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Agenda 09/27/2011 Item #16K4 912712011 Item 16.K.4. r""\ EXECUTIVE SUMMARY Request for authorization to advertise and briag back for future consideration an alDendlD~nt to Ordinance No. 04-12,. asaJQen~ relating to ambulance and advQCed life support services, for thepllrpose of clarifying/updating certain provisions and adding a new classifteation of Certificate of Public Convenience aad Necessity (COPeN) that allows nOD- transport Advanced Life Support services. OBJECTIVE: To obtain the Board of County Commissioners (Board's) approval to advertise an ordinance for future consideration that amends Ordinance No. 04-12, as amended, in order to clarifY and update certain provisions and add a new classification of COPCNthat allows non- transport Advanced Life Support services. CONSm'RATlONS: As a prerequisite to state licensure for basic life support or advanced life support (ALS) service Section 401.25, Florida Statutes requires an applicant to show that it has obtained a COPCNfrom the county in which it will operate. On February 24, 2004, the Board adopted Ordinance No. 04-12, establishing a procedure to obtain a COPCN and regulating those entities issued a COPCN. Presently there are two COPCN classifications: (1) Collier County EMS (ALS transport and non-transport) and (2) Collier County Hospitals (Interfacility ALS transport). ~ On January 25, 2011, the Board issued North Naples Fire CQntrol and Rescue District (District) a COPCN so that it may provide ALS .non-transport within the District's service area. Revision is now necessary to include a Class. 3 COCPN that contemplates ALS non-transport and generally incorporates ALS non-transport into the Ordinance. Revisions to clarifY/update the Ordinance are also proposed. Proposed revisions include: ~ · Addition of a Class 3 Classification for ALS non'-transport. (Class 3 operators will have the option of contracting with the County. for use of its Medical Director or using its own medical director,) See Pages 7-8 of the proposed amendment. · If a Class 3 operator has entered into a contract with the County. for use of its Medical Director its paramedics are required to be certified by the County's Medical Director and comply with Medical Director's ride time requirement. Otherwise, its own medical director will perform the certification. and ride time is limited to when a Class) operator initiates ALS Services on the patient in order to ensure continuum of care. .. See Pages,. 9- 10 of the proposed amendment. · Joint agreement by the medical director of each operator and compliance with Florida law on the type of medical and emergency equipment on the vehicles. See Page 9 of the proposed amendment. · References to Chapter 401 ,Florida Statutes and Florida Administrative Code, where appropriate. · Revisions for clarification and internal consistency. 1 Packet Page -2477- 9/27/2011 Item 16.K.4. ---- The proposed amendment was approved by the Emergency Medical Services Policy Advisory Board on August 19, 2011. At that meeting the District had no objection. FISCAL IMP ACT: Advertising cost is estimated to be $400. GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated withthis Executive Summary. LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote. - JBW RECOMMENDATION: That the Board of County Commissioners authorizes the County Attorney's Office to advertise an ordinance for future consideration that amends Ordinance No. 04-12, as amended, for the purpose of clarifYing/updating certain provisions and adding a new classification of Certificate of Public Convenience and Necessity that allows non-transport Advanced Life Support services. Prepared by: Artie R. Bay, Administrative Supervisor, Emergency Medical Services Jennifer B. White, Assistant County Attorney Attachments: Proposed DRAFT Ordinance amending Ordinance No. 04-12, as amended Ordinance No. 04-12 Ordinance No. 05-16 ---- l1-EMS-002841l1 -., 2 Packet Page -2478- 9/27/2011 Item 16.K.4. ~ COLLIER COUNTY Board of County Commissioners Item Number: 16.K.4. Item Summary: Request for authorization to advertise and bring back for future consideration an amendment to Ordinance No. 04-12, as amended, relating to ambulance and advanced life support services, for the purpose of clarifying/updating certain provisions and adding a new classification of Certificate of Public Convenience and Necessity (COPCN) that allows non-transport Advanced Life Support services. Meeting Date: 9/27/2011 Prepared By Name: NeetVirginia Title: Legal Assistant/Paralegal,County Attorney 9/16/2011 10:32:52 AM ~ Submitted by Title: Assistant County Attorney,County Attorney Name: WhiteJennifer 9/16/2011 10:32:53 AM Approved By Name: KopkaWalter Date: 9/19/201111:17:11 AM Name: WhiteJennifer Title: Assistant County Attorney,County Attorney Date: 9/19/201111:35:44 AM Name: SummersDan Title: Director - Bureau of Emergency Services, Date: 9/19/2011 3:14:06 PM -., Name: K1atzkowJeff Title: County Attorney, Date: 9/19/20114:10:44 PM Packet Page -2479- ,-, ..-.. ..-.. Name: PryorCheryl Title: Management! Budget Analyst, Senior,Office of Management & Budget Date: 9/20/2011 9:21 :38 AM Name: OchsLeo Title: County Manager Date: 9/20/2011 9:33:52 AM Packet Page -2480- 9/27/2011 Item 16.K.4. 9/27/2011 Item 16.K.4. .~ 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 ANI)..,DUTIES GRANTED BY CERTIFICATE; SECTION ELE,~; EMERGENCY PROVISIONS; SECTION TWELVE, <2~'SSIFICATIONS OF CERTIFICATES; SECTION FIFTEEN "'.,ERAL OPERATING REGULATIONS; SECTION TWENTY~m;;' NUB T OF DRIVERS AND ATTENDANTS; SECTION )I\\V,ENTY -0 '''J~ ., .P ASSENGERS; SECTION TWENTY-TWO, OJ,ut))jiNCE TO T'. ',FIC LAWS, ......' ...,......,: ..,;:+:.~ ':f" ORDINANCES AND REGULA TIQ~S; PROVIDING F' ",~~(;ONFLICT AND SEVERABILITY; PROVID'ij[G" FOR "J.NCLUSIO.~~ THE CODE OF LAWS AND ORDINANCE$hANli~jROVIDING':--' AN EFFECTIVE DATE ~i;t:Ji",. . ";,n;H:/Jf;i!Ei" . P~"~~.::?H'::;i;~" ',:::: ;:.iHL ...~:;. "~~ut~;'~l~';:., ":;:ii1feb" WHEREAS, Collier County ~anC~!;~~:":2004-t2.;'f~::~ended, is codified as Article '~h;;';'~- ", :~:.;; ~:;"~;';-. .'. '-:;:;~;:~~i.; .....~.. ".:....~~,u~,,' .~~:~...~. III of Chapter 50 of the . ", J.-aws ana\i~dinan~~[~f:;~~llieF~ty, and originally enacted through its Predeces~~:t,~. 81 _7~1!:,!:Y:jjllii"-'"4~~~,- WHE~~, Colit~\~~ow:ttyjif~~!~~s to ~~ available to its c~tizens safe, professional '==~]~ililil;;;::t. ':'~~~;itimWW:'''''''::'~~ii;\;];,:;;,:>... ':',.:;:; emerg ealth ca'fe;~sporta~1.l and noii;;tfMsportation services for emergency pre-hospital '; '. ,. ...'~:;~fITi(;:;L;;'l~;t![~l,,":i:' responses-';~~ht?e transfer dt1~~ients"~:~en and among local hospital facilities; and "t~!m~;;~~ ': ~g'mh, ~t~:h\!r!~ WHERE1~I~'f~,Collier Co~;!':~', desires to facilitate the provision of such services and has the . ertise, professional certifications and licenses to do so; and ,.-.. '!;~endment 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: Words underlined added and words strite!. threaga are deleted. DQ".A 1 ,..;',") Packet Page -2481- ! I , I =~ I ,- --... 9/27/2011 Item 16.K.4. 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. Board shall mean the Collier Countt:~oard of.~punty Com""l~" ioners. ';':~:~:,mi:~, .~~~~:mnF~' . '. 1 Certificate means a _e,ate. of publi6il~"~hience and necess, as authorized in Section 40 1.25 (2)~q,1f~~1~~~ Statutes:~::.~i1ii;fi;:,. . ~~~jli~~. "';~:W~~~~:'h:.:. '~~~~i~}~t~&., Emergency Call shall m~llh.thetrah$itof an ~pylance under conditions which warrant~, ".,,~.:;, 'th tlashittgiJights an,~;~~:~APpe~g. ::,,,;. .'. -.+>, :::::n!~'[f"":"~~~:imt;.", ", all mean~iany perSo~:pr:ganizatiort;;6t governmental entity providing ambulait. . r ALS ilvices.::mr ~"i~~~~f.gh... ,'iii";;;:li;~~r;;"" ;:;['.i: f:l~d{; .,.... .,~lHl~all'ffit.. ij:ari'tnal~~~ wh~';is ill, sick, injured, wounded, or otherwise ")!-:'-'~..'C'" ......~s::".., ':,.",,;:.,.,.,". .,' incapael~p or n~!p'!~ss. ,. '''.: ~~lj~th"" '~~~~H~~iHfl' Routine Carti.. outi:ii~ltrransfer shall mean the transportation of a patient under ~-emergency: '..1 cond'i6pns. ~~~ '- F. -., G. A. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida Administrative Code, SeetioB 64E and the Collier County Medical Director's protocol. B. Administrator shall mean the County Manage,- .1;t " Ambulance means any privately or publ.igl!l~. is designed, constructed, reconstruct~d;jj~arn . used for or intended to be used fOr':jiu, land, or .,. who are sick, injured, or othe~~T-j~~lPless. c. land, air, or water vehicle that " equipped or operated, and is transportation of persons, D. E. J. 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: SECTION FOUR: EXEMPTIONS AND EXCLUSIONS FROM CERTIFICATE REQUIREMENT. ~ Certificates shall not be required for: Words underlined added and words stAJek threligfl are deleted. "P...... ') no. I') Packet Page -2482- 9/27/2011 Item 16.KA. ,,-... 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. transport him out of the county, or which"'~'~ ~. transport him into the county. " up a patient in the county and a patient out of the county and .' E. Vehicles used to transport persq~Fj~oi routine' . Vehicles transporting persons _w~~~t~quire services this exemption. "H!iU!::: '1~'~~I;~i":' . "::::~r:~ t. duled medical treatments. ute are not covered by ,,-... ,:i:f~~, "-~'"n,..,.''' .".~.,...,."" ... ':':.;;.~j:.:. .::i:~i:;~~;~:;'::' . ,- SECTION THREE: Amendmen~j!~f;~.ection Five;o~t~dfnance No. 04-12, amended. '~~~~tE~~Wi:~:.... ':!~~~i1~:. .Ulo....'. ...(:............ . '-'.:1......... Section Five of Ordinance No. 04-12, '~amena.e4" is hereb"y'iimended as follows: ~f~rifrL "~:~.fH;i8ig~~~.. (~~~~~trt~ SECTION FIVE: PRO .' .FOR OB~~~INq;l~~~t:I~IC~. ,~. , ~~?6:b~, :;':fi~f:::. ,;~Litt;!:~!f:~' "::;:~~i;~}~~~~~. An applican.'. .;,l;l certific~~:shall obtiij(f6ll-Rs fromfhj:'aepartment to be eompleted and returned to fue-~!rJ.sion ~vide the A:~rninistrator with the follo~in~ information in order fo.r, a re ue~~;for am~-- .. 'cate to b~t:considered. Each appheanen request shall c ",:~::f~. ~~; :~';~~}~~: .dress of'tlle owner of the ambulance or ALS provider " e 0 'f\. a corporation, then of the directors of the corporation oide ,iLolding more that 25% of the outstanding shares. For , this Information shall be supplied for members of the ***** 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. -., Words underlined added and words strusk t~ligh are deleted. DGft_ '2 ,..f' 1'" Packet Page -2483- 9/27/2011 Item 16.K.4. --. 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 mergeaey Med-ieal Serviees emer enc medical services (EMS) capabilities of the County. (2) The effect of the proposed se quality of service and cost of set -., SECTION FIVE: Amendments to Section N amended. ~';ligl~h ~__ .. Section Nine of Ordinance No. 04-1 ":.. ended, is he - -,amended as follows: ....i;;, ':::.~?;~~f~f~fr!>,>::::._ ~"G~~~~b;._ SECTION NINE: RIGHTS AND DUTrns.GRANtED BY CBI'l;[FICA TE. ..';'-' , '<:::;..'.:dd~))f.':i,"-'~~Ej The certifical~~". e Boatd;,i~J:u~JE~j:v~tijt~~J:_ o~ calendar year and shall be personal to the appIi"7"" . sferable~~;;~i~t case ofa~~orporation, if there occurs such a transfer of stock or oth "..9idents ownershitfij$,to change the majority or largest stockholder, a new certifi must be" , ~ges iftii~r, officers of the corporation will not require a new ce '"., "::;;:'!!!rm!i~m::::1!!t1h ,.the appli2~t shall obligate the applicant to: B. adjoining zones, if available. when requested to do so by emerlZency disoatch for emergency calls when the certificate e is unable to respond. "~{'iEP 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. .---- Words underlined added and words stnlek t1treugh are deleted. n___ A _.&',"'" Packet Page -2484- 9/27/2011 Item 16.K.4. ~ E. Employ at all times sufficient personnel experienced in operation and management of emergency medical services to ensure proper and efficient operation. :\~ .... ~;.. '~'. f..... 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. ., ..r::p.' .,. The Board may modify, suspend or revoke a ~,;:':' e in the interest of the public health, safety and welfare, only at public hearing and"..,..... nable notice has been given to the certificate holder affected. However, if a situa~iolijff~ls '. h poses a serious threat that amlnllBBee af r6Se\ie sendee the Operator will .,'A~ e' availablei;..:~~~y certain area of Collier County, the Administrator shall have such ary emergency'U ers as are necessary to provide that service. These temporary pow intended to provi erim protection until such time as the Board meets to resolve the erne . .y. . SECTION SEVEN: Amendments inance No. 04-12, as amended. ~ classific'a~~ps of service in Collier County, as follows: '~~~~(r~h :!ALS Tlhsport: S pro~;iict~f,i[Opel~tor with the capability of rendering on the . .~~!;. scene pre' . 't~ A . rvices with transport capability and who mayor may not <:;'i~1!jt;:, elect to trans.' ati. ed on medical necessi . An EMS proYider Operator "1i~g[lbmdering this" ,I of s'€~ce for a governmental entity shall be deemed to be b~~ting under . Class i - ALS rescue certificate of public convenience and neC'~~~jy' held b :....: governmental entity. An EMS I'f{)';ider Operator holding a Class':Eli~ij~L.' . ue certificate may provide post-hospital interfacility medical transfer s,._..~. d routine ALS and BLS calls within the County. A certificate of public c nience 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 I'ra',ider Operator who renders ALS interfacility medical transfer services. An EMS provider Operator 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 pfG';iaer Operator to provide Words underlined added and words !ltnlek tArey.ga are deleted. Da,.....( ".1"1 Packet Page -2485- 9/27/2011 Item 16.K.4. ~, emergency backup service. In 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. ~. ...- 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 0 . ned from the County before engaging in this level of medical service. r; ~: . > . "", ..... ..;.; ~i~t( ~-;;~~~~~~;. .. "':'-1.~.m...;':':"~;"", ':"':';::U',' , "!~~l~J;" eertifieate"~)4.er's"'p~~~el as tcFthe availability of "off line" serviee to resolve ~~1~ftk'problems, B)~~ eo~and previae seryioes in an emergeney as that term is "'~~~~:::rc' . .,..~~'"'... . I M~t:!t......~_..... "rH~~~:~~.; '~~n~~}: ;~~ 3. Class-2 transfer certificate holde eertifieate kohier' s Medieal Direeter $:1 set forth in Florida Statutes, S,~jQn 401.26$, Florida Administrative Code. :(':::'i,;,:." ntract with the Class 1 fesooe the performance of services Cha ter 64J-1.004 4 a "': ...... BMTs). -., . ';;m~~: ,:~Lj: , q1;lQ:lity asstiPiiftee progf8:ft1 that inoludes bllt is not limited to a prompt r~/iev; of patieRt eare reeords, direet oeservatien, and eomparison of performanee standards fer arugs, eqt:lipment, system flretocols and proeechlr-es. He shall be reSJ>oooible fur partie~atiRg iR quality asS\:H'8flee programs developea by the Class 2 uaflsfer eertifieate helEler. g. He shall en&\:1fe aHa eertify that seeurit)' preeeek:wes ef tile Class 2 uansfer eemfieate helaer for meaieations, fhlias afld eeatrellea sues1afJ.ees are in eempliaHee with eb.apters 401, 499 aHa 893, Florida 8tStfllle-s, aHa ehapter IOD 45 efthe Flerida .-\elministFative Code. .-.. Words underlined added and words stnlek threiigh are deleted. 'P~nA I'.. "t 1~ Packet Page -2486- 9/27/2011 Item 16.K.4. ~. .-.. h. He shall ereate, al:1tkarize afld ensure adhefeaee ta, demilee '.witteR apefating proeeEiares regarding all aspeets af the llaft6liBg of meeieetiaRs, fl1:1ids Me eaftt.felled substaBees BY tke EMS perseRftel BRei eemply ,,-vitA all pe~airemeBts af eBapters 101, 199 ana 893, FkJl'ida Staltltes. i. He shall Ratify the Planae Departmem af Health, (hereinafter tke "D~artmeftt") iB '.vritiRg WHen the lise ef telemetry is nat aeeessary. j. He shall Ratify the aepartmeRt in -;Jri.tiag af eaeh stlbstitl:1tioR of equipment or medieatieB. k. He sl:lall asS\:URe eireet responsibility for the use by 1m EMT of 1m a1:ltematie or semi aatomatie defiBrillator; the perfermanee af esaphageaJ i~eetian by 1m EMT; ~ 8ft r8utiBe iaterfa". tFftnsperts, the manitariBg ~d mamteBftDee afRoR me(:heetesI.V.s by an-ii-.-= He shall eBS1:lfe tBet the EMT IS tl'Biaee t8 perfeHB these preeeslifes;!lJlji\;;"-.blish -.witteR preteeels fer the perfsl'fftBftee af these proeesl:1res; antl~~Wiall".'idevRitteft e';iseaee te the ,';~~:~1 ~!:. . . ,'<1~.... . . . :,,' '. .-.. and receive all training ~~~~mi~~ .;~~~~~ .~~~~~~~~ '. "^-\\.~:~[lHnjJ~;~ '~:~ ;::'iJjb 1. A"" , on-. ort: Ali"EMS 0 erator who renders Advanced Life Siffipbrt ore-hospital1je~ices'~ut transport capability. '::~';:;~:;;~;. 'ifi.~~ ~~~l;tu;{~,:.; ~':2Um;h Class 3'Y~ificat~; holders work in concert with applicable Class 1 providers lfil~ure adecile and timely response to prehospitaI incidents with the intent to either redu~1ff,WJ'li~' resoonse times or otherwise augment the level of services as requested by thfNi~~d Class 1 Ooerator. Unless an EMS Operator possesses a Class 1 - ALS Rescue c~cate issued bv 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-3 certificate holders shall contract with the County for a negotiated amount oer year for administrative services offered by the Office of the Medical Director for the creation and update of medical protocol: and other general support as requested by the Class-3 certificate holder. The Office of the Medical Director shall not be considered the medical director for a Class-3 Ooerator for om:poses of this Ordinance or Florida Statutes unless the Class-3 Ooerator separately contracts with the County in order for the Words underlined added and words stnlel( th:el:lgB are deleted. Dft.....a. ~ _~,"" Packet Page -2487- 9/27/2011 Item 16.K.4. . ;-..., County's Medical Director to serve as its medical director for the performance of services set forth in Section 401.265. Florida Statutes. and Chapter 64J.2.004(4)(a). Florida Administrati ve Code. 4. The medical director for the Class.3 certificate holder shall work 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 deleeate or relinquish any responsibilities identified in Section 401.265. Florida Statutes. and associated Florida Administrative Code rules. SECTION EIGHT: Amendments to Section Fifteen 0(" ance No. 04.12, as amended. ., ,.-.. Section Fifteen of Ordinance No. 04-12, as amendeci, ":~~:: 'o=pded as follows: '~;Ut~:~: SECTION FIFTEEN: GENERAL OPERA TINGH~ULA TIONS.', '", .;~-;;~:!i~i\r:' . .~';.. ";i'!WU:, ,m", .1'['''11'' .,,,-.,,.~. All certificate holders, operators, and -:r ,'" S shall mply witHj~;:': administrative regulations as followi~g regulations. '\,. . '1. A. Twenty-four Hour S ~yery certi r-e.a;~ holder shall be required to operate sufficient ambulances> releVant a ar' as stated on the eertifieate sf operation vehicle Dermif'"" ued;';H~:;A.the State~ ent of Heal Bureau of Emergenc:th.edical Servi~es"and dete,ged b);<;~;~elH'd permit issued by the Boar~~~l_~ call at ~lj~~m~~vIT#~P"~~~'" ~"". '~;:mm.r:=t:;:.:' , B. Ev~~W~all for ambulance service shall be answered roH:i~~ate1 assessed treated acka ed loaded and :: . t is li:eensed to trans ort without being subject to All ca l~jijf.~f;;, efuergency assistance requiring over twenty om , ,APf notification to arrival on scene shall be reported to the ":h4if4.~:;..Administrat8 'th comm~t.e documentation of the circumstances, which delayed '~il;~tm..~ response. =;,..",..~e ins~es where more than three (3) minutes elapse between r~i-.pt of an e~ency call and dispatch of an emergency vehicle ambulance shan~so be rep _""'0 to the Administrator with documentation of circumstances. .. :,:,:.~2~~~.. ~"':';h:m. , C. Bed Li~~~~!!~~Iy Operator transporting patients shall provide clean GleaH and sanitary bed;lffiiifiens shall be provided for each patient carried ami which shall be changed as soon as practicable afteI: the discharge of the patient. D. Daily Log. Every eQperator transportine oatients 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. Every eQperator shall retain and preserve all daily logs for at least two (2) years, and such logs shall be available for inspection by the Administrator. ,.-.. Words underlined added and words &truek tliray,gB are deleted. 1)n~a 0 ~~ 1 '"l Packet Page -2488- . ; ;, r. ~ ~. ~"" . .f> ~.-' .,..,.., ~. ~, ~. ~., ~ ~ 9/27/2011 Item 16.K.4. E. Communications. Each amblilaaee 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 Operator's vehicle~ shall be equipped with the proper medical and emergency equipment as r~quir-ed by the iointly agreed to by the medical director of each licensed provider and the laws of the State of Florida tRe laws ef Florida and tftls Ordhllmee. G. '~gri(~;~iii ). .t'l;~11~iffiD;!:, H. Ride Time";:.. uirement. Each aramedic em 10 ed b Collier Count EMS a Class-! Operator or a Class-2 Operator must work. at a minimum. with a Class-! Ooerator's ambulance not less than one full month's work shift annually. Each paramedic employed by a Class-3 Operator that has its ovm medical director must accompany a patient on the Collier County EMS ALS transport from scene to hospital when the paramedic for such Class-3 Operator initiates ALS services on a patient prior to Collier County EMS transport arrival or if the patient's condition requires that additional level of expertise. Each Daramedic employed by a Class-3 Operator that has separately entered into a contract with the County in order for the County's Medical Director to serve as its medical director for the performance Words underlined added and words strl:lsk threagh are deleted, n.......... n _~1~ Packet Page -2489- t ~-;-., r.: ~ t:<~;.. ;l". ~. ."'-... t.. ~, :.;' (.. y' ;.,. ", . -., --- 9/27/2011 Item 16.K.4. of services set forth in Section 401.265. Florida Statutes. and Chapter 64J- 2.004(4)(a). Florida Administrative Code. shall either work with a Collier County EMS ambulance not less than one full month's work shift annually or must accompanv a patient on the Collier County EMS ALS transport from scene to hospital when the paramedic for such Class-3 Operator initiates ALS services on a patient prior to a Collier County EMS transport arrival or if the patient's condition requires that additional level of exoertise. as provided for in its contract with the County. lhl... Application. Each ambulance or ALS service s}~tul be subject to those rules and regulation as promulgated by Ordinances of ' ...."ard for the purpose of carrying out this ordinance. SECTION NINE: Section Twenty of Ordinance No. 04-12, as SECTION TWENTY: CONDUCT OF DRlVERS All drivers, EMT's and par .,,,.,,,, ,":f;~~ll complY: ...:.:._ the laws of the State of Florida, in order to meet the requirements set 6lIbJIi'"'t1Us~;Ordinand~~~~::k no driver, EMT or paramedic . d h d h II '"-*'f':' "~'}:, ''':~ ,.. ":.~ reglstere ereun er sa: ':}~4~;;\'\nn~",:._' ,,"," ~::::}::~:~~SG~;. . :~t,:-! ~ ';~":':~:~~ ;~;-;';.:_, "::gil\ilil;0f[mi:m'!~' ..':lj~~\l~~1~ vehicle'~kulaflee without using seatbelts. (Personnel ~'ri:'i:i~:ll:~~ ,~Sectio~,j::j;Twenty-ODe of Ordinance No. 04-12, as .;,..A~~~;:, -ri,;j;.;;,;~m; ~"~:::t~ '~:~Hm::" .~~~;:. 1. ';~~~r~~c, Section Twenty~'~~:' No. 04-12, as amended, is hereby amended as follows: " No person shall be . ard ambulances when engaged in emergency or real-iRe medieal eall5-routine calls except the following: A. Driver, attendants and fire or law enforcement personnel; B. Patients; C. Not more than ORe relathe or elese fness of the patieRt, or if the sitl::latioIl '.'~ants, the paramedie is eharge may autherize more than ORe passeRger. Relatives or close friends of the patient when authorized bv an EMS Battalion Words underlined added and words stniel( thr9HgR are deleted. 0"''''6 1n ,...t'1"') Packet Page -2490- 9/27/2011 Item 16.K.4. .-. Chief or oosition of a higher rank. These. requests will only be granted under exceptional circumstances: ~;' .... ..~~ :.,,"';ti:o- '. D. Physicians and nurses; ~.-..'~ '. E. Personnel in an observing capacity that are being trained for ambulance or ALS service-;:-or . I ~.,!.'" F. Operator's supervisory personnel. A. of Ordinance No. 04-12, as ;;....~.. SECTION ELEVEN: Amendments to Section Twe ..;. .'." amended.'~e '. '" ; '.. ~..; ~ ...,,~~~::. Section Twenty-Two of Ordinance No. 04-12, asd~nci~d, is he ..-'" .. ,i~: . iF County 0'" ,iii"': applicable' l.;~:-;~~,:"~I Ordinance is ~~r~~yalid or un . ~1'~!:;..;:,;:..~. '~~t....~.:-..:. "";~;;'.,"~,~~~ ~ shall be deemed a se""""'o , SECTION TWENTY -TWO: OBEDIENC REGULA TIO TRAFFIC OR -- e driver of an lance or ALS r while transporting a patient may 'ver has reasonable grounds to exercise of such privileges: " , ; ~ , i." : :~ -~ : '.'r'.'. ,~.~erab~~~~. "'cd~;'m::' '~m~:~~_~ .. hould"'i', ,..~.onflict with any other Ordinance of Collier " ,,;:.:~r~;;. "~-:flH;1 the iH~~~~:Strictive shall apply. If any phrase or portion of this titutional by any court of competent jurisdiction, such portion and independent provisions and suc!: holding shall not affect the validity of the remaini' 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- ,.-.. Words underlined added and words struek tRr9\!gA are deleted. P"".. 1 1 "f' 1 ., Packet Page -2491- 9/27/2011 Item 16.K.4. ,--- ) lettered and internal cross-references amended throughout to accomplish such. and the word .';. t. -'.. "ordinancen may be changed to "section," "article," or any other appropriate word. i ..... ~" ,'" 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. ATTEST: D~GHTE.BROCK,CLERK Comm;ssioners of Collier County, Florida, this -:";:~,,ifr . :~:}~n?' ~~;j~i~~i~~~; ',.. ~Q~ OF COUNT . .... ,MMISSIONERS ......~.......... '-r~.. J~..~.~. G, IER COUNTY FL' . A ., , ~;-~. ,2011. I, ""',,' PASSED AND DUL Y ADOPTED by a vote ....., . "~., By: , Deputy Clerk ~ Approved as to form and legal sufficiency';":' ~~;, "j" ,..-... Words underlined added and words s9'l:Iek threl:lga are deleted. D___ ,"" _&',.... Packet Page -2492- 9/27/2011 Item 16.K.4, .-. ,\2.3456> ~/ . 6~ l CAPR axJs .\. ORDINANCE NO. 2005 . ~ ~ ~CPlilIJ[r" ',,\ AN ORDINANCE AMENDING ORDINANCE 04-12 BY \ CIAJ reI AMENDING SECTION FOUR ENTITLED: EXEMPTIONS AND ~ EXCLUSIONS FROM CERTIFICATE REQUIREMENT, ~~..zo'tE,' "k "I bl " . " (' I" I . WHEREAS. Collier County deSires to ma e avUl a e to Its cItizens sa e, pro esslona emergency health care trunsportation services lor the transfer of patients between and amung 10l.:al hospitul ["adlities; 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 WH EREAS, the amendment to Ordinance Number 04-12 results in a benefit to Collier County by reducing response times tor certain transports and providing for the availability of mure transport vehicles, --I... ,......) NOW THEREFORE: BE IT ORDAINED BY THE BOARD ~('CotlNTY r-:" c;.rI COMMISSIONERS OF COLLIER COUNTY, FLORIDA: ;'::.~ :x ." ~i:: ~ c- ~:;i ...;, ! Section 1: Purpose (;"'1;; - !'n ""'1-.'1 :J: This ordinance is adopted pursuant to Chapters 125 and 40 I, Florida ~telf.? T~ ~:l> c..n 0'-' purpose of this ordinance is to provide better protection for the health, safety and ~mar~)r the residents of Collier County, in ambulance and ALS matters, by establishing unifonn county-wide ..-.. standards for certification of ambulance or advanced life support or services, or operations by promulgating complete and clear rules and regulations for operation of all ambulance or rescue companies or services in Collier County. Section 2: Definitions A. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida Administrative Code, Section 64E. 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 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. Packet Page -2493- 9/27/2011 Item 16.K.4, ~ 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. .I. Rescue Scrvice shall mean first response trcatmcnt of patients but does not include Advanced Li fe Support (A LS) or transport. Section 3: Requirements For Certificate It shall bc unlawful for any person. firm. agency. or any other entity, including governmental units, to provide an ambulance service or provide advanced life support without first obtaining a certificate therefore from the Board of County Commissioners of Collier County. Section 4: Exemptions and Exclusions From Certificate Requirement Certificates shall not be required for: ..-.. A. Rescue Services, B. The use of a non-ambulance for any transport of a patient pursuant to the Good Samaritan Act, Section 768,13, Florida Statues. 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 that 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 ef 'J/he Rllillt Be sames eft Ii stFeteRer. I are not covered by this exemption. Section 5: Procedure For Obtaining Certificate An applicant for a certificate shall obtain forms from the department to be completed and ..-... returned to the Division 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 Words underlin, Packet Page -2494- lk t1trel:lgh are deleted. 2 9/27/2011 Item 16,K.4. B. For governmental units, this . that 25% of the outstanding shares, holdmg more . . hall be supplied for members of the governing body. mformalJon s The boundaries of the territory desired to be served. h h. 'Ies the applicant will .' .' f the ambulances or ot er ve IC The number and bnel descnptlon 0 ~ c. E. have available, The address of the intended headquarters and any sub-stations. The training and experience of the applicant, h d addresses of three (3) Collier County residents who will act as references T e names an 0, F. H, for the applicant. A schedule of rates which the service intends to charge, Such other pertinent information as the administrator may require. An application or renewal fee of two hundred fifty dollars ($250,00). (Exception Collier G. I. County EMS,) j, Financial data including assets and liabilities of the operator, A schedule of all debts encumbering any equipment shall be included, ..-... Section 6: Review of Application The Administrator shall review each application and shall investigate the applicant's reputation, competence, financial responsibility, and any other relevant factors, The Administrator shall also make an investigation as to the public necessity for an ambulance or ALS operation in the territory requested, and shall then make a report to the Board containing his recommendation whether to grant a certificate to the applicant within sixty (60) days of the time the Administrator determines the application is complete, Section 7: 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 satis fi ed: 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. Words under! Packet Page -2495- llel( threagft are deleted, 3 9/27/2011 Item 16,K.4. ~ (3) The effect of the proposed service on the overall cost of EMS service in the -. County, (4) The effect of thc 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 sutlicient knowledge and experience to properly operate the proposed service. (', 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, Section 8: Appointment of Hearing Officer 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. Seetion 9: 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 ofthe certificate by the applicant shall obligate the applicant to: A. Service the entire zone granted to the applicant. B. Provide coverage to adjoining zones, when requested to do so by Emergency Control 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). Words underlin Packet Page -2496- el( tftral:lgR are deleted. 4 ~ 9/27/2011 Item 16.K.4, .-. D. Operate in accordance with the rules and regulations adopted pursuant to this Ordinance and any applicable County Ordinances, and Chapter 40 I Florida Statutes, and any administrative regulatiolls adopted pursuant thereto. E, Employ at all times sufticienl personnel experienced in operation and management of emergency medical services to ensure proper and efficient operation. Section 10: Renewal of Certificate Each certificalC holder shall file within ninety (90) days of expiration, an application lor renewal of his certificate. Renewals shall be based upon the same standards, as the granting or the original certificate along with such other factors as may be relevant. The renewal application shall be accompanied by a two hundred and fifty dollar ($250.00) renewal fee. The renewal certificate may be approved routinely by the Board, upon advice of the ~ Administrator, or the Board may hold a hearing on same. Section 11: 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 ambulance or rescue service 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 12: Classifications of Certificates There shall be two (2) classifications of serviee in Collier County, as follows: A, Class I: Collier County EMS: ALS Rescue: An EMS provider with the capability of rendering on the scene prehospital ALS services and who mayor may not elect to transport patients, An EMS provider rendering this level of service for a governmental entity shall be. deemed to be operating under the Class I . ALS rescue certificate of public convenience and necessity held by the governmental entity. An EMS provider holding a Class I - 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. ~ Words underlinl Packet Page -2497-lk tftreugh are deleted. 5 ..-... ~ ..-... 9/27/2011 Item 16.K.4. B. Class 2: Collier County Hospitals: I. ALS Transfer: An EMS provider who renders ALS interfacility medical transfer services. An EMS provider who is awarded a Class 2 - ALS transfer certiticate and does not possess a Class I -- ALS rescue certificate shall not respond to an emergency call and provide ALS rescue services unless called upon by the appropriate Class I - ALS rescue provider to provide emergency backup service. In these instances, it shall be deemed to be operating under the Class I .- ALS rescue certificate of the governmental entity requesting such emergency backup service. 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 o\lt-of-County transports, Unless an EMS provider possesses a Class I - ALS Rescue certificate issued by the County, a Certifieate Of Public Convenience and Necessity must be obtained from the County betore engaging in this level of medical service, 3. Class-2 transler certificate holders shall contract with the Class-- I rescue certificate holder's Medical Director for the performance of services set forth in Florida Statutes. Section 401.265 and as specifically set forth herein as follows: a. He shall supervise and accept direct responsibility for the medical performance of the paramedics and Emergency Medical Technicians (hereinafter EMTs), b. He shall develop medically correct standing orders or protocols relating to life support system procedures when communication cannot be established with a supervising physician or when any delay in patient care would potentially threaten the life or health of the patient. c. He shall issue standing orders and protocols to ensure that the Class-2 transfer certificate holder transports each of its patients to facilities that offer a type and level ofcare appropriate to the patient's medical condition, d. He or his appointee shall provide continuous 24-hour-per-day, 7-day-per-week medical direction which shall include, in addition to the development of protocols and standing orders, direction to the Class-2 transfer Words underlin Packet Page -2498- ak tftfetlgh are deleted. 6 9/27/2011 Item 16,K.4. ~ certificate holder's personnel as to the availability of "off-line" service to resolve problems, system conflicts, and provide services in an emergency as that tenn is defined by section 252,34(3), Florida Statl/tes, e. He shall establish a quality assurance committee to provide lor quality assurance review of all EMTs and paramedics operating under his supervision, f. He shall audit the perfomlance of system personnel by use of a quality assurance program that includes but is not limited to a prompt review of patient care records, direct observation, and comparison of perfomlance standards for drugs, equipment, system protocols and procedures. He shall be responsible for participating in quality assurance programs developed by the Class-2 transfer certi ficate holder. g. He shall ensure and certify that security procedures of the Class-2 transfer certificate holder for medications, fluids and controlled substances are in compliance with chapters 401, 499 and 893, Florida Statutes, and chapter IOD-45 of the Florida Administrative Code. It, He shall create, authorize and ensure adherence to, detailed wriuen operating procedures regarding all aspects of the handling of medications, fluids and controlled substances by the EMS personnel and comply with all requirements of chapters 401,499 and 893, Florida Statutes. 1. He shall notify the Florida Department of Health, (hereinafter the "Department") in writing when the use of telemetry is not necessary. J' He shall notify the department in writing of each substitution of equipment or medication, k. He shall assume direct responsibility for the use by an EMT of an automatic or semi-automatic defibrillator; the perfonnance of esophageal intubation by an EMT; and on routine interfacility transports, the monitoring and maintenance of non-medicated I.V.s by an EMT. He shall ensure that the EMT is trained to perfonn these procedures; shall establish written protocols for the perfonnance of these procedures; and shall provide written evidence to the Florida Department of Health documenting compliance with the provisions of this paragraph, --- ..-... Words underlin Packet Page -2499- ak furellgh are deleted, 7 9/27/2011 Item 16.K,4, --- \. He shall ensure that all EMTs and paramedics are trained in the use of the trauma scorecard methodologies as provided in sections ME-2.o1 7 of the F,A,C., for adult trauma patients and 64E-2.0175, F,A.C., for pediatric trauma patients, ---. m, He shall participate as a crewmember on an EMS vehicle for a minimum of 10 hours per year and complete a minimum of 10 hours per year of continuing medical education related to pre-hospital care or tcaching or a combination of both. n. He shall ensure that all of the Class-2 transfer certificate holder's EMTs and paramedics have all proper certifications and receive all training necessary to maintain their certification. Seetion 13: Transfer Or Assignment of Certificates No certificate issued under this Ordinance shall be assignable or transferable by the person to whom issued except unless approval is obtained from the Board in the same manner and subject to the same application, investigation, fees and public hearing as original applications for certificates. Any majority transfer of shares or stock or interest of any person or operator so as to cause a change in the directors, officers, majority stockholders or managers of such person or operator shall be deemed a transfer or assignment as contemplated in this Ordinance and subject to the same rules and regulations as any other transfer or assignment. Section 14: Revocation, Alteration Or Suspension Grounds A, Every certificate issued under this Ordinance shall be subject to revocation, alteration and/or suspension of operation, by the Board, for a period of up to one year, ~here it shall appear that: I. The operator has failed or neglected for a period of thirty (30) days during any calendar year to render all services authorized by his certificate. 2. The operator has been convicted of a felony or any criminal offense involving moral turpitude. 3. The certificate was obtained by an application in which any material fact was omitted or falsely stated. 4. The operator has knowingly permitted any of its motor vehicles to be operated in violation the laws which result in conviction of the driver or operator of a ---. Words underlin Packet Page -2500- <lit thrsHgh are deleted, 8 --- B, ..-... 9/27/2011 Item 16.K.4. misdemeanor in the second degree or greater, or has knowingly permitted a driver with more than two previous convictions to operate emergency vehicles, The operator has failed to comply with any of the provisions of this Ordinance, The public interest will best be served by revocation, alteration, or suspension of any certificate upon good cause shown. The operator or his agent has demanded money or compensation other that that established and prescribed under this ordinance. (I f applicable). The operator has without sufficient justification failed or refused to furnish emergency care and/or transportation promptly tor a sick or injured person, The operator or his agent has been found guilty of malpractice or willful and wanton misconduct in the openltion of its service. All complaints shall be investigated and a report thereon made to the Board, together with findings and recommendations, within fi fleen (15) days. I frevocation, suspension or alteration of any certificate appears warranted, the Board shall give notice to the operator holding the certificate that the same will be considered at a specific commission meeting, provided the date of such meeting shall not be less than five (5) days from the date of the notice, The Board shall thereupon consider the complaint and either revoke, suspend or alter the certificate or dismiss the complaint. Section 15: General Operating Regulations 5, 6. 7. 8, 9, 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, as stated on the certificate of operation and determined by the Board, on immediate call at all times. B, Prompt Service Required, Every call for ambulance service shall be answered promptly. Patients shall be loaded and ttaDsported 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 that three (3) minutes elapse between receipt of an emergency call and dispatch of an ambulance shall also be reported to the Administrator with documentation of circumstances. .-. Words underlin Packet Page -2501- lIe tflr8tiga are deleted. 9 --- ~ ..-... 9/27/2011 Item 16,K.4. c. Bed Linens. Clean and sanitary bed linens shall be provided for each patient carried and shall be changed as soon as practicable after the discharge of the patient. Daily Log. Every operator shall maintain in a daily log upon whieh shall be recorded the place or origin, time of call, time of dispatch, time of arrival at scene, time left lor 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. 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. Communications, Each ambulance 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. Vehicles and Equipment. Each vehicle shall be equipped with the proper medical and emergency equipment as required by 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, Certitication, In addition to the State of Florida Department of Health, Bureau of Emergency Medical Services requirements for eertification, each paramedic must be certified by the County Medical Director. Each paramedic must work with a Collier County EMS ambulance for a sufficientlenglh 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. Salaries of other than Collier County EMS paramedics will be paid by the agency seeking the Medical Director Certification. 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, D. E. F. G, Section 16: Central Place of Business Each operator shall maintain a central place of business which shall be entirely within his designated operating zone, at which place he shall provide two-way radio communication with his vehicles, the County Emergency Control Communications Center, and his place of business, a properly listed telephone for receiving all calls for service and at which central place of business he shall keep such business records and daily logs available for inspection or audit by Words underlir Packet Page -2502- ek tkreligk are deleted, 10 9/27/2011 Item 16.K.4, -- the Administrator. Every operator shall keep on file with the Administrator and the County Emergency Control Communications Center a business address and telephone number at which the operator may be reached at all times. This information will be maintained at the Emergency Control Center. Section 17: Records To Be Kept Every operator shall keep accurate records of receipts from operations, operating and other expenses, capital expenditure and such other operating and patient information as may be required by the Board. Section 18: Rates Every operator shall file with the Board a schedule of the rates. Such rates shall be tiled as a part of each new or renewal application, and a rate schedule shall also be filed when changes in rates are proposed. All such rates shall be subject to review and approval by the Board. Section 19: Operator's Insurance' Every ambulance operator shall carry bodily injury and property damage insurance with solvent and responsible insurers authorized to transact business in the State of Florida to secure payment for any loss or damage resulting from any occurrence arising out of or caused by the operation or use of any of the operator's motor vehicles. Each vehicle shall be insured for the sum of at least one hundred thousand dollars ($100,000.00) for injuries to or death of anyone person arising out of anyone accident and the sum of at least three hundred thousand dollars ($300,000.00) for injuries to or death or more than one person in anyone accident and for the sum of at least fifty thousand dollars ($50,000,00) for damage to property arising from anyone accident. They shall also have malpractice insurance. Every insurance policy or contract for such insurance shall provide for the payment and satisfaction of any financial judgment entered against the operator and present insured or any person driving the insured vehicle. Such insurance shall be obtained and certificates or certified copies of such policies shall be filed with, the Board. All such insurance policies, certificates thereof or certified copies of such insurance policies shall provide for a thirty (30) day cancellation notice to the Board. Section 20: Conduct of Drivers And 'Attendants All drivers, EMT's and paramedics shall comply with the 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: --. ..-... Words underlin Packet Page -2503- ak thFettgh are deleted. II --- A, B. ---- ~ 9/27/2011 Item 16.K.4. Failor refuse to promptly transport, if applicable, or attend any sick or injured person after responding to a call. Demand or receivc compensation other that that established and approved in accordance with this ordinance or fail to give a receipt for moneys received, (If applicable). c. Give or allow rebate, commission, discount or any reduced rate not provided in the D, established rate, (Ifapplicable.) At any time induce or seek to induce any person engaging an ambulance or ALS service to patronize or retain the services of any hospital, convalescent home, mortuary, cemetery, attorney, accident investigator, nurse, medical doctor or other service occupation or profession. At any time release his patient from his care until he is assured that some responsible person is available to receive sueh patient. At any time use a siren or flashing red light unless on an emergency call. Disobey the lawful orders of the law enforcement officer at the scene of an accident, or other similar such emergency or at a fire scene, the fire officer in charge. Smoke while within the confines of an ambulance. E, F. G, H, 1. Operate or ride in an ambulance without using seatbelts. (Personnel attending patients are exempt). Seetion 21: Passengers No person shall be aboard ambulances when engaged in emergency or routine medical calls except the following: A. Driver, attendants and fire or law enforcement personnel; B. Patients; C. Not more that one relative or close friend of the patient, or if the situation warrants, the paramedic in charge may authorize more than one passenger. Physicians and nurses; Personnel in an observing capacity that are being trained for ambulance or ALS service. Operator's supervisory personnel. D. E, F. A. Section :z:z: Obedience to Traffic Laws, Ordinances or Regulations, The 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 Words underlin Packet Page -2504- ai, tlu'8Hgft are deleted, 12 9/27/2011 Item 16.K.4. c. reasonable grounds to believe that an emergency in fact exists requiring the exercise of such privileges: I. Park or stand, irrespective of the otherwise applicable provisions oflaw, ordinance or regulations. 2, Proceed past a red light or stop signal or stop sign, but only after slowing down as may be necessary for safe operations. 3. Exceed the maximum speed limits permitted by law so long as he does not endanger life or property. 4. Disregard laws, ordinances or regulations governing direction or movement or turning in specified directions so long as he does not endanger life or property, The exemptions herein granted shall apply only when such vehicle is making use of audible and/or visible signals meeting the requirements of this Ordinance. The foregoing provisions shall not relieve the driver of a vehicle from the duty to drive with due regard for the safety of all persons, nor shall such provisions protect the driver from the consequences of his reckless disregard for the safety of others. Section 23: Violations In addition to the remedies provided herein, a violation of any provision of this ordinance shall be punishable as provided by law for the violation of County ordinances. Section 24: Uniformity of Application The Ordinance shall constitute a uniform law applicable in all of Collier County. Section 25: Authority To Enforce It is hereby declared to be the duty of the Board of County Commissioners of Collier County, its officers, agents, employees and other governmental agencies, the sheriffs department of Collier County, its deputies and agents, fire departments, as well as the police departments of the various municipalities falling under the provisions of this Ordinance to strictly enforce the provisions of this Ordinance. Section 26: Repeal and Codification Ordinance 75-50 is hereby repealed. This Ordinance shall be codified in the Collier County Code as Chapter 4 of said Code, and said Code is hereby amended accordingly, Section 27: Conflict and Severability In the event this. Ordinance should ever conflict with any other ordinance of Collier County, or applicable ordinance of any municipality, or other applicable law, rule or regulation, ~ B. -- ~ Words underlin Packet Page -2505- ek threygh are deleted. 13 9/27/2011 Item 16.K.4, .-. the more restrictive shall apply. If any section. sub-section, sentence, clause, phrase or portion of this Ordinance is for any reason held invalid or unconstitutional by any court of competent jurisdiction, such portion shall be deemed a separate, distinct and independent provision and such holding shall not affect the validity of the remainder of the Ordinance. Section 18: Effective Date This Ordinance shall become effective upon receipt of notice that it has been tiled with the SecretarY of State. PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County, Florida., this ;J.:3 day of 7f{~ ~ i .2005. ..-... BY:~1dn'~ t2JtM'U~ . J:L. Mtest IS to C~a tr;~tf... Sigaltlll"l OC\l.;l~~,:'::~~ 0;...'.. A Vcid~.t~~~..~:.: ...".l:~t., . ~. : ~ ~ : -.Ti\i: ',' .' .-.. '.", ; I ~UmCle&l .... :'i' '::.'. . .." " " :. ~', t., -:;~ ,j.;> _~. "'O~ . .'.~ Scott Teach ":'<J.~':sU~\~~'f~;',.. Assistant County, I.\~omey BOARD OF COUNTY COMMISSIONERS ::LLmR~:~~ Fred W. Coyle. Chairman ATTEST: DWIGHT E. BROCK, Clerk '" ,; ~ . ordInance tiled witn the T!'1I!? . t St te's Office th~ ~cr,tOry 0 ~-:.~1. ~ '4.uh day of~' ~ t ledoement of t\'lot Clnd Oc <-nOW -. MJ,., day tili~e<:eivedth\S~ Qt ' . e DeO""" C,"", Words underlined added and words Wttek thresgll are deleted, 14 Packet Page -2506- 9/27/2011 Item 16. K.4, - STATE OF FLORIDA) COUNTY OF COLLIER) I, DWIGHT E. BROCK, Clerk of Courts in and for the Twentieth Judicial Circuit, Collier County, Florida, do hereby certify that the foregoing is a true and correct copy of: ORDINANCE 2005-16 Which was adopted by the Board of County Commissioners on the 23nd day of March 2005, during Regular Session. WITNESS my hand and the official seal of the Board of County Commissioners of Collier County, Florida, this 28th day of March, 2005. ....It......I'-'1 DWIGHT E. BROC~,.,."", tn'~~.'...'r,. Clerk of Cour~'s~ ~~~'-€-~~k ~ E f f" . 13~ . ~. " ~~, - x-o lC10 ~9 ~'? ~.or:, ~\~..\ County comml~~ . ..s. "i:!~l'" 1 ~ :~: (~.., ','F_E Q. ", "',..1,1 r; ".. '...~ ,t ""dJ ............~.f1~",:..,....... By: Linda A. Hou~t...~",,~~i. ;". Deputy Clerk '............. (fl;/' .., ".~.", . ./".~" . Packet Page -2507- 9/27/2011 Item 16.KA. r~-' c' r: --- -" ORDINANCE NO. 2004 - ..lL , r'.) AN ORDINANCE AMENDING ORDINANCE 81-75 Ifr', ..:J ADDlNG SECTION TWEL VE ENTITLED:'P CLASSIFICATIONS AND CERTIFICATES; PROVIDING FOR;;; 0' INCLUSION IN CODE OF LAWS AND ORDINANCES; PROVIDING FOR CONFLICT AND SEVERABILITY; AND PROVIDING FOR AN EFFECTIVE DATE. ...""", III WHEREAS, Collier County desires to make available to its citizens safe, professional emergency health care transportation services for 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, expel1ise, professional certifications and licenses to do so; und WHEREAS, the amendment to Ordinance Number 81- 75 results in a benefit to CoIlier 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 C~'JNTY, FLORIDA: Section I: Purpose --- This ordinance is adopted pursuant to Chapters 125 and 40), Florida Statutes. The purpose of this ordinance is to provide better protection for the health, safety and welfare of the residents of Collier County, in ambulance and ALS matters, by establishing uniform county-wide standards for certification of ambulance or advanced life support or services, or operations by promulgating complete and clear rules and regulations for operation of all ambulance or rescue companies or services in Collier County. Section 2: Definitions A. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida Administrative Code, Section 64E. 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 convenience and necessity as authorized in Section 401.25 (2)( d), Florida Statutes. Packet Page -2508- ~ ..-.. ,-. 9/27/2011 Item 16,K.4. F. Emergency CaH shaH mean the transit of an ambulance under conditions which warrants travel with flashing lights and siren operating, Q, Operator shaH mean any person, organization or governmental entity providing amhulum;e 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 shaH mean first response treatment of patients but does not include Advanced Life Support (ALS) or transport, Section 3: Requirements For Certificate It shall be unlawful for any person, firm, agency, or any other entity, including governmental units, to provide an ambulance service or provide advanced life support without first obtaining a certificate therefore from the Board of County Commissioners of Collier County. Section 4: Exemptions and Exclusions From Certificate Requirement Certificates shall not be required for: A. Rescue Services B. The use of a non-ambulance for any transport of a patient pursuant to the Good Samaritan Act, Section 768.1 J, Florida Statues, 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 that 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. V chicles used to transport persons for routine scheduled medical treatments, Vehicles transporting persons who require services en route or who must be carried on a stretcher are not covered by this exemption. Words underline" "rlrlA'" ~_... ...__...1_ -._uk tkrel:lgh are deleted, PacketPage-2509- 2 9/27/2011 Item 16.K.4. Section 5: Procedure For Obtaining Certificate ---. An applicant for a certificate shall obtain fonns from the department to be completed and returned to the Division Administrator, Each application shall contain: A. The name, age, and address of the owner of the ambulance or ALS provider, or if the owncr 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, B, The boundaries of the territory desired to be served, C, The number and brief description of the ambulances or other vehicles the applicant will have available. D, 'nle addrcss of the intended headquarters and any sub-stations. E, The training and experience of the applicant. F. The names and addresses of three (3) Collier County residents who will act as references for the applicant. G, A schedule of rates which the service intends to charge, ..-. H. Such other pertinent information as the administrator may require, I. An application or renewal fee of two hundred fifty dollars ($250,00). (Exception Collier county EMS J. Financial data including assets and liabilities of the operator. A schedule of all debts encumbering any equipment shall be included, Section 6: Review of Application The Administrator shall review each application and shall investigate the applicant's renutation, competence, financial responsibility, and any other relevant factors. The Administrator shall also make an investigation as to the public necessity for an ambulance or ALS operation in the territory requested, and shall then make a report to the Board containing his recommendation whether to grant a certificate to the applicant within sixty (60) days of the time the Administrator determines the application is complete. Section 7: Requirement For Board Approval In Granting Certificate ..-. The Board of County Commissioners shall not grant a certific~te unless it shan find, after public hearing and based on competent evidence that each of the following standards has been satisfied: Words underline'" -......-... -- ~ u_ - , . Ie thrsl:Igh are deleted. Packet Page -2510- 3 9/27/2011 Item 16.K.4. A, That thcrc is a public necessity for the service, In making such determination. the Board .-. ofCollnty Commission shall consider, as a minimum, the following factors: (I) The extent to which the proposed service is needed to improve the overall Emergency Medical Services (EMS) capabilities oflhe 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 suffieient personnel and equipment to adequately cover the proposed service area, Section 8: Appointment of Hearing Officer 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. Section 9: 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 corpora.tion, if there occurs such a transfer of stock or other incidents of ownership as to change the majority or largest stockholder, Words underlinetl "tltl..tl ""rl ...~_..I- ---'-k tBFel:lga are deleted. Packet Page -2511- 4 '9/27/2011 Item 16,K.4, ..-... a new certificate must be applied for, Changes in the officers of the corporation will not require a new certificate. Acct:ptllncc of the certificate by the applicant shall obligate the applicant to: A. Service the entire zone granted to the applicant. B, Provide coverage to adjoining zones, when requested to do so by Emergency Control for emergency calls when the certificate holder for that zone is unable to respond. C. Keep posted at his plaee 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, F, Employ at all times sufficient personnel experienced in operation and management of emergency medical services to ensure proper and efficient operation, Section 10: Renewal of Certificate Each certificate holder shall file within ninety (90) days of expiration, an application for -, renewal of his certificate. Renewals shall be based upon the same standards, as the granting of the original certificate along with such other factors as milY be relevant. The renewal application shall be accompanied by a two hundred and fifty dollar ($250.00) renewal fee. The renewal certificate may be approved routinely by the Board, upon advice of the Administrator, or the Board may hold a hearing on same. Section 11: 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 ambulance or rescue service 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 12: Classifications of Certificates ..-... There shall be two (2) classifications of service in Collier County. as follows: A, Class I: CollierCountv EMS: Words underlinetl "tltl..tl ,,",1 ",~_..I- -+---k threl:lgh are deleted. Packet Page -2512- 5 9/27/2011 Item 16.K.4, ~ ALS Rescue: An EMS provider with the capabilitv of renderine: on the scene prehospital ALS services and who may or may not elect to transport patients. An EMS provider renderine: this level of service for a e:overnmcntal entity shall be deemed to he opera tine under the Class I - ALS rescue certificate of public convenience and necessity held by the e:overnmental entity. An EMS provider holdine: a Class I - ALS rescue certificate may provide post- hospital interfacilitv medical transfer services and routine ALS and RLS calls within the County. A certificate of public convenience and necessity must be obtained from the County before ene:ae:ine: in this level of medieal service, B. Class 2: Collier County Hospitals: I. ALS Transfer: An EMS provider who renders ALS interfacilitv medical transfer services. An EMS provider who is awarded a Class 2 - ALS transfer certificate and does not possess a Class J - ALS rescue certificate shall not respond to an emerl!encv call and provide ALS rescue services ~ unless called upon bv the appropriate Class J - ALS rescue provider to provide emer~encv backup service, In these instances, it shall he deemed to be operatinl! under the Class J - ALS rescue certificate of the e:overnmental entity reauestinl! such emerl!encv backup service. 2. Class 2 - ALS transfer certificate holders may provide post-hospital interfacilitv medical transfer services and routine ALS and RLS calls within the County but only to hospitals owned bv the certificate holder. however. the Class 2 certificate holder may provide out-of-Countv 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 eDl!ae:in2 in this level of medical service. 3. Class-2 transfer certificate holders shall contract with the Class _ 1 rescue certificate holder's Medical Director for the performance of services set forth in Florida Statutes. Section 401.265 and ..as soecificallv set forth herein as follows: ..-... Words underlinen RiliI..rl Rn,! "'M,j~ p.~'~k tftfel:lga are deleted. Packet Page -2513- 6 9/27/2011 Item 16.K.4. .--.. a. He shall supervise and accept direct responsibility for the medical performance of the paramedics and Emel'l!encv Medical Technicians (hereinafter EMTs), b. He shall develop medicallv correct stand in!! orders or protocols relatin!! to life support system procedures when communication cannot be established with a supervisin!! physician or when any delav in patient care would potentiallv threaten the life or health of the patient. c, He shall issue stand in!! orders and protocols to ensure that the Class-2 transfer certificate holder transports each of its patients to facilities that offer a type and level of care appropriate to the patient's medical condition, d, He or his appointee shall provide continuous 24-hour-ner-dav. '-dav-ner-week medical direction which shall include. in addition to the development of protocols and stand in!! orders. direction to the ~ Class-2 transfer certificate holder's personnel as to the availability of "off.line" service to resolve problems. system conflicts. and provide services in an emel'l!encv as that term is defined bv section 252,34(3). Florida Statutes, e. He shall establish a auality assurance committee to provide for auality assurance review of all EMTs and naramedics oneratinl! under his supervision, f, He shall audit the performance of system personnel bv use of a auality assurance pro!!ram that includes but is not limited to a prompt review of patient care records. direct observation. and comparison of performance standards for dru!!s. eauipment. SYstem protocols and procedures. He shall be responsible for parficipatin!! in auality assurance nro!!rams developed bv the Class-2 transfer certificate holder. ..-... 2. He shall ensure and certify that security procedures of the Class-2 transfer certificate holder for medications. fluids and Words underlined added llnci wnrtJ" ~._.-IC thFElligh are deleted, Packet Page -2514- 7 9/27/2011 Item 16,K.4. ~ controlled substances are in compliance with chapters 401. 499 and 893. Florida Statlltes. and chapter IOD-45 of the Florida Administrative Code. h, He shall create. authorize and ensure adherence to, detailed written operatine: procedures ree:ardine: all aspects of the handline: of medications. fluids and controlled substances by the EMS personnel and comply with all requirements of chapters 401. 499 and 893. Florilla Slalllles. i, He shall notify the Florida Department of Health. (hereinafter the "Department") in writine: when the use of telemetrv is not necessary. i. He shall notify the department in writine: of each substitution of equipment or medication. k. He shall assume direct responsibilitv for the use by an EMT of an automatic or semi-automatic defibrillator: the performance of ~ esophae:eal intubation bv an EMT: and on routine interfaciJitv transports. the monitorine: and maintenance of non-medicated I. V .s bv an EMT. He shall ensure that the EMT is trained to perform these procedures: shall establish written protocols for the performance of these procedures: and shall provide written evidence to the Florida Department of Health documentine: compliance with the provisions of this parae:raph, I, He shall ensure that all EMTs and paramedics are trained in the use of the trauma scorecard methodoloe:ies as provided in sections 64E-2.017 of the F.A.C.. for adult trauma patients and 64E-2.0175. F.A.C.. for pediatric trauma patients. m. He shall participate as a crewmember on an EMS vehicle for a minimum of 10 hours per vear and complete a minimum of 10 hours oer vear of continuine: medical education related to pre-hospital care ..-... or teachine: or a combination of both. Words underlineA ~AA~A __..l _____.J_ -< k tJu:el:l.ga are deleted. Packet Page -2515- 8 9/27/2011 Item 16,K.4. ~ n, He shall ensure that all of the Class-2 transfer certificate holder's EMTs and paramedics have all proper certifications and receive all traininl! necessarv to maintain their certification, Section H lJ.: Transfer Or Assignment of Certificates No certificate issued under this Ordinance shall be assignable or transferable by the person to whom issued except' unless approval is obtained from the Board in the same manner and subject to the same application, investigation, fees and public hearing as original applications for certificates. Any majority transfer of shares or stock or interest of any person or o:)erator so as to cause a change in the directors, officers, majority stockholders or managers of such person or operator shall be deemed a transfer or assignment as contemplated in this Ordinance and subject to the same rules and regulations as any other transfer or assignment. Section H H: Revocation, Alteration Or Suspension Grounds A. Every certificate issued under this Ordinance shall be subject to revocation, alteration and/or suspension of operation, buy the Board, for a period of up to one year, where it ~ shall appear that: I. The operator has failed or neglected for n period of thirty (30) days during any calendar year to render all services authorized by his certificate. 2. The operator has been convicted of a felony or any criminal offense involving moral turpitude, 3. The certificate was obtained by an application in which any material fact was omitted or falsely stated, 4. The operator has knowingly permitted any of its motor vehicles to be operated in violation the laws which result in conviction of the driver or operator of a misdemeanor in the second degree or greater, or has knowingly permitted a driver with more than two previous convictions to operate emergency vehicles, S. The operator has failed to comply with any of the provisions of this Ordinance. 6. The public interest will best be served by revocation, alteration, or suspension of any certificate upon good cause shown, 7. The operator or his agent has demanded money or compensation other that that .'-- established and prescribed under this ordinance. (If applicable), Words underlined addeOllnn wnrt/.. nt~'-k taf9llgft are deleted. Packet Page -2516- 9 9/27/2011 Item 16.K.4, ~ 8, The operator has without sufficient justification failed or refused to furnish emergency care and/or transportation promptly for a sick or injured person. 9. The operator or his agent has been found guilty of malpractice or willful and wanton misconduct in the operation of its service. B. All complaints shall be investigated and a report thereon made to the Board. together with findings and recommendations, within fifteen (15) days, If revocation, suspension or alteration of any certificate appears warranted, the Board shall give notice to the operator holding the certificate that the same will be considered at a specific commission meeting, provided the date of such meeting shall not be less than five (5) days from the date of the notice. The Board shall thereupon consider the complaint and either revoke, suspend or alter the certificate or dismiss the complaint. Section .J.4 15: General Operating Regulations All certificate holders, operators, and drivers shall comply with all state statutes and administrative regulations as following regulations: A. Twentv-four Hour Service. Every certificate holder shall be required to operate --- sufficient ambulances, as stated on the certificate of operation and determined by the Board, on immediate call at all times. B. Prompt Service Required, Every call for ambulance service shall be answered promptly. Patients shall be loaded and transported 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 that three (3) minutes elapse between receipt of an emergency call and dispatch of an ambulance shall also be reported to the Administrator with documentation of circumstances. C. Bed Linens. Clean and sanitary bed linens shall be provided for each patient carried and shall be changed as soon as practicable after the discharge of the patient. D. Dailv Lo~, Every operator shall maintain in a daily log upon which shall be recorded the place or origin, time of call, time of dispatch, time of arri,:,al 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. Every operator shall Words underline-" ~"A_'" --.. "'h~_ -, k tMsl:Igh are deleted, Packet Page -2517- 10 9/27/2011 Item 16.K.4. ..-... retain and preserve all daily logs for at least two (2) years, and such logs shall be available for inspection by the Administrator, E. Communieations. Each ambulance shall maintain two-way radio communication with the location of primary dispateh from which it operates, as well as any additional communication capabilities n::quired 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 laws of the State of Florida and shall be su~jected 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. 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. Salaries of other than Collier ,-. County EMS paramedics will be paid by the agency seeking the Medical Director Certification, 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 ~16: Central Place of Business Each operator shall maintain a central place of business which shall be entirely within his designated operating zone, at which place he shall provide two-way radio communication with his vehicles, the county emergency control communications center, and his place of business, a properly listed telephone for receiving all calls for service and at which central place of business he shall keep such business records and daily logs available for inspection or audit by the Administrator. Every operator shall keep on file with the Administrator and the County Emergency Control Communications Center a business address and telephone number at which the operator may be reached at all times. This information will be ml:!intained at the Emergency C...ntrol Center. ~ Words underlinetlllrlrlpfl "nrl u',..r"!~ cl~'~k thratlgh are deleted, Packet Page -2518- II 9/27/2011 Item 16.K.4, ."-'" Section 1611: Records To Be Kept Every operator shall keep accurate records of receipts from operations, operating and other expenses, capital expenditure and such other operating and patient information as may be required by the Board. Section .J.+ 18: Rates Every operator shall file with the Board a schedule of the rates. Such rates shall be filed as a part of each new or renewal application, and a rate schedule shall also be filed when changes in rates are proposed. All such rates shall be subject to review and approval by the Board, Section .J.8 19: Operator's Insurance Every ambulance operator shall carry bodily injury and property damage insurance with solvent and responsible insurers authorized to transact business in the State of Florida to secure payment for any loss or damage resulting from any occurrence arising out of or caused by the operation or use of any of the operator's motor vehicles. Each vehicle shall be insured for the sum of at least one hundred thousand dollars ($100,000.00) for injuries to or death of anyone person arising out of anyone accident and the sum of at least three hundred thousand dollars ---.. ($300,000,00) for injuries to or death or more than one person in anyone accident and for the sum of at least fifty thousand dollars ($50,000.00) for damage to property arising from anyone accident. They shall also have malpractice insurance, Every insurance policy or contract for such insurance shall provide for the payment and satisfaction of any financial judgment entered against the operator and present insured or any person driving the insured vehicle, Such insurance shall be obtained and certificates or certified copies of such policies shall be filed with the Board. All such insurance policies, certificates thereof or certified copies of such insurance policies shall provide for a thirty (30) day cancellation notice to the Board, Section t9 ~: Conduct of Drivers And Attendants All drivers, EMT's and paramedics shall comply with the 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: A, Failor refuse to promptly transport, if applicable, or attend any sick or injured person after responding to a call. ---.. Words underlineti ..titi...ti ,,~-l ...~~-l~ ~'-'-k threl:lgh are deleted. Packet Page -2519- 12 9/27/2011 Item 16.K.4. ,-,. B, Demand or receive compensation other that that established and approved in accordance with this ordinance or fail to give a receipt for moneys received, (If applicable). C. Give or allow rebate, commission, discount or any reduced rate not provided in the established rate. (If applicable,) [), At any time induce or seek to induce any person engaging an ambulance or ALS service to patronize or retain the services of any hospital, convalescent home, mortuary, cemetery, attorney, accident investigator, nurse, medical doctor or other service occupation or profession. E. At any time release his patient from his care until he is assured that some responsible person is available to receive suchpatient. F. At any time use a siren or flashing red light unless on an emergency call. G, Disobey the lawful orders of the law enforcement officer at the scene of an accident, or other similar such emergency or at a fire scene, the fire officer in charge. H. Smoke while within the confines of an ambulance, .--. I. Operate or ride in an ambulance without using seatbelts, (Personnel attending patients are exempt), Section ~ ll: Passengers No person shaU be aboard ambulances when engaged in emergency or routine medical caUs except the following: A. Driver, attendants and fire or law enforcement personnel; B, Patients; C, Not more that one relative or close friend of the patient, or if the situation warrants, the paramedic in charge may authorize more than one passenger, 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 ~ 22: Obedience to Traffic Laws, Ordinances or Regulations, A. The driver of an ambulance or ALS vehicle when responding t? an emergency caU or while .--. transporting a patient may exercise the following privileges when such driver has Words underline..! ....!..!....! ~"rl ...~_rl_ -.-'-k tftrsl:Igft are deleted. Packet Page -2520- 13 9/27/2011 Item 16.K.4. ~ reasonable grounds to believe that an emergency in fact exists requiring the exercise of such privileges: I. Park or stand, irrespective of the otherwise applicable provisions of law, ordinance or regulations, 2, Proceed past a red light or stop signal or stop 'sign, but only after slowing down as may be necessary for safe operations, 3, Exceed the maximum speed limits permitted by law so long as he does not endanger life or property, 4, Disregard laws, ordinances or regulations governing direction or movement or turning in specified directions so long as he does not endanger life or property. B. The exemptions herein granted shall apply only when such vehicle is making use of audible and/or visible signals meeting the requirements of this Ordinance, C, The foregoing provisions shall not relieve the driver of a vehicle from the duty to drive with due regard for the safety of all persons, nor shall such provisions protect the driver from the consequences of his reckless disregard for the safety of others, ~ Section ~ 23: Violations In addition to the n:medies provided herein, a violation of any provision of this ordinance shall be punishable as provided by law for the violation of County ordinances. Section ~ 24: Uniformity of Application The Ordinance shall constitute a uniform law applicable in all of Collier County. Section ~ 25: Authority To Enforce It is hereby declared to be the duty of the Board of County Commissioners of Collier County, its officers, agents, employees and other governmental agencies, the sheriffs department of Collier County, its deputies and agents, fire departments, as well as the police departments of the various municipalities falling under the provisions of this Ordinance to str..~tly enforce the provisions of this Ordinance. Section *"~: Repeal and Codification Ordinance 75-50 is hereby repealed. This Ordinance shall be codified in the Collier County Code as Chapter 4 of said Code, and said Code is hereby amen~ed accordingly. ..-... Words underlined Rnnpn Ann U/n.r1~ DbL'"\ tftFe~gh are deleted, Packet Page -2521- 14 9/27/2011 Item 16,K.4, Section ~ 27: Conflict and Severability ..-... Is 88)' seeses, sl:lsseetiea, semesee, elaase er )9Fe\'isies ef this OFEliRaRee is aele is\'tdie, the remaiseer efthis OFEliB8Bee shall set ge affeetee theres}', In the event this Ordinance should ever conflict with any other ordinance of Collier County. or applicable ordinance of any municipality. or other applicable law. rule or rellulation. the more restrictive shall apply. If any section. sub-section. sentence. clause. Phrase or portion of m:,; Ordinance is for any reason held invalid or unconstitutional by any court of competent iurisdiction, such portion shall be deemed a separate. distinct and independent provision and such holdinllshall not affect the validity of the remainder of the Ordinance, Section ~ 28: Effective Date This Ordinance shall become effective upon receipt of notice that it has been filed with the Secretary of State. PASSED AND nUL Y ADOPTED by the Board of County Commissioners of Collier County, Florida, this ~ day of ~HAil.I"Y ,2004. .-.. BOARD OF COUNTY COMMISSIONERS COLLIER C TY, FLORIDA By: DO J queline Williams Hubbard Assistant County Attorney This ordinance filed with thli s.~cr,etor}' of State's Of~8 ~ day ofYYY1ff--'" , . and acknowlcdgeme that filirvv;c ived ihis doy of__ , By.. O.c.. . H: OrdinanceIRovision ofOrd 81-75 1Iem, ESE; - Agenda DSle ~'.:l.I-/.O,/ --- Date Rec'd ~-I-04 --=:;..; ~ Words underlined added ann worn" "t......I, thre\lgB are deleted. Packet Page -2522- 15 9/27/2011 Item 16.K.4, ~ STATE OF FLORIDA) COUNTY OF COLLIER) I, DWIGHT E. BROCK, Clerk of Courts in and for the Twentieth Judicial Circuit, Collier County/ Florida, do hereby certify that the foregoing is a true and correct copy of: ORDINANCE 2004-12 Which was adopted by the Board of County Commissioners on the 24th day of February, 2004, during Regular Session. WITNESS my hand and the official seal of the Board of ~ County Commissioners of Collier County, Florida, this 1st day of March, 2004. DWIGHT E. BROCK Clerk of Courts~\~mdt"~J:"~ Ex- 0 f f ic ioto ~:,~~.~' ';'",;'~,-"" ~. ~~_~.., J"'~_'';'''' County comm}~~!~:~4 'i\~~~'{ f-"'~" . '~',.' · -s.~" ~- I 'a '. .~i :'><~i/. }l)l: ~ ..~ ~-o 1"'':''. ?#, ..;' i'~'~ :~'.-;' ~ :. .. ,""w .1',..... _t,,;,' . ~'('~ ,..~I'!.1: or "it.. loo.; ,"'\' '":'~ .. ......!it' By: Linda M;, ':J:Ptltz~~;.".:4'~ Deputy c't;~*~~..~:.:;~~~<\:o,,, ""~vtIl! oJ . "" "'Ji"J6ml\"'" ."~ ..-... Packet Page -2523-