Agenda 02/25/2020 Item #16E 6 (COPCN - Care Med Transportation)02/25/2020
EXECUTIVE SUMMARY
Recommendation to approve a Certificate of Public Convenience and Necessity for non-
emergency BLS inter-facility ambulance transports to Care Med Transportation, LLC, to provide
post-hospital and inter-facility medical ambulance transfer services.
OBJECTIVE: To proceed in the best interest of the public health, safety, and welfare by
granting a Certificate of Public Convenience and Necessity-Class 2, Basic Life Support (BLS) post-
hospital, inter-facility ambulance transports to Care Med Transportation, LLC, hereinafter referred to as
“Care Med.”
CONSIDERATIONS: On June 26, 2019, the Collier County's Bureau of Emergency Services received
an application from Care Med for a Certificate of Public Convenience and Necessity (COPCN) to
provide Basic Life Support (BLS) Class 2 (post-hospital inter-facility medical transfer services)
ambulance transportation within Collier County. Staff and the Emergency Medical Authority (EMA) on
February 12, 2020, reviewed the information submitted and deem the application complete, and
recommend that the COPCN and associated Permit be granted for one year.
It is the opinion of the Bureau of Emergency Services that this BLS service is necessary and practical to
provide additional medical transportation services to patients being transferred from hospital-to-hospital,
hospital-to-home, or for clinical procedures, etc. It is reasonable to accept the services of an additional
provider who will assist in the anticipated future demands of the fast pace of the expanding number of
nursing homes, rest homes, and skilled care facilities as well as population growth. The expansion of
additional BLS transportation service for non-emergency ambulance vehicles should reduce wait times
for facilities and their patients during discharge, and further reduce the calls for non-emergency service
transport placed upon Collier County EMS, which is preferred to allow for Collier County EMS to focus
on its pre-hospital emergency medical delivery.
Care Med has purchased (2) two, Federal Department of Transportation Specification Standard KKK-A-
1822-E type ambulance vehicles. These vehicles are noted on the permit and will be placed in-service
following the County’s approval of the Certificate and subsequent State Department of Health- EMS
vehicle inspection.
Collier County, nor does the Sheriff’s 911 Center receive or track such calls for non-emergency inter-
facility service made between a hospital, nursing home, or doctor’s office, etc. All estimates for calls for
service are compiled from data provided by Care Med based upon their local experience with non-
stretcher medical transport services.
Staff’s broad estimates suggest that approximately 300-400 transports are likely to be handled by a Class
2 BLS Certificate holder on an annual basis from current facilities in Collier County. A broad estimate of
the over 500 beds reported in permitting for local construction could generate an additional 100-200
annual convalescent transports in the near future as additional facilities become operational and local
population and seasonal increases occur. Staff does not have information as to the timing of bed’s and
facility openings, as referenced above. As a result of the market-place nature of the additional facilities
and beds, the convalescent transport estimates are rudimentary at best. The County has no obligations to
compensate a private ambulance provider for any services, nor does the County receive any revenue
from service delivery by a private ambulance provider
Should the Board approve an annual Class 2 BLS Certificate of Public Convenience and Necessity to
Care Med the following provisions of the Certificate are recommended requirements:
1. Care Med shall provide the Emergency Medical Authority an updated copy of its Certificate of
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Insurance with its malpractice coverage noted.
2. Care Med shall begin its operation with (1) one ambulance within 30 days and is approved to
make operational up to a total of (2) two ambulances within this annual permit.
3. Staff is recommending this current COPCN application if approved to expire on February 24,
2021.
4. Care Med’s COPCN shall be required to be renewed annually. Its renewal application is to be
received no later than 90 days prior to its expiration.
5. Care Med Transporta tion will be required to work closely with Collier County EMS,
Collier County Sheriff's 911 dispatch personnel, local licensed facilities, and other responders
to ensure that their entry into local and regional inter-facility ambulance transportation is
properly coordinated and services appropriately represented. Collier County Bureau of Emergency
Services and/or its EMS Division shall be allowed to conduct any reasonable inspections or site
visits and receive in a timely manner any statistical call volume information needed to evaluate
services, monitor complaints and address any quality of care issues in conjunction with its
respective Medical Directors.
This redistribution of non -emergency transports to Care Med Transportation, Ambitrans, and
Concierge Ambulance service doing business as Brewster’s Ambulance Service would allow for
increased utilization of Collier County EMS for the escalating emergency scene calls for service. Staff
deems the increase in emergency vehicle availability for its core mission worthy of this effort.
FISCAL IMPACT: There is no fiscal impact to the Board for the granting of this certificate.
The Board is requested to accept and recognize as revenue the application fee of $250 in Fund
(001) with the corresponding application.
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting from
this action.
LEGAL CONSIDERATIONS: Regarding the consideration of this item, Ordinance No. 04-12, Section
7 states:
“The Board of County Commissioners shall not grant a certificate unless it shall find, after public
hearing and based on competent evidence that each of the following standards has been satisfied:
A. That there is a public necessity for the service. In making such determination, the
Board of County Commissions 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.
(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.
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(6) That the applicant has sufficient knowledge and experience to properly
operate the proposed service.
B. That, if applicable, there is an adequate revenue base for the proposed service.
C. That the proposed service will have sufficient personnel and equipment to
adequately cover the proposed service area.”
Ordinance No. 04-12, Section 8 provides:
“In making the determinations provided for in Section 7 above, the Board may, in its sole
discretion, appoint a Hearing Officer to hold a public hearing and to make factual findings and
conclusions as a result of the hearing. Should a Hearing Officer be appointed, said, Hearing
Officer shall render a written report to the Board within 30 days of the hearing, which report shall
contain the officer's findings and conclusions of fact and a recommended order. The findings and
conclusions of fact shall be binding upon the Board, but the recommended order shall be advisory
only.”
A copy of the application is included with this Executive Summary. Copies of staff response and
protocols are available for examination in the office of the Board of County Commissioners. This item is
approved for form and legality and requires a majority vote for Board action. JAB
RECOMMENDATION: To approve and authorize the following:
1. A Certificate of Public Convenience and Necessity for Care Med Transportation, LLC, Inc
for up to (2) two Basic Life Support ambulances during the term of the permit.
2. The Chairman to execute the Permit and Certificate;
3. The Board to accept and recognize as revenue the application fee of $250 in Fund (001).
Prepared by: Dan E. Summers, Director, Bureau of Emergency Services
ATTACHMENT(S)
1. [Linked]Full application (PDF)
2. CAO Approved Permit CareMed LLC (PDF)
3. CAO Approved Certificate CareMed LLC (PDF)
4. CAO Approved VIN List CareMed LLC (PDF)
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.6
Doc ID: 11678
Item Summary: Recommendation to approve a Certificate of Public Convenience and Necessity
for non-emergency BLS inter-facility ambulance transports to Care Med Transportation, LLC for the
purpose of providing post-hospital and inter-facility medical ambulance transfer services.
Meeting Date: 02/25/2020
Prepared by:
Title: Executive Secretary – Emergency Management
Name: Kathy Heinrichsberg
02/12/2020 12:50 PM
Submitted by:
Title: Division Director - Bureau of Emer Svc – Emergency Management
Name: Daniel Summers
02/12/2020 12:50 PM
Approved By:
Review:
Emergency Management Daniel Summers Additional Reviewer Completed 02/12/2020 1:14 PM
Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 02/12/2020 1:25 PM
Emergency Medical Services Tabatha Butcher Additional Reviewer Completed 02/13/2020 8:53 AM
County Attorney's Office Kathy Heinrichsberg Level 2 Attorney of Record Review Skipped 02/13/2020 3:24 PM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 02/13/2020 5:37 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 02/14/2020 8:06 AM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 02/14/2020 8:13 AM
Office of Management and Budget Laura Wells Additional Reviewer Completed 02/14/2020 10:17 AM
County Manager's Office Sean Callahan Level 4 County Manager Review Completed 02/17/2020 2:49 PM
Board of County Commissioners MaryJo Brock Meeting Pending 02/25/2020 9:00 AM
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16.E.6.b
Packet Pg. 2246 Attachment: CAO Approved Permit CareMed LLC (11678 : CareMed CoPCN)
16.E.6.c
Packet Pg. 2247 Attachment: CAO Approved Certificate CareMed LLC (11678 : CareMed CoPCN)
16.E.6.d
Packet Pg. 2248 Attachment: CAO Approved VIN List CareMed LLC (11678 : CareMed CoPCN)