Agenda 12/08/2015 Item #16E13 Proposed Agenda Changes
Board of County Commissioners Meeting
December 8,2015
Add-On Item 4A: Proclamation designating January 16,2016 as National Religious Freedom Day in
Collier County. To be accepted by Greg Harper,Father Michael Orsi,Father Philemon Patitsas,Pastor Rick
Baldwin and Pastor Tom Harris. (Commissioner Henning's request)
Continue Item 16A22 to the January 12.2015 BCC Meeting:Recommendation to approve the name
of a Collier County artificial reef site pursuant to the Memorandum of Understanding with the
Community Foundation of Collier County and accept and appropriate a donation in the amount of
$98,000 for Artificial Reef Donations Project No.44038. (Community Foundation request)
Continue Item 16D25 to the January 12,2016 BCC Meeting: Recommendation to approve FY15-16
contract with the State of Florida Department of Health for the operation of the Collier County Health
Department in the amount of$1,378,200 and also to allocate additional funds in the amount of
$249,220 to fill a funding gap due to state non-funding of the ACHA Medicaid match programs. (Staffs
request)
Move Item 16E13 to Item 11F: Recommendation to accept a report on the status of the North Collier
Fire Control and Rescue District's second submission of a Certificate of Public Convenience and
Necessity for an Advanced Life Support Class 3 Certificate and not to process the application.
(Commissioner Hiller's request)
Move Item 16D22 to Item 11G: Recommendation to approve a resolution amending the Collier County
State Housing Initiatives Partnership(SHIP)Local Housing Assistance Plan(LHAP)for Fiscal Years
13/14-15/16,to add a tiered structure approach for the purchase assistance program including
increasing the maximum award to$50,000,and the addition of two new strategies to include Rental
Rehabilitation and Rental Acquisition;and reaffirm implementation as administrative and
ministerial. (Commissioner Henning's request)
Time Certain Requests:
Item IOC to be heard at 9:30 a.m.
Item 10D to be heard immediately following Item 10C
Item 10A to be heard at 9:45 a.m.
Item 12A to be heard immediately following Item 10A
Item 11C to be heard at 10:00 a.m.
Item 9C to be heard at 10:15 a.m.
Item 11E to be heard following Item 9C
Items 9A and 9B may be heard no sooner than 1:00 p.m.
Item 11A to be heard immediately following Item 9A
10B to be heard at 1:05 p.m.
12/8/2015 8:36 AM
12/8/2015 16.E.13.
EXECUTIVE SUMMARY
Recommendation to accept a report on the status of the North Collier Fire Control and
Rescue District's second submission of a Certificate of Public Convenience and Necessity for an
Advanced Life Support Class 3 Certificate and not to process the application.
OBJECTIVE: To report to the Board that the second Certificate of Public Convenience and
Necessity ( COPCN) Application for a Class 3 Certificate received from North Collier Fire
Control and Rescue District dated September 30, 2015 requested to be heard by the Board
would violate the Board's Reconsideration Ordinance and Policies.
CONSIDERATIONS: At the September 22, 2015 meeting the Board heard staff and applicant's
testimony and denied the March 5, 2015 COPCN application to North Collier Fire Control and Rescue
District.
On September 30, 2015 North Collier Fire Control and Rescue District submitted a second COPCN
application.
After thorough review of the two applications, it is staff's opinion, with comments noted below, that the
NCFCRD - COPCN application submitted to the County Manager on September 30, 2015 has no material
changes from the original application heard by the Board on September 22, 2015.
The following observations are noted:
1. The North Collier Fire Control and Rescue District ( NCFCRD) application(s) received on both
March 5, 2015 and September 30, 2015 clearly state the application is for "the provision of Class
3 Non — Transport Advanced Life Support (ALS) services within the District's boundary ".
The NCFCRD submission for a Class 3 Non - Transport ALS service on March 51' requests an
amendment to their existing COPCN to include the recently absorbed Big Corkscrew Fire
District. While the NCFCRD cover letter refers to an amendment to expand services for the
newly combined district, there is no modification/amendment process within our County
ordinance. Each COPCN is applied for on an annual basis. The Board approves the COPCN as a
defined service area. (See County Ordinance Medical Transportation Section 50 -59.)
The NCFCRD submission on September 30th for a Class 3 Non - Transport ALS service again
asks for the same classification including the expanded area of the now legislatively approved
merger of the Big Corkscrew Fire District. This application and service area was the same as the
March 5th application as previously referenced which was denied by the Board.
4. The September 30th application following the Board's denial, while providing extensive
academic research, expanded agency reference information, accomplishments, etc., is still a Class
3 application with the combined service district(s) as referenced above. Just as in the March
submission, all the Ordinance requirements were satisfied. It is staff's opinion that the volume of
supplemental information provided is immaterial to the application and reconsideration policies.
5. The September 30th application noted an increase in the number of vehicles (from 13 to 18) and
paramedics (from 10 to 18) to be certified should the Certificate be granted. It is my opinion that
the increase in paramedics and vehicles again was immaterial as we do not evaluate performance
measures or level of service when a COPCN is granted. The original application of March 5th
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had more than sufficient services of paramedics and vehicles.
6. North Collier Fire Control and Rescue District contends that its September 30th COPCN
application is different from the March 5th submittal because it endorses the sustainment of the
current Big Corkscrew Island (NCFCRD- successor) and Collier County EMS Advance Life
Support Partnership Agreement. It is staff s opinion that there is no material change in the
application due to a change in the District's opinion about a prior County agreement for existing
ALS services within the Big Corkscrew area.
FISCAL IMPACT: There is no fiscal impact to the Board for this associated action.
GROWTH MANAGEMENT IMPACT: There are no Growth Management impacts associated
with this action.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney. I concur with
staff that this second application seeks no material changes from the original application heard by the
Board on September 22, 2015. Accordingly, bringing this item forward at this point in time would
circumvent the Board's Reconsideration ordinance and policies. With that noted, this item is approved
for form and legality and requires a majority vote for Board action. -JAK
RECOMMENDATION: That the Board accept this report to note that the Board's Reconsideration
ordinance and policy (81 -54 as amended) prohibits the September 30'` North Collier Fire Control and
Rescue District Class 3 ALS Non - Transport COPCN application from being heard.
Prepared by: Dan E. Summers, CEM Director Bureau of Emergency
Services
Attachments: Memorandum to Jeff Klatzkow, County Attorney, from Dan Summers,
dated October 26, 2015
North Collier Fire Control COPCN Application, September 30, 2015.
(Due to the size of this document, a web link is provided for viewing at
littp: / /w ,,v-,v.col l i ereov. net /ftp /2015BCCMeetings /A gendaDecO8l 5 /Admi n Servi ces/NCFR
CDDenial.pdf A hard copy is also available at the County Manager's Office.)
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12/8/2015 16.E.13.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.E.16.E.13.
Item Summary: Recommendation to accept a report on the status of the North Collier
Fire Control and Rescue District's second submission of a Certificate of Public Convenience and
Necessity for an Advanced Life Support Class 3 Certificate and not to process the application.
Meeting Date: 12/8/2015
Prepared By
Name: HeinrichsbergKathy
Title: Executive Secretary, Bureau of Emergency Services
11/16/2015 10:46:13 AM
Submitted by
Title: Executive Secretary, Bureau of Emergency Services
Name: HeinrichsbergKathy
11/16/2015 10:46:14 AM
Approved By
Name: SummersDan
Title: Division Director - Bureau of Emer Svc, Bureau of Emergency Services
Date: 11/16/2015 1:26:37 PM
Name: pochopinpat
Title: Operations Coordinator, Administrative Services Department
Date: 11/16/2015 2:14:57 PM
Name: KopkaWalter
Title: Chief - Emergency Medical Services, EMS Operations
Date: 11/16/2015 2:36:49 PM
Name: PriceLen
Title: Department Head - Administrative Svc, Administrative Services Department
Date: 11/16/2015 3:47:34 PM
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Name: KlatzkowJeff
Title: County Attorney,
Date: 11/16/2015 3:47:42 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 11/16/2015 4:04:51 PM
12/8/2015 16.E.13.
Name: WellsLaura
Title: Management/Budget Analyst, Senior, Office of Management & Budget
Date: 11/17/2015 3:20:20 PM
Name: OchsLeo
Title: County Manager, County Managers Office
Date: 11/19/2015 10:31:04 AM
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Administrative Services Department
Bureau of Emergency services Division
MEMORANDUM
TO: Jeff Klatzkow, County Attorney
FROM: Dan E. Summers, Director
DATE: October 26, 2015
RE: Supplement - Request for Legal Services - North Collier Fire Control and Rescue District
(NCFCRD) - Certificate of Public Convenience and Necessity ( COPCN)
On or about October 11, 2015 we discussed by phone the RLS submitted on October 9, 2015 regarding a
request to clarify whether a new COPCN application warranted Board consideration in light of a vote by
the Board to deny the application.
You asked me to render an opinion to you as to whether the recently received application had any
substantial or material changes that would reasonably warrant the Board's hearing the COPCN item as a
new item.
After thorough review of the two applications, it is my opinion, with comments noted below, that the
NCFCRD - COPCN application submitted to the County Manager on September 30, 2015 has no material
changes from the original application heard by the Board on September 22, 2015. 1 offer the following
observations as justification.
1. The North Collier Fire Control and Rescue District (NCFCRD) application(s) received on both March
5, 2015 and September 30, 2015 clearly state the application is for "the provision of Class 3 Non —
Transport Advanced Life Support (ALS) services within the District's boundary".
2. The NCFCRD submission for a Class 3 Non - Transport ALS service on March 5`h requests an
amendment to their existing COPCN to include the recently absorbed Big Corkscrew Fire District.
(See Merger document submitted with the RLS referenced above.) While the NCFCRD cover letter
refers to an amendment to expand services for the newly combined district, there is no
modification /amendment process within our County ordinance. Each COPCN is applied for on an
annual basis. The Board approves the COPCN as a defined service area. (See County Ordinance
Medical Transportation Section 50 -59.)
� 1{
Bureau o, Emergency Services Division . 8075 Lely Cultural Parkway • Naples, Florida 34113.239- 252 -3600 - FAX 239 - 252 -3700 • www.collierem.org
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3. The NCFCRD submission on September 301h for a Class 3 Non - Transport ALS service again asks for
the same classification including the expanded area of the now legislatively approved merger of
the Big Corkscrew Fire District. This application and service area was the same as the March 5th
application as previously referenced which was denied by the Board.
a. The September 30th application following the Board's denial, while providing extensive
academic research, agency reference information, accomplishments, etc., is still a Class 3
application with the combined service district(s) as referenced above. Just as in the
March submission, all the Ordinance requirements were satisfied. It is my opinion that
the volume of supplemental information provided is immaterial to the application and
reconsideration.
The September 30th application included an increase in the number of vehicles (from 13
to 18) and paramedics (from 10 to 18) to be certified should the Certificate be granted. It
is my opinion that the increase in paramedics and vehicles again was immaterial. The
application of March 5th had more than sufficient services of paramedics and vehicles.
4. North Collier Fire Control and Rescue District contends that it's September 30th COPCN application
is different from the March 5th submittal because it endorses the sustainment of the current Big
Corkscrew Island (NCFCRD- successor) and Collier County EMS Advance Life Support Partnership
Agreement. It is my opinion that there is no material change in the application due to a change
in the District's opinion about a prior County agreement for existing ALS services.
If you have any questions or concerns, please don't hesitate to call.
Thank you.
Attachments: Collier County Ordinance — Medical Transportation excerpt
Florida 64 -J ALS Non - transport highlighted
CC: Leo Ochs, County Manager
Len Price, Administrator - Administrative Services Department
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Collier County Medical Transportation from Municode
• Sec. 50 -59. - Rights and duties granted by certificate.
(a)
(b)
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the certtficateanied by,ii%e Board shall be aIid,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
roust be applied for. Changes in the officers of the corporation will not require a new certificate.
Acceptance of the certificate by the applicant shall obligate the applicant to:
(1)
$eiyice, the @ultra zone granted; to the.applicanis.
(2 )
(3)
(4)
(5)
Provide coverage to adjoining zones, if available, when requested to do so by emergency dispatch for emergency calls when the certificate
holder for that zone is unable to respond.
Keep posted at his place of business a copy of the fee schedule, which must be filed with the Administrator (if applicable).
Operate in accordance with the rules and regulations adopted pursuant to this Ordinance and any applicable County Ordinances, and F.S. ch.
401, and any administrative regulations adopted pursuant thereto.
Employ at all times sufficient personnel experienced in operation and management of emergency medical services to ensure proper and
efficient operation.
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Florida (Excerpt)
64J -1.003 Advanced Life Support Service License — Ground.
(1) To obtain a license or renewal each applicant for an ALS license shall submit to the department DH Form
631, 04/09, Ground Ambulance Service Provider License Application, which is incorporated by reference and
available from the department, as defined by subsection 64J- 1.001(9), F.A.C., or at http: / /www.fl- ems.com.
(2) Each ALS provider shall ensure and document in its employee records that each of its EMTs or paramedics
hold a current certification from the department.
(3) Each ALS provider shall ensure that a current copy of all standing orders authorized by the medical director
shall be available in each of the provider's vehicles; for review by the department; to each of the provider's
paramedics; and supplied to each physician designated by the medical director to receive a copy.
(4) Each ALS permitted vehicle when available for call, shall be equipped and maintained as approved by the
medical director of the service in the vehicle minimum equipment list. The vehicle minimum equipment list shall
include, at a minimum, one each of the items listed in Tables I and II, and shall be provided to the department upon
request, except those exempted in paragraph 64J- 1.006(1)(a), F.A.C. Substitutions are allowed with signed approval
from the medical director and written notification to the department.
(5) The medical director may authorize an EMT instead of the paramedic or licensed physician to attend a BLS
patient on an ALS permitted ambulance under the following conditions:
(a) The medical director determines what type of BLS patient may be attended by an EMT and develops standing
orders for use by the EMT when attending the type of BLS patients identified. The onscene paramedic shall conduct
the primary patient assessment to determine if the patient's condition meets the criteria in the standing orders for
BLS care. This survey shall be documented on the patient care record and shall identify the paramedic who
conducted the survey.
(b) The patient care record for any patient care or transport shall clearly state whenever an EMT attends the
patient.
(c) The provider shall maintain and have accessible for review by the department documentation of compliance
with the above requirements.
(6) ALS Nontransport:
(a) Unless otherwise specifically exempted, each advanced life support nontransport vehicle, when personnel
are providing advanced life support treatment or care, must be staffed with a certified paramedic or licensed
physician.
(b) A permitted advanced life support nontransport vehicle may operate as a basic life support emergency
vehicle when the vehicle is not staffed by a certified paramedic or licensed physician and only in lieu of placing the
unit completely out of service. When such advanced life support nontransport vehicle is operating under this section,
the vehicle must be staffed with at least one person who must be an emergency medical technician, and shall carry
portable oxygen, airway adjuncts, supplies and equipment as determined by the medical director of the licensed
service.
1. Each service provider having permitted vehicles operating pursuant to this section shall log changes in vehicle
status.
2. Vehicles operating pursuant to this section shall not display markings indicating advanced life support (other
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than permit sticker) when responding as basic life support emergency vehicle.
(c) Unless otherwise specifically exempted, the following advanced life support non - transport vehicles when
personnel are providing emergency treatment or care, must be staffed, at a minimum, with a certified paramedic or
licensed physician:
1. Advanced life support vehicles that respond to requests to provide emergency treatment or care during
special events or activities or in locations where access by permitted transport vehicles is restricted or limited.
2. Advanced life support vehicles that respond to requests to provide emergency treatment or care in vehicles
that cannot accommodate two persons, due to design and construction of the vehicle.
3. Advanced life support vehicles under 13,000 pounds gross vehicle weight that respond to requests to provide
emergency treatment or care and are met at the scene by other concurrently responding permitted vehicles.
Examples include vehicles that respond to requests to provide emergency treatment or care within a gated or
restricted community that is established pursuant to Chapter 190, F.S.; vehicles that respond to requests to provide
emergency treatment or care which are owned or operated by counties or municipalities established pursuant to
Chapter 125 or 166, F.S.; or vehicles that respond to requests to provide emergency treatment and care which are
owned or operated by advanced life support services licensees. Vehicles staffed pursuant to this section shall operate
in accordance with a certificate of public convenience and necessity.
4. Advanced life support non - transport vehicle over 13,000 pounds gross vehicle weight that respond to
requests to provide emergency treatment or care. Vehicles staffed pursuant to this section shall operate in
accordance with a certificate of public convenience and necessity.
(d) Vehicles staffed pursuant to paragraph 641- 1.003(6)(c), F.A.C., may respond to requests for medical
assistance in accordance with Section 252.40, F.S.
(e) Nothing herein shall prohibit an on duty certified EMT or paramedic who arrives on scene from initiating
emergency care and treatment at the level of their certification prior to the arrival of other responding vehicles.
(7) Advanced life support non - transport vehicles, staffed pursuant to paragraph 64J- 1.003(6)(c), F.A.C., are not
required to carry the equipment and supplies identified in Table I or II. Such vehicles when personnel are providing
advanced life support treatment or care, or when responding to calls in an ALS capacity shall at a minimum carry
portable oxygen, defibrillation equipment, airway management supplies and equipment, and medications and fluids
authorized by the medical director of the licensed service.
>end<
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