Agenda 12/13/2011 Item #16F712/13/2011 Item 165.7.
EXECUTIVE SUMMARY
Authorize County Manager or designee to advertise an ordinance for future consideration
that amends Ordinance No. 04 -12, as amended, for the purpose of revising the Class 2
Certificate of Public Convenience and Necessity for post- hospital interfacility transport
services.
OBJECTIVE: To obtain the Board of County Commissioners (Board) approval to advertise
an ordinance for future consideration that amends Ordinance No. 04 -1.2, as amended, for the
purpose of revising Class 2 Certificate of Public Convenience and Necessity ( COPCN) for Post -
hospital interfacility transport services.
CONSIDERATIONS: On October 25, 2011 the Board approved a COPCN for Ambitrans
Medical Transportation to provide Class 2 (post- hospital inter - facility medical transfer services)
within Collier County and authorized staff to bring necessary amendments to the COPCN
ordinance related to Class 2 certificate holders. The proposed changes to the Ordinance include:
• Revised description and specification of duties for Class 2 operators providing
interfacility transport services.
• Provides that those Class 2 and Class 3 Operators that have separately entered into a
contract with the County for Medical Director services shall be certified pursuant to the
terms of the contract.
• Provides for a Ride Time Requirement for all Operators that have entered into a contract
with the County for Medical Director services. Not subject to the ride time requirements
are those Operators who have not contracted with the County and serve under their own
medical director.
• Provides that each Operator, within 90 days of Certificate issuance, shall maintain a place
of business which shall be within the designated operating zone, provide communication
with Operator's vehicles as well the Collier County Emergency Medical Services
Department.
• Requires that business, training and vehicle records, along with daily logs be maintained
and available for inspection or audit by the Administrator.
• Requires that every Operator keep on file with Administrator and County Emergency
Medical Services Department a current business address and phone number.
The proposed revisions to Ordinance No. 04 -12, as amended, were approved by the EMS Policy
Advisory board at their November 18, 2011 meeting.
After the EMS Policy Advisory board met a revision to the proposed Ordinance was made to
clarify that ALS transfer certificate holders may provide post - hospital medical transfer services
for routine and emergency ALS and BLS patients.
FISCAL IMPACT: Advertising cost is estimated to be $400 and is included in the FY12 budget
for EMS, Fund 490.
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12/13/2011 Item 161.7.
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated
with this Executive Summary.
LEGAL CONSIDERATIONS: The proposed ordinance has been reviewed by the County
Attorney, and is legally sufficient. This item requires majority vote for approval. -JAK
RECOMMENDATION: To authorize the County Manager or designee to advertise an
ordinance for future consideration that amends Ordinance No. 04 -12, as amended, for the purpose
of revising the Class 2 Certificate of Public Convenience and Necessity for post - hospital
interfacility transport services.
Prepared by: Artie R. Bay, Administrative Supervisor, Emergency Medical Services
Jennifer B. White, Assistant County Attorney
Attachments: Proposed Ordinance
Proposed Ordinance without strike - throughs and underlines
Codified COPCN Ordinance
Packet Page -3448-
12/13/2011 Item 161.7.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.F.7.
Item Summary: Authorize staff to advertise an ordinance for future consideration that
amends Ordinance No. 04 -12, as amended, for the purpose of revising the Class 2 Certificate
of Public Convenience and Necessity for post - hospital interfacility transport services.
Meeting Date: 12/13/2011
Prepared By
Name: BayArtie
Title: Supervisor - Accounting,EMS Operations
12/1/20114:24:56 PM
Approved By
Name: KopkaWalter
Date: 12/2/20118:00:31 AM
Name: SummersDan
Title: Director - Bureau of Emergency Services,
Date: 12/2/20118:18:21 AM
Name: WhiteJennifer
Title: Assistant County Attorney,County Attorney
Date: 12/2/2011 10:30:30 AM
Name: KlatzkowJeff
Title: County Attorney,
Date: 12/2/2011 1:21:14 PM
Name: PryorCheryl
Title: Management/ Budget Analyst, Senior,Office of Management & Budget
Date: 12/5/2011 12:33:23 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 12/5/2011 3:07:26 PM
Packet Page -3449-
Name: OchsLeo
Title: County Manager
Date: 12/5/20114:17:39 PM
Packet Page -3450-
12/13/2011 Item 16.F.7.
12/13/2011 Item 16.F.7.
ORDINANCE NO. 2012 -
AN ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, AMENDING ORDINANCE 04 -12, AS
AMENDED, BY AMENDING, SECTION TWELVE, CLASSIFICATIONS
OF CERTIFICATES; SECTION FIFTEEN, GENERAL OPERATING
REGULATIONS; SECTION SIXTEEN, CENTRAL PLACE OF
BUSINESS; PROVIDING FOR CONFLICT AND SEVERABILITY;
PROVIDING FOR INCLUSION IN THE CODE OF LAWS AND
ORDINANCES; AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, Collier County Ordinance No. 2004 -
III of Chapter 50 of the Code of Laws and Ordinances of`
through its predecessor Ordinance No. 81 -75; and
WHEREAS, Collier County desires to i i"k availably
emergency health care transportation and non transportation sf
responses and the transfer of patients between an'd,among local
WHEREAS, this amendment to
intended to expand the Class -2 post 'hospi
NOW THEREFORE: BE IT
COMMISSIONERS OF COLLIER COON r
SECTION ONE Amendments to Sec
h ,y
Section Twelve of Ordinance No 04 -12, as
SECTI
shall be three.t3 cl
transport
upended, is codified as Article
County, and originally enacted
itizens safe, professional
f emergency pre - hospital
facilities; and
12, as amended, is primarily
BOARD OF COUNTY
No. 04 -12, as amended.
is hereby amended as follows:
TES.
of service in Collier County, as follows:
B. Class -2. Collier County Hems Inter - Facility Transport Services:
-ALS Transfer: An EMS Operator who render-s provides post - hospital
ALS -inter facility medical transfer services, both within and outside the County
If requested by he appropriate Class 1 — ALS rescue Operator, will nrovide
emergency pre - hospital backup service ALS transfer certificate holders may
provide post - hospital medical transfer services for routine and emergency ALS
and BLS patients. Class -2 transfer certificate holders must either provide for their
own medical director or contract with the County Medical Director, and will
operate under protocols approved by the County Medical Director. If the
Operator provides for its own medical director, that medical director shall work
cooperatively with the County's Office of the Medical Director to ensure
continuity of care. Class 2 Operators shall comply with all guidelines and policies
approved by the Board of County Commissioners and shall notify and work with
Words underlined added and words swaek dwough are deleted.
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12/13/2011 Item 161.7.
all hospitals and facilities to educate them as to the services Operator provides.
The County reserves the right to review and evaluate all calls made by the
Operator to ensure that the appropriate level of personnel, supplies, equipment
and vehicles are being utilized, as set forth in Florida Statute and Florida
Administrative Code. R EN49 ;avhe s a—Arded— i�ass 2 —.4-1 F4
No. 04 -12, as amended.
Certification. (i) In addition to the State of Florida Department of Health,
Bureau' of , Emergency Medical Services requirements for certification, each
Collier County EMS paramedic, Class -2 Operator's paramedic, and 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
of services set forth in Section 401.265, Florida Statutes, and Chapter 64J-
2.004(4)(a), Florida Administrative Code, must be certified by the County
Medical Director. Each Collier County EMS paramedic and Class -2 Operator
paramedic, that contracts with the County for Medical Director services must
work with a Collier County EMS ambulance for a sufficient length of time
pursuant to paragraph H. for the County's Medical Director to properly judge the
paramedic's capability. Salaries of other than Collier County EMS paramedics
will be paid by the agency seeking the Medical Director Certification.
Words underlined added and words strums are deleted.
1 11
Packet Page -3452-
H.
SECTION
12/13/2011 Item 16.F.7.
(ii). The Me iea ni- Class 3 n Q All Operators,
exeluding ---llie" Cep EMS, shall certify its paramedics pursuant to
Section 401.265, Florida Statutes, and Chapter 64J- 2.004(4)(a), Florida
Administrative Code.
(iii). A Class -2 and Class -3 Operators that has have 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 of services set forth in
Section 401.265, Florida Statutes, and Chapter 64J- 2.004(4)(a), Florida
Administrative Code, shall be certi�Vl ursuant to the terms of such
contract.
Ride Ti me Requirement. Each
Class -1 Operator or „ Class
,. 1 1 � . . --
Operator's ambulance not less than
paramedic employed by a Class -3 ,
accompany a patient on the Collier
hospital when the paramedic for sucl
patient prior to Collier County EMS
requires that additional jewel of expe
Operator that has separately entered
the County's},Medical Director to ser
of services sets forth in Seecton 4(
2.004(41 Florida Admims ratve {
EMS 'ambulance nbt less than - fi e'
accom
County.
)n the Co
level
by a Collier County EMS, a
s° must work, f a; minimum, with a Class -1
one full month's",
onth's work shift annually. Each
>erator that has its owr medical director must
County EMS ALS transport from scene to
Class 3, Operator initiate§ ALS services on a
transport arrival or if the patient's condition
tise Each paramedic employed by a Class -3
into a contract with the County in order for
ye=as its medical director for the performance
11.265 ,Florida Statutes, and Chapter 64J-
$de, shall,-either work with a Collier County
full month's work shift annually or must
County EMS ALS transport from scene to
`'Class -3 Operator initiates ALS services on a
transport arrival or if the patient's condition
rtise, as provided for in its contract with the
ents t6' Section Sixteen of Ordinance No. 04 -12, as
Section Sixteen of Ordinance No��04 -12, as amended, is hereby amended as follows:
SECTION SIXTEEN: GE�7�AL PLACE OF BUSINESS.
Within 90 days of Certificate issuance each Eaeh Operator shall maintain a eentf-al place of
business which shall be entirely within his designated operating zone, at which place he shall
provide twe-way redie communication with his vehicles, the Collier County Emergency Medical
Services Department Centfol Ce: munieations Gente , and his place of business, a properly listed
telephone for receiving all calls for service and at which eefArel place of business he shall keep
such business records, training records, vehicles, and daily logs available for inspection or audit by
the Administrator. Every Operator shall keep on file with the Administrator and the County
Emergency Medical Services Department re::tre'= Gemmuniea4ieas Gente a business address and
Words underlined added and words stFuelE t4weugh are deleted.
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12/13/2011 Item 16.17.7.
telephone number at which the Operator may be reached at all times. This information will be
maintained at the Emergency Medical Services Department Gaf4fel GefAe-
SECTION FOUR: Conflict and Severability.
In the event this Ordinance should ever conflict with any other Ordinance of Collier
County or other applicable law, the more restrictive shall apply. If any phrase or portion of this
Ordinance is held invalid or unconstitutional by any court of competent jurisdiction, such portion
shall be deemed a separate, distinct, and independent provisions and such holding shall not affect
the validity of the remaining portions.
SECTION FIVE: Inclusion in the Code of Laws `and Ordinances.
The provisions of this Ordinance shalt, be made a part of the Code of Laws and
Ordinances of Collier County, Florida. The sections'o the ordinance may be "renumbered or re-
Ordinances
and internal cross - references amended throughout >to accomplish such, and the word
"ordinance" may be changed to "section," � "article," br any other appropriate word.
SECTION SIX r ffecti ` ate.
This Ordinance shall be considered adopted upon the date written below and subject to
filing with,the Florida Depart rnefif of
AND DULY ADOPTED by a vote of majority of the Board of County
Collier County; Florida; this day of , 2012.
ATTEST:
DWIGHT E. BROCK,
By:
Deputy Clerk
Approved as to form
and legal sufficiency:
Jeffrey A. Klatzkow
County Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
FRED W. COYLE, CHAIRMAN
Words underlined added and words stfu,a gueug . are deleted.
Packet Page -3454-
12/13/2011 Item 16.F.7.
ORDINANCE NO. 2012 -
AN ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, AMENDING ORDINANCE 04 -12, AS
AMENDED, BY AMENDING, SECTION TWELVE, CLASSIFICATIONS
OF CERTIFICATES; SECTION FIFTEEN, GENERAL OPERATING
REGULATIONS; SECTION SIXTEEN, CENTRAL PLACE OF
BUSINESS; PROVIDING FOR CONFLICT AND SEVERABILITY;
PROVIDING FOR INCLUSION IN THE CODE OF LAWS AND
ORDINANCES; AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, Collier County Ordinance No. 2004 -12 amended, is codified as Article
III of Chapter 50 of the Code of Laws and Ordinances of Collier County, and originally enacted
through its predecessor Ordinance No. 81 -75; and
WHEREAS, Collier County desires to make `available to its citizens safe, professional
emergency health care transportation and non t"r"ansportation services for emergency pre - hospital
responses and the transfer of patients between aridy among local hospital facilities, and
WHEREAS, this ame
intended to expand the Class -2
NOW THEREFORE: BE
COMMISSIONERS OF COLLIER
to Ordinance. No
pital transport cerl
A:
to
12, as amended, is primarily
BOARD OF COUNTY
ante No. 04 -12, as amended.
No. %12, as amended, is hereby amended as follows:
TES.
of service in Collier County, as follows:
B. Class 2.. Collier Coi- my Inter - Facility Transport Services:
ALS Transfer An EMS Operator who provides post - hospital inter - facility
medical transfer',services, both within and outside the County. If requested by the
appropriate Class 1 — ALS rescue Operator, will provide emergency pre - hospital
backup service. ALS transfer certificate holders may provide post- hospital
medical transfer services for routine and emergency ALS and BLS patients.
Class -2 transfer certificate holders must either provide for their own medical
director or contract with the County Medical Director, and will operate under
protocols approved by the County Medical Director. If the Operator provides for
its own medical director, that medical director shall work cooperatively with the
County's Office of the Medical Director to ensure continuity of care. Class 2
Operators shall comply with all guidelines and policies approved by the Board of
County Commissioners, and shall notify and work with all hospitals and facilities
to educate them as to the services Operator provides. The County reserves the
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12/13/2011 Item 16.F.7.
right to review and evaluate all calls made by the Operator to ensure that the
appropriate level of personnel, supplies, equipment and vehicles are being
utilized, as set forth in Florida Statute and Florida Administrative Code.
SECTION TWO: Amendments to Section Fifteen of Ordinance No. 04 -12, as amended.
Section Fifteen of Ordinance No. 04 -12, as amended, is hereby amended as follows:
SECTION FIFTEEN: GENERAL OPERATING REGULATIONS.
All certificate holders, operators, and drivers shall comply with all state statutes and
administrative regulations as following regulations: h ''
G. Certification. (i). In addition ta(the' State of Florida Department of Health,
Bureau of Emergency Medical 5evices requirements,for certification, each
Collier County EMS paramedic, Class -2 Operator's paramedic, and Class -3
Operator that has separately entered ;into a contract with the 'County in order for
the County's Medical Director to servo:as its medical director f6f the performance
of services set forth i ;Section 401.265, Florida Statutes, aril Chapter 64J-
2.004(4)(a), Florida Admmistrative Code, £,.must be certified by the County
Medical Director. EacholherCounty Elf paramedic and Class -2 Operator
paramedic, that contracts with the County for Medical Director services, must
work with-K. a Collier County_ rEMS ambulance for> a sufficient length of time
pursuant to` paragraph H. for the County's Medical Director to properly judge the
paramedic's capability. Salariesof "other than Collier County EMS paramedics
will be paid by the agency seeking fhe Medical Director Certification.
paramedics pursuant to Section 401.265,
64J- 2.004(4)(a), Florida Administrative
-A Class 2- and Class -3 Operators that have 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 of services set forth in
Section 401.265, Florida Statutes, and Chapter 64J- 2.004(4)(a), Florida
AIn imstrative Code, shall be certified pursuant to the terms of such
H. Ride Time Requirement. Each paramedic employed by a Collier County EMS, a
Class -1 Operator or Operator that has entered into a contract with the County for
Medical Director services must work, at a minimum, with a Class -1 Operator's
ambulance not less than one full month's work shift annually. Each paramedic
employed by a Class -3 Operator that has its own 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 paramedic employed by a Class -3
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12/13/2011 Item 161.7.
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
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
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 a Collier County EMS transport arrival or if the patient's condition
requires that additional level of expertise, as provided for in its contract with the
County.
SECTION THREE: Amendments to Section S
amended.
Section Sixteen of Ordinance No. 04 -12, as
SECTION SIXTEEN: PLACE OF BU
Within 90 days of Certificate issuance,
which shall be entirely within his designated
communication with his vehicles, the C411ier i
and his place of business, a properly h tell telep
place of business he shall keep such �ausme5s
available for inspection or audit by the Admini
Administrator and the County Emergency Me(
telephone number at which the ;Operator may z
maintained at the Emergencv Medical Services]
SECTION FOUR:
event
County or other applicable! the
Ordinance is held 'invalid or
shall be deemed a
the validity of the
should
for
Ordinance No. 04 -12, as
as follows:
shall maintain a place of business
at which place;, he shall provide
icy Medical Services Department,
ig all calls for service and at which
records, vehicles, and daily logs
)perator shall keep on file with the
►epartment a business address and
.1 times. This information will be
with any other Ordinance of Collier
ictive shall apply. If any phrase or portion of this
itutional by any court of competent jurisdiction, such portion
and independent provisions and such holding shall not affect
SECTION FIVE: Inclusion in the Code of Laws and Ordinances.
The provisions of this Ordinance shall be made a part of the Code of Laws and
Ordinances of Collier County, Florida. The sections of the Ordinance may be renumbered or re-
lettered and internal cross - references amended throughout to accomplish such, and the word
"ordinance" may be changed to "section," "article," or any other appropriate word.
Packet Page -3457-
SECTION SIX:
Effective Date.
12/13/2011 Item 161.7.
This Ordinance shall be considered adopted upon the date written below and subject to
filing with the Florida Department of State.
PASSED AND DULY ADOPTED by a vote of majority of the Board of County
Commissioners of Collier County, Florida, this day of , 2012.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA
By:
Deputy Clerk
Approved as to form
and legal sufficiency:
Jeffrey A. Klatzkow
County Attorney
_:
W. COYLE, CHAIRMAN
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12/13/2011 Item 16.F.7.
PART I - CODE
Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES [66]
tom) Editor's note— Ord. No. 04 -12, § 26, adopted Feb. 24, 2004, repealed divs. 1 and 2 of art. III, §§
50- 51- 50 -68, 50- 76- 50 -86, in their entirety. Sections 1 -25 of said ordinance enacted similar provisions to read
as herein set out.
(66) Cross reference— Businesses, ch. 22; health and sanitation, ch. 66
(66) State Law reference— Medical transportation services, F.S. § 401.2101 et seq.
Sec. 50 -51. - Purpose.
Sec. 50 -52. - Definitions.
Sec. 50 -53. - Reauirements for certificate
Sec. 50-54. - Exemptions and exclusions from certificate requirement
Sec. 50 -55. - Procedure for obtaining certificate
Sec. 50 -56. - Review of application.
Sec. 50 -57. - Requirement for board approval in granting certificate
Sec. 50 -58. - Appointment of hearing officer.
Sec. 50-59. - Rights and duties granted by certificate
Sec. 50 -60. - Renewal of certificate.
Sec. 50 -61. - Emergency provisions.
Sec. 50 -62. - Classifications of certificates.
Sec. 50 -63. - Transfer or assignment of certificates
Sec. 50 -64. - Revocation alteration or suspension grounds
Sec. 50 -65. - General operating regulations
Sec. 50 -66. - Central place of business
Sec. 50 -67. - Records to be kept.
Sec. 50 -68. - Rates.
Sec. 50 -69. - Operator's insurance.
Sec. 50 -70. - Conduct of drivers and attendants
Sec. 50 -71. - Passengers.
Sec. 50 -72. - Obedience to traffic laws ordinances or regulations
Sec. 50 -73. - Violations.
Sec. 50 -74. - Uniformity of application.
Sec. 50 -75. - Authority to enforce.
Secs. 50 -76 -50 -100. - Reserved.
Sec. 50 -51. - Purpose.
This article is adopted pursuant to F.S. chs. 125 and 401. The purpose of this article 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. AW
Page 1 of 12 Collier County, Florida, Code of Ordinances
Packet Page -3459-
12/13/2011 Item 165.7.
PART I - CODE
Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
(Ord. No. 04 -12, § 1)
Sec. 50 -52. - Definitions.
The following words, terms and phrases, when used in this article, shall have the meanings ascribed to
them in this section, except where the context clearly indicates a different meaning:
Administrator shall mean the County Manager or his designee.
Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida
Statutes and Florida Administrative Code, and the Collier County Medical Director's protocol.
Ambu lance 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.
Board shall mean the Collier County Board of County Commissioners.
Certificate means a certificate of public convenience and necessity as authorized in F.S. § 401.25(2)(d).
Emergency Call shall mean the transit of an ambulance under conditions which warrants travel with
flashing lights and siren operating.
Operator shall mean any person, organization or governmental entity providing ambulance or ALS
services.
Patient shall mean an individual who is ill, sick, injured, wounded, or otherwise incapacitated or
helpless.
Rescue Service (Non -ALS) shall mean first response treatment of patients but does not include
Advanced Life Support (ALS) or transport.
Routine Call or Routine Transfer shall mean the transportation of a patient under non - emergency call
conditions.
(Ord. No. 04 -12, § 2; Ord. No. 2011 -36, § 1)
Sec. 50 -53. - 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.
(Ord. No. 04 -12, § 3)
Sec. 50 -54. - Exemptions and exclusions from certificate requirement.
Certificates shall not be required for:
(1) Rescue Services (Non -ALS).
(2) The use of a non - ambulance for any transport of a patient pursuant to the Good Samaritan
Act, F.S. § 768.13.
Page 2 of 12
Collier County, Florida, Code of Ordinances
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12/13/2011 Item 161.7.
PART I - CODE
Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
(3) 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 than are available in the county.
(4) 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.
(5) Vehicles used to transport persons for routine scheduled medical treatments. Vehicles
transporting persons who require services en route are not covered by this exemption.
(Ord. No. 04 -12, § 4; Ord. No. 05 -16, § 4; Ord. No. 2011 -36, § 2)
Sec. 50 -55. - Procedure for obtaining certificate.
An applicant for a certificate shall provide the Administrator with the following information in order for a
request for a certificate to be considered. Each request shall contain:
(1) The name, age, and address of the owner of the ambulance or ALS Operator, or if the owner
is a corporation, then of the directors of the corporation and of all the stockholders holding more
than 25% of the outstanding shares. For governmental units, this information shall be supplied for
members of the governing body.
(2) The boundaries of the territory desired to be served.
(3) The number and brief description of the ambulances or other vehicles the applicant will have
available.
(4) The address of the intended headquarters and any substations.
(5) The training and experience of the applicant.
(6) The names and addresses of three Collier County residents who will act as references for the
applicant.
(7) A schedule of rates which the service intends to charge.
(8) Such other pertinent information as the administrator may require.
(9) An application or renewal fee of $250.00. (Exception Collier County EMS).
(10) Financial data including assets and liabilities of the operator. A schedule of all debts
encumbering any equipment shall be included.
(Ord. No. 04 -12, § 5; Ord. No. 2011 -36, § 3)
Sec. 50 -56. - 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 60 days of the time the administrator determines the application is complete.
Page 3 of 12 Collier County, Florida, Code of Ordinances
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12/13/2011 Item 161.7.
PART I - CODE
Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
(Ord. No. 04 -12, § 6)
Sec. 50 -57. - Requirement for board approval in granting certificate.
The Board of County Commissioners shall not grant a certificate unless it shall find, after public hearing
and based on competent evidence that each of the following standards has been satisfied:
(1) That there is a public necessity for the service. In making such determination, the Board of
County Commissioners shall consider, as a minimum, the following factors:
a. The extent to which the proposed service is needed to improve the overall emergency
medical services (EMS) capabilities of the County.
b. The effect of the proposed service on existing services with respect to quality of service
and cost of service.
c. The effect of the proposed service on the overall cost of EMS service in the county.
d. The effect of the proposed service on existing hospitals and other health care facilities.
e. 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.
(2) That the applicant has sufficient knowledge and experience to properly operate the proposed
service.
(3) That, if applicable, there is an adequate revenue base for the proposed service.
(4) That the proposed service will have sufficient personnel and equipment to adequately cover
the proposed service area.
(Ord. No. 04 -12, § 7; Ord. No. 2011 -36, § 4)
Sec. 50 -58. - Appointment of hearing officer.
In making the determinations provided for in section 50 -57 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.
(Ord. No. 04 -12, § 8)
Sec. 50 -59. - Rights and duties granted by certificate.
(a) 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.
(b) Acceptance of the certificate by the applicant shall obligate the applicant to:
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Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
(1) Service the entire zone granted to the applicant
(2) Provide coverage to adjoining zones, if available, when requested to do so by emergency
dispatch for emergency calls when the certificate holder for that zone is unable to respond.
(3) Keep posted at his place of business a copy of the fee schedule, which must be filed with the
Administrator (if applicable).
(4) Operate in accordance with the rules and regulations adopted pursuant to this Ordinance and
any applicable County Ordinances, and F.S. ch. 401, and any administrative regulations adopted
pursuant thereto.
(5) Employ at all times sufficient personnel experienced in operation and management of
emergency medical services to ensure proper and efficient operation.
(Ord. No. 04 -12, § 9; Ord. No. 2011 -36, § 5)
Sec. 50 -60. - Renewal of certificate.
Each certificate holder shall file within 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 may be relevant. The renewal application shall be accompanied by a $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.
(Ord. No. 04 -12, § 10)
Sec. 50 -61. - 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 the Operator will not be
available to any certain area of Collier County, the Administrator shall have such temporary emergency
powers as are necessary to provide that service. These temporary powers are intended to provide
interim protection until such time as the Board meets to resolve the emergency.
(Ord. No. 04 -12, § 11; Ord. No. 2011 -36, § 6)
Sec. 50 -62. - Classifications of certificates.
There shall be three (3) classifications of service in Collier County, as follows:
(1) Class 1: ALS Transport: ALS Rescue: An EMS Operator with the capability of rendering on
the scene prehospital ALS services with transport capability and who may or may not elect to
transport patients based on medical necessity. An EMS Operator rendering this level of service for
a governmental entity shall be deemed to be operating under the Class 1 - ALS rescue certificate
of public convenience and necessity held by the governmental entity. An EMS Operator holding a
Class 1 — ALS rescue certificate may provide post - hospital interfacility medical transfer services
and routine ALS and BLS calls within the County. A certificate of public convenience and
necessity must be obtained from the County before engaging in this level of medical service.
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(2) Class 2: Collier County Hospitals:
a. ALS Transfer: An EMS Operator who renders ALS interfacility medical transfer services.
An EMS 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 Operator to
provide 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.
b. Class 2 — ALS transfer certificate holders may provide post - hospital interfacility medical
transfer services and routine ALS and BLS calls within the County but only to hospitals
owned by the certificate holder, however, the Class 2 certificate holder may provide
out -of- County transports. Unless an EMS provider possesses a Class 1 — ALS Rescue
certificate issued by the County, a certificate of public convenience and necessity must be
obtained from the County before engaging in this level of medical service.
c. Class 2 transfer certificate holders shall contract with the the County for the
performance of services set forth in F.S. § 401.265 and Chapter 64J- 1.004(4)(a), Florida
Administrative Code.
(3) Class 3: ALS Non - Transport:
a. ALS Non - Transport: An EMS Operator who renders Advanced Life Support pre - hospital
services without transport capability.
b. Class 3 certificate holders work in concert with applicable Class 1 providers to assure
adequate and timely response to prehospital incidents with the intent to either reduce
applicable response times or otherwise augment the level of services as requested by the
associated Class 1 Operator. Unless an EMS Operator possesses a Class 1 — ALS Rescue
certificate issued by the County, a certificate of public convenience and necessity must be
obtained from the County before engaging in this level of medical service.
c. Class -3 certificate holders shall contract with the County for a negotiated amount per
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 Operator for purposes of this Ordinance or Florida Statutes unless the
Class -3 Operator separately contracts with the County in order for the County's Medical
Director to serve as its medical director for the performance of services set forth in F.S. §
401.265, and Chapter 64J- 2.004(4)(a), Florida Administrative Code.
d. 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 delegate or relinquish any responsibilities identified in
F.S. § 401.265, and associated Florida Administrative Code rules.
(Ord. No. 04 -12, § 12; Ord. No. 2011 -36, § 7)
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Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
Sec. 50 -63. - Transfer or assignment of certificates
No certificate issued under this article 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 article and subject to the same rules and regulations as
any other transfer or assignment.
(Ord. No. 04 -12, § 13)
Sec. 50 -64. - Revocation, alteration or suspension grounds.
(a) Every certificate issued under this article shall be subject to revocation, alteration and /or
suspension of operation, buy [by] the board, for a period of up to one year, where it shall appear that:
(1) The operator has failed or neglected for a period of 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.
(5) The operator has failed to comply with any of the provisions of this article.
(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 established and
prescribed under this article (if applicable).
(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 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 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.
(Ord. No. 04 -12, § 14)
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Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
Sec. 50 -65. - General operating regulations.
All certificate holders, operators, and drivers shall comply with all state statutes and administrative
regulations as following regulations:
(1) Twenty -four Hour Service. Every certificate holder shall be required to operate sufficient
ambulances, or relevant apparatus, as stated on the vehicle permit issued by the State
Department of Health, Bureau of Emergency Medical Services and permit issued by the Board, on
immediate call at all times.
(2) Prompt Service Required. Every call for service shall be answered promptly. Patients shall
be appropriately assessed, treated, packaged, loaded and transported by an Operator that is
licensed to transport without being subject to unreasonable delays. All calls for emergency
assistance requiring over twenty (20) minutes from time of notification to arrival on scene shall be
reported to the Administrator with complete documentation of the circumstances, which delayed
the response. Those instances where more than three (3) minutes elapse between receipt of an
emergency call and dispatch of an emergency vehicle shall also be reported to the Administrator
with documentation of circumstances.
(3) Bed Linens. Every Operator transporting patients shall provide clean and sanitary bed linens
for each patient carried which shall be changed as soon as practicable after the discharge of the
patient.
(4) Daily Log. Every Operator transporting patients shall maintain in a daily log upon which shall
be recorded the place or origin, time of call, time of dispatch, time of arrival at scene, time left for
hospital, time of arrival at hospital, and charges for each trip made and such other operating and
patient information as may be required by Ordinance. 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.
(5) Communications. Each 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.
(6) Vehicles and Equipment. Each Operator's vehicles shall be equipped with the proper medical
and emergency equipment as jointly agreed to by the medical director of each licensed provider
and the laws of the State of Florida.
(7) Certification.
a. In addition to the State of Florida Department of Health, Bureau of Emergency Medical
Services requirements for certification, each Collier County EMS paramedic, Class -2
Operator's paramedic, and 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 of services set forth in F.S. § 401.265, and Chapter 64J- 2.004(4)(a), Florida
Administrative Code, must be certified by the County Medical Director. Each Collier County
EMS paramedic and Class -2 Operator paramedic must work with a Collier County EMS
ambulance for a sufficient length of time pursuant to subsection (8) for the County's Medical
Director to properly judge the paramedic's capability. Salaries of other than Collier County
EMS paramedics will be paid by the agency seeking the Medical Director Certification.
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PART I - CODE
Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
b. The Medical Director of a Class -3 Operator or a Class -1 Operator, excluding Collier
County EMS, shall certify its paramedics pursuant to F.S. § 401.265, and Chapter
64J- 2.004(4)(a), Florida Administrative Code.
c. 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 of
services set forth in F.S. § 401.265, and Chapter 64J- 2.004(4)(a), Florida Administrative
Code, shall be certified pursuant to the terms of such contract.
(8) Ride Time Requirement. Each paramedic employed by Collier County EMS, a Class -1
Operator or a Class -2 Operator must work, at a minimum, with a Class -1 Operator's ambulance
not less than one full month's work shift annually. Each paramedic employed by a Class -3
Operator that has its own 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 paramedic 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 of services set forth in F.S. § 401.265, 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 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 a Collier County EMS transport arrival or if the
patient's condition requires that additional level of expertise, as provided for in its contract with the
County.
(9) 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.
(Ord. No. 04 -12, § 15; Ord. No. 2011 -36, § 8)
Sec. 50 -66. - 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 maintained at the emergency control center.
(Ord. No. 04 -12, § 16)
Sec. 50 -67. - 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.
(Ord. No. 04 -12, § 17)
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Sec. 50 -68. - Rates.
12/13/2011 Item 161.7.
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.
(Ord. No. 04 -12, § 18)
Sec. 50 -69. - 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 $100,000.00 for
injuries to or death of any one person arising out of any one accident and the sum of at least
$300,000.00 for injuries to or death or more than one person in any one accident and for the sum of at
least $50,000.00 for damage to property arising from any one 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 30 -day cancellation notice to the board.
(Ord. No. 04 -12, § 19)
Sec. 50 -70. - 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:
(1) Fail or refuse to promptly transport, if applicable, or attend any sick or injured person after
responding to a call.
(2) Demand or receive compensation other that established and approved in accordance with
this article or fail to give a receipt for moneys received (if applicable).
(3) Give or allow rebate, commission, discount or any reduced rate not provided in the
established rate (if applicable.)
(4) 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.
(5) At any time release his patient from his care until he is assured that some responsible person
is available to receive such patient.
(6) At any time use a siren or flashing red light unless on an emergency call.
(7) 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.
(8) Smoke while within the confines of an ambulance.
Collier County, Florida, Code of Ordinances
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PART I - CODE
Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
(9) Operate or ride in a vehicle without using seatbelts. (Personnel attending patients are lvaow
exempt.)
(Ord. No. 04 -12, § 20; Ord. No. 2011 -36, § 9)
Sec. 50 -71. - Passengers.
No person shall be aboard ambulances when engaged in emergency or routine calls except the
following:
(1) Driver, attendants and fire or law enforcement personnel;
(2) Patients;
(3) Relatives or close friends of the patient when authorized by an EMS Battalion Chief or
position of a higher rank. These requests will only be granted under exceptional circumstances;
(4) Physicians and nurses;
(5) Personnel in an observing capacity that are being trained for ambulance or ALS service; or
(6) Operator's supervisory personnel.
(Ord. No. 04 -12, § 21; Ord. No. 2011 -36, § 10)
Sec. 50 -72. - Obedience to traffic laws, ordinances or regulations.
(a) Under the provisions of Florida State law, the driver of an ambulance or ALS vehicle when Awk
responding to an emergency call or while transporting a patient may exercise the following privileges
when such driver has reasonable grounds to believe that an emergency in fact exists requiring the
exercise of such privileges:
(1) 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 article.
(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.
(Ord. No. 04 -12, § 22; Ord. No. 2011 -36, § 11)
Collier County, Florida, Code of Ordinances
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PART[-CODE
Chapter 50 - EMERGENCY SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES
Sec. 50 -73. - Violations.
In addition to the remedies provided herein, a violation of any provision of this article shall be
punishable as provided by law for the violation of county ordinances.
(Ord. No. 04 -12, § 23)
Sec. 50 -74. - Uniformity of application.
The article shall constitute a uniform law applicable in all of Collier County.
(Ord. No. 04 -12, § 24)
Sec. 50 -75. - 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 article to strictly enforce the provisions of this article.
(Ord. No. 04 -12, § 25)
Secs. 50 -76-50 -100. - Reserved.
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