMo, in that on or about December 15, 2021, in the County of Jackson, State of Missouri, the defendant caused the death of Tami N Knight by crashing a Pierce Impel fire apparatus into a Honda CRV which then collided with Tami Knight, and did so with criminal negligence in that the defendant entered an intersection against a red traffic control signal without braking or ensuring that it was safe to exercise a negative right of way. 4, The probable cause statement filed in criminal case 2316-CR00$10-01 against Biscari stated that numerous surveillance cameras in the area captured the crash. The footage revealed at 10:18:58 PM the traffic signals for north and southbound Broadway were red and the traffic signals for Westport Road were green for east and westbound traffic. At 10:19:14 the traffic lights were the same color when Pumper 19 crashed into the westbound Honda. Biscari was driving the fire truck that was heading northbound on Broadway. The Honda CRV was heading west on Westport Road. The Pierce fire apparatus was equipped with an Onboard Vehicle Data Recorder. The data from the DR showed that Biscari was traveling 51.48 MPH in a 35 MPH zone with 100%throttle and the ABS was engaged when the crash occurred. The Honda was traveling 30-31 MPH through the intersection in a 25 MPH zone. The accident investigation team determined that Biscari entered an intersection with limited view of cross-traffic, through red traffic control signal at a speed that was too fast for the conditions that Biscari faced, 5. Onor about February 21, 2023, Biscari entered an Alford plea to the three (3) counts of involuntary manslaughter-2" degree, class E felonies. Biscari received a suspended imposition of sentence with three (3) years of supervised probation, Biscari is required to perform forty (40) hours of community service, not own, possess, or keep any firearms or ammunition during the term of his probation and to not have any criminal contact with any vietims or witnesses, specifically no contact outside of court related proceedings 6. One (1) KC Fire Department policy states in paragraph 4.13 that the driver is responsible for his/her actions and the safety of the passengers. Unless all lanes can be accounted for by the driver during an emergency response, all Fire Department vehicles shall come to a complete stop at all red light intersections and negative right of way situations. Another KC Fire Department policy states: KCFD vehicle operators shall be prepared to come to a complete stop when directed to do so by other KCED personnel; when ditected to do so by a law enforcement officer; when a schoo! bus with red operating flashing warning lights is encountered on the same roadway; and when encountering a railroad crossing gate in the down position. General Operating Guideline (GOG) 10-29. GOG 10-29 goes on to state that: KCED vehicle operators shall exercise caution and may proceed for a safe operation without coming to a complete stop whenapproaching a red traffic signal, a stop sign, a negative right of way intersection or an unguarded railroad crossing. Id. (emphasis added). ‘These policies were in effect on the date of the crash, December 15, 2021 Biscari has not been dri 1g an ambulance since the date of the accident on December 15, 2021. Biscari has not received any driver’s training by his employer following the date of the accident on December 15, 2021. ‘The driver's training that Biscati had prior to the accident was on-the job training. 8. One of Biscari’s co-workers on the Kansas City Fire Department submitted an e- ‘mail, through the chain of command complaining as to how Biscati was driving an ambulance in September of 2021. The e-mail indicated that Biscari was driving the ambulance too fast, both with and without a patient in the ambulance, ‘The e-mail also stated that Biscari became airborne at one point while going over a hill. ‘The e-mail further indicated Kansas Ci ty Fire Department staff were thrown around the back of the ambulance due to the fact that Biscari was taking tums too fast and hard, 9. ‘The Department held an informal conference with Biscari and his attorney, Louie Wright. During the informal conference, Biscari informed Department representatives that at the time of the accident, he was not aware of the complaint that had been made against him in September of 2021 about how he was driving the ambulance. Biscari also stated the complaint contained in the referenced e-mail was not investigated by the Fire Department, nor was Biscari made aware of it, prior to the vehicular accident on December 15, 2021. Biscari also stated that December 15, 2021, was the first time he had driven the fire truck during an emergency. Biscari stated that he was driving the fire ‘truck on the way to a reported house fire. Estimates were made that the Honda was‘traveling 30-31 MPH through the intersection in a25 MPH zone, but at least one (1) witness statement estimated the Honda’s speed at approximately 50 MPH. There was no ‘evidence that the driver of the Honda made any effort to slow down or take evasive actions, prior to the crash. 10. ‘The Department has the authority to discipline Biscari JOINT CONCLUSIONS OF LAW 1, For all relevant times herein, to the present, section 190.165, RSMo, (Cum. Supp. 2023), stated, in pertinent part, as follows: 2. ‘The department may cause @ complaint to be filed with the administrative hearing commission as provided by chapter 621 against any holder of any certificate, permit or license required by sections 190.100 to 190.245 or any person who has failed to renew or has surrendered his or her certificate, permit of license for failure to comply with the provisions of sections 190.100 to 190.245 or any lawful regulations promulgated by the department to implement such sections. ‘Those regulations shall be ited to the following: (2) Being finally adjudicated and found guilty, or having entered a plea of guilty or nolo contendere," in a criminal prosecution under the laws of any state or of the United States, for any offense reasonably related to the qualifications, functions or duties of any activity licensed or regulated Pursuant to sections 190.100 to 190.245, for any offense an essential element of which is fraud, dishonesty or an act of violence, or for any offense involving moral turpitude, whether or not sentence is imposed; (16) Any conduct or practice which is or might be harmful or dangerous to the mental or physical health or safety of a patient or the public; " Biscari entered an Alford Piea, which is roughly equivalent to plea of nolo contendere. Missouri recognizes Alford Pleas. In making an Alford Plea, a dofendant maintains her or his innocence, but acknowledges the possibility of being found guilty by the cour. See North Carolina v. Alford, 400 U.S. 25 G70).2. From all relevant times herein, to the present, Missouri regulation 19 CSR 30- 40.365 stated, in pertinent part, as follows: (2) The department may cause a complaint to be filed with the Administrative Hearing Commission as provided by Chapter 621, RSMo, against any hold of any certificate, permit, or license required by the comprehensive emergency medical services systems act or any person who has failed to renew or has surrendered his or her certificate, permit, or license for failure to comply with the provisions of the comprehensive emergency medical services systems act or for any of the following, reasons: (B) Being finally adjudicated and found guilty, or having entered a plea of guilty or nolo contendere,? in a criminal prosecution under the laws of any state or of the United States, for any offense reasonably related to the qualifications, functions, or duties of any activity licensed or regulated Pursuant to the comprehensive emergency medical services systems act, for any offense an essential element of which is fraud, dishonesty or an act of violence, or for any offense involving moral turpitude, whether or not sentence is imposed; (P) Any conduct or practice which is or might be harmful or dangerous to the mental or physical health or safety of a patient or the public; and 3. Section 190.165.2(2), RSMo, (Cum. Supp. 2023) and 19 CSR 30-40,365(2)(B) provide the Department with cause to discipline Biscari’s EMT-Basic license because on or about February 21, 2023, while he did not allocute to the elements of a crime and, in fact, maintained his innocence, Biscari entered an Alford plea, which in Missouri is treated as a guilty plea, to three (3) counts of involuntary manslaughter-2" degree, class E felonies. In Watkins vs. the State Board of Registration for the Healing Arts, the Missouri Court of Appeals, Western District held that Watkins’ Alford Plea was still a ® See Note I, supra (Alford Plea). Citations or references herein to nolo contendere may be understood to apply to an Alford Plea,plea of guilty even though Watkins accompanied the guilty plea with a “protestation of innocence,” 651 S,W.2d 582, 583 (Mo. App. 1983). The Missouri Court of Appeals, Westem District stated, “The state board was not required by statute to show that Dr. ‘Watkins admitted her guilt, only that she was convicted on a guilty plea.” Id. at 584. Similarly, section 190.165.2(2), RSMo and 19 CSR 30-40,365(2)(B) do not require Biscari to admit his guilt, but only that he entered a plea of guilty. ‘The three (3) counts of involuntary manslaughter-second degree are criminal offenses that are reasonably related to the qualifications, functions or duties of any activity licensed or regulated pursuant to sections 190.100 to 190.245, RSMo. Biscari was driving a fire truck during a fire emergency when he crashed the fire truck into a vehicle and a pedestrian causing the deaths of three (3) people. EMT-Basics are the primary EMS personnel who drive ambulances. EMT-Basics may respond and participate in emergencies by driving ambulances at higher speeds than are required by the set speed limits. EMT-Basics may also be driving ambulances during emergencies under poor road conditions. EMT-Basies must be knowledgeable and competent to drive ambulances during emergencies and in following laws that protect staff and patients who may be riding in ambulances and others who may be on the roadways. 4, Section 190.165.2(16), RSMo, (Cum. Supp. 2023) and 19 CSR 30-40.365(P) provide the Department with cause to discipline Biscari’s EMT-Basic license because Biscari was driving a fire truck that collided with a Honda CRV killing both the driver and the passenger, which then collided with Tami Knight killing Ms. Knight. Biscari was traveling at $1.48 MPH in a 35 MPI zone with 100% throttle and the ABS was engaged when the crash occurred, The Honda was estimated to be traveling at 30-31 MPH.through the intersection in a 25 MPH zone. Biscati entered an intersection with limited view of cross-traffic, through a red traffic control signal at a speed that was too fast for the conditions that Biscari faced. As a licensed EMT-Basic, Biscari will likely be driving an ambulance. Biscari’s failure to abide by the law and policies related to driving emergency vehicles is @ conduct or practice which is or might be harmful or dangerous to the mental or physical health or safety of a patient or the public. ‘Three (3) people were killed on December 15, 2021, as a result of Biscari driving the fire truck/emergency vehicle. 5. Cause exists to discipline Biscari’s EMT-Basic license pursuant to sections 190.165.2(2) & (16), RSMo, (Cum. Supp. 2023) and 19 CSR 30-40.365(2)(B) & (P) Part 11 Based on the above, the parties agree and stipulate that the Department shall discipline Biscari's EMT-Basic license based on the following terms and conditions: 1. Within ten (10) business days of the date this Settlement Agreement is effective and final, the Department shall discipline Biscari's EMT-Basic license. 2. Pursuant to section 621.045.5, RSMo (2016), the date this Settlement Agreement is effective and final is the date the findings of fact and conclusions of law are entered by the administrative hearing commission that the facts agreed to by the parties to the settlement may constitute grounds for the discipline of Biscari’s EMT-Basic license. 3. Biscari shall be placed on probation with the Department for a period of three (3) 3 years, Three (3) yeas isthe same period of probation imposed pursuant to Biscar's Alford plea. The pies agree tha, in the event te Court terminaies Bisear's probation in less than thee (3) years, Biseari andor bis counsel may ask the Department o consider shortening the term of probation imposed by the Deparment 104. During the period of his probation, Biscari shall annually obtain a current criminal background check from the Federal Bureau of Investigation and this background check shall be sent annually, from the effective and final date of this settlement agreement to the Department, specifically to the attention of the Bureau Chief, 5. If Biscari fails to submit a criminal background check ftom the Federal Bureau of Investigation referred to in number four (4) above to the Department annually from the effective and final date of this settlement agreement; then the Department may in its discretion vacate this Settlement Agreement and impose such discipline as the Department shall deem appropriate. 6. During Biscari’s period of probation, Biscari shall contact the Department, specifically the Bureau Chief of the Bureau of EMS, within 72 hours of when he is arrested or if not artested then Biscari shall contact the Department, specifically the Bureau Chief of the Bureau of EMS, within 72 hours of being charged with any crimes in any court of law in the United States, including federal, state, municipal and military courts, 7. Ifduring the period of his probation, Biscati fails to contact the Department, specifically the Bureau Chief of the Bureau of EMS, within 72 hours of when he is, arrested or if not arrested then Biscari fails to contact the Department, specifically the Bureau Chief of the Bureau of EMS, within 72 hours of being charged with any erimes in any court of law in the United States, including federal, state municipal and military courts, then the Department may in its discretion vacate this Settlement Agreement and impose such discipline as the Department shall deem appropriate. ulDuring Biscati’s period of probation, Biscati shall report to the Department within ten (10) days of the date Biscari is determined by a court of law to have violated his three 3) year probation for the criminal offenses of involuntary manslaughter in the second, degree, case number 2316-CR00810-01, for which he entered Alford Pleas to on February 21, 2023. 9. Lf Biscari is found by a court of law to have violated his probation for the criminal offenses of involuntary manslaughter in the second degree, then the Department may in its discretion vacate this Settlement Agreement and impose such discipline as the Department shall deem appropriate. 10. Biscari shall complete a National Association of Emergency Medical Technicians (-NAEMT") EMS Vehicle Operator Safety (“EVOS”) course and before he drives an ambulance for any employer. This EVOS course shall consist of a sixteen (16) hour course with eight (8) hours of classroom content and eight (8) hours of hands-on driving instruction. Biscari completed this EVOS course on July 20 and 21, 2023. Biscari shall provide the Department with a certificate of completion for the course that he took on July 20 and 21, 2023, within ten (10) days of the effective date of this Agreement. 11, If Biscari fails to provide the Department with a certificate of course completion within ten (10) days of the effective date of this Agreement, then the Department may in its discretion vacate this Settlement Agreement and impose such discipline as the Department shall deem appropriate. 12, During Biscari’s period of probation, Biscari’s employer(s) in emergency medical services and the healthcare field shall each be informed of his Alford pleas to the Class E felonies of involuntary manslaughter in the second degree and Biscari’s role in theincident; be given a copy of this Settlement Agreement; sign an acknowledgement of both which will be sent to the Department within ten (10) days of hire or the effective date of the Agreement and send the Department's Bureau of Emergency Medical Services quarterly reports by the 10" of the month for which the report is due during Biscari’s three (3) years of probation regarding Biscari’s job performance, including his performance driving an ambulance or other emergency vehicle, to the following address: Attn: Bureau Chief, Missouri Department of Health and Senior Services, Bureau of Emergency Medical Service,920 Wildwood Drive, PO Box 570, Jefferson City, Missouri 65102-0570. 13, If Biscari fails to inform his employers in emergency medical services and the healthcare field of his Alford pleas to the Class E felonies of involuntary manslaughter in the second degree and Biscari’s role in the incident and give a copy of the settlement ‘agreement to these employers and the Department fails to receive an acknowledgement of both within ten (10) days of hire or the effective date of the Agreement, then the Department may in its discretion vacate this Settlement Agreement and impose such discipline as the Department shall deem appropriate 4. f. ar fails to send or his employer(s) in emergency medical services and the healthcare field fails to send to the Department quarterly reports by the 10" of the month for which the report is due during Biscari’s probation regarding Biscari’s job performance, including his performance driving an ambulance or other emergency vehicle; then the Department may in its discretion vacate this Settlement Agreement and impose such discipline as the Department shall deem appropriate. 1315, During Biscari's period of probation, Biscari shall keep the Department aware in ‘iting of his employment in the emergency medical services and the healthcare field where he is utilizing his EMT-Basic license which includes the name of the employer(s) and the beginning date of employment. Biscari shall send this information to the Department in writing within ten (10) days of beginning such employment and atthe start of this settlement agreement. Biscari shall report any changes of employment to the Department in writing within forty-eight (48) hours. 16, If Biscari fails to keep the Department aware of his employment in the emergency ‘medical services and the healthcare field where he is utilizing his EMT-Basic license which includes the name of the employer(s) and the beginning date of employment in writing within ten (10) days of beginning employment and at the start of this settlement agreement and for any change in employment within forty-eight (48) hours; then the Department may in its discretion vacate this Settlement Agreement and impose such discipline as the Department shall deem appropriate. 17, The parties acknowledge that Biscati’s EMT-Basic license may expire before Biscari’s probation ends, If Biscari applies to renew his EMT-Basic license or applies for an EMT-Paramedic license during the period that Biscari is on probation with the Department, then the Department may grant Biscari’s EMT-Basic renewal application or Biscari’s EMT-Paramedic application for initial licensure and Biscari agrees to serve the remainder of his probation period as outlined in Part II of this settlement agreement in succession under his EMT-Basic or EMT-Paramedic license. At the end of his probation period, Biscari will be released from this probation. ‘The renewal of any license shall require conformance with sections 190,001 to 190.245 and sections 190.525 to 190.537, and rules adopted by the department pursuant to sections 190.001 to 190.245 and 190,525 to' 190.537." § 190.160 418. This Settlement Agreement does not bind the Department or restrict the remedies available to it conceming any other violation of Chapter 190, RSMo, by Biscari not specifically mentioned in this document. 19. Biscari agrees to comply with all applicable state statutes and regulations 1 services as an EMT-Basic. pertaining to the provision of emergency medi 20. ati hereby waives and releases the Department and any ofits employees, agents or attorneys, including former employees, agents or attomeys, of, or from, any liabitity, claim, actions, causes of action, fees, costs and expenses, and compensation, including, but not limited to any claims or attorney’s fees and expenses, including any claims pursuant to section 536.087, RSMo or any claim arising under 42 U.S.C 1983, which may be based upon, arise out of or relate to any of the matters raised in Settlement Agreement, or from the negotiation or execution of this Settlement Agreement, ‘The parties acknowledge that this paragraph is severable from the remaining portions of this Settlement Agreement in that it survives in perpetuity even in the event that any court of law deems this Settlement Agreement or portion thereof void or unenforceable. 21. In consideration of the foregoing, the parties consent to the termination of any further proceedings based upon the facts set forth herein 22. The conditions of this Settlement Agreement shall be in effect for three (3) years ‘from the date this Settlement Agreement is effective and final. 15APPROVED AS TO FORM: FOR Respondent Louie Wright, Attomey Wright Law Offices, LLC 2500 Holmes Street Kansas City, MO 64108-2743 Tel; (816) 474-3350 Fax: (816) 474-3551 FOR DHSS Brenda Rackers tn Brenda Rackers, Attomey Department of Health and Senior Services P.O. Box 570 Jefferson City, MO 65102-0570 Tel: (573) 751-6005 Fax: (573) 751-0247 16EMPLOYERS TO SIGN We are aware of the terms of the settlement agreement between Dominic Biscari and the Missouri Department of Health and Senior Services, Bureau of Emergency Medical Services and agree to review Mr. Biscari’s performance and discuss any problems regarding his employment, including his performance driving an ambulance or other emergency vehicle. We will submit quarterly documentation to the Department regarding Mr. Biscari’s performance by the 10" of the month in which the documentation is due during the three (3) years of Mr. Biscari’s probation with the Department. We will inform the Department within forty-eight (48) hours if Mr. Biscari ceases to be employed with us. Name Date Ress Ctnidy Sanu tle Deotecin chic f Employer {CE oD Employers: Please send required documentation to the following address: ATTN: Bureau Chief Missouri Department of Health and Senior Services Bureau of Emergency Medical Services 920 Wildwood Drive P.O. Box 570 Jefferson City, Missouri 65102-0570 Contact phone number for the Bureau Chief is (573) 751-6366 7