Loading...
Agenda 09/22/2015 Item #10C 9/22/2015 10.C. EXECUTIVE SUMMARY Recommendation that the Board consider entering into an ALS inter-local agreement with North Collier Fire and Rescue. OBJECTIVE: To treat all Fire Districts the same, while utilizing COPCN agreements for medical transport only. CONSIDERATION: Historically, the County has approved inter-locals for Advance Life Support (ALS) for independent fire departments, dependant fire departments and municipalities. (See Attachments for historical documentation) In 2009, North Naples Fire Control and Rescue applied to the County for a COPCN. Staff recommended denial. On October 26, 2010, this item was placed on the BCC agenda and was voted down. This item was reconsidered and passed on January 25, 2011. Staff recommended denial during the reconsideration based in part on the following: "Fire District submitted an application for a non - transport Certificate of Public Convenience and Necessity for the purposes of providing Advanced Life Support Non - Transport Operations separate and apart from the County Medical Director's medical direction, coordination, and control, solely to the North Naples Fire District. Such separate medical direction is contrary to the provisions, duties, and responsibilities of the County's Medical Director, as referenced in Florida Statute 401. 265. This ruling was further clarified by a Final Order issued by the Florida Department of Health, in Department of Health case number 2010-0040." Inter-local agreements are widely used and are general agreements by two or more government agencies. These types of agreements can be crafted to meet specific needs. Historically, the County's Medical Director and the North Naples Fire Control and Rescue District (NNFD) have been unable to work successfully together. Since NNFD hired its own Medical Director, this issue has been resolved. FISCAL IMPACT: To be determined. GROWTH MANAGEMENT IMPACT: None. LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, raises no legal issue at this time,. and requires majority vote for approval. -JAK RECOMMENDATION: Direct the County Manager and County Attorney to develop and forward an Inter-local Agreement to North Collier Fire and Rescue, to be brought back to the Board prior to the expiration of the existing COPCN. The proposed Agreement should be substantially similar to the County's prior agreements for Advance Life Support. and should include but not be limited to North Collier Fire and Rescue cooperating with and following the medical protocol of Collier County's Medical Director. Packet Page -32- 9/22/2015 10.C. In addition, September 2016, the Board should be provided with an audited financial of the Corkscrew fire service area, together with whatever additional information County Staff deems necessary. PREPARED BY: Commissioner Tom Henning Attachments: A) BCC Oct 26 2010 10H Agenda Item NNFD; B) MIFD Ops Plan 2008 — 2009; C) MIFD Interlocal Agreement May 2007; D) GGFD ALS Interlocal 06-10-2014; E) GGFD ALS Interlocal FINAL 06-10-2014 Packet Page-33- 9/22/2015 10.C. COLLIER COUNTY Board of County Commissioners Item Number: 10.10.C. Item Summary: Recommendation that the Board consider entering into an ALS inter-local agreement with North Collier Fire and Rescue. (Commissioner Henning) Meeting Date: 9/22/2015 Prepared By Name: BrockMaryJo Title: Executive Secretary to County Manager, County Managers Office 9/16/2015 11:01:06 AM Submitted by Title: Executive Secretary to County Manager, County Managers Office Name: BrockMaryJo 9/16/2015 11:01:07 AM Approved By Name: IsacksonMark Title: Division Director-Corp Fin &Mgmt Svc, Office of Management&Budget Date: 9/16/2015 11:15:01 AM Name: KlatzkowJeff Title: County Attorney, Date: 9/16/2015 12:36:43 PM Name: OchsLeo Title: County Manager, County Managers Office Date: 9/16/2015 2:12:13 PM Packet Page -34- 9/22/2015 10.C. Agenda item ivo. .I ut-i October 26, 2010 Page 1 of 7 EXECUTIVE SUMMARY Recommendation to deny North Naples Fire Control and Rescue District's Application for a Certificate of Public Convenience and Necessity for an Advanced Life Support Non-Transport Service. OBJECTIVE: To proceed in the best interest of public health, safety and welfare as it relates to Advanced Life Support (ALS). CONSIDERATION: On September 17, 2009, North Naples Fire Control and Rescue District ("Fire District") submitted an Application for a Certificate of Need to provide ALS Non-Transport Services ("Application"). Staff timely conducted a thorough review of the Application, submitted correspondence for additional information that was not submitted or incomplete within the application, and met with the District's legal counsel. The Application was also placed in suspense for a period of time at the request of the Fire District and then subsequently re-activated at the request of the District's legal counsel. Staffs basis for denial is set forth in a letter to the County Manager, dated July 1, 2010 (see copy attached). Importantly, staff recommends denial of the Application based on the following: • Fire District submitted an application for a non-transport Certificate of Public Convenience and Necessity for the purposes of providing Advanced Life Support Non-Transport Operations separate and apart from the County Medical Director's medical direction, coordination, and control, solely to the North Naples Fire District. Such separate medical direction is contrary to the provisions, duties, and responsibilities of the County's Medical Director, as referenced in Florida Statute 401.265. This ruling was further clarified by a Final Order issued by the Florida Department of Health, in Department of Health case number 2010-0040. (This order is included in the staff response and documentation which due to its size is too large for mass publication. Copies of staff response and documentation are available for examination in the office of the Board of County Commissioners.) • The Application did not provide any empirical data for its particular district or the County, supporting a Certificate of Public Convenience and Necessity other than citing references to the 2007 Emergency Medical Service Master Plan document, which was developed to review and analyze County-wide level of service standards in support of the Annual Update to Inventory Reporting (AUIR). Numerous operational changes have taken place since the 2007 report. • The Fire District also failed to indicate that it would staff the necessary emergency medical response resources in a manner that would not conflict or delay a medical call if its personnel and apparatus were responding to or involved in a fire response. Packet Page -35- 9/22/2015 10.C. Agenud i iCU i ivu. i un October 26, 2010 Page 2 of 7 FISCAL IMPACT: There is no fiscal impact associated with this Executive Summary. LEGAL CONSIDERATIONS: 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: (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. B. That the applicant has sufficient knowledge and experience to properly operate the proposed service. C. That, if applicable, there is an adequate revenue base for the proposed service. D. 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 Officer 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." Staff response and documentation for this item is too large for mass publication. Copies of staff response are available for examination in the office of the Board of County Commissioners. —JAK GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this Executive Summary. RECOMMENDATION: That the Collier County Board of County Commissioners denies North Naples Fire Control and Rescue District's Application for a Certificate of Public Packet Page -36- 9/22/2015 10.C. Ages Iuc Ages iuck un October 26, 2010 Page 3 of 7 Convenience and Necessity for an Advanced Life Support Non-Transport Service as there is no public necessity for the service. PREPARED BY: Dan E. Summers, Director of the Bureau of Emergency Services. Packet Page -37- 9/22/2015 10.C. Agenaa item Ivo. 1uri October 26, 2010 Page 4 of 7 Co ier County Bureau of Emergency Services Memorandum TO: Mr. Leo Ochs,County Manager FROM: Dan E.Summers, Direct DATE: July 1, 2010 RE: Staff Review-COPCN Application North Naples Fire Control and Rescue District Enclosed is the Certificate of Public Convenience and Necessity filed by the North Naples Fire Control and Rescue District,along with a compilation of written communication involved in the review. The COPCN filing was originally received in your office September 18, 2009 and submitted by J. Christopher Lombardo, Chairman of the North Naples Board of Fire Commissioners. The appropriate filing fee was also received. During the review of the application, Mr. Richard Yovanovich became the principal agent for this filing. Along the course of the application review period Mr.Yovanovich requested the application be placed "on-hold", as numerous discussions and meetings were held at their request regarding the current Advanced Life Support Interlocal Agreement(s)which were considered for amendment in lieu of the COPCN process. These lengthy discussions with Mr.Yovanovich,the Medical Director,and others at various boards and committee meetings as well as the Blue Ribbon Study group, did not resolve the many debates between the Advance Life Support and Basic Life Support delivery modalities preferred by North Naples. On May 17, 2010 Mr.Yovanovich notified the County of his desire to re-open our review of the COPCN application. Days following this notification,written communication was transmitted to Mr.Yovanovich, acknowledging his re-activation of the application along with additional requests for information to help provide a thorough review of the application. Subsequent to the additional information referenced above, it has come to my attention that the financial information provided by the North Naples Fire and Rescue District was out-of-date with the re- opening of the COPCN. I communicated by email with Mr.Yovanovich and received the latest financial B=S 8075 Lely Cultural Parkway•Naples,Florida 34113.239-252-3600•FAX 239-252-3700•www.collierem.org Packet Page -38- 9/22/2015 10.C. Age.. 'um October 26, 2010 Page 5 of 7 Staff Review-COPCN Application North Naples Fire Control and District I aT, Rescue District July 1,2010 Page 2 information. I have deemed the application submittal complete, effective June 29,2010 within the intent of Ordinance 2005-16 as required. Mr.Yovanovich has been notified in writing of the application being deemed complete by my office. It should be noted that the bulk of the application submission included a copy of the 2007 EMS System Master Plan prepared by a consultant, in conjunction with discussions associated with a review of the Annual Update to Inventory Reporting(AUiR). The 2007 EMS Master Plan reviewed data and projections during the periods of 2005, 2006, and 2007 which were periods of extensive growth within the County. Due to changes in the EMS delivery systems, national refinements in best practice,and population projections,the 2007 Master plan discounts the substance of the application as requested by North Naples Fire Control and Rescue District in its justification of the COPCN application. Many factors highlighted by North Naples Fire Control and Rescue District in their application have been _ overcome by a number of changes in either delivery of services or are mute with respect to the spirit of the COPCN supporting county-wide services.They include, but are not limited to,the following: - Absence of growth projections that were predicted during the time of the report. - Refinements in national standards and academic research verifying the importance of a two- tiered BLS/ALS system delivery. - Implementation of the Advanced Practice Paramedic(MedCom) in one-man vehicles. - Improved dispatch procedures. - Cancellation of the ALS agreements at the North Naples and East Naples Fire District. - Ongoing data point analysis by the Blue Ribbon group to further refine system delivery in a two-tiered fashion. - Collier County's extensive network of publicly and privately accessible Automatic External Defibrillators and their associated registration ordinance. Additionally,the COPCN Ordinance in Section 7 states the following: "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 met." Essentially,there are eight provisions within Section 7 of the ordinance that have,in my opinion, not been met,further discounting • the award of a certificate. I have given the application a thorough review based on criteria provided in the ordinance referenced above. In summary,it is my recommendation that a Certificate of Public Convenience and Necessity should not be granted to the North Naples Fire Control and Rescue District,as it does not demonstrate better protection for the health, safety and welfare of the residents of Collier County as a whole in ambulance and ALS matters, by establishing uniform countywide standards,etc.,as referenced in Section 1 of the Purpose statement of the ordinance. In the absence of countywide improvement alone, S Packet Page -39- 9/22/2015 1O.C. Agenua item NO. iuh October 26, 2010 Page 6 of 7 Staff Review-COPCN Application ,) North Naples Fire Control and Rescue District July 1,2010 Page 3 the COPCN application,in my opinion,is not a valid application for services and threatens to increase risk in the pre-hospital care field environment with separate medical controls. The COPCN effort is designed for services within the"County"—geographically overall,and in my opinion,is not applicable for a district limited type of service as requested by North Naples Fire Control and Rescue District. North Naples.Fire Control and Rescue District's application provided no indication that they would provide services outside of their boundaries on a routine basis as opposed to the current way in which mutual aid is provided on a case-by-case incident basis,therefore not serving the County as a whole. Denial of this COPCN application does not prohibit the county or the Medical Director from exploring other refinements to the two-tiered concept of pre-hospital care delivery involving the Fire services. Indeed the Fire Service can and does provide important services to the emergency scene.Those efforts should continue in a fashion that provides prompt BLS support in an environment of reduced risk, ensuring adequate resources for their primary mission and links in the chain of care that are consistent standards of practice, and single point medical control. 1 look forward to meeting with you at your earliest convenience regarding this discussion. J Thank you. Attachments: North Naples,COPCN Application cc: Mr.Scott Teach, Deputy County Attorney 41/01 Packet Page -40- 9/22/2015 10.C. Age,,uat 'tam wu. iun October 26, 2010 Page 7 of 7 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS Item Number: 10H Item Summary: This item to be heard at 1:00 p.m. Recommendation to deny North Naples Fire Control and Rescue Districts Application for a Certificate of Public Convenience and Necessity for an Advanced Life Support Non-Transport Service.(Dan Summers,Director, Bureau of Emergency Services) Meeting Date: 10/26/2010 9:00:00 AM Prepared By Dan E.Summers Director of Emergency Services Date Bureau of Emergency Services and Emergency Bureau of Emergency Services and Management Emergency Management 10/18/2010 3:14:56 PM Approved By Dan E.Summers Director of Emergency Services Date Bureau of Emergency Services and Emergency Bureau of Emergency Services and Management Emergency Management 10/18!2010 3:24 PM Approved By Jeff Page Chief-Emergency Medical Services Date Bureau of Emergency Services EMS Operations 10/18/2010 3:26 PM Approved By Sherry Pryor Management/Budget Analyst,Senior Date Office of Management& Budget Office of Management&Budget 10/1912010 11:26 AM Approved By Leo E.Ochs,Jr. County Manager Date County Managers Office County Managers Office 10/19/2010 2:16 PM Approved By Jeff Klatzkow County Attorney Date 10/19/2010 2:47 PM Packet Page -41- 9/22/2015 10.C. City of Marco Island Fire Rescue Department ALS Resource Operational Plan October t,2008 Objective The objective of this plan is to develop a Pilot Program intended to evaluate a modified supervisory span-of-control and response plan to maximize the utilization of all pre-hospital BLS/ALS resources,provide cost effectiveness,and improve operational efficiencies.This Operational Plan is designed to improve the availability of resources during concurrent incidents, maximize command oversight,and to maintain readiness and availability of the transport unit for incidents involving patients of high-acuity.The Pilot Program will commence October 27,2008 through March 27,2009 for evaluation purposes. Procedure Marco Island Fire Rescue and Collier County EMS units stationed at Station 50/51 will respond to medical emergencies utilizing the following procedure: 1. An ALS Engine will be first out for all incidents of medical emergency.On arrival the crew will initiate patient assessment/treatment and determine the transportation need. If the patient requests transport by CCEMS,the Company Officer will make the request to Control.If consent is implied the Company Officer will notify Control to dispatch CCEMS for transport.The on-scene Company Officer will also determine the CCEMS unit mode of response(respond or enroute) (The terminology ALS Engine refers to either an Engine or Aerial units) 2. Exception: An ALS Engine and CCEMS Unit will respond to the following call type: Cardiac Arrest Respiratory Distress/Arrest Drowning Chest Pain Electrocution Man Down Vehicle Accident Chemical exposure Burns Airway Obstruction Childbirth Unconscious Altered LOC 3. In situations of concurrent calls not meeting exception 42,the ALS Engine responds to the first incident,MR 50 responds to the second incident if staffed at 3 personnel, leaving an ALS Engine available for fire and medical emergencies. 4. The Marco Island Fire Rescue Battalion Chief in cooperation with Battalion Chief 80 will maintain direct supervisory oversight of all BLS/ALS resources and has the latitude to send Marco Island resources to in-district incidents based on additional information received. Out-of-district responses/operations will be coordinated through Battalion Chief 80. S. Both agencies agree to hold bi-weekly reviews between Command staff inclusive of Battalion 50 and Battalion 80. Reviews will include QA/QI review with the Fire Rescue/ EMS crews. 111111 i ?doe /c V t o; Packet Page -42- 9/22/2015 10.C. City of Marco Island Fire Rescue Department �- ALS Resource Operational PIan February 5,2009 Objective The objective of this plan is to develop a Pilot Program intended to evaluate a modified supervisory span-of-control and response plan to maximize the utilization of all pre-hospital BLS/ALS resources,provide cost effectiveness, and improve operational efficiencies.This Operational Plan is designed to improve the availability of resources during concurrent incidents, maximize command oversight,and to maintain readiness and availability of the transport unit for incidents involving patients of high-acuity.The Pilot Program was initiated on October 27,2008 through March 27,2009 for evaluation purposes.The Program initiates Phase 2 on February 91h. Procedure—Phase 2 Marco Island Fire Rescue and Collier County EMS units stationed at Station 50/51 will respond to medical emergencies utilizing the following procedure: 1. When staffed with three(3)personnel,Medic Rescue 50 will operate in a single unit response mode to medical emergencies. On arrival the crew will initiate patient assessment/treatment and determine the transportation need. If the MR 50 Company Officer needs further assistance the request will be made to Control.The on-scene Company Officer will determine the mode of response for the additional resource. (respond or enroute) 2. Exception:An ALS Engine and CCEMS Unit will respond to the following call type; Cardiac Arrest Respiratory Distress/Arrest Drowning Chest Pain Electrocution Man Down Vehicle Accident Chemical exposure Burns Airway Obstruction Childbirth Unconscious Altered LOC Trauma 3. Marco Island Fire Rescue may otherwise choose to respond to all medical incidents when staffing is below Marco Island's minimal levels. 4. The Marco Island Fire Rescue Battalion Chief in cooperation with Battalion Chief 80 will maintain direct supervisory oversight of all BLS/ALS resources and has the latitude to send Marco Island resources to in-district incidents based on additional information received. Out-of-district responses/operations will be coordinated through Battalion Chief 80. 5. Both agencies agree to hold reviews between Command staff inclusive of Battalion 50 and Battalion 80.Reviews will include QA/QI review with the Fire Rescue/EMS crews. 6. QA/QI will be conducted on 100%of calls occurring on Marco Island with representatives from CCEMS and Marco Island Fire Rescue. QA/QI case studies and relevant trends will be coordinated by the Office of the Medical Director. 7, When Station 51 is staffed and a medical incident is received in its zone, Station 51 apparatus will respond to the incident regardless of the patient call type. 0,/,kmvAll() •_ a # _44(t)(r Packet Page -43- 9/22/2015 10.C. 6. QA 1 Qi will be conducted on 100%of calls occurring on Marco Island with representatives from CCEMS and Marco Island Fire Rescue.QA/QI case studies and relevant trends will be coordinated by the Office of the Medical Director. 7. All ALS Engines will complete a hard copy trip ticket for each incident,supplying the yellow copy to the Medic Unit upon transfer of care. 111 110 p MACS Packet Page -44- 9/22/2015 10.C. INTERLOCAL AGREEMENT ADVANCED LIFE SUPPORT PARTNERSHIP BETWEEN COLLIER COUNTY AND CITY OF MARCO ISLAND THIS INTERLOCAL AGREEMENT, made and entered into this 22 day of /J 2007, by and between the Board of County Commissioners, Collier County, Florida, a political subdi'ision of the State of Florida, ( +-n - called the "COUNTY") and the CITY OF MARCO ISL• e, "hereinafter called the"CITY"). PURPOSE The purpose of this irrerde al agreement is to provide quality and cost effective fire rescue and emergency medical services to the residents of the City of Marco Island and Collier County. The recognition and utilization of existing and funtre personnel skills,qualifications and resources is in the interest and benefit of both agencies anri the public we serve. WITNESSETH • WHEREAS, the C11 Y and COUNTY seek to enhance emergency service further through a continued partnership;and WHEREAS, the Advanced Life Support (hereinafter "ALS") partnership provides for a CITY Firefighter/Paramedic an;3'ar nefighter/Emergency Medical Technician, (hereinafter"EMT"), to work and train on a COUNTY Ath .cl Life Support Transport Unit providing firefighter/paramedic duties and/or basic life support EMT dutiea,and WHEREAS, The LS _;.hip provides for a COUNTY Paramedic/Firefighter to work and train on a CITY Fire-Rescues resi p vidin2 firefighting and paramedic duties;and WHEREAS, the C1i Y rid COUNTY work cooperatively to assure appropriate response of sufficient emergency medical resources NOW, THEREFORE In consideration of the above premises, and the mutual covenants, terms, and provisions contail hem the COUNTY and the CITY agree as follows: SECTION I: DEFINITIONS 1.0 ALS means treatment of life-threatening medical emergencies through the use of techniques such as endotracheal intubation, the administration of drugs or intravenous fluids, telemetry, cardiac monitoring, and cardiac defibrillation by a qualified person, pursuant to rules of the COUNTY Medical Director. 1.1 BLS means treatment of medical emergencies by a qualified person through the use of techniques such as patient assessment, cardiopulmonary resuscitation(CPR), splinting, obstetrical assistance, bandaging, administration of oxygen, and other techniques which have been approved and are performed under conditions specified by rules of the COUNTY Medical Director. 1.2 FTO means a Field Training Officer; a certified paramedic recognized by the Medical Director as having sufficient skill and experience to train and direct medical providers in working under the approved medical protocols. 1.3 OA/OI means Quality Assurance/Quality Improvement which is the Medical Director approved program which assesses and monitors the medical performance of Paramedics and Emergency Medical Technicians. 1.4 PCR means the Patient Care Record which chronicles the medical treatment of the patient. 1.5 MOU means a Memorandum of Understanding between agencies. Packet Page -45- 9/22/2015 10.C. 1.6 Licensed means a non-transporting ALS fire apparatus and rapid response vehicle operating under the ALS license issued to COUNTY Emergency Medical Services Department (hereinafter "EMS")for the purpose of enhancing 911 medical responses. 1.7 Non-licensed means to any response vehicle that is not required by State Statute to be licensed, but is authorized by the Medical Director. SECTION II: COUNTY'S RESPONSIBILITY The following specific services,duties,and responsibilities will be obi, ,n of the COUNTY: 2.0 The COUNTY will provide through the County's EMS; medical direction, medical protocols, training and quality assurance on a countywide basis. 2.1 The COUNTY will maintain at least one (1) ALS transport unit stained by the CITY and the COUNTY under the Board of Commissioner's (hereinafter -BCC} authority pursuant to the current Chapter 401.Fla. Stat. and Subtitle 64E-2, Fla. Admin. Code) at Marco Island Station 50 as a first-due apparatus on all medical,rescue and fire incidents. 2.2 The COUNTY, as a sole licensed provider of advanced life support under Chapter 401.Fla. Stat. and Subtitle 64E-2, Fla. Admin. Code, will license a total of three (3), CITY fire apparatus or response vehicles as non-transporting ALS vehicle(s) under the COUNTY EMS license for the purpose of enhancing 911 medical responses. 2.3 The COUNTY will provide the initial ALS equipment ald r. r--1 supplies to all County recognized licensed ALS fire apparatus/rapid response vehicles a'rw^ n`-licensed ALS response vehicles, staffed 365 days per year, 24 hours per day including those .tioned at the following locations: 1. Engine 50, 1280 San Marco Road,Marco Island 2. Tower 50, 1280 San Marco Road,Marco Island 2.4 The COUNTY will license and equip additional vehicles as non-na^soorting ALS vehicles, as identified in 2.3 and mutually agreed upon, under the COUNTY EMS license during the term of this Interlocal Agreement. 2.5 The COUNTY EMS Department will provide one(1) Param-- is Fir` ohrsr to the CITY 365 days per year, 24 hours per day to be utilized on fire appane.uis v ei clel s) licensed as an ALS nontransporting unit under the Board of County Commissioner's authority pursuant to Chapter 401,Fla. Stat. and Subtitle 64E-2,Fla.Admin. Code. 2.6 As pursuant to Chapter 401, Fla. Stat. and Subtitled 64E-2, 1a _ ran. Code, the City may operate any of their licensed and/or non-licensed ALS vehicles or a_-naratus as a BLS responder when a paramedic does not staff the vehicle. SECTION III:CITY'S RESPONSIBILITY The following specific services,duties,and responsibilities will be the obligation of the CITY: 3.0 The CITY will provide through the City's Fire Rescue Depa,.uuent; Incident Command, incident safety direction, fire rescue standard operating guidelines and training on a regional basis. 3.1 The CITY will maintain two (2) ALS apparatus, licensed and equipped by the COUNTY, at locations referenced in Section 2.3. These unit(s) will be designated within the County Sherriff s Office Computer Aided Dispatch (CAD) program to automatically respond to medical incidents with, or in place of, an ALS transport unit committed to a previous medical, rescue or fire operation in accordance with the COUNTY's Emergency Medical Dispatch protocol as an emergency medical response and/or fire suppression vehicle. The CITY will maintain one (1) additional ALS Apparatus licensed by the COUNTY and equipped by the CITY. This unit will be designated as a reserve ALS Apparatus to be only used when staffing allows. 3.2 The CITY will comply with medical protocol, and will participate in medical training and quality assurance programs in accord with the COUNTY. 3.3 The CITY will provide one (1) Firefighter/Paramedic or Firefighter/EMT to the COUNTY 365 days per year,24 hours per day to be utilized on the ALS transport unit assigned to Station 50. 3.4 The CITY may provide at least one (1) MOU Training Coordinator, approved by the medical director,to function as a Field Training Officer(FTO)/Supervisor for CITY Paramedic and EMT training. Packet Page -46- 9/22/2015 10.C. 3.5 The CITY will designate a representative to the COUNTY a Medical Director approved Quality Assurance member to participate on the ALS Non-Transport Quality Assurance Committee. 3.6 The CITY may provide additional non-licensed ALS vehicles when paramedic staffing allows. 3.7 The CITY may provide additional medical equipment and advanced service with the approval of the COUNTY. 3.8 The CITY shall be responsible for replacing expendable medical supplies and for the cost of repair and maintenance of all ALS equipment supplied by the COUNTY,not on County staffed vehicles. SECTION IV:MUTUAL CONVENANTS 4.0 The COUNTY in coordination with the CITY will be responsible for verifying that CITY Firefighter/Paramedics and/or Firefighter/EMTS meet all requirements for State licensure and recertification as Florida Certified Paramedics and/or EMTs. The CITY in coordination with the County will be responsible for verifying that the COUNTY Paramedic/Firefighters meet all requirements for licensure and recertification as required by law (e.g., Florida Statutes, Florida Administrative Code,and rules and regulations of the Division of State Fire Marshall's Bureau of Fire Standards and Training.) 4.1 The COUNTY and the CITY will provide each other's department employees similar training and internship programs as would be provided for a COUNTY or CITY employed Firefighter/Paramedic or Firefighter/EMT. 4.2 Necessary qualifications for both CITY and COUNTY firefighter/paramedics will be cooperatively developed and defined within the Collier County Fire Chiefs'Association(CCFCA) Firefighter Cross Training Program, and Collier County Medical Director's Paramedic Qualification/Certification Matrix. 4.3 The COUNTY and CITY will work cooperatively to identify and request appropriate grants in order to improve the operations and service capabilities of both departments. 4.4 The operational decision to change the location of either apparatus assignment identified in sections 2.1 or 3.3 may be changed by mutual written consent between the Chief of the CITY's Fire Rescue and COUNTY's County Manager or his designee(e.g.Chief of EMS). SECTION V: OPERATING PROCEDURES 5.0 The CITY Firefighter/Paramedics and Firefighter/EMTs will meet the same requirements and perform at the appropriate medical protocol as defined by the COUNTY EMS Medical Director, standard operating procedures, quality assurance program, general orders and chain of command as employees of the COUNTY EMS Department. 5.1 The CITY Firefighter/Paramedics shall be certified to perform as ALS Engine Paramedics under current medical protocol. The COUNTY EMS Medical Director shall regularly evaluate the skills of the CITY Paramedics for consideration of expanding the medical protocol under which they perform. 5.2 The COUNTY EMS Department Paramedic/Firefighters will meet the same requirements and perform under the same Fire specialized response protocols, standard operating procedures and chain of command as employees of the CITY. 5.3 The ALS Partnership Operations Plan, Attachment A, may be revised by mutual written consent between the Chief of the CITY's Fire Rescue and COUNTY's County Manager or his designee (e.g. Chief of EMS). Such revisions must not conflict with the terms and standards set forth in this Agreement. 5.4 Licensed and non-licensed ALS vehicles, programs, personnel or details may be developed and implemented by joint agreement and in cooperation between the CITY and COUNTY. Such resources may not conflict with the standards set forth in this agreement. 5.5 The CITY and COUNTY EMS Department will recognize and abide by the respective ranks and abilities of assigned personnel. 5.6 All discipline and investigations leading to discipline will be handled by the respective employing agency. 5.7 The CITY and COUNTY will utilize Command Staff and assets for logistical, support, and operational needs for national,state and local emergencies. 5.8 The State of Florida recognized Incident Management System (IMS) is the standard for emergency operations. The CITY shall assume command and control of all incidents where the Packet Page -47- 9/22/2015 10.C. CITY is the Authority Having Jurisdiction. In all instances where the CITY has established command,COUNTY EMS shall assume responsibility for,and be in charge of patient care. 5.9 The COUNTY and CITY will jointly develop medical recordkeeping procedures and share statistical data. SECTION VI:RESOLUTION OF CONFLICTS 6.0 If the two governing es operating procedures, chain of command or any other unforeseen circumstances con= ' Pict issues will immediately be decided in the following manner; 1. First and foremost by t e medical needs of the patient and responder safety 2. The COUNTY will have jurisdiction of medical issues concerning appropriate patient care. 3. The CITY will have ju±diction of fire/rescue issues concerning operations and safety. 4. Conflicts involving patient care issues will be resolved through a QA/QI process. 5. Should conflicts arise that are unresolvable, the chain of command within each department will come sir in an attempt to resolve those issues at the equivalent levels of each depwmcnt and in unison move up the chain of command as necessary. SECTION VII:AGREEMENT TERM 7.0 This Interlocal Agreement supers tb`agreement titled "Interlocal Agreement Advanced Life Support Engine Partnership,betwe i CITY and COUNTY,dated July 31,2001. 7.1 The Interlocal Agreement shall remain in full force and effect from the date first above written and shall terminate after written notice of y-nination. 7.2 This Interlocal Agreement:hall be reswed and renegotiated as necessary after three (3) years. Absent termination or =mantra this Interlocal Agreement, the term of this Interlocal Agreement will automatic renew in (3) three year periods. Nothing within this Agreement shall preclude review and amendment of any provision within the three (3) year period or successive renewal periods »� amendment is mutually agreed to in writing by the COUNTY and CITY. 7.3 Either the COUNTY or the LI i Y nom:-terminate this Interlocal Agreement after providing written notice of its intent to terminaae ninety(90)days in advance of the date of termination. 7.4 In the event that the COUNTY's Mexal Director determines that the CITY's failure to fulfill any of the obligations under this Agreement adversely affects or may adversely affect the medical needs of the patient and/or responder safety,EMS may provide written notice to CITY of its intent to recommend that the BCC terminate this Agreement. BCC consideration of termination of this Agreement must occur at the next available regular meeting of the BCC. Advance notice of the BCC meeting date and agenda i stem must be provided to the Medical Director and CITY. Unless otherwise determined by the BCC at the meeting, the notice of intent to recommend that the BCC terminate this Agreement shall be deemed to be fully sufficient and to have commenced the (90) ninety day notice period. In the alternative, the BCC at the meeting may, after receiving information from the Medical Director and CITY, terminate this Agreement without further action or notice to the CITY. Nothing in this Agreement shall limit the authority of the Medical Director as set forth in the Florida Statutes and the Florida Administrative Code. 7.5 The terminating party must also provide the non-terminating parry's representatives with an opportunity to consult with the terminating party's representatives regarding the reason(s) for termination during the notice periods provided in Section VII of this Agreement. SECTION VIII: INSURANCE 8.0 The CITY and COUNTY shall maintain insurance in the minimum amounts and types required by Florida State Statutes. Packet Page -48- 9/22/2015 10.C. 8.1 The CITY and COUNTY agree that either party may be self-insured on the condition that all self- insurance must comply with all State laws and regulations and must meet with the approval of the other party to this Interlocal Agreement. 8.2 To the extent permitted by law and as limited by and pursuant to the provisions of Florida Statutes, Section 768.28 CITY and COUNTY agree to hold harmless the other_ their employees and agents against any and all claims and/or damages by or behalf of as.- err - employee or legal entity arising from their respective negligent acts pursuant to this z _j—Brent that allows employees of the other to occupy and ride in each other's vehicles_ No - intended to alter either party's immunity in tort or otherwise impose liability on CITY or tie COUNTY TY when it would not otherwise be responsible. SECTION IX: MISCELLANEOUS 9.0 This Interlocal Agreement shall be governed by and construed under the laws of the State of Florida. In the event any litigation is instituted by way of construction or enfor=-Dmt of this Interlocal Agreement, the party prevailing in said litigation shall be entitled to collect and recover from the non-prevailing party all court costs and other expenses, including reasonable Attorney's fees. 9.1 It is understood that this Interlocal Agreement must be executed by both parties prior to the CITY and COUNTY commencing with the work, services, duties and respernsnnT described heretofore. 9.2 Prior to its effectiveness, this Interlocal Agreement and any subsequent 2tnc to this Agreement(including amendments to the ALS Partnership Operations Plan. Attacirneni A), shall be filed with the Clerk of Courts for the Circuit Court for Collier County pw 'str.'u FS 163.01 (II). The COUNTY shall file this Interlocal Agreement as soon as practicable >a:.•.n val and execution by both parties. IN WITNESS WHEREOF, the parties hereto have caused this Interlocal Agreement to be exemrr d by their appropriate officials, as of the date first above written. ATTEST: BOARD OF COUNTY COMMISSIONERS OF Dwight a $rock, Clerk COLLIER COUNTY, FLORIDA • By: ',L:r / est. Its._)tO C� roan 6 jim Co etta., hairman lS'-i 9%l t.Ur.e till u Approval as to form and legal Sufficiency: Jentil er A. Belpeaio Assistant County Attorney ATTEST MARCO ISLAND CITY MANAGER Laura Litzan, C -rk BY:/a"A! may' A. William Moss, City Manager Packet Page -49- 9/22/2015 10.C. ATTACH=MENT A COLLTFR. COUNTY EMERGENCY MEDICAL SERVICES / FIRE DEPARTMENT AND MARCO ISLAND FIRE AND RESCUE DEPARTMENT ALS PARTNERSHIP OPERATIONS PLAN �/�f� REFERENCE: ALS Program Interlocal Agreement,/M(1( ;2007 PLTRPOSE To provide quality and cost effective fire rescue and emergency medical servic to the residents of the City of Marco Island (MIFD) and Collier County (COUNTY)_ The recognition and utilization of existing and future personnel skills, qualifications and resources is in the interest and benefit of both agencies and the public we serve_ 1. QUALIFICATION REQUIREMENTS a. COUNTY Paramedic/Firefighters utilized on designated fire apparatus must s,intain the following valid and current qualifications: i. Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards (Firefighter II); ii. Florida Bureau of Emergency Medical services and Community Health Resources Paramedic Certification; iii. Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter 64E; iv. Collier County Medical Director's Paramedic Certification/Qualification Matrix Rescue Paramedic and; v. Collier County Fire Chiefs' Association Firefighter Cross Training Certification. b. MIFD Firefighters utilized on the County Medic unit must maintain the following valid and current qualifications: i. Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards (Firefighter II); ii. Florida Bureau of Emergency Medical services and Community Health Resources EMT or Paramedic Certification; iii. Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter 64E and; Packet Page -50- 9/22/2015 10.C. iv. Collier County Medical Director's Orientation, as referenced in the Collier County Medical Director's Paramedic Certification/Qualification Matrix c. At least one MIFD Firefighter/Pc utilized on licensed MIFD ALS apparatus or vehicle must mein tile following valid and current qualifications; i. Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards (Firefighter II); ii. Florida Bureau of Emergency Medical services and Community Health Resources Paramedic Certification and; iii. Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter 64E and; iv. Collier County Medical Director's Paramedic Certification/Qualification Matrix Engine Paramedic Certification or above. d. MIFD Firefighter/Paramedics utilized in non-licensed apparatus or assignments must maintain the following:valid and current qualifications; i. Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards (Firefighter II); ii. Florida Bureau of Emergency Mescal services and Community Health Resources Paramedic Certiu on and; iii. Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter 64E and; iv. Collier County Medical Director's Paramedic Certification/Qualification Ma. x rune Paramedic Certification or above. 2. SCHEDULING AND POSITION ASSIGNv -TS a. The COUNTY and MIFD Chiefs or their designee, must approve all Exchange Program participants. b. The COUNTY Battalion Chief 80 and MIFD Division Chief 50 will consult openly in order to assure continuity and efficiency. c. The COUNTY will continuously provide MIFD with one [1] COUNTY Paramedic/Firefighter as qualified within Section 1, a for use on a designated ALS apparatus or vehicle. d. MIFD will continuously provide the COUNTY with one [1] MIFD Firefighter as qualified within Section 1. b. for use on the appropriate designated apparatus or vehicle. e. Exchange Program participants will participate in appropriate on-duty training, station duties and unit assignments in accordance with assignment and rank. Packet Page -51- 9/22/2015 10.C. f It is recognized by COUNTY and MIFD that harmonious and productive relationships between all personnel are necessary. Teamwork and cooperation is encouraged and expected. g. Applicable COUNTY and/or CITY policies, practices, procedures, stand operating guidelines, general orders, protocols and/or applicable Bargaii-7,g Unit Contract language will be observed. 3. COMMUNICATION AND DISPATCH a. COUNTY and MIFD staff will assure all personnel operate on the appropriate radio frequency, unit identifier dispatch and zone coverage protocol in accordance with Computer Aided Dispatch (CAD) and the CCFCA Communications Manual. Designated assignments are outlined as follows: i. Medical Director approved Emergency Medical Dispatch (EMD) Models shall be designed to assure the initial response of appropriate ALS licensed apparatus. ii. COUNTY and Marco Island Fire Department (hereinafter "MIFD") chief officers will utilize available MIFD licensed resources to assure ALS coverage is continuously maintained within the City of Marco Island. iii. COUNTY and MIFD chief officers will assure licensed and non- licensed ALS assets will respond to out-of-district emergencies or coverage when identified by CAD as the closest available Al S unit. b. Applicable COUNTY and/or CITY policies, practices, procedures_ standard operating guidelines, general orders, protocols and/or applicable Bargaining Unit Contract language will be observed. 4. DOCUMENTATION a. The first arriving licensed and non-licensed ALS unit will document each patient contact in a hand written Patient Care Report (PCR). The PCR must record any notations from on-scene patient treatment, patient identifying data completed and collected prior to transfer of patient care, AR number, Dispatch times, and crew signatures with State paramedic or EMT license numbers. When ALS units arrive at the same time, the PCR will be completed by the transporting unit. Shift PCRs are to be collected in a secured envelope with completed coversheet and submitted to the appropriate EMS representative. b. Before the end of shift, an accurate and complete EMS2000 report will be electronically transmitted for each patient contact 100% of the time. All BLS/ALS procedures performed by the personnel assigned to the ALS response will be fully documented. "CHART" format with documented "BSI" is required. Packet Page -52- 9/22/2015 10.C. c. Prior to 0900hrs, or as call volume permits, Battalion 50 or designee must fax or email a complete ALS Engine Staffing Report to Battalion 81's office. An updated report will be provided to Battalion 81 prior to or at the end of shift to reflect staffing changes during that tour. Battalion 81 will fax a complete EMS B, g report to Battalion 50's office. 5. QUALITY ASSIIRANCE a. MIFD wdI appoint a Medical Director approved "Quality Assurance (QA) member to participate on the ALS Non-Transport Quality Assurance Committee, and will be granted privileges to enable them to review their department's EMS 2000 PCRs. b. At the discretion of the Medical Director or designee, routine or informational QA Review may be handled by the MiFD member. The QA Committee will provide the me mb,°r with appropriate documentation detailing the area of interest_ The member shall review and complete the material with the MIFD personnel and rein all necessary documentation to the ALS Non-Transport QA Cornminee w-it- n thirty[301 calendar days. C. In the event the Medical Director orders remediation, the QA member shall be present uode vng that confidential medical information will be discussed. If a signif - issue is identified by the QA Committee, the EMT or Paramedic mpv be immediately prohibited from providing patient care until all processes are rnpleted. 6. TRAINING a. MIFD will appoint a Medical Director approved "EMS Training person(s)" to work as an aj= t for the Collier County EMS Training Center so to instruct MIFD personnel in pre-hospital medicine and protocol. b. The MIFD Training person(s) is qualified to instruct MIFD firefighter paramedics or EMTs Medical Director approved in-services, certifications, classes, etc. c. Any curriculum taught by the MIFD EMS Training person(s) must be submitted with a complete student roster to the Medical Director in order to qualify for County accreditation. In addition, the EMS Training person(s) will be granted privileges to EMS 2000 to accurately record continuing education hours of any personnel completing their training. d. MIFD will provide to the State Fire College appropriate approved training documentation for recognized State approved fire classes. Packet Page -53- INSTR 4997711 OR 5050 PG 240 9/22/2015 10.C. RECORDED 6/19/2014 4.48 PM PAGES 12 DWIGHT E. BROCK, CLERK OF THE CIRCUITURT ... COLLIER COUNTY FLORIDA REC$103.50 INTERLOrAL AGREEMENT ADVANCED LIFE SUPPORT PARTNERSHIP BETWEEN COLLIER COUNTY AND GOLDEN GATE FIRE CONTROL AND RESCUE DISTRICT THIS INTERLOCAL AGREEMENT, made and entered into this 10 vh day of . •j'rt.rte 2014, by and between the Board of County Commissioners, Collier County, Florida, a political subdivision of the State of Florida, (hereinafter "COUNTY") and the GOLDEN GATE FIRE CONTROL AND RESCUE DISTRICT, an Independent Special District of the County of Collier. State of Florida, created under Chapter 61-2032, Laws of Florida, and its potential successor, the Greater Naples Fire and Rescue District, (hereinafter "GOLDEN GATE"). PURPOSE The purpose of this Interlocal Agreement is to provide quality and cost effective fire rescue and emergency medical services to the residents of the GOLDEN GATE district and Collier County. The recognition and utilization of existing and future personnel skills, qualifications and resources is in the interest and benefit of both agencies and the public we serve. WITNESSETH WHEREAS, GOLDEN GATE and COUNTY seek to enhance emergency service further through a continued partnership: and WHEREAS. the Advanced Life Support (hereinafter "ALS") partnership provides for an GOLDEN GATE Firefighter/Paramedic or a Firefighter'Emergency Medical Technician to work and train on a COUNTY Advanced Life Support Transport ambulance providing Paramedic/Firefighter duties and/or basic life support E'`YIT duties; and WHEREAS. The ALS partnership provides for a COUNTY Paramedic/Firefighter to work and train on an GOLDEN GATE Fire-Rescue unit providing firefighting and paramedic duties: and WHEREAS. GOLDEN GATE and COUNTY work cooperatively to assure appropriate response of suit±dent emergency medical resources. NOW, THEREFORE. In consideration of the above premises. and the mutual covenants. terms. and provisions contained herein. the CO? NTY and GOLDEN GATE agree as fdllo\\s: SECTION I: DEFINITIONS .1 ALS means treatment of life-threatening medical emergencies through the use of techniques such as endotracheal intuhation. the administration of drugs or intravenous fluids. cardiac monitoring, and cardiac defibrillation b\ a qualified person. pursuant to rules of the C01 NTY 'Medical Director (hereinafter I._ BLS "Basic life support- means treatment of medical emergen cies b■ a qualified person through the use of techniques such as patient assessment. cardiopulmonary resuscitation (CPR). splinting.. obstetrical assistance. handagine, administration of ox\'g n . administration of a Packet Page -54- PagF 1 of 12 9/22/2015 10.C. 1oo subcutaneous injection using a premeasured auto injector of epinephrine to a person suffering an anaphylactic reaction. and other techniques described in the Emergency Medical Technician Basic Training Course Curriculum of the United States Department of Transportation. The term "basic life support" also includes other techniques which have been approved and are performed under conditions specified by rules of the department or the OMD. 1.3 BCC refers to the Collier County Board of Commissioners. 1.4 FTO means a Field Training Officer; a certified paramedic recognized by the OMD as having sufficient skill and experience to train and direct medical providers in working under the approved medical protocols. 1.5 QA/QI means Quality Assurance/ Quality Improvement which is the Medical Director approved program which assesses and monitors the medical performance of Paramedics and Emergency Medical Technicians. 1.6 PCR means the Patient Care Record which chronicles the medical treatment of the patient. 1.7 MOU refers to a Memorandum of Understanding between agencies. 1.8 Permitted means a non-transporting ALS fire apparatus and rapid response vehicle operating under the ALS license issued to COUNTY Emergency Medical Services Department (hereinafter"EMS")for the purpose of enhancing 911 medical responses. 1.9 Non-Permitted refers to any response vehicle that is not required by State Statute to be permitted. but is authorized by the OMD. 1.10 EMCC refers to the Golden Gate Emergency Medical Care Coordinator. 1.11 OMD refers to the Collier Counts Office of the Medical Director. SECTION .11. COUNTY'S RESPONSIBILITY. The following specific services. duties, and responsibilities will be the obligation of the COUNTY: 2.1 The COUNTY will provide through the County's Emergency Medical Services (EMS) Department and the OMD: medical direction. medical protocols. training and qualm assurance on a countywide basis. _._ The COUNTY will maintain at least one (1 ) ALS transport ambulance staffed by GOLDEN GiATE_ and the COUNTY under the Board of Commissioners' authorit pursuant to the current Chapter 401. Pia. .Siat. and Chapter 64.1. Admin. Code in GOLDEN GATE as a first-due apparatus on all medical. rescue and fire incidents. _. The COUNTY. as a licensed provider of advanced life support under Chapter 401. F a. Ski!. and Chapter 64.1. Flu. Achnirl. Cock, \s ill permit a minimum of two (2). GOLDEN GATE fire apparatus or response vehicles as nos-trans ortin`C ALS vehicle((st under the COUNTY EMS license for the purpose of enhancing 911 medical responses. as non-trans poriin< ALS vehicles. as identified in _. The CC ° '1'r' will permit additional vehicles ` i- _.3 and mumalls atifteed upon. under the COUNTY i'1 EMS license during the term of this lnteriocal Agreement. _._ The COUNTY Y EMS Department will pros ide one ( 1) Paranledic,F: efghter to GOLDEN GATE E 365 days per year. 2 4 hours per da\ to he utilized on fire apparatus vehicle si located in Packet Page -55- Page 2 of 12 6 9/22/2015 10.C. GOLDEN GATE and permitted as ALS non transporting unit under the Board of County Commissioner's authority pursuant to Chapter 401, Fla. Stat. and Chapter 64J, Ha. Admin. Code. 2.6 Pursuant to Chapter 401, Fla. Stat. and Chapter 64J, Fla. Admin. Code, GOLDEN GATE may operate any of their permitted and/or non-permitted ALS vehicles or apparatus as a BLS responder when a paramedic does not staff the vehicle SECTION III: GOLDEN GATE'S RESPONSIBILITY The following specific services, duties, and responsibilities will be the obligation of GOLDEN GATE: 3.1 GOLDEN GATE will provide through GOLDEN GATE Fire Rescue District: Incident Command. incident safety direction, fire rescue standard operating guidelines and training on a regional basis. 3 2 GOLDEN GATE will maintain a minimum of two (2) ALS apparatus, permitted by the COUNTY, as referenced in Section 2.3. These unit(s) will be designated within the County Sheriffs Office Computer Aided Dispatch (CAD) program to automatically respond to medical incidents with, or in place of an ALS transport unit committed to a previous medical, rescue or fire operation in accordance with the COUNTY'S Emergency Medical Dispatch protocol as an emergency medical response andior fire suppression vehicle. 3.3 GOLDEN GATE will comply with medical protocol, equipment standards, and will fully participate in medical training and quality assurance programs in accord with the COUNTY. 3.4 GOLDEN GATE will maintain all medical run reports in an OMD approved records system and will handle them in a manner consistent with County operating guidelines. Federal, and State laws. 3.5 GOLDEN GATE will ensure all GOLDEN GATE personnel providing medical care maintain all state and federall required licensure. Records shall be maintained by GOLDEN GATE and available to the COUNTY upon request. 3.6 GOLDEN GATE will provide one (1) Firefighter/Paramedic or Firefichteri Emergency.' Medical Technician to the COUNTY 365 days per year. 24 hours per day to be utilized on the ALS transport unit assigned to COUNTY. 3.7 GOLDEN GATE will provide at least one liaison as an Emergency Medical Care Coordinator (hereinafter "EMCC"), approved by the OMD to function as a Training Officer! Supervisor for GOLDEN GATE Paramedic and EMT training. The EMCC shall work with COUNTY EMS 1 rainintrc Mali to enhance the BLS and First Responder Program by assisting in teaching per the annual published in-service schedule. If the GOLDEN GATE cannot io tsticall. attend ESC training. the may teach OMD approved curriculum at remote sites provided: • The OMD approved EMCC attends all in-service classes taught at the ESC in order to insure the training, liaison is kept up to date on protocol changes. trends in local treatment. case reviews, etc. and can more el'Tectivrl\ communicate the material in context to their agency's personnel. • The MCC_ use (ink curriculum iculum prc-appro ed by the OMD for medical training. in the case of ,egularl\ scheduled County in-service. the approved curriculum will be provided the month after the conclusion of scheduled in services at ESC. 2 GOLDEN GATE will designate an OMD approved representative as a Qualit\ Assurance member to participate in Ou alit\ Assurance. Packet Page -56- Page 3 of 12 L9/22/2015 10.C. ULU 3.9 GOLDEN GATE may provide additional non-permitted ALS vehicles when paramedic staffing permits. 3.10 GOLDEN GATE may provide additional medical equipment and advanced service with the approval of the COUNTY. 3.11 GOLDEN GATE shall be responsible for replacing expendable medical supplies and for the cost of repair and maintenance of all ALS equipment supplied by the COUNTY, not on County staffed vehicles. SECTION IV:MUTUAL CONVENANTS 4.1 The COUNTY and GOLDEN GATE will provide each other's department employees similar training and internship programs as would be provided for a COUNTY or GOLDEN GATE employed Firefighter/Paramedic or Firefighter/EMT. 4.2 Necessary qualifications for both GOLDEN GATE and COUNTY firefighter/paramedics will he cooperatively developed and defined within the ALS Operational Plan. and OMD's Paramedic Qualification/Certification Matrix. 4.3 The COUNTY and GOLDEN GATE will work cooperatively to identify and request appropriate grants in order to improve the operations and service capabilities of both departments. 4.4 The operational decision to change the location of either apparatus assignment may be changed by mutual written consent between the Chief of GOLDEN GATE or his designee and COUNTY's County Manager or his designee(e.g.Chief of EMS). 4.5 NOTIFICATION OF EXPOSURE TO INFECTIOUS DISEASES: In the event that Collier County EMS Department is notified of an exposure to infectious disease_. EMS shall notify GOLDEN GATE Infectious Control Officer or EMCC so they may take appropriate action. Upon notification, the treatment procedures shall be the responsibility of GOLDEN GATE In the event that GOLDEN GATE is notified of an exposure to infectious disease, GOLDEN GATE shall notify the EMS Infectious Control Officer or BC 80 so they may take appropriate action. SECTION V: OPERATING PROCEDURES .11 GOLDEN GATE Firefighter/Paramedics and Firefighter;' Emergency Medical Technicians will meet the same requirements quirement_ =nd i „lrm at the appropriate medical protocol as defined by the ()MD. standard operating procedures. quality assurance program. general orders and chain of command as employees of the COUNTY EMS Department. GOLDEN GATE Firelighter/Paramedics shall he certified to perform as ALS Engine Paramedics under current medical protocol. The COUNTY EMS Medical Director shall regularly evaluate the skills of GOLDEN GATE Paramedics for consideration of expanding the medical protocol under tvttich they perform. The COZ.N I A EMS Department Paramedic't'irerighters will meet the same requirements and perform under the same file specialized response protocols. standard operatincg procedures and chain of command as employees of GOLDEN GATE. 5.4 The ALS Operational Plan. Attachment A. may be revised ht mutual written consent between the Chief of the GOLDEN GATE Fire Rescue and COUNTY's County Manager or his designee (e.g. Chief of EMS). Such revisions must not conflict with the terms and, standards set Packet Page -57- Page 4 of 12 9/22/2015 10.C. lotM forth in this Agreement. �.? Permitted and non-permitted ALS vehicles, programs personnel or details may he developed and implemented by joint agreement and in cooperation between GOLD EN GATE and COUNTY. Such resources may not conflict with the standards set forth in this agreement. 5.6 GOLDEN GATE and COUNTY EMS will recognize the respective ranks and abilities o f assigned personnel. 5.7 AlI discipline and investigations leading to discipline will he handled by the respective employing agency. 5.8 GOLDEN GATE and COUNTY will utilize Command Staff and assets for logistical, support, and operational needs for national, state and local emergencies. 5.9 The State of Florida recognized Incident Management System (IMS) is the standard for emergency operations. GOLDEN GATE shall assume command and control of all incidents where GOLDEN GATE is the Authority Having Jurisdiction. In all instances where GOLDEN GATE has established command, COUNTY EMS shall assume responsibility for, and be in charge of, patient care. 5.10 The COUNTY and GOLDEN GATE will share statistical data. SECTION VI:RESOLUTION OF CONFLICTS, 6.1 If the two governing entities' standard operating procedures, chain of command or any other unforeseen circumstances come into conflict, issues will immediately be decided in the following manner: . First and foremost by the medical needs of the patient and responder safety. 2. The COUNTY will have jurisdiction of medical issues concerning appropriate patient care. GOLDEN GATE will have jurisdiction of fire./rescue issues concerning operations and safety. 4. Conflicts involving patient care issues will he resolved through a QA/ QI process. 5. Should conflicts arise that are irresolvable, the chain of command within each department will come together in an attempt to resolve those issues at the equivalent levels of each department and in unison move up the chain of command as necessary. JE_CTIO1 Vii: A.GREFMENT TERM, The interlocal Agreement shall remain in full force and effect from the date first above written and shall terminate after written notice of termination. This Interlocal Agreement shall be reviewed and renegotiated as necessar after three (3) years. Absent termination or amendment to this Interlocal Agreement. the term of this Interlocal treement will afnorlati alb renew in (Y) three ea" periods. Nothinc within this a eemet:nt shall preclude review, and amendment of any provision within the three (3) year period or successive renewal periods when such amendment is mutually agreed to in writing by the COUNTY and GOLDEN GATE. -`. Either the COUNTY or GOLDEN GATE may terminate this Interlocal A.greement after providing written notice its intent to terminate at least ninety t,00' da s in advance of the date Packet Page -58- Page 5 oft 9/22/2015 10.C. 16E 6 of termination. In the event that the COUNTY`s Medical Director determines that the GOLDEN GATE failure to fulfill any of the obligations under this Agreement adversely affects or may adversely affect the medical needs of the patient and/or responder safety, EMS may provide written notice to GOLDEN GATE of its intent to recommend that the BCC terminate this Agreement. BCC consideration of termination of this Agreement must occur at the next available regular meeting of the BCC. Advance notice of the BCC meeting date and agenda item must be provided to the Medical Director and GOLDEN GATE. Unless otherwise determined by the BCC at the meeting, the notice of intent to recommend that the BCC terminate this Agreement shall be deemed to be fully sufficient and to have commenced the (90) ninety day notice period. In the alternative, the BCC at the meeting may, after receiving information from the Medical Director and GOLDEN GATE, terminate this Agreement without further action or notice to GOLDEN GATE. Nothing in this Agreement shall limit the authority of the Medical Director as set forth in the Florida Statutes and the Florida Administrative Code. In the event that the DISTRICT's Fire Chief determines that EMS failure to fulfill any of the obligations under this Agreement adversely affects or may adversely affect the needs of the GOLDEN GATE citizens and/or responder safety, GOLDEN GATE may provide written notice to COLLIER COUNTY of its intent to recommend that the Board of Fire Commissioners(hereinafter "GGFD") terminate this Agreement. GGFD consideration of termination of this Agreement must occur at the next available regular meeting of the GGFD. Advance notice of the GGFD meeting date and agenda item must be provided to the EMS Chief and Collier County. Unless otherwise determined by the GGFD at the meeting, the notice of intent to recommend that the GGFD terminate this Agreement shall be deemed to be fully sufficient and to have commenced the (90) ninety day notice period. In the alternative, the GGFD at the meeting may, after receiving information from the Fire Chief and GGFD. terminate this Agreement without further action or notice to COLIER COUNTY. Nothing in this Agreement shall limit the authority of the Fire Chief as set forth in the Florida Statutes and the Florida Administrative Code. The terminating party must also provide the non-terminating party's representatives with an opportunity to consult with the terminating party's representatives regarding the reason(s) for termination during the notice periods provided in Section VII of-this.Agreement. SECTION VIII: INSURANCE .{ GOLDEN GATE. :n Fd COUNTY shall maintain insurance in the minimum amounts and types. required tw Florida `Mate Statues. 8.2 GOLDEN GATE 1 and COUNTY aoree that either party mar be self-insured on the condition that all stztifsinsurance must comply with all State law's and regulations and must meet with the approval of the other party to this intern.cal Agreement. event. 8.3 To the extent permitted dv is w and as limited by and pursuant to the provisions oI -X101"1CI 1 .S`tatutes Section 768.28 GOLDEN GATE E and COUNTY agree to ilold harmless the other. their empim ees and agents against any and all claims find or damages: by or behalf of and person... en pio- ee 07 legal entity arising From their respecti'C negligent acts pursuant to this agreement that allow s employees of the other to occupy and ride in each other's vehicles. Nothing is intended to alter either nartv's immunity in tort or otherwise impose liability on GOLDEN GATE o, the COUNTY Y s h -n it would not otherwise he responsible. Packet Page -59- ?age 6 of 12 9/22/2015 10.C. 1 6 E SECTION IX: MISCELLANEOUS 9.1 This Interlocal Agreement shall be governed by and construed under the laws of the State of Florida. In the event any litigation is instituted by way of construction or enforcement of the Interlocal Agreement, the party prevailing in said litigation shall be entitled to collect and recover from the opposite party all court costs and other expenses, including reasonable Attorney's fees. 9.2 It is understood that this Interlocal Agreement must be executed by both parties prior to GOLDEN GATE and COUNTY commencing with the work. services, duties and responsibilities described heretofore. 9.3 Prior to its effectiveness, this Interlocal Agreement and any subsequent amendments shall be filed with the Clerk of Courts for the Circuit Court for Collier County pursuant to Section 163.01 (2). Fla Stat. The COUNTY shall file said agreement as soon as practicable after approval and execution by both parties. [Remainder of page intentionally left blank,signature page to follow] Packet Page -60- Pap!. 7 of 12 1 9/22/2015 10.C. IN WITNESS WHEREOF. the parties hereto have caused this Inter local Agreement to be executed by their appropriate officials. as of the date first above written. ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK COLLIER COUNTY. FLORIDA // /1/ II,_A .; I.., A A.A Arierlil lb( . BY:— ilt.,--, /A------, II 416 Clerk Tom Henning. Cest as to,Chlr: Chairman ti sIgnature,only,'" Approved as to for and legality \,..C4Aleen M. Greene Assistant County Attorney ATTEST: GOLDEN GATE FIRE CONTROL AN R" CUE ISTRICT , ..' Chairman it i Packet Page -61- Page 8 of 12 9/22/2015 10.C. I h 6 ATTACHMENT A COLLIER COUNTY EMERGENCY MEDICAL SERVICES I FIRE DEPARTMENT AND GOLDEN GATE FIRE CONTROL AND RESCUE DISTRICT ALS OPERATIONAL PLAN REFERENCE: ALS Program Inter local Agreement, . 20 I 4 PURPOSE: To provide quality and cost effective fire rescue and emergency medical services to the residents of GOLDEN GATE (GGFD) and Collier County (COUNTY). The recognition and utilization of existing and future personnel skills, qualifications and resources is in the interest and benefit of both agencies and the public we serve. 1. QUALIFICATION REQUIREMENTS a. COUNTY Paramedic/Firefighters utilized on designated fire apparatus must maintain the following valid and current qualifications: Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards (Firefighter II); ii. Department of Health Emergency Medical Services Paramedic Certification: iii. Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter 64J; iv. Collier County Medical Director's Paramedic Certification/Qualification Matrix Rescue Paramedic and; v. Collier Count■ Fire Chiefs Association Fiftitialiter Cross Trainine. Certification. b. GGFD Firefighters utilized on the County Medic ambulance must maintain the followinc valid and current qualifications: Florida Bureau of Fire Standards and Traini.ng Certificate of Compliance for Minimum Standards (Firefighter [1'1: Department of Health Emergency Medical Sen ce Enicrgei1L Medic Technician or Paramedic Certification: iii. Emergency Vehicle Operator Certification in accordance with F.A.C. Chapter 64.1 and; Collier County Medical Director's Orientation, as referenced in the Collier Counn Medical Director's Paramedic Certification/Qualification Matrix. Packet Page -62- Page 9 of 12 19/22/2015 10.C. ULU c. At least one GGFD Firefighter/Paramedic utilized on permitted GGFD ALS apparatus or vehicle must maintain the following valid and current qualifications; i. Florida Bureau of Fire Standards and Training Certificate of Compliance for Minimum Standards(Firefighter II); ii. Department of Health Emergency Medical Services Emergency Medical Technician or Paramedic Certification and; iii. Collier County Medical Director's Paramedic Certification/Qualification Matrix Engine Paramedic Certification or above. e. SCHEDULING AND POSITION ASSIGNMENTS i. The COUNTY and GGFD Chiefs or their designee, must approve all Exchange Program participants. ii. The COUNTY Battalion Chief 82 and GGFD Battalion Chief 70 will consult openly in order to assure continuity and efficiency. iii. The COUNTY will continuously provide GGFD with one [I] COUNTY Paramedic/Firefighter as qualified within Section I. a. for use on a designated ALS apparatus or vehicle. iv. GGFD will continuously provide the COUNTY with one [1] GGFD Firefighter Paramedic or a Firefighter/ Emergency Medical Technician as qualified within Section 1. b. for use on the appropriate designated apparatus or vehicle. V. Exchange Program participants will participate in appropriate on-duty training, station duties and unit assignments in accordance with assignment and rank. vi. It is recognized by COUNTY and GGFD that harmonious and productive relationships between all personnel are necessary. Teamwork and cooperation is encouraged and expected. vii. Applicable COUNTY and/or GOLDEN GATE policies, practices, procedures, standard operating guidelines, general orders, protocols and/or applicable Bargaining Unit Contract language will he observed. I COMMUNICATION AND DISPATCH a. COUNTY and GGFD staff will assure all personnel operate on the appropriate radio frequency, unit identifier dispatch and zone coverage protocol in accordance with Computer Aided Dispatch (CAD) and the CCFCA Communications Manual Designated assignments are outlined as follows: i. Medical Director approved Emergency Medical Dispatch (ENID) Models snail be designed to assure the initial response of appropriate ALS permitted apparatus. ii. COUNTY and GGFD chief officers will utilize available GGFD permitted resources to assure ALS coverage is continuously maintained within GOLDEN GATE. iii. COUNTY and GGFD chief officers will assure permitted and non-permitted ALS assets will respond to out-of-district emergencies or coverage when identified by CAD as the closest available ALS unit. Packet Page -63- Page 10 12 9/22/2015 10.C. 1 t, b. Applicable COUNTY and/or GOLDEN GATE policies, practices, procedures, standard operating guidelines, general orders, protocols and/or applicable Bargaining Unit Contract language will be observed. III. DOCUMENTATION The first arriving permitted and non-permitted ALS unit will document each patient contact in an OMD approved Patient Care Report (PCR). Collier EMS utilizes electronic reporting as its primary PCR system but in the event the GOLDEN GATE does not have on scene electronic reporting capability, handwritten reports may be utilized until electronic reporting can be completed. The PCR must record any notations from on-scene patient treatment, patient identifying data completed and collected prior to transfer of patient care, AR number, Dispatch times, and crew signatures with State paramedic or EMT certificate numbers. Some specific call types may require additional documentation (such as Release/Competency forms for patient sign outs) as specified by protocol and EMS documentation standards. When ALS units arrive at the same time,the PCR will be completed by the transporting unit. Shift PCRs are to be collected in a secured envelope with completed coversheet and submitted to the appropriate EMS representative daily. ii. Before the end of shift, an accurate and complete OMD approved electronic report (E- PCR) will be transmitted for each patient contact 100% of the time. All medical procedures performed by the personnel assigned to the response will be fully documented. "CHART" format with documented "BSI" is required. iii. Prior to 0900hrs. or as call volume permits, the GOLDEN GATE Battalion Chief or designee must fax or email a complete ALS Staffing Report to Battalion Chief 80's office. If staffing changes are made during the shift. an updated report will be provided to Battalion Chief 80 prior to or at the end of shift to reflect staffing changes. Battalion Chief 80 will provide a complete EMS Staffing report to the GOLDEN GATE Battalion Chiefs office. I NI. QUALITY ASSURANCE GOLDEN GATE will appoint an OMD approved "Quality Assurance (QA) member to participate on the ALS Non-Transport Quality Assurance Committee, and will be granted privileges to enable them to review their department's PCRs. ii. GOLDEN GATE will adhere to QA standards of the OMD and provide quarterly reports reflecting the monitoring guidelines employed by the County. iii. Patient care concerns may be found outside of report monitoring and may be reported by either agency or allied personnel such as hospital staff deputies. etc. Concerns should be made in writing to a QA Committee member via the Quality Assurance Review Fonii whenever possible and including pertinent specific details. iv. The OlviD will review all potential malpractices and make recommendations for follow up with call participants and future treatment or training guidelines. Feedback will be provided to both the complainant and the treating paramedic by the QA committee upon the resolution of the issue. Packet Page -64- Page 11 of 12 9/22/2015 10.C. 1610 v. At the discretion of the OMD or designee, routine or informational QA Review with GOLDEN GATE personnel may be handled entirely by the GOLDEN GATE member. The member shall review and complete all paperwork with the GOLDEN GATE personnel and return all necessary documentation to the ALS Non-Transport QA Committee within thirty [30] calendar days. vi. In the event the OMD orders remediation,the QA member shall be present understanding that confidential medical information will be discussed. If a significant issue is identified by the QA Committee, the EMT or Paramedic may be immediately prohibited from providing patient care until all processes are completed. V_ TRAINING The GOLDEN GATE Training person(s) is qualified to instruct GOLDEN GATE firefighter paramedics or EMTs Medical Director approved in-services, certifications, classes, etc. utilizing preapproved curriculum ii. Any curriculum taught by the GOLDEN GATE EMS Training person(s) must be submitted with a complete student roster to the OMD in order to qualify for COUNTY accreditation. In addition, the EMS Training Officer will accurately record continuing education hours of any personnel completing their training and provide those records to the COUNTY quarterly. GOLDEN GATE will provide to the State Fire College appropriate approved training documentation for recognized State approved fire classes. VI. MUTUAL COVENANT GOLDEN GATE will provide a Firefighter / Paramedic at least fifty percent (50%) of shifts to staff an EMS ambulance. The remaining shifts will be staffed by an GOLDEN GATE Firefighter/Emergency Medical Technician. ii. GOLDEN GATE Firefrehters / Paramedics will staff an EMS ambulance for a 24 hour shift at least every forty-five (45) calendar days. Monthly reports will be provided to the COUNTY by GOLDEN GATE which reflects GOLDEN GATE personnel. dates and hours in which they staffed an EMS ambulance. Packet Page -65- Page 12 of 12.