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Agenda 05/24/2011 Item #16F2Agenda Changes Board of County Commissioners Meeting May 24, 2011 Continue Item 16D9 to the June 14, 2011 BCC Meetin • To approve and authorize the Chairman to sign an amendment to the Collier County Hunger and Homeless Coalition (HHC) Subrecipient Agreement for the U.S. Department of Housing and Urban Development (HUD) Homeless Prevention and Rapid Re- Housing (HPRP) Grant approved by the Board on September 15, 2009, Item 161319. This amendment will allow for a revision of Exhibit A of the Subrecipient Agreement to accommodate the HHC request to no longer include Homeless Management Information System (HMIS) activities and to allow HHC to more fully expend grant funds. (Staffs request to modify back -up documents to satisfy County Attorney's requirements) Move Item 16E3 to Item IOD: Recommendation to approve the First Amendment to Lease Agreement, aka the cattle lease, for the Pepper Ranch Preserve under the Conservation Collier Land Acquisition Program and direct the County Manager, or his designee, to implement the Lease Amendment terms. (Commissioner Coletta and Commissioner Hiller's separate request) Move Item 16E4 to Item IOE: Recommendation to approve an Access Easement to the Florida Department of Environmental Protection (FDEP) and a Declaration of Restrictive Covenant which will allow FDEP to monitor the cattle vat clean -up site at Pepper Ranch Preserve and restrict public uses within the cattle vat clean -up site. (Commissioner Coletta and Commissioner Hiller's separate request) Move Item 16E5 to Item 1OF: Recommendation to authorize the release of $250,000 held in escrow to Lake Trafford Ranch, LLLP, the Seller of Pepper Ranch Preserve, and approve the associated Budget Amendment. (Commissioner Coletta and Commissioner Hiller's separate request) Move Item 16F2 to Item 10G: Authorize the County Attorney to advertise an ordinance for future consideration which would amend Ordinance No. 04 -12, as amended, adding provisions relating to requirements for certificate holders operating non - transport Advanced Life Support (ALS) services. (Commissioner Hiller and Commissioner Henning's separate request) Move Item 16C6 to Item IOH: Recommendation to award Contract #11 -5673, "Disaster Debris Removal and Disposal Services," to three firms, and approve AshBritt Environmental Services, Inc., as the initial debris removal contractor in operational readiness for the 2011 Hurricane Season. The firms provide post - disaster equipment and human resources for the collection, removal and disposal of disaster generated debris, which will ensure prompt, timely and efficient restoration of essential services. (Commissioner Hiller's request) Note: Proclamations 4A and 4B to be presented at end of proclamations due to awardees not available at beginning of proclamations being presented. Correction to Bid Number for Item 16C2: Award bid #11 5657 Award bid #11 -5647, Grease Hauling Services, to Rockfill Associates, Inc. D/B /A Crews Environmental and authorize the Chairman to sign the agreement following County Attorney approval, in the estimated annual amount of $50,000. (Staff's request to clarify language) 5/26/20112:38 PM 5/24/2011 Item 16.F.2. EXECUTIVE SUMMARY Authorize the County Attorney to advertise an ordinance for future consideration which would amend Ordinance No. 04 -12, as amended, adding provisions relating to requirements for certificate holders operating non - transport Advanced Life Support (ALS) services. OBJECTIVE: To obtain the Board of County Commissioners (Board) approval to amend Ordinance No. 04 -12, as amended, in order to provide for those non - transport ALS responders holding a Certificate of Public Convenience issued by the County. CONSIDERATIONS: On February 24, 2004, the Board adopted Ordinance No. 04 -12 to regulate the issuance of Certificates of Public Convenience and Necessity ( COPCN). The COPCN Ordinance established two classes of Certificates: (1) Collier County EMS (ALS transport and non - transport) and (2) Collier County Hospitals (ALS interfacility transport). On January 25, 2011, Agenda Item IOG, the Board granted a COPCN to North Naples Fire and Rescue District to provide non - transport ALS response within its district. This action precipitated the need to amend Ordinance No. 04 -12 to contemplate non - transport ALS providers. Most notable amendments to this Ordinance include: 1. Establishes classifications for the various levels of COPCN permit holders. a. Class 1 – ALS Transport (countywide) b. Class 2 – Collier County Hospitals (hlterfacility transport only) c. Class 3 – Non - transport ALS responder 2. Requires that Class 3 Certificate holders enter into a contract with the County for the performances of services as set forth in Section 401.265, Florida Statutes. Class 2 Certificate holders already have this requirement. 3. Establishes rules as to transfer of care from Class 3 to Class 1, specifically should ALS services be provided by non - transport ALS providers, the ALS non - transport provider will accompany the patient on the ALS transport from scene to hospital. 4. Provides that every call for service shall be answered promptly and that the first responder arriving on scene shall assess patient condition and communicate directly with the following response unit. The amendments to this Ordinance were approved by the Policy Advisory Board on April 15, 2011. FISCAL IMPACT: The cost of advertising the amending ordinance is estimated at $400. GROWTH MANAGEMENT IMPACT: None. LEGAL CONSIDERATIONS: This item has been reviewed and approved by the County Attorney's Office and is legally sufficient. This item requires a majority vote. —JBW. Packet Page -1850- 5/24/2011 Item 16.F.2. RECOMMENDATION: That the Board of County Commissioners authorizes the County Attorney to advertise an ordinance for future consideration which would amend Ordinance No. 04 -12, as amended. PREPARED BY: Artie R. Bay, Administrative Supervisor, Emergency Medical Services Packet Page -1851- COLLIER COUNTY Board of County Commissioners Item Number: 16.F.2. 5/24/2011 Item 16.F.2. Item Summary: Authorize the County Attorney to advertise an ordinance for future consideration which would amend Ordinance No. 04 -12, as amended, which amends definitions, exemptions and exclusions from certificate requirement, procedure for obtaining certificate, requirement for Board approval in granting certificate, rights and duties granted by certificate, emergency provisions, classifications of certificates, general operating regulations, conduct of drivers and attendants, passengers, and obedience to traffic laws, ordinances or regulations. Meeting Date: 5/24/2011 Prepared By Name: BayArtie Title: Supervisor - Accounting,EMS Operations 5/3/2011 10:23:58 AM Approved By Name: PageJeff Title: Chief - Emergency Medical Services,EMS Operations Date: 5/9/2011 8:11:30 AM Name: SummersDan Title: Director - Bureau of Emergency Services, Date: 5/9/2011 9:49:50 AM Name: WhiteJennifer Title: Assistant County Attorney,County Attorney Date: 5/12/2011 10:40:28 AM Name: KlatzkowJeff Title: County Attorney, Date: 5/12/20113:43:04 PM Packet Page -1852- 5/24/2011 Item 161.2. Name: PryorCheryl Title: Management/ Budget Analyst, Senior,Office of Management & Budget Date: 5/16/2011 8:24:28 AM Name: IsacksonMark Title: Director -Corp Financial and Mgmt Svs,CMO Date: 5/17/20116:14:01 PM Packet Page -1853- 5/24/2011 Item 16.17.2. ORDINANCE NO. 2011- AN ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AMENDING ORDINANCE 04 -12, AS AMENDED, BY AMENDING, SECTION TWO, DEFINITIONS; SECTION FOUR, EXEMPTIONS AND EXCLUSIONS FROM CERTIFICATE REQUIREMENT; SECTION FIVE, PROCEDURE FOR OBTAINING CERTIFICATE; SECTION SEVEN, REQUIREMENT FOR BOARD APPROVAL IN-;; GRANTING CERTIFICATE; SECTION NINE, RIGHTS AND DUTIES GRANTED BY CERTIFICATE; SECTION ELEVEN, EMERGENCY PROVISIONS; SECTION TWELVE, CLASSIFICATIONS OF CERTIFICATES; SECTION FIFTEEN, GENERAL ;, OPERATING REGULATIONS; SECTION TWENTY, CONDUCT OF 'DRIVERS AND ATTENDANTS; SECTION TWENTY -ONE: PASSENGERS; SECTION TWENTY -TWO, OBEDIENCE TO TRAFFIC ' LAWS, ORDINANCES AND REGULATIONS ;` PROVIDING FOR CONFLICT AND SEVERABILITY; PROVIDING FOR INCLUSION IN THE CODE OF LAWS AND ORDINANCES; AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, Collier County desires to make available to its citizens safe, professional emergency health care transportation and non - transportation services for emergency pre - hospital responses and the transfer of patients between and among local hospital facilities; and WHEREAS, Collier. County desires to facilitate the provision of such services and has the necessary equipment, training, expertise, professional certifications and licenses to do so; and WHEREAS, this amendment °creates a Class 3 Non - Transport ALS certificate classification that will result in a benefit to Collier County by reducing response times for certain transports and providing for the availability of more transport vehicles. NOW THEREFORE: BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA: SECTION ONE: Amendments to Section Two of Ordinance No. 04 -12, as amended. Section Two of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION TWO: DEFINITIONS. Words underlined added and words strask thfeugh are deleted. Packet Page -1854- 5/24/2011 Item 16.F.2. A. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida Administrative Code, Seetien 64E and the Collier County Medical Director's roy tocol. B. Administrator shall mean the County Manager or his designee. C. Ambulance means any privately or publicly owned land, air, or water vehicle that is designed, constructed, reconstructed, maintained, equipped or operated, and is used for or intended to be used for air, land, or water transportation of persons, who are sick, injured, or otherwise helpless. D. Board shall mean the Collier County Board of County Commissioners. E. Certificate means a certificate of up blic convenience and necessity as authorized in Section 401.25 (2)(d), Florida Statutes. F. Emergency Call shall mean the transit of an ambulance under conditions which warrants travel with flashing lights and siren operating. G. Operator shall mean any, person, organization or governmental entity providing ambulance or ALS services. H. Patient shall mean an individual who is ill, sick, injured, wounded, or otherwise incapacitated or helpless. I. Routine Call or Routine Transfer shall mean the transportation of a patient under non - emergency call= conditions. J. Rescue Service (Non -ALS) shall mean first response treatment of patients but does not include Advanced Life Support (ALS) or transport. SECTION TWO: Amendments to Section Four of Ordinance No. 04 -12, as amended. Section Four of Ordinance No. 04 -12, as amended, is hereby amended as follows: Words underlined added and words stpde� gh are deleted. Packet Page -1855- 5/24/2011 Item 161.2. SECTION FOUR: EXEMPTIONS AND EXCLUSIONS FROM CERTICATE REQUIREMENT. Certificates shall not be required for: A. Rescue Services (Non -ALS). B. The use of a non - ambulance for any transport of a patient pursuant to the Good Samaritan Act, Section 768.13, Florida Statutes. C. Vehicles rendering ambulance -type services when requested to do so by the Board of County Commissioners or County Manager in the` event of a major, catastrophe or other such emergency which requires more ambulances thant are available in the county. D. Ambulances based outside the county which pick up a patient in the county and transport him out of the county, or which pick up a patient out of the county and transport him into the county. E. Vehicles used to transport persons for routine scheduled medical treatments. Vehicles transporting persons who require services en route are not covered by this exemption. SECTION THREE: Amendments to Section Five of Ordinance No. 04 -12, as amended. Section Five of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION FIVE: PROCEDURE FOR OBTAINING CERTIFICATE. An applicant for a certificate shall obtain forms from the department from the County to be completed and returned to the Divisien Administrator. Each application shall contain: A. The name, age, and address of the owner of the ambulance or ALS provider, or if the owner is a corporation, then of the directors of the corporation and of all the stockholders holding more that 25% of the outstanding shares. For governmental units, this information shall be supplied for members of the governing body. Words underlined added and words str-uek thfaugh are deleted. Packet Page -1856- 5/24/2011 Item 165.2. SECTION FOUR: Amendments to Section Seven of Ordinance No. 04 -12, as amended. Section Seven of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION SEVEN: REQUIREMENT FOR BOARD APPROVAL IN GRANTING CERTIFICATE. The Board of County Commissioners shall not grant a certificate unless it shall find, after public hearing and based on competent evidence that each of the following standards has been satisfied: A. That there is a public necessity for the service. In making such determination, the Board of County Commission shall consider, as a minimum, the following factors: (1) The extent to which the proposed service is needed to improve the overall emergency medical services (EMS) capabilities of the County. (2) The effect of the proposed service on existing services with respect to quality of service and cost of service. SECTION FIVE: Amendments to Section Nine of Ordinance No. 04 -12, as amended. Section Nine of Ordinance No. 04 -12; as °amended, is hereby amended as follows: SECTION NINE: RIGHTS AND DUTIES GRANTED BY CERTIFICATE. The certificate granted by the Board shall be valid for one calendar year and shall be personal to the applicant and not transferable. In the case of a corporation, if there occurs such a transfer of stock or other incidents of ownership as to change the majority or largest stockholder, a new certificate must be applied for. Changes in the officers of the corporation will not require a new certificate. Acceptance of the certificate by the applicant shall obligate the applicant to: Words underlined added and words stfe,a= are deleted. Packet Page -1857- 5/24/2011 Item 165.2. A. Service the entire zone granted to the applicant. B. Provide coverage to adjoining zones, if available, when requested to do so by €mer-gene Geat+el emergency dispatch for emergency calls when the certificate holder for that zone is unable to respond. C. Keep posted at his place of business a copy of the fee schedule,_ which must be filed with the Administrator (If applicable).. D. Operate in accordance with the rules and regulations adopted pursuant to this Ordinance and any applicable County Ordinances, and Chapter 401 Florida Statutes, and any administrative regulations adopted pursuant thereto. E. Employ at all times sufficient personnel experienced in operation and management of emergency medical services to ensure proper and efficient operation. SECTION SIX: Amendments to Section Eleven of, Ordinance No. 04 -12, as amended. Section Eleven of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION ELEVEN: EMERGENCY PROVISIONS. . The Board may modify, suspend or revoke a certificate in the interest of the public health, safety and welfare, only at public hearing and after reasonable notice has been given to the certificate holder affected. However, if a situation exists which poses a serious threat that a}bulanEe— er�-eseue -sef-viee the Operator will not be available to any certain area of Collier County, the Administrator shall have such temporary emergency powers as are necessary to provide that service. These temporary powers are intended to provide interim protection until such time as the Board meets to resolve the emergency. SECTION SEVEN: Amendments to Section Twelve of Ordinance No. 04 -12, as amended. Section Twelve of Ordinance No. 04 -12, as amended, is hereby amended as follows: Words underlined added and words stfttelgk are deleted. Packet Page -1858- 5/24/2011 Item 161.2. SECTION TWELVE: CLASSIFICATIONS OF CERTIFICATES. There shall be three two (3) (2) classifications of service in Collier County, as follows: A. Class 1: ALS Transport: ALS Rescue: An EMS previde Operator with the capability of rendering on the scene prehospital ALS services with transport capability and who may or may not elect to transport patients based on medical necessity. An EMS provider rendering this level of service for a governmental entity shall be deemed to be operating under the Class 1 - ALS rescue certificate of public convenience and necessity held by the governmental entity. An EMS pr-evide Operator holding a Class 1 — ALS rescue certificate may provide' post- hospital interfacility medical transfer services and routine. ALS and BLS calls within the County. A Certificate Of Public Convenience and Necessity must be obtained from the County before engaging in this level of medical service. B. Class 2: Collier County Hospitals: 1. ALS Transfer: An EMS provider who renders ALS interfacility medical transfer services. An EMS provider who is awarded a Class 2 — ALS transfer certificate and does not possess a Class 1 — ALS rescue certificate shall not respond to an emergency call and provide ALS rescue services unless called upon by the appropriate Class 1 — ALS rescue provider to provide emergency backup service. these instances, it shall be deemed to be operating under the Class 1 — ALS rescue certificate of the governmental entity requesting such emergency backup service. Words underlined added and words .....aek th"-oug are deleted. Packet Page -1859- 5/24/2011 Item 161.2 . 2. Class 2 — ALS transfer certificate holders may provide post - hospital interfacility medical transfer services and routine ALS and BLS calls within the County but only to hospitals owned by the certificate holder, however, the Class 2 certificate holder may provide out -of- County transports. Unless an EMS provider possesses a Class 1 — ALS Rescue certificate issued by: the County, a Certificate Of Public Convenience and Necessity must be obtained from the County before engaging in this level of medical service. 3. Class -2 transfer certificate holders shall contract with the de r -1 r-eseue eei4 fi""`° holder's Meaiea Three.+ the County for the performance of services set forth in Florida Statutes, Section 401,265 and Chapter 64BJ- 2.004(4)(a), offer a type and level of arp ate to the patient's ,.,,ieal _dit day per- -week -- medical direeti9i3— 'whieh— shiner — include,, in addition to the Words underlined added and words s4uek thfaugk are deleted. Packet Page -1860- 5/24/2011 Item 161.2. eeftifieMe helder's per-sefine! as a the -e bile€ "e€f-linne," sen,iee —te -- - - - - - MT .� Words underlined added and words stf:uek thfough are deleted. Packet Page -1861- 5/24/2011 Item 16.F.2. C. Class 3: ALS Non-Transport: 1. ALS Non - Transport: An EMS operator who renders Advanced Life Support pre - hospital services without transport capability Words underlined added and words stne-k thfoug are deleted. Packet Page -1862- 5/24/2011 Item 161.2. 2 Class 3 certificate holders work in concert with applicable Class 1 providers to assure adequate and timely response to prehospital incidents with the intent to either reduce applicable response times or otherwise augment the level of services as requested by the associated Class 1 provider. Unless an EMS provider possesses a Class 1 — ALS Rescue certificate issued by the County, a Certificate of Public Convenience and 4. The medical direct cooperatively with the County's Office of the Medical Director to ensure continuity of care The Medical Director for the Class -3 certificate holder shall not delegate or relinquish any responsibilities identified in section 401.265 Florida Statutes, and associated Florida Administrative Code rules. SECTION EIGHT: Amendments to Section Fifteen of Ordinance No. 04 -12, as amended. Section Fifteen of Ordinance No. 04 -12, as amended, is hereby amended as follows: Words underlined added and words stme g are deleted. Packet Page -1863- 5/24/2011 Item 165.2. SECTION FIFTEEN: GENERAL OPERATING REGULATIONS. All certificate holders, operators, and drivers shall comply with all state statutes and administrative regulations as following regulations: A. Twenty -four Hour Service. Every certificate holder shall be required to operate sufficient ambulances, or relevant apparatus, as stated on the vehicle permit of and deteEmined by the Be permit issued by the Board, on immediate call at all times. B. Prompt Service Required. Every call for ambulanee service shall be answered promptly. C. 491 Patients shall be appropriately assessed treated packaged loaded and transported by an operator that is licensed to transport without being subject to unreasonable delays. All calls for emergency assistance "requiring over twenty (20) minutes from time of notification to arrival on scene shall be reported to the Administrator with complete documentation of the circumstances, which delayed the response. Those instances where more than three (3), minutes elapse between receipt of an emergency call and dispatch of an emergency vehicle,, amber; shall also be reported to the Administrator with documentation of circumstances. Bed Linens. Every` operator transporting patients shall provide clean Clean and sanitary bed linens shat be provided for each patient carried afid which shall be changed as soon as practicable after "the discharge of the patient. Daily Log. Every operator transporting patients shall maintain in a daily log upon which shall be recorded the place or origin, time of call, time of dispatch, time of arrival at scene, time left for hospital, time of arrival at hospital, and charges for each trip made and such other operating and patient information as may be required by Ordinance. Words underlined added and words str •• -'-��� non are deleted. Packet Page -1864- 5/24/2011 Item 161.2. Every operator shall retain and preserve all daily logs for at least two (2) years, and such logs shall be available for inspection by the Administrator. E. Communications. Each amb lase emergency vehicle shall maintain two -way radio communication with the location of primary dispatch from which it operates, as well as any additional communication capabilities required by Ordinance, or state law. F. Vehicles and Equipment. Each vehicle shall be equipped with the proper medical and emergency equipment as required by the medical director of each licensed provider and the laws of the State of Florida and shall be subjected to inspection from time to time to insure compliance with the laws of Florida and this Ordinance. G. Certification. In addition to the State of Florida _Department of Health, Bureau of Emergency Medical Services requirements for certification, each paramedic must be certified by the County Medical Director, or the individual Medical Director of the licensed agency. Each paramedic must work with a Collier County EMS ambulance for a sufficient .length of time for the ambulance service medical director to properly judge his capability. At minimum, the paramedic must work in that capacity not less than one full month's work shift annually or in the case of non - transport ALS providers, if ALS services are provided' prior to EMS transport arrival or if the patient's condition requires that additional level of expertise, the ALS_non- transport provider will accompany the Salaries of other than Collier County EMS paramedics will be paid by the agency seeking the Medical Director Certification. Words underlined added and words std are deleted. Packet Page -1865- 5/24/2011 Item 16.17.2. H. Application. Each ambulance or ALS service shall be subject to those rules and regulation as promulgated by Ordinances of the Board for the purpose of carrying out this ordinance. SECTION NINE: Amendments to Section Twenty of Ordinance No. 04 -12, as amended. Section Twenty of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION TWENTY: CONDUCT OF DRIVERS AND ATTENDANTS. All drivers, EMT's and paramedics shall comply with tfie laws of the State of Florida, in order to meet the requirements set out in this Ordinance and no driver, EMT or paramedic registered hereunder shall: I. Operate or ride in aii vehicle an.bula-F-i-ee without using seatbelts. (Personnel attending patients are exempt). SECTION TEN: Amendments to Section Twenty -One of Ordinance No. 04 -12, as amended. Section Twenty -One of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION TWENTY -ONE: PASSENGERS. No person shall be aboard ambulances when engaged in emergency or r-outine medieal l routine call except the following: A. Driver, attendants and fire or law enforcement personnel; B. Patients; C. pafafnedie in ehaf9in may t more than one Relatives or close friends of the patient when authorized by an EMS Battalion Chief or position of a higher rank These requests will only be granted under exceptional circumstances Words underlined added and words 4� are deleted. Packet Page -1866- 5/24/2011 Item 16.17.2. D. Physicians and nurses; E. Personnel in an observing capacity that are being trained for ambulance or ALS service. F. Operator's supervisory personnel. SECTION ELEVEN: Amendments to Section Twenty -Two of Ordinance No. 04 -12, as amended. Section Twenty -Two of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION TWENTY -TWO: OBEDIENCE TO TRAFFIC LAWS, ORDINANCES OR REGULATIONS.: A. Under the provisions of Florida State law, Tthe driver of an ambulance or ALS vehicle when responding to an emergency call or while transporting a patient may exercise the following privileges when such driver has reasonable grounds to believe that an emergency in fact exists requiring the exercise of such privileges: SECTION TWELVE: Conflict and Severability. In the event this Ordinance should ever conflict with any other Ordinance of Collier County or other, applicable law, the more'restrictive shall apply. If any phrase or portion of this Ordinance is held invalid or unconstitutional by any court of competent jurisdiction, such portion shall be deemed a separate, distinct, and independent provisions and such holding shall not affect the validity of the remaining portions. SECTION THIRTEEN: Inclusion in The Code of Laws And Ordinances. The provisions of this Ordinance shall be made a part of the Code of Laws and Ordinances of Collier County, Florida. The sections of the Ordinance may be renumbered or re- lettered and internal cross - references amended throughout to accomplish such, and the word "ordinance" may be changed to "section," "article," or any other appropriate word. Words underlined added and words st fu,.'�fough are deleted. Packet Page -1867- 5/24/2011 Item 16.F.2. SECTION FOURTEEN: Effective Date. This Ordinance shall be considered adopted upon the date written below and subject to filing with the Florida Department of State. PASSED AND DULY ADOPTED by a vote of majority of the Board of County Commissioners of Collier County, Florida, this day of , 2011. ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA By: By. Deputy Clerk FRED W. COYLE, CHAIRMAN , Approved as to form and legal sufficiency: Jennifer B. White Assistant County Attorney Words underlined added and words strae'. gh are deleted. Packet Page -1868- 5/24/2011 Item 16. F.2. . C I M Read more at napliesnews.corn Guest commentary: Emergency Medical Service and North Naples Fire District Achieves `Continuity of Care' James V. Talano, MID President, Collier County Medical Society Chairman, Emergency Medical Services Policy Advisory Board Saturday, May 7, 2011 There has been much debate and consternation over North Naples Fire District's Certificate of Public Convenience and Necessity ( COPCN). As such, the Board of County Commissioners (BOCC) passed the North Naples COPCN earlier this year. Since then, the EMS Policy Advisory Board has met several times to make recommendation to change and amend the original ordinance. In addition, the county manager agreed to accept the proposed language changes concerning the statute and would read the new language into the records. To formalize this change, the BOCC will meet this month to approve the new ordinance. The EMS Advisory Panel, consisting of the chief of the Bureau of Emergency Services, Jeff Page, Collier County Director of Medical Services Dr. Robert Tober, and the NNFD Deputy Chief Medical Service, Jorge Aguilera, agreed on many of the changes to include the definition of Advanced Life Support applicable to the Florida statutes and the Collier County Medical Director's protocol. Many of the changes were discussed and agreed upon by the Collier County EMS and the fire department. Also, the panel supported creation of a fire department medical director as part of the COPCN certificate who will work cooperatively with the county director of medical services to ensure continuity of care for all transported patients. To this end, it was agreed that if the Advanced Life Support (ALS) first responder fire department arrives first on the scene and initiates ALS on a patient, then this team would accompany the patient with the ambulance to the hospital. This was a major issue concerning continuity of care. However, if ALS is rendered by Collier County EMS paramedics, then the ALS first responder does not have to ride with the patient unless the EMS paramedics deems they need additional medical help. The Collier County Medical Society is confident this new protocol will provide adequate continuity of care for Collier County residents. For the first time in this debate between Collier County EMS and the fire department, we appear to have sound minds and facilitators leading the process. What is now needed is the continuing oversight by the Public Service Authority, as we now have all stakeholders coming to the table and using sound judgment to work out what is best for the citizens of Collier County. My congratulations to the Collier County EMS and the fire department for working together. Packet Page -1869- © 2011 Scripps Newspaper Group — Online 5/24/2011 Item 16.F.2. Packet Page -1870-