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Ordinance 81-75 OI:IDINANC~ NO. 81-?$ .... ~.~ ,,~ ORnIN,'U~CE RELATING TO 'n-rs OPE~.ATIO~ OF PRIVATE, VOLUNTARY, AND COVERNMENTAD' ' ~BU~CE ~ RESCUE SERVICES~ PROVIDING FO~ PURPOSE~ PROVIDING FOR DEFINITIONS OF TE~SI PROVIDING FOR REQUIREHE~ CERTIFICATE~ PROVIDING FOR EXERTIONS' ~'J EXCLUSIONS FRO~ CERTIFICATE REQUIRE- ..... ~ PROVIDING FOR PROCEDURES FOR OBTAINING CERTIFICATE~ PROVIDIHO FOR ~VIEW OF APPLICATION~ PROVIDING FOR ~QUIRE~E~ FOR BOA~ ~PROVAL IN G~- lNG CERTIFICATE~ PROVIDING ST~A~S FOR C~ING OF CERTIFICATES~ PROVIDING FOR RIGHTS ~ DUTIES G~ED BY CERTI- FICATE~ PROVIDING FOR RULES ~ REGU~- TIONS~ PROVIDING FOR SUSPENSION OR ~VOCATION OF CERTIFICATES; PROVIDING FOR PENALTIES~ PROVIDING FOR INCLUSION IN CODE~ PROVIDING FOR ~PLICABILI~I PROVIDING FOR REPEALING ~WS IN CON- FLICT; PROVIDING FOR APPROVAL OF ~TES; PROVIDING FOR SEVE~BILI~ ~ PROVIDING FOR ~ EFFECTI~ DATE. BE IT ORDAINED BY TIlE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA.' Section 1. Purr)ese This ordinance is adopted pursuant to Chapter 125, Florida Statutes and Section 401.25(8) Florida Statutes. The purpose of this ordinance is co provide better protection for the health, safety and welfare of the residents of Collier County, in ~bulance and ALS matters, by estab- lishing uniform county-wide standards for certi£ication of ambulance or advanced lt£a support or services, or opera- tiGriS b7 promulgating complete and clear rules and regula- tions for operation of all ambulance or rescue companies or services in Collier County. ~ ~ Section 2. Definitions ~ Advanced Life Su. pport (ALS) shall mean proc~dure~. conducted as defined in applicable Florida Statutes Florida Administrative ~:ode, Ch, 10D-66. Administrator shall mean the County Manager or his designee. ~mbulance aeans any privately or publicly owned land, air, or water v.hicle that is designed, constructld, reconstructed, maintained, equipped or operated, and Il used for or intended to be used for air, land, or water transportation of Dersons who are sick, injured, or otherwise helpless. Board shall mean the Collier County Board of County Commissioners. C,9~tSfiqat? means a certificate of convenience and necessity as authorized in Section 401.25(3)d, Florida Statutes. Emerqency Call shall mean the transit of an ambulance undQr conditions which warrants travel with flashing lights and siren operating. Operator ~hall mean any person, organization or govern- mental entity providing ambulance or ALS services. !I. Patient shall mean an individual who ia ill, sick, injured, wounded, or otherwise incapacitated or helpless. ' .... Routine Call or Routine Transfer shall mean the trans- portation of a patient under non-emergency call conditions. Rescue Service shall mean first response treatment of patients but does not include Advanced Life Support (ALS) or transport. Section 3. Requirement For Certificate It shall be unlawful for any person, firm, agency, or any o~er entity, including governmental units, to provide an ambulance service or provide advanced life support ' without first obtaining a certificate therefore from the Board of County Commissioners of Collier County. Section 4. Exemptions And Kxclusions From Certificate ~utrement Certificates shall not be required for~ A. Rescue Se~vices. The use of & non-ambulance for any transport of patient pursuant to the Good Samaritan Act, Section 768.13, Florida Statutes. 013 ZSZ !0/8/01 Ce Vehicles rendering ambulance-type servicee when re- quested to do so by the Board of County Commissioners or County Manager in the event of a major catastrophy or other such emergency which requires more ambulances than ara available in the county. De Ambulances based outside the county which pick up a patient in the county and transport him out of the county, or which pick up a patient out'of the county and transport him into the county. Vehicles used to transport persons for rout/ne schedulcd medical treatmQnts. Vehicles transporting persons who require medical services en route or who must be carried on a stretcher are not covered by this exemption. Section 5. Procedure For Obtaining Certificate An applicant for a certificate shall obtain forms from the department to be completed and returned to the Division Administrator. Each application shall contain: ae The name, age, and address of the owner of the ambu- lance or ALS provider, or if the owner is a corporation, then of the directors of the corporation and of all the s:~ockholders holding more than 25% of the outstanding shares. For governmental units, this information shall be supplied for members of the governing body. The boundaries of the territory desired to be se~-~ed. Ce The number and brief description of the ambulances or other vehicles the applicant will have available. The address of the intended headquarters and any sub- stations. The training and experience of the applicant. The names and addresses of thre~ (3) Collier County residents who will act as references for the applicant. A schedule of rates which the service intends to charge. He Such other pertinent information as the administrator say require. ~u~ application or ranawal £eo of two hundred fifty dollars ($250.00). Financial data including assets and liabilities of the operator. A schedule of all debts encumbering any eguipment shall be included. ' Section 6. Review Of Applicatio~ The Administrator shall review each application and shall investigate the applicant's reputation, competence, financial responsibility, and any other relevant factors. The Administrator aha11 also make an investigation as to the public necessity for an ambulance or ALS operation in the territory requestnd, and shall then make a report to the Board containing his recommendation whether to grant a certificate to the applicant within sixty (60) days of the time the Administrator determines the application is complete. Section 7. Requirement For Board Approval Xn Granting Certificate The Board of County Commissioners shall not grant a certificate unless it shall find, after public hearing and baaed on competent evidence that each of the following standards has been satisfied~ , A. That there is a publio necessity for the service, In making such determination, the Board of County Commis- sion shall consider, aa a minimum, the following factors~ (1) The extent to which the proposed service is needed to improve the overall Emergency Medical Services (EMS) capabilities of the County. (2) The effect of the proposed service on existing services with respect to quality of service and cost of service. (3) The effect of the proposed service on ~he overall cost of EMS service in the County. (4) The effect of the proposed service on existing hospitals and other health care facilities. (5) The effect of the proposed service on personnel of existing services and the availability of suffi- cient qualified personnel in the local area to That the applicant has sufficient knowledge and experi- ence to properly operate the proposed service. Ce That, if applicable,' there is an adequate revenue base for the proposed service. De That the proposed service will have sufficient per- sonnel and equipment to adequately cover the proposed ee~"vice area. Section 8. Appointment of Mearing Officer Xn making the determinations provided for in Section 7 above, the Board may, in its sole discretion, appoint a Hearing Officer to hold a public hearing and to make factual findings and conclusions as a result of the hearing. Should a }]earing Officer be appointed, said Hearing Officer shall render a written report to the Board within 30 days of the hearing, which report shall contain the officer's findings and conclusions of fact, and a recomm-nded order. The findings and conclusions of fact shall be binding upon the Board, but the recommended order shall be advisory only. section 9. Rights And Duties Granted By Certificate The certificate granted by the Board shall be valid for one calendar year and shall be personal to the applicant and not transferable. In the cane of a corporation, if there occurs such a transfer of stock or other incidents of owner- ship aa to change the majority or largest stockholder, a new certificate must be applied for. Changes in the officers of the corporation wtll not require a new certificate. Acceptance of the certificate by the applicant shall obligate the applicant to: A. Service the entire zone granted to the applicant; Provide coverage to adjoining zones, when requested to do so by Emergency Control for emergency calls when the certificate holder for that zone is unable to respond. Keep posted at hie place of business a copy of the fee schedule which must be f/led with the Administrator (if applicable.) D~ Operate in accordance with the rules and regulations adopted pursuant to this Ordinance and any applicable County ordinances, and Chapter 401 Florida Statutes, · nd any administrative regulations adopted pursuant thereto. Employ at all times sufficient personnel experienced in operation and management of emergency medical service· to ensure proper ·nd efficient operation. Section 10. Renewal Of Certificate Each certificate holder shall file within ninety (90) days of expiration, an application for renewal of his certi- fic·~e. Renew·la shall be based upon the same standards as the granting of the original certificate along with such other factors as may be relevant. Th,~ renewal application shall be accompanied by a two hundred and fifty dollar ($250.00) renewal fee. The renewal certificate may'be approved routinely by the Board, upon a ]vice of the Administrator, or the Board may hold a hearing on same. Section 11. Emerqeocy provisions The Board may modify, suspend or revoke a certificate in the interest of the public health, safety and welfare, only at a public hearing and after reasonable notice has been given to the certificate holder affected. Ilowever, if · situation exists which poses a serious threat that ambu- lance or rescue servic;: will not be available to any certain area of Collier County, t. he Administrator shall have such temporary emergency powers as are necessary to provide that service. These temporary powers are intended to provide interim protection until much time as the Board meets to resolve the emergency. Section 12. Transfer Or Assignment Of Certificates No certificate i·sued unCer ~hia Ordinance shall be · ssignable or transferable by tho person to whom issued except unless approval is obtained from the Board in · ~me manner and subject to the sams app~ic·tion, investig·- tion, fees and public hearing as ~riginal application· for certificates. Any majority transfer ~f shares or stock or interest of any person or operator so &· to cause · change in t. he directors, officers, majority stockholders or mana- gers of such person or operator shall be deemed · transfer 013 Or assignment as contemplated in this Ordinance and subject to the same rules and regulations ss any other transfer or assignment. ~ction 13. Rgvgcation~ Alteration or suspension Grounds Every certificate iosued under this Ordinance shall be s~Ject to revocation, alteration and/or suspension of operation, by the Board, for a period of up to one year, where it shall appear that: The operator has failed or neglected for a period of thirty (30) days during any calendar year to render all services authorized by his certificate. The operator has been convicted of a felony or any criminal offense involving moral turpitude. The certificate was obtained by an application in which any material fact was omit-ted or falsely stated. The operator has knowingly permitted any of motor vehicles to be operated in violation of the laws which result in conviction of the driver or operator of a misdemeanor in the second degree or greater, or ha, knowingly permitted a driver with more than two previous convictions to operate emergency vehicles. The operator has failed to comply with any of the provisions of this Ordinance. The public interest will best be served by revoca- t/on, alteration, or suspension of any certificate upon good cause shown. The operator or his agent has dcmanded money or compensation other than that established and prescribed under this ordinance. (If applicable.) The operator has without sufficient Jumtification failed or refused to furnish emergency care and/or ~r&nsportation promptly for a sick or injured person. ~ O/O/S 1 The operator or his agent hau been found guilty of mslpractice or wilful and wanton misconduct in operation of its service,. All complaints shall be investigated and a report thereon made to the Board, together with findings and recommendations, within fifteen (15) days. If revoca- tion, au.pension or alteration of any certificate appears warranted, the Board shall give notice to the operator holding the certificate that the same will be considered at a specific commission meeting, provided the date of such meeting shall not be less than five (5) days from the date of the notice. The Board shall thereupon consider the complaint and either revoke, suspend or alter the certificate or dismiss the complaint. Section 14. General operating Regulations All certificate holders, operators, and drivers shall comply with all state ~tatutes and adminis~rative regula- tions as well as the following regulations: Twenty-four lieu.; Service. Every certificate holder shall be required to operate sufficient an~ulances, as stated on tho certificate of operation and determined by the Board, on immediate call at all times. F~pmpt service Required, Every call for ambulance lervice shall be answered promptly. Patients shall be loaded and transported without being subjected to unreasonable delays. All calls for emergency assis- t&rice requiring over twenty (20) minutea from time of notification to arrival on scone ~hall be reported to the Adminimtrator with complete documentation of the circumstancem which delayed the response. Those instances where more than three (3) minutes elapse between receipt of an emergency call and dispatch of an ambulance shall also ba repo:'ted to the Administrator with documentation of circumstances. Dad Linens. Clean and sanitary bed linens shall be provided for each patient carried snd shall be changed sS soon as practicable after the discharge of the patient. 013 Daily Lo~. Every operator shall maintain in a daily log upon which shall be recorded the place or origin, time of call, time of dispatch, time of arrival at scene, time left for hospital, time of arrival at hospital, and charges for each trip made and such other operating and patient informa~ion as may be required by Ordinance. Every op.rator shall retain and preserve all daily log~ for at least two (2) years, and such logs shall be available for inspection by the Adminis- trator. Communications. Each ambulance shall maintain two-way radio communication with the location of primary dis- patch from which it operates, as well as any additional communication capabilities required by Ordinance or state law. Vehicles and Equipment. Each vehicle shall be equipped with the proper medical and emergency equipment as required by the laws of the State of Florida and shall be subjected to inspection from time to time to insure compliance with the laws of Florida and this Ordinance. Certification. In addition to the State of Florida Department of Health and Rehabilitative Services re- quirements for certification, each paramedic must be certified by the County Medical Director. Each para- medic must work with a Collier County EMS ambulance for a sufficient length of time for the ambulance service medical director to properly Judge his capability. At minimum, the paramedic must work in that capacity not less than one full month's work shift annually. Sal- aries of other than Collier County EMS paramedics will be paid by ~]e agency seeking the Medical Director Certification. Each ambulance or ALS service shall be subject to those rules and requlations aa promulgated by Ordinances of the Board for the purpose of carrying out this ordinance. Section 15. Central Place Of Business Each opera%or shall maintain a central place of bus- iness which shall be entirely within his designated operat- ing zone, at which place he shall provide two-way radio co~munication with his vehicles, the county emergency con- trol co.~unicationm center, and his place of business, & properly listed telephone for receiving all calls for ser- vice and at which central place of business he shall keep such business records and daily togs available for inspec- tion or audit by tho Administrator. Every operator shall keep on file with the Administrator and the County Emergency Control Communications Center a business address and tele- phone number at which the operator may be reached at all timee. This information will be maintained at the Emergency Control Center. Section 16. Records To Be Kept Every operator shall keep accurate records of receipts from operations, operating and other expenses, capital expenditure and such other operating and patient information as may be required by the Board. Section 17. Rates Every operator shall file with the Zoard a schedule of the rates. Such rates shall be filed as a p~rt of each new or renewal application, and a rat9 schedule shall also be filed when changes in rates are proposed. All such rates shall be subject to review and approval by the Board. Section 18. Operator's Insurance Every ambulance operator shall carry bodily injury and property damage tnGurance ,.'ith 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 opera- tion or use of any of the operator's motor vehicles. Each vehicle shall be insured for the sum of at least one hundred thousand dollars ($100,000.00) for injuries to or death of any one person arising out of any one accident and the sum of at least three hundred thousand dollars ($300,000.00) for injuries tO or death of more ~an one person in any one accident and for the sum of at lems~ fifty thousand dollars ($50,000.00) for damage to property arising from any one accident. They shall also have malpractice insurance. Every insurance policy or contract for such insurance shall pro- vide 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 aha11 be obtained and certificates or certified copiea of such policies shall be filed with the Board. All such insurance · ., "' 013 =298 :L 0 ~ 0/8/_8 ~. policies, certificates thereof or certified copies o£ such insurance policies shall provide for a thirty (30) day cancellation notice to the Soard.. Section 19. 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 require- ments set out in this Ordinance and no driver, EMT or para- medic registered hereunder shall~ Fail or refuse to promptly transport, if applicable, or attend any sick or injured person after responding to a call. Demand or receive compensation other than that estab- lished and approved in accordance with this ordinance or fail to give a receipt for moneys received. (If applicable.) Give or allow rebate, commission, d~scount or any reduced rate not provided in the established rate. (If applicable.) Do At any time induce or seek to induce any person engag- ing an ambulance or ALS service to patronize or retain the services of any hospital, convalescent home, mortu- ary, cemetery, attorney, accident investigator, nurse, medical doctor or other service occupation or profes- sion. At any time release his patient from his care until he is assured that some re,pon,ibis person is available to receive such patient. Fo At any time usa a siren or flashing red light unless on an emergency call. Disobey the lawful orders of the law enforcement of- ricer at the scene of an accident, or other similar such emergency or at a fire scene, the fire officer in charge. Smoke while within the confines of an ambulance. O~arste or rids in an ambulance without using seat- Section 20. Passenger~ No person shall be aboard ambulances when engaged in emergency or routine medical calls except the following~ A. Driver, attendants and fire or law enforcement person- nel; B. Patients; Not more than one relative or close friend of the patient, or if the situation warrants, the paramedic in charge may authorize more than one passenger. D. Physicians and nurses; Personnel in an observing capacity that are being trained for ambulance or ALS service. F. Operator's supervisory personnel. Section 21. Obedience To Traffic Lawst Ordinances or Regulations The driver of an ambulance or ALS vehicle when respond- ~ng to an emergency call or while transporting a pa- tient may exercise the following privileges when such driver has reasonable grounds to believe that an emergency in fact exists requiring the exercise of such privileges: Park or stand, irrespective of the' othcr~ise applicable provisions of law, ordinance or regula- tions. Proceed past a red light or stop signal or stop sign, but only after slowing down aa may be neces- mary for safe operation. Exceed the maximum speed limits permitted by law so long as he does not endanger life or property. Disregard laws, ordinances or regulations govern- ing direction or movement or turning in specified directions so long am he does not endanger life or property. Be The exemptions herein granted shall apply only when such vehicle is making use of audible and/or visible signals meeting the requirements of this Ordinance. Ce The for.going provimionm 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 reck- less disregard for the safety of others. Section 22. Violations In addition to the remedies provided herein, a viola- tion of any provision of this ordinance shall be punishable as provided by law for the violation of County ordinances. Section 2~. Uniformity of Application This Ordinance shall constitute a uniform law appli- cable in all of Collier County. Section 24. Authority To Enforce It is hereby declared to be the duty of the Board of County Commissioners of Collier County, its officers~ ag.)nts, 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 Ordinance to strictly enforce the provisions of this Ordinance. section 25. Repeal And Codification Ordinance 75-50 is hereby repealed. This Ordinance shall be codified in the Collier County Code as Chapter 4 of said Code, and said Code is hereby amended accordingly. section 26. Severability If any 0ection, subsection, sentence, clause or pro- vision of %his Ordinance is held invalid, %he remainder of this Ordinance shall not be affected thereby. Section 27. Effective Date law. This Ordinance shall take effect as provided by general ADOPTED this 1st day of' December , 1981. COUNTY OF COLLIER ) BOARD OF COUN/"f COMMISSIONERS COLLIER COUN/~', FLORIDA c£ab ' BY: ~'~ CHAIRMAN X, WILLI~! J. REAGAN, Clerk of Courts in and for the ~entieth Judicial Circuit, Collier County, Florida, do hereby certify that the foregoing is a true original oft ORDINANCE NO. 81-75 which was adopted by the Board of County Commissioners during Regular Session December 1, 1981. WITNESS my hand and the official seal of the Board of County Commissioners of Collier County, Florida, this 1st day of December, 1981. WILLIAM J. REAGAN Clerk of Courts and Clerk Ex-officio to Board of County Commissioners Virgi~a Magri Du.~. y Clerk. '" ~ This ordinance filed with the Secretary of State's~ ..,'.,'-, ' .".~ Office ~he 8~h day of b=cember' 1981 and acknowled~O~~ . %..."%~, ]|/Igg/84-C 013