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Agenda 02/27/2018 Item #16E 202/27/2018 EXECUTIVE SUMMARY Recommendation to approve a Certificate of Public Convenience and Necessity for non- emergency inter-facility ambulance transports to Just Like Family Concierge Medical Transport Services, LLC to allow post-hospital intra-facility and inter-facility medical ambulance transfer services to continue after an ownership change. OBJECTIVE: To recognize a transfer in ownership of Just Like Family Concierge Medical Transport Services LLC (“Just Like Family”) following the death of its principal owner operator, and proceed in the best interest of the public health, safety and welfare by granting a new Certificate of Public Convenience and Necessity-Class 2, Advanced Life Support (ALS) post-hospital, inter and intra-facility ambulance transfer services as required by Ordinance No. 04-12, Section 9. CONSIDERATIONS: On October 27, 2015, the Board of County Commissioners issued a Class 2 Certificate of Public Convenience and Necessity for non-emergency inter-facility ambulance transports to Just Like Family Concierge Medical Transport Services, LLC which has since been renewed and expires on October 31, 2018. A Class 2 operator provides post-hospital inter-facility medical transfer services, both within and outside the County. The Manager and his partners have created a limited liability company and are in the process of purchasing all of the stock of Just Like Family. Ordinance No. 04-12, Section 9, requires that a new COPCN be issued to continue the service under new ownership and states: The certificate granted by the Board shall be valid for one calendar year and shall be personal to the applicant and not transferable. In the case of a corporation, if there occurs such a transfer of stock or other incidents of ownership as to change the majority or largest stockholder, a new certificate must be applied for. Changes in the officers of the corporation will not require a new certificate. Accordingly, the Certificate holder has applied for a new COPCN. Staff has deemed the application as complete and recommends that the COPCN be issued for one year beginning upon completion of the transfer in ownership providing such transfer is completed no later than October 31, 2018; the expiration of the COPCN presently in effect. Staff was informed that if this item is approved, actions will be taken to transfer ownership as soon as practicable. No operational changes will be made. It is the opinion and findings of the Bureau of Emergency Services that this service is necessary and practical to provide additional medical transportation options to patients being transferred from hospital- to-hospital, hospital-to-home, or transport for clinical procedures, etc. It is reasonable to expect the services of an additional provider will assist in the anticipated future demands of the pace of the expanding number of nursing homes, rest homes and skilled care facilities as well as overall population growth. The expansion of additional non-emergency ambulance vehicles should reduce wait times for facilities and their patients during discharge and further reduce the calls for non-emergency service transport placed upon County EMS. County EMS has experienced a significant decrease in non- emergency transport requests which is preferred in order to allow for County EMS to focus on its pre- hospital emergency medical delivery. County EMS expects further reduction in non -emergency transport calls for service with the approval of this COPCN in light of the growth of additional facilities and beds. The COPCN holder operates three ambulances in service as part of this COPCN annual certificate. The COPCN holder reports that its local Florida certified Emergency Medical Technicians and 16.E.2 Packet Pg. 1234 02/27/2018 Paramedics will operate under a medical protocol approved by Dr. Jeffrey A. Panozzo. The medi cal protocol adopted and utilized by Just Like Family Concierge Medical Transport LLC., is the approved common medical protocol utilized by Collier County EMS under the medical direction of Dr. Robert Tober. Neither Collier County, nor the Sheriff’s 911 Center, receive or track such calls for non-emergency inter-facility service made between a hospital, nursing home, or doctor’s office, etc. All estimates for calls for service are compiled from data provided by private providers and from the infrequent request for inter-facility transports to Collier County EMS when 911 is contacted for the dispatch of a Collier County EMS ambulance. Staff’s broad estimates suggest that approximately 6,000 transports are typically handled by a Class 2 Certificate holder on an annual basis from current facilities in Collier County. A broad estimate of the over 500 beds reported in permitting for local construction could generate an additional 100-200 annual convalescent transports in the near future as additional facili ties become operational. Staff does not have information as to the timing of beds and facility openings as referenced above. As a result of the market-place nature of the additional facilities and beds, the convalescent transport estimates are rudimentary at best. The County has no obligations to compensate a private ambulance provider for any services, nor does the County receive any revenue from service delivery by a private ambulance provider. Should the Board approve an annual Class 2 Certificate of Public Convenience and Necessity, the following provisions of the Certificate are recommended requirements: 1. Staff is recommending the COPCN be issued for one year beginning upon completion of the transfer in ownership which shall occur not later than October 31, 2018, the expiration of the COPCN presently in effect. 2. The COPCN shall be required to be renewed annually. Its renewal application is to be received by the County no later than 90 days prior to its expiration. 3. The COPCN holder will be required to work closely with Collier County EMS, Collier County Sheriff's 911 dispatch personnel, local licensed facilities and other responders to ensure that their entry into local and regional inter-facility ambulance transportation is properly coordinated and services appropriately represented. Collier County EMS shall be allowed to conduct any reasonable inspections or site visits and receive in a timely manner any statistical call volume information needed to evaluate services, monitor complaints and address any quality of care issues. If this item is not approved, the previously issued COPCN will continue until it expires so long as Just Like Family Concierge Medical Transport Services, LLC does not change ownership pursuant to Ordinance No. 04-12, Section 9. ADVISORY BOARD RECOMMENDATION: The Emergency Medical Authority has reviewed the application and by unanimous vote, supports the issuance of the COPCN. FISCAL IMPACT: There is no fiscal impact to the Board for the granting of this cer tificate. The Board is requested to accept and recognize as revenue in Fund (490) the $250.00 application fee with the corresponding application. GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting from this action. 16.E.2 Packet Pg. 1235 02/27/2018 LEGAL CONSIDERATIONS: Legal counsel for the Manager and his partners informed our Office that Just Like Family Concierge Medical Transport Services, LLC will continue as the operator but that the entirety of its stock will be purchased by Concierge Medical Transport Services, LLC making it the controlling company, also known as Sole Member. The County Attorney’s Office will hold the COPCN and Permit documents in escrow until closing of the transaction. Such transfer may be demonstrated by a new operating agreement and stock purchase. Once the transfer has occurred the COPCN and Permit will be finalized and routed for Chairman signature. Ordinance No. 04-12, Section 7 states: “The Board of County Commissioners shall not grant a certificate unless it shall find, after public hearing and based on competent evidence that each of the following standards has been satisfied: A. That there is a public necessity for the service. In making such determination, the Board of County Commissioners shall consider, as a minimum, the following factors: (1) The extent to which the proposed service is needed to improve the overall Emergency Medical Services (EMS) capabilities of the County. (2) The effect of the proposed service on existing services with respect to quality of service and cost of service. (3) The effect of the proposed service on the overall cost of EMS service in the County. (4) The effect of the proposed service on existing hospitals and other health care facilities. (5) The effect of the proposed service on personnel of existing services and the availability of sufficient qualified personnel in the local area to adequately staff all existing services. (6) That the applicant has sufficient knowledge and experience to properly operate the proposed service. B. That, if applicable, there is an adequate revenue base for the proposed service. C. That the proposed service will have sufficient personnel and equipment to adequately cover the proposed service area. Ordinance No. 04-12, Section 8 provides: “In making the determinations provided for in Section 7 above, the Board may, in its sole discretion, appoint a Hearing Officer to hold a public hearing and to make factual findings and conclusions as a result of the hearing. Should a Hearing Officer be appointed, said Hearing Of ficer shall render a written report to the Board within 30 days of the hearing, which report shall contain the officer's findings and conclusions of fact, and a recommended order. The findings and conclusions of fact shall be binding upon the Board, but the recommended order shall be advisory only.” A copy of the application and staff comments are included with this Executive Summary. This item is approved for form and legality and requires a majority vote. -JAB RECOMMENDATION: That the Board of County Commissioners: 1. Accepts the findings of the Director of the Bureau of Emergency Services. 16.E.2 Packet Pg. 1236 02/27/2018 2. Accepts the recommendations of the Emergency Medical Authority. 3. Issues the Certificate of Public Convenience and Necessity to Just Like Family Concierge Medical Transport Services, LLC for one year beginning upon transfer in control which shall occur not later than October 31, 2018, for up to (3) three ambulances. 4. Authorizes the Chairman to execute the Permit and Certificate. 5. Approves a Budget Amendment to recognize and appropriate the $250 application fee. Prepared by: Dan E. Summers, Director, Bureau of Emergency Services ATTACHMENT(S) 1. Just Like Family Resubmitted CoPCN Application (PDF) 2. 2018 JLF Permit - signed new (PDF) 3. 2018 JLF Certificate - signed new (PDF) 16.E.2 Packet Pg. 1237 02/27/2018 COLLIER COUNTY Board of County Commissioners Item Number: 16.E.2 Doc ID: 4745 Item Summary: Recommendation to approve a Certificate of Public Convenience and Necessity for non-emergency inter-facility ambulance transports to Just Like Family Concierge Medical Transport Services, LLC to allow post-hospital intra-facility and inter-facility medical ambulance transfer services to continue after an ownership change. Meeting Date: 02/27/2018 Prepared by: Title: Executive Secretary – Emergency Management Name: Kathy Heinrichsberg 02/02/2018 12:18 PM Submitted by: Title: Division Director - Bureau of Emer Svc – Emergency Management Name: Daniel Summers 02/02/2018 12:18 PM Approved By: Review: Emergency Management Daniel Summers Additional Reviewer Completed 02/02/2018 12:19 PM Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 02/02/2018 3:32 PM County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 02/05/2018 10:53 AM Administrative Services Department Len Price Level 2 Division Administrator Review Completed 02/13/2018 4:45 PM Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 02/14/2018 11:22 AM Office of Management and Budget Laura Wells Additional Reviewer Completed 02/14/2018 1:55 PM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 02/20/2018 7:55 AM County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 02/20/2018 10:52 AM Board of County Commissioners MaryJo Brock Meeting Pending 02/27/2018 9:00 AM 16.E.2 Packet Pg. 1238 APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY CLASS TWO CONCI ERG E M EDICAL TRANSPORT 16.E.2.a Packet Pg. 1239 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) December 7,2017 Mr. Dan Summers Collier County Emergency Management 8075 Lely Cultural Parkway Naples, FL343,13 Re: Application for Certificate of Public Convenience and Necessity- Class 2 ALS Transfer Dear Mr. Summers, Enclosed p_lease find the Concierge Medical Transport, LLC., (or CMT) application for a Certificate of Public Convenience and Necessity (COPCN) Class 2 ALS Transfer. I would like to inform you that there will be a change in ownership of Concierge MedicalTransport. Charles Bacon, and Dr. Paul Hobaica will assume ownership of Concierge Medical Transport upon the Collier County Board of Commissioners issuance of COPCN. Charles Bacon has been COO of CMT for two years and will continue to oversee the company. No other operational changes will be taking place other than the ownership. CMT currently holds an Adva"nced Life Suppolt Class Two COPCN for Collier County and is also certified by the State of Floiida as an Advanced Life Support ground Ambulance. Concierge Medical Transport is a healthy and.strong company that has been providing excellent uninterrupted services to the residence and visitors of Collier County for two years now. We look forward to continuing this service for many years to come. lf you need any additional information, or find something to be missing in our application, please do not hesitate to contact me. with kind /( Charles Bacon Ch ief O perati ng Office r/Owner Concierge Medica I Transport regardg 16.E.2.a Packet Pg. 1240 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) An applicant for a certificate shall obtain forms from the department to be completed and returned to the division administrator. Each application shall co nta i n: 1. The name, age, and address of the owner of the ambulance or ALS Operator, or if the owner is a corporation, then of the directors of the corporation and of all the stockholders holding more than 25% of the outstanding shares. For governmental units, this information shall be supplied for members of the governing body Owner Name and Age . Charles Bacon, 47 years old, 50% Owner of LLC . Paul Hobaica, 52 years old, 50% Owner o Concierge Medical Transport , LLC. 3200 Bailey Ln. Suite #117 Naples, FL 34105 . (239) 682-8907 www.ilfcmt.com cbacon@jlfserves.com 2. The boundaries of the territory desired to be served. CMT currently services Collier County as a Class ll Advanced Life Support provider. 3. The number and brief description of the ambulances or other vehicles the applicant will have available CMT currently has three Type llAdvanced Life Support ambulances available within Collier County. They are available 24hours a day,365 days per year. CMT has the ability to purchase additional ambulances to meet the needs of a growing population. The address of the intended headquarters and any substations Concierge Medical Transport is located at: 3200 Bailey Ln. Suite #1,17 Naples, FL 34105 16.E.2.a Packet Pg. 1241 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) 4. The training and experience of the applicant. Chief Operating Officer/Owner: Chuck Bacon, (Attachment ) Owner: Dr. Paul Hobaica, (Attachment) Medical Director: jeffrey A. Panozzo, D.O., FACEP, serves as Medical Director (Attachment ) 5. The names and addresses of three Collier County residents who will act as references for the applicant. (Letters available in Attachments) Susan Takas, COO of Physicians Regional HealthCare System Resident Collier County. (Attach ment) Taylor lves, Senior Vice President Wasserman Golf Resident Collier County (Attachment) Laurance Baer, Owner Baer's Furniture Resident Collier County (Attachment) Thomas Brown, CEO ALTA Health Group Resident Collier County (Attach me nt) 16.E.2.a Packet Pg. 1242 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) 6. A schedule of rates which the service intends to charge. Code 4c,428 A.0429 Ato426 AO427 AO433 AO434 40425 AO999 Service Description Basic Life Support Rate (Non-emergency) Basic Life Support Rate (Emergency) Advanced Life Support (Non-emergency) Advanced Life Support (Emergency ALS Level 1-) Advanced Life Support (ALS Level 2) Specialty Care Transport Rate Mileage (Per loaded mile) Oxygen Rate s 3ss.oo s 42s.OO s 3ss.oo S soo.oo s 72s.OO s so0.0o S i_o.oo S 4s.oo 7. Such other pertinent information as the administrator may require. No additional information was requested from the administrator at the time of submission. An application or renewa! fee of S25O.OO. (Exception Collier County EMS). (Attachment ) Financia! data including assets and liabilities of the operator. A schedule of all debts encumbering any equipment shall be included. (Attachment ) 8. 9. 16.E.2.a Packet Pg. 1243 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) t.Thqt there is o public necessity for fhe service. In moking such determinotion,lhe Boord of County Commissioners sholl consider, os o minimum, ihe following foctors: The following ore brief onswers to the questions thot ore listed in the Medicql ironsportotion Concierge Medicol Tronsport (CMT) hos been in service for opproximotely two yeors. ln this time CMT hos executed Tronsportotion Services Agreements with oll of the mojor focilities within Collier County including The Lee County Tronsfer Center. With these ogreements CMT hos ironsported opproximotely ten thousond residents ond visitors of Collier County. CMT's presence in the County hos posiiively impocted hospitol dischorge times, 911 provider offlood times ond ollowing continuous potient flow throughout the heolthcore system. The extent to which the proposed seryice is needed fo improve the overoll emergency medicol services (EMS) copobililies of the County. CMT's service is needed to improve the overoll EMS copobilities by improving focility dischorge times which ultimotely improve g1 1 provider offlood times. CMT provides emergent tronsports from focility to focility which keeps the 911 provider in service for true prehospitol emergencies. CMT ossists in the event of moss cosuolty, ond or noturol emergencies. CMT ossisted in multiple potient tronsports during the Brush Fires ond Hurricone lrmo. This ogoin resulted in keeping the 911 provider in service for the irue prehospitol emergencies. Ihe effect of lhe proposed service on exisfing services wilh respecf fo quolity of service ond cosf of service. CMT will only positively offect services throughout the couniy. Focilities ond potients hove o choice of o second ombulonce tronsport provider thot con ossist in moving potients without extended woit times. The quolity of service thot exists with CMT hos been proven. CMT strives to be o leoder when if comes to quolity. This stems from the monogement teom, Medicol Director ond the employees thot ore employed with CMT. We ore o high quolity customer service driven compony. The cost of interfocility ombulonce service is driven by the Medicore Reimbursement Rotes. Ihe effect of |he proposed service on exisfing hospifols ond other heolth core focilifies. The effect on existing focilities ogoin hos been proven. CMT hos Tronsportotion Services Agreements in ploce with oll of the mojor focilities within Collier County. These controcts hove ollowed CMT to tronsport 2. 3. 4. 16.E.2.a Packet Pg. 1244 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) multiple potients to ond from focilities resulting in shorter dischorge times ond ollowing potients to be on time for scheduled oppointments. CMT is port of the overoll heolthcore system in the County. Hospitols ond focilities depend ond rely on CMT's ombulonce services. 5. Ihe effect of the proposed service on person nel of exisfing seryices ond lhe ovoilobility of sufficienl quolified personnel in fhe locol oreo lo odequofely stoff oll exisfing services. The effect CMT hos on personnel is positive. CMT hos greot relotions with oll of the 9l I providers os well os ottends oll of EMS reloted meetings within Collier ond Lee Counties. This ollows CMT monogement teom to be up to dote with Protocols, Quolity Assuronce, troining ond trending chonges within the EMS community. CMT currently employs multiple port time employees thot work full iime for locol 91 I providers. This is extremely odvontogeous to CMT success. These employees come to CMT highly troined ond extremely customer service driven. CMT continuously receives requests for employment of EMT ond Poromedic. This cleorly shows thot there ore mony highly troined individuols looking for employment. 6. Thol the oppliconf hos sufficienf knowledge ond experienc e Io properly operote the proposed service. CMT hos been in service for opproximotely two yeors ond hos proven itself in this time. CMT COO Chorles Bocon hos olmost 30 yeors of experience in the Fire EMS Field. CMT owner Dr. Poul Hoboico olso hos yeors of pre hospitol EMS experience. Chorles ond Poul ore extremely octive in the community ond hove been on influentiol leoders in the prehospitol oreno. 7. Thot, if opplicoble, fhere is on odequofe reyenue bose for lhe proposed service. CMT hos been in service for opproximotely two yeors ond hos odequote revenue to mointoin services. 8. Thot the proposed service will hove sufficienf personnel ond equipment to odequofely cover the proposed service oreo. CMT hos been in service for opproximotely two yeors. CMT is currently providing ombulonce tronsport within Collier County. CMT hos sufficient personnel ond equipment to continue the odequote coveroge of Collier County. CMT hos the obility to odd to its existing ombulonce fleet if needed to keep up wiih the tronsportotion needs of the community. 16.E.2.a Packet Pg. 1245 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) Detail by Entity Name Florida Limited Liability Companv JUST LIKE FAMILY CONCIERGE MEDICAL TRANSPORT SERVICES, LLC Filinq lnformation Document Number FEI/EIN Number Date Filed State Siatus Last Event Event Date Filed Event Effective Date Princioal Address 32OO BAILEY LANE. SUITE 117 115000086517 NONE 05t15t2015 FL ACTIVE CORPORATE MERGER 05/16/2016 NONE NAPLES, FL 34105 Changed: 05/09/2016 Mailinq Address 32OO BAILEY LANE, sulTE 117 NAPLES, FL 34105 Changed: 05/09/2016 Reoistered Aoent Name & Address NOVATT, JEFF, ESQ. 1415 PANTHER LANE SUITE 327 NAPLES, FL 34109 Authorized Pelson(s) Detall Name & Address Tit|e MGR NASSBERG, ELISABETH 32OO BAILEY LANE, SUITE 117 NAPLES, FL 34105 16.E.2.a Packet Pg. 1246 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) Electronic Articles of OrganizationFor Florida Limited Liability Company L1 5000086517 FILED 8:00 AM Mav 15. 2015Sei. Of Statetburch Article I 'fhe name of the Limited Liabilitv Company is: JLIST [,IKE FAMILY CONCIERGE MEDICAL TRANSPORT SERVICES. LLC Article II The street address of the principal offrce of the Limited Liability Compau is: 45OO EXECLTTIVE DRIVE SUITE #205 NAPLES, FL. 34I19 The mailing address of the Limited Liability Company is: 45OO EXECLITIVE DRIVE SLIITE #205 NAPLES, FL. 34I19 Article III The name and Florida street address of the registered agent is: JEFF NOVATT ESQ. 14I5 PANTHER LANE SUITE 327 NAPLES. FL. 34109 Havins bccn named as regislered agenl and to accept service ofprocess for the above stated limited liabili& companv at tlre place desig-nated in ttris ceriificate. I hereby accept dre appointrnent as registered asent ixd asiee io act inthis capac-iw. I further agree to complv ri'itr f'd orovisions of all statute-s re-lating to fie proper and complete derformance oTmy duties. rind I am fahiliar with and accept the obligations of my position as registered agort. Registered Agent Signature: JEFF NOVATT. ESQ. 16.E.2.a Packet Pg. 1247 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) Article IV The name and address of person(s) authorized to manage LLC: Title: MGR ELISABETH NASSBERG 45OO EXECUTIVE DRIVE, SUITE #205 NAPLES. FL. 34I19 Signature of member or an authorized representative Electronic Signature: JEFF NOVATT. ESQ. Ll 500008651 7 FILED 8:00 AM Mav 15.2015Sei. Of Statetburch I am the member or audrorized representative subnritting these Articles of Orsanization and affirm that the facts staled herein are true. I am iru'arc that false inforfration submitted in a ilocument to the Deoarhnent of State constitutes a third degree tblony as provided for in s.817.155. F.S. I understand the requirementto file an annual report b-etween Januan' lstand lt{ay lst in the calendar vear following formationof the LLC and even'vear drereafter to maintairi "active" statirs. 16.E.2.a Packet Pg. 1248 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) b ri:l.Elc ItrIEl< I ()=l()cdl'ao I LJI q.).I oD: I cd=| .eE lo()ElE;F stI ct-l rll*Se Xl Hl> 0)'t \-l Yl#ss Pl ;'\rl=\t-o6rl sprl 3t:o.l czt.:Ol Ealer.il €&lE Xl er4l 3til -o F.ll Edl ?, UI ,E -IEEt IEil 'Ett EIal HI FI \ \ \ t cEI :Eldoor9 CB O)b'H F3i ae.. I = (-) O.s€2 .c o- I, 6E +I :9 7I Ef;a 2 I ditE II =t E5u tr I sl E*;I EI ;gEI q :EB=I El -E53I ra1 i€ o.r lo El rt: il: ;)* ;EE E glolf :l€ rlE 2 rlr lu El: *u, g elsl' 3 EE+ xI 2l L)=-I <l r= EI Jl trcd.=I I (E- =I il .gi:I il EE!I El €;eil 1?g iI =.E- I:t ;. I uI -.t f,| frE &i Yt r.lr & -1 E? 2) t& Ii9.-; .9J trrtrEiEo| 8Ei s€, -q< 6l mllt () z tro't t- rlJIJdlolo.lalzl<ldl =l5l al ral EI ,.rl oldl r.l I olzl 8l >lrl EI<lEI r.rlvl JI-lal =l-ll iid P 0.)() o F F II92UJto -5 q EIEHi;b Hofi= qH=:H -oetrY, !l,btH tob 23et,fo 16.E.2.a Packet Pg. 1249 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) 6F\-_ooc.lNjo0-Ftt(Y) L T€ox 8e.. q) .c EiE 8? EL oO a 'Eds #AO rrr Ei L o o r\ iE * tB:AEE ; A --€ .9 E{H.Et gE *i t EigeI ii EE ; g€E'irq l EE I EI€E HEEA 3; E EEt;II EF HEI=BiEBfrEH e i E*tE.i !;#Eit =E 2g IEEEEElfiE = 5 :3Ef EiH;EEE = qiBEi€i.EE!E =AEnIIT;oEExEEEigEEiE I a ,i Eicl{ = 6u, tr1 rdil&rd EI--*l.r '' o a -li F o2 o 16.E.2.a Packet Pg. 1250 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) LIST OF VEHICLES IN FTEET - 2017.18 MERCEOES SPRINTER wD3PE7CD8FP118959 Als PERMITflO19703 2015 MERCEDES SPRINTER WD3PE7CD9FP121112 Ats PERMlTS019541 2015 FORD TRANSIT 1FDYR2CM1HKAl5492 ALS PERMtTfo20462 2017 e 16.E.2.a Packet Pg. 1251 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) 5:56 PM 12t15t17 Cash Basis Concierge Medical Transport Balance Sheet As of November 30, 2017 ASSETS Current Assets Checking/Savings 1000 . Concierge Medica! Transport Tota! Checking/Savings Accounts Receivable {200 . Accounts Receivable 1210 . Accounts Receivable Soneto Total Accounts Receivable Total Current Assets TOTAL ASSETS LIABILITIES & EQUITY Liabllities Current Liabilities Other Current Liabilitles !nsurance Payable Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity Additional Paid-in Capital 30000' Opening Balance Equity 32000' Retained Earnings Net lncome Total Equlty TOTAL LIABILITIES & EQUITY Nov 30, l7 82,056.27 82,056.27 1 35, I 67.35 -461.00 134,706.35 216,762.62 216,762.62: -4,830.20 -4,830.20 -4,830.20 -4,830.20 455,589.33 1 35,1 67.35 -275,826.',t5 -93,337.71 221,592.82 216,762.62 Page 1 16.E.2.a Packet Pg. 1252 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) C HAR LES BACO N PHONE (239) 23.| _610'I . CBACON@JLFSERVICES.COM PROFESSIONAL EXPERI ENCE 2016-present Concierge Medical Transport, Naples, FL Chief Operating Officer . Oversees Quality Assurance Committee. . Oversee all operations. o Keep up to date on all state rules and regulations to keep license current and In compliance. (401, 64J) . Work with hospitals and facilities on all contractual and insurance needs with Medicare and lnter-facility transport needs . Oversees EMSTARS . Works directly with Medical Director for Protocol Development, training, and f uture projects and education. 2006-2016 North Collier Fire Rescue District Naples, FL Captain EMS Coordinator . Oversees the operational component of the Advanced Life Support program within the District. . Oversee medical supply purchasing and budget. . Oversees and develops lncident Action Plans for all special events within the district . Works with Medical Director as part of the Quality Assurance Committee o Provides lncident Command at complex high acuity g'l l calls for service. . Sits and has chaired on multiple regional comities, councils that steer pre hospltal emergency medicine. 2000-2006 North Naples Fire Rescue District, Naples, FL Fire Fighter Paramedic 16.E.2.a Packet Pg. 1253 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) o Provided Fire Fighter Paramedic duties. . lnvolved in Quality Assurance Committee. 1994-2000 Hingham Fire Rescue, Hingham, MA Fire Fighter Paramedic Assistant EMS Coordinator . Provided Fire Fighter Paramedic Duties o Assisted in Quality Assurance, Protocol Development . lmplemented new software for EPCR documentation . Maintained State Compliancy for Medical Supply. 1994-2000 South Shore Hospital, Weymouth, MA Paramedic . Provided Paramedic duties that included pre hospital and hospital based services. 1989-1994 Fallon Ambulance Seryice, Milton MA EMT/Paramedic . Provided EMT and Paramedic services. This included 911 calls for service as well as lnter Facility transports. 16.E.2.a Packet Pg. 1254 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) Curriculum Vilae Paul J. Hobaica, M.D. 4202 Silver Fox Drive Naples, FL 341 l9 239-598-0923 PHobaica@comcast.net EDUCATION: Medical School: St. George's University School of Medicine Doctor of Medicine degree University of Massachusetts Medical Center Residency in Intemal Medicine Undergraduate: Bridgewater State College, Bridgewater, MA Bachelor of Science degree in Business Management Major: Business Management; Minor: Biology Stonehill College, South Easton, MA University of Massachusetts, Boston, MA EMPLOYMENT: ArthrexMedicalCenter Medical Director/ Corporate Health and Wellness Physicians Regional Medical Center Director Executive Health/Occupation Medicine FirstCare Clinic/AccessMD-, Naples, Florida Private Healthcare for First Responders Naples, Florida Naples Urgent Care Medical Director/ Staff Physician/Partner University of Massachusetts Medical Center Department of Internal Medicine- Medical Resident Easton Pool and Spa Inc., South Easton, MA Partner/ Owner. Vice President of Operations Town of West Bridgewater Fire-Department Fire-Fighter/ Emergency Medical Technician Ambulance Systems of America Emergency Medical Technician 1992-1996 t996-1999 I 983- I 988 1990-1991 1991-1992 20 I 1 -Present Jan 08-201 I 2007-Present 2000-2007 1996-1999 I 979-present l 989-200 l 1986-1992 LICENSES: Florida Medical License 1999- Current Massachusetts Medical License 1996 -Current ACLS/ BLS Certificate 1994 - present USMLE, Step I, II, & III 1994,1995,1997 Emergency Medical Technician 1986-2000 AFFILIATIONS: American Board of InternalMedicine 1999-Present American College of Physicians 1998-present INTERESTS: Pre-Hospital Medical Care/EMS, Tele Health, Corporate Wellness Occupational Health, First Responder Health REFERENCES: Available Upon Request 16.E.2.a Packet Pg. 1255 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) Curriculum Vitae 4726Tumstone Ct. Naples, Fl 34119 Phone: 239-877-7778 JPDO@aol.com Eouc,rrroN Doctor of Osteopathic Medicine Chicago College of Osteopathic Medicine Bachelor of Science Loyola University Chicago. lllinois PRoressroxlt- TRll xlxc June 1989 May 1981 Internship Chicago College of Osteopathic Medicine Chicago, Illinois Emergency Medicine Residency Cook County Hospital Chicago, Illinois ClnnBn Expenrsxcns 1989-1990 1990-1993 Chairman of Emergency Medicine Medical Director of the Emergency Department NCH North Collier/TEAMHealth FMD Naples Florida A high acuity, high volume comprehensive Emergency Department Chairman of Emergency Medicine Medical Director of the Emergency Department PRMC Naples, Florida EMS Medical Director North Collier Fire and Rescue District (formerly North Naples Fire) Naples, Florida Senior Staff Physician- ER Doctors, Ltd. Community Hospital of Ottawa, Mendota Community Hospital, 2012-present 2006-2012 2006-2012 2007-present 1995-2006 16.E.2.a Packet Pg. 1256 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) Sandwich Hospital, Illinois Valley Hospital Ottawa, Mendota, Sandwich, and Princeton, Illinois Assistant Medical Director of the Emergency Department 1993-2004 Gottlieb Memorial Hospital Melrose Park, Illinois PnoressroNAl CREDENTIALS Fellow of the American College of Emergency Medicine 1994-present Osteopathic Physician and Surgeon 1993-present Member of Numerous Professional Medical Organizations Hrcur-rcHTED CAREER SUMMATIoN Clinical Instructor- Emergency Medicine Residencies 1993-2004 Cook County Hospital and University of Chicago EMS Medical Director Gotllieb Memorial Hospital 1997-2004 Affiliated with Loyola, Edward and Downers Grove EMS Programs Vice Chief of Staff 2009-2011 PRMC Active Member and Chair of Numerous Hospital Based Committees 1993-present Multiple Presentations, Lectures and Educational Preceptorships Certified FF II, NREMT-P, ERT, Flight Paramedic 1981-1990 Clinical Affiliate- Emergency Medicine. Nova Southeastern 2007-present University College of Medicine and Health Care Sciences Teaching Emergency Medicine to Medical and PA Students Board Member- Collier Drug Free 2014-2015 Board Member Collier County EMS Advisory Board/?ublic Service 2006-2014 Authority Founding Member, Step Wise Collier- Fall Prevention Coalition 2014-present 16.E.2.a Packet Pg. 1257 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) AC# The OSTEOPATHIC PHYSICIAN named below has met all requirements of the laws and rules of the state of Florida. Expiration Date: MARCH 31,2018 JEFFREY A. PANOZZO ATTN: EMERGENCY MEDICINE NAPLES COMMUNITY HOSPITAL NAPLES, FL 34119 STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE REQUIRED BY LAW DATE LICENSE NO.CONTROL NO 0711412016 os 9974 59219 GOVERNOR and Secretary 16.E.2.a Packet Pg. 1258 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) PANOZZO, JEFFREY A DO JUST LIKE'FAMILY MEDICAL CONSIERGE TRANS 45OO EXECUTIVE DR. sutTE 205 NAPLES, FL 341 19-0000-000 1,,IIl,l,,l,r,11,,,lll,1,,I1,,,I1,,,11,,,11,,,ll,r,I!,,,It, CONTROTLED SUSSTAIICE REOISTRAIION CERIIFICATE UNTTEO SIATES DEPARNTENT OF JU9TICE ORUO ENFORCEII/IEi'T ADUIMSTRANON wAsHt}{gToN D.C.20537 ,LIKE FAMILY MEOICAL CONS]ERGE TRANSPORT EXECUTIVE DR. FL 34r19{000 66ctlG ea lnd :000 C2t UsC 824 rnd og0 ol he CodrotedSuE['n€s Act ol 1e70, a! lmaracd, Flr,dr thd lhr AlbrneyGaEd mry tddre o s,Sand s rlgiltdrcn b marutrctqe, dltfdhrf!, d?.cra, tnpdt or erpdl s mbolLd srrbirnca. TIIIS CERTIFICATE 18IIOT IMNSFEMBLE OI{ CHAilOE OF owNER3Hp, CONIFO\ LOCAIION, OR Br ilrESS A6MTY. AilO rI 18 NO' VALIO AFIER THC EXFTRANON DA?E. CON'ROLLED SUBTiTANCE REGISTRATIOTI CERTIFICATE UNITED STAIES DEPARTII,ENT OF .I.,STICE DRUG ENFORCEMEM ADMINISTRATION WASHINGTON D,C.20537 2,2N, 3,3N,4,5, PRACTITIONER 01.11 so NN 5o EeG JUST LIKE FAMILY MEDICAL CONSIERGE TRANSPORT 45OO EXECUTIVE DR. NAPLES, FL 34119.0000 Sedlons 304 end t008 (21 usc 82/t In 958) oltho ConHlad Substencos Ad ol 1970, 8r enloft,od, provldo that the Attorncy Ganar.l rngy rEvoko orlu8pcd a fsglstre$on lo manufectuG, dirtribute, dl!p6n8a, lmpon of .xpo.l e conllollad suD8l8nca. Ttlls CERTIFICATE lS NOT TRANSFERAaLE ON CHANGE OF OyVl.lERSHlP, CONTRO| , LOCAIION, OR BUSTNESS ACTMTv, ANO IT IS NOT VruD AFTER THE O(PIRANON DATE. FP5736585 0$31-2019 $731 16.E.2.a Packet Pg. 1259 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) ^N'ALTA HEALTH GROUP I'ilTlllitT (-l8N I lrllll] " ,il!()U:l,t!i.Xiit ]l&i.! f.iN December 20,20L7 To: Collier County Commissioners Re: Change of Ownership Concierge Medical Transportation PaulJ. Hobaica, MD It is my pleasure to write a letter of recommendation for Dr. Hobaica and endorse him in a new ownership position of concierge Medical Transportation. I have known Paul for about seven years in both a personal and professional capacity. He is a very honorable and capable individual and would be a real asset to any organization and certainly to medical service one. Paul resides in Naples at 42A2 Silver Fox Drive and is active in many civic events and causes. I highly recommend the commissioners approve the new ownership for a COpCN certificate to own and operate concierge Medical Transportation. Sincerelv vours. #$illlr,L Thomas G. Brown Chief Executive Officer 29r&ts B: Tel 239-434-6000 . Fax 239 -434-6008 www.Al taHeak}rGro up. co m 16.E.2.a Packet Pg. 1260 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) ffi wASsE RMAN Best regards, 'io/*/u Taylor Ives To: Re: Senior Vice President, Wasserman Golf December 19.241'7 Collier County Commissioners Change of Ownership - Concierge Medical Transportation Paul J. Hobaica, MD It is with great pleasure that I offer you this letter of recommendation for Dr. Paul Hobaica to take an ownership position rvith Concierge Medical Transportarion, a Coilier County based company. llar ing had the privilege to know Dr. Hobaica on both a professional and personal level since I relocated to Naples in 2001 , I fully support his potential involvement with Concierge Medical Transportation. Paul is not only well respected in the medical community in whicir he works but also in the community ofNaples in which he lives. Paul and his f'amily reside at 4202 Silver Fox Drive, Naples, Florida 341 I 9 and he is supponive of many civic events and causes. In fact, since 2001, I har-e been forhlnate enough to work closely with Dr. Hobaica in his volunteer role of Medical Director for the PGA TOUR's QBE Shootout which is played annually at Tiburon Golf Club. The countless hours Paul contributes to that charitable event and many like it are incredibly valuable to the county. I fully support and recommend the commissioners approve the new ownership for a COPCN certificate to own and operate Corrcierge Medical Transportation. If I can ans\rer any questions of the commissioners, I am happy to do so and can be reached on239 254 9770. 90l0StrddaStellCourt.Suite202,Naples.Florida34l09 [p] (239)254-9770 [w] rearnwasscorn 16.E.2.a Packet Pg. 1261 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) URNITU December 20,2417 To: Collier County Commission Re: COPCN certificate for Dr. Paul Hobaica I am writing this letter on behalf of Dr. Paul Hobaica in regard to his purchase of the Concierge Medical Transportation Corporation. I have known Dr. Hobiaca as one of his patients and as a neighbor for over 12 years. During that time I have gotten to know Dr. Hobaica very well and can confidently vouch for his character and abilities. Dr. Hobaica lives at 4202 Silver Fox Drive. I became his next door neighbor in 2005 and we both have children of similar age. Over the years we have interacted personally and professionally, I was impressed initially when I learned of how Dr. Hobaica's childhood admiration and interest in the Fire Department and EMS had motivated him to pursue a career in medicine. I have been more impressed, as time has passed, to see that those same passions continue to motivate him today to become a better physician, and how he has a genuine interest in helping others. I have been present over the years day or night, weekday and weekend, when Dr. Hobaica has interrupted whatever he was doing to stop and help someone who had an emergency of had a specific medical issue or need. I have seen many times where he helped, gave advice or recommendations to people that did not have the means to pay him. As a cancer survivor, there were many times when I had my own questions or concerns, and he never hesitated to help and or do the work to stay up on the latest information in regard to my own long term health and care. I highly recommend that the commission approves Dr. Hobaica for a COPCN certificate which would give him the ability to own and operate Concierge Medical Transportation. He is an asset to out community. Sincerely, Laurance Ba Baers Furniture I5485 TAMIAMI TRAIL NORTH, NAPLES, FLORIDA 34IIO PHONE:239.513.2237 I FAX: 239.596.6663 I BAERS.COM ,S I NC. 16.E.2.a Packet Pg. 1262 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) fri XIil*lnt*#GroNAL December t8,2077 To Whom lt May Concern: As a resident of the Collier County community, I am strongly in support of Concierge Transport Services. I have interacted with the leadership and staff of Concierge Transport Services in my professional position and I am impressed with the level of service they provide to our community. I personally believe that competition for services can raise the level of quality and service provided to the patients. I truly believe that having a second medical transport company in Collier County has been a positive addition to our community and the patients that are served by these strong organizations. Sincerely, "t {trt,tr 0J Susan Takacs Chief Operating Officer collier Boulevard campus . 8300 collier Blvd., Naple s,FL 34Lr4 . (239)354-6000 Pine fudge Campus ' 6101 pine tudge Road, Napies, FL 34r ti - 1zls,134g-4000 www.PhysiciansRegional.com 16.E.2.a Packet Pg. 1263 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) E E LEE HEALTH LZ/23/2077 To whom it may concern: I have known and worked collaboratively with Chuck Bacon for the past 8 years. Chuck and I have worked professionally together in the roles of public safety administration, pre-hospital quality management, medical delivery performance improvement, and critical transportation services. Chuck is held in high regard by the Trauma Department and others in the local emergency response and public health sectors. Chuck's long time service to the surrounding community has helped to support successful coordination and collaboration of emergency response teams with their various roles. His ongoing advocacy for the ill and injured patient always puts the care of the patient first and foremost and the quality of care delivery has continued to improve over the years due in part to Chuck's dedicated leadership. He has willingly been a major voice for effective, appropriate and timely emergency response and transportation with a patient first focus. He has been an effective advocate for development and implementation of emergency policies and protocols in numerous settings including quality management, peer reviews, and public policy development when warranted. Chuck's leadership and partnership has been one of the key factors to our success in serving patients, families and clinicians throughout Collier County and the Trauma Services District (encompassing Lee, Charlotte, Hendry and Glades counties). Chuck is a trusted advisor and we value his observations and input. Chuck is a consummate professional of high moral and ethical character and it is my sincere pleasure to be asked to compose this Ietter on Chuck's behalf. As our Southwest Florida region has grown and changed over the years, chuck has shown that he is crucial to answer to the changing needs of our community in pursuit of emergency transportation excellence, and public safety. Please feel free to contact me if you require any further information. Sincerely, Michael Marcus RN, CEN Trauma Program Manager Lee County Trauma Services District Michael.Marcus@ LeeHealth.org RTNC 2780 cleveland Ave., Suite 7o2, Fort Myers, FL 33901 . 239-243-3474 . LeeHeatth.org 16.E.2.a Packet Pg. 1264 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) fri Xxl';:#!:,,HGroNAL December 18,2077 To Whom lt May Concern: Physicians Regional Healthcare System is a strong supporter of Concierge Transport Services in Collier County' Concierge has been a good partner to our healthcare system over the past few years. We have utilized their services frequently to assist us with intrafacility transport within our two hospitals. Their services have positively impacted our patient's experiences and our ability to care for our patients between our two campuses. Additionally, we utilized Concierge to transport our patients to outside facilities - and again, their support and level of service are excellent, We support having a choice for medical transport services in Collier County and highly recommend Concierge Transport Services as a provider to our community. Sincerely, ---?\A/M Scott Lowe Chief Executive Officer collier Boulevard Campus . 8300 collier Blvd., Naples, FL 34114 . (239) 354-d000 Pine Ridge Campus . 6101 Pine Ridge Road, Naples, FL 34119 . (z3g)34g4000 www.PhysiciansRegional.com 16.E.2.a Packet Pg. 1265 Attachment: Just Like Family Resubmitted CoPCN Application (4745 : Just Like Family Concierge) COLLIER COUNTY FLORIDA Chcr'2u COPCI|I Name of service: Jr"t Lik" F*ily cor"ioo" M"di""l T**n so,ri"", LLC Name of Owner: Concierqe MedicalTransoort Services. LLC Principle Address of Service: 201 Pioer Boulevard Suite 24 Naoles. FL 341l0 Bnsiness Tclephone: Q39) 652-8907 Description of Service: tnter-facilitv for Collier County Number of Ambulances: (3) Three See attacbment See 4pplication forvehicle inforrnaion This permit as provided by Ordinance No. 2004-12, as amended, shall allowthe above named Ambulance Service to operate intra-facility, inter-facility and out of county tratNports for a fee or charge for the following alea(s): Collier County for one year from the date executed hereon" except that this permit may be revoked by the Board of County Commissioners of Collier County at any time the scrvice named herein shallfail to comply with any local, sate or federal laws or rcgulation application to the provisions of Emergency Medical Services. Issued and approved this __ day of ATTEST: CLERK DWIGIIT E. BROCK 2018 BOARD OF COI'NTY COMMISSIONERS COLLIER COI.'NTY, FLORIDA , Deputy Clerk Approved as to form and legality: Jennifer A. Bclpedio Assistant County Attomey Andy Solis, Chaimun 16.E.2.b Packet Pg. 1266 Attachment: 2018 JLF Permit - signed new (4745 : Just Like Family Concierge) {{{ -H* rt rJrE' lt, tt,FF-Et tt, tt, (n u) t) U><l nu;:i !r, IDFIFot- 16FX tE a rno Da o e E o o txrE U(!EIc oo* >tsg.e BFErr AP 9EDEt!qT>*EtooI € E$$sF$grBs g[iig[[IgalE HE Hig;ElE$+F E q E: ragar g'i g *A EiFEE EEE AE;*i5i gg[ 3 EsB73: sE."E+gg$ E"3 tsa. (no ID oiD :! Ee UEo CA E'or rdE Eilc9.EL<oo Fg I i 9,,, ! i i I 16.E.2.c Packet Pg. 1267 Attachment: 2018 JLF Certificate - signed new (4745 : Just Like Family Concierge)