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BCC Minutes 03/03/2011 W (Public Safety Authority Concepts & Options) MINUTES BCC Workshop Meeting March 3 , 2011 March 3, 2011 MINUTES OF THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS/EMS BLUE RIBBON COMMITTEE WORKSHOP Naples, Florida, March 3,2011 LET IT BE REMEMBERED, that the Collier County Board of County Commissioners and the Blue Ribbon Committee in and for the County of Collier, having conducted business herein, met on this date at 9:00 AM in a WORKSHOP SESSION in Building "F", of the Government Complex, Naples, Florida with the following members present: Chairman: Commissioner Fred Coyle Vice Chairman: Commissioner Jim Coletta Commissioner Tom Henning Commissioner Donna Fiala Commissioner Georgia Hiller Blue Ribbon Panel: Chairman: Geoff Mobius Vice Chairman: Edward Morton Robert Metzger ALSO PRESENT: Leo Ochs, Jr. - County Manager Jeff Klatzkow - County Attorney Ian Mitchell - Executive Manager/BCC Dan Summers - Emergency Services Director 1 March 3, 2011 The meeting was called to order hy Commission Chairman F'red Coyle at 9:05 AM. Pledge of Allegiance was recited. 1. Presentation of Puhlic Safety Authority Concepts and Options by County Staff and Blue Ribbon Panel Chair and Co-Chair County Manager Leo Ochs stated the report is the final report of the Blue Ribbon Panel presented to him and the Board of County Commissioners on January 11th, 2011. The Board directed the County Manager and County Attorney to explore options that had been prescnted by the Blue Ribbon Panel and present them at a workshop. Commissioner Hiller had also mct with stakcholders as well as staff and will give a prescntation later. Staffpresented a slide presentation of the 6 recommendations as follows: 1. Forming an Independent Special District 2. Forming a Dependent Special District 3. Creating an Authority by Interlocal Agreement within Chapter 163, F.s. 4. Transferring PEMTT related Fire and EMS functions to the Sheriff's Office directly or under contract to the Sheriff 5. Expand the Bureau of Emergency Services within the County Manager's Agency guided by an appointed Advisory Board 6. Reconstitute the existing and active EMS Policy Advisory Board into a Public Safety Authority The recommendation of the County Manager and County Attorney was the number six (6) option of reconstituting the existing and active EMS Policy Advisory Board into a Public Safety Authority. Commissioner Coyle mentioned the Chair and Vice-Chair of the Blue Ribbon Panel also endorsed #6 as thcir preferred option. Blue Ribbon Panel Chairman, Mr. Geoff Mobius gave several reasons they supported reconstituting the existing Advisory Board into a Public Safety Authority. I. Can implement changes quickly 2. Authority would have coordinating power hut the decision making power will remain with the Board of County Commissioners. 3. The existing EMS Advisory Board can be disbanded and reconstituted 4. The Authority would be reviewed annually and reconstituted as seen fit by the Board of County Commissioners. 5. The Board would meet quarterly 6. The Chairman of the Authority should be an individual who can bring everyone together to work on common issues and continual improvement of pre-hospital care. He gave the number of members the panel suggested being on the Authority as follows: 1 Collier County Medical Director, 2 Hospital Emergency Department Directors, 1 Trauma Director from Lee Memorial, 2 Hospital Administrative representatives, 5 Fire, 2 EMS, 1 Sheriff representative, 2 or 3 community experts with experience in Pre-Hospital Care. 2 March 3, 2011 Another possibility is persons from the Fire Commission, City Councilor County Commissioners. They left that option open. The total number of Board members is 17 with 6 Administrative members. Administration support would be non-voting members. Commissioner Coyle suggested a much smaller board with medical knowledge and not political. Commissioner Coletta was concerned with the politics that has been involved and suggested they limit it to the professionals. He was also concerned with the number of persons on the board. Commissioner Henning questioned which type of board will the Public Safety Authority be _ an Authority (who has power) or an Advisory Board (who advises only). He asked Mr. Mobius a question concerning Advanced Life Support (ALS) versus Basic Life Support (BSL) as not to confuse the role between departments. Mr. Mobius stated BSL is best in providing services and have always stated there should be a paramedic on site as quick as possible. Getting the patient to the hospital is important. Bringing the hospitals together is extremely important, working together and diseussing continuity of supplies and equipment. Commissioner Henning suggested the Authority is made up of all medical personnel. The emergency doctors are an important part. He stated to take the politics out of it. Commissioner Coyle agreed with Commissioner Henning on the political issue being kept out of the Authority but again concerned with the number of members. He suggested a smaller board with experts with the best medical knowledge in emergency care and focus on uniform emergency standard care. Commissioner Hiller stated the group she worked with isn't far from what Mr. Mobius has stated. The current EMS Advisory Board hasn't worked. She also agreed with Commissioner Henning concerning the politics being kept out of the Authority Board. When members are appointed by the Board of Commissioners, it can be a problem. She stated Mr. Mobius's report is going in the right direction. Mr. Mobius stated everyone is stating the same thing. They need a council to deliver and bring all the parties together. The panel felt the Seattle program is the premier program in the country. Getting the right people on the panel, how many, who and who will lead it is very important. Dan Summers, Emergency Services Director mentioned the challenge is the independent districts are separate governments and execution, training and delivery is a rcal challcngc. Thcy have good working rclationships but are all indcpendent. Training, cxccution and policy is where they have real challengcs. 3 March 3, 2011 2. Presentation of other options Commissioner Hiller explained she held a scries of workshops with many representativcs ofthc mcdical, hospital, firc and sheriffs' officc. The County was not rcprescntcd as thcy worked with thc Bluc Ribbon Committec. Chicf Murphy from Marco Island along with Dr. Rice.- Dircctor of Emcrgency Room Scrviccs for North Collier will givc the report. Chief Bloom from the sheriffs officc also attcnded their mectings. Their presentation isn't much different than Mr. Mobius's. Chief Murphy, Fire Chief/Marco Island summarized the results of their report in a powcr point prcsentation. . Purpose _ create a seamless system from the receipt of the 91/ emergency calls through the Emergency Room treatment process for all emergency medical services in Collier County. . They looked at the same items the Blue Ribhon Panel report looked at. . Authority be created by Ordinance . All memhers will be appointed hy their respective agencies annually. . Members-2 Emergency Medical Physicians, 1 Lee County Trauma, 1 Collier County Medical Examiner, 2 Medical Directors, 1 County, 2 Municipal, I Independent Fire District, (ALS-l CC Paramedic, 1 Independent First District Paramedic, 1 Municipal Paramedic), (BLS-Independent Fire District EMT), 1 CC Sheriff, 1 Municipal Police Chief. (Administration-Hospital Administrator, County EMS Chief, Independent Fire District Chief. Municipal Fire Chief), 2 citizens appointed hy the Authority . Terms were given . Functions were summarized - Broward County worked on subcommittees Recommendations were given- . Direct County Attorney to write a County Ordinance possibly within 30 days creating the Authority . Transition Authority into an Independent District . Direct County Manager to separate all costs into a hudget- after review, possibly bring an Executive Director in. . Convene a meeting with of the Authority participants within 21 days Commissioner Coyle asked ifthcy were basically in agreement with the Blue Ribbon Panel on the Authority - ChicfMurphy agreed. Commissioner Coyle expressed the Independent Fire Districts were willing to share in costs in staff or funding at one timc but not sure that is still a possibility. Whcn making a decision of crcating an Authority with an executive director, you are talking about taxing the taxpayer. The main objective is to consolidate EMS into a separatc Authority and out ofthc Board of County Commissioners into thc administration of the Fire Districts. Break-19:37 AM Reconvened -10:51 AM 4 March 3, 2011 3, Board discussion Mr. Edward Morton, Vice Chairman of the Blue Ribbon Panel gavc his comments. . Has been a general consensus by everyone thus far . Evolution versus Revolution - he preferred an Evolutionary process . Responsibility of the Authority mcdical only? Can medical protocol be taken independently? And incorporated independently? He stated it cannot. . Supportive ofthc County Manager's approach with reconstituting the EMS Advisory Group . Rcport received by Commissioner Hillcr is to bc taken very seriously with scrutiny and was very wcll put together, but the community may question taxation. . The Authority be charged with global responsibility - a broad rcsponsibility Chief Murphy commented on the Firc Districts taking steps to move forward with the BCC taking a leadership role in taking those first steps. 4. Public Comment Duane Billington, Resident - he stated he is somewhat skeptical but is seeing evcryone come together. Protocol and training are important and dccisions need to be made by the medical field only. (Emergency room doctors) Hc mentioned opcrations and the voting and non-voting members. He talked about the various persons that should be on the committee in order to ensure accomplishments. Hc asked if they can provide a highcr standard of care. The Board needs to be one standard system of protocol established by the medical community. Orly Stotts, North Naples Fire - he was glad thcy recommended #6. It is something they are all talking about. He said the system is screwed up but they are all working together and good at what thcy do. They need to be working with one protocol. Hc was very encouragcd at what he heard. He didn't feel they will ever get rid of politics in their jobs. He agreed they nced subcommittecs. Commissioner Henning mentioned thc County Managcr, with the assistance of the County Attorney, gencrate an ordinance creating an Authority without being in thc sunshine. Commissioner Fiala stated standardized protocol and training should be included in the Ordinance. Possibly the Prcsident of the Medical Society could serve on the board. She also suggested thc hospital endorse participation of the doctors to scrve. Commissioner Coyle stated he supports moving forward immediately and to provide guidelincs and havc staff work out all the details. County Manager Jeff KIatzkow mentioned he wasn't surc how they can create an Authority without being in the sunshine but will look into it. 5 March 3,2011 Commissioner Hiller suggested Broward County be contacted as they have been successful in creating an ordinance as such. Robert Metzger mentioned each reconstituted group must state the qualifications that each representative needs to have, and focus on pre-hospital emergency medicine. Commissioner Hiller suggested staff use her model as framework for the Authority to move forward. It was suggested by Commissioner Fiala that all information gathered at the workshop be meshed together and find one outcome. County Manager Ochs needed to know if the Commissioners wanted elected officials on the Board added into the ordinance. County Attorney Klatzkow will create a proposed amendment for discussion with a uniform EMS system throughout the County at a future Board of Commissioners meeting. 5. Adjournment .-,:1''' There being no further business for the good of the County, the Workshop was concluded by order of the Chair at 11 :34 AM. COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS commi~et;>~Oy~aD ATTE~T." ))1.tI'~jt ' DW!~IU.E~ B~~K, CLERK .,.t:. " 1~':<-'~_-- - ,.,:,:::i ~ ~lIi.!_t. it9R~.~-t.if.: ,_.iF These minute:!ap -"Ved by the Board on 1-1 M~ 10 II as presented ~A or as amended - 6