E.1) Discussion and consideration to approve an agreement between Elko County and Dr. Kersten Milligan to provide medical direction services for Elko County Ambulance Service.  Dr. Robert Stefanko, has provided outstanding medical direction service for eight years. He has retired from his role as an Emergency Room physician and is enjoying retirement. Elko County Ambulance Service is required to have a medical director by statute.  The medical director provides clinical oversight and directs quality assurance and control activities.   Dr. Kersten Milligan is an Elko local who serves as an Emergency Room Physician at NNRH and welcomes the opportunity to be the Medical Director for Elko County Ambulance Service.