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Chapter 50 - Emergency ServicesChapter 50 EMERGENCY SERVICES* Article I. In General Secs. 50-1—50-25. Reserved. Article II. Reserved Secs. 50-26—50-50. Reserved. Article III. Medical Transportation Services Sec. 50-51. Purpose. Sec. 50-52. Definitions. Sec. 50-53. Requirements 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; Appeals. 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. Collier Regional Medical Directors Coalition. Sec. 50-66. General operating regulations. Sec. 50-67. Place of Business. Sec. 50-68. Records to be Kept. Sec. 50-69. Rates. Sec. 50-70. Operator's Insurance Requirements for Non-Governmental Enti- ties. Sec. 50-71. Conduct of Drivers and Attendants. Sec. 50-72. Passengers. Sec. 50-73. Obedience to Traffic Laws, Ordinances or Regulations. Sec. 50-74. Violations. Sec. 50-75. Uniformity of Application. Sec. 50-76. Authority to enforce. Secs. 50-77—50-100. Reserved. Article IV. Community Automated External Defibrillator Program Sec. 50-101. Title. Sec. 50-102. Findings and purpose. Sec. 50-103. Applicability. Sec. 50-104. Requirements and procedures. Secs. 50-105—50-130. Reserved. *Cross references—Civil emergencies, ch. 38; fire prevention and protection, ch. 58; emergency medical services system impact fee, § 74-266 et seq.; law enforcement, ch. 78; special districts providing for rescue services, ch. 122. CD50:1Supp. No. 116 ARTICLE I. IN GENERAL Secs. 50-1—50-25. Reserved. ARTICLE II. RESERVED* Secs. 50-26—50-50. Reserved. ARTICLE III. MEDICAL TRANSPORTATION SERVICES† Sec. 50-51. Purpose. This Ordinance is adopted pursuant to Chapters 125 and 401, 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 promulgat- ing complete and clear rules and regulations for operation of all ambulance or rescue companies or services in Collier County. (Ord. No. 04-12, § 1; Ord. No. 2024-25, § 1) Sec. 50-52. Definitions. The following words, terms and phrases, when used in this Ordinance, 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 or her designee. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida Administrative Code. The provision of ALS services may include ambulance service or ALS non-transport services. Advanced Life Support Non-Transport (ALS non-transport) shall mean the provision of ALS services in an emergency by a licensee until the arrival of an air ambulance or an ambulance which is used for, or intended to be used for, land, air, or water transportation of sick or injured persons requiring or likely to require medical attention during transport. 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 help- less. Basic Life Support (BLS) means the assess- ment of treatment by a person qualified under Florida Statute and Florida Administrative Code in the use of techniques described in the EMT- Basic National Standard Curriculum or the National EMS Education Standards of the United States Department of Transportation and approved by the Department of Health. Board shall mean the Collier County Board of County Commissioners. Certificate means a certificate of public convenience and necessity as authorized in Sec- tion 401.25(2)(d), Florida Statutes. Countywide Medical Protocols means the medi- cally correct standing orders or protocols that permit specified ALS and BLS procedures when communication cannot be established with an Operator's medical director or when any delay in patient care would potentially threaten the life or health of the patient, which all Class 1, 3, and 4 certificate holders' emergency medical service professionals, such as paramedics and emergency medical technicians (EMTs), must follow for patient assessment, treatment, transportation, and delivery to definitive care. Countywide Medi- cal Protocols must be approved by the Collier Regional Medical Directors Coalition in accordance with this Ordinance. An Operator's medical direc- tor may elect not to have its emergency medical *Editor’s note—Ord. No. 2009-01, § 6, adopted Jan. 13, 2009, repealed art. II §§ 50-26—50-28, which pertained to the Collier County Emergency Medical Services Advisory Council and derived from: Ord. No. 80-80, §§ 1—3; Ord. No. 81-1, § 1; Ord. No. 00-70, § 1; Ord. No. 02-39, § 1; Ord. No. 2006-55, § 1; and Ord. No. 08-35, § 1. †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. Cross references—Businesses, ch. 22; health and sanita- tion, ch. 66. State law reference—Medical transportation services, F.S. § 401.2101 et seq. § 50-52EMERGENCY SERVICES CD50:3Supp. No. 116 service professionals carry all medicines or perform all procedures required by a County- wide Medical Protocol but such medical director shall ensure that its emergency medical service professionals are fully trained on the entire protocol. Emergency Call shall mean the transit of an ambulance under conditions which warrants travel with flashing lights and siren operating. Governmental Entity shall mean Collier County, a municipality, or an independent special fire control and rescue district within Collier County. Non-governmental Entity shall mean any person, organization, firm, agency, or entity includ- ing, but not limited to, a corporation, partner- ship, limited liability company, or sole proprietorship that is not affiliated, through ownership or control, with a governmental entity. Operator shall mean any non-governmental entity or governmental entity providing ambulance or ALS non-transport 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 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; Ord. No. 2019-38, § 1; Ord. No. 2024-25, § 2) Sec. 50-53. Requirements for Certificate. It shall be unlawful for any non-governmental entity or governmental entity to provide an ambulance service or ALS services or interfacil- ity transport services without first obtaining a certificate therefore from the Board or the Administrator, as provided by this Ordinance. (Ord. No. 04-12, § 3; Ord. No. 2024-25, § 3) Sec. 50-54. Exemptions and exclusions from Certificate Requirement. Certificates shall not be required for: A. Rescue Services (Non-ALS). B. The use of a non-ambulance for any transport of a patient pursuant to the Good Samaritan Act, Section 768.13, Florida Statutes. C. Vehicles rendering ambulance-type services when requested to do so by the Board or Administrator in the event of a major catastrophe or other such emergency which requires more ambulances than are available in the county. D. Ambulances based outside the county which pick up a patient in the county and transport the patient out of the county, or which pick up a patient out of the county and transport the patient into the county. E. Vehicles used to transport persons for routine scheduled medical treatments. Vehicles transporting persons who require services en route are not covered by this exemption. (Ord. No. 04-12, § 4; Ord. No. 05-16, § 4; Ord. No. 2011-36, § 2; Ord. No. 2024-25, § 4) Sec. 50-55. Procedure for Obtaining Certificate. A. Non-governmental entities applying for any classification of 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. 2. The boundaries of the territory desired to be served (also known as a zone). 3. The number and brief description of the ambulances or other vehicles the applicant will have available. § 50-52 COLLIER COUNTY CODE CD50:4Supp. No. 116 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 refer- ences 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 two hundred fifty dollars ($250.00). 10. Financial data including assets and liabilities of the Operator. A schedule of all debts encumbering any equipment shall be included. B. Governmental entities applying for a Class 1, Class 3, and/or Class 4 certificate shall provide the Administrator with the following informa- tion in order for a request for a certificate to be granted. Each request shall contain: 1. The name of the governmental entity. 2. (a) The boundaries of the territory to be served by a Class 1 or Class 3 Operator that is a governmental entity includes the governmental entity's jurisdiction and any areas in which the governmental entity has an automatic aid or mutual aid agreement for fire and emergency medical services or in accordance with a closest unit response agree- ment. If an applicant submits an application that does not include the same number of Collier County EMS ambulances that were previ- ously stationed within the governmental entity's boundaries at the time of its Class 1 certificate application ("Prior Coverage"), a statement that the Class 1 Opera- tor recognizes that Collier County EMS may continue to provide transport services within its terri- tory and, to avoid the disruption of transport services to the public, the governmental entity will coordinate with Collier County EMS related to ambulance coverage within its boundaries until such time as the governmental entity activates the same Prior Coverage. (b) If a governmental entity's ability to provide service under a Class 4 certificate is activated in accordance with this Ordinance, the Operator is authorized to provide fire, rescue, and emergency medical services countywide if the Operator has the closest or most appropriate unit that is able to provide the response. 3. A certification by the Fire Chief or applicable administrator of the governmental entity that the governmental entity has the ability to obtain all licenses and certificates as may be required by Chapter 401, Florida Statutes. 4. The governmental entity's annual report or its last fiscal audit submitted to the Florida Auditor General. 5. A schedule of rates which the service intends to charge, if applicable. The schedule of rates may be a statement that such rates are the rates as set by the Federal Government. 6. The number of vehicles that the applicant will permit under its state license for ambulances and ALS non-transport vehicles, as applicable. No application or renewal fee shall be required for any applicant that is a governmental entity applying for a Class 1, Class 3 or Class 4 certificate. An applicant may apply for multiple certificates simultaneously. (Ord. No. 04-12, § 5; Ord. No. 2011-36, § 3; Ord. No. 2024-25, § 5) Sec. 50-56. Review of Application. A. For all applicants that are non-governmental entities, the Administrator shall review each application and shall investigate the applicant's § 50-56EMERGENCY SERVICES CD50:5Supp. No. 116 reputation, competence, financial responsibility, and any other relevant factors. The Administra- tor shall also make an investigation as to the public necessity for an ambulance or ALS opera- tion in the territory requested, and shall then make a report to the Board containing his or her recommendation whether to grant a certificate to the applicant within sixty (60) days of the time the Administrator determines the application is complete. B. Notwithstanding any other ordinance or provision, no administrative review or review by the Board, a county-appointed board, entity, or commission shall be required for any applicant that is a governmental entity applying for a Class 1, Class 3, and/or Class 4 certificate. Upon submission of an application that includes the information required by this Ordinance, the Administrator shall administratively approve the application and shall issue the requested certificate or certificates to the governmental entity within sixty (60) days of the application submission. (Ord. No. 04-12, § 6; Ord. No. 2024-25, § 6) Sec. 50-57. Requirement for Board Approval in Granting Certificate. The Board shall not grant a certificate to a non-governmental entity 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 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 Collier County. 2. The effect of the proposed service on existing services with respect to qual- ity 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 quali- fied 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 suf- ficient personnel and equipment to adequately cover the proposed service area. (Ord. No. 04-12, § 7; Ord. No. 2011-36, § 4; Ord. No. 2024-25, § 7) Sec. 50-58. Appointment of Hearing Officer; Appeals. A. 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 thirty (30) days of the hearing, which report shall contain the officer's findings and conclu- sions 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. B. All decisions rendered by the Administra- tor or the Board shall be appealable by request- ing a hearing before a Hearing Officer. 1. The hearing shall be requested within fifteen (15) business days of the date of the decision to be challenged. 2. A hearing date shall not be postponed or continued unless a request for continu- ance is received in writing by the Hear- ing Officer at least ten (10) business days prior to the date set for the hearing. No § 50-56 COLLIER COUNTY CODE CD50:6Supp. No. 116 additional continuances shall be granted without concurrence of the Administra- tor. 3. The fact-finding determination of the Hearing Officer shall be limited to whether the alleged violation occurred or whether competent, substantial evidence sup- ports the Administrator's or Board's deci- sion. Based upon this fact-finding determination, the Hearing Officer shall either affirm or reverse the decision of the Administrator or Board. If the Hear- ing Officer affirms the decision of the Administrator or Board, the named party shall have fifteen (15) calendar days from the date of the decision of the Hearing Officer to comply with the deci- sion of the Administrator or Board unless some other period is agreed to by the County. C. All decisions rendered by the Hearing Officer shall be appealable to the Board of County Commissioners, and all decisions rendered by the Board shall be appealable as permitted by Florida law, and shall be considered quasi- judicial decisions. (Ord. No. 04-12, § 9; Ord. No. 2011-36, § 5; Ord. No. 2024-25, § 8) Sec. 50-59. Rights and Duties Granted by Certificate. A. The certificate granted by the Board to a non-governmental entity shall be valid for one (1) 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. The certificate granted by the Administrator to a governmental entity shall remain valid until such time as the governmental entity provides one (1) year notice to the Administrator that it will no longer be providing ALS services. Notwithstanding, a certificate issued to a governmental entity may be revoked in accordance with this Ordinance. B. A Class 1 and Class 3 certificate holder may increase the number of vehicles providing services upon notifying Collier County within five (5) business days of additional State vehicle permits, including whether such vehicle is an ambulance or providing ALS non-transport services (as applicable). Nothing in this Ordinance shall supersede any State administrative rule that allows a vehicle to provide BLS services. C. Acceptance of the certificate by the applicant shall obligate the applicant to: 1. Service the entire zone granted to the applicant or the area provided in this Ordinance for Class 1, Class 3, and Class 4 certificate holders. 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. A Class 4 certificate holder is authorized to provide fire, rescue, and emergency medical services county- wide if activated in accordance with this Ordinance. 3. Keep posted at the Operator's 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 Chapter 401, Florida Statutes, and any administrative regula- tions adopted pursuant thereto. 5. Employ, at all times, sufficient personnel experienced in operation and manage- ment of emergency medical services to ensure proper and efficient operation. 6. Submission of a list of all vehicles permit- ted by the State Department of Health. (Ord. No. 04-12, § 9; Ord. No. 2011-36, § 5; Ord. No. 2024-25, § 9) Sec. 50-60. Renewal of Certificate. Each non-governmental entity certificate holder shall file within ninety (90) days of expiration, § 50-60EMERGENCY SERVICES CD50:7Supp. No. 116 an application for renewal of the 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 two hundred fifty dollars ($250.00) renewal fee. If the initial certificate was issued under this Ordinance, 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; Ord. No. 2024-25, § 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 situa- tion exists which poses a serious threat that the Operator will not be available in 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 protec- tion until such time as the Board meets to resolve the emergency. (Ord. No. 04-12, § 11; Ord. No. 2011-36, § 6; Ord. No. 2024-25, § 11) Sec. 50-62. Classifications of certificates. To fulfill ongoing needs for emergency medical services in Collier County, as it grows and responds to service needs, there shall be four (4) classifica- tions of service in Collier County, as follows: A. Class 1: Primary ALS Transport: ALS Rescue. 1. An Operator with the capability of rendering on the scene prehospital ALS services with transport capabil- ity and who may or may not elect to transport patients based on medical necessity. An 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 Opera- tor 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 medi- cal service. An Operator with a Class 1—ALS rescue certificate may provide both ambulances and ALS non-transport services based on the information provided to Collier County in accordance with this Ordinance. An Operator with a Class 1 certificate is authorized to have its ALS non-transport vehicles provide transport on a limited basis upon (1) the issuance of an emergency order has been issued by the Governor of the State of Florida declaring or extending a state of emergency for a natural disaster or public health emergency that includes Collier County, (2) the occur- rence of an active shooting incident in Collier County as determined by the Collier County Sheriff's Office, (3) the occurrence of an injury to a firefighter, paramedic, or law enforce- ment officer that results in the need for the immediate transport, or (4) the occurrence of a mass casualty as defined by the Collier County Fire Chiefs Mass Casualty Incident Guidelines in Collier County. A Class 1 certificate holder may also temporarily add additional ambulances based on special events within its boundaries. 2. The medical director for a Class 1 certificate holder shall not delegate or relinquish any responsibilities identified in Section 401.265, Florida Statutes, and associated Florida Administrative Code rules. The medical director for a Class 1 § 50-60 COLLIER COUNTY CODE CD50:8Supp. No. 116 certificate holder shall actively participate in the Collier Regional Medical Directors Coalition and must implement the Countywide Medical Protocols developed in accordance with this Ordinance to ensure continuity of care. 3. Only governmental entities may be Class 1 certificate holders. B. Class 2: Inter-Facility Transport Services: BLS or ALS Transfer. An 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 the protocols approved by the Class 2 Operator's Medical Direc- tor. 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 poli- cies 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 right to review and evaluate all calls made by the Opera- tor to ensure that the appropriate level of personnel, supplies, equipment and vehicles are being utilized, as set forth in Florida Statute and Florida Administra- tive Code. C. Class 3: ALS Non-Transport. 1. An Operator who renders ALS pre- hospital services without transport capability. 2. Class 3 certificate holders work in concert with applicable Class 1 Operators 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 associ- ated Class 1 Operator. Class 3 certificate holders service will improve patient outcomes, reduce time to initial assess to care, and improve performance on quality measures as developed by state or national oversight groups. If requested by a Class 1 Operator, each paramedic employed by a Class 3 certificate holder must accompany a patient on an Operator's ALS transport from scene to hospital when the paramedic for such Class 3 Operator initiates ALS services on a patient prior to the Class 1 Operator transport arrival or if the patient's condition requires that additional level of expertise. Unless an 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. 3. The medical director for a Class 3 Operator shall work cooperatively with the Class 1 Operators to ensure continuity of care. The medical direc- tor for a Class 3 certificate holder shall not delegate or relinquish any responsibilities identified in Sec- tion 401.265, Florida Statutes, and associated Florida Administrative Code rules. The medical director for a Class 3 certificate holder shall actively participate in the Collier Regional Medical Directors Coali- tion and must implement the Coun- tywide Medical Protocols developed in accordance with this Ordinance to ensure continuity of care. § 50-62EMERGENCY SERVICES CD50:9Supp. No. 116 4. Only governmental entities may be Class 3 certificate holders. D. Class 4: Secondary ALS Transport 1. An Operator with the capability of rendering on the scene prehospital ALS services with transport capabil- ity and who may or may not elect to transport patients based on medical necessity. An Operator with a Class 4 certificate may only transport upon: a. the request of a Class 1 certificate holder, with such requests being limited to emergencies where due to call volumes, mutual aid is needed; b. the issuance of an emergency order has been issued by the Governor of the State of Florida declaring or extending a state of emergency for a natural disaster or public health emergency that includes Col- lier County; c. the occurrence of an active shooting incident in Collier County as determined by the Collier County Sheriff's Office; d. the occurrence of an injury to a firefighter, paramedic, or law enforcement officer that results in the need for the immediate transport; or e. the occurrence of a mass casualty as defined by the Col- lier County Fire Chiefs Mass Casualty Incident Guidelines in Collier County. 2. A Class 4 Operator does not have the authority to provide inter-facil- ity transport services unless there is: a. the issuance of an emergency order has been issued by the Governor of the State of Florida declaring or extending a state of emergency for a natural disaster or public health emergency that includes Col- lier County; b. the occurrence of an active shooting incident in Collier County as determined by the Collier County Sheriff's Office; or c. the occurrence of a mass casualty as defined by the Col- lier County Fire Chiefs Mass Casualty Incident Guidelines in Collier County. 3. The medical director for a Class 4 certificate holder shall work cooperatively with Class 1 Opera- tors to ensure continuity of care. The medical director for a Class 4 certificate holder shall not delegate or relinquish any responsibilities identified in Section 401.265, Florida Statutes, and associated Florida Administrative Code rules. The medical director for a Class 4 certificate holder shall actively participate in the Collier Regional Medical Directors Coalition and must implement the Countywide Medical Protocols developed in accordance with this Ordinance to ensure continuity of care. 4. Only governmental entities may be Class 4 certificate holders. To qualify for a Class 4 certificate, the Opera- tor must also have a Class 3 certificate. An Operator may be issued multiple certificates for different classes of service. (Ord. No. 04-12, § 12; Ord. No. 2011-36, § 7; Ord. No. 2012-04, § 1; Ord. No. 2019-38, § 2; Ord. No. 2024-25, § 12) Sec. 50-63. Transfer or Assignment of Certificates. No certificate issued under this Ordinance shall be assignable or transferable by the person to whom issued unless approval is obtained from the Board in the same manner and subject to the § 50-62 COLLIER COUNTY CODE CD50:10Supp. No. 116 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 assign- ment as contemplated in this Ordinance and subject to the same rules and regulations as any other transfer or assignment. (Ord. No. 04-12, § 13; Ord. No. 2024-25, § 13) Sec. 50-64. Revocation, Alteration or Suspension Grounds. A. Every certificate issued under this Ordinance shall be subject to revocation, altera- tion and/or suspension of operation, 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 thirty (30) days during any calendar year to render all services authorized by the certificate. 2. The Operator has been convicted of a felony or any criminal offense involving moral turpitude. 3. The certificate was obtained by an applica- tion 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 of 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 (2) previous convictions to operate emergency vehicles. 5. 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 its agent has demanded money or compensation other than established and prescribed under this Ordinance (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 its 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. (Ord. No. 04-12, § 14; Ord. No. 2024-25, § 14) Sec. 50-65. Collier Regional Medical Directors Coalition. The continuity of care for patients of emergency medical services within the County is imperative for the safety of citizens and visitors in Collier County. As a result, the implementation of Coun- tywide Medical Protocols is required by Class 1, Class 3, and Class 4 certificate holders. A. There is hereby created the Collier Regional Medical Directors Coalition (hereinafter the "MD Board"), whose purpose is to ensure that the rendering of on scene prehospital emergency medi- cal services within the County is coopera- tive and seamless between Operators. B. The members of the MD Board consists of the medical director for each Class 1 and 3 Operator, with each Operator having a single medical director as a member, the Chair of Emergency Medicine, or the Chair of Emergency Medicine's physi- cian designee, from each hospital system that is operating within Collier County, and the Chair of Emergency Medicine, or § 50-65EMERGENCY SERVICES CD50:11Supp. No. 116 the Chair of Emergency Medicine's physi- cian designee from the regional trauma center in Lee County. C. The purpose of the MD Board is to develop medical protocols that will be implemented as Countywide Medical Protocols as well as to develop a creden- tialing and recredentialing standards for EMTs and paramedics of Class 1, 3, and 4 Operators. The MD Board will also make recommendations for equipment, supplies, medications to fulfill medical protocols, including changes related to equipment/medication shortages. D. Any Operator's Medical Director, or the Operator's Medical Director's physician designee, may propose a medical protocol for consideration to be implemented as a Countywide Medical Protocol. The medi- cal protocol shall be deemed a County- wide Medical Protocol upon a majority approval of the MD Board members. E. Operators' Medical Directors have an equal vote on the board and a Medical Director may not represent more than one (1) Operator on the MD Board at any given time. The hospital-based Emergency Medicine chairs are non-voting members. F. The County's Medical Director shall serve as the initial Chair of the MD Board and shall serve a one (1) year term as Chair. G. The MD Board shall be staffed by the Operator that is represented by the Chair. H. Robert's Rules of Order shall be applicable to board meetings and Chapter 286, Florida Statutes, is not applicable. The MD Board shall adopt by-laws for doing its work and conducting its business, including but not limited to quorum, voting on non-protocol related issues, the election and term of the Chair, the appoint- ment of members by Operators when they share a medical director to ensure each Operator has representation on the MD Board, and how new or modified protocols are implemented to ensure appropriate training. I. The MD Board will designate appropri- ate working committees and the leader- ship and responsibilities of those committees. Working committees may include non-MD Board members. J. The MD Board may coordinate with other boards or organizations such as the Lee County Medical Control Board and the Collier County EMS Council. K. The MD Board will conduct quality reviews that are protected by Peer Review statutes and standards in place in Florida for such activities. Each member of the MD Board must agree to comply with Health Insurance Portability and Account- ability Act (HIPAA) and Florida Informa- tion Protection Act (FIPA) requirements, as amended. Protected health informa- tion may not be disclosed to a MD Board member unless an agreement addressing HIPAA and FIPA has been executed between the certificate holder and MD Board member. (Ord. No. 2024-25, § 15) Editor’s note—Ord. No. 2024-25 added new provisions designated as § 50-65 and renumbered existing §§ 50-65— 50-75 as 50-66—50-76, as herein set out below. Sec. 50-66. General operating regulations. All Operators and drivers shall comply with all state statutes and administrative regulations as well as the following regulations: A. Twenty-four Hour Service. Every Opera- tor shall be required to operate sufficient ambulances, if applicable, or relevant apparatus, as stated on the vehicle permit issued by the State Department of Health, Bureau of Emergency Medical Services on immediate call at all times. Notwithstanding, an Operator that is a Class 1 certificate holder may provide less than twenty-four (24) hour services based on the information provided to Collier County in accordance with this Ordinance. B. Prompt Service Required. Every call for service shall be answered promptly and in line with medical necessity. Patients § 50-65 COLLIER COUNTY CODE CD50:12Supp. No. 116 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. C. 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. D. 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 operat- ing 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 recognizing that informa- tion that is protected by the Health Insurance Portability and Accountability Act (HIPAA) and Florida Information Protection Act (FIPA), as amended, may not be disclosed to the Administrator unless an agreement addressing HIPAA and FIPA has been executed between the certificate holder and the County. E. Communications. Each emergency vehicle shall maintain two-way radio communica- tion 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 vehicles shall be equipped with the proper medical and emergency equipment as jointly agreed to by the Collier Regional Medical Directors Coalition and in accordance with the laws of the State of Florida. G. Certification. All Operators shall certify its paramedics pursuant to Section 401.265, Florida Statutes, and Chapter 64J-2.004(4)(a), Florida Administrative Code. The credentialing and recredential- ing process developed by the Collier Regional Medical Directors Coalition shall be implemented by all Class 1, 3, and 4 certificate holders, and such certificate holders shall ensure that the credential- ing and recredentialing process is incorporated into their respective collec- tive bargaining agreements. H. Application. Each ambulance or ALS service shall be subject to those rules and regulations as promulgated by Ordinances of the Board for the purpose of carrying out this Ordinance. I. Continuity of Care. For Class 1, 3, and 4 certificate holders, each certificate holder must implement the Countywide Medi- cal Protocols developed in accordance with this Ordinance to ensure continuity of care. (Ord. No. 04-12, § 15; Ord. No. 2011-36, § 8; Ord. No. 2012-04, § 2; Ord. No. 2024-25, § 16) Sec. 50-67. Place of Business. Within ninety (90) days of a license being issued by the State Department of Health, each Operator shall maintain a place of business which shall be entirely within the designated operating zone, at which place the Operator shall provide communication with its vehicles, the Collier County Emergency Medical Services Division, and its place of business, a properly listed telephone for receiving all calls for service and at which place of business the Operator shall keep such business records, training records, vehicles, and daily logs available for inspection or audit by the Administrator. Every Operator § 50-67EMERGENCY SERVICES CD50:13Supp. No. 116 shall keep on file with the Administrator and the County Emergency Medical Services Division a business address and telephone number at which the Operator may be reached at all times. This information will be maintained at the Emergency Medical Services Division. (Ord. No. 04-12, § 16, Ord. No. 2012-04, § 3; Ord. No. 2024-25, § 17) Sec. 50-68. 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 or by Florida Statute. (Ord. No. 04-12, § 17; Ord. No. 2024-25, § 18) Sec. 50-69. 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, unless such rates are those that are set and implemented by the Federal Government. (Ord. No. 04-12, § 18; Ord. No. 2024-25, § 19) Sec. 50-70. Operator's Insurance Require- ments for Non-Governmental Entities. Every ambulance operator that is not a governmental entity shall carry bodily injury and property damage insurance with solvent and responsible insurers authorized to transact busi- ness in the State of Florida to secure payment for any loss or damage resulting from any occur- rence 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 any one person arising out of any one 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 any one accident and for the sum of at least fifty thousand dollars ($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 Opera- tor 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. (Ord. No. 04-12, § 19; Ord. No. 2024-25, § 20) Sec. 50-71. Conduct of Drivers and Attendants. All drivers, EMTs and paramedics shall comply with the laws of the State of Florida, in order to meet the requirements set out in this Ordinance. No driver, EMT or paramedic registered hereunder shall: A. Fail or refuse to promptly transport, if applicable, or attend any sick or injured person after responding to a call. B. Demand or receive compensation other 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). D. 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, mortu- ary, cemetery, attorney, accident investiga- tor, nurse, medical doctor or other service occupation or profession. E. At any time release a patient from the Operator's care until there is assurance that some responsible person is available to receive such patient. F. Disobey the lawful orders of the law enforcement officer at the scene of an § 50-67 COLLIER COUNTY CODE CD50:14Supp. No. 116 accident, or other similar such emergency or at a fire scene, the fire officer in charge. (Ord. No. 04-12, § 20; Ord. No. 2011-36, § 9; Ord. No. 2024-25, § 21) Sec. 50-72. Passengers. No person shall be aboard ambulances when engaged in emergency or routine calls except the following: A. Driver, attendants and fire or law enforce- ment personnel; B. Patients; C. Relatives or close friends of the patient when authorized by the Operator of the ambulance; D. Physicians and nurses; E. Personnel in an observing capacity that are being trained for ambulance or ALS service; or F. Operator's supervisory personnel. (Ord. No. 04-12, § 21; Ord. No. 2011-36, § 10; Ord. No. 2024-25, § 22) Sec. 50-73. Obedience to Traffic Laws, Ordinances or Regulations. A. Under the provisions of Florida state law, the driver of an ambulance or ALS vehicle when responding to an emergency call or while transporting a patient, may disregard laws, ordinances or regulations governing direction or movement or turning in specified directions so long as he does not endanger life or property when the driver has reasonable grounds to believe that an emergency in fact exists requiring the disregard of such laws. B. The exemption 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 or her reckless disregard for the safety of others. (Ord. No. 04-12, § 22; Ord. No. 2011-36, § 11; Ord. No. 2024-25, § 23) Sec. 50-74. 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 viola- tion of County ordinances. (Ord. No. 04-12, § 23; Ord. No. 2024-25, § 24) Sec. 50-75. Uniformity of Application. This Ordinance shall constitute a uniform law applicable in all of Collier County. (Ord. No. 04-12, § 24; Ord. No. 2024-25, § 25) Sec. 50-76. Authority to enforce. It is hereby declared to be the duty of the Board, its officers, agents, employees and other governmental agencies, the Collier County Sheriff's Office, 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. (Ord. No. 04-12, § 25; Ord. No. 2024-25, § 26) Secs. 50-77—50-100. Reserved. ARTICLE IV. COMMUNITY AUTOMATED EXTERNAL DEFRIBRILLATOR PROGRAM* Sec. 50-101. Title. This article shall be known and may be cited as the "Community Automatic External Defibril- lator Program Ordinance" for Collier County. (Ord. No. 98-36, § 1) *Editor’s note—Ord. No. 98-36, adopted May 12, 1998, set out provisions for a community automatic external defibrillator program. This material was included as §§ 50- 101—50-104 at the editor's discretion. See the Code Compara- tive Table. § 50-101EMERGENCY SERVICES CD50:15Supp. No. 116 Sec. 50-102. Findings and purpose. Pursuant to F.S. § 125.01(1)(e), the Board of County Commissioners of Collier County, Florida finds that it is empowered to provide ambulance and emergency medical services. Pursuant to article VIII of the Constitution of the State of Florida, the Board of County Commissioners of Collier County, Florida further finds it has the authority to exercise broad home rules powers and as such finds that it is in the best interest of the citizens of Collier County to enact this article. It is the purpose of this article to create the Community Automatic External Defibrillator Program which will establish guidelines for use, training, data collection and data recovery require- ments and procedures for Automatic External Defibrillators (hereinafter known as AEDs). (Ord. No. 98-36, § 2) Sec. 50-103. Applicability. Notwithstanding any provisions of any other county zoning or other ordinance to the contrary, this article shall apply to, and be enforced in, the incorporated as well as the unincorporated areas of the county. Hospitals, as defined in F.S. § 395.002(12), are exempt from the provisions of this article. (Ord. No. 98-36, § 3) Sec. 50-104. Requirements and procedures. The following shall be the requirements and procedures for use, training, data collection and data recovery of the AED program: (1) No AED shall be used in the incorporated or unincorporated area of Collier County without first complying with the require- ments and procedures set forth in this section, except as hereinafter provided in subsection (10). It shall be the responsibil- ity of the owner of the AED to ensure that only trained individuals operate, or have access to, the AED. (2) The purchase of AED's will be done only after a written request is made to the Collier County Emergency Medical Services Department by the individual, organization or company requesting the purchase of an AED. The written request must contain the name, location, number of units, number of people to service and type and manufacturer of the AED. (3) Upon receipt of the written request to purchase, the EMS department will coordinate a training class for the request- ing party, and all intended users of the AED, on the proper operation of AEDs. Training will consist of a required class which will include: a. History of sudden death. b. Signs and symptoms of cardiac arrest. c. Adult cardio-pulmonary resuscita- tion. d. Proper use, maintenance and periodic inspection of the AED. (4) Upon proof of successful completion of the above-required training, the Collier County EMS medical director will then issue a prescription for the purchase of an AED which has been approved, and authorized for purchase, by the Food and Drug Administration. (5) Users of the AED will follow the policies and procedures developed and authorized by the Collier County Emergency Medi- cal Services Department Medical Direc- tor. These policies and procedures will be provided to the individual, organization or company requesting the purchase of an AED upon the successful completion of the training required by this section. (6) Re-certification of users and inspection of the AED will be done on bi-annual basis by the Collier County Emergency Medical Services Department. (7) The Collier County Emergency Medical Services Department will conduct qual- ity assurance testing after use of the AED. The quality assurance testing will be on the proper use, placement and maintenance of the AED. An additional use of such testing will be to gather § 50-102 COLLIER COUNTY CODE CD50:16Supp. No. 116 statistical information on the benefits AED availability provides to the com- munity. (8) Any person who uses an AED is required to contact the EMS department as soon as reasonably possible upon use of the AED. (9) Upon notification of the use of an AED, the EMS department will be responsible for the collection and recovery of data generated by the AED. The owner of the AED will not unreasonably withhold consent to the retrieval of such data or to any quality assurance testing. The manner in which data is recovered will be dictated by the capability of the particular AED unit, since the method of data collection differs depending upon the type of AED. All data, once recovered by the EMS department, will be stored at a centralized database to be located and operated by the Collier County EMS Department. (10) In the event an individual not trained in the use of an AED is the only person available to operate the AED, and emergency medical services has been activated, an AED-emergency medical dispatch certified 911 operator shall be authorized to instruct that individual on the proper operation and use of the AED. All other provisions of this section which are not inconsistent with subsection (10) remain in full force and effect. (Ord. No. 98-36, § 4; Ord. No. 99-43, § 1, 6-8-99; Ord. No. 03-22, § 1, 5-13-03) Secs. 50-105—50-130. Reserved. § 50-130EMERGENCY SERVICES CD50:17Supp. No. 116 Chapters 51-53 RESERVED CD51:1