BCC Minutes 01/25/2016 W (w/North Collier Fire Control and Rescue District) BCC
JOINT SESSION
MEETING
MINUTES
January 25, 2016
January 25, 2016
TRANSCRIPT OF THE MEETING OF THE
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS and
BOARD OF FIRE COMMISSIONERS OF THE NORTH COLLIER FIRE
CONTROL AND RESCUE DISTRICT
Naples, Florida, January 25, 2016
LET IT BE REMEMBERED that the Board of County Commissioners,
in and for the County of Collier, and the Board of Fire Commissioners of North
Collier Fire Control and Rescue District met on this date at 10:00 a.m., in
JOINT SESSION at Saint John the Evangelist Catholic Church, 625 111th
Avenue, North Naples, Florida
CHAIRMAN: Donna Fiala
Georgia Hiller
Tom Henning
ALSO PRESENT: Tim Nance
Leo Ochs, County Manager Penny Taylor
Jeffrey Klatzkow, County Attorney
Walter Kopka, Chief, Collier County EMS
Dan Summers, Emergency Management Director
BOARD OF FIRE COMMISSIONERS: CHAIRMAN: Norm Feder
Christopher L. Crossan
Margaret A. Hanson
M. James Burke
Roman E. Chao
Richard Hoffman
J. Christopher Lombardo
John McGowan
NORTH COLLIER FIRE CONTROL AND RESCUE DISTRICT:
James Cunningham, Operations Chief Orly Stolts, Fire Chief
Rita Greenberg, Executive Chief Jorge Aguilera, Deputy Chief EMS
Page 1
JOINT BOARD MEETING
OF THE
BOARD OF FIRE COMMISSIONERS OF THE
NORTH COLLIER FIRE CONTROL AND RESCUE DISTRICT
AND THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY
January 25, 2016
10:00 AM
AGENDA
1. MEETING CALLED TO ORDER
2. PLEDGE OF ALLEGIANCE
3. ROLL CALL
4. PRESENTATION OF STATEMENT OF CONFLICT ASSESSMENT ISSUES
CHART
5. DISCUSSION OF THE CONFLICT RELATING TO NORTH COLLIER FIRE
CONTROL AND RESCUE DISTRICT RESOLUTION 15-043 AND
SETTLEMENT OF SUCH CONFLICT
6. CONSIDERATION OF NORTH COLLIER FIRE CONTROL AND RESCUE
DISTRICT'S REQUEST TO EXTEND ITS EXISTING COPCN FROM JANUARY
29, 2016 EITHER THROUGH THE RESOLUTION OF THE CONFLICT OR
ANOTHER FUTURE DATE AS DETERMINED BY THE BOARD OF COUNTY
COMMISSIONERS
7. PUBLIC COMMENT
8. ACTION BY COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS (if
any)
9. ACTION BY NORTH COLLIER FIRE CONTROL AND RESCUE DISTRICT
BOARD (if any)
10. SCHEDULE ADDITIONAL MEETINGS TO CONTINUE TO SEEK RESOLUTION
OF THE CONFLICT (if necessary)
11. ADJOURN
January 25, 2016
CHAIRMAN FIALA: The meeting will come to order. Welcome,
everyone. Pretty soon I'm going to take my jacket off, but -- I know it would be
nice if I did, but I just can't yet.
And I welcome you-all this morning. I'm glad to see such a nice audience
that has joined us on this nice Monday morning.
I ask you to stand, please, and say with me the Pledge of Allegiance.
(The Pledge of Allegiance was recited in unison.)
CHAIRMAN FIALA: Thank you. And now may we have a roll call,
please? I don't know who's going to give the roll call, but that's on our list.
Leo, do you know who's going to be giving the roll call this morning?
MR. OCHS: We could ask our court reporter to begin the roll call and the
names.
THE COURT REPORTER: Okay. Donna Fiala?
CHAIRMAN NANCE: Oh, okay. We each give our own names and
positions then, okay. My name is Donna Fiala. I'm Chairman of the Collier
County Board of County Commissioners.
COMMISSIONER HILLER: Commissioner Georgia Hiller, District 2,
and Chair of Economic Development.
COMMISSIONER NANCE: Tim Nance, District 5.
COMMISSIONER TAYLOR: Penny Taylor, District 4.
COMMISSIONER McGOWAN: John McGowan, Commissioner, North
Naples.
COMMISSIONER BURKE: Jim Burke, Commissioner, North Collier
Fire.
COMMISSIONER CHAO: Ramon Chao, Commissioner, North Collier
Fire.
COMMISSIONER HOFFMAN: Richard Hoffman, Commissioner, North
Collier Fire.
COMMISSIONER HANSON: Margaret Hanson, North Collier Fire
Commissioner.
COMMISSIONER CROSSAN: Chris Crossan, North Collier Fire.
COMMISSIONER LOMBARDO: Chris Lombardo, North Collier Fire.
COMMISSIONER FEDER: Norman Feder, Chairman of Collier Fire.
CHAIRMAN FIALA: Laura?
MS. DONALDSON: Oh, sorry. Laura Donaldson, counsel for
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January 25, 2016
North MS. DONALDSON: Oh, sorry. Laura Donaldson, counsel for
North Collier.
MR. KLATZKOW: Jeff Klatzkow, County Attorney.
CHAIRMAN FIALA: And while we're at it, let's have the people in the
fire service that are in the back row at that table also just mention who they are.
Jim, you want to start?
CHIEF CUNNINGHAM: James Cunningham, operations chief, North
Collier.
CHIEF GREENBERG: Rita Greenberg, Executive Fire Chief, North
Collier Fire.
CHIEF STOLTS: Orly Stolts, Fire Chief, North Collier.
CHIEF AGUILERA: Jorge Aguilera, Deputy Chief of EMS for North
Collier Fire.
CHAIRMAN FIALA: Thank you very much. I was going to start with
the attorneys --
COMMISSIONER NANCE: The county?
CHAIRMAN FIALA: Pardon me?
COMMISSIONER NANCE: You want to do the county?
CHAIRMAN FIALA: Oh, our county people, yes.
MR. OCHS: Good morning. Leo Ochs, County Manager.
CHIEF KOPKA: Walter Kopka, the chief of the EMS.
MR. SUMMERS: Dan Summers, Director, Emergency Services.
MS. PRICE: Len Price, Department Head for Administrative Services.
CHAIRMAN FIALA: And forgive me for overlooking. It's kind of hard
to see from here down to where you guys are. Excuse me.
I was going to start with a presentation by the two attorneys but, instead, I
would like Leo Ochs to please take the podium and present the Statement of
Conflict Assessment Issues Chart.
(Commissioner Henning entered the meeting room.)
CHAIRMAN FIALA: Commissioner Henning, would you please state
your name for the record also.
COMMISSIONER HENNING: Tom Henning, Collier County
Commissioner, District 3.
CHAIRMAN FIALA: Thank you.
MR. OCHS: Thank you, Madam Chair. Good morning, Commissioners,
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January 25, 2016
ladies and gentlemen. My name is Leo Ochs. I'm the County Manager.
On January 13th and 14th, county staff, along with the Board's County
Attorney, met with members of the North Collier District staff and their legal
counsel on a series of conflict assessment meetings. We spent the better part of
two afternoons on the 13th and 14th of January identifying issues of conflict and
attempting to resolve those issues.
From a personal perspective, I would like all the commissioners to know
that I found discussions on those two days to be professional, frank, very
constructive. I thought that both parties worked in good faith to resolve the
issues that they could resolve given the parameters that were identified by both
of the elected bodies that we work for.
And so we did spend a couple of days working primarily on the elements
of an interlocal agreement. That interlocal agreement from the fire district side
was conditioned on the issuance of a Certificate of Public Convenience and
Necessity. We set that issue aside while we talked about the interlocal
agreement, understanding that that issue was one that we were unlikely to be
able to resolve at the staff level, and we reserved that discussion for this meeting
today of the public bodies.
I think with regard to the interlocal agreement, we did find some potential
common ground in areas related to a common county medical protocol,
pursuing some common credentialing criteria for all of the ALS medics that
work in the system, either on an ambulance or on an engine. We found some
common ground on training protocols.
We were unable to resolve issues relating to the medical director and the
authorization and appointment of medical directors. We also still have some
work to do on patient care reporting, quality assurance, quality control and,
essentially, that was, at least from the county's perspective, the outcome of the
two days of the conflict assessment.
So I would characterize it as we still -- we made some progress, but there
are still some fundamental differences, those primarily being the issue of the
issuance or non-issuance of the certificate and also the issue of the county's
interest in having a county medical director set the standards for medical
protocol, training, paramedic credentialing, patient care reporting, quality
assurance, and quality control.
Of course, our board is very open to the district having the autonomy to
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January 25, 2016
select their own medical director but would like, ultimately, all the medical
directors working as associates or in some way under the final guidance and
oversight of a single county medical director.
So that's my report, Madam Chair.
CHAIRMAN FIALA: Thank you.
MR. OCHS: I'm sure Chief Stolts may want to make some comments as
well.
CHAIRMAN FIALA: Very good. Chief Stolts?
CHIEF STOLTS: Good morning, everyone. Everything that I was going
to say Leo just said for me. But I will say the meetings that we did have -- the
two afternoon meetings that we held were very good meetings. We were able to
sit at the table and communicate very well.
We made headway on some of the things. A few of the other things,
really, we felt that -- beyond our control, and that's what we felt we needed to
bring to you-all today.
So I appreciate county staff participation in those meetings and our staffs
participation. We felt we made some pretty good progress on that, so thank you
very much.
CHAIRMAN FIALA: Thank you very much.
Now we're going to have discussion of the conflict relating to the North
Collier Fire Control and Rescue District Resolution No. 15-043 and settlement
of such conflict. And I believe that that would start with the attorneys, right?
Yes?
And so let's start -- Jeff, would you like to start? County Attorney Jeff
Klatzkow.
MR. KLATZKOW: I guess the primary issue, really, that needs to be
addressed is whether or not we can do business under an interlocal agreement
and only an interlocal agreement, or whether we can do business under the
issuance of a COPCN. That's the core issue here.
I think many of the other issues can be resolved at a staff level, if that
issue can be resolved. And I think that probably will be the primary discussion
point.
CHAIRMAN FIALA: Laura Donaldson, would you like to speak there?
MS. DONALDSON: Commissioner, I agree with County Attorney
Klatzkow. During the conflict assessment meetings, we did make progress, but
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January 25, 2016
there are a couple of fundamental issues that staff was not empowered to make
decisions on and, really, the purpose of this meeting is to try to have a dialogue
among the board members.
The County Attorney and I have a great working relationship. We can
pick up the phone and talk but, really, this is an opportunity for the boards to be
able to talk about the issue as it relates to the issuance of a COPCN.
CHAIRMAN FIALA: Very good. Let us start with the North Naples
Chairman, if you would, please. Norm Feder.
COMMISSIONER FEDER: Thank you, Commissioner Fiala.
What I would recommend is we have in front of us -- and I think the
public has access to it, I hope, as well -- a series of issues -- and let's get those
copies out -- that were discussed with the staff.
And it might be helpful if each of the attorneys would basically note their
position on the item, let the boards then discuss it, see if we can resolve that
issue or at least better define exactly where we are on that issue. If we can't get
it resolved, move to the next issue, and go down the list. Hopefully, I can get
some successes, come back to those issues that we didn't resolve.
The first one being, obviously, somewhat the hardest, as is already
identified. I think maybe that one actually gets changed over to the end and we
do that as the last one, I might recommend. But I think we need to go through
each of these issues, evaluate where we are, and start with the issuance of the
COPCN.
In this case, the Collier County position was noted as North Collier would
operate under Collier County's COPCN state license and, of course, North
Collier's position is that North Collier would operate under North Collier's
COPCN state license. So we've got a difference there.
If we can get each of the attorneys to review why maybe they've advised
their board the way they have, and then the boards can discuss that. And, as I
said, if we can at least further define the issues and maybe get them narrowed in
or resolve it and then go to the next issue, that would be my recommendation.
COMMISSIONER NANCE: Madam Chair?
CHAIRMAN FIALA: Okay. Certainly.
COMMISSIONER NANCE: Yeah. I believe currently there is litigation
to determine if indeed an interlocal agreement -- it's my understanding that
North Collier Fire at this point maintains that interlocal agreements are illegal,
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January 25, 2016
so I don't see any reason why we should have a big discussion on anything that
can be handled at the staff level while that's still a determination.
If North Collier Fire is resolved that we're going to take this to court and
that's the stance, I think we're wasting our time today.
COMMISSIONER FEDER: I would tell you that we specifically wanted
this meeting and put our legal issue on hold. We don't relish the idea to be in a
legal battle with the county, but at the same time we have to preserve our rights.
So having said that, I think that what we're doing today is saying let's put
that to the side, which we've done, and rather than proceeding on that right now,
find if there's some way that we, together, can work through these issues.
COMMISSIONER NANCE: So you're telling me you've withdrawn the
lawsuit?
COMMISSIONER FEDER: We have not withdrawn it. I will defer to
Laura for the status on that.
MS. DONALDSON: Madam Chair?
CHAIRMAN FIALA: Please.
MS. DONALDSON: We are under the Chapter 164 dispute resolution
process. So the lawsuit, effectively, have been stayed.
This joint meeting is required by statute under a very quick time period as
well as, if we're unsuccessful here, the statute requires us to go to mediation.
But right now the lawsuit has been stayed.
And it was filed because there was a 21-day time period that we had to
submit the lawsuit or we'd lose that right to challenge the lawsuit, so we had to
very quickly file it recognizing at some point that we'd have to sit down and talk
about the issues.
COMMISSIONER FEDER: And I think it's important at the outset -- I
know, at least myself-- and others who can speak for themselves. But I believe,
from our board, we honestly would like to see if we can make some progress
today, ideally, on all of these issues. But if we can't, let's understand that we
tried very hard to get to that point, because I don't think any of us wants the
other approaches to be the way we have to proceed forward.
COMMISSIONER NANCE: Very well.
CHAIRMAN FIALA: Okay. Jeff Klatzkow, do you have a comment on
that as far as the stay, and can we discuss this openly as long as the lawsuit is
stayed?
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January 25, 2016
MR. KLATZKOW: The lawsuit's very simple. It's whether or not the
COPCN is legally required. So feel free to discuss anything and all you want.
CHAIRMAN FIALA: Okay. Commissioner Hiller?
COMMISSIONER HILLER: Since this directly affects the constituents
of my district, I have great concerns about what's going on here.
The dispute is over a question of law, and the question, as Jeff properly
said, is whether or not a COPCN is required in order for the two independent
agencies to enter into an interlocal agreement, in effect, a mutual-aid agreement.
And I would submit that it is absolutely necessary. It is necessary that
both agencies have a COPCN individual to those -- to each agency that allows
for the same level of service that is the basis for the mutual-aid agreement that is
being proposed by the county.
So to that end, I don't feel that the county can contemplate entering into an
interlocal agreement with North Naples Fire to provide ALS services to the
constituents of my district, District 2, without awarding a COPCN to the North
Naples Fire District to allow North Naples to provide ALS services. And that
is, for everything I can see from reading the law, how the matter has to be
resolved.
Now, what I also don't understand is how this board can deny North
Naples Fire a COPCN based on the evidence that North Naples has produced at
the public hearing since the facts provided clearly rise to the level that would
afford this board the right and the duty to grant North Naples a COPCN to
provide ALS services.
Lastly, if we can extend, based on the evidence that North Naples has
presented, the COPCN by a day into the new year, by a month into the new
year, by two months into the new year, we cannot deny 365 days because the
facts that support the COPCN for a one-day extension are the same facts that
support a 365-day extension.
The bottom line is, the residents of District 2 are being compromised by
what the Board of County Commissioners has done by wrongly denying North
Naples Fire a COPCN and, as a consequence, the inability of the county to enter
into an interlocal agreement to provide mutual aid, to provide ALS services, to
save lives in District 2, as well as now the expanded North Naples Fire District,
which includes, I believe it's your --
COMMISSIONER CHAO: Big Corkscrew.
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January 25, 2016
COMMISSIONER HILLER: -- your district, which is Big Corkscrew.
So I have very, very grave concerns. I believe the public's health, safety, and
welfare is being compromised.
CHAIRMAN FIALA: Any other commissioners want to -- yes,
Commissioner Henning.
COMMISSIONER HENNING: Yeah, thank you.
The City of Naples works under an ALS agreement. The City of Marco
Island works under an ALS agreement. All the other independent fire districts
work under an ALS agreement, not a COPCN.
By expanding the request for a COPCN is fragmenting care in Collier
County. The citizens of Collier County doesn't stay within the district. District
2 residents travel outside of District 2, okay. There needs to be a common
response protocol, and if we keep on issuing COPCNs to the other independent
district or the municipalities, we wouldn't have a common practice, okay. It's
very simple.
Now, the COPCN settlement that was forwarded to the County Attorney
and the Board of Commissioners is illegal. It's simply illegal under the Florida
Statutes. We can't do that.
So I think it's very important. And I know that you're looking at one area,
but the Board of Commissioners needs to take a look at all the residents and
visitors within Collier County and -- at least that's -- my position is if we can
have a standardized procedure, training, response, and knowledge -- I mean,
you have, correct me if I'm wrong, over 100 paramedics in the district; is that
correct?
(No verbal response.)
COMMISSIONER HENNING: Okay. We don't have that many to
service all of Collier County. And one of the concerns is, is the knowledge --
the hands-on knowledge that the paramedics have when they go to a call.
Can you imagine if you went to a realtor that practices real estate but cuts
hair on the side and only does it a couple times a year, or would you want to go
to somebody that cuts hair on a regular basis? That is one of the issues.
Now, I've heard from the men and women on the street "shared
information." Just as you would share information when you take that patient to
the emergency room, that same information needs to be shared with our EMS
administration and the personnel for that patient care.
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January 25, 2016
However, I think the real issue is if we had a consolidated fire and EMS,
set your own protocol and let the county get out of the business.
That's my comment.
CHAIRMAN FIALA: Commissioner Hiller?
COMMISSIONER HILLER: Thank you. I'd like to respond to
Commissioner Henning.
COMMISSIONER HENNING: I -- you know, I don't think it's necessary.
This back and forth, Commissioner Hiller, doesn't serve anybody -- anybody
any good. You have your opinion. Everybody knows your opinion. To counter
my opinion is just not productive at all.
COMMISSIONER HILLER: It's my right. So as I was saying --
COMMISSIONER TAYLOR: Madam Chair, do we have a protocol for
this meeting? Are we going to go back and forth, or are we going to make
statements?
CHAIRMAN FIALA: No.
COMMISSIONER TAYLOR: Can we set something? And I don't mean
to put you on the spot, but I think it's very important.
CHAIRMAN FIALA: That's all right. That's the seat that I hold. But I
would like to hear what Commissioner Hiller has to say, and then I want to hear
from the people in North Naples so that we get their opinion as well.
COMMISSIONER HILLER: Thank you, Commissioner Fiala.
In response to Commissioner Henning, Commissioner Henning's logic is
flawed. The state sets the standard. The standard of care is uniform throughout
the state. So citizens who live in one district traveling out of Collier County
into another county will receive the same level of service as they would in
District 1, 2, 3, 4, and 5 in Collier County. Whether they're in Lee County or
Dade County or Leon County, the state sets standard of care.
There is no disparity when ALS services are provided. So that argument
that we have interlocal agreements in order to ensure a uniform standard of care
without granting those independent fire districts COPCNs is incorrect. And the
fact of the matter is, all those independent districts, whether it's the independent
fire districts or the cities, should have their own COPCNs in order to have
interlocal mutual-aid agreements with respect to ALS services.
CHAIRMAN FIALA: Thank you. Thank you so much.
COMMISSIONER HENNING: Madam Chair? Commissioner Fiala, can
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January 25, 2016
we hear from our EMS chief to see if-- who sets the standard of care in our
county?
CHAIRMAN FIALA: I know that you folks were willing to speak.
Would you mind if I heard from EMS first?
COMMISSIONER FEDER: Go ahead.
CHAIRMAN FIALA: Okay, fine. Thank you.
CHIEF KOPKA: Good morning. For the record, Walter Kopka, Chief of
EMS.
The state sets the standards for equipment, medications, training for the
EMS agency. The medical director sets the protocol.
COMMISSIONER HENNING: Thank you.
CHIEF KOPKA: Medical protocol. But the state sets standards for what
medications we have to have, what equipment we have to have, what training
we have to do, but the medical director sets the standard for the protocol.
COMMISSIONER NANCE: Chief Kopka, would you please explain
protocol.
CHIEF KOPKA: Medical protocol, what procedures are done for certain
patients, what medications are delivered for patients, what hospital they're
transported to. There are some certain criteria for trauma-alert patients that the
state sets standards for but, other than that, the medical protocol standards are
set by the medical director how patients are treated.
COMMISSIONER TAYLOR: Thank you.
CHAIRMAN FIALA: Did you have a question?
COMMISSIONER NANCE: No, I just wanted -- I just wanted to say
something relative to the general discussion that's here. And I believe that it's
completely ridiculous to say that the level of care is equivalent across our
county and across Southwest Florida. I don't see any way that the services, for
example, that are delivered in Lee County can compare to what we have in
some areas of Collier County.
And that having been said, in the eastern part of the county, the
low-density areas where distance turns into a time issue, there certainly are big
challenges. I don't think anybody can assume that the care that is ultimately
delivered in the county can be said, honestly, it's equivalent. Certainly the effort
is there, but I think that the task before us is not to defend the current system but
how to determine how we can deliver the very best in services.
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January 25, 2016
And I don't think that, based on a national evaluation on who gets the very
best in results, that it's controversial at all that we certainly ought to move to a
unified emergency response. And the only way we can move to a unified
emergency response is if we have a completely cooperative and coordinated
effort, and that is going to require us to change what we're doing now.
I don't think moving to independent licenses where we continue to engage
in a debate over which system is better or best is going to take us where we need
to be.
We certainly need to have consistent and coordinated information so we
can evaluate it and respond rapidly, and we need to have all units, regardless of
political boundaries or independent reformed districts working in concert, and I
don't think there's any issue right now that that is not taking place as well as it
could be.
Have there been improvements made? Absolutely. Have the fire districts
done great work in their consolidation? Absolutely. Does it mean we're where
we need to be? I think we're falling well short of our opportunity, and I think
that's the goal before us.
That's, I believe, what the Board of County Commissioners want to do,
and I hope that that's what the independent fire districts would like to see done,
and that is to finally be able to put together a unified emergency response as
others in the United States have done. I mean, if we want to be the gold
standard, then we have to -- you know, I hope everybody aspires to that like I
do. And that's what I'm interesting -- I'm interested in getting done, and, you
know, I think we have to overcome some of these issues here before we can get
there.
CHAIRMAN FIALA: Thank you.
COMMISSIONER FEDER: If I could, before we hear from staff or the
fire, I'm going to ask that we on the board here -- and I'll start out, and then go
down -- others that want to.
First of all, Commissioner Nance, I very much appreciate your comments.
I think we all want to see continued improvement, some modifications
countywide over time. And I think that's good, but it's not really the issue at
hand right now. We're not dealing with the issue of a broader consolidation.
We're dealing with the issue right now of medical treatment and continuation of
care.
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January 25, 2016
COMMISSIONER NANCE: Sir, respectfully, I did not use the word
"consolidation," and I did not mean consolidation.
COMMISSIONER FEDER: Okay.
COMMISSIONER NANCE: I meant exactly what I said, sir, a unified
emergency response.
COMMISSIONER FEDER: Okay. And I appreciate that. I still agree
with that statement as well.
I would point out, though, I find it interesting, we are working under one
single protocol. This is basically what's in each of our paramedics' and EMTs'
-- on their phone, in their trucks, the protocol. Right at the bottom it says,
medical director, Dr. Tober; assistant director, Dr. Lee. It is the protocols. It's
what everybody works from, including every single paramedic and EMT within
North Collier.
And so when we say "a consistent protocol," I think it's important to note
that we have one protocol within the county. And as a matter of fact, if we go
to change, even through our own medical director, we have to bring that to Dr.
Tober and seek his authorization to change the protocol in any manner. So
we're working under one protocol.
As far as quality assurance and other issues, I think that's where, under --
once we have a COPCN -- an interlocal agreement, we've got the ability to
expand and make further improvements, and I agree that that's critical that we
have good reporting, that we have good quality control and those issues, and I
think there's many respects we do.
The last thing I'll just throw out for the general discussion is we have a lot
of strategies on how is the best way to approach it but, at the same time, we've
had five years of experience, very, very productive experience. There have not
been problems at all. As a matter of fact, they're very good results they've
experienced from North cooperating under a COPCN for the last five years.
So it's not that we had a problem that we're trying to solve, and that's why
I raise that issue. Yes, I think we need all-hazards, but we've already started
there, and now we're retracting from that.
Commissioner Lombardo?
COMMISSIONER LOMBARDO: Thank you.
Madam Chairman, do you mind?
CHAIRMAN FIALA: Yes, certainly.
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January 25, 2016
COMMISSIONER LOMBARDO: I'm going to try to focus us from a
little more of a pragmatic perspective. Far be it for the lawyers to be pragmatic.
So be it as it is.
We're not talking about hairdressers working as realtors. We're talking
about emergency responders, first responders that are cross-trained, that are
state certified in two disciplines which is an extremely efficient model to deliver
services.
We're talking about 100 paramedics that four days from now will no
longer be able to practice. We're talking about more paramedics than the county
has. That's what North Collier has. We're talking about a training program that
exceeds the state requirements for training by more than twice. It's double what
the state requires.
So we're talking about excellent paramedics on both sides of the equation,
by the way, both the county and North Collier. We're talking about providing
services across the board that allows for that to continue.
The disturbing aspect of this, for me, is for five years we've operated
under a COPCN. For five years that results in people sitting in this county that
would not have survived but for the fact that we have cross-trained North
Collier paramedics that saved their lives. I'm sure if they were here today they
would say to you that this is unbelievable that we would have this discussion.
We applied for a renewal of our COPCN in March. And, by the way, we
had a COPCN. We didn't get our response until September, and that's when we
became aware of this circumstance.
For me what's disappointing is if we were going to have a paradigm shift,
a different approach in how we're going to do this, then I think the appropriate
way to have been -- to do this is to tell us back in March, gee, we're thinking
about a different approach so we could at least work our way through rather
than wind up in circumstance where we're now past the expiration date of our
COPCN, we're in an extension, we're four days away from shutting down the
system again.
And by the bye, for us it's very, very scary, not just for the residents of
North Collier, but also for the individual paramedics, and they are paramedics,
because the question becomes, what's their liability if at 12:01 they continue to
provide services? That's a problem.
So I look at this and I think the answer is really pretty simple. The answer
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January 25, 2016
is, if we need to talk about a different approach -- and we need to recognize that
we didn't write the statute that says we cannot do an interlocal agreement.
That's not us; that was the state. And that's scary also because there's a
reasonable interpretation that could be made that if you're functioning under an
interlocal agreement without a COPCN -- so you're not a like-kind entity -- then
you have personal liability when you sit on a board like this.
I don't want personal liability. I don't want to be responsible for someone
who's injured as a result of the fact that they don't have access to a paramedic. I
don't want that, particularly when I'm fighting to get the answer. I mean, to me,
that's the problem.
So we didn't write the statute. I can't help it that there are other interlocal
agreements that I think are inappropriate and unenforceable and, quite frankly,
expose those members of the boards to potential personal liability. It's a
mistake.
I don't think you continue to repeat mistakes. I think the answer is this:
We -- allow us to have a COPCN for the next year with the understanding that
you-all want to talk about a different approach. I agree with Mr. Nance that a
unified response is a good thing.
Quite frankly, that's why we're trying to provide a unified response across
North Collier, and we're North Collier. We're no longer North Naples and Big
Corkscrew Island. We're North Collier. We are a significant aspect of your
county. We are covering a significant number of your constituents.
And you're right, Commissioner Henning, we don't have people in District
2 that don't -- we don't just have people in District 2 that travel outside District
2. It turns out we have people in District 1, District 5, District 4, District 3 that
go through District 2. And so we impact everybody in this county.
What you have is a proven system with a quality team with a quality
training program which, by the way, we're willing to open up to the county
EMS as well. You're talking about 100 paramedics or more that are
state-certified paramedics, some of them former trainers for Collier EMS.
So we're not talking about a circumstance here where we are putting
anyone at risk by continuing what we've done. In fact,just the opposite.
If we continue with this where we equate this to hairdressers working as
realtors, we are putting people at risk. That's not what we're dealing with.
We're dealing with people's lives. We're -- every single day.
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January 25, 2016
Four days from now someone's going to have to answer to people as to
why it is that we took 100 paramedics out of service.
Extend the COPCN for a year. We'll -- we understand you want to
re-approach this. We'll go into negotiations. We'll figure out the answer. I tend
to think that the interlocal agreement doesn't work. Again, we don't write the
statute. But that's the short answer, and we need to get to it soon.
CHAIRMAN FIALA: Let me just ask a question, if I may. One of the
things I heard someone up here on this side say was that the information
between the North and Greater Naples is not shared as far as, you know,
patients or protocols or so forth. I don't think it's protocols,just shared
information so that in case we're answering something, do you -- would you be
amenable to sharing information between the two?
COMMISSIONER LOMBARDO: Well --
COMMISSIONER FEDER: Yeah.
CHAIRMAN FIALA: That's a big sticking point.
COMMISSIONER LOMBARDO: I'm not sure if the question is North
Naples -- North Collier with Greater Naples Fire Control or North Collier with
the county EMS, and I'm going to --
CHAIRMAN FIALA: I think it's with EMS.
COMMISSIONER FEDER: Yes.
COMMISSIONER LOMBARDO: Okay. My understanding -- and I'm
going to ask Chief Aguilera, if you wouldn't mind. I don't think that's the issue
for us. I mean, obviously, there are HIPAA issues and things of that nature
we've got to comply with, but what typically happens, as I understand it, is
when our paramedics arrive on scene, when your paramedics arrive, we share
information. We update them on what the status is, and we turn over control.
The objective is to get a paramedic on scene as fast as possible. We're
trying to save lives.
CHIEF AGUTLERA: Good morning, Madam Chair. Jorge Aguilera,
Deputy Chief of EMS for the North Collier Fire Department.
The answer is there's ways of sharing information. I mean, there's using, I
believe they're called, business agreements or business affiliation agreements
that follow the federal HIPAA compliance laws. There are ways of doing that.
I mean -- so the key is, can we get to a point where we can discuss those
agreements?
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January 25, 2016
Now, as Commissioner Lombardo was saying is, the state law basically
requires to do a verbal transfer of care when the North Collier paramedic is on
scene and starts care. That happens all the time. There's a verbal transfer of
care between both agencies to move forward.
We're in the process of sharing that information with the hospitals in a
similar fashion as the Collier County EMS currently shares or run reports with
the hospital.
I don't think this is an issue of sharing information. I think we can get
there if there's a need for it. Both agencies -- I guess the key is this here: This
key for sharing information is to ensure quality on both sides, and that is a
quality assurance function that -- once again, if we can get a point to be able to
discuss the format and do that -- and if you see your 10 points, we did have
some discussion on how to achieve that -- we can potentially achieve that.
That's not -- I don't think that is an unsurmountable goal, if that's what we want
to call it, a goal, to share information.
CHAIRMAN FIALA: Thanks. I just thought --
COMMISSIONER FEDER: I'm going to show it to you in just --
CHAIRMAN FIALA: -- if you take -- you know, pick apart some of
these things that have been presented to us and maybe come to a conclusion, we
could gather them together and come to a final conclusion, if it can be worked
out. It might not be worked out today, folks, and if it isn't -- I would love to see
it, but this is the toughest of all of the questions, and it happens to be first.
So I think that we have to do whatever we can to find a way to work
together, and if we cannot, then we have to turn it back over to the attorneys, I
guess.
COMMISSIONER HOFFMAN: Can I ask a question?
COMMISSIONER FEDER: I would -- go ahead.
COMMISSIONER HOFFMAN: If North Collier has a COCPN (sic) or is
given a COCPN --
COMMISSIONER CROSSAN: COPCN.
COMMISSIONER HOFFMAN: You know what I mean -- does that
mandate that we have our own medical director?
CHAIRMAN FIALA: Well, they wanted their own medical director, if I
might jump in.
UNIDENTIFIED SPEAKER: By law you have to have that.
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January 25, 2016
COMMISSIONER LOMBARDO: We have to have one, by the way.
COMMISSIONER FEDER: Yes. It would have to be different, but it has
to be there.
COMMISSIONER HOFFMAN: COPCN.
COMMISSIONER FEDER: I believe -- I'll just make a comment. I don't
think we could get there; we need to get there. And I think that's part of what
we'll discuss shortly.
I believe Mr. Kopka had some interest in speaking to that issue.
COMMISSIONER LOMBARDO: Well -- and I want to throw in one
other thing.
Commissioner Fiala, I hear you, and I am here to find a solution, but I'm
also here to remind everybody that we have four days. I mean, therein lies the
problem. We're talking about taking over 100 paramedics -- and, by the way,
someone of the most senior tenured paramedics in this county -- out of service
in four days, and we're talking about taking them out of service in probably the
highest density of population in the county.
Again, to me, the answer is rather than go through the process we are with
lawsuits and meetings like this, the answer would have been much, much better
had you just said to us, we're going to extend for one more year, but we're going
to open up discussions right now to work through this so we don't wind up, up
against the wall by December 31, 2016. That's the problem with what we're
doing.
CHAIRMAN FIALA: Chief Kopka.
CHIEF KOPKA: If I may, Madam Chair. Just to clarify, the patient care
reporting system that we're referring to is all the documentation that goes into
how a patient is treated, what is done for that patient, what medications are done
for that patient. EMS and the districts that we have interlocal agreements with
are on a patient care reporting system, and all that information is kept in one
place.
North Collier has its own patient care reporting system. They're two
completely separate systems. They currently don't mix. We don't have access
to them. So it's two different patient care reporting systems.
And also, as for the training aspect, the commissioners have made a
comment which is absolutely true. There is one common medical protocol but,
since there are two different medical directors, there are different standards how
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January 25, 2016
those paramedics are trained to that common medical protocol. But there are --
but there is one common medical protocol. The training standards are different
because there are two separate systems.
I hope that clarifies.
CHAIRMAN FIALA: Yes.
COMMISSIONER FEDER: Madam Chair?
CHAIRMAN FIALA: I have a real stickler question, but I don't know if I
should put it on the table yet or not, and I haven't spoken to anybody about it, so
Norman?
COMMISSIONER FEDER: Madam Chair, I'd have you fall (sic)
anything you want to raise. I was just going to raise that -- I'd see if there's
anyone else on our board that wanted to address this and if not, maybe that we
go on to the next issue and come back to this one a little bit later.
CHAIRMAN FIALA: Okay. I know Commissioner Taylor wanted to
say something.
COMMISSIONER TAYLOR: Yeah, a couple of things. First of all, from
my reading and certainly from talking to some medical personnel in our county
and also some folks who came out of our county to offer a data-driven-decisions
seminar this year, as much as ALS is important, it's BLS that is the critical part.
And so that, you know, 100 paramedics, ALS cross-trained paramedics, are
going to be out of-- not going to be able to practice in North Naples doesn't
address the fact that it's -- without BLS, lives wouldn't be saved. That's why
they're there first.
And, oftentimes, it's my understanding, that basic life support, when it's
undertaken at a call, sometimes ALS is not even required. Now, I'm not -- I
don't have data in front of me. I've just been told by experts.
The other issue would be regarding the medical director and the training.
It's my understanding that the ride time on ambulances is extremely important
for paramedics' training, and they don't always get it, and that, under the current
medical director, the training requirement varies district to district.
Given that, why would North Naples not want to be part of a larger system
whereby it appears there's flexibility in the training on the ride time, specifically
the ride time on ambulances? And that it is not one size fits all. It is based on
geography; it's based on the amount of training the paramedic has on a monthly
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January 25, 2016
basis. So it's looked at very carefully. Why would North Naples not want to be
part of that?
COMMISSIONER LOMBARDO: If I may respond. First we're in North
Collier.
COMMISSIONER TAYLOR: I'm sorry, North Collier.
COMMISSIONER LOMBARDO: Secondly, when it comes to training,
our training protocols and our training programs are roughly twice what the
county does.
Third, we've done -- this is not a new issue. I've been on this commission
now for almost, what, 18 years. This is an issue that we've wrestled with for
years and years.
We did the ride-share program before. We listened to the argument that
riding on an ambulance is extremely critical for a paramedic. Here's what we
learned. Our firefighter/paramedics became drivers, and so they weren't getting
hands-on experience. They were getting experience driving a vehicle. We have
plenty of experience driving vehicles, thank you very much. What they need is
experience in the back of the ambulance, and that's not what they were getting.
What we found is by implementing our own training programs where we
can provide hands-on programs -- and we do joint training programs with
Arthrex where our paramedics work on cadavers. We have identified para --
excuse me, doctors that have done training programs in obstetrics, in pediatrics,
in senior care. We even had a veterinary care program come through so that we
can provide a full range of services and keep them current.
So we are a critical part of the system right now and have been for the last
five years. In fact, I would tell you that I think in the field it's worked extremely
well.
The -- this is not a circumstance where there is a functional problem on
the ground level. This is a political situation. That's what this is.
I respect the fact that there are those that would like to see other
objectives. The way to do this is to say, fine, we're going to extend the COPCN
for a year, and then we're going to go into negotiations to resolve how we
handle things like data exchange and patient-file sharing, because all of that can
be done, and it can be done with business agreements or things of that nature.
The idea of taking 100 paramedics out of service in the interim while we
try to figure out the answer, that, to me, as a long-term citizen of this county,
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January 25, 2016
unacceptable, unacceptable.
CHAIRMAN FIALA: Did you have somebody else on your board that
would like to speak?
COMMISSIONER FEDER: Yes. Commissioner Crossan.
COMMISSIONER CROS SAN: Just for the public, like Commissioner
Lombardo has just stated -- and let me preface of my background a little bit. I
started in the fire service in 1991 under Chief Murphy back there, and I'm
currently still in it. And I don't draw the lines -- and I work well with some of
the county paramedics who are also firefighters, and I agree with Commissioner
Nance that at some point, you know, we have to get there. We have to get there,
and it has to be a single-service delivery.
But when they come on a fire scene and they're paramedic/firefighters --
just like last week, the building was on fire -- I don't draw the lines. He comes
in and does his job.
And as far as we're concerned in the Corkscrew delivery area -- I think
that's one of the reasons last time the Naples Daily News gave me the nod; my
captain's paper was on the role of the paramedic.
And I can tell you, Ms. Taylor, that I do agree with BLS, first BLS. I'm
CPR certified. I start with that. But there's those times when we need that ALS
intervention. And I have a lot of-- a lot of the county employees who live in
my district who think this is absolutely ludicrous that we're not being allowed to
do this.
And I respectfully submit that you guys vote for the extension of the
COPCN today and we continue working on these other items as well because --
Ms. Taylor, it's those times when a child needs an asthma treatment and maybe
one of the QRV projects. And then I've had employees of the county, as
yesterday, two days ago, that they have 16 positions available but only 11
people signed up. So if our 100 paramedics go to the wayside, then, wow, we're
even more in trouble. And believe me, it does work, you know.
And I know the comment about the hairdresser and everything else. But
when I run a scene, my interest is starting from Lori and ending with maybe
Spencer -- because I like him back there, but Chris Spencer back there, and it's
each individual person.
And we always place that county paramedic or the paramedic from the
firefighters because, believe me, on both sides of the coin, there are really strong
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January 25, 2016
suits, and there's people who aren't that good. And we just simply make the -- I
make the process, when I run a scene or when Chief Murphy runs a scene, to
take care of each individual sitting there, and that's what this is about. It's not,
can the firefighter do the job, because everybody's held to a high standard in our
organization now.
And I only expect that, and that's why I pride myself for working for
Marco Island but also working with North Collier, because we have so many
schools out in that delivery area. And now that we've merged as one, there's
people from the North Naples service delivery area and the Corkscrew in the
North Collier service. The shirts are all the same now. The paramedics have
came across that line.
And we need that service, too, and we need to further that service on our
ALS engines, too. As many times as one of the toughest places in the county --
and Chief Allen is here from Immokalee -- that when they're out on that fire,
and they're out on that fire all the time, that when that engine moves up, we
have the ability to deliver that service as well as far as a single source, like Mr.
Nance says, through the county, which we would not have the ability now
because everybody knows in this room who's in the know, too, there's been
many just paramedics out in Immokalee that have pulled that hose line for that
fire engine apparatus that only had two people on it at some time. And that's
what it's all about. It's about everybody in this building having the same
service.
And, I agree, we'll get there under that protocol. We'll get all these little
things, you know, before. But this COPCN is of importance because, you
know, I've had one of my firefighters whose father passed away right in front of
him because he couldn't get enough epi, and it was -- I see the heartbreak on his
eyes. He worked with me yesterday, and it was years ago.
And I've seen, with coaching football at FBA or whatever, I went and
assisted with those asthma treatments. And I know there's only one nurse
working in the three elementary schools. So when is it -- that day that that kid's
going to have that thing? And that's all I'm talking about here.
CHAIRMAN FIALA: Thank you. Thank you. I appreciate that. Yes,
sir.
COMMISSIONER CHAO: I wanted to -- the most important thing that
everyone in this room and in this county needs to understand -- and I'll go back
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January 25, 2016
to my history. I worked for Collier County EMS for 15-and-a-half years. I
retired out as a special operations lieutenant. I was -- I trained, and a lot of
those people that I trained are working in all of the different fire departments
now.
I've been accused that I'm pushing the whole fear-mongering thing and
stuff like this, but there is -- on the Naples Daily News they played the
advertising, and when -- they didn't play the advertisement. They played the
actual call, and in the call you hear the deputy arrive, a minute later he calls that
the guy's in arrest, the fire department arrives, and they're there giving awesome
BLS.
But all the ALS treatment that could have gone through, putting a heart
monitor, starting an IV, giving the medication -- for four minutes they stood
there doing what the deputy had already started, the CPR, and establishing an
airway. That's the difference between the ALS.
And for the people that are out there, be sound and safe to know that you
have got top-notch paramedics. And all this stuff going on that you hear here
does not -- and I'm telling you -- does not go on in the field.
When a medic shows up, there is the utmost respect. They're handing off
Everyone is working together. You don't see -- if you got on a truck and you
worked a month, you wouldn't even know there's anything -- there are no seams
here. It's a seamless, uniform operation.
But the fact that you're going to cancel this and take it away is just -- as I
have said in the past, it becomes criminal that someone has to see their -- sit
there and watch someone knowing you have the skill and you cannot use it.
Because I can tell you this: I know a lot of these kids -- and I call them kids
because they're in their 20s and their 30s now, and I'm in my 50s -- that they
would jump out there and save that person and do what they had to do if the
equipment is available to them, not realizing the jeopardy they're putting their
families in all over a simple thing.
CHAIRMAN FIALA: Sir, could you -- could we --
COMMISSIONER CHAO: That's it.
CHAIRMAN FIALA: Okay. I wanted to get back to the subject instead
of the examples.
Peggy?
COMMISSIONER HANSON: Okay.
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January 25, 2016
COMMISSIONER FEDER: Do we have any other comment? Oh,
Commissioner.
COMMISSIONER HANSON: I would -- certainly, I agree with the idea
that Commissioner Lombardo put out giving us a year and trying to work
forward with something, obviously.
What I want to just mention is that -- because it was mentioned "sharing,"
okay. There's one way where we can share on a certain level, and that's by
having all of our paramedics who are available get together at these meetings
that we have started. And this was started by Jamie Cunningham and Jorge
Aguilera.
And we have an EMS council that meets, sometimes every month,
sometimes it might be every other month. And we have sometimes half a dozen
doctors who come there. And one doctor who has -- who spends time in other
parts of the country, and he's known throughout the nation. We have not only
the doctors locally, though, but we have a doctor from -- isn't that crazy -- Lee
Memorial Trauma Center, as a matter of fact, who comes to the meeting. I
couldn't even think of the Lee Memorial.
Anyway, we have a pharmacist many times. We have someone from the
Sheriffs Department. We have nurses, and we have many fire chiefs who
come. We have very few paramedics from other areas.
CHAIRMAN FIALA: Thank you, Peggy.
COMMISSIONER HANSON: And I'd like to see us have a joining of all
the paramedics so that we can find out the latest in drugs, because some drug
companies, if they're not making enough money, they're dropping some of these
essential drugs, and we have to go with something else.
CHAIRMAN FIALA: Thank you. Now --
COMMISSIONER HANSON: Well, we've written letters to our medical
director and told him about a number of things, never getting anything back.
There should be a sharing of this. And that's a perfect opportunity where all
these paramedics could get together and really learn a great deal, I think. So the
COMMISSIONER FEDER: Thank you. Thank you, Commissioners.
CHAIRMAN FIALA: You know, as I'm listening here -- and we're not
going very far. It's been an hour and we haven't gone anyplace. So I'm going to
throw something out on the table. And the good thing is, I don't have a dog in
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January 25, 2016
this fight, so it's pretty easy for me to preside, which is great. What I'd like to
say is, I hear from both sides, and I'm trying to sort things out in my brain here.
I'm hearing what you say: Give us one year, and then we'll sort things out.
How about if we give them one year with their own COPCN with the drop-dead
date of one year but everything has to be resolved and ready to go into place,
and we might have to consider changing medical directors so that there's one
medical director that both sides can accept, because a lot of this goes back to the
medical director at this time.
And I think if we can do those things, we just -- as long as the drop-dead
date is one year, and after that we just take over or we have a combined effort.
To me, that would seem to be -- you have a goal in mind; you have a date in
mind; you understand what needs to be done. Now get there and do it. That's
my suggestion.
COMMISSIONER FEDER: Commissioner? Commissioner, I would tell
you that we would find that to be a very responsive approach. I think it's one
that allows the public to weigh in, both of us to evaluate options and hopefully
to make some progress.
CHAIRMAN FIALA: Commissioner Nance?
COMMISSIONER NANCE: Commissioner Fiala, very respectfully,
when I arrived on the County Commission -- and I arrived there not to have a
career position. I arrived there to do something following my retirement. One
of the first things I was told is that this issue had been kicked down the road for
over 20 years before I got there.
We had testimony on the dais, okay. We have an opportunity right now to
build -- to continue to build a unified response. The independent fire districts
have done great work. There have been movements on everybody's front,
except North Collier's, to cooperate.
I don't see any reason why we need to continue to kick this down the road.
We've defined the difference. North Collier has the ability to cooperate if they
want to. They have the ability, but what is lacking, in my evaluation of this
analysis, is their will to do it. That's the only thing. They have the ability.
They don't have the will.
Collier County has the ability to move toward -- to continue to move
towards a unified response. There is absolutely nothing that I can see that more
time kicking this down the road is going to make a difference.
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January 25, 2016
If everybody agrees that these are -- that the differences that are outlined
in this analysis are hard differences and everybody agrees that these differences
are firm, then we are wasting our time doing it. Until somebody decides they
want to cooperate with the county and they want to continue to suggest that
somehow the county is depriving them of the ability to do something, this is
absolutely nonsense.
The only thing that's depriving them from working together with
everybody else who somehow has found a way is the will of North Collier Fire
to do so, and I don't think time is going to produce that will.
CHAIRMAN FIALA: Thank you.
COMMISSIONER LOMBARDO: I respectfully disagree. The law is the
problem here. I can't help it if the way you're doing this with other districts and
cities is incorrect. We're not going to go down that path. We haven't been
kicking --
COMMISSIONER NANCE: Well, Commissioner, you're the only one
that's right.
COMMISSIONER LOMBARDO: We have not been kicking -- we have
not been kicking this can --
COMMISSIONER NANCE: Everybody's finding a way to work
together, and you can't figure it out.
COMMISSIONER LOMBARDO: I'm sorry. Go ahead. I'll listen.
COMMISSIONER NANCE: You cannot figure out a way to cooperate
because there's some esoteric, philosophical thing that exists out there that
means that everybody else is wrong except you. This is ridiculous.
COMMISSIONER LOMBARDO: All right. Let's make sure we
understand something. We're not talking about esoteric philosophy. We're not
talking about me. We're talking about a state law. That's what we're trying to
do is follow the law. And so that's what creates the problem here.
It isn't a lack of will or a lack of desire. We're sitting at a table. We asked
you to come to this table to work this out. Why? Because we recognize the
problem.
We've been doing this for five years under this approach. It's you that
changed the direction.
COMMISSIONER TAYLOR: With all due respect, you --
COMMISSIONER LOMBARDO: Wait -- allow me to finish. I took
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January 25, 2016
interruptions before, but I'm going to complete.
We have -- you have 100 paramedics -- we have more paramedics than
you do. We're in the middle of season. We have a record number of people
here for the season right now. Four days from now you're taking 100
paramedics out of the system. That's reckless. That's absolutely reckless.
We have a desire to resolve this. My approach is a little different than
yours. I'm not going to tolerate being bullied. The answer is, you -- had you
warned us back in March when we made this application, we could have opened
up that discussion. You didn't. You waited. And so here we find ourselves in
this very embarrassing predicament which, if I was sitting out there, I'd be just
astonished, absolutely astonished.
The answer is we extend for a year. We understand your objective. We
work through it, we figure it out, and we figure out how to do this so it is
compliant with the law. Not compliant with esoteric philosophies, not
compliant with what I'm asking, but compliant with the law.
CHAIRMAN FIALA: Okay.
COMMISSIONER FEDER: I would go --
CHAIRMAN FIALA: I have some people --
COMMISSIONER FEDER: If I could go a little further.
CHAIRMAN FIALA: -- asking to speak, okay. I've had Commissioner
Hiller waiting. Norman, you are waiting. Commissioner Taylor is waiting.
COMMISSIONER FEDER: Okay. Let me then -- let me just proceed
forward on that.
CHAIRMAN FIALA: So you want to go first?
COMMISSIONER FEDER: Please, please, if you allow.
What I think is very, very important here is that you've had a process for
five years that's worked very well. All of a sudden the surprise of change after
an application in March in September.
Bottom line is this: It is not so much that we are uncooperative. We are
being dictated to. That's number one. Number two, I will find a solution for
you. Here's a good one. Right now, if you will put one of your EMS
paramedics on each one of our vehicles, we'll solve the problem. I don't need a
COPCN.
Now, where we need a COPCN is that we don't have that ability from
EMS to be as responsive as you can from the fire delivery, and we know we get
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January 25, 2016
there first. Now, that's not necessarily better. I think it's as good but,
nonetheless, we're there first. Then we hand over. And we don't transport, and
we didn't ask for any of that.
Now, eventually, I think an all-hazards is going to get a lot of these issues,
and I agree there. But the fact of the matter is, we're out there; we're responding
to a need; it has been very effective for five years.
And so there is an approach. Is the county ready to support its own EMS
to the tune of being able to have somebody from EMS on every one of the fire
trucks so that they will be there first every time?
CHAIRMAN FIALA: Commissioner Hiller?
COMMISSIONER HILLER: Thank you.
I have to agree with Commissioner Fiala and with Commissioner
Lombardo. I'll begin with Commissioner Lombardo. It is about the law. It is
not about philosophy, and there is nothing esoteric in these arguments.
All the independent districts, the municipalities, and the county are
governed by the same statute, and that statute is clear that if ALS services are to
be provided, a COPCN has to be granted to the political unit, and that political
unit has to have its own medical director, and the standard of care has to be the
state standard, and the standard of training has to be the state standard.
It is also clear that to have an interlocal agreement both political units
have to have the legal ability to provide the same service that is the subject of
that agreement. A lot has been accomplished, contrary to what has been stated.
More importantly, there has been agreement on significant issues which,
for some reason this morning, notwithstanding the introduction by County
Manager Ochs and by Chief Orly Stolts, have been suggested to divide.
There is agreement between county staff and North Collier staff on a
countywide common medical protocol. That's not an issue. It's done. It's
agreed that there's going to be a common medical protocol countywide. There's
an agreement that there is going to be a common countywide credentialing and
re-credentialing criteria standard set. It's a nonissue.
There is -- with respect to the training, the training, as was said when I
first started talking about this, is set by the state. Every single paramedic, in
order to be recertified, has to prove a certain level of training. That's
established.
Coordination on purchases. That's going on.
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January 25, 2016
So, again, while we're having debates about issues which staff has told us
has been resolved, we consistently avoid the most significant issue, which is the
law, and this debate is about the law.
And I believe Commissioner Fiala's recommendation that we extend the
COPCN, as we have for this past month, for the next year -- and, again, it makes
no sense. If you can extend it for a month, you necessarily have to extend it for
a year because the facts and circumstances haven't changed -- and then work
through the understanding of the law, and maybe the county will see reason and
the other independent agencies in the cities will see reason and recognize that
we must do what the statute provides.
And unless the law changes, that's what we're faced with. And maybe the
statute will be changed in the interim. But I think Commissioner Fiala has
proposed the correct solution in the public's interest.
And as to ALS and BLS -- and there is no question that to save a life --
and when we provide ALS -- when we provide emergency services, it is to the
worst-case scenario, which is death. And if ALS is needed, we have to be able
to provide it, and the county does not have the money and does not have the
staff and does not have the equipment to provide ALS to the level necessary to
save lives. And it's of great concern. We can't do it without any of the
independent districts. We can't do it without the cities. We need everybody
involved.
And Commissioner Nance is right that there are areas which are not
getting the same response times. They're getting the same level of service, the
same care, but they are not receiving the same response times to incidents
because we don't have the equipment and we don't have the personnel and we
don't have the stations and we don't have the money to get it. And Big
Corkscrew is one such district, and North Collier will provide that response time
to that area by increasing the staffing and the equipment.
CHAIRMAN FIALA: Thank you so much. Now --
COMMISSIONER HILLER: But we are preventing that from happening
by denying North Collier a COPCN that incorporates Big Corkscrew.
COMMISSIONER HOFFMAN: Commissioner Hiller --
CHAIRMAN FIALA: One of the --
COMMISSIONER HOFFMAN: -- are you saying the other districts don't
have the ALS services that we have? Is that what I heard you say?
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January 25, 2016
COMMISSIONER HILLER: No, that's not what I said. What I said is
that the other districts operating under an interlocal agreement without having
their own ALS COPCN, without their own ALS state license are doing so
illegally.
And what Commissioner Lombardo said is that each of the council
members or commissioners of those cities or districts are facing personal
liability in the event something happens to a patient who is provided ALS care
under such an interlocal agreement and then they pass or are paralyzed.
And as -- so just so you understand, cardiac arrest, four minutes -- four
minutes, and then the countdown -- the countdown goes to 10 minutes and
you're dead, and I just pray to God you never need that.
Now, let me just say one last thing on medical information sharing. I have
a question. Does the Lee Memorial system -- does the Trauma Center have the
same system that Collier County EMS has for information? I'm just curious.
CHIEF KOPKA: For the record, Walter Kopka. Yes, they have access to
our patient care reporting system. Lee Memorial does --
COMMISSIONER HILLER: No, no. They have a different system
though, right?
CHIEF KOPKA: Yes.
COMMISSIONER HILLER: They're on a different system.
CHIEF KOPKA: A patient care reporting system, sure.
COMMISSIONER HILLER: Different than our system?
CHIEF KOPKA: Correct.
COMMISSIONER HILLER: Just like North Collier's system is different
than our system.
Do you have a business-affiliate agreement with Lee Memorial?
CHIEF KOPKA: Yes, ma'am.
COMMISSIONER HILLER: Yeah. So the very same situation as
between Collier County EMS and Lee Memorial -- and just so people
understand, if there is a trauma where someone has to be helicoptered from
Collier County to the Lee Trauma Center, there has to be an exchange of
information, and it's no different than if there's an exchange of information
between Collier EMS's paramedic and North Naples' paramedic, because you've
got two systems here; you have two systems between Collier County and EMS
and Lee.
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January 25, 2016
So to make the argument that somehow, you know, everyone has to have
the same system is a red herring.
CHIEF KOPKA: Let me clarify it. Is very different. When North Naples
gets on scene of that call and starts to render care, that information is not
recorded in our system. When the ambulance gets on scene, that information's
recorded. It's sent to a cloud. The MedFlight crew picks up that information
from the ambulance, and all the information goes to Lee Memorial with the
patient.
So Lee Memorial has access to everything that EMS did for that patient
except for what North Naples did for that patient. They don't have access to
that. That's not in that same system.
CHAIRMAN FIALA: And which is -- I'm going to just say, as I
introduce Commissioner --
COMMISSIONER HOFFMAN: I haven't finished.
COMMISSIONER HILLER: I want to --
CHAIRMAN FIALA: -- Commissioner Henning, because he's still
waiting also. I just wanted to say this all started many, many years ago, as long
as -- as far back as I can remember, and I've been on this commission since the
year 2000. And all that time we've wanted to, in the end, have a combined -- a
unified system between fire and EMS, and we've been heading toward that. We
have been pushing toward that so that in the end that's what we have. And I
think right now the argument is that it's difficult for people to give up what they
have in order to bring together a system that will serve all of our residents in the
same manner and in the same capacity, and I think that's what you see.
Commissioner Henning?
COMMISSIONER HENNING: Thank you. I'm not ready to move on to
do an extension until we deal with this other issue on top of that. I still want to
stay on No. 5.
CHAIRMAN FIALA: Okay.
COMMISSIONER HENNING: Okay. However, I do have some feelings
on No. 6, but I really want to understand some of the things that the fire
commissioners have stated.
Commissioner Lombardo, you stated that the statute says it's illegal for the
fire department to enter into an interlocal agreement for ALS service. Hang on.
COMMISSIONER LOMBARDO: That's not exactly what I said, but
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January 25, 2016
that's all right.
COMMISSIONER HENNING: Okay. That's my understanding.
I know the Florida Attorney General recognizes interlocal agreements
with fire departments. There's one out there. Several attorneys have opined,
outside of the county, that it is legal.
My question is exactly what statutes are you referring to and exactly what
does it say?
COMMISSIONER LOMBARDO: We've provided that information.
And let's make sure we understand each other.
First of all, the Attorney General is not the court of last resort when it
comes to determining liability. The Attorney General can render opinions, and
those opinions are not necessarily dispositive or binding on the final outcome.
What the county is asking us to do, because the statute -- and, Laura, if
you will, give me the statute site. The statute provides that we have to be on
equal footing, essentially, when we talk about interlocal agreements.
So we don't -- we are not on equal footing, and therein lies the problem,
and that's what opens the door for personal liability. Interestingly enough, if we
look at our neighbor, Lee County, Lee County, 15 independent -- Lee County --
COMMIS SIONER HENNING: No, no. It's a simple question.
COMMISSIONER LOMBARDO: And I'm giving you a simple answer.
Lee County has 15 independent fire districts. Not a single one operates under
an interlocal agreement. Every single one has their own COPCN. You're
asking us to take on -- you're asking us to violate the statute.
COMMISSIONER HENNING: What's the statute? What is the statute?
What's it for?
MS. DONALDSON: Madam Chair?
CHAIRMAN FIALA: Yes. Thank you.
MS. DONALDSON: The statute is Section 163.01, and it basically states
that the governments have to have the same level of authority, and the
agreement cannot give additional authority to one government that they don't
have otherwise. There's case law specifically not related to COPCN but related
to other additional authorities.
I will tell you, since I have had the privilege of watching your County
Commissioner meetings over the last couple months, many, many years ago
when I was asked -- I got a phone call asking to help with an existing interlocal
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January 25, 2016
agreement, never looked --just said we need you to fix a couple provisions. It
wasn't until September 8th, and I will tell you I was at the hospital in the
emergency room with my eight-year-old. And Commissioner Hiller made the
comment about -- that you can't do more than what you can, and the next day I
called and said, I need to look into this issue. And at that point we did the
research as it relates to the interlocal agreement.
One of the options that we've given to the county staff was entering into
an interlocal agreement to put a county EMS on each vehicle of the fire district.
The district currently has the authority to allow someone to go onto a fire truck.
So that at that point is like-like, and it's really just related to ALS, because
Chapter 401 and 191 state specifically that fire districts have to do -- can
provide advanced life support under -- pursuant to Chapter 401 and under a
COPCN. So I think that's kind of what the difference is.
COMMISSIONER HENNING: Well, okay. So does it say that it cannot
enter into an interlocal agreement?
MS. DONALDSON: Madam Chair?
What we have said, and one of the options that we -- several options that
we gave to the county was if we --
COMMISSIONER HENNING: I heard you said that.
MS. DONALDSON: If we had a COPCN, we could enter -- well, there's
different types of interlocal agreements, but as it relates to ALS services, if we
had a COPCN then, yes, the district could enter into an interlocal agreement to
address many of these issues dealing with credentialing, training, and all of that,
yes.
COMMISSIONER HENNING: Okay. On the same topic, has the Court
ever challenged an ALS interlocal agreement between a county and any other
provider?
MS. DONALDSON: Madam Chair?
CHAIRMAN FIALA: Uh-huh.
MS. DONALDSON: I have not found a case on that at all. And for your
information, our lawsuit doesn't even get into that issue. Our lawsuit's related to
the board's decision.
COMMISSIONER HENNING: Okay. Well,just one comment on that
topic. You have an interlocal agreement. Challenge it. Let's see what the Court
says.
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January 25, 2016
COMMISSIONER LOMBARDO: Yeah. But on your --
COMMISSIONER HENNING: Another question -- another question.
Commissioner Crossan, I appreciate your experience, and now I
understand that you work for Marco Island Fire Department.
COMMISSIONER CROSSAN: Yeah.
COMMISSIONER HENNING: As a paramedic? Firefighter?
COMMISSIONER CROSSAN: No, as an EMT --
COMMISSIONER HENNING: As an EMT.
COMMISSIONER CROSSAN: -- but I know the role of the paramedic.
COMMISSIONER HENNING: Okay. Does each paramedic experience
hands-on experience? How many paramedics do you have in Marco Island; do
you know?
COMMISSIONER CROSSAN: Chief, what's the number -- Chief
Murphy -- about?
CHIEF MURPHY: Twenty-eight.
COMMISSIONER HENNING: Twenty-eight?
COMMISSIONER CROSSAN: Yeah.
COMMISSIONER HENNING: And how many residents? What is it --
do you have 40,000 on Marco Island?
COMMISSIONER CROSSAN: Yeah.
COMMISSIONER HENNING: How often do they get to use that
experience?
COMMISSIONER CROSSAN: We'd have to pull the protocols, but I
have seen them use the experience, and, you know, there might be people out
there -- go ahead, Chief. I'll have Chief--
COMMISSIONER HENNING: On a day-to-day basis?
CHIEF MURPHY: If you're going to direct questions to my department,
I'd rather they be deferred to me.
COMMISSIONER HENNING: Just your --
CHAIRMAN FIALA: Chief Murphy, if you need to speak, you need to
speak into a microphone, if you're answering Mr. Crossan's question, so we
have it on record. Thank you.
CHIEF MURPHY: Good morning. For the record, I'm Mike Murphy.
I'm the Fire Rescue Chief of Marco Island.
And the answer to your question is we have 28 paramedics that ride on
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January 25, 2016
our units every day, on all units. And those units respond to 3,500 calls, of
which about 2,600 are -- or 2,200 are medically related.
Our units -- our paramedics arrive on the scene in some cases 20 minutes
before an EMS, not on a great number of calls. But on ALS calls, as was
discussed, my paramedics arriving on an engine have the capability of
administering for asthma patients, for a seizing child, for -- and in particular
what we're finding out is trauma alerts related to seniors where advanced life
support has to be put in place where that patient's going to be flown out of that
facility and flown to the Lee Trauma Memorial Center.
Our personnel -- and, for the record, our personnel are phenomenal
personnel both in the county, in North Collier. I've been on incidents all the
over this county. And we keep talking about BLS. And I believe over -- if you
ask for the data, you'll find that -- and I won't quote the county, but probably 60
percent of the data informs that it's an ALS call.
And when that paramedic arrives in a high-rise structure, there are times
when we could be 11 minutes just from the time we receive the call till we
arrive on the scene. That ALS intervention is critical to that patient all the time,
whether it comes on a paramedic or whether it comes on an ambulance.
And we keep forgetting about the patient here. And the critical issue here
is you're about to take 14 units, ALS units, off the road that support us.
COMMISSIONER HENNING: Okay. Here's my point. Marvin needs to
provide that information about a lot of data that -- you know, calls, what type of
calls, how many paramedics, how many firefighters, so on and so forth. My
point is, and the conclusion that it comes to, when you have more, it doesn't
mean it's better. And there's many articles on there on that particular topic.
It's the -- it's not only the educational experience. It's the hands-on
experience. And that's why I asked you, Commissioner Crossan, is -- and I'm
glad that North Naples has a lot of experience, but what I'm looking for is that
day-to-day hands-on experience.
So, Commissioner Feder, I'd be happy to entertain putting a paramedic on
your engine but, however, no different than we do anywhere else in the county.
No more, no less. And it's about the paramedic -- Collier County paramedic,
our standard of response time.
And, I mean, if you want to work that out, I'm sure we could work it out
without an ALS or a COPCN, or we could do an ALS and put your guy on an
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January 25, 2016
ambulance. But I understand that that didn't work out. Commissioner
Lombardo gave us the history on that. I think that can be worked on to where
your paramedic can do patient care instead of driving a vehicle.
COMMISSIONER FEDER: What I would say in response, if I can is,
first of all, we're talking about reducing the level of care rather than
maintaining.
COMMISSIONER HENNING: Well, that's an opinion.
COMMISSIONER FEDER: That's the issue of concern. Now, what I said
is --
COMMISSIONER HENNING: It's an opinion.
COMMISSIONER FEDER: -- if you want to put an EMS on every one
of our vehicles, which is what we have today with ALS, on each one of them,
then we could work that.
Now, again, I think that all of this data at 3,000 feet that shows I have
twice as many mutual aids given as we received, which tells me the data has
some flaws on it -- but I think it's good that we're starting to become data driven,
and we need to. But the bottom line still becomes, for five years we've had
very, very good relations with EMS, very good response to the important
people, and that is the people that needed services out in the field, and that is
about to be very significantly reduced at an additional cost to the taxpayers for
you to put in some overtime units, and I'm not sure I understand why.
Again, it's nice to talk about concepts of structure and education. And as
Commissioner Fiala pointed out, we can do that over the next six, nine, 10
months, a year, while we don't reduce what has been working for the last five
years.
COMMISSIONER CROSSAN: And let me just address real quick, Tom,
your -- my observation of more paramedics. When I started in the service -- and
I started with Jeff Page and Walter back in the day, I always remember a male
and a female paramedic, for discretion, you know, whether we had a male or
female patient. It worked wonderfully.
It then became the pit-crew mentality. And the pit-crew mentality is
basically like when you watch Nascar and you have everybody working quickly
to resolve the death of the heart muscle, and I've seen that operate. And when
you have, like, three or four paramedics on scene and they know exactly what
they're doing, rather than one paramedic with all that weight on his shoulders,
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January 25, 2016
and then you've got three or four EMTs surrounding him -- now, there is a place
for the EMT. I'm the one to go in and start compressions and everything else.
But when you have those medics around you and you have those
firefighter medics around you who don't recognize each other, it works
wonderfully, and I've seen -- I've seen your employees run a pit crew with our
employees as subordinates, and I saw the person's life saved multiple times.
COMMISSIONER LOMBARDO: And if I may add --
CHAIRMAN FIALA: Thank you. Now,just a minute. Just a minute. I
let you interrupt a lot, but we --
COMMISSIONER LOMBARDO: I have not been interrupting. I'm
interrupting you now.
CHAIRMAN FIALA: We'll go back to Mr. -- I wanted to go back -- oh --
COMMISSIONER LOMBARDO: He's not here.
CHAIRMAN FIALA: Okay -- to Mr. Henning, because he was still
involved, and Mr. Hoffman has -- was also going to speak before Mr. Crossan.
COMMISSIONER TAYLOR: Madam Chair, may I digress a minute?
This was on the floor.
MS. COTHRAN: It's mine. It has the statute right off the Florida --
CHAIRMAN FIALA: Okay. So go ahead Mr. Hoffman -- or
Commissioner Hoffman, excuse me.
COMMISSIONER HOFFMAN: Yes, thank you.
Surprisingly enough, I agree with Commissioner Feder, and I agree with
Commissioner Nance.
From Commissioner Feder's point of view, I think we've been hearing a
lot of anecdotal evidence by both sides, and it makes it very difficult to really
come to any kind of a conclusion. From Commissioner Nance's perspective, I
don't think we're going to be able to resolve any issues today.
But I do have a question for Commissioner Hiller. Are you suggesting
that the other fire districts have a CO -- should have a COCPN (sic), and if they
don't have a COCPN, the directors are liable?
And my position would be, if we have a COCPN, everybody should have
a COCPN for the similar reason. And if we don't get one, nobody should get
one. So let's be uniform going forward and go decide on the COCPN.
COMMISSIONER HILLER: Thank you, Commissioner Hoffman.
COMMISSIONER HANSON: COPCN.
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January 25, 2016
COMMISSIONER HOFFMAN: COPCN. Thank you for correcting me.
COMMISSIONER HILLER: And, you know, the question you raise I
want to clarify. It's the law. It's not a question of whether we want everyone or
no one. The law --
COMMISSIONER HOFFMAN: What is the law?
COMMISSIONER HILLER: The law is clear. The law says that if North
Collier is to provide ALS services, that it must stand before the county at a
public hearing and provide the evidence as set out by the statute to show that it
qualifies to be approved for a COPCN --
COMMISSIONER HOFFMAN: I understand.
COMMISSIONER HILLER: Let me answer -- and that with that
COPCN it can apply to the state for a state license to provide ALS services.
And that is true for North Collier. That is true for every fire district in this
county. That is true for the municipalities. That is true for any organization that
wants to provide ALS. And it doesn't have to be a political entity. It can
actually be a hospital.
COMMISSIONER HOFFMAN: This is --
COMMISSIONER HILLER: But it also -- the statute -- let me -- I'd like
to finish answering the question, because it's a very important question, and I
am grateful that you ask it, because it's the essence of-- it's the heart of this
discussion.
It also provides that every licensee that provides ALS under that statute
shall have its own medical director, and the statute also provides that there will
be a uniform standard of care and that there will be a uniform minimum
standard of training for all those licensed paramedics who provide ALS.
So in answer to your question, is it a zero-sum game all or nothing? The
answer to that is it's what the law provides. And the law provides that if Marco
or Naples or NCH or Greater Naples Fire Control wants to provide ALS in
Collier County, they have to apply for a COPCN, and then after being approved
for that COPCN by the Board of County Commissioners, they have to apply to
the state for a license.
And if those agencies, once they have their COPCN and their state license,
want to enter into an interlocal agreement with the county to provide mutual aid
given that now both entities can provide that same service, ALS service, they
can do so.
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January 25, 2016
CHAIRMAN FIALA: Now, Commissioners, everyone, right now we're
going to take a 10-minute break for our court reporter because her fingers are
about to drop off.
So I tell you that we're going to adjourn or, I'm sorry, we're going to recess
for 10 minutes. See you back at about quarter to.
(A brief recess was had.)
CHAIRMAN FIALA: May the meeting please come to order. Please
take your seats. Thank you.
First and foremost, I want to ask all of the commissioners seated in this
area to please make sure, when you're speaking, to speak into the microphone so
the court reporter can get all the information and it can be recorded for later
usage.
The second thing is, we discussed with the County Manager and a few
other people right here that we -- it looks like the meeting is going to go on a lot
longer than we thought, and rather than end at 1:30 and cut everybody off, I've
asked the County Manager to order some lunch for those of us sitting here,
because sometimes people need to eat in order to not get crabby and have a
headache, right? So he's going to --
COMMISSIONER NANCE: I think it's too late.
COMMISSIONER LOMBARDO: No, it's not.
COMMISSIONER NANCE: I think it's way too late for that.
CHAIRMAN FIALA: He's ordered that. And so in one hour we will
break for a lunch period. So anybody in the audience who wants to go out and
have a lunch, that's fine. We'll continue on. It would be nice if we could get
past this first No. 5 in order to get to No. 6 and then to public comment. I would
love to do that unless -- unless --
COMMISSIONER FEDER: Madam Chair, I think -- let's go on that
basis, and let's continue on. People can come back to the issues they're going to,
if they will, but let's move on to No. 6.
COMMISSIONER LOMBARDO: I'm going to ask -- for just a moment,
though. I'd like to have a comment. And I recognize you want to take a break.
CHAIRMAN FIALA: Could somebody close that back door.
COMMISSIONER FEDER: It is cold.
CHAIRMAN FIALA: Yeah, it's freezing in here.
COMMISSIONER LOMBARDO: This boils down to a simple issue,
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January 25, 2016
which is what we cannot and -- can and cannot do under the law. The law is
very, very clear. It's unequivocal. We cannot -- we can't base our decision
based upon the fact that we may have done it wrong in the past because -- nor
am I willing to base our decision on the idea that somehow we'll take the risk of
being sued, because that risk is on this commission right here and not on that
commission, personally, quite frankly.
By the way, my belief is the AGOs, when it talks about other issues, takes
the position that that statute stands for the prospect that you are -- you're looking
at equal rights. That's what this is about. To get into an interlocal agreement,
you have to have agencies that are of the same style or have the same rights.
The other thing though, the other comment that was made that I find very
concerning -- and let me take a step back. I don't even agree with
Commissioner Feder when it comes to putting a Collier County EMS paramedic
on each one of our vehicles, because I would tell you that I would expect that
that paramedic then meet the same standards that we have set, because we have
higher training standards.
And I would expect that paramedic to meet the standards we have set so
that we are sure that we are taking care of our constituents.
And the last thing I'm going to say, I've listened to the less-is-more
argument for a while now. I am -- maybe I'm a little stodgy, maybe I'm just
getting old. I'm a curmudgeon, but, you know, for as long as I can remember,
more is more. Less is not more.
This is not a circumstance where we put less paramedics out in the field
and somehow -- and the idea is that they're going to get greater experience
because they're getting to deal with more hands-on events. I don't think that's
the case. And I think the team approach is where it's at, and I think these
paramedics are quite busy as it is. And the idea that you're going to take
paramedics out of the field to give other paramedics more experience, that
makes zero sense to me.
In essence, it's like telling the Sheriffs Office that you cannot give an
officer a gun who hasn't fired that gun in an actual circumstance where he's
shooting at someone who is an aggressor. That's not how it works. We have
training. We have high-quality training. That's what it is. It's about
conditioning those paramedics.
So taking 100 paramedics out of service four days from now in the middle
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January 25, 2016
of season with hundreds of thousands of people here, here's what happens:
Those paramedics now won't have experience. You're going to get them rusty.
By the time we wake up and say, oh, my gosh, this is a horrendous situation --
and it will be when someone dies -- those paramedics now have been out of the
circuit for a while.
To me -- and I'm going to go back to what I said from the beginning -- the
proper way to have done this -- if you-all have a different opinion on how we're
going to do this, you should have given us a heads-up. You should have given
us time. That's the appropriate way to do this.
And so given the fact that it's clear you want a different approach, then
here's what you do: You extend us for the year, you let us work through that,
and we'll get through all of-- what I hear are technical issues that do not seem
insurmountable: Exchanging financial -- or excuse me -- personal information,
medical records. Those things are not insurmountable.
You work already with Lee County. I don't get this. To me, we have a
responsibility to constituents. And hear me out. We're North Collier. We're no
longer North Naples. So from where I sit, I'm not about to stand for an answer
that means the people who live in the North Naples service area get better
service than the people who live in Big Island -- Big Corkscrew Island. That's
not fair. That's not what they agreed to.
The simple answer is extend it for a year. Let the professionals who
understand the technical issues resolve them. We don't know that.
I mean, Commissioner Nance and I -- I like Commissioner Nance, but
Commissioner Nance and I aren't going to be able to figure out how to exchange
the medical data necessary between the districts. That's not an answer we're
going to be able to come to. I mean, it's just not.
Let the pros handle that. They seem to be able to work together well.
There's your simple answer so we don't have to be here all day.
CHAIRMAN FIALA: Commissioner Lombardo, thank you very much
for your comments.
And Commissioner Nance, and then I want to ask after -- I'll certainly
listen to you first. I want to ask then, and I want you all to be thinking about
this, are we going to come up with a decision on this now, or shall we move on
to the next? But first Commissioner Nance.
COMMISSIONER NANCE: I would like to -- there's been a lot of
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January 25, 2016
discussion about legality here as a reason for not moving forward and
addressing some of these issues. I would like to hear the County Attorney opine
on his perspective on the legality of an interlocal agreement as a methodology
for cooperative work.
MR. KLATZKOW: I believe you can do it by interlocal agreement.
UNIDENTIFIED SPEAKER: Can you speak in to the mike, please.
MR. KLATZKOW: I believe you can do it by interlocal agreement. We
have done it by interlocal agreement. We're not the only county that has done
this as well.
CHAIRMAN FIALA: Thank you. Okay. Is that the answer?
COMMISSIONER NANCE: Well, it seems like we're going to disagree
on that, and I guess, you know, we're going to go to court to make that
determination, and --
CHAIRMAN FIALA: Okay.
COMMISSIONER NANCE: -- frankly, you know, I've spent the last
three years, the first three years of my service to the county, being told by
personnel from North Naples Fire and then North Collier Fire that they would
never agree to some of these things. So I don't see any reason to expect that
that's going to change.
And, you know, if we can't -- if we can't agree that we can be more
effective -- I think there is absolutely no reason to think that we cannot be more
effective than we are today, and we certainly can be more efficient.
So that's the two things you've got to have in any operational endeavor.
You have to be effective, and you have to be efficient.
And I think there is clear evidence that a uniform system of emergency
response is going to do both of those things. But what you have to have is you
have to have the will to do that, and I don't think -- I think we have a party here
that does not have the will to join everyone else to do this.
They want to rely on a law or what they say is an interpretation of the law
to find an excuse not to do so. People always find an excuse to do what they
want to do or they don't want to do.
So I think we're -- I think we should move ahead and just start taking
some votes and figure out how we're going to move forward.
COMMISSIONER BURKE: Madam Chair, clarification. We're talking
about it's the law as if it's settled law. And from what I just heard from the
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January 25, 2016
County Attorney is he doesn't agree with that; am I right?
CHAIRMAN FIALA: Yes. But you know what, let's say it, every lawyer
can read the same sentence, and each one will come out with a different answer,
and we all know that.
COMMISSIONER BURKE: Okay.
CHAIRMAN FIALA: So no matter -- you know, I don't think you can
even base it on "it's the law," because it's interpretation.
COMMISSIONER BURKE: Thank you.
CHAIRMAN FIALA: So let's see now. Do you want to come up with a
determination with an answer on this Question 5, or shall we move on to the
next one?
COMMISSIONER TAYLOR: I think the critical -- the critical issue is
whether or not the cou -- I'm sorry.
CHAIRMAN FIALA: Go ahead.
COMMISSIONER TAYLOR: Whether or not North Collier will be
granted a COCPN (sic), and I think if we -- we just take a vote on it, and I think
that will decide everything. Because without -- they don't seem to be willing to
negotiate. They've drawn a line in the sand.
CHAIRMAN FIALA: Okay.
COMMISSIONER TAYLOR: And so I think we're at that point.
CHAIRMAN FIALA: Let me hear from the other commissioners. Do
you agree with that? The commissioners -- the Collier County commissioners
and then the fire commissioners.
Yes, Commissioner.
COMMISSIONER HENNING: I'm not sure that we can take a vote, but I
think it's spot on of the real issue is the COPCN, ALS interlocal agreement.
And I think I've heard from the majority of the board it's the COPCN; however,
I'm hearing from my colleagues it's an interlocal agreement providing ALS
service, so...
CHAIRMAN FIALA: Yes.
COMMISSIONER TAYLOR: Maybe we can hear some legal from the
county --
CHAIRMAN FIALA: Gentleman, I'm sorry. I don't know your name.
COMMISSIONER McGOWAN: Commissioner McGowan.
I agree with Commissioner Lombardo that, you know, we should probably
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January 25, 2016
work through these issues with a continuation of the current system maybe over
the next six to 12 months. I disagree with continuing to go to court between the
two government agencies over this particular issue.
I agree with you, Commissioner Fiala, lawyers can agree or disagree on
any sentence. I disagree with Commissioner Lombardo in terms of the Attorney
General's opinion. I think the Attorney General should be asked about this
particular legal issue and give an opinion on it, and we all should live by
whatever that particular opinion is. If we can't have an interlocal agreement,
then it should operate the opposite.
COMMISSIONER LOMBARDO: The problem with that --
CHAIRMAN FIALA: Okay. Now, let me see. I've got a bunch of people
here waiting to speak.
COMMISSIONER BURKE: Let's do it.
CHAIRMAN FIALA: And if we're not going to come up with an answer,
I would like to -- now, there's another item here, which is No. 6, and you
probably all know it, to extend the existing COPCN. So we've been discussing
that. I think we've been combining those two.
And if we -- if we're going to just say the same thing over and over and
we're both -- and we already know what everybody's going to say and it's no
secret, maybe we should just go on to the public comments so the public has
their right to speak before lunch arrives, okay.
And with that -- and I hope you-all are in agreement. So let me just move
on.
Mr. Naegele.
MR. NAEGELE: Thank you, Commissioner Fiala, Commissioners -- Fire
Commissioners, Board of County Commissioners, thank you very much.
CHAIRMAN FIALA: Mr. Naegele, let me hold you for one second.
MR. NAEGELE: Certainly.
CHAIRMAN FIALA: Is there a timekeeper here?
MS. FREIBURG: Yes.
CHAIRMAN FIALA: You're going to keep the time?
MS. FREIBURG: Yes.
CHAIRMAN FIALA: Yes, three minutes. Thank you.
MR. NAEGELE: Surely. Thank you. Yes, Bob Naegele, 7993 Via
Vecchia, resident of North Naples. Formerly North Naples Fire District, now
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January 25, 2016
NCRFRD.
And I'd like to just say in the big picture we have -- 66 percent of our calls
are rescue and medical, and 2.2 percent are fire.
Now, there's a group in between that are good-intention calls and false
alarms, that type of thing. So those are the two items that we're dealing -- seem
to be dealing with.
Now, in my estimation,just having been an observer for some time, it
seems to me that fire is trying to control medical, and I don't believe that's
prudent, I don't believe it's practical, and it's terribly political.
We need to move, as Commissioner Nance had said, toward a unified
emergency response. I think we have the March 15th straw ballot possibility. I
don't know whether my commission has supported that or not, but I think that's
a valid -- valid thing to do.
And a unified emergency response under the county medical director
seems to me to be a good solution.
Laying it over for a year, it's likely that all of you will be replaced in the
next election, very likely, and it's likely that you're going to have great turnover
in the next election, so kicking the --
COMMISSIONER HENNING: I'm not going to be here.
MR. NAEGELE: You're not going to be here. So we need to solve this
problem sooner rather than later, and kicking it down the road is not a good
option.
I'll read one thing I received from Stan Farb, and he said -- who is a doctor
living in Pelican Bay. He said, I know that PB -- Pelican Bay Property Owners
Association, of which I am the president, is quite familiar with the North Naples
Emergency Service controversy. If there was ever a case of"it ain't broke, don't
fix it," this is a prime example.
This matter is too serious to be left to the whims of our commissioners. I
in no way want to demean our fire department, but I do not want my emergency
medical care to be provided by someone whose training and experience relates
to managing fires.
This is a serious matter, and I urge the PBPOA, that's our group, to inform
to mobilize (sic) the Pelican Bay community about the political shenanigans that
threaten to dilute our superb emergency medical emergency care.
My letter also -- she sent a letter to Commissioner Hiller's office.
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January 25, 2016
So I would just say thank you very much. I know you're working on it. I
respect the sincerity of both sides on this issue, and thank you very much.
CHAIRMAN FIALA: Thank you. The next speaker is Janet Vasey, and
Mr. Marvin Eastman will follow, and so would you --
MR. EASTMAN: I'll pass.
CHAIRMAN FIALA: You'll pass, okay. After that Jim Horner. If you'd
like to come and stand up here --
MR. HORNER: I'll pass.
CHAIRMAN FIALA: -- move it on. You'll pass?
MR. HORNER: I'll pass.
CHAIRMAN FIALA: Okay. And the next one is George Danz. And if
you would come up and stand here ready to speak. Okay. I don't even see him.
Janet, go ahead.
MS. VASEY: Okay. Janet Vasey, for the record. I'm a citizen of the
North Collier Fire District, and I am speaking just as a citizen.
I have some comments based on what I've heard here today, and the real
issue -- it gets fuzzied up a lot, but the real issue is, is this, as an interlocal
agreement, legal or not? All of the rest of the stuff is -- falls under that decision.
And I would submit that you need to know that the emperor has no
clothes. This legal argument is bogus.
It's -- you can look at the -- the Section 163.3171, and it clearly says that
these joint agreements entered into under the authority of this section be
liberally, broadly, and flexibly construed to facilitate intergovernmental
cooperation between cities and counties.
To make it very restrictive is to do so intentionally. It allows you a broad
interpretation.
Our attorney says it's legal. I believe it's legal. Everybody else who's
entered into these agreements believes it's legal. North Naples, when they had
an interlocal agreement, believed it was legal. It was only when they no longer
had the option of a COPCN and were given only the option of an interlocal
agreement that now they said that this is illegal. So, you know, that's what's --
that's what's driving this whole thing.
Commissioner Lombardo says that lives were saved because North Collier
Fire District had a COPCN. Well, that's not exactly true. Lives were saved --
would have been saved under an interlocal agreement just as well. They were
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January 25, 2016
saved because North Collier participated with their fire paramedics. So it
doesn't have to be a COPCN. It just has to be your willingness to participate.
And I think the public should understand that the county is not taking
away the authority of you to have your fire paramedics participate. You are the
ones that are doing that by a very narrow interpretation and your decision not to
let them.
So when Commissioner Hiller says the public safety and welfare may well
be compromised, it's not being compromised by the county. It's being
compromised by North Collier Fire District. It's up to you to decide whether
you want to continue to participate or not.
Patient care reporting system. I think it's outrageous that you do not
provide that information all these years to the EMS. Why wouldn't you want to
tell what procedures you performed on patients, what medications were given?
And then if there's anything wrong, if there's anything that needs correction,
there's a record. It seems crazy that that wouldn't be done.
So -- does that mean my time? Okay. Thank you very much.
CHAIRMAN FIALA: Thank you.
George Danz followed by Doug Fee.
Doug, you can get up there and stand in line. Go ahead.
MR. DANZ: Madam Chair, Commissioners, my name is George Danz. I
live at 813 Charlemagne Boulevard, Naples, Florida.
A little history. Before I retired and moved to Naples, I retired from
Broward County where I was director of emergency services and later the
trauma management agency for the county.
In Broward County we have 21 fire departments all with their own
certificates, all doing advanced life support, all doing transport. They work
under the common medical protocols for the county that they've all agreed
upon. Each of those departments has or shares a common -- has or shares a
medical director, and they work together with those protocols.
I find it a little bit unconceivable that a department or an agency that's had
her certificate for five years and has no complaints against that agency, why that
certificate is being taken away. It's got to be pure politics, I guess.
And in all honestly, Commissioner Hanson brought up about that EMS
committee that they had that includes doctors and representatives from most of
the fire departments, from the Trauma Center in Lee County, et cetera. The
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January 25, 2016
only representative that is not there is Dr. Tober.
But I think whatever the political issue is, you have a system where you
have an advanced life support provider that has a certificate and is working
under common protocols that are agreeable to both the county and the -- and the
district, and I see no reason why -- or can't believe why that certificate is being
taken away.
CHAIRMAN FIALA: Thank you. Doug Fee, followed by Paul
Anderson. Mr. Anderson, would you come and be ready. Thank you.
MR. FEE: For the record, Doug Fee. I live in North Naples.
If the emperor has no clothes, it's because the -- certain areas of this
county are paying for service for other areas of the county.
North Naples has, over the years, helped out a lot of different areas in the
county, and I know it's both ways. But the data that's been presented in
meetings that I've attended, North Naples has definitely done its share, and it
will continue to do its share if it's allowed to do it, okay.
Over the last four or five years, the county itself has prepared spreadsheets
that show zones in particular areas of the county that do not have the response
times, and a few of those are in North Naples. I've watched that data.
Today I don't believe we have that solved. The county itself is
underfunded in the EMS area. And until the county provides the dollars to shore
up the EMS system, it needs to have the cooperation of all these fire districts,
unless you go ahead and tax us to provide a level service.
So am I for this COPCN? I'm for what we've been doing. Please extend it
if you do nothing else. Get the legal questions answered. Each one of you have
a duty to the voters. And if you take these paramedics, these firefighters, away
from the system for the fact that there is not a legal answer (sic) that's been
answered, that is not the right thing to do.
I respect each one of you sitting there. You represent the voters. Please
make a decision today to keep the status quo until you can work through it,
because you will only be hurting the constituents of each one of you.
Thank you very much.
CHAIRMAN FIALA: Mr. Paul Anderson followed by Jeff Parnu?
Would -- Jeff Parnu? I probably pronounced the name wrong, but I can't --
DR. PANOZZO: Dr. Panozzo. I'm going to waive.
CHAIRMAN FIALA: Waive, okay. Then after that is Paul, starts with an
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January 25, 2016
H.
DR. HOBAICA: Hobaica.
CHAIRMAN FIALA: Pardon me?
DR. HOBAICA: Hobaica.
CHAIRMAN FIALA: Hobaica?
DR. HOBAICA: Yes.
CHAIRMAN FIALA: Would he please come forward.
DR. HOBAICA: Sure.
CHAIRMAN FIALA: Go ahead, Mr. Anderson.
CHIEF ANDERSON: Paul Anderson, fire chief and district manager,
Immokalee Fire Control District.
I was hoping someone else would read the statute so I wouldn't have to
take up my three minutes doing it, but I believe, for the benefit of the audience
and the citizens, it's necessary.
Florida Statute 163.01(4), ifs called the Florida Interlocal Cooperation Act
of 1969. It's been revised multiple times since then.
A public agency of this state may exercise jointly with any other public
agency of the state -- of any other state or of the U.S. government, any power,
privilege or authority, which such agencies share in common and which each
might exercise separately.
That's the key point. In order to -- in order for a fire department to
exercise the provision of advanced life support, paramedic services separately
from anybody else, it requires two things, a license from the State of Florida
Department of Health and a COPCN issued by the county. That's the key issue.
The only way to reconcile the differences in the legal opinions is to get an
official interpretation from the State Attorney General. This has never been
challenged. It is apparently being challenged now.
Immokalee Fire District, my commissioner was here. She got called out
and had to leave, requested that I speak on her behalf as well.
Immokalee Fire District is requesting that the County Commission extend
the COPCN for North Collier at least until this can be resolved and at least until
after we get an official interpretation from the State Attorney General to do this.
Immokalee Fire Control District, our goal is to be providing ALS from
Immokalee fire engines with Immokalee fire paramedics by the end of the year.
So if it's not resolved here, you're going to be sitting here with me again when
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January 25, 2016
we try to do that.
Seventy-one percent of the paramedics nationwide are employed by fire
departments. In Florida the percentage of paramedics employed by fire
departments is way above the national average. The majority of those are riding
on non-transport fire apparatus, not transport units.
It's ludicrous to think that a paramedic cannot keep up his training and
skills unless he rides in the back of an ambulance. There's paramedics
throughout Florida, throughout the nation, who proved that wrong.
You can -- you can get -- an example of that, the CLINCON conference in
Florida is the EMS conference. They have an ALS competition routinely won
by fire-based paramedics.
Fire Rescue East Conference, through the Florida Fire Chiefs Association,
has an ALS competition won by fire-based paramedics.
CHAIRMAN FIALA: Thank you, Chief Anderson. I appreciate that.
Thank you for being here.
Paul Hobaica.
Somebody turn down the air conditioner. It's gotten so cold in here. I
don't know --
COMMISSIONER CHAO: You mean turn it up, not down.
CHAIRMAN FIALA: Boy, I hope that they even it out a little bit so it
isn't quite so chilly, whoever did that. Thank you.
And after Mr. Hobaica.
COMMISSIONER HILLER: Dr. Hobaica.
CHAIRMAN FIALA: Dr. Hobaica?
DR. HOBAICA: Doctor.
CHAIRMAN FIALA: I'm sorry --
DR. HOBAICA: No, that's okay.
CHAIRMAN FIALA: -- for massacring your name. There's -- I think it's
Brian some -- I can't even pronounce that.
MR. DUNN: I'll waive that. Brian Dunn.
CHAIRMAN FIALA: Okay. Then there's Dr. Joseph Doyle.
Okay.
DR. HOBAICA: Yeah. For full disclosure, Paul Hobaica. I am the
district physician, North Collier, my eighth year. I came on board when they
didn't have any real director oversight. And I started in the capacity of wellness
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January 25, 2016
and occupational health, and then it just drifted slowly into, over the years with
the team that was built, to advise on medical issues, including what's the ALS
program. So I feel like I'm an expert in offering an opinion here.
We have one of the strongest programs from a teaching perspective, yet it
never gets discussed. Not once have I personally ever been asked to sit around a
table and offer -- and asked my opinion on the way things are going.
I also work at Arthrex for other -- for full disclosure. And it was
mentioned earlier, we do some training there. So I've dug into the community
more than the average physician, especially in terms of my relationship with
first responders. I was a previous paramedic up in the Boston area in the '80s.
But I've got to tell you, this is a bad deal, bad deal for the county, bad deal
for North Naples residents. I live in North Naples. Really, tactically,
managerially, it's just an awful setup, especially if the license gets pulled.
I don't believe that anybody in this room has a doctorate in health care
except Dr. Panozzo and myself and yet, again, the decisions to run one of the
largest medical practices in the county, which is the EMS system, isn't discussed
on how it's managed medically from the top.
So we'd be more than willing -- I'm more than willing to sit on any kind of
a committee, advisory board and really advise on training and oversight, which
has to be done. It's unlikely any medical practice doesn't have advisors from the
medical perspective. Yet again, it doesn't get discussed.
So I'm a little bit embarrassed at the decision to do something as important
as this for the county. We're not even referencing the physician input and what
the experts in standards of care are and what's the best practices out there in the
country.
And if the trend is that medical is the bulk of the response out there, don't
you think we should have the best system out there available? And if it's
accumulative -- if there's opportunity for accumulative effort to put the minds
together from the doctoring and disseminate that information down in the field,
wonderful opportunity to do this and get this done right.
I agree, postpone this, give this a leave of-- a time to vet this a little bit
better. This is a rush to do something that is disastrous to the community and
for those of us that know the impact.
And I'll give you one example why this is important. December 12th, I
was at the soccer field at Vineyards, and the calls came out -- started coming
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January 25, 2016
out. The ambulance in that district went on a call, the ambulance in Immokalee
Road/75 went on a call 30 seconds later. A minute after that, the Pelican Bay
ambulance went on a call, then the unit up in the Bonita Vanderbilt Drive went
on a call down in Pelican Bay.
We had no ambulances. And until (sic) the fifth or sixth call came in, they
pulled an ambulance from -- it was Golden Gate and, I want to say, Santa
Barbara and Radio Road, to come up to Bentley Village.
So if you don't think there's a need to have stopgap measures in place to
have these wonderful paramedics continue doing their skills -- it is an utter
disaster to yank that license away until this is properly vetted and the experts
have weighed in.
And, finally, the training that we have and undergo, you're not always out
there putting breathing tubes in people's lungs. I haven't done one in 10 years,
but I think I'm pretty qualified to do one if I had to.
It's more the thought process that people have when they are out there in
the field. If they're a paramedic and they're thinking -- and they're operating at a
basic level, great, but their physiology and thought process is at a much
advanced level.
Keep it going. Don't make the mistake. Don't leave here until it's solved.
Thank you.
CHAIRMAN FIALA: Thank you very much.
Dr. Joseph Doyle and then Sandy Doyle.
DR. DOYLE: Yes. She's ceded time to me. Dr. Joseph Doyle. I do have
a medical degree as well as an MBA, a master's of public health, and a master's
of public administration, so I cover the water fountain when it comes to
business and the government.
And what we have here is really a problem with -- it's all about power, and
it's all about money. And, you know, you had the Uber discussion. We did
deregulation back in December, and we had the professor who came in and
talked about economic deregulation versus safety deregulation. I think that was
an important distinction.
What we have here is level of service versus level of care. Because I hear
that being thrown around here a lot today. We have efficiency versus
effectiveness. I don't see any data. I mean, we've seen some, you know -- I'd
like to see, what is the outcome for the care? What is the outcome for the
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January 25, 2016
service?
We're paying a lot up here. North Naples -- I live in North Naples. North
Naples is getting soaked by this fire department. Now, if-- you know, let's look
at an example. If you need 50 paramedics to save 20 lives -- we supposedly
have 100 paramedics. How many more lives are they saving? If we get another
50 paramedics, how many more lives are they saving?
It's the same thing when you study for an exam. You study two hours to
get a B; four hours, which is double, to get an A. You need six hours or maybe
eight hours to get the A plus.
Are we willing to be spending all that extra money to save one more life?
I guess that's the question here, but no one's asking us, the taxpayer.
Everyone says that one more life is worth it. Well, it is, but guess what, if
you're independently wealthy and you want to pay for that, fine, but this is
taxpayer money, and we're only going to have a certain level of care.
And, by the way, folks, we should be looking at all of our budgets, the
BCC budget, the fire department budget, Pelican Bay budget, because we're
heading for another recession here, if you've been watching the market, and we
need to start looking at how we're spending the taxpayer money.
So I say, rather than going for a one-year extension, maybe six months.
Let's get this done by June 30th so that -- because the budgets have to come out
in September, so let's not wait till December when we're in another budget year.
Let's move this fast forward.
Everybody already knows what they want. Keep the status quo to June
30th. Get this figured out. I think we need to restructure how we're doing
business here and whittle back this fire department and work for a unified level
of service.
Thank you.
CHAIRMAN FIALA: Thank you.
Shirley Cotton (sic)?
MS. COTHRAN: Cothran.
CHAIRMAN FIALA: And will be followed by Marcie -- Marcia.
MS. NAES: Naes.
CHAIRMAN FIALA: Okay. And if you would come up and take your
place in line to follow Shirley, please.
MS. COTHRAN: Okay. Shirley Cothran, 836 Grand Rapids in the Big
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January 25, 2016
Corkscrew area.
CHAIRMAN FIALA: Would you talk into the microphone?
MS. COTHRAN: Yes. I was going to read the statute because I think that
you've all given opinions on it, but that's been done.
I want to know whether or not -- you all have opinions, and you have said
you wanted to base this on fact, not an anecdote, not emotion, but if you listen
to yourself, some of you get very emotional when you speak about this.
The more-is-less, less-is-more argument, if less is more, let's cut, say, the
number of paramedics on the county staff by another 10 percent or 20 percent or
in half.
Commissioner Nance had read into the record the white paper from the
University of Oklahoma, and it said that nothing is further than (sic) the truth
than putting more paramedics on is a good thing. Nothing could be further from
the truth. Then it goes on to say -- to support that by saying, recent studies "may
indicate," "might mean." It used very soft words to support that argument.
And I think -- and then it says, when a critical mass is reached. Well,
Commissioner Nance has gotten us an extra paramedic out in Big Corkscrew, so
we're up to two. Is two the critical mass? Is three too many? It -- I don't think
that that paper very well describes what is happening in real life.
And there's been a lot of talk about we've always used interlocals and they
have been okay. Well, I used to speed a lot. And when I finally got pulled over,
when I told the officer this is how fast I always drive this road, it didn't go very
far. So just because it's always been done doesn't mean it's been done legally.
And I'm glad somebody has asked the State Attorney General to look into
this particular issue because, there were three AGOs out there that quote the
paragraph that Chief Anderson read, and they all say they have to have the
power to do it independently before they can enter into an agreement.
And that's -- oh, and there were 35 other counties that have multiple ALS
agencies, one as many as 20.
CHAIRMAN FIALA: Thank you, thank you.
Marcia, followed by Michael Jimenez.
MR. JIMENEZ: I'm going to cede my time to Christopher Spencer.
CHAIRMAN FIALA: Okay. And then after that is Christopher Spencer.
Thank you.
MS. NAES: My name is Marcia Naes, and I live at 4670 Saint Croix
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January 25, 2016
Lane, Naples, 34109.
I'm concerned that both sides of the table have their issues and have their
positions, and we don't seem to be moving forward.
In four days -- I don't like to think of the consequence of someone not
getting the help they need, bottom line.
I've been a citizen of Collier County for 14 years. I'm a retired teacher
with a professional career of 30 years. I have three certifications and have
taught in areas of disability as well as regular classroom. I also trained other
teachers in how to present information so that all could learn. I'd have my work
cut out if I had to deal with this group.
Now, it seems to me the most reasonable thing, given all the different
issues that have been talked about here, is to at least postpone this decision on
cutting off service to North Collier residents.
I've got a lot of friends that come in from Lee County every day. I've got
a lot of friends that come from other parts of the county every day. I don't live
far from Immokalee Road, and I can't imagine fire trucks or ambulances getting
through very quickly. They don't. It's season.
And I also am concerned that it's not only a matter of life and death --
that's serious enough -- but it's a matter of a life-long disability, and this is very
important for everyone to understand. Disabilities happen at any age. A soccer
event, accident at home, workplace accident, all of those things without the
proper intervention can lead to permanent damage and the resulting emotional
trauma of having a disability for the rest of your life.
I urge you to be cognizant of the fact of how this looks at the grass-roots
level, and I urge you to cooperate fully with each other. And if it takes
postponing for a time any decision making until the legal ramifications can be
clarified, then so be it, whether that's six months or a year.
But I urge you, because of the seriousness at the grass-roots level, to deal
with these issues and continue the service we have.
Thank you.
CHAIRMAN FIALA: Thank you.
MS. NAES: Both sides.
CHAIRMAN FIALA: Chris Spencer followed by Everett Alsbrook.
MR. SPENCER: Okay. Before we get started, I just want -- can
everybody hear me? My name is Christopher Spencer. Everybody can hear
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January 25, 2016
me? Okay.
So first thing I want to ask is, is Dr. Tober here? No, he's not. Are any of
you paramedics? Anybody? Any EMTs? Anybody have a CPR card?
Okay. So what we have here is a board that's making decisions to talk
about the service of public emergency response from state-certified paramedics
who are following the guidelines in the same book that the Collier County EMS
employees follow under the direction of your county medical director, Dr. Bob
Tober.
It's been in service for five years, and the only time it was going to be
taken off the consent agenda was to praise it in these last five years, but now all
of a sudden it has to come off and be totally thrown out with nothing in place,
so 14 units in North Collier's district that have paramedics that work hand in
hand with Collier County EMS and turn over the employ -- the patients to the
employees is going by the wayside.
You know, Naples Community Hospital has a hospital in the North
Collier area. They've got -- through Allen Weiss we received a letter saying he
supports the COPCN for North Collier.
The Immokalee firefighters have supported us, the Marco Island
firefighters support us, Greater Naples firefighters have supported us, and all of
the Collier County EMS employees support the COPCN process because of the
fact that you don't have enough ambulances out there. You take one ambulance
out of the county, and the wait times become drastically longer.
Chief Murphy from Marco Island -- good morning, Chief-- had indicated
that they've got to wait 20 minutes. Hey, guess what, we're in North Collier.
You think we're closer to the hospitals? Sometimes we have the same problems.
The actions that are being asked here is to extend this. I don't want you to
-- I know you can hear me, but I want you to listen to me because, guess what,
with my vote, you are my employees. You're all these people's employees, and
I'm not happy with the idea that a couple of you have gotten together and taken
some data and said, this is a model we're going to use, so all of a sudden after
five years of proven success, people are walking around -- everyone wants to
use the word, oh, that's anecdotal. It's the truth. It's the God's honest truth.
And I implore you, I beg you, I beseech you, please just continue to let
this thing go on for one more year, take care of your constituents, your family,
yourself, and let the men and women who have prided themselves on the
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greatest profession out there, be it with Collier County EMS or be it with any of
the fire departments in the county, to deliver ALS service and work hand in
hand as they've done, brother and brother, sister to sister with this agreement by
issuing the COPCN. And if you want to work out some details, work it out, but
don't stop it. Thank you.
CHAIRMAN FIALA: Thank you. And the last speaker, Everett
Alsbrook.
DR. ALSBROOK: Hi. My name's Everett Alsbrook. I've lived in Collier
County since 1983. I've practiced medicine in Collier County since 1983. The
vast majority of my medical practice has been in critical care.
As I listen to this discussion, I've been reading about the arguments that
have gone on that have led up to this. Like the last gentleman, I would wonder
who has actually given mouth-to-mouth resuscitation to someone. I have three
times. I have -- I know what it's like to lie on a floor to put an intratracheal tube
in someone, those difficult situations where you need the skills.
I would say to you that this is a problem of identifying principles and
establishing a strong chain of command. You need to let the decision making
about the medical care go with the people who give the medical care, who know
what it's about. They need to come to you with fairly succinct decisions. You
have to coordinate expenses, dollar amounts, the logistics of making it all
happen.
But what I would say is whoever allowed this crisis to come to pass, or
however many people, they need to stick their tail between their legs, suck it up,
and cooperate to get through this period of time until a more reasoned approach
can be taken. And then the attitude should be one of agree to agree. And I hear
sometimes there are people who don't have that attitude of agree to agree,
because in the final analysis you need to have a workable, crucial care situation
for the citizens of the county. So you need to agree amongst yourselves that
you're going to do that.
So I would encourage you to cooperate with one another. I understand
that there are many agendas going on here. And it is political; you have to
honor the politic. But there are certain principles you need to be keeping your
eye on, and all your actions should be addressed toward those principles.
And, yes, you can make mistakes from time to time, but you're in a
position of correcting them. And, yes, some of you will not be here next year or
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January 25, 2016
the year after or whatever, but you're here now because you have a feeling of
civic responsibility.
Yes, you have to work together and there have to be political concessions
and give and take and forming consensus, but I would encourage you to not
dwell in the details which you -- like the last gentleman said, which you really
don't know anything about.
CHAIRMAN FIALA: Thank you.
DR. ALSBROOK: Leave that to the people who do.
CHAIRMAN FIALA: Thank you, Dr. Alsbrook.
I have a question before we continue, and that is really for the attorney.
So if the COPCN were not extended -- I mean, we're talking about four
days left -- and they've got many, many paramedics on the North Collier Fire
crew -- they can still go out, right? I mean, they still have an ALS agreement,
right?
COMMISSIONER HILLER: No.
MS. DONALDSON: Madam Chair, midnight on Friday, which is what,
the 29th, the district will need to, in order to comply with state law and
regulations, remove the ALS equipment off the vehicles, and the paramedics
will no longer be able to provide ALS service because they -- we are not
licensed.
The minute we lose our COPCN, we lose our state license. You can only
have a state license to provide ALS non-transport if you have a COPCN from
the county you're providing the service.
COMMISSIONER HENNING: Madam Chair?
CHAIRMAN FIALA: I don't know who's talking to me.
COMMISSIONER HENNING: That's Commissioner Henning.
CHAIRMAN FIALA: Oh, I'm sorry.
COMMISSIONER HENNING: Yeah. You know, I haven't heard
anybody here that doesn't want North Collier to do ALS service. The whole
argument is what kind of agreement do we provide to make that happen. That's
where the rub is. And it's already out of the bag you want to wait till the new
county commissioners take over, which is a chance. I mean, you don't know if
the new board is going to agree on support by COPCN.
I mean, that tactic is not, in my opinion, a good tactic to do; however, if
we -- if it takes that long to come to a conclusion, shame on us. It shouldn't take
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that -- until after the election for these two boards to come to a conclusion what
we're going to do.
However, my observation is we're stuck. It's a matter of-- it's not a matter
of we don't want or you don't. We all want for you to provide advanced life
support. It's how we get there.
And I'm willing, you know, to do that, have Dr. Panozzo still train and
oversee the operation of advanced life support, basic life support under an
interlocal agreement that hasn't been proven illegal in the court of law.
So, you know, if you want to deny the citizens of North Collier, to not
provide ALS, then so be it.
CHAIRMAN FIALA: Commissioner Hiller?
COMMISSIONER HILLER: Thank you. I have to say I'm so impressed
by the speakers. I mean, I'm -- and it is emotional for me. My husband died in
cardiac arrest, so this is a big deal in my mind, because I never want to see what
happened to me and to him and to my children happen to any of you.
Doug, what you said was unbelievable, okay. I mean, you spoke the truth
from the heart, and you called it, as did you, as did George Danz, the medical
director from Broward County, as did Chief Anderson, as did Dr. Hobaica, as
did Shirley, Marcia, Chris Spencer, Allen Weiss from NCH, and Dr. Everett
Alsbrook.
Every single one of you made it clear that in the public's interest, in the
interest of saving lives and preventing disability, we must do what is within our
power to do and what our community needs, which is award that COPCN,
which we know is the legal way to get things done.
We can't sit here and play Russian roulette and speculate whether or not
the interlocal agreement approach that Commissioner Henning wants to
exercise is the right way to go. We know for sure that awarding a COPCN is
legal. We know that is the right way.
And what has happened is this Board of County Commissioners, by a
majority vote, wrongly denied North Collier their COPCN notwithstanding the
evidence presented to this board under oath. They had no legal right to deny
that COPCN.
. This is frightening. I mean, I'm actually shaking.
We had the chief from Immokalee read to us Florida Statute 401.321. It's
clear.
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January 25, 2016
Janet Vasey is incorrect. I'm sorry, not 1 -- forgive me. Not 401.321, but
163.3171 regarding interlocal agreements. And the interlocal agreements can
only be entered into where both entities share in common the service intended to
be cooperated upon where each entity can exercise the right to engage in that
service separately.
And then 401.321, Florida Statutes, provides transferability of license.
Each license is valid only for the licensee to whom it is issued and is not subject
to sale, assignment, or transfer voluntary or involuntary. Reading those two
statutes together, nothing could be clearer.
But the bottom line is, we know that awarding a COPCN to North Naples
allows North Naples to provide ALS.
COMMISSIONER HENNING: North Collier.
COMMISSIONER HILLER: I'm sorry, North Collier. Thank you for
correcting me, and that is very important because Big Corkscrew is being
seriously hurt by this.
And it allows North Collier to enter into an interlocal agreement with
respect to the provision of ALS services with Collier County and Collier
County's EMS.
I think Commissioner Fiala said it correctly when she said what we should
do now is, given that we can, given the evidence that was presented to us,
extend not for a day or a month, but extend for the year to protect the lives of
the citizens of Collier County and to allow for a conclusion to be arrived at
regarding the legality of these interlocal agreements if there is an absence of a
COPCN award.
And whether or not that should be done by an Attorney General's opinion
or by court action is a question that I think is answered with the obvious, and
that is, this is not anything that can be decided by any entity that doesn't make
that decision binding.
This is about patient care. This is about the people. Dr. Hobaica brought
that up. No one is sitting here talking about patient care. They're talking about
data and taxes and whether we should, you know, lower taxes because, is it
worth saving one more life? Well, I'll tell you, yes, it is, and if-- whoever that
speaker was that said that wants to -- was it you, sir?
DR. DOYLE: Yes, it was.
COMMISSIONER HILLER: Okay. If you want to sacrifice your life to
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lower taxes, then please let the other citizens know, but I assure you, I will not
ask any citizen to put their life on the line in order to lower taxes, because that's
what -- this is not -- this is not what this is about. I mean, that is, like, a false
argument.
I am so concerned, and I want to thank you, Commissioner Fiala. I want
to thank you from the bottom of my heart for bringing forward what these
people want, which is the extension of that COPCN for one year to allow for a
dec action to move forward to get a final decision from the courts as to whether
or not these interlocal agreements in the absence of a COPCN can proceed.
But we know for sure that a COPCN does allow for ALS services to be
provided and does allow for an interlocal agreement between North Collier and
this county. So why not go down the road that we know is correct?
I really beg the rest of this board. Commissioner Nance, I really implore
you. I implore you from the bottom of my heart, extend that COPCN.
CHAIRMAN FIALA: Now, who else had asked to speak on our board? I
want to get to this board as well.
(No response.)
CHAIRMAN FIALA: Okay. No one. Let's -- let me try. Okay. Was
your hand up first, and then --
COMMISSIONER CROSSAN: Yeah, it was.
CHAIRMAN FIALA: Mr. Hoffman (sic), and then Chris Lombardo.
COMMISSIONER CROS SAN: Okay. Let's just -- I know everybody's
getting emotional, but just to focus on everybody out here, you know.
You know, as a young man with a young family and everybody out there,
I mean, what did you always want for your kids? You wanted your kids to
thrive. You wanted them to do the best.
The same thing in the fire departments as with EMS. You wanted them to
grow up and be that star or whatever, but -- and I've always encouraged, in my
infancy, Chief Greenberg, as she was the delivery area, to get those paramedics
on the street because I saw -- I saw exactly how it worked, you know.
If you see something, anybody around here, goes on with their neighbors,
what are you going to do? You're going to love thy neighbor. You're going to
go over there, and you're going to help them,just the way each one of you have
set the tone with this new mobile data terminal. What you guys have done,
which is unveiled this week, I don't even think Lee County has it.
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And what it does, what you guys are unveiling, what you voted for, yes, is
that when all of these police officer cars and all of these -- and this is not
anecdotal evidence -- all of these engines, as they're traveling around the
county, there's a big board, and it doesn't recognize that -- if the North Collier
delivery truck is down in the City of Naples and they're the closest, they're
responding, and they can get there before.
Or if they're in the Greater Naples district as well and those are out -- and
you guys have spent millions of dollars, and that's going to -- that's going to
save so many lives right there. But these fire trucks -- and it's all about getting to
the patient quicker.
And, you know what, if Dr. Panozzo doesn't play nice and Dr. Tober
doesn't play nice, like -- Commissioner Nance, you stated a long time ago that if
they don't play nice then, boy, we have to find somebody else. And if our
management doesn't play nice over there, we are going to task them, like you --
I would expect to task your people, to say, hey, you're going to work this out.
And I -- you know what -- and if it's not a year, if you guys wanted to
before you got out of office, and maybe I'm voted out of office -- six months,
six months in July, like the doctor said, you know. I think we have a lot of
groundwork here that we could get this work through in six months. I know we
could get something from the Attorney General within six months; I would hope
that we could.
And I just -- I just -- you know what -- and I think we need to leave all of
our egos on the floor and focus outward to all these people right here and vote
for the COPCN. Only if it -- even if it's only for six months. If it's six days, I'll
take it, but I would -- I would ask for that latitude to serve our people.
CHAIRMAN FIALA: Thank you, sir.
Mr. Hoffman?
COMMISSIONER HOFFMAN: I agree with half of what Commissioner
Crossan said.
Let me explain my position and the way I look at it. From a North Naples
point of view -- North Collier, excuse me, we don't want to provide ALS service
unless we have a COCP -- C-O.
COMMISSIONER CHAO: P-C.
COMMISSIONER HOFFMAN: -- P-C-N. Thank you.
So here's my proposal. The question that has to be asked -- answered --
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and I don't know who the right person is to answer it, whether it's a judge or the
Attorney General. Can North Collier provide ALS service under an interlocal
agreement with the county? That's the question. We need to ask that question
to somebody in authority who can give us an answer.
While we're waiting for that answer, we extend the COCPN (sic) to, let's
say, one month after we receive that answer so we have time to do whatever it
is. And I think if we did -- took that approach, we get an official answer.
CHAIRMAN FIALA: Okay.
COMMISSIONER HOFFMAN: That's my position.
CHAIRMAN FIALA: Thank you. And Chairman -- are you Chairman?
No, you're not chairman anymore.
COMMISSIONER LOMBARDO: No, no, no. I'm the past chairman.
CHAIRMAN FIALA: Okay. Just an attorney.
COMMISSIONER LOMBARDO: I'm just a member of the commission.
CHAIRMAN FIALA: A lowly attorney.
COMMISSIONER LOMBARDO: That's me. That's me.
CHAIRMAN FIALA: Okay.
COMMISSIONER LOMBARDO: I'm going to echo what Commissioner
Hoffman just said to you, and I want you to think about this. I mean, the
problem that I have from the get-go is the fact that we've placed this at a
high-pressure level with incredibly high stakes.
Here's the problem. You cannot tell me the statute doesn't say what it
says. It does. The language is pretty plain. It's there. It's no different than
telling me that less means more.
And you cannot tell me, as the county, that if you're wrong and this
commission gets sued that somehow you're going to step up and take care of
that. You're asking us to take the risk. That's not reasonable. That's not
appropriate or fair. To me, we have to do essentially a cost-benefit analysis.
So the question becomes this: You have a proven system that you've
looked at and watched for five years. President Spencer's right, you've been
given accolades for the job that it's done. It is a well-run, experienced system.
It exists. It's there, and it's providing a necessary service for this community at
large, not just North Collier, but the entire community. So we know we have a
good system. We know we have an effective system. We know we can afford
the system.
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Now, we wind up with this very difficult legal issue about whether it's an
interlocal agreement or whether it's a COPCN. You've done five years of
COPCNs. You cannot assure us that the interlocal agreement is the right way to
go. I appreciate Jeff Klatzkow's predicament. If I was him, I would be saying
the same thing. Sure, these are -- these are enforceable because there are a lot of
them out there. That doesn't mean it's enforceable. That means there's risk out
there.
That's a tough call. It's a tough spot to be as a lawyer. When you look at
this and you say, well, all right, that's different, then really think about the
impact of that statute, and now we have to reconsider.
So here's the question. Do you take this line where you cannot tell us the
statute says something other than it does recognizing that in four days we have
to shut our system down and hope that there's a way to cover this community
over the next six months to a year while we sort this out, or do you say to
yourselves, look, we don't have the answer, but there's really no harm. It costs
the county nothing. It does nothing but protect their lives to extend this.
And, Commissioner Henning, I don't know the out-of-the-bag comment.
Whether it's three months, six months, or a year, whatever it takes to get this
done needs to be done. We're clearly not going to find the answer right here.
And so whether we go to the AGO or whether we file motions for
summary judgment and let the judge decide, we have a way to get to the
answer. But the question is, is it reasonable to put citizens' lives at risk while
we find out the answer? And I would suggest to you no.
There's no harm to the county in extending the COPCN, but there is harm
for the district to do the interlocal agreement and, in particular, for all eight
commissioners sitting here, whether we realize it -- and I would question -- I'm
a trial lawyer. I don't know whether I wouldn't try to say that I bootstrap all five
commissioners from the county into this.
COMMISSIONER HILLER: Unequivocally.
COMMISSIONER LOMBARDO: You know -- and so, is that a risk
we're all willing to take? Why would we do that when we have a proven system
and we're talking about a pretty simple answer?
I mean, I agree, we need to put the egos to bed. We need to just move on.
We need to find a solution. I don't think anybody on this side of the table is
saying to you that we're not willing to work through all these other issues, nor
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are we saying we're not willing to go and seek an opinion, whether it's an AGO
or the courts, to find out the answer on the interlocal agreement.
What's clear is none of us have the answer. And by Saturday at 12:01 a.m.
we have a crisis.
CHAIRMAN FIALA: Did I understand you to say that you didn't know if
you could operate under an ALS agreement?
COMMISSIONER LOMBARDO: Oh, no. I firmly believe the statute
says what it says. We have to have a COPCN, but that's my personal opinion.
And what I'm telling you is, let's not -- let's not battle out our opinions at the risk
of the general public. That makes no sense.
CHAIRMAN FIALA: Do you think that you can -- if a six-month
deadline was put in place, do you think you would then be able to come to an
understanding --
COMMISSIONER LOMBARDO: Commissioner Fiala, here's what I
think.
CHAIRMAN FIALA: -- that you can then operate under an ALS, or do
you think it never can be done?
COMMISSIONER LOMBARDO: Well, here's what I -- here's the way I
look at this. I don't know that you put a hard stop on this because the issue's too
critical. I think you say, at six months -- if that's what you want to do; I would
prefer a year. But if it's six months, it's six months. We do a review of this, and
we determine whether we've got an AGO or a summary judgment or some
decision from a court that gives us the assurance when it comes to the legal
issue; at the same time, start working through -- we know the stat -- here's
what's crazy about this.
On the ground level, the two sets of staff work together well. Your staff
recommended the extension -- the granting of the COPCN. I mean, to me that's
rather surprising. It's your staff that's telling you, yep, we're okay with this. So
what do we know? We know they can work together.
I -- and, you know, someone asked. I've given mouth to mouth. I've done
CPR. I've pulled bodies out of springs. I've been there. But I have no clue how
to solve a data-sharing issue or coordinate those kinds of things. I know we've
hired some great people that are extremely good at that. And in this six-month
window, because they are passionate about this, they will help find answers.
But, to me, this game of chicken, which is what this is, you know, stand us
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on a yellow line, send a car at us at 90 miles an hour, and then tell us you don't
have an ambulance to get to us after we get to the car and get hit by the car,
that's not right.
CHAIRMAN FIALA: Norman?
COMMISSIONER FEDER: I think we need to remember how we got
here. There was a submission to continue what had been five years of COPCN
after a merger. We're all talking about all-hazards and expansion of issues, and
then all of a sudden it wasn't until September that there was any indication that
that wasn't the continuation we were going to be experiencing.
COMMISSIONER HENNING: We heard that. We've heard that. So
how do we move forward, Mr. Feder?
COMMISSIONER FEDER: Okay. If you'd give me a second. You
made the charge that it's all on us because we won't go to an interlocal
agreement. So what I'm trying to say --
COMMISSIONER HENNING: What I heard from your colleagues is,
why don't we seek an opinion.
COMMISSIONER FEDER: I didn't disagree with that. Now, what do we
do in the interim?
COMMISSIONER HENNING: Okay. Let's talk about that.
CHAIRMAN FIALA: Commissioner Henning.
COMMISSIONER FEDER: Okay. In the interim we go COPCN
extension, and we work towards that opinion, and we work towards
continuation of all-hazards and issues that are being worked on in the county
and, by the way, having gotten stopped just because we had a COPCN. Our
merger with Big Corkscrew was part of that example of it continuing in spite of
a COPCN being out there.
CHAIRMAN FIALA: Okay. Did you want to finish, Commissioner?
COMMISSIONER CHAO: I've got a comment.
COMMISSIONER HENNING: Well, I --
CHAIRMAN FIALA: Just a minute, please.
COMMISSIONER HENNING: For the attorneys, is it a question of the
Court, or is the question of the AGO? Now, I heard some say they don't believe
in the AGO.
MR. KLATZKOW: They're the ones that raised the issue.
COMMISSIONER HENNING: Right.
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MR. KLATZKOW: They're the ones that raised the liability. They're the
ones that raised that this is illegal, okay.
I'm indifferent. If they agree with an AGO opinion, that will take less
time, I suppose, or we can go through the court system and get it that way. I'm
indifferent. But, really, the issue's been raised by North Collier, not by us.
COMMISSIONER TAYLOR: But I heard from Commissioner
Lombardo that he doesn't want to stop with an AGO opinion. He doesn't want
to start. He wants --
COMMISSIONER LOMBARDO: That's not what I said, but that's okay.
MR. KLATZKOW: I would ask them what they want.
COMMISSIONER TAYLOR: That's a good question.
COMMISSIONER LOMBARDO: I'm sitting here. You can ask me.
MR. KLATZKOW: Well, you're one vote out of eight. I mean, I've heard
different things from you folks.
COMMISSIONER TAYLOR: Can I --
CHAIRMAN FIALA: Let's just -- let's speak one at a time, because our
court reporter cannot get two people talking at the same time on one little tape.
MS. DONALDSON: Madam Chair?
CHAIRMAN FIALA: Yes. And then this gentleman over here had asked
also to speak.
MS. DONALDSON: The concern with an Attorney General Opinion
request is there's no statutory requirement that they issue an opinion.
Oftentimes, when there are conflicting governments involved, they say, we're
not going to get involved.
So I think, potentially, we could try to do an Attorney General Opinion
request. If she says no, then we would move forward with seeking a request
from the courts to get clarification. I just don't want it to be tied to an issuance
of an Attorney General Opinion when the Attorney General is not legally
obligated to give us one.
COMMISSIONER HENNING: May I say something very important on
point. We've been involved in this before where we've had litigation. They
would not answer the question because of the litigation. So maybe the true
question should be of the courts.
MS. DONALDSON: I don't disagree. I just wanted to raise the issue of,
if we just say it's only Attorney General Opinion, that there might be some
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issues related to getting the Attorney General Opinion.
COMMISSIONER HILLER: May I?
CHAIRMAN FIALA: Now, this gentleman over here -- I'm sorry, I don't
know your name.
COMMISSIONER CHAO: Commissioner Chao.
COMMISSIONER FEDER: Commissioner Chao.
CHAIRMAN FIALA: Okay. Thank you.
COMMISSIONER CHAO: Yes, ma'am.
We need to just extend the COPCN. It was originally coming, and it was
supposed to be accepted or rejected in October.
We can't say concretely we're going to -- if it isn't done by October, by
golly, we're going to fix it. If it's going to go to the courts, we all know how that
goes. We have to take it to there. And if we're all here or none of us are here,
that's to the betterment of the people if the COPCN is extended, because at this
point the public isn't going to be at a higher risk than they sit here today.
And adjacent (sic) to that, whatever vote that you guys make, when you
guys voted to cancel the -- or the way the COPCN was done, the people of
Corkscrew, if an ALS engine comes over from North Collier, they cannot treat
the people in Corkscrew. They can go to Marco Island, Everglades City, Golden
Gate, any part of the county, and they can treat.
The North Collier that are inside the Naples, the old North Naples Fire
District, they can go treat those people. They cannot come and treat my mother,
my father, my sisters, my neighbors, my family, my friends, anyone because of
the decision, the way it was done.
And all this came about because we asked to just extend it into -- to
include them. And whatever decision goes, we need to -- for the betterment and
the protection of all the county people, especially the ones of Corkscrew, to fix
that issue, even if you're going to deny it.
CHAIRMAN FIALA: Commissioner Feder --
COMMISSIONER FEDER: Feder.
CHAIRMAN FIALA: -- and then -- okay, Commissioner Hiller,
Commissioner Taylor. Thank you.
COMMISSIONER FEDER: Okay. What I would like to do -- we've had
very, very good discussion. We've had a lot of good public input. I think we
need to be working towards getting an answer, because in four days I don't think
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any of us wants to be where we're looking at.
We've got an agenda item under No. 9 that I may invoke as Chairman of
the North Collier Fire District and ask of the other members here, and even by
vote -- I'm going to ask if there's a motion for us to seek legal opinion as to
whether or not we can enter into an interlocal or if we are required to have a
COPCN to do so; is that correct?
COMMISSIONER BURKE: I'd so moved.
UNIDENTIFIED SPEAKER: A comment for the attorney.
COMMISSIONER FEDER: Just one second, please. I wanted to hear
from counsel if that's a correct motion.
MS. DONALDSON: I would just have it clarified through the courts.
COMMISSIONER LOMBARDO: Right.
COMMISSIONER FEDER: Clarified through the courts, okay.
CHAIRMAN FIALA: So what does that mean?
COMMISSIONER FEDER: The motion is that we, as a board, are going
to seek clarification through the courts. Now, again, I'm going to ask my
attorney to make --
MR. KLATZKOW: You're doing that now.
COMMISSIONER FEDER: No. As a matter of fact -- and my attorney
can help me here, but my understanding is we are in a legal proceeding, which
we have put in abeyance, on hold, to look at the issuance of the COPCN and the
process relative to that that would followed.
It does not include, and specifically didn't include, because we didn't want
to raise the issue countywide, whether or not an interlocal without a COPCN is
a viable mechanism under which we can operate, is that not correct, for ALS?
MS. DONALDSON: Madam Chair? Yes, that is correct.
COMMISSIONER FEDER: So we are not asking that of the courts. I am
now asking my board if they're willing to specifically make that request of the
courts, because an Attorney General's opinion might not come forward,
wouldn't necessarily be binding, and so I would like to get this answered,
because it seems to be the biggest stumbling block we, as two boards that need
to work together, are having.
CHAIRMAN FIALA: So do you want that answer right now?
COMMISSIONER FEDER: So I have -- yeah, to have the courts --
COMMISSIONER BURKE: Commissioner?
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January 25, 2016
COMMISSIONER FEDER: -- relate to this issue and to give us
clarification on it as to our --
CHAIRMAN FIALA: So, COMMISSIONER FEDER,just let me make
sure I understand what you just said.
COMMISSIONER FEDER: Yes.
CHAIRMAN FIALA: So you want them to make a decision to get the
opinion of the Court, which means that we make -- we do -- take no action
today, which means in four days this is --
COMMISSIONER HILLER: No, no, no, no.
COMMISSIONER FEDER: No. I would hope that is not the case. I
would hope that if I'm taking this action --
COMMISSIONER HILLER: That we do take action.
COMMISSIONER FEDER: -- that is good faith for this board to extend
the COPCN until we can get that answer out of the courts because, like you
said, we've been working under a COPCN very successfully. We know that that
works. And right now I'm in the middle of season, we're servicing people,
servicing them very well, and we need to continue to until we have an alternate,
and if that alternate turns out that it does not require a COPCN interlocal, we're
then in that discussion.
But right now we're not in that discussion because of what we're reading
and what we're understanding is in the statute, and so we're going to ask the
courts to opine.
CHAIRMAN FIALA: So that is your proposal.
Commissioner --
COMMISSIONER BURKE: Commissioner Feder, can you repeat that
motion.
CHAIRMAN FIALA: -- Hiller, then Commissioner Taylor.
COMMISSIONER FEDER: I was waiting for someone to make a motion
specifically, but --
COMMISSIONER HOFFMAN: Well, can we have discussion before.
COMMISSIONER FEDER: Of course.
COMMISSIONER HOFFMAN: I don't know how to work this out, but I
think that motion should be, you call it good faith conditional on the county
commissioners giving us an -- letting us keep our COCPN -- excuse me --
COPCN until --
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January 25, 2016
COMMISSIONER FEDER: Until such time and for a period after that to
work through the issues, yes.
COMMISSIONER HOFFMAN: Right. And then we'll know the answer,
yes or no, and we have a COPCN, or we operate --
COMMISSIONER FEDER: Well --
COMMISSIONER HOFFMAN: -- under an interlocal agreement.
COMMISSIONER FEDER: -- we'd continue to service people until we
have an answer.
COMMISSIONER HOFFMAN: Yes.
COMMISSIONER FEDER: Yes. Is there any -- is there any second to
that motion?
COMMISSIONER McGOWAN: I'll second it.
COMMISSIONER FEDER: Okay.
COMMISSIONER LOMBARDO: For discussion purposes, that may not
be something the county wants. May I -- you know --
COMMISSIONER FEDER: We're making our vote contingent upon their
continuing the COPCN.
COMMISSIONER LOMBARDO: No, no, no. You don't understand my
point.
COMMISSIONER FEDER: Yeah.
COMMISSIONER LOMBARDO: I mean, I'm not so sure the county
wants a decision as to whether, you know, interlocal agreements are enforceable
or not, and I don't know whether we have standing in this lawsuit to even raise
that issue, you know. We'd have to think about how we approach that.
Now, I'm not opposed to the idea. There are procedural approaches we
have to follow, too, because the problem we have is it's very likely that the
Attorney General, because of the litigation, is not going to step up.
And by the bye, even if the Attorney General does express an opinion, it is
an opinion. It is persuasive but not binding. I mean, that's the problem. And so
it doesn't solve the problem.
When it gets to the Court, we did not phrase -- we did not frame that
lawsuit around that issue, and we did that on purpose. We stuck to what we saw
as the issue at hand, which is whether the county had right to deny the COPCN.
What you're talking about is a different issue, which may mean that we
have to amend the lawsuit to get to the point where a court would even consider
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answering that, which means the county has to stipulate and agree to that
amendment.
MS. DONALDSON: Mr. Chair, what I would recommend is we actually
keep our current litigation stayed and then we seek a separate action related to
getting clarification on the statute.
COMMISSIONER HILLER: Right.
MS. DONALDSON: Because I think that if we start moving the one
lawsuit forward, there's a whole lot of issues, a lot of discovery that would go
into that that we really -- it may be premature to go through that; whereas, if we
can get the question answered separately, it's not tied to the lawsuit, but it would
impact, ultimately, the lawsuit.
COMMISSIONER FEDER: And, Laura, conditioned on the COPCN
being extended, that would be what I would enter in the motion is, in fact, that
we go as a separate effort, legal, to get an opinion from the courts.
CHAIRMAN FIALA: So you have a motion on the floor and a second.
Do you want to withdraw that motion, or do you want to --
COMMISSIONER FEDER: No. I'm asking that that motion include that,
and I need the second to identify if they concur.
COMMISSIONER McGOWAN: I concur.
CHAIRMAN FIALA: Okay.
COMMISSIONER FEDER: Amending it, yes. Does the second concur?
CHAIRMAN FIALA: But you recommended they didn't do that, right?
COMMISSIONER McGOWAN: Concur.
COMMISSIONER FEDER: Concur, okay.
COMMISSIONER LOMBARDO: And if I can comment, the problem
with filing now a second lawsuit is -- which would be against the county, is
we're going to wind up with the same objection the county -- potentially, the
county could make that it made to this lawsuit, which puts us back into the
alternative dispute resolution process, which puts us right back here. I mean,
you know, that's a 120-day clock. I mean, all of this just devours time, folks,
but --
COMMISSIONER HILLER: And may I respond?
CHAIRMAN FIALA: Yes.
COMMISSIONER HILLER: Ahead of your vote, I'd like to comment.
The decision to move forward with, in effect, a dec action to get an
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opinion on the validly of interlocal agreements for ALS services in the absence
of awarding a COPCN to the requesting agency is something that does have to
be answered by the courts, and there is no question that we as the Board of
County Commissioners need to extend North Collier's COPCN to include Big
Corkscrew till the courts rule on that decision.
Since -- I mean, you know, at a minimum we've already had our staff tell
us that the evidence presented to us supports awarding that COPCN, so we
know it's justified to award it.
To make your motion contingent upon our awarding that COPCN until
such time as the Court rules on the new question that will come out of this new
lawsuit is absolutely appropriate, and we as a board need to extend the North
Collier COPCN until such time as we know definitively whether or not these
interlocal agreements are valid or not.
CHAIRMAN FIALA: Commissioner Nance? Oh, I'm sorry.
COMMISSIONER HILLER: So I think it's absolutely essential that we
make that decision today.
We, on our agenda, the way this meeting has been noticed, does allow our
board and your board to take action under 8 and 9, so I think we do need to take
action.
CHAIRMAN FIALA: Commissioner Nance?
COMMISSIONER NANCE: Yes. I think, clearly, this is a situation and
a quagmire that only a lawyer could create, okay. It is very clear to me, through
the comments of Commissioner Lombardo, that this is never going to -- it's
never going to come to an end.
There is never going to be a determination that doesn't support North
Collier Fire having their own independent license and operating independently
from everybody else in the county that is going to cause them to cease the
action. That's the only thing that's going to cause them to cease this endless
action.
We are, in Collier County, right on the cusp of having the ability to put
together a unified emergency response. The only thing it's lacking is North
Collier Fire's will to do so, okay. They want to talk about they can work out a
way to share information. You want me to show you how you share
information? You go like this (indicate), okay.
It's that complicated. It's that complicated. Everybody else does it. How
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complicated are these interlocal agreements? They're not. Everybody else in
the county is doing it.
I cannot support anything that is going to kick this down the road any
further. I cannot kick -- I cannot support anything that is going to take
something that's that close from being unified and fragment it so all of a sudden
we've got an endless chain of licenses, interlocal agreements, medical directors,
protocols, trainings, recertification, everybody else has got an opinion. I can't
support any of that.
So if these guys want to vote to continue down this road, I can tell you
what, you're going to be out of the ALS business if I have anything to say about
it because it's never, ever, ever, ever, ever going to end. It couldn't be done
before me, and it's going to -- you know, today -- as far as I'm concerned, if I
have a vote, today's the day this is going to stop. It's going to stop until
somebody sees realization.
If you want to continue in the court system for the next five years, you
guys can just go on down the road, because I don't think there's anything
anybody can do about it. I really don't. I don't think anybody in the world on
either one of these boards can stop you from doing that if lawyers want to do
that. You can just keep on going down the road. It will be a do loop without
end. I'm sorry.
CHAIRMAN FIALA: I'm sorry to interrupt, but I just got the word there
are people waiting outside who have this room reserved apparently, so --
COMMISSIONER NANCE: What a shock.
COMMISSIONER FEDER: What I'm going to do -- is there any other
comments on either board? And then open it to the public. Yes, Commissioner.
COMMISSIONER TAYLOR: Yes, I wanted to say this a while ago, but I
can assure you, commissioners and the public, before I took this action and a
vote in September, I asked our County Manager if we as the county could
effectively and safely service the North Collier/Corkscrew area for EMS, and I
was assured we could. In fact, the response is, we did it before. We could do it
again.
Thank you.
COMMISSIONER LOMBARDO: I have a response.
COMMISSIONER TAYLOR: Excuse me, sir.
COMMISSIONER LOMBARDO: No, no, allow me to respond.
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January 25, 2016
COMMISSIONER HENNING: This is not litigation in the court.
COMMISSIONER LOMBARDO: Let's try --
CHAIRMAN FIALA: She is not finished. Commissioner Lombardo, let
her finish, please.
COMMISSIONER TAYLOR: I -- we really don't need this as an
argument. I can assure you this is what was stated to me, and that's why I
confidently voted the way I did in September.
The -- I think it's a ruse about this board's decision throwing people at
great risk to the point where the world is going to end.
I think that going forward we need to keep our eye on the goal, and that is
a unified emergency response system within Collier County with all information
being shared. Think about it. Right now that's not the case. That is frightening
to me.
Thank you.
CHAIRMAN FIALA: Okay. Commissioner Feder?
COMMISSIONER FEDER: If I don't have any more on your board, I'm
going to ask my board.
We've got a motion on the floor and seconded.
COMMISSIONER HILLER: I'd like to comment.
COMMISSIONER FEDER: Commissioner Hiller, and then we'll go back
to our board.
COMMISSIONER HILLER: Yeah. We do not -- we do not have the
funds, we do not have the staff, we do not have the stations, we do not have the
equipment to provide the level of service that will be discontinued if we do not
award the COPCN. There is no question about it. Doug Fee brought that up.
He's looked at the numbers. I know he has looked at the numbers.
It is putting lives at risk. It is not true that we can provide the same level
of service, and if we reduced the level of service, there is no question that there
is the risk of lost lives that otherwise would be saved; there is the risk of
disability that otherwise could be prevented. This is unacceptable.
This discussion is not about unification of the independent fire districts.
The independent fire districts were created by the voters of this county. The
decision to dissolve any single fire district will be decided by the voters of those
districts of this county, not by this board, and it is not up to this board nor can
this board unify the independent fire districts. It's not permitted by law. We
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January 25, 2016
don't have the jurisdiction or the legal ability to do it. And while --
COMMISSIONER NANCE: Commissioner, nobody suggested that,
ma'am.
COMMISSIONER HILLER: No, no, let me finish. Yes, it is. You have
been suggesting it constantly.
COMMISSIONER NANCE: I said provide response.
CHAIRMAN FIALA: Let's one at a time, please.
COMMISSIONER HILLER: The bottom -- and with respect to the
exchange of information, there are federal guidelines on that. It's called
HIPAA. You have privacy issues. There are guidelines on how information can
be exchanged in these situations. It can be done as has been discussed by our
staff, by the fire board. That is not the issue.
COMMISSIONER FEDER: With all due respect. Madam Chair?
COMMISSIONER HILLER: Hang on a sec. And don't say "with all due
respect." That's, like, straight out of Boondock Saints.
COMMISSIONER FEDER: Okay, good. This is our motion on the floor.
COMMISSIONER HILLER: I understand.
CHAIRMAN FIALA: Yes.
COMMISSIONER HILLER: I just want to finish. I want to finish --
CHAIRMAN FIALA: I'm trying to give you the --
COMMISSIONER HILLER: -- and say that I want to -- let me finish,
please.
I support your motion, I applaud your entire board for taking the position
you're taking, and I implore my board to extend that COPCN to allow the level
of service to be maintained for North Collier, for my district, which is District 2,
which is North Naples, and for Big Corkscrew.
It is completely wrong. It is immoral. It is unethical. It is wrong not to
extend the COPCN which we know from our staff, based on the evidence
presented to us, is justified as extended and will save lives.
Until the courts decide, let's protect the people. This is about the people.
This is not about you or your policy to unify. This is about ALS advanced
life-saving service for the benefit of the patient, for patient care.
CHAIRMAN FIALA: Okay. Now we have a motion on the floor.
COMMISSIONER FEDER: We have a motion on the floor.
CHAIRMAN FIALA: And second.
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COMMISSIONER FEDER: I want to go back to my commission and to
the public for comment.
I'm going to start off the comments here and then go down the board.
The first one is I see we've got three options here. We've got the option to
capitulate and go to an interlocal agreement because we're told that's what the
county wants us to do even though that puts us in liability, from everything we
can see, legally.
We've got the option to continue a lawsuit that is going to try and say,
county, you had no right to not issue the COPCN and to force it to be issued.
Or, in the spirit, I thought, of cooperation, we can go and say the biggest
bugaboo that we've argued over for how many hours is whether or not we have
that legal right, and go to the courts and get that answered, but only while we
are continuing to service the people, especially under peak season and with
what's coming in this county.
So having said that, we have three options. This third one, I think, is an
effort at getting some resolution today. So I'm going to continue that discussion
down here and open it to the public.
Commissioner?
COMMISSIONER LOMBARDO: I'm disappointed that Commissioner
Nance is not in the room right now.
Look, this is not about me, and I don't appreciate the personal attacks on
me. I didn't write the statute. I didn't create this circumstance. I can read it like
everybody else can. You can't tell me that it doesn't say what it says. It says
what it says.
The answer is to separate the two. Let's continue to provide the service,
and let's find the answer in a methodology that will allow us to do this without
impacting the public.
COMMISSIONER HILLER: Right.
COMMISSIONER LOMBARDO: That's the problem. If we take your
other approach -- and let's assume, Commissioner Taylor, that the county has
another hundred paramedics or whatever it needs to do to cover North Collier,
that's wonderful news, but the reality is, it's not like North Collier is letting go of
those hundred paramedics. Those hundred paramedics are cross-trained
paramedics, and so they're here. They're there. They show up to work. Why
not use them? Why not use them? Isn't that the most efficient thing?
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January 25, 2016
And, again, while I hear you-all on this unified response, that's not what
we're talking about today. I'm more than willing, and we have always been
willing, to talk about how we provide better service on a higher level to make
sure this community is protected.
We've never, ever done anything to frustrate that and, in fact, we've
typically led the way and been right there as a hardworking partner to find
solutions.
But we've got a legal issue that we can't solve, and so let's separate the
two. Let's let us find the legal answer, but let's make sure we continue the status
quo, which has been fine for you-all for five years and protected everybody for
years. There's -- it's the same paramedics. There's no reason not to.
And so, you know, again, I'm not going to sit here and tell you I have the
answer either, but I don't appreciate the approach. And, Commissioner Nance,
you and I someday need to sit down and have lunch and talk about your feelings
towards me and lawyers in general, but the reality is, the system -- there's a
jurisprudence system that's out there. That's how we define and resolve things.
Lawyers are never liked because we have to sit there and get in the trenches and
find the answers.
COMMISSIONER HOFFMAN: That's not the reason.
COMMISSIONER LOMBARDO: We don't need to harm these people in
the process.
COMMISSIONER HENNING: Chairman? Chairman Feder?
CHAIRMAN FIALA: Yeah.
COMMISSIONER HENNING: Is the comments under the motion, or are
we going to continue this?
COMMISSIONER FEDER: We're going down the line, and then we're
going to get public comment, and we're going to call the motion.
COMMISSIONER HENNING: Is it on the motion, or it's just open it up
to anything?
COMMISSIONER FEDER: It's on the motion. Go ahead.
COMMISSIONER HOFFMAN: What's the motion?
COMMISSIONER FEDER: The motion specifically is that we ask the
courts to define what -- well --
COMMISSIONER LOMBARDO: File a separate lawsuit.
COMMISSIONER FEDER: Yes, separate --
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January 25, 2016
COMMISSIONER HOFFMAN: Can we provide a --
COMMISSIONER FEDER: -- a separate lawsuit filed by us to get the
courts to define what specifically are the capabilities and the issues under the
statutes as they exist. Once we know that, then we can continue to work
through these issues.
COMMISSIONER HOFFMAN: That's a very vague motion.
COMMISSIONER FEDER: And during that time --
COMMISSIONER HOFFMAN: That's a very vague motion.
COMMISSIONER FEDER: During that time, the COPCN be extended.
COMMISSIONER HOFFMAN: That's a very vague motion. My motion
would be can North Collier provide ALS services under an interlocal agreement
with the county, period.
COMMISSIONER HILLER: Without having a COPCN that allows for
ALS under the county?
CHAIRMAN FIALA: Wait, Commissioners.
COMMISSIONER HOFFMAN: Yes.
CHAIRMAN FIALA: We can't take two motions at the same time.
COMMISSIONER FEDER: I am not fashioning the specific lawsuit
language; rather we are deciding whether or not we're -- if the county continues
on a COPCN during this time, we are going to go to the courts to get a
determination.
Now, the exact language of that is something still to be determined.
CHAIRMAN FIALA: Okay. So we have a motion on the floor and a
second.
COMMISSIONER FEDER: And do I have any other comments from the
commission itself?
(No response.)
COMMISSIONER FEDER: From the public we've got some people.
COMMISSIONER BURKE: Well, I've got a question on this.
COMMISSIONER FEDER: Yes.
COMMISSIONER BURKE: What this motion does is asks for an
extension of the certificate, one, right?
COMMISSIONER FEDER: Yes.
COMMISSIONER LOMBARDO: Correct.
COMMISSIONER BURKE: And under the extended period, we can --
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January 25, 2016
we'd go to the courts for clarification on the --
COMMISSIONER FEDER: And it gives good faith to the county that we
are specifically ready to go to courts on that issue while they're continuing the
COPCN, yes.
COMMISSIONER BURKE: So if the county commissioners today, as
Commissioner Nance said he wants to put an end to this today, if they put an
end to it, we go to the courts.
COMMISSIONER FEDER: Then we can't do anything else if that is the
position that they take, that is correct.
COMMISSIONER BURKE: But it would still, then, go to the courts.
MS. DONALDSON: Mr. -- Madam Chair?
CHAIRMAN FIALA: Yes, I'm Chair.
MS. DONALDSON: If there's not success at today's meeting --
COMMISSIONER FEDER: Entertain any other motion.
MS. DONALDSON: -- then the statute requires us to go to mediation,
and we have to select a mediator within 14 days, I believe, of today's meeting.
If we can't agree to that, then it's seven business days. We end up going to
mediation, we go through mediation. If mediation is not successful, then we go
back to court with our existing lawsuit, and we will move forward with that
issue.
COMMISSIONER HOFFMAN: Can I make a comment?
CHAIRMAN FIALA: So does this -- does Commissioner Feder's motion
COMMISSIONER FEDER: We have a motion; we have a second.
CHAIRMAN FIALA: Yes, but I'm asking her if that changes that
position in any way.
COMMISSIONER FEDER: No, it does not.
CHAIRMAN FIALA: Okay. So then we've got a motion on the floor and
a second, and --
COMMISSIONER HOFFMAN: Comments?
COMMISSIONER FEDER: I'm asking if there's any public comment.
COMMISSIONER HOFFMAN: I still -- I would like to make a
comment. I think we should discuss this after we hear the vote of the
commission.
COMMISSIONER FEDER: Okay. We have a motion and a second.
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January 25, 2016
COMMISSIONER HOFFMAN: That would make sense.
COMMISSIONER FEDER: And, yes, Bob.
MR. NAEGELE: Bob Naegele.
A couple of questions. Of this hundred paramedics that seem to be
floating in limbo, they will still be doing the BLS work, correct?
COMMISSIONER FEDER: They will always --
MR. NAEGELE: Or are they sitting out everything?
COMMISSIONER FEDER: Yes. Just not going to have ALS.
MR. NAEGELE: There will still be a -- it isn't like we're without -- that
we're naked? We still have these hundred folks working BLS and helping take
-- get folks on the way to the hospital?
COMMISSIONER FEDER: (Nods head.)
MR. NAEGELE: No, I know we don't have transport.
And the other thing I have, I thought I heard Laura say we're going to have
a lawsuit here. And every time you do a lawsuit north Naples picks up 86
percent of that cost. So I want us to be very careful anytime we say, well, we're
going to take another shot with a lawsuit.
Thank you.
COMMISSIONER FEDER: We're trying to get clarification, yes. Any
other comments?
CHAIRMAN FIALA: Okay.
COMMISSIONER FEDER: Yes. Doug?
CHAIRMAN FIALA: Are you going to be taking all these comments
from the audience --
COMMISSIONER FEDER: We're taking comments before we vote, yes.
CHAIRMAN FIALA: -- regarding -- okay.
COMMISSIONER FEDER: And I'm asking that they be to the issue as
best they can, yes.
MR. FEE: Good afternoon.
CHAIRMAN FIALA: You're going to have them all lined up again. Mr.
Feder?
MS. DONALDSON: I'm sorry. Madam Chair, under the statute, before
we take an action on the item we have to hear public comment, and this is a
different issue.
COMMISSIONER FEDER: And I want to hear the public comment. I'm
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January 25, 2016
not going to have a motion and not hear the public. And Doug?
CHAIRMAN FIALA: We're going to be -- we're going to take a recess in
10 minutes -- nine minutes for our court reporter. So just so you know, we've
got a time limit here also.
COMMISSIONER FEDER: Again, I'll ask people to stay to the item. Go
ahead, Doug.
MR. FEE: Very briefly. Doug Fee, for the record.
This is to the North Collier Fire. I appreciate that you're bringing up the
fact that we need a legal opinion -- and we only have four days -- but I would
like to suggest that that wasn't necessarily told to the public prior to the meeting.
What I think is on the agenda is the extension of the COPCN.
COMMISSIONER FEDER: Which is what we're asking for with this as
well, yes.
MR. FEE: Okay. And so it seems to me we're adding something. If it
wasn't in the original suit -- which I attended the meeting as the public, and you
held that meeting and you went forward with it. This -- the strategy of not
going down that road to get that answer was not put out in the public.
While I support the getting the answer, there is obviously some things that
the public in North Collier need to be aware of and -- the dollars.
So I support, but I think today that it's great that you do that, but I think
you need to come back to the citizens that you represent to go down that road.
So it makes it a difficult call, but please --
COMMISSIONER FEDER: I appreciate that, Doug, but at the same time
we've noticed -- one of the major notice issues was to seek continuation of the
COPCN. That's what this motion is.
We are acknowledging that we'll take some action during that time if, in
fact, the county does extend the COPCN to try and get an answer to the question
that's been raised heavily by the county as why not under an interlocal, and that
will also address our legal implications as well.
So they are very directly related; otherwise, how could I have any
resolution or any issue today at all?
MR. FEE: And with that -- I agree with what you just said, but if the
Board, the County Commission, were asked to vote on the extension of North
Collier's COPCN and they needed, in order to do that, a clarification to get that
answer from you, then I would say that that would be a good thing on their part,
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but I do believe that that answer would have to have further vetting at the fire
district level. Does that make sense? So good luck.
MS. COTHRAN: Shirley Cothran.
COMMISSIONER FEDER: Hi, Shirley.
MS. COTHRAN: Something has been bothering me, and that is you keep
talking about extending the COPCN, which leaves Big Corkscrew out, as I
understand it.
COMMISSIONER HILLER: No.
COMMISSIONER FEDER: No, it included Big Corkscrew.
MS. COTHRAN: Okay, good.
COMMISSIONER CHAO: No, it does not.
COMMISSIONER HENNING: No, it doesn't.
COMMISSIONER HILLER: It does.
COMMISSIONER CHAO: No, it does not.
MS. COTHRAN: Extending the current one doesn't. Approving the
September one would, expanding it.
The other thing I want to point out is that the contingency plan that the
county came up with, if you go out of the ALS business, not only is it
unbelievably expensive compared to the COPCN route, but it requires overtime
on the part of the paramedics.
There are limits on how long pilots can fly without having rest period, on
train engineers, on truck drivers, on bus drivers, on anybody carrying
passengers, and I would think that a passenger -- a patient would be considered
a passenger in an ambulance.
But your paramedics work 24-hour shifts, and then they would work
overtime? So they're working 48 hours? I don't understand why a pilot can't fly
an airplane for 48 hours but a paramedic can make lifesaving decisions. So this
whole thing is just crazy.
COMMISSIONER FEDER: Okay. I appreciate that.
If there's not any other comments, I think we had one question that got
raised, and our intent always, if we had a COPCN, was then to be able to
provide services through our own mutual aid and the like to Big Corkscrew, and
that would still be my intent relative to this motion.
COMMISSIONER BURKE: Mr. Chair?
COMMISSIONER FEDER: Yes.
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January 25, 2016
COMMISSIONER BURKE: If this board votes to support the motion and
the County Commission rejects it, I guess that's the term, that means at midnight
Saturday our paramedics are out of service?
COMMISSIONER FEDER: Barring any other motion or action, yes.
UNIDENTIFIED SPEAKER: On ALS.
COMMISSIONER BURKE: On ALS.
COMMISSIONER FEDER: Yes.
Okay. We've had considerable discussion. We had a motion and a
second. We'll call the question.
All those in favor, signify by saying aye.
COMMISSIONER McGOWAN: Aye.
COMMISSIONER BURKE: Aye.
COMMISSIONER CHAO: Aye.
COMMISSIONER HANSON: Aye.
COMMISSIONER CROSSAN: Aye.
COMMISSIONER LOMBARDO: Aye.
COMMISSIONER FEDER: Aye.
Opposed?
COMMISSIONER HOFFMAN: I don't know where my light is, but I'm
opposed just because the motion is too -- is not specific.
COMMISSIONER HENNING: Madam Chair?
COMMISSIONER FEDER: Okay. So it passes 7-1 with Commissioner
Hoffman opposed.
COMMISSIONER HENNING: Madam Chair?
CHAIRMAN FIALA: Yes, sir.
COMMISSIONER HENNING: We're talking about the extension of the
North Naples region COPCN. There's no ALS from the firefighters in Big
Corkscrew at this time, and there's not going to be if the COPCN is extended.
COMMISSIONER FEDER: Point of clarification. My understanding is
if we had a COPCN, we can establish agreement to provide services within the
balance of our district; is that not the case?
COMMISSIONER HILLER: No, you can't.
COMMISSIONER FEDER: You can't.
COMMISSIONER HENNING: Okay. And --
COMMISSIONER FEDER: And somebody wanted to speak to it?
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January 25, 2016
COMMISSIONER HENNING: And that is a concern of mine if we keep
on kicking this down the road.
So, Jeff, the question is, how quick, in your opinion, can we get an answer
from the Court on the legality of the ALS for -- or interlocal agreement to
provide ALS?
MR. KLATZKOW: Well, it would depend upon how quickly North
Collier was prosecuting this lawsuit. I don't know where the incentive is for
them to quickly process this lawsuit so -- because as long as the lawsuit is open
COMMISSIONER HENNING: Right.
MR. KLATZKOW: -- their certificate is open. So this could be a lengthy
process.
COMMISSIONER HENNING: Well -- and I understand you want to
kick it down the road until after the election. I get that.
COMMISSIONER CHAO: That's not true.
COMMISSIONER HENNING: It's been stated.
COMMISSIONER CHAO: You stated it. We did not.
COMMISSIONER HENNING: Yeah. And it's been said on several --
COMMISSIONER CHAO: It's just about the lives of our people. That's
all we're looking for.
COMMISSIONER HENNING: All right. Well, then, why not have the
lives -- in your opinion, it's about ALS -- the fire department providing ALS.
Why wouldn't you try to get the answer as soon as possible?
COMMISSIONER CHAO: Sir, that's what we are attempting to do.
COMMISSIONER HENNING: So can we get it in the next 30 days,
potentially?
MR. KLATZKOW: I don't think that's going to happen.
COMMISSIONER HENNING: You don't think they're going to --
MR. KLATZKOW: I mean, anything's possible, sir, but I don't think that
will happen, no.
COMMISSIONER LOMBARDO: Just for clarification --
MR. KLATZKOW: And now you're --
COMMISSIONER HENNING: No, I have the floor.
MR. KLATZKOW: I mean, if what they're saying is bringing the lawsuit,
okay, we'll have to reply to that lawsuit, then there will have to be motions
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made. It's not going to happen in 30 days, I don't think. And then you're asking
a judge to simply -- to dictate to a judge how quickly he's going to prosecute --
answer this question?
COMMISSIONER HENNING: I'm just trying to get an opinion how
long it's going to take.
MR. KLATZKOW: I think it's going to take a long time. That's my
opinion.
COMMISSIONER TAYLOR: Six to eight to 12 months.
COMMISSIONER HENNING: Yeah, that doesn't answer the question.
Laura, do you have any idea?
MS. DONALDSON: Commissioner, I think that we could commit on
how quickly we file it to the Court. But, as the County Attorney stated, the
county then has to respond, and then, depending on what issues are raised, then
the judge will have to set it. I mean, we can commit to having it filed, the
pleading filed --
COMMISSIONER HENNING: Right.
MS. DONALDSON: -- within a certain time frame, but beyond that,
we're not in control.
COMMISSIONER HENNING: Yeah. I was just looking for -- based
upon your knowledge of when the Court might hear and rule on it. That's --
MR. KLATZKOW: You're probably looking six months to a year
minimum. That's probably what you're looking at.
COMMISSIONER HILLER: Which is why the COPCN should be
extended for a year.
CHAIRMAN FIALA: Okay. So --
COMMISSIONER HENNING: But in the meantime we're not going to
address the question. So you'd get an answer out of the State Attorney General
much quicker than you would the courts.
COMMISSIONER HILLER: You're not going to get --
CHAIRMAN FIALA: So, folks, on our commission now, what do you
want to do from here? Do you want to make a motion yourselves? Do you want
to just continue on with the next questions?
COMMISSIONER HENNING: Well, I would like to --
CHAIRMAN FIALA: We should break.
COMMISSIONER NANCE: Let's take a break.
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January 25, 2016
COMMISSIONER HENNING: I would like to talk to the -- I would like
to talk to the County Attorney and make a decision at the Board of
Commissioners meeting as far as a motion.
Now, I really want to answer the question, but there's a lot of problems in
here. One is you don't have any -- you have paramedics within the Corkscrew
area, but you want to enhance service. Got that. That doesn't provide it. So
either the Board has a unified system to where we have interlocal agreements
throughout Collier County to provide ALS by the independents or
municipalities, or we're doing COPCNs.
COMMISSIONER HOFFMAN: Mr. Chairman?
COMMISSIONER HENNING: So I want to talk to the County Attorney.
I don't want to drag this out for a year.
CHAIRMAN FIALA: Yeah.
COMMISSIONER HOFFMAN: Could I make a motion that we accept
the county's offer, if I could use those words, to enter into an interlocal
agreement? We've gone around in a complete circle, and my real concern is
providing service to the citizens of North Collier.
COMMISSIONER HILLER: Yeah, it's illegal.
CHAIRMAN FIALA: Let him finish, please.
COMMISSIONER HOFFMAN: Okay. That would be my motion. And
if it -- why is it illegal for us and not for the other districts to do it?
COMMISSIONER HILLER: It's illegal for them, too.
COMMISSIONER HOFFMAN: So it's illegal for everybody? That's
your position?
COMMISSIONER HILLER: Yes.
COMMISSIONER HOFFMAN: Okay.
CHAIRMAN FIALA: Is that the truth?
COMMISSIONER HOFFMAN: Well, that raises a whole 'nother issue.
COMMISSIONER HILLER: I'm reading the law. I've got -- I have a
statute here.
COMMISSIONER HOFFMAN: Yeah. I've heard different --
COMMISSIONER FEDER: We've giving the county a --
CHAIRMAN FIALA: Okay.
COMMISSIONER FEDER: With all due respect, Commissioner, we're
giving the county the chance to go through their end of the issues.
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January 25, 2016
Do I hear a second on that on this board? I don't think I do.
COMMISSIONER BURKE: A what -- second on what?
COMMISSIONER FEDER: On the motion to go into an interlocal
agreement at this time.
COMMISSIONER BURKE: Is that the motion made by Commissioner
Hoffman?
COMMISSIONER HOFFMAN: Yes.
COMMISSIONER BURKE: I would second it.
COMMISSIONER LOMBARDO: Call the question.
COMMISSIONER FEDER: Call the question.
COMMISSIONER HENNING: Don't you want public comment?
COMMISSIONER FEDER: Public comment, yes.
CHIEF ANDERSON: Paul Anderson, Fire Chief, Immokalee.
I just wanted to suggest that maybe the motion -- a more appropriate
motion -- because extending the current COPCN does not include Big
Corkscrew. A more appropriate motion may be to request the county to
approve the proposed COPCN that does include the Big Corkscrew service
delivery area.
And as far as I know, they're -- the expiration date on a COPCN is not set
by statute. So the county can put any expiration they want on it.
COMMISSIONER HENNING: It's a two-year.
CHIEF ANDERSON: Is that in the statute?
COMMISSIONER HENNING: Yes.
COMMISSIONER FEDER: Yes, there's a --
COMMISSIONER HENNING: And the Board of Commissioners cannot
reconsider an item. It's past due.
COMMISSIONER FEDER: Okay. Again, is there any other public
comment before we call this motion?
CHIEF ANDERSON: The Board has reconsidered. They do have a time
to reconsider when they've made a vote. The Board has used that in the past.
Commissioner Nance used that within a month or two of him coming in office.
COMMISSIONER HENNING: It's -- the time has expired.
CHIEF ANDERSON: North Collier requested you to reconsider it within
the time limit in the county ordinance, and they were wrongfully denied.
COMMISSIONER HENNING: Wrongfully denied. Thank you, Chief.
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January 25, 2016
COMMISSIONER FEDER: Doug Fee.
MR. FEE: I'll be brief. Doug Fee.
Question is for Chief Kopka and Leo Ochs. We're talking about the
interlocal agreement. Are all interlocal agreements today regarding EMS, fire,
sheriff, per district or municipality, are they word for word the same barring the
map? So right now you're wanting us to -- you're wanting the situation to go to
an interlocal agreement but, in fact, those that are in place right now are not
consistent.
So you're trying to create a one -- an efficient system, but that which
you're under right now is not efficient. How do you get there? Do you go down
and create a new blanket interlocal agreement and get those out there, which
takes time? You need all of the municipalities to go through this with you.
And, two, you already have a CP -- COPCN which is in place with one district,
that that could be the -- that's the document that you can go forward with others
and make it consistent.
Thank you.
COMMISSIONER FEDER: Okay. Comment, too, from the Board here,
and then we're going to call the question.
COMMISSIONER LOMBARDO: Do you mind, Chris?
COMMISSIONER CROS SAN: No.
COMMISSIONER LOMBARDO: I can't support this motion because I
have no idea what an interlocal agreement looks like at this point. We don't
know what the financial impact of it is. We don't know what the parameters
are.
Doug Fee is right, there isn't a standard interlocal agreement that we can
look at and say, that's the deal.
COMMISSIONER FEDER: Nor the legal.
COMMISSIONER LOMBARDO: And here's where you're at. We're
four days away from the expiration time. We know what the COPCN looks
like. We know that it's worked. You've got four days. There's no way we're
going to be able to negotiate an interlocal agreement in four days. We can't
even agree to disagree in four hours here. So, you know, I can't support it.
COMMISSIONER FEDER: Commissioner Crossan.
COMMISSIONER CROSSAN: Just real quick. You note -- and this is a
question for the lawyers as well -- is if we have the same thing in mind,
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Commissioner Henning, as I do and as you do as getting the answer, can't we
come together as a board for everybody out here and just go to the courts
quickly and just say, hey, what do you guys think on this? You know, let's
move this up. This is -- this is -- this is about everybody.
And if we could move that together quickly -- that way we don't have
reservation and you guys don't have reservation -- and extend this COPCN. I
don't want to kick this bucket down anymore.
COMMISSIONER FEDER: Okay.
COMMISSIONER CROSSAN: I don't want to be in the same things, you
know. I just want to focus on that, and then go from there.
COMMISSIONER FEDER: Thank you, Commissioner.
I'm going to call the question. Again, everybody -- all those in favor,
signify by saying aye.
COMMISSIONER McGOWAN: Aye.
COMMISSIONER BURKE: Aye.
COMMISSIONER HOFFMAN: Aye.
CHAIRMAN FIALA: All those opposed, like sign?
COMMISSIONER CHAO: Aye.
COMMISSIONER HANSON: Aye.
COMMISSIONER CROSSAN: Aye.
COMMISSIONER LOMBARDO: Aye.
COMMISSIONER FEDER: Aye.
I believe it passes -- no, I mean fails, 5-3. Is my understanding -- who
voted for it?
COMMISSIONER HOFFMAN: I need somebody to tell me what the
motion is again.
COMMISSIONER CHAO: It's your motion.
COMMISSIONER FEDER: It was your motion, sir.
COMMISSIONER HOFFMAN: We're voting on my motion? All right.
COMMISSIONER FEDER: It was your motion. It failed 5-3.
Having said that, before --
COMMISSIONER HOFFMAN: Interlocal agreement --
COMMISSIONER FEDER: Excuse me. Before we got into that
discussion, we had offered over to the county, and the county was having their
discussion. I'd like them to get a chance to continue that.
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January 25, 2016
CHAIRMAN FIALA: You know what, we are going to break for lunch
right this minute because we need to give our court reporter another break.
COMMISSIONER HENNING: I cannot come back. If we're going to
take a lunch, I cannot come back. I have other obligations that I need to do.
And I just want to reiterate what I said.
And thank you for your comments, Commissioner Crossan.
I want to talk to the County Attorney to see what can be done to step it up
quickly. And after my conversation, I want to have a -- I'm going to make a
motion during the Board of County Commissioners meeting and see what the
will of the majority of the Board is.
COMMISSIONER NANCE: I will support that.
COMMISSIONER HENNING: Okay.
COMMISSIONER TAYLOR: Make a motion.
CHAIRMAN FIALA: Okay. And our meeting is tomorrow, by the way.
COMMISSIONER HENNING: The meeting is tomorrow. I understand.
COMMISSIONER HILLER: Well, I think that's going to be a problem
because we're supposed to be -- I mean, if we don't resolve anything here today,
it's an impasse, and --
COMMISSIONER HANSON: Commissioner Henning?
COMMISSIONER HILLER: -- you go to litigation. This is not a
procedure that -- are we extending this meeting with this board into tomorrow?
Procedurally, I think this is incorrect.
CHAIRMAN FIALA: When we get back -- you can talk with the County
Attorney about that. When we get back --
COMMISSIONER HILLER: I'm going to talk to both of them.
CHAIRMAN FIALA: -- he can advise us as to what we're going to do.
COMMISSIONER HILLER: I don't think we can do what's being
proposed, because we need both boards here by law --
CHAIRMAN FIALA: But we really need to -- I'm sorry. We're both
talking at the same time.
COMMISSIONER HILLER: Sorry.
CHAIRMAN FIALA: We really need to take a break so our court
reporter can get these minutes and take a break herself.
MR. OCHS: Madam Chair, are you breaking for 10 minutes for a court
reporter break?
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January 25, 2016
CHAIRMAN FIALA: Well, I was saying for lunch, but I don't know if
that will work.
COMMISSIONER NANCE: Ten minutes for a court reporter break.
COMMISSIONER HILLER: Let's break for lunch. Let's do an hour.
COMMISSIONER HOFFMAN: I thought somebody else had this room.
COMMISSIONER HILLER: Let's break for lunch for an hour.
CHAIRMAN FIALA: Leo, is there a lunch there to break to?
MR. OCHS: Not right now, ma'am, but we can certainly go rustle
something up here pretty quick.
CHAIRMAN FIALA: I thought you were ordering something, Leo.
MR. OCHS: No, ma'am. We don't have it here right now. But I'm
looking at our board here for some consensus.
COMMISSIONER TAYLOR: Excuse me. Can we not make a motion to
give -- we have a -- No. 8 says action by -- well, No. 8, in fact, North Collier
went ahead of us. Action by Collier County Board of County Commissioners,
if any. Let's take action.
COMMISSIONER HENNING: Yes. I'll make a motion. I'll make a
motion that we table this decision and have a discussion and a vote at the Board
of Commissioners meeting tomorrow.
COMMISSIONER NANCE: Second.
COMMISSIONER HILLER: Objection. That can't happen in the
absence of the fire commission board. This process is mandated by statute.
There is a way this has to be done, and it has to be in the presence of both
boards. We can't separate ourselves, have our own meeting where they are not
in an equal position to us.
COMMISSIONER NANCE: Okay.
CHAIRMAN FIALA: Okay. I have a motion on the floor and a second.
Any further comment?
COMMISSIONER HENNING: Boy, the lawyers are really talking, aren't
they?
CHAIRMAN FIALA: I'm sorry?
COMMISSIONER HENNING: Nothing.
CHAIRMAN FIALA: Okay. Commissioner Taylor?
COMMISSIONER TAYLOR: Yeah. No, I just -- I would like to call the
question.
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January 25, 2016
CHAIRMAN FIALA: I have a motion on the floor and a second. Any
further comment?
COMMISSIONER HILLER: Yes. I'd like -- I'd like an opinion from
both counsels on this, because I think this is a procedural issue which --
COMMISSIONER HENNING: You already made you opinion.
COMMISSIONER HILLER: I would like an opinion from both
attorneys.
MR. KLATZKOW: Commissioner Hiller? Commissioner Hiller, I
understand what you're saying. You guys are all over the place today.
COMMISSIONER HILLER: Can you please --
CHAIRMAN FIALA: Boy, you've got that right.
COMMISSIONER HILLER: This is a serious issue.
MR. KLATZKOW: The question is whether the fire district's going to
object to it. That's what I'm trying to figure out.
COMMISSIONER HILLER: And I would think they would.
MR. KLATZKOW: Well -- but you're not their attorney.
MS. DONALDSON: Potentially -- obviously, I have to talk to the Chair.
The statute is clear that if we don't reach an agreement at today's meeting, then
we have to -- we're forced to go into mediation.
If it's open -- if my board is open to it, to agree to the one-day extension
and if the county does not grant the COPCN extension, the current North Naples
service delivery area extension tomorrow, then we'll be deemed -- it's an
impasse, and then we can go to mediation. That gives you time. It gives us
certainty of a day, and then if we don't get the result, which is an extension, then
we're at an impasse and we go to mediation, and we're under 164 the rest of the
way.
COMMISSIONER FEDER: Okay. To help out, I will move that we --
MS. DONALDSON: I see miss -- I see --
COMMISSIONER LOMBARDO: I disagree. There's a process, and I
don't think you can change the -- this is a process --
COMMISSIONER CHAO: We have to do public notice.
COMMISSIONER LOMBARDO: That's true, too. This is a process that
the county demanded. This came from the county. We're here because of the
demand.
MR. KLATZKOW: This is a process that's statutorily mandated, sir, and
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January 25, 2016
you know that. You guys bypassed it to begin with, so let's not get into that.
COMMISSIONER LOMBARDO: Let's try to be a little more civil.
MS. DONALDSON: So could I just say --
COMMISSIONER LOMBARDO: You could have waived that demand,
and you know that.
And so my point is, is bifurcating this process, I think, is incorrect. I can't
support it.
CHAIRMAN FIALA: Ms. Donaldson, would you like -- did you try and
say something there?
MS. DONALDSON: I was just going to say statute does allow the parties
to move dates beyond, but obviously if the Board does not want to do the day --
COMMISSIONER FEDER: My concern is bifurcation, but if the Board
needs this, is there an option to extend or to table --
CHAIRMAN FIALA: Well, we have a motion on the floor and a second.
MR. KLATZKOW: You can always --
COMMISSIONER FEDER: -- and reconvene as both boards?
MR. KLATZKOW: You can always declare an impasse right now. That
would start the mediation process. And tomorrow, if you want to discuss
anything the Board wants to discuss, you can discuss it.
COMMISSIONER NANCE: Let's do that.
CHAIRMAN FIALA: Commissioner Henning, your --
COMMISSIONER HENNING: Yeah. I mean, I don't care. I just -- I
need a little bit of time to talk to legal counsel. That's all -- that's all I want to do
here.
CHAIRMAN FIALA: So your motion is still on the floor and a second,
and we're about to vote. Do you want to --
COMMISSIONER FEDER: And I think where we would end up being
by that is declaring an impasse, is what we're saying now.
CHAIRMAN FIALA: I know. That's what I'm just trying to ask him.
Please.
COMMISSIONER TAYLOR: We have a motion --
CHAIRMAN FIALA: Did you want to declare an impasse instead?
COMMISSIONER HENNING: No.
CHAIRMAN FIALA: Oh, okay. You want to keep your motion on the
floor as-is?
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January 25, 2016
COMMISSIONER HENNING: Yeah.
CHAIRMAN FIALA: Okay.
MS. DONALDSON: Madam Chair, I don't mean to interrupt. So the fire
district board is going to have to agree to the extension under the statute or we
need to declare it's an impasse.
CHAIRMAN FIALA: I see.
COMMISSIONER TAYLOR: Well, let's take our --
MS. DONALDSON: It is -- one party can't deem it to be moving on and
the other party hasn't agreed to it. I mean, the statute -- because we're within the
time requirements, and we're allowed to have one meeting unless the parties
agree to additional meetings.
COMMISSIONER HILLER: But here's the issue that I have. If the
decision is made to have an additional meeting, it has to be noticed.
UNIDENTIFIED SPEAKER: Microphone.
COMMISSIONER HILLER: I'm sorry. It has to be noticed by their
board. We have a meeting tomorrow, but their board doesn't have a noticed
meeting tomorrow, and they have to be present to continue in this forum in this
fashion.
I mean, they all have to come to tomorrow's meeting if we're going to
continue this to tomorrow's meeting by mutual agreement, and then you have to
notice the public that your board is going to be at our meeting to continue this
discussion tomorrow.
COMMISSIONER FEDER: We did not -- we didn't meet noticing
requirements, and we've got four days before --
COMMISSIONER HILLER: I don't see how you are legally --
COMMISSIONER HENNING: You need to ask your attorney, because I
found out a lot of opinions from this board is not true. You have an attorney
that you're paying, so you might want to ask.
So I call my motion.
CHAIRMAN FIALA: Okay.
COMMISSIONER TAYLOR: Let's -- Madam Chair, may we vote on
this and then --
CHAIRMAN FIALA: That's just what I said.
COMMISSIONER TAYLOR: Thank you.
CHAIRMAN FIALA: Call for the motion. And I've said, or I started to
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say, all in favor, signify by saying aye.
COMMISSIONER TAYLOR: Aye.
COMMISSIONER NANCE: Aye.
CHAIRMAN FIALA: Aye.
COMMISSIONER HENNING: Aye.
CHAIRMAN FIALA: Opposed, like sign?
COMMISSIONER HILLER: Aye.
CHAIRMAN FIALA: Okay. 4-1 vote.
COMMISSIONER HILLER: This is illegal. It's illegal.
MS. DONALDSON: Madam Chair --
CHAIRMAN FIALA: Yes.
MS. DONALDSON: And I need to have North Collier's board vote, or
it's an impasse.
COMMISSIONER HILLER: But how are you going to physically get
them into our boardroom and notice the public? The public has a right to know
that they are going to convene tomorrow. And we can't have this meeting
continued without them being present.
MS. DONALDSON: Commissioner, there's flexibility within the statute,
and I think that if it's solely based on -- not a continuation of today's meeting but
solely based on the action taken by your board tomorrow, it's not a -- what I
thought, it would not be a continuation of this meeting. It would solely be --
COMMISSIONER HILLER: So they can convene and speak?
COMMISSIONER FEDER: Yeah. Unfortunately, what I think I heard
here -- and I'm going to defer again to legal and to the rest of this board. What I
heard was that we made a -- and passed a motion that would have said if you
extended the COPCN, we will pursue legal analysis and input.
The decision I think this board has made is you want to pull out of this
meeting, convene as a group, and make a decision. What that on the surface
seems to do is say that we declare it an impasse, and then if you take action that
extends the COPCN, that changes what comes after the issue of the impasse. If
not, then we continue forward.
The other one is, somehow we figure out how, with four days in front of
us, at no ability to go out and publicly notice -- I don't know how we go the
other, but I'm open to whatever motion comes from this board.
Right now, I think, unfortunately, we -- the only motion we have is one to
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declare an impasse if, in fact, that is the vote that was just made by the Board of
County Commissioners.
MS. DONALDSON: And, Commissioner, we actually don't have to
declare an impasse. It states, "if no agreement is reached."
COMMISSIONER FEDER: Then it is one, okay.
MS. DONALDSON: And there's not --
COMMISSIONER FEDER: Then we don't have to declare it.
MS. DONALDSON: It appears not to have an agreement.
COMMISSIONER FEDER: Then do I have any motion on this board to
continue this meeting even though we have no ability to provide sufficient
public notice, especially with the four-day --
COMMISSIONER BURKE: Continue the meeting?
COMMISSIONER HENNING: When is your next meeting, your regular
meeting?
COMMISSIONER LOMBARDO: The next meeting is tomorrow (sic).
COMMISSIONER FEDER: Our next meeting is next month.
COMMISSIONER McGOWAN: February 1 lth.
COMMISSIONER CROSSAN: I just have a question, Laura. Do you
think that legally this could go forward tomorrow, and -- that's what you said
earlier about -- as far as the noticing requirements? That's what you said?
MS. DONALDSON: No.
COMMISSIONER CROSSAN: Oh, no.
MS. DONALDSON: I would not recommend --
COMMISSIONER CROSSAN: You wouldn't.
MS. DONALDSON: -- this commissioners (sic) show up for a sunshine
meeting tomorrow with no notice --
COMMISSIONER CROSSAN: Okay.
MS. DONALDSON: -- as independent special districts have to give
seven days' notice unless it's a health, safety, and welfare issue.
COMMISSIONER LOMBARDO: I'm here to get this done. Let's get
this done. I mean -- and there are half steps that can be taken. For the life of
me, I don't understand why can't take a half step and --
COMMISSIONER HENNING: We just did.
COMMISSIONER CROSSAN: But this is a health, safety issue, correct?
COMMISSIONER HANSON: Commissioner, I'll try to be very brief.
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January 25, 2016
Your County Attorney has said that it could take up to, you know -- it would be
six months to a year. Let's hope -- if we could try to move it along as quickly as
possible, if you people would be willing to give us our COPCN for, say, nine
months. That is before there's a re-election, if you are concerned about that, and
sort of a time in between. So if we get -- if we could get nine months to have
this stay as-is, would you --
CHAIRMAN FIALA: Somebody's talking in back. Could you please be
a little quiet, because it's hard for our court stenographer to hear both
conversations.
COMMISSIONER HANSON: Can you hear me all right?
CHAIRMAN FIALA: Go ahead.
COMMISSIONER HENNING: Do you want me to answer the question?
COMMISSIONER HANSON: Pardon? If you would, yes, possibly give
nine months.
COMMISSIONER HENNING: Would you like me to answer the
question? I want --
COMMISSIONER HANSON: I will stop now and have you answer the
question.
COMMISSIONER HENNING: Okay. I understand the question. I want
to resolve this, before I leave office, for North Collier to provide advanced life
support. And we're going to do it under a countywide system no matter what. It
has to be that way.
COMMISSIONER HANSON: Well, you would still be there nine
months from now, wouldn't you?
COMMISSIONER HENNING: I just answered your question.
COMMISSIONER HANSON: You would like to.
COMMISSIONER HENNING: I want to resolve this prior to leaving
office.
COMMISSIONER HANSON: Yes. Well, that would be prior still.
COMMISSIONER HENNING: Yeah.
CHAIRMAN FIALA: Commissioner Nance?
COMMISSIONER FEDER: Okay. There's no motion from this board.
CHAIRMAN FIALA: Commissioner Nance?
COMMISSIONER NANCE: Yeah. Let me put the shoe on the other
foot.
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January 25, 2016
What about if North Collier Fire agrees -- since your legal staff and your
thinking is the one that created this legal issue, you are the one that raised your
own question to prove that you, yourself, were doing -- getting ready to do
something illegal, which I find wonderfully entertaining. But suppose you
entered into an interlocal agreement with Collier County until the Court ruled
that you couldn't?
COMMISSIONER LOMBARDO: The problem with that is that exposes
every single commissioner to individual liability.
COMMISSIONER NANCE: There's no establishment of that fact.
COMMISSIONER LOMBARDO: I'm sorry. I didn't --
COMMISSIONER NANCE: You were the one that said you wanted to
ask the question.
COMMISSIONER LOMBARDO: I'm sorry. I did not realize you
weren't done.
COMMISSIONER NANCE: I'm not done.
COMMISSIONER LOMBARDO: I'll be quiet and I'll listen.
COMMISSIONER NANCE: I'm not done.
You're the one that asked the question. Nobody knows the answer. If
everybody knew the answer, we wouldn't be having this conversation.
But, you know, you operated under that assumption before. You operated
under an interlocal agreement before, and everything was fine until you decided
that asking this question was going to conveniently produce the only result that
you could possibly have was to get what you were seeking, which is a COPCN.
So if you calmly entered into the same -- for the same period of time
you're asking us to have faith, if you entered into an interlocal agreement, if the
Court then ruled that no, no, I'm sorry, we can't operate like that, I'm sure that
will cast a whole 'nother perspective on the actions of the county and yourself.
COMMISSIONER LOMBARDO: We operated with a COPCN for five
years. That's the safest path we all know. That's a path we're all comfortable
with. You're asking us to do something that we see the statute says we cannot
do.
And so, to me, when you're asking me to take on personal liability, and
I'm telling you that if we could do it the other way -- and we'll find out the
answer on whether we can do an interlocal or not, but that way we're all
insulated and we're doing the right thing. That's the logical path, what we've
Page 99
January 25, 2016
been doing all along. You didn't have an objection for five years.
COMMISSIONER CROSSAN: Commissioner Hennings, I just -- I echo
what you say.
COMMISSIONER HENNING: There's no S on there.
COMMISSIONER CROSSAN: Sorry; Henning, sorry. I echo what you
say that we have to find -- and if it's by the end of your tenure, you know, that's
fine. And I humbly ask you guys to extend the COPCN.
And let's just get this right. Extend it for a period of time, whether it's six
months or nine months, and let's get this done. Let's get this done, you know,
together collectively.
COMMISSIONER HILLER: I make a motion to extend the COPCN for
an additional nine months.
CHAIRMAN FIALA: Do I have a second?
(No response.)
CHAIRMAN FIALA: The motion dies for lack of a second. Okay.
COMMISSIONER FEDER: Commissioners, appreciate your time.
COMMISSIONER HILLER: So that means we're at an impasse? So
you're going to move -- I just want to clarify for the record. We are at an
impasse and you're moving to mediation; is that correct? Ms. Donaldson?
Could you please state that for the record.
MR. KLATZKOW: That is correct.
COMMISSIONER HILLER: All right. So there is an impasse, and we're
moving to mediation. There's no resolution. And in four days the residents of
North Collier, which is North Naples and Big Corkscrew, will lose 100 ALS
paramedics.
CHAIRMAN FIALA: Okay.
COMMISSIONER HILLER: It's shameful.
CHAIRMAN FIALA: So before everybody walks out of the room, I'll
say this meeting is adjourned.
*****
Page 100
January 25, 2016
There being no further business for the good of the County, the meeting was
adjourned by order of the Chair at 1:55 p.m.
BOARD OF COUNTY COMMISSIONERS
BOARD OF ZONING APPEALS/EX
OFFICIO GOVERNING BOARD(S) OF
SPECIAL DISTRICTS UNDER ITS CONTROL
1749
DONNA FIALA, Chairman
ATTEST:
DWIGHTFE. BROCK, CLERK
ff Dc
l� C. .
Attest as to
a
•signature 01.
These minutes proved by the Board on a--1411 )01,(,, , as presented
or as corrected
TRANSCRIPT PREPARED ON BEHALF OF GREGORY COURT
REPORTING SERVICE, INC., BY TERRI LEWIS, COURT REPORTER
AND NOTARY PUBLIC.
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