Agenda 05/14/2024 Item #16F 2 (Proposed Ordinance - To enhance current ambulance service and advanced life support (ALS) services)05/14/2024
EXECUTIVE SUMMARY
Recommendation to direct the County Attorney to advertise and bring back for a public hearing a proposed
ordinance repealing and replacing Ordinance No. 81-75, as amended, which establishes uniform standards
for certification of ambulance or advanced life support services.
OBJECTIVE: To enhance current ambulance service and advanced life support (ALS) services.
CONSIDERATIONS: On December 1, 1981, The Board of County Commissioners adopted Ordinance No. 81 -
75, in order to establish uniform county-wide standards for certification of ambulance or advanced life support or
services, and to establish complete and clear rules and regulations for operation of all ambulance or rescue
companies or services in Collier County. Ordinance No. 81-75 and its many amendments are codified as Chapter
50, Article III, of the Collier County Code of Laws and Ordinances.
The proposed ordinance provides a collaborative approach: Collaboration among Collier County EMS and the
different fire agencies fosters a stronger sense of community and enhances overall emergency response efforts. It
promotes knowledge/training equalization, standardization of protocols, and mutual support, ultimately benefiting
patient care and outcomes.
In emergency situations or during peak demand periods, having multiple agencies available for transport adds
flexibility and adaptability to the system. It allows for better management of surges in demand and ensures that
patients can be transported promptly regardless of fluctuations in call volume.
Further, by allowing other agencies within our county to transport patients not only alleviates the strain on our busy
Advanced Life Support (ALS) system but also enhances the overall efficiency, responsiveness, and effectiveness of
the closest unit response of emergency medical services within our county.
Substantive changes include:
• Sets out a detailed process for applications for a certificate of public convenience and necessity as
authorized in F.S. § 401.25(2)(d).
• Confirms the requirement of a uniform Countywide Medical Protocols.
• Establishes a county wide “Medical Director Coalition” for DATA driven medical treatment.
• Upon approval of application, it allows partner agencies the ability to transport.
• Allows for appeals of a hearing officer decision to the Board of County Commissioners.
FISCAL IMPACT: There is no fiscal impact associated with this request.
GROWTH MANAGEMENT IMPACT: There is no growth management impact related to this request.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is approved as to form and
legality and requires majority vote for approval. -JAK
RECOMMENDATION: That the Board of County Commissioners directs the County Attorney to advertise and
bring back for a public hearing a proposed ordinance repealing and replacing Ordinance No. 81 -75, as amended, for
the purposes stated above.
PREPARED BY: Michael J. Choate, Executive Director of Public Safety
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ATTACHMENT(S)
1. Ordinance - Medical Transport Services (CoPCN) - 4.16.24 - CAO stamped (PDF)
2. ARTICLE_III.___MEDICAL_TRANSPORTATION_SERVICES municode updated 3-5-24 revised by ljd
flattened (PDF)
3. line numbered version - Ordinance Medical Transport Services (CoPCN) - 4.16.24 (PDF)
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.F.2
Doc ID: 28827
Item Summary: Recommendation to direct the County Attorney to advertise and bring back for a public hearing a
proposed ordinance repealing and replacing Ordinance No. 81-75, as amended, which establishes uniform standards
for certification of ambulance or advanced life support services.
Meeting Date: 05/14/2024
Prepared by:
Title: – Emergency Medical Services
Name: Cherie DuBock
05/07/2024 11:13 AM
Submitted by:
Title: – Emergency Medical Services
Name: Bruce Gastineau
05/07/2024 11:13 AM
Approved By:
Review:
Emergency Medical Services Bruce Gastineau EMS Chief Review Completed 05/08/2024 2:53 PM
Emergency Management Michael Choate Executive Director Review Completed 05/07/2024 11:51 AM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 05/07/2024 12:01 PM
Office of Management and Budget Agnieszka Chudy OMB Reviewer Completed 05/07/2024 2:39 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 05/07/2024 2:40 PM
Corporate Business Operations Jennifer Reynolds OMB Reviewer Completed 05/08/2024 12:08 PM
County Manager's Office Amy Patterson Level 4 County Manager Review Completed 05/08/2024 12:24 PM
Board of County Commissioners Geoffrey Willig Meeting Pending 05/14/2024 9:00 AM
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PART I - CODE
Chapter 50 - EMERGENCY SERVICES
ARTICLE III. MEDICAL TRANSPORTATION SERVICES
Collier County, Florida, Code of Ordinances Created: 2024-03-06 09:38:54 [EST]
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ARTICLE III. MEDICAL TRANSPORTATION SERVICES1
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.
(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 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 helpless.
Basic Life Support (BLS) means the assessment 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 F.S. § 401.25(2)(d).
1Editor's note(s)—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 reference(s)—Businesses, ch. 22; health and sanitation, ch. 66.
State law reference(s)—Medical transportation services, F.S. § 401.2101 et seq.
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Countywide Medical Protocols means the medically 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 Medical Protocols must be approved by the Collier Regional Medical Directors Coalition in accordance
with section 50-77. An Operator’s medical director may elect not to have its emergency medical service
professionals carry all medicines or perform all procedures required by a Countywide 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 including, but not
limited to, a corporation, partnership, 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-xx, § x )
Sec. 50-53. Requirements for certificate.
It shall be unlawful for any non-governmental entity or governmental entity to provide an ambulance service
or provide ALS services or interfacility 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-xx, § x)
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.
(3) 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.
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(4) 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.
(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; Ord. No. 2024-xx, § x)
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 (known as a zone).
(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.
(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 information 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 agreement. If an applicant submits an application that does not include the same
number of Collier County EMS ambulances that were previously stationed within the governmental entity’s
boundaries at the time of its Class 1 certificate application (“Prior Coverage”), a statement that the Class 1
Operator recognizes that Collier County EMS may continue to provide transport services within its territory
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 Section 50-62, 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.
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(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 F.S. Ch. 401.
(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-xx, § x)
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 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 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 Section 50-55.B.(1)-(6), 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-xx, § x)
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:
(1) That there is a public necessity for the service. In making such determination, the Board 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 Collier 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.
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(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; Ord. No. 2024-xx, § x)
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 thirty (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; Ord. No. 2024-xx, § x)
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 Section 50-61.
(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 Section 50-55.B(2)(a) 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 countywide if activated in
accordance with Section 50-62.
(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 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.
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(6) Submission of a list of all vehicles permitted by the State Department of Health.
(Ord. No. 04-12, § 9; Ord. No. 2011-36, § 5; Ord. No. 2024-xx, § x)
Sec. 50-60. Renewal of certificate.
Each non-governmental entity certificate holder shall file within ninety (90) days of expiration, 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
$250.00 renewal fee.
If the initial certificate was issued under section 50-57. 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-xx, § x)
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 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 protection until such time as the Board
meets to resolve the emergency.
(Ord. No. 04-12, § 11; Ord. No. 2011-36, § 6; Ord. No. 2024-xx, § x)
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) classifications of service in Collier County, as follows:
A. ALS Transport
Class 1 Primary ALS Rescue Transport
1. An 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 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 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. The medical director of a Class 1
certificate holder, unless as provided for in Section 50-77, shall actively participate in the Collier Regional
Medical Directors Coalition and must implement the Countywide Medical Protocols developed in accordance
with Section 50-77 to ensure continuity of care.
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 Sections 50-55(B.) and 50-
59.
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
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of Florida declaring or extending a state of emergency for a natural disaster or public health emergency that
includes Collier County, (2) the occurrence 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
enforcement 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 F.S. § 401.265, and associated Florida Administrative Code rules. The medical director for a Class
1 certificate holder, unless as provided for in Section 50-77, shall actively participate in the Collier Regional
Medical Directors Coalition and must implement the Countywide Medical Protocols developed in accordance
with Section 50-77 to ensure continuity of care.
3. Only governmental entities may be Class 1 certificate holders.
B. Class 2: Collier County 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 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 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.
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 associated 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 for purposes of this Ordinance or Florida Statutes unless the Class
3 shall work cooperatively with the Class 1 Operators to ensure continuity of care. The medical director for a
Class 3 certificate holder shall not delegate or relinquish any responsibilities identified in F.S. § 401.265, and
associated Florida Administrative Code rules. The medical director for a Class 3 certificate holder, unless as
provided for in Section 50-77, shall actively participate in the Collier Regional Medical Directors Coalition and
must implement the Countywide Medical Protocols developed in accordance with Section 50-77 to ensure
continuity of care.
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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 capability 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 (1) the request of a Class 1 certificate holder, with such requests being limited to
emergencies where due to call volumes, mutual aid is needed, (2) 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, (3) the occurrence of an active shooting incident in Collier
County as determined by the Collier County Sheriff’s Office, (4) the occurrence of an injury to a firefighter,
paramedic, or law enforcement officer that results in the need for the immediate transport, or (5) the occurrence
of a mass casualty as defined by the Collier County Fire Chiefs Mass Casualty Incident Guidelines in Collier County.
2. A Class 4 Operator does not have the authority to provide inter-facility transport services unless there is a (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
occurrence of an active shooting incident in Collier County as determined by the Collier County Sheriff’s Office, or
(3) the occurrence of a mass casualty as defined by the Collier 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 Operators to ensure
continuity of care. The medical director for a Class 4 certificate holder shall not delegate or relinquish any
responsibilities identified in F.S. § 401.265, and associated Florida Administrative Code rules. The medical director
for a Class 4 certificate holder, unless as provided for in Section 50-77, shall actively participate in the Collier
Regional Medical Directors Coalition and must implement the Countywide Medical Protocols developed in
accordance with Section 50-77 to ensure continuity of care.
4. Only governmental entities may be Class 4 certificate holders. To qualify for a Class 4 certificate, the Operator
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-xx, § x)
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; Ord. No. 2024-xx, § x)
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, 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.
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(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 (2) 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 its 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 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
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-xx, § x)
Sec. 50-65. General operating regulations.
All Operators and drivers shall comply with all state statutes and administrative regulations as following
regulations:
(1) Twenty-four Hour Service. Every Operator 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 Section 50-59.
(2) Prompt Service Required. Every call for service shall be answered promptly and in line with medical
necessity. 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
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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
recognizing that information 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.
(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 Collier Regional Medical Directors Coalition and in
accordance with the laws of the State of Florida.
(7) Certification.
All Operators shall certify its paramedics pursuant to F.S. § 401.265, and Chapter 64J-2.004(4)(a),
Florida Administrative Code. The credentialing and recredentialing 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 credentialing and
recredentialing process is incorporated into their respective collective bargaining agreements.
(8) 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.
(9) For Class 1, 3, and 4 certificate holders, each certificate holder must implement the Countywide Medical
Protocols developed in accordance with Section 50-77 to ensure continuity of care.
(Ord. No. 04-12, § 15; Ord. No. 2011-36, § 8; Ord. No. 2012-04, § 2; Ord. No. 2024-xx, § x)
Sec. 50-66. 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
Department, 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 shall keep on file with the Administrator and the
County Emergency Medical Services Department 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 Department.
(Ord. No. 04-12, § 16, Ord. No. 2012-04, § 3; Ord. No. 2024-xx, § x)
Sec. 50-67. Records to be kept.
Every Operator that is a non-governmental entity 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. Every Operator that is a governmental entity 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 Florida Statutes.
(Ord. No. 04-12, § 17; Ord. No. 2024-xx, § x)
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Sec. 50-68. 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-xx, § x)
Sec. 50-69. Operator's insurance requirements 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 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; Ord. No. 2024-xx, § x)
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 patient from the Operator’s care until there is assurance that some responsible
person is available to receive such patient.
(6)
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.
(Ord. No. 04-12, § 20; Ord. No. 2011-36, § 9; Ord. No. 2024-xx, § x)
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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 the Operator of the ambulance;
(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; Ord. No. 2024-xx, § x)
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 responding to an
emergency call or while transporting a patient 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 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 or her
reckless disregard for the safety of others.
(Ord. No. 04-12, § 22; Ord. No. 2011-36, § 11)
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, its officers, agents, employees and other governmental
agencies, the sheriff's 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.
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(Ord. No. 04-12, § 25; Ord. No. 2024-xx, § x)
Sec. 50-76. – Appeal.
(a) All decisions rendered by the Administrator or the Board shall be appealable by requesting 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 continuance is received in writing by
the hearing officer at least ten (10) business days prior to the date set for the hearing. No additional continuances
shall be granted without concurrence of the Administrator.
(3) The fact-finding determination of the hearing officer shall be limited to whether the alleged violation occurred
or whether competent, substantial evidence supports the Administrator’s or Board’s decision. Based upon this
fact-finding determination, the hearing officer shall either affirm or reverse the decision of the Administrator or
Board. If the hearing 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 decision of the
Administrator or Board unless some other period is agreed to by the County.
(b) All decisions rendered by the Board or a hearing officer shall be appealable as permitted by Florida law, and
shall be considered quasi-judicial decisions.
(Ord. No. 2024-xx, § x)
Sec. 50-77. – 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 Countywide Medical Protocols is required
by Class 1, Class 3, and Class 4 certificate holders.
(1) 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 medical services within the
County is cooperative and seamless between Operators.
(2) 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 physician designee, from each hospital system that is operating within Collier County,
and the Chair of Emergency Medicine, or the Chair of Emergency Medicine’s physician designee from the
regional trauma center in Lee County.
(3) 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 credentialing 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.
(4) 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 medical
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protocol shall be deemed a Countywide Medical Protocol upon a majority approval of the MD Board
members.
(5) 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.
(6) 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.
(7) The MD Board shall be staffed by the Operator that is represented by the Chair.
(8) Robert’s Rules of Order shall be applicable to board meetings and F.S. Ch. 286 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 appointment 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.
(9) The MD Board will designate appropriate working committees and the leadership and responsibilities of
those committees. Working committees may include non-MD Board members.
(10) The MD Board may coordinate with other boards or organizations such as the Lee County Medical Control
Board and the Collier County EMS Council.
(11) 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 Accountability Act (HIPAA) and Florida Information Protection Act (FIPA) requirements, as
amended. Protected health information 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-xx, § x)
Secs. 50-78—50-100. Reserved.
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ORDINANCE NO. 24 - ______ 1
2
3
AN ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF 4
COLLIER COUNTY, FLORIDA, REPEALING ORDINANCE NO. 81-75, AS 5
AMENDED, IN ORDER TO ADOPT UPDATED UNIFORM STANDARDS FOR 6
AMBULANCE OR ADVANCED LIFE SUPPORT SERVICES, INCLUDING THE 7
ISSUANCE OF CERTIFICATES OF PUBLIC CONVENIENCE AND 8
NECESSITY; PROVIDING FOR INCLUSION IN THE CODE OF LAWS AND 9
ORDINANCES; PROVIDING FOR CONFLICT AND SEVERABILITY; AND 10
PROVIDING FOR AN EFFECTIVE DATE. 11
12
13
WHEREAS, Chapter 125, Florida Statutes, establishes the right and power of counties to 14
provide for the health, welfare and safety of their citizens by enacting regulations necessary for 15
the protection of the public, including ambulance services; and 16
17
WHEREAS, the Collier County Board of County Commissioners (Board) desires to make 18
available to its citizens safe, professional emergency health care transportation and non-19
transportation services for emergency pre-hospital responses and the transfer of patients between 20
and among local medical facilities; and 21
22
WHEREAS, the Board had previously adopted Ordinance No. 81-75, which was 23
subsequently amended by Ordinance Nos. 82-92, 82-102, 04-12, 05-16, 11-36, 12-04, and 19-38, 24
and which are currently codified as Chapter 50, Article III of the Code of Laws and Ordinances of 25
Collier County, Florida, to establish uniform standards for certification and operation of 26
ambulance or advanced life support services in Collier County, including the issuance of 27
certificates of public convenience and necessity; and 28
29
WHEREAS, the Board desires to repeal and replace Ordinance No. 81-75 and all 30
subsequent amendments, with the updated standards and policies set forth in this Ordinance. 31
32
33
NOW, THEREFORE, BE IT ORDAINED BY THE BOARD OF COUNTY 34
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that: 35
36
37
SECTION 1: Purpose. 38
39
This Ordinance is adopted pursuant to Chapters 125 and 401, Florida Statutes. The purpose 40
of this Ordinance is to provide better protection for the health, safety and welfare of the residents 41
of Collier County, in ambulance and ALS matters, by establishing uniform county-wide standards 42
for certification of ambulance or advanced life support or services, or operations by promulgating 43
complete and clear rules and regulations for operation of all ambulance or rescue companies or 44
services in Collier County. 45
46
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47
SECTION 2: Definitions. 48
49
The following words, terms and phrases, when used in this Ordinance, shall have the 50
meanings ascribed to them in this section, except where the context clearly indicates a different 51
meaning: 52
Administrator shall mean the County Manager, or his or her designee. 53
Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable 54
Florida Statutes and Florida Administrative Code. The provision of ALS services may include 55
ambulance service or ALS non-transport services. 56
Advanced Life Support Non-Transport (ALS non-transport) shall mean the provision of ALS 57
services in an emergency by a licensee until the arrival of an air ambulance or an ambulance which 58
is used for, or intended to be used for, land, air, or water transportation of sick or injured persons 59
requiring or likely to require medical attention during transport. 60
Ambulance means any privately or publicly owned land, air, or water vehicle that is designed, 61
constructed, reconstructed, maintained, equipped or operated, and is used for or intended to be 62
used for air, land, or water transportation of persons who are sick, injured, or otherwise helpless. 63
Basic Life Support (BLS) means the assessment of treatment by a person qualified under 64
Florida Statute and Florida Administrative Code in the use of techniques described in the EMT-65
Basic National Standard Curriculum or the National EMS Education Standards of the United States 66
Department of Transportation and approved by the Department of Health. 67
Board shall mean the Collier County Board of County Commissioners. 68
Certificate means a certificate of public convenience and necessity as authorized in Chapter 69
401.25(2)(d), Florida Statutes. 70
Countywide Medical Protocols means the medically correct standing orders or protocols that 71
permit specified ALS and BLS procedures when communication cannot be established with an 72
Operator’s medical director or when any delay in patient care would potentially threaten the life 73
or health of the patient, which all Class 1, 3, and 4 certificate holders’ emergency medical service 74
professionals, such as paramedics and emergency medical technicians (EMTs), must follow for 75
patient assessment, treatment, transportation, and delivery to definitive care. Countywide Medical 76
Protocols must be approved by the Collier Regional Medical Directors Coalition in accordance 77
with this Ordinance. An Operator’s medical director may elect not to have its emergency medical 78
service professionals carry all medicines or perform all procedures required by a Countywide 79
Medical Protocol but such medical director shall ensure that its emergency medical service 80
professionals are fully trained on the entire protocol. 81
Emergency Call shall mean the transit of an ambulance under conditions which warrants 82
travel with flashing lights and siren operating. 83
Governmental Entity shall mean Collier County, a municipality, or an independent special 84
fire control and rescue district within Collier County. 85
Non-governmental Entity shall mean any person, organization, firm, agency, or entity 86
including, but not limited to, a corporation, partnership, limited liability company, or sole 87
proprietorship that is not affiliated, through ownership or control, with a governmental entity. 88
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Operator shall mean any non-governmental entity or governmental entity providing 89
ambulance or ALS non-transport services. 90
Patient shall mean an individual who is ill, sick, injured, wounded, or otherwise incapacitated 91
or helpless. 92
Rescue Service (Non-ALS) shall mean first response treatment of patients but does not include 93
ALS or transport. 94
Routine Call or Routine Transfer shall mean the transportation of a patient under non-95
emergency call conditions. 96
97
98
SECTION 3: Requirement for Certificate. 99
100
It shall be unlawful for any non-governmental entity or governmental entity to provide an 101
ambulance service or ALS services or interfacility transport services without first obtaining a 102
certificate therefore from the Board or the Administrator, as provided by this Ordinance. 103
104
SECTION 4: Exemptions and Exclusions from Certificate Requirement. 105
106
Certificates shall not be required for: 107
108
A. Rescue Services (Non-ALS). 109
110
B. The use of a non-ambulance for any transport of a patient pursuant to the Good Samaritan 111
Act, Chapter 768.13, Florida Statutes. 112
113
C. Vehicles rendering ambulance-type services when requested to do so by the Board or 114
Administrator in the event of a major catastrophe or other such emergency which requires 115
more ambulances than are available in the county. 116
117
D. Ambulances based outside the county which pick up a patient in the county and transport 118
the patient out of the county, or which pick up a patient out of the county and transport the 119
patient into the county. 120
121
E. Vehicles used to transport persons for routine scheduled medical treatments. Vehicles 122
transporting persons who require services en route are not covered by this exemption. 123
124
125
SECTION 5: Procedure for Obtaining Certificate. 126
127
128
A. Non-governmental entities applying for any classification of certificate shall provide the 129
Administrator with the following information in order for a request for a certificate to be 130
considered. Each request shall contain: 131
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1. The name, age, and address of the owner of the ambulance or ALS Operator, or if 132
the owner is a corporation, then of the directors of the corporation and of all the 133
stockholders holding more than 25% of the outstanding shares. 134
2. The boundaries of the territory desired to be served (also known as a zone). 135
3. The number and brief description of the ambulances or other vehicles the applicant 136
will have available. 137
4. The address of the intended headquarters and any substations. 138
5. The training and experience of the applicant. 139
6. The names and addresses of three Collier County residents who will act as 140
references for the applicant. 141
7. A schedule of rates which the service intends to charge. 142
8. Such other pertinent information as the Administrator may require. 143
9. An application or renewal fee of two hundred fifty dollars ($250.00). 144
10. Financial data including assets and liabilities of the Operator. A schedule of all 145
debts encumbering any equipment shall be included. 146
147
B. Governmental entities applying for a Class 1, Class 3, and/or Class 4 certificate shall 148
provide the Administrator with the following information in order for a request for a 149
certificate to be granted. Each request shall contain: 150
151
1. The name of the governmental entity. 152
153
2. (a) The boundaries of the territory to be served by a Class 1 or Class 3 Operator 154
that is a governmental entity includes the governmental entity’s jurisdiction and 155
any areas in which the governmental entity has an automatic aid or mutual aid 156
agreement for fire and emergency medical services or in accordance with a closest 157
unit response agreement. If an applicant submits an application that does not 158
include the same number of Collier County EMS ambulances that were previously 159
stationed within the governmental entity’s boundaries at the time of its Class 1 160
certificate application (“Prior Coverage”), a statement that the Class 1 Operator 161
recognizes that Collier County EMS may continue to provide transport services 162
within its territory and, to avoid the disruption of transport services to the public, 163
the governmental entity will coordinate with Collier County EMS related to 164
ambulance coverage within its boundaries until such time as the governmental 165
entity activates the same Prior Coverage. 166
167
(b) If a governmental entity’s ability to provide service under a Class 4 certificate 168
is activated in accordance with this Ordinance, the Operator is authorized to provide 169
fire, rescue, and emergency medical services countywide if the Operator has the 170
closest or most appropriate unit that is able to provide the response. 171
172
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3. A certification by the Fire Chief or applicable administrator of the governmental 173
entity that the governmental entity has the ability to obtain all licenses and 174
certificates as may be required by Chapter 401, Florida Statutes. 175
176
4. The governmental entity’s annual report or its last fiscal audit submitted to the 177
Florida Auditor General. 178
179
5. A schedule of rates which the service intends to charge, if applicable. The schedule 180
of rates may be a statement that such rates are the rates as set by the Federal 181
Government. 182
183
6. The number of vehicles that the applicant will permit under its state license for 184
ambulances and ALS non-transport vehicles, as applicable. 185
186
No application or renewal fee shall be required for any applicant that is a governmental 187
entity applying for a Class 1, Class 3 or Class 4 certificate. An applicant may apply for 188
multiple certificates simultaneously. 189
190
191
SECTION 6: Review of Application. 192
193
A. For all applicants that are non-governmental entities, the Administrator shall review each 194
application and shall investigate the applicant's reputation, competence, financial 195
responsibility, and any other relevant factors. The Administrator shall also make an 196
investigation as to the public necessity for an ambulance or ALS operation in the territory 197
requested, and shall then make a report to the Board containing his or her recommendation 198
whether to grant a certificate to the applicant within sixty (60) days of the time the 199
Administrator determines the application is complete. 200
201
B. Notwithstanding any other ordinance or provision, no administrative review or review by 202
the Board, a county-appointed board, entity, or commission shall be required for any 203
applicant that is a governmental entity applying for a Class 1, Class 3, and/or Class 4 204
certificate. Upon submission of an application that includes the information required by 205
this Ordinance, the Administrator shall administratively approve the application and shall 206
issue the requested certificate or certificates to the governmental entity within sixty (60) 207
days of the application submission. 208
209
210
SECTION 7: Requirement for Board Approval in Granting Certificate. 211
212
The Board shall not grant a certificate to a non-governmental entity unless it shall find, 213
after public hearing and based on competent evidence that each of the following standards has 214
been satisfied: 215
216
A. That there is a public necessity for the service. In making such determination, the Board 217
shall consider, as a minimum, the following factors: 218
219
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1. The extent to which the proposed service is needed to improve the overall 220
emergency medical services (EMS) capabilities of Collier County. 221
222
2. The effect of the proposed service on existing services with respect to quality of 223
service and cost of service. 224
225
3. The effect of the proposed service on the overall cost of EMS service in the County. 226
227
4. The effect of the proposed service on existing hospitals and other health care 228
facilities. 229
230
5. The effect of the proposed service on personnel of existing services and the 231
availability of sufficient qualified personnel in the local area to adequately staff all 232
existing services. 233
234
B. That the applicant has sufficient knowledge and experience to properly operate the 235
proposed service. 236
237
C. That, if applicable, there is an adequate revenue base for the proposed service. 238
239
D. That the proposed service will have sufficient personnel and equipment to adequately cover 240
the proposed service area. 241
242
243
SECTION 8: Appointment of Hearing Officer; Appeals. 244
245
A. In making the determinations provided for in Section 7 above, the Board may, in its sole 246
discretion, appoint a Hearing Officer to hold a public hearing and to make factual findings 247
and conclusions as a result of the hearing. Should a Hearing Officer be appointed, said 248
hearing officer shall render a written report to the Board within thirty (30) days of the 249
hearing, which report shall contain the officer's findings and conclusions of fact, and a 250
recommended order. The findings and conclusions of fact shall be binding upon the Board, 251
but the recommended order shall be advisory only. 252
253
B. All decisions rendered by the Administrator or the Board shall be appealable by requesting 254
a hearing before a Hearing Officer. 255
256
1. The hearing shall be requested within fifteen (15) business days of the date of the 257
decision to be challenged. 258
259
2. A hearing date shall not be postponed or continued unless a request for continuance 260
is received in writing by the Hearing Officer at least ten (10) business days prior to 261
the date set for the hearing. No additional continuances shall be granted without 262
concurrence of the Administrator. 263
264
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3. The fact-finding determination of the Hearing Officer shall be limited to whether 265
the alleged violation occurred or whether competent, substantial evidence supports 266
the Administrator’s or Board’s decision. Based upon this fact-finding 267
determination, the Hearing Officer shall either affirm or reverse the decision of the 268
Administrator or Board. If the Hearing Officer affirms the decision of the 269
Administrator or Board, the named party shall have fifteen (15) calendar days from 270
the date of the decision of the Hearing Officer to comply with the decision of the 271
Administrator or Board unless some other period is agreed to by the County. 272
273
C. All decisions rendered by the Hearing Officer shall be appealable to the Board of County 274
Commissioners, and all decisions rendered by the Board shall be appealable as permitted 275
by Florida law, and shall be considered quasi-judicial decisions. 276
277
278
SECTION 9: Rights and Duties Granted by Certificate. 279
280
A. The certificate granted by the Board to a non-governmental entity shall be valid for one (1) 281
calendar year and shall be personal to the applicant and not transferable. In the case of a 282
corporation, if there occurs such a transfer of stock or other incidents of ownership as to 283
change the majority or largest stockholder, a new certificate must be applied for. Changes 284
in the officers of the corporation will not require a new certificate. The certificate granted 285
by the Administrator to a governmental entity shall remain valid until such time as the 286
governmental entity provides one (1) year notice to the Administrator that it will no longer 287
be providing ALS services. Notwithstanding, a certificate issued to a governmental entity 288
may be revoked in accordance with this Ordinance. 289
290
B. A Class 1 and Class 3 certificate holder may increase the number of vehicles providing 291
services upon notifying Collier County within five (5) business days of additional State 292
vehicle permits, including whether such vehicle is an ambulance or providing ALS non-293
transport services (as applicable). Nothing in this Ordinance shall supersede any State 294
administrative rule that allows a vehicle to provide BLS services. 295
296
C. Acceptance of the certificate by the applicant shall obligate the applicant to: 297
298
1. Service the entire zone granted to the applicant or the area provided in this 299
Ordinance for Class 1, Class 3, and Class 4 certificate holders. 300
301
2. Provide coverage to adjoining zones, if available, when requested to do so by 302
emergency dispatch for emergency calls when the certificate holder for that zone is 303
unable to respond. A Class 4 certificate holder is authorized to provide fire, rescue, 304
and emergency medical services countywide if activated in accordance with this 305
Ordinance. 306
307
3. Keep posted at the Operator’s place of business a copy of the fee schedule, which 308
must be filed with the Administrator (if applicable). 309
310
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4. Operate in accordance with the rules and regulations adopted pursuant to this 311
Ordinance and any applicable County Ordinances, and Chapter 401, Florida 312
Statutes, and any administrative regulations adopted pursuant thereto. 313
314
5. Employ, at all times, sufficient personnel experienced in operation and 315
management of emergency medical services to ensure proper and efficient 316
operation. 317
318
6. Submission of a list of all vehicles permitted by the State Department of Health. 319
320
321
322
SECTION 10: Renewal of Certificate. 323
324
Each non-governmental entity certificate holder shall file within ninety (90) days of 325
expiration, an application for renewal of the certificate. Renewals shall be based upon the same 326
standards, as the granting of the original certificate along with such other factors as may be 327
relevant. The renewal application shall be accompanied by a two hundred fifty dollars ($250.00) 328
renewal fee. 329
330
If the initial certificate was issued under this Ordinance, the renewal certificate may be 331
approved routinely by the Board, upon advice of the Administrator, or the Board may hold a 332
hearing on same. 333
334
335
336
SECTION 11: Emergency Provisions. 337
338
The Board may modify, suspend or revoke a certificate in the interest of the public health, 339
safety and welfare, only at public hearing and after reasonable notice has been given to the 340
certificate holder affected. However, if a situation exists which poses a serious threat that the 341
Operator will not be available in any certain area of Collier County, the Administrator shall have 342
such temporary emergency powers as are necessary to provide that service. These temporary 343
powers are intended to provide interim protection until such time as the Board meets to resolve the 344
emergency. 345
346
347
SECTION 12: Classifications of certificates. 348
349
To fulfill ongoing needs for emergency medical services in Collier County, as it grows and 350
responds to service needs, there shall be four (4) classifications of service in Collier County, as 351
follows: 352
353
354
A. Class 1: Primary ALS Transport: ALS Rescue. 355
356
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1. An Operator with the capability of rendering on the scene prehospital ALS services 357
with transport capability and who may or may not elect to transport patients based 358
on medical necessity. An Operator rendering this level of service for a 359
governmental entity shall be deemed to be operating under the Class 1 – ALS rescue 360
certificate of public convenience and necessity held by the governmental entity. An 361
Operator holding a Class 1 – ALS rescue certificate may provide post-hospital 362
interfacility medical transfer services and routine ALS and BLS calls within the 363
County. A certificate of public convenience and necessity must be obtained from 364
the County before engaging in this level of medical service. 365
An Operator with a Class 1 – ALS rescue certificate may provide both ambulances 366
and ALS non-transport services based on the information provided to Collier 367
County in accordance with this Ordinance. 368
An Operator with a Class 1 certificate is authorized to have its ALS non-transport 369
vehicles provide transport on a limited basis upon (1) the issuance of an emergency 370
order has been issued by the Governor of the State of Florida declaring or extending 371
a state of emergency for a natural disaster or public health emergency that includes 372
Collier County, (2) the occurrence of an active shooting incident in Collier County 373
as determined by the Collier County Sheriff’s Office, (3) the occurrence of an injury 374
to a firefighter, paramedic, or law enforcement officer that results in the need for 375
the immediate transport, or (4) the occurrence of a mass casualty as defined by the 376
Collier County Fire Chiefs Mass Casualty Incident Guidelines in Collier County. 377
A Class 1 certificate holder may also temporarily add additional ambulances based 378
on special events within its boundaries. 379
2. The medical director for a Class 1 certificate holder shall not delegate or relinquish 380
any responsibilities identified in Chapter 401.265, Florida Statutes, and associated 381
Florida Administrative Code rules. The medical director for a Class 1 certificate 382
holder shall actively participate in the Collier Regional Medical Directors Coalition 383
and must implement the Countywide Medical Protocols developed in accordance 384
with this Ordinance to ensure continuity of care. 385
3. Only governmental entities may be Class 1 certificate holders. 386
387
388
B. Class 2: Inter-Facility Transport Services: BLS or ALS Transfer. 389
390
An Operator who provides post-hospital inter-facility medical transfer services, both 391
within and outside the County. If requested by the appropriate Class 1 – ALS Rescue Operator, 392
will provide emergency pre-hospital backup service. ALS transfer certificate holders may provide 393
post-hospital medical transfer services for routine and emergency ALS and BLS patients. Class 2 394
transfer certificate holders must either provide for their own medical director or contract with the 395
County Medical Director, and will operate under the protocols approved by the Class 2 Operator’s 396
Medical Director. If the Operator provides for its own medical director, that medical director shall 397
work cooperatively with the County's Office of the Medical Director to ensure continuity of care. 398
Class 2 Operators shall comply with all guidelines and policies approved by the Board of County 399
Commissioners, and shall notify and work with all hospitals and facilities to educate them as to 400
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the services Operator provides. The County reserves the right to review and evaluate all calls made 401
by the Operator to ensure that the appropriate level of personnel, supplies, equipment and vehicles 402
are being utilized, as set forth in Florida Statute and Florida Administrative Code. 403
404
405
C. Class 3: ALS Non-Transport. 406
407
1. An Operator who renders ALS pre-hospital services without transport capability. 408
409
2. Class 3 certificate holders work in concert with applicable Class 1 Operators to 410
assure adequate and timely response to prehospital incidents with the intent to either 411
reduce applicable response times or otherwise augment the level of services as 412
requested by the associated Class 1 Operator. Class 3 certificate holders service will 413
improve patient outcomes, reduce time to initial assess to care, and improve 414
performance on quality measures as developed by state or national oversight 415
groups. If requested by a Class 1 Operator, each paramedic employed by a Class 3 416
certificate holder must accompany a patient on an Operator’s ALS transport from 417
scene to hospital when the paramedic for such Class 3 Operator initiates ALS 418
services on a patient prior to the Class 1 Operator transport arrival or if the patient's 419
condition requires that additional level of expertise. Unless an Operator possesses 420
a Class 1 – ALS Rescue certificate issued by the County, a certificate of public 421
convenience and necessity must be obtained from the County before engaging in 422
this level of medical service. 423
424
3. The medical director for a Class 3 Operator shall work cooperatively with the Class 425
1 Operators to ensure continuity of care. The medical director for a Class 3 426
certificate holder shall not delegate or relinquish any responsibilities identified in 427
Chapter 401.265, Florida Statutes, and associated Florida Administrative Code 428
rules. The medical director for a Class 3 certificate holder shall actively participate 429
in the Collier Regional Medical Directors Coalition and must implement the 430
Countywide Medical Protocols developed in accordance with this Ordinance to 431
ensure continuity of care. 432
433
4. Only governmental entities may be Class 3 certificate holders. 434
435
436
D. Class 4: Secondary ALS Transport 437
438
1. An Operator with the capability of rendering on the scene prehospital ALS services 439
with transport capability and who may or may not elect to transport patients based 440
on medical necessity. An Operator with a Class 4 certificate may only transport 441
upon: 442
443
a. the request of a Class 1 certificate holder, with such requests being limited 444
to emergencies where due to call volumes, mutual aid is needed; 445
446
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b. the issuance of an emergency order has been issued by the Governor of the 447
State of Florida declaring or extending a state of emergency for a natural 448
disaster or public health emergency that includes Collier County; 449
450
c. the occurrence of an active shooting incident in Collier County as 451
determined by the Collier County Sheriff’s Office; 452
453
d. the occurrence of an injury to a firefighter, paramedic, or law enforcement 454
officer that results in the need for the immediate transport; or 455
456
e. the occurrence of a mass casualty as defined by the Collier County Fire 457
Chiefs Mass Casualty Incident Guidelines in Collier County. 458
459
2. A Class 4 Operator does not have the authority to provide inter-facility transport 460
services unless there is: 461
462
a. the issuance of an emergency order has been issued by the Governor of the 463
State of Florida declaring or extending a state of emergency for a natural 464
disaster or public health emergency that includes Collier County; 465
466
b. the occurrence of an active shooting incident in Collier County as 467
determined by the Collier County Sheriff’s Office; or 468
469
c. the occurrence of a mass casualty as defined by the Collier County Fire 470
Chiefs Mass Casualty Incident Guidelines in Collier County. 471
472
473
3. The medical director for a Class 4 certificate holder shall work cooperatively with 474
Class 1 Operators to ensure continuity of care. The medical director for a Class 4 475
certificate holder shall not delegate or relinquish any responsibilities identified in 476
Chapter 401.265, Florida Statutes, and associated Florida Administrative Code 477
rules. The medical director for a Class 4 certificate holder shall actively participate 478
in the Collier Regional Medical Directors Coalition and must implement the 479
Countywide Medical Protocols developed in accordance with this Ordinance to 480
ensure continuity of care. 481
482
4. Only governmental entities may be Class 4 certificate holders. To qualify for a 483
Class 4 certificate, the Operator must also have a Class 3 certificate. 484
485
An Operator may be issued multiple certificates for different classes of service. 486
487
488
SECTION 13: Transfer or Assignment of Certificates. 489
490
No certificate issued under this Ordinance shall be assignable or transferable by the person to 491
whom issued unless approval is obtained from the Board in the same manner and subject to the 492
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same application, investigation, fees and public hearing as original applications for certificates. 493
Any majority transfer of shares or stock or interest of any person or Operator so as to cause a 494
change in the directors, officers, majority stockholders or managers of such person or Operator 495
shall be deemed a transfer or assignment as contemplated in this Ordinance and subject to the same 496
rules and regulations as any other transfer or assignment. 497
498
499
SECTION 14: Revocation, Alteration or Suspension Grounds. 500
501
A. Every certificate issued under this Ordinance shall be subject to revocation, alteration 502
and/or suspension of operation, by the Board, for a period of up to one year, where it shall 503
appear that: 504
505
1. The Operator has failed or neglected for a period of thirty (30) days during any 506
calendar year to render all services authorized by the certificate. 507
508
2. The Operator has been convicted of a felony or any criminal offense involving 509
moral turpitude. 510
511
3. The certificate was obtained by an application in which any material fact was 512
omitted or falsely stated. 513
514
4. The Operator has knowingly permitted any of its motor vehicles to be operated in 515
violation of the laws which result in conviction of the driver or Operator of a 516
misdemeanor in the second degree or greater, or has knowingly permitted a driver 517
with more than two (2) previous convictions to operate emergency vehicles. 518
519
5. The Operator has failed to comply with any of the provisions of this Ordinance. 520
521
6. The public interest will best be served by revocation, alteration, or suspension of 522
any certificate upon good cause shown. 523
524
7. The Operator or its agent has demanded money or compensation other that 525
established and prescribed under this Ordinance (if applicable). 526
527
8. The Operator has without sufficient justification failed or refused to furnish 528
emergency care and/or transportation promptly for a sick or injured person. 529
530
9. The Operator or its agent has been found guilty of malpractice or willful and wanton 531
misconduct in the operation of its service. 532
533
B. All complaints shall be investigated and a report thereon made to the Board, together with 534
findings and recommendations, within fifteen (15) days. If revocation, suspension or 535
alteration of any certificate appears warranted, the Board shall give notice to the Operator 536
holding the certificate that the same will be considered at a specific commission meeting, 537
provided the date of such meeting shall not be less than five (5) days from the date of the 538
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notice. The Board shall thereupon consider the complaint and either revoke, suspend or 539
alter the certificate or dismiss the complaint. 540
541
542
SECTION 15: Collier Regional Medical Directors Coalition 543
544
The continuity of care for patients of emergency medical services within the County is 545
imperative for the safety of citizens and visitors in Collier County. As a result, the implementation 546
of Countywide Medical Protocols is required by Class 1, Class 3, and Class 4 certificate holders. 547
548
A. There is hereby created the Collier Regional Medical Directors Coalition (hereinafter the 549
"MD Board"), whose purpose is to ensure that the rendering of on scene prehospital 550
emergency medical services within the County is cooperative and seamless between 551
Operators. 552
553
B. The members of the MD Board consists of the medical director for each Class 1 and 3 554
Operator, with each Operator having a single medical director as a member, the Chair of 555
Emergency Medicine, or the Chair of Emergency Medicine’s physician designee, from 556
each hospital system that is operating within Collier County, and the Chair of Emergency 557
Medicine, or the Chair of Emergency Medicine’s physician designee from the regional 558
trauma center in Lee County. 559
560
C. The purpose of the MD Board is to develop medical protocols that will be implemented as 561
Countywide Medical Protocols as well as to develop a credentialing and recredentialing 562
standards for EMTs and paramedics of Class 1, 3, and 4 Operators. The MD Board will 563
also make recommendations for equipment, supplies, medications to fulfill medical 564
protocols, including changes related to equipment/medication shortages. 565
566
D. Any Operator’s Medical Director, or the Operator’s Medical Director’s physician designee, 567
may propose a medical protocol for consideration to be implemented as a Countywide 568
Medical Protocol. The medical protocol shall be deemed a Countywide Medical Protocol 569
upon a majority approval of the MD Board members. 570
571
E. Operators’ Medical Directors have an equal vote on the board and a Medical Director may 572
not represent more than one (1) Operator on the MD Board at any given time. The hospital-573
based Emergency Medicine chairs are non-voting members. 574
575
F. The County’s Medical Director shall serve as the initial Chair of the MD Board and shall 576
serve a one (1) year term as Chair. 577
578
G. The MD Board shall be staffed by the Operator that is represented by the Chair. 579
580
H. Robert’s Rules of Order shall be applicable to board meetings and Chapter 286, Florida 581
Statutes, is not applicable. The MD Board shall adopt by-laws for doing its work and 582
conducting its business, including but not limited to quorum, voting on non-protocol 583
related issues, the election and term of the Chair, the appointment of members by Operators 584
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when they share a medical director to ensure each Operator has representation on the MD 585
Board, and how new or modified protocols are implemented to ensure appropriate training. 586
587
I. The MD Board will designate appropriate working committees and the leadership and 588
responsibilities of those committees. Working committees may include non-MD Board 589
members. 590
591
J. The MD Board may coordinate with other boards or organizations such as the Lee County 592
Medical Control Board and the Collier County EMS Council. 593
594
K. The MD Board will conduct quality reviews that are protected by Peer Review statutes and 595
standards in place in Florida for such activities. Each member of the MD Board must agree 596
to comply with Health Insurance Portability and Accountability Act (HIPAA) and Florida 597
Information Protection Act (FIPA) requirements, as amended. Protected health information 598
may not be disclosed to a MD Board member unless an agreement addressing HIPAA and 599
FIPA has been executed between the certificate holder and MD Board member. 600
601
602
SECTION 16: General Operating Regulations. 603
604
All Operators and drivers shall comply with all state statutes and administrative regulations 605
as well as the following regulations: 606
607
A. Twenty-four Hour Service. Every Operator shall be required to operate sufficient 608
ambulances, if applicable, or relevant apparatus, as stated on the vehicle permit issued by 609
the State Department of Health, Bureau of Emergency Medical Services on immediate call 610
at all times. Notwithstanding, an Operator that is a Class 1 certificate holder may provide 611
less than twenty-four (24) hour services based on the information provided to Collier 612
County in accordance with this Ordinance. 613
614
B. Prompt Service Required. Every call for service shall be answered promptly and in line 615
with medical necessity. Patients shall be appropriately assessed, treated, packaged, loaded 616
and transported by an Operator that is licensed to transport without being subject to 617
unreasonable delays. All calls for emergency assistance requiring over twenty (20) minutes 618
from time of notification to arrival on scene shall be reported to the Administrator with 619
complete documentation of the circumstances, which delayed the response. Those 620
instances where more than three (3) minutes elapse between receipt of an emergency call 621
and dispatch of an emergency vehicle shall also be reported to the Administrator with 622
documentation of circumstances. 623
624
C. Bed Linens. Every Operator transporting patients shall provide clean and sanitary bed 625
linens for each patient carried which shall be changed as soon as practicable after the 626
discharge of the patient. 627
628
D. Daily Log. Every Operator transporting patients shall maintain in a daily log upon which 629
shall be recorded the place or origin, time of call, time of dispatch, time of arrival at scene, 630
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time left for hospital, time of arrival at hospital, and charges for each trip made and such 631
other operating and patient information as may be required by Ordinance. Every Operator 632
shall retain and preserve all daily logs for at least two (2) years, and such logs shall be 633
available for inspection by the Administrator recognizing that information that is protected 634
by the Health Insurance Portability and Accountability Act (HIPAA) and Florida 635
Information Protection Act (FIPA), as amended, may not be disclosed to the Administrator 636
unless an agreement addressing HIPAA and FIPA has been executed between the 637
certificate holder and the County. 638
639
E. Communications. Each emergency vehicle shall maintain two-way radio communication 640
with the location of primary dispatch from which it operates, as well as any additional 641
communication capabilities required by Ordinance or state law. 642
643
F. Vehicles and Equipment. Each Operator's vehicles shall be equipped with the proper 644
medical and emergency equipment as jointly agreed to by the Collier Regional Medical 645
Directors Coalition and in accordance with the laws of the State of Florida. 646
647
G. Certification. All Operators shall certify its paramedics pursuant to Chapter 401.265, 648
Florida Statutes, and Chapter 64J-2.004(4)(a), Florida Administrative Code. The 649
credentialing and recredentialing process developed by the Collier Regional Medical 650
Directors Coalition shall be implemented by all Class 1, 3, and 4 certificate holders, and 651
such certificate holders shall ensure that the credentialing and recredentialing process is 652
incorporated into their respective collective bargaining agreements. 653
654
H. Application. Each ambulance or ALS service shall be subject to those rules and regulations 655
as promulgated by Ordinances of the Board for the purpose of carrying out this Ordinance. 656
657
I. Continuity of Care. For Class 1, 3, and 4 certificate holders, each certificate holder must 658
implement the Countywide Medical Protocols developed in accordance with this 659
Ordinance to ensure continuity of care. 660
661
662
663
664
SECTION 17: Place of Business. 665
666
Within ninety (90) days of a license being issued by the State Department of Health, each 667
Operator shall maintain a place of business which shall be entirely within the designated operating 668
zone, at which place the Operator shall provide communication with its vehicles, the Collier 669
County Emergency Medical Services Division, and its place of business, a properly listed 670
telephone for receiving all calls for service and at which place of business the Operator shall keep 671
such business records, training records, vehicles, and daily logs available for inspection or audit 672
by the Administrator. Every Operator shall keep on file with the Administrator and the County 673
Emergency Medical Services Division a business address and telephone number at which the 674
Operator may be reached at all times. This information will be maintained at the Emergency 675
Medical Services Division. 676
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677
678
SECTION 18: Records to be Kept. 679
680
Every Operator shall keep accurate records of receipts from operations, operating and other 681
expenses, capital expenditure and such other operating and patient information as may be required 682
by the Board or by Florida Statute. 683
684
685
SECTION 19: Rates. 686
687
Every Operator shall file with the Board a schedule of the rates. Such rates shall be filed as a part 688
of each new or renewal application, and a rate schedule shall also be filed when changes in rates 689
are proposed. All such rates shall be subject to review and approval by the Board, unless such rates 690
are those that are set and implemented by the Federal Government. 691
692
693
694
SECTION 20: Operator's Insurance Requirements for Non-Governmental Entities. 695
696
Every ambulance operator that is not a governmental entity shall carry bodily injury and 697
property damage insurance with solvent and responsible insurers authorized to transact business 698
in the State of Florida to secure payment for any loss or damage resulting from any occurrence 699
arising out of or caused by the operation or use of any of the Operator’s motor vehicles. Each 700
vehicle shall be insured for the sum of at least one hundred thousand dollars ($100,000.00) for 701
injuries to or death of any one person arising out of any one accident and the sum of at least three 702
hundred thousand dollars ($300,000.00) for injuries to or death or more than one person in any 703
one accident and for the sum of at least fifty thousand dollars ($50,000.00) for damage to property 704
arising from any one accident. They shall also have malpractice insurance. Every insurance policy 705
or contract for such insurance shall provide for the payment and satisfaction of any financial 706
judgment entered against the Operator and present insured or any person driving the insured 707
vehicle. Such insurance shall be obtained and certificates or certified copies of such policies shall 708
be filed with the Board. All such insurance policies, certificates thereof or certified copies of such 709
insurance policies shall provide for a thirty (30) day cancellation notice to the Board. 710
711
712
713
SECTION 21: Conduct of Drivers and Attendants. 714
715
All drivers, EMTs and paramedics shall comply with the laws of the State of Florida, in order to 716
meet the requirements set out in this Ordinance. No driver, EMT or paramedic registered hereunder 717
shall: 718
719
A. Fail or refuse to promptly transport, if applicable, or attend any sick or injured person after 720
responding to a call. 721
722
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B. Demand or receive compensation other that established and approved in accordance with 723
this Ordinance or fail to give a receipt for moneys received (if applicable). 724
725
C. Give or allow rebate, commission, discount or any reduced rate not provided in the 726
established rate (if applicable). 727
728
D. At any time induce or seek to induce any person engaging an ambulance or ALS service to 729
patronize or retain the services of any hospital, convalescent home, mortuary, cemetery, 730
attorney, accident investigator, nurse, medical doctor or other service occupation or 731
profession. 732
733
E. At any time release a patient from the Operator’s care until there is assurance that some 734
responsible person is available to receive such patient. 735
736
F. Disobey the lawful orders of the law enforcement officer at the scene of an accident, or 737
other similar such emergency or at a fire scene, the fire officer in charge. 738
739
740
SECTION 22: Passengers. 741
742
No person shall be aboard ambulances when engaged in emergency or routine calls except 743
the following: 744
745
A. Driver, attendants and fire or law enforcement personnel; 746
747
B. Patients; 748
749
C. Relatives or close friends of the patient when authorized by the Operator of the ambulance; 750
751
D. Physicians and nurses; 752
753
E. Personnel in an observing capacity that are being trained for ambulance or ALS service; or 754
755
F. Operator's supervisory personnel. 756
757
758
759
SECTION 23: Obedience to Traffic Laws, Ordinances or Regulations. 760
761
A. Under the provisions of Florida state law, the driver of an ambulance or ALS vehicle when 762
responding to an emergency call or while transporting a patient, may disregard laws, ordinances 763
or regulations governing direction or movement or turning in specified directions so long as he 764
does not endanger life or property when the driver has reasonable grounds to believe that an 765
emergency in fact exists requiring the disregard of such laws. 766
767
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B. The exemption herein granted shall apply only when such vehicle is making use of audible 768
and/or visible signals meeting the requirements of this Ordinance. 769
770
C. The foregoing provisions shall not relieve the driver of a vehicle from the duty to drive 771
with due regard for the safety of all persons, nor shall such provisions protect the driver from the 772
consequences of his or her reckless disregard for the safety of others. 773
774
775
SECTION 24: Violations. 776
777
In addition to the remedies provided herein, a violation of any provision of this Ordinance 778
shall be punishable as provided by law for the violation of County ordinances. 779
780
781
SECTION 25: Uniformity of Application. 782
783
This Ordinance shall constitute a uniform law applicable in all of Collier County. 784
785
786
SECTION 26: Authority to enforce. 787
788
It is hereby declared to be the duty of the Board, its officers, agents, employees and other 789
governmental agencies, the Collier County Sheriff’s Office, its deputies and agents, fire 790
departments, as well as the police departments of the various municipalities falling under the 791
provisions of this Ordinance to strictly enforce the provisions of this Ordinance. 792
793
794
SECTION 27: Repeal of Ordinance No. 81-75, as amended. 795
Ordinance Nos. 81-75, 82-92, 82-102, 04-12, 05-16, 11-36, 12-04, and 19-38, and all 796
amendments thereto, are hereby repealed in their entirety and superseded by this Ordinance. 797
798
799
SECTION 28: Inclusion in the Code of Laws and Ordinances. 800
The provisions of this Ordinance shall be made a part of the Code of Laws and Ordinances 801
of Collier County, Florida, as Chapter 50, Article III of said Code. The Sections of the Ordinance 802
may be renumbered or re-lettered to accomplish such, and the word "Ordinance" may be changed 803
to "section," "article," or any other appropriate word. 804
805
806
SECTION 29: Conflict and Severability. 807
808
In the event this Ordinance conflicts with any other Ordinance of Collier County or other 809
applicable law, the more restrictive shall apply. If any phrase or portion of the Ordinance is held 810
invalid or unconstitutional by any court of competent jurisdiction, such portion shall be deemed a 811
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separate, distinct and independent provision and such holding shall not affect the validity of the 812
remaining portion. 813
814
815
SECTION 30: Effective Date. 816
817
This Ordinance shall become effective upon filing with the Florida Department of State. 818
819
820
PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier 821
County, Florida, this ____day of_________________, 2024. 822
823
824
825
ATTEST: BOARD OF COUNTY COMMISSIONERS 826
Crystal K. Kinzel, Clerk of Courts COLLIER COUNTY, FLORIDA 827
828
829
By: ___________________________ By: _____________________________ 830
, Deputy Clerk Chris Hall, Chairman 831
832
833
Approved as to form and legality: 834
835
836
______________________________ 837
Jeffrey A. Klatzkow, County Attorney 838
839
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