Backup Documents 02/09/2016 Item #10B iD
1 0 B
NORTH COLLIER FIRE CONTROL AND RESCUE DISTRICT
BOARD OF FIRE COMMISSIONERS
Norman E.Feder,Chairman • Christopher L.Crossan,Vice Chairman • Margaret Hanson,Secretary-Treasurer
James Burke • Ramon E.Chao •Richard Hoffman . J.Christopher Lombardo ■ John O.McGowan
(Via Hand Delivery& U.S. Mail)
February 5, 2016
Leo Ochs
County Manager
Collier County
3299 Tamiami Trail East,Suite 202
Naples, FL 34112
Dear Leo:
As discussed, the North Collier Fire Control and Rescue District's (District) Board of Fire
Commissioners unanimously approved the Board of County Commissioners' (BOCC) offer of a
one year certificate of public convenience and necessity (COPCN) to provide advanced life
support (ALS) non-transport services within the entirety of the District's boundaries and accepts
the County's conditions associated with the issuance of the COPCN, with such conditions
elaborated within an interlocal agreement (I/A) to be executed by the parties. As many of the
BOCC's conditions were general statements, the District is proposing to further refine as
follows:
County Requirement a.: The District shall appoint the Collier County Medical Director serve
as the District's Medical Director and shall utilize the protocols and standards issued by the
Collier County Medical Director to govern the provision of advanced life support services
authorized by its COPCN and licensed by the State.
The District proposes to execute a contract with the Collier County's Medical Director to serve
as the District's Medical Director. This allows the District to meet statutory requirements as
well address liability issues. The contract with the County's Medical Director will include
specific provisions that are also included within the I/A with County, including credentialing and
recredentialing standards, training requirements, ride time, and a provision that designates the
District's current Medical Director as the District's Deputy Medical Director, who will be directly
responsible for District's ALS program. The District would appoint a liaison to interface
between the Collier County's Medical Director and District Deputy Medical Director.
1885 Veterans Park Drive Naples,FL 34109•(239)597-3222• Fax(239)597-7082• www.northcollierfire.com
Leo Ochs 1 0 B
February 5,2016
Page 2 of 4
Since 2011,the District has used the Countywide Common Medical Protocols developed by the
Collier County Medical Director. The District agrees to continue to utilize such protocols. The
District proposes that the District's Deputy Medical Director will be responsible for determining
the range of ALS services within the Countywide Common Medical Protocols that may be
provided by the District's paramedics.
County Requirement b.: The District shall operate under the paramedic credentialing
standards issued by the Collier County Medical Director. The District shall adhere to the
paramedic recredentialing and recertification ride-time requirements issued by the Collier
County Medical Director.
The District proposes that the credentialing and recredentialing standards be specified in the
I/A. The District proposes to use its Deputy Medical Director to credential and recredential
District's paramedics and EMTs per the standards agreed to with the Collier County Medical
Director. As Collier County does not have recredentialing standards for ALS non-transport
paramedics,the District's recredentialing standards are proposed to be used for its paramedics
and EMTs. They have served the District well over the past 5 years. However, as the District's
Medical Director, the Collier County Medical Director must agree to the standards. In addition,
any changes would need to be agreed to by Collier County, the District and the Collier County
Medical Director prior to the execution of the I/A and contract with the Collier County Medical
Director as the standards must be included within such agreements. Finally, as the District's
paramedics and EMTs were just recredentialed, the District proposes that all existing
credentialed District paramedics remain credentialed. If they are required to go through the
process again, a substantial amount of District resources and money will be spent.
The District proposes that its current ride time requirement that provides that a District
paramedic will ride on the ambulance if the District paramedic initiates ALS services or if
requested by Collier County Emergency Medical Services (CCEMS) due to patient needs
continues. CCEMS will continue to determine whether the patient needs demand the
assistance from the District in the ambulance. This option is cost effective and ensures that
there is no reduction in the level of service that is currently being provided.
County Requirement d.: The District shall adhere to the quality assurance program
requirements established by the Collier County Medical Director.
The District proposes an internal and external Quality Assurance/Quality Improvement
Committee (QA/QIC) program. The internal QA/QIC program consists of the County's Medical
Director, District's Deputy Medical Director and District staff. The external QA/QIC program
would consist of a Countywide Quality Assurance/Improvement Program that consists of
County Medical Director, District's Medical Director or associates, at least one individual from
each ALS service provider, hospitals and other appropriate parties. This is similar to the
District's current EMS Council as the District feels that it's extremely important that all parties
1885 Veterans Park Drive Naples,FL 34109•(239)597-3222■ Fax(239)597-7082. www.northcollierfire.com
Leo Ochs ,
February 5,2016 1 0
Page 3 of 4
are involved to ensure and improve the continuum of care. To satisfy federal non-disclosure
requirements, a business affiliation agreement would be executed by the parties.
County Requirement e.: The District shall adhere to the patient care reporting system
requirements established by the Collier County Medical Director.
In order to ensure the continuum of care for patients, the District will provide to CCEMS a one-
user login account to a view only Patient Care report dashboard to be used for quality
assurance and performance benchmarking purposes. Collier County EMS will provide a one-
user login account to view only Patient Care report dashboard to be used for Quality Assurance
and performance benchmarking. Any concerns raised by either the District, CCEMS or the
Collier County Medical Director must go through the QA/QIC process. To satisfy federal non-
disclosure requirements, a business affiliation agreement would be executed by the parties.
Although the BOCC did not include a training requirement, the District proposes that the I/A
include such a requirement. The District representative(s) will attend the Collier County
quarterly EMS training in-services and then subsequently train the Districts paramedics/EMTs.
In addition, the District will continue to provide monthly medical training and Collier County
paramedics can attend at no cost unless it is specialty training in which the District charges
other outside parties to attend. The Collier County Medical Director will approve all North
Collier medical training.
In developing the BOCC conditions, the Board of Fire Commissioners weighed patient safety,
statutory requirements, financial costs, impacts to workload and potential impacts to the
collective bargaining agreement with the District's union. Please know that the District was
limited in some of its options as all efforts are being made to avoid having to open the District's
collective bargaining agreement. If there is an impact to the collective bargaining agreement,
there could be substantial delay as the District addresses the issues with its union. We can all
agree that any unnecessary delay should be avoided.
Due to the expiration of the District's COPCN in less than 3 weeks, the Board of Fire
Commissioners respectfully requests that the BOCC approve an extension of the District's
current COPCN through March 31, 2016. Progress is being made to timely resolve this dispute.
A one month extension to the current COPCN's expiration date will allow the I/A to be
negotiated and approved by both governing bodies as well as a contract negotiated between
the District and the Collier County Medical Director. This request is not an attempt to delay the
process; rather, the extension is needed to ensure sufficient time to finalize the agreement.
The District also respectfully requests that the BOCC agree to extend any chapter 164, Florida
Statutes, requirements while we negotiate the settlement of this issue. The statute allows for
extension of dates if both parties agree in writing. As it is not financially prudent to go through
mediation at this time, the Board of Fire Commissioners has approved staff to agree to such
extensions.
1885 Veterans Park Drive Naples,FL 34109■(239)597-3222. Fax(239)597-7082 a www.northcollierfire.com
0 B
Leo Ochs 1
February 5,2016
Page 4 of 4
I hope that with the BOCC's action last week and my Board of Fire Commissioners' action today,
we are finally on a path to resolve this dispute. Although this issue has not impacted the great
working relationship between CCEMS and District field personnel to date, we must do all things
necessary to ensure that this political dispute does not boil over and impact the high level of
service that both of our personnel provide as a team to the citizens of the District. As always,
we've had open communications on this issue and I appreciate your openness to discuss the
matter. Please do not hesitate to contact me if you have any questions.
Sincerely,
Orly olts
Fire/Chief
North Collier Fire Control and Rescue District
cc: North Collier Fire Board of Fire Commissioners
Collier County Board of Commissioners
County Manager Leo Ochs
County Attorney Jeff Klatzkow
District Counsel Laura Donaldson
Collier County EMS Chief Walter Kopka
1885 Veterans Park Drive Naples,FL 34109■(239)597-3222. Fax(239)597-7082■ www.northcollierfire.com
1,-7 PE% lOB
LULIffA '
NORTH COLLIER FIRE CONTROL AND RESCUE DISTRICT
BOARD OF FIRE COMMISSIONERS
Norman E. Feder, Chairman • Christopher L.Crossan,Vice Chairman • Margaret Hanson,Secretary-Treasurer
James Burke • Ramon E. Chao • Richard Hoffman • J.Christopher Lombardo • John 0. McGowan
ED
(Via Hand Delivery& U.S. Mail) R C I V
Office of the County '>> anzger
February 5, 2016 FEB 0 ; 21115
Donna Fiala
Chairman ----- -----
Board of County Commissioners
Collier County
3299 Tamiami Trail East, Suite 303
Naples, FL 34112
Dear Chairman Fiala:
On behalf of the North Collier Fire Control and Rescue District (District), please consider this
notification that the District's Board of Fire Commissioners unanimously approved the Board of
County Commissioners' (BOCC) offer of a one year certificate of public convenience and
necessity (COPCN) to provide advanced life support (ALS) non-transport services within the
entirety of the District's boundaries and accepts the County's conditions associated with the
issuance of the COPCN, with such conditions elaborated within an interlocal agreement (I/A) to
be executed by the parties. As many of the BOCC's conditions were general statements, the
District is proposing to further refine as follows:
County Requirement a.: The District shall appoint the Collier County Medical Director serve
as the District's Medical Director and shall utilize the protocols and standards issued by the
Collier County Medical Director to govern the provision of advanced life support services
authorized by its COPCN and licensed by the State.
The District proposes to execute a contract with the Collier County's Medical Director to serve
as the District's Medical Director. This allows the District to meet statutory requirements as
well address liability issues. The contract with the County's Medical Director will include
specific provisions that are also included within the I/A with County, including credentialing and
recredentialing standards, training requirements, ride time, and a provision that designates the
District's current Medical Director as the District's Deputy Medical Director, who will be
directly responsible for District's ALS program. The District would appoint a liaison to interface
between the Collier County's Medical Director and District Deputy Medical Director.
1885 Veterans Park Drive Naples, FL 34109•(239)597-3222■ Fax(239)597-7082■ www.northcollierfire.com
Chairman Fiala 0 O
February 5,2036
Page 2 of 4
Since 2011, the District has used the Countywide Common Medical Protocols developed by the
Collier County Medical Director. The District agrees to continue to utilize such protocols. The
District proposes that the District's Deputy Medical Director will be responsible for determining
the range of ALS services within the Countywide Common Medical Protocols that may be
provided by the District's paramedics.
County Requirement b.: The District shall operate under the paramedic credentialing
standards issued by the Collier County Medical Director. The District shall adhere to the
paramedic recredentialing and recertification ride-time requirements issued by the Collier
County Medical Director.
The District proposes that the credentialing and recredentialing standards be specified in the
I/A. The District proposes to use its Deputy Medical Director to credential and recredential
District's paramedics and EMTs per the standards agreed to with the Collier County Medical
Director. As Collier County does not have recredentialing standards for ALS non-transport
paramedics, the District's recredentialing standards are proposed to be used for its paramedics
and EMTs. They have served the District well over the past 5 years. However, as the District's
Medical Director, the Collier County Medical Director must agree to the standards. In addition,
any changes would need to be agreed to by Collier County, the District and the Collier County
Medical Director prior to the execution of the I/A and contract with the Collier County Medical
Director as the standards must be included within such agreements. Finally, as the District's
paramedics and EMTs were just recredentialed, the District proposes that all existing
credentialed District paramedics remain credentialed. If they are required to go through the
process again, a substantial amount of District resources and money will be spent.
The District proposes that its current ride time requirement that provides that a District
paramedic will ride on the ambulance if the District paramedic initiates ALS services or if
requested by Collier County Emergency Medical Services (CCEMS) due to patient needs
continues. CCEMS will continue to determine whether the patient needs demand the
assistance from the District in the ambulance. This option is cost effective and ensures that
there is no reduction in the level of service that is currently being provided.
County Requirement d.: The District shall adhere to the quality assurance program
requirements established by the Collier County Medical Director.
The District proposes an internal and external Quality Assurance/Quality Improvement
Committee (QA/QIC) program. The internal QA/QIC program consists of the County's Medical
Director, District's Deputy Medical Director and District staff. The external QA/QIC program
would consist of a Countywide Quality Assurance/Improvement Program that consists of
County Medical Director, District's Medical Director or associates, at least one individual from
each ALS service provider, hospitals and other appropriate parties. This is similar to the
District's current EMS Council as the District feels that it's extremely important that all parties
1885 Veterans Park Drive Naples,FL 34109•(239)597-3222• Fax(239)597-7082•www.northcollierfire.com
Chairman Fiala
February 5,2016 � O
Page 3 of 4
are involved to ensure and improve the continuum of care. To satisfy federal non-disclosure
requirements, a business affiliation agreement would be executed by the parties.
County Requirement e.: The District shall adhere to the patient care reporting system
requirements established by the Collier County Medical Director.
In order to ensure the continuum of care for patients, the District will provide to CCEMS a one-
user login account to a view only Patient Care report dashboard to be used for quality
assurance and performance benchmarking purposes. Collier County EMS will provide a one-
user login account to view only Patient Care report dashboard to be used for Quality Assurance
and performance benchmarking. Any concerns raised by either the District, CCEMS or the
Collier County Medical Director must go through the QA/QIC process. To satisfy federal non-
disclosure requirements, a business affiliation agreement would be executed by the parties.
Although the BOCC did not include a training requirement, the District proposes that the I/A
include such a requirement. The District representative(s) will attend the Collier County
quarterly EMS training in-services and then subsequently train the Districts paramedics/EMTs.
In addition, the District will continue to provide monthly medical training and Collier County
paramedics can attend at no cost unless it is specialty training in which the District charges
other outside parties to attend. The Collier County Medical Director will approve all North
Collier medical training.
In developing the BOCC conditions, the Board of Fire Commissioners weighed patient safety,
statutory requirements, financial costs, impacts to workload and potential impacts to the
collective bargaining agreement with the District's union. Please know that the District was
limited in some of its options as all efforts are being made to avoid having to open the District's
collective bargaining agreement. If there is an impact to the collective bargaining agreement,
there could be substantial delay as the District addresses the issues with its union. We can all
agree that any unnecessary delay should be avoided.
Due to the expiration of the District's COPCN in less than 3 weeks, the Board of Fire
Commissioners respectfully requests that the BOCC approve an extension of the District's
current COPCN through March 31, 2016. Progress is being made to timely resolve this dispute.
A one month extension to the current COPCN's expiration date will allow the I/A to be
negotiated and approved by both governing bodies as well as a contract negotiated between
the District and the Collier County Medical Director. This request is not an attempt to delay the
process; rather, the extension is needed to ensure sufficient time to finalize the agreement.
The District also respectfully requests that the BOCC agree to extend any chapter 164, Florida
Statutes, requirements while we negotiate the settlement of this issue. The statute allows for
extension of dates if both parties agree in writing. As it is not financially prudent to go through
mediation at this time, the Board of Fire Commissioners has approved staff to agree to such
extensions.
1885 Veterans Park Drive Naples,FL 34109•(239)597-3222■ Fax(239)597-7082■ www.northcollierfire.com
Chairman Biala 0 B
, February 5,2016
Page4of4
For the first time in months, I feel as though we may be able to successfully resolve this issue
without litigation. With your Board's action to offer a settlement and our unanimous action to
accept the offer and work towards clarification language for the development of the required
I/A and contracts, I hope that you agree that we have made considerable progress. We must
continue to put our citizens' lives first. I look forward to working with you. Please do not
hesitate to contact me if you have any questions.
Since,=ly,
& ,
N rman E. Feder
hairman
North Collier Fire Control and Rescue District
Board of Fire Commissioners
cc: North Collier Fire Board of Fire Commissioners
Collier County Board of Commissioners
County Manager Leo Ochs
County Attorney Jeff Klatzkow
District Counsel Laura Donaldson
1885 Veterans Park Drive Naples, FL 34109•(239)597-3222■ Fax(239)597-7082■ www:northcollierfire.com
Jrin3 Q II
Add AdQ-"February 9,2016 0/1-•
EXECUTIVE SUMMARY
Recommendation to consider North Collier Fire Control and Rescue District's
response to the County's settlement proposal regarding the provision of Advanced
Life Support (ALS) Services in the District.
OBJECTIVE: To consider the proposal made by the North Collier Fire Control and Rescue District for
the continued provision of ALS services in the District as outlined in the enclosed correspondence dated
February 5,2016.
CONSIDERATIONS: On January 27, 2016, at the direction of the Board, the County Manager sent a
correspondence to North Collier Fire Control and Rescue District Chairman, Norman Feder,
communicating the County Commission's decision to extend the District's existing Certificate of Public
Convenience and Necessity (COPCN) until midnight on February 25, 2016 as well as its terms for
issuance of a new District-wide COPCN for a period of one year. On February 5,2016, Chairman Feder,
sent a correspondence to the County Commission Chair responding to the Board's offer.
I am placing this time sensitive item on the agenda for further County Commission deliberation and
action.
FISCAL IMPACT: To be determined by future Board action.
GROWTH MANAGEMENT IMPACT: None
LEGAL CONSIDERATIONS: None
RECOMMENDATION: To consider the District's proposal.
PREPARED BY: Donna Fiala,BCC Chair
108
a :" Office of the County Manager
Leo E. Ochs, Jr.
3299 Tamiami Trail East,Suite 202•Naples Florida 34112-5746•(239)252-8383•FAX:(239)252-4010
January 27,2016
Mr.Norman Feder, Chairman
North Collier Fire Control and Rescue District
1885 Veterans Park Drive
Naples, FL 34109
Via: E-mail and U.S. Mail: nfeder@northcollierfire.com, ostolts@northcollierfire.com
Dear Chairman Feder:
I have been directed to notify you of the following actions taken by unanimous vote of the Board
of County Commissioners at their January 26, 2016 Commission meeting:
1. The Board of County Commissioners (Board)has granted an extension to the enclosed
Certificate of Public Convenience and Necessity and Permit issued by the Board to the
North Collier Fire Control and Rescue District (District) dated December 9, 2014. This
extension shall expire on February 25, 2016 at 12:00 midnight. The County's authorized
representative shall notify the appropriate State Agency of the Board's action in writing
by close of business today.
2. As part of settlement discussions,the Board of County Commissioners voted to offer the
North Collier Fire Control and Rescue District a district wide Certificate of Public
Convenience and Necessity(COPCN) for a period of one year conditioned upon the
District's acceptance of the following teens:
a. The District shall appoint the Collier County Medical Director to serve as the
District's Medical Director and shall utilize the protocols and standards issued by
the Collier County Medical Director to govern the provision of advanced life
support services authorized by its COPCN and licensed by the State.
b. The District shall operate under the paramedic credentialing standards issued by
the Collier County Medical Director.
c. The District shall adhere to the paramedic credentialing and recertification ride-
time requirements established by the Collier County Medical Director.
d. The District shall adhere to the quality assurance program requirements
established by the Collier County Medical Director.
e. The District shall adhere to the patient care reporting system requirements
established by the Collier County Medical Director.
10 B
We understand that you will likely want to schedule meetings with your Board and staff to
discuss this matter further. Our staff and I will be available for additional discussions if
requested.
Sincerely,
()IL
Leo E. Ochs, Jr.
County Manager
CC: County Commissioners
Jeff Klatzkow, County Attorney
Chief Orly Stolts,North Collier Fire Control
Len Price,Administrative Services Department Head
Dan E. Summers,Director, Emergency Services Bureau
Chief Walter Kopka, Collier County EMS
COLLIER COUNTY FLORIDA
10 B
Renewal of Class"3"COCPN
This Permit is Effective January 1,2015 and
Expires December 31, 2015
Name of Service: North Collier Fire Control and Rescue District
Name of Owner: North Collier Fire Control and Rescue District
Principle Address of Service: 1885 Veterans Park Drive, Naples, FL 34109
Business Telephone: 239-597-3222
Description of Service: Non-Transport Advanced Life Support
Number of Ambulances: 18 Ground Units available
See Application for Description of Vehicles
This permit, as provided by Ordinance No. 2004-12, as amended, shall allow the above named Non-
transport ALS Service to operate within the North Naples Service Delivery response boundary and
pursuant to the Collier County Fire Chiefs Local Mutual Aid Agreement until the expiration date hereon,
except that this permit may be revoked by the Board of County Commissioners of Collier County at any
time the service named herein shall fail to comply with any local, state or federal laws or regulation
applicable to North Collier Fire Control and Rescue District.
Issued and approved this 9day of -9vre.—a .�, 2014
ATTESTS
. BOARD OF COUNTY COMMISSIONERS
DW1t HTE BROOK€ERK COLLIER FLORIDA
;/
Attest j CI AV;
E r Tom.Henning, Chairs an
a Co Chaps� g
signature`"oh1yy, ,,,4
Approved as to form and legality:
e
Jenner A. Belpe iko (� vZ\ I
Assistant County Attorney ' ��J'`ti
E _,,-03
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