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EMS Policy Agenda 3/25/2011 COLLIER COUNTY EMERGENCY MEDICAL SERVICES POLICY ADVISORY BOARD AGENDA MEETING TO BE HELD: NEIGHBORHOOD HEALTH CLINIC 121 Goodlette Road N. Naples, FL 34102 Second Floor Education Room DATE: March 25, 2011 TIME: 3 :30 p.m. 1. CALL TO ORDER AND PLEDGE OF ALLEGIANCE 2. AGENDA AND MINUTES A. Approval of To day's Agenda B. Approval of Minutes from the January 21 st Policy Advisory Board Meeting 3. OLD BUSINESS 4. NEW BUSINESS A. COPCN Ordinance ReviewIRecommendations to BCC B. CCSO Release of AED Information 5. STAFF REPORTS 6. PUBLIC COMMENT 7. BOARD MEMBER DISCUSSION 8. ESTABLISH NEXT MEETING DATE 9. ADJOURNMENT January 21,2011 MINUTES OF THE MEETING OF THE COLLIER COUNTY EMERGENCY MEDICAL SERVICES POLICY ADVISORY BOARD Naples, Florida, January 21, 2011 LET IT BE REMEMBERED that the Collier County Emergency Medical Services Policy Advisory Board, having conducted business herein, met on this date at 3:30 PM in REGULAR SESSION at the Neighborhood Health Clinic, 12 Goodlette Road N., Naples, Florida, with the following Members present: CHAIRMAN: Vice Chair: James Talano, M.D. Chief Walter Kopka Rosemary LeBailly, RN Chief Robert Metzger Jerry Pinto ALSO PRESENT: Commissioner Georgia Hiller, District 2 Dr. Robert Tober, Collier County Medical Director Jennifer Florin, EMS Administrative Assistant, Jeff Page, Chief, Bureau of Emergency Services, Staff Liaison Wayne Watson, Deputy Chief, Bureau of Emergency Services Dan Bowman, Deputy Chief, Bureau of Emergency Services Jorge Aguilera, Deputy Chief Medical Services/Community Relations January 21,2011 1. Call to Order and Pledge of Allegiance: Vice Chairman Metzger called the meeting to order at 3:35 P.M. and a quorum was established. The Pledge of Allegiance was recited. Commissioner Fred Coyle was present earlier but left to avoid a violation of the Sunshine Laws due to the presence of Commissioner Georgia Hiller. 2. Agenda and Minutes: A. Approval of Today's Agenda Chief Walter Kopka moved to approve the agenda as submitted. Second by Jerry Pinto. Carried unanimously, 4 - O. B. Approval of Minutes from September 17, 2010 Meeting: Chanf!es: · On Page 4, last paragraph, substitute EMD Supervisors ("Emergency Medical Dispatch") for "Fire District Chiefs" in the first sentence. Chief Walter Kopka moved to approve the minutes as amended. Second by Jerry Pinto. Carried unanimously, 3 - O. Note: Vice Chairman Metzger did not vote since he was not present at the September meeting. 3. Old Business: A. Review of Blue Ribbon Committee Report Vice Chairman Metzger stated staff added the topic to the agenda and asked if there was a specific item to be reviewed. (Dr. Talano arrived at 3:40 P.M) Chairman Talano thanked the Blue Ribbon Committee for their efforts to study the existing problems and for visiting other areas around the country to establish a basis of comparison. Vice Chairman Metzger concurred that committee presented a "solid report." It was noted two members of the advisory board did not have an opportunity to review the document and the topic will be added to the next agenda for action. 4. New Business: A. Election of Chairman and Vice Chairman for the 2011 Term Chief Walter Kopka nominated Dr. James Talano to serve as Chairman. Second by Vice Chairman Metzger. There were no other nominationsfrom thefloor. The Motion carried, 4-"Yes"/1-"Abstention." Dr. Talano abstained. Vice Chairman Metzger nominated Chief Walter Kopka to serve as Vice-Chairman. Second by Chairman Talano. There were no other nominations from the floor. The Motion carried, 4-"Yes"/1-~tAbstention." Chief Kopka abstained. 2 January 21,2011 B. Establish Schedule for 2011 Meeting The Advisory Board Members adopted the following schedule: . March 25, 2011 . June 10,2011 · August 19,2011 · October 7, 2011 · November - to be determined The meetings will be held at the Neighborhood Health Clinic, 121 Goodlette Road North, commencing at 3:30 PM, unless otherwise notified. It was noted the terms for Rosemary LeBailly, RN, and Jerry Pinto will expire in September, 2011. Chief Robert Metzger moved to accept the meeting schedule as above-referenced. Second by Vice-Chairman Kopka. Carried unanimously, 5 - O. 5. Staff Reports: A. Review of COPCN e'Certificate of Public Convenience and Necessity") Application from North Naples Fire District Chief Jeff Page stated the application had been provided to the Board and Naples Community Hospital was also submitting an application for renewal. He explained the 2007 advisory board established the policy for COPCN applications to be reviewed by subsequent Boards. He noted the NCH application consisted of two letters, dated November 15,2010 and January 7,2011, addressed to Dan Summers, Director - Bureau of Emergency Services. (Copies of the documents were provided to the Board.) Deputy Chief Jorge Aguilera, Medical Services - North Naples, stated he would answer any questions from the Board. Chairman Talano inquired about any changes from the September 2009 application. Deputy Chief Aguilera stated there were no changes. The application was heard by the Board of County Commissioners in October 20 I 0, but failed to be approved. It was placed back on the agenda by unanimous consent of the BCC for reconsideration. The BCC will meet on Tuesday, January 25,2011 to reconsider the application. Chairman Talano questioned reviewing the application since the recommendations of the Blue Ribbon Committee had not been incorporated into the application. Chief Robert Metzger asked if the application had been reviewed by the previous EMS Policy Advisory Board. Deputy Chief Aguilera stated it had not. Chief Metzger questioned why the Policy Advisory Board was being asked to review the application when the Board had not reviewed it upon initial presentation. 3 January 21,2011 Vice Chairman Kopka referenced the policy outlined in Ordinance 2009-01 which stated the Policy Advisory Board is to review any pre-hospital emergency medical care. The Ordinance states: "The Advisory Board is created to assist the Board of Co unty Commissioners with all issues affecting pre-hospital emergency medical services within all of Collier County. " Section Two of the Ordinance, entitled "Functions, Powers and Duties," states: "The Advisory Board shall have the following duties: 1. To review and advise the Board of County Commissioners of all issues concerning pre-hospital emergency medical services within Collier County. " He stated reviewing the COPCN by the Advisory Board falls under the directive since the goal of the application is to change the current EMS policy in North Naples. Chief Page pointed out the last meeting of the Advisory Board was held in September 20 10 and the application was submitted in October. Chairman Talano reiterated the Blue Ribbon Committee's recommendation has not been reviewed by the Advisory Board or incorporated into the COPCN Application. He stated the Advisory Board should review the report before considering the application. Vice Chairman Kopka stated he was not sure if fragmenting the services was the goal of the Blue Ribbon Committee and cited some of the recommendations in the report: "Mandate that all agencies providing ALS ("Advanced Life Support ") also provide patient transport to hospitals; The Blue Ribbon Committee consideredfunctional consolidation of Fire Services in Collier County and re-allocation of resources in response to demographics and professional standards; ... encourage all Fire Services to collaborate in order to develop Common Response Protocols ... " He further stated there was much more in the report that did not "dove-tail" with approving the COPCN for North Naples. Chairman Talano concurred and pointed out that transportation issues were not addressed in the COPCN. He stated the COPCN's Protocols were not clear enough. Chief Metzger noted the Blue Ribbon Committee's Report referenced a three-year time line for phased-in implementation of their recommendations. The process is to be determined by the various stakeholders and subject-matter experts. The application made by North Naples is for a system enhancement to take place in the near future. 4 January 21,2011 The Chief continued the application could be integrated into the overall recommendation made by the Blue Ribbon Committee. He stated the ideal is a new, progressive, common service and to postpone consideration for North Naples may not serve the best interests of their residents, especially if North Naples' capability can be improved. Discussion ensued and the following points were raised: · Did North Naples COPCN Application support the conclusion that there would be an improvement in the delivery of care to the residents? · The report recommends system changes that may never happen. · The Blue Ribbon Committee is trying to work toward a functional consolidation of the system and for continuing the current two-tier model. · The Blue Ribbon Committee's report should be thoroughly vetted to determine the feasibility of the recommendations. · Since North Naples is willing to enhance their ability to respond to patients, it could have some positive impact to the overall system - potentially by allowing other ALS resources to be diverted to other areas of the County. · "Enhancement" is a presumption. A number of paramedics in North Naples have less clinical experience. · The two-tiered system supports early BLS ("Basic Life Support") intervention as the key to saving patients' lives. · The academic literature points to prompt BLS with conservative ALS by a limited cadre of paramedics. Dr. Robert Tober stated the recommendations of the Blue Ribbon Committee should be analyzed and a determination made concerning the type of authority to be created before separating out one independent state of ALS activity when there is nothing to support such action. Vice Chairman Kopka again cited from the Committee's Report: The Panel also strongly believes in one medical leader for the County. " He stated his definition of "fragmenting the service" is having a different Medical Director in a particular district with different protocols, procedures and levels of care. Chief Metzger agreed that Dr. Tober's position regarding cardiac care was correct but there were other medical conditions that benefited from early ALS intervention. He cited Canadian studies which identified airway obstructions, anaphylaxis, and other types of medical emergencies respond to the immediacy of ALS procedures and have a positive impact. Dr. Tober noted the engines and the BLS equipment carried by the engines include airway emergency equipment and "Epi-Pens." He further stated the majority of the Canadian studies that examined cardiac and trauma found no more morbidity benefit from ALS procedures, and the procedures should be limited and those resources diverted to early/prompt BLS. He had not found any medical literature to support extending ALS privileges to those who do not regularly practice the skills have been shown to be a benefit. 5 January 21, 2011 Dr. Tober continued: · Enough airway equipment has been distributed to the engines to intervene - they carry King Tubes and Subcutaneous Epinephrine. · During the past six months, North Naples calls had been analyzed and in approximately 6,000 calls, only 4% required technical ALS procedures and half of that number consisted of connecting the patient to a cardiac monitor. · One option under consideration is to train a small number of paramedics from North Naples to a higher level to create a small cadre of ALS Early Response should there be a delay. · All of the BLS engines have everything that is needed. Chief Aguilera noted only a summary was provided. He requested that the Board review the entire application before any recommendations were made. The Canadian system is much different than the U.S. - the certifications, qualifications, and classifications are drastically different. Chairman Talano stated to take action without comparing both reports was premature. Public Comment: Commissioner Hiller noted the Board of County Commissioners has not adopted the recommendations of the Blue Ribbon Committee, but merely accepted the report. The BCC decided to schedule a Workshop to determine if a Public Safety Authority should be created and its structure. The recommendations of the report will be deliberated and decided by the Public Safety Authority. She expressed concern over the details of the report which she described as "vague." She was also concerned that Dr. Tober intended to de-certify some paramedics. Dr. Tober explained EMS is the "Court of Last Resort" and must transport. His concern was trying not to overly spread the distribution of drugs into inexperienced hands. Approximately fifty paramedics are loaned to the Fire Districts and, after a two to three month rotation they must go back to ambulances to reinforce their skill levels (at their request). He stated there are only so many opportunities to practice clinical skills and he was trying to cut back on the unnecessary expansion of paramedics. Deputy Chief Dan Bowman stated the Blue Ribbon Committee discussed a number ofthe same issues expressed by the Advisory Board but its conclusions have not been clarified. The details need to be more completely described. He continued the application may be justified by the Blue Ribbon Committee and there may be elements for North Naples to include. He further stated the EMS Board is in a position to encourage whether the COPCN should be considered and he suggested waiting until a final product has been produced. A question was asked concerning the sunset of the COPCN. Chief Page noted a COPCN is renewed annually. If a COPCN (non-transport) is granted, North Naples will take over the responsibility. The number of EMS units in North Naples theoretically could be reduced by approximately 40% and could be relocated to rural areas or further reduce the number of units provided to the County for a tax savings. He suggested if a COPCN is granted, it should contain transport to allow the County to Re-disburse the units. There are a number of factors to be considered by the BCC. He will 6 January 21,2011 meet with Chief Stoltz and Dan Summers at the conclusion of the BCC meeting. Chief Metzger stated the COPCN could be phased in, first without and then with transport, as a way to move the system forward. A potential benefit could be the redistribution of assets. Chief Page stated North Naples has the capability of providing ALS engine transport and could have the same agreements as East Naples and Marco Island. Chairman Tolano stated to have a non-transport agreement was not good medical policy and he would not support it. Vice Chairman Kopka stated the current request is for ALS non-transport. Vice Chairman Kopka moved to recommend not approving the North Naples COPCN application and to forward the recommendation to the Board of County Commissioners. Second by Rosemary LeBailly. Ms. LeBa illy stated all members of the Advisory Board should be fully informed. Chief Metzger stated his concerns: · Two members have not had the opportunity to read the Blue Ribbon Report in its entirety, and · Th~ EMS Policy Advisory Board has not has an opportunity to review the COPCN Application in it's entirety. He suggested tabling any action until the members have had the opportunity to review the documents. Dr. Tober pointed out to table the motion is to take no action, and no recommendation will be made to the Board of County Commissioners who will vote on the application at the next meeting. He suggested sending a recommendation to the BCC to delay their vote for at least one month. Chief Metzger noted if North Naples does not have consideration within a specific timeframe, their process will begin again. He contended for the Advisory Board to take a position without being adequately informed is not responsible and misleading. Chairman Tolano questioned Chief Metzger's opinion. He stated if the BCC has more information to make a decision than the Policy Advisory Board, then advice from the Policy Advisory Board would be of no consequence. Dr. Tober questioned whether there would be any "harm" in recommending that BCC delay making a decision for one month. Vice Chairman Kopka restated his motion: He moved that the Policy Advisory Board recommend to the Board of County Commissioners to not approve the North Naples COPCN Application at this time. Second by Rosemary LeBailly. Motion carried, 3 - uYes"/l- uNo"/l- UAbstention." Chief Metzger was opposed and Mr. Pinto abstained. Rosemary LeBa illy stated the goal is to make an informed decision - it should not be a battlefield. There must be a way to present the motion to make sure it is the logical, informed way to do the right thing and is best for all. Chairman Tolano suggested the Policy Advisory Board could recommend to the Board of County Commissioners to delay the decision until more study is done -- integrate the 7 January 21,2011 recommendations made by the Blue Ribbon Committee as compared to the full document from North Naples. Rosemary LeBa illy stated the door was not being closed on the North Naples COPCN Application. She voted "no" as the only way to hold off until everyone could be informed. Chief Metzger stated "further study" will take a very long time Chairman Tolano disagreed, noting the Advisory Board could make a recommendation to the Board of County Commissioners next month. He stated the report has been out for only a short period of time. It was suggested an explanation for why the Board of County Commissioners voted against approving the application when it was first presented was their comment that the Blue Ribbon Report was not available at that time. Deputy Chief Aguilera stated Chairman Coyle directed the COPCN to be brought to the Advisory Board after it had been reviewed by County staff, was heard, and denied by the BCC. The application will be brought back for a second hearing by the BCC for reconsideration. He confirmed the process has been followed. Chairman Talano acknowledged that while "the process" has been followed, he stressed that, as a scientist, he could not make a decision before reviewing both documents completely. The status of the Motion (Ucarried") was confirmed. Public Comment: Commissioner Hiller stated the Board of County Commissioners will be exploring whether or not to create a Public Safety Authority, and to what degree it will have the ability to make public policy decisions. If established, the Public Safety Authority will determine what the protocols or strategy will be, and the decision will not necessarily be based solely on the recommendations of the Blue Ribbon Committee's Report. All options will be considered. She reiterated the Board of County Commissioners has not adopted the recommendations of the Blue Ribbon Committee as binding. "To compare whatever North Naples is applying for to the report is not an exercise that will lead to anything. " Chairman Talano pointed out the Advisory Board was asked to make a decision on what was actually happening in terms of the report. To approve it without knowledge is like "putting the cart before the horse." Commissioner Hiller continued the comment that the service to be provided would be less than what is currently provided is not a true statement because once someone assumes the duty as a Medical Director, to provide a certain level of service, the level of service has to be provided - there is a duty, a responsibility, and a standard of care. To suggest by North Naples having a Medical Director would compromise the level of service received by North Naples residents would not be a true statement. Dr. Tober noted, that when North Naples had drugs for two years, there were serious errors in medical care. He had to determine what would be more harmful to the 8 January 21,2011 community. He made the decision to withdraw ALS from that group of paramedics, many of whom were inexperienced, rather than continue it. His decision was carefully deliberated and he concluded there would have been a greater danger to the community if he had not decided to withdraw the ability to dispense medicines. He continued the assumption of whether North Naples will or will not improve care is up for debate. Commissioner Hiller countered any Medical Director who assumes responsibility has liability for the decisions made with respect to protocols, training, supervision, what drugs should or should not be allowed to be disbursed. The [proposed] Medical Director for North Naples would assume the legal liability. It would be his duty to ensure the North Naples paramedics were properly trained and their actions in the field meet the protocols he determined were necessary to meet the standard of care. Dr. Tober reiterated he was the Medical Director for North Naples and he decided to withdraw medicines from North Naples because it was not complicit with training and quality management. Commissioner Hiller stated when North Naples has its own Medical Director, it will be that individual's responsibility to make those types of decisions. Dr. Tober asked how her statement related to what she had said - that it would be "automatic" when North Naples has ALS skills, it will be an improved system. The system was not improved when North Naples reported to him. Commissioner Hiller claimed when North Naples has ALS paramedics under a Medical Director whose concentration is directed to the training, supervision and management of only those paramedics, the level of concentration will hopefully allow... at a minimum, it will be equal to what is provided for the rest of the County because that is what the law reqUIres. Dr. Tober stated the law requires that we do our best to oversee - it does not require that the paramedics perform at a certain level of perfection. There is a training office that spends considerable time reviewing calls and cases to determine how the paramedics are functioning. You oversee the system by reviewing how the runs come down. Chairman Talano concluded the time for public comment. B. Review of COPCN Renewal from NCH Chief Page stated the letters submitted constituted the renewal application but did not contain information regarding insurance records and proposed charges for patient care. He outlined a problem for Mr. Summers to consider: · NCH currently has only one unit available for transport. · Service is supposed to be available, by Statute, on a 24/7 basis but NCH has not complied. · There have been instances when service was shut down for an evening and NCH requested the County provide transport. 9 January 21,2011 · In the past year, the County has covered 190 transports for NCH from the Marco facility. · Transports coming from Marco have also been problematic because NCH has utilized the Marco Medic Unit to handle transports between facilities. · In some cases, HMA' s facility on Collier Boulevard has been bypassed. It was pointed out to Marco and they have complied. · Marco sent a letter to Dan Summers stating it will add a second unit in February to facilitate Marco-area transports but apparently this claim has been made before and never materialized. · There have been staffing issues with Marco. Chief Page stated Chief Murphy on Marco Island provided information and concerns since he helps staff the Marco unit with two paramedic/firefighters. The situation has become burdensome. He stated additional documents has been requested before Mr. Summer can make his recommendation. The Chief noted his report was presented as an "FYI" for the Board since the issue may become contentious. He was not sure when the application will be presented to the Board of County Commissioners. Dr. Tober stated there was a situation again on Saturday with a NCH transport that did not want to take the patient to Physician's Regional on Collier even though it was the closest appropriate hospital for the call. Chief Page stated a call was received from NCH during the meeting claiming their unit had a two-hour back-up and requesting EMS transport a stable patient. When informed EMS would only transport emergency patients, a second call was placed by NCH declaring an emergency situation. It is the same situation with Marco Island. Vice Chairman Kopka asked ifNCH was currently in compliance with its current COPCN and the response was "no." Chief Page outlined a challenge for North Naples if the COPCN is granted: · The current COPCN language requires all paramedics to be certified by the Medical Director and some in North Naples are not. · Another issue is the paramedics are required to ride on a transport unit for at least one month on an annual basis - North Naples has not complied. · He noted NCH has also not complied with the requirement. Dan Summers requested Chief Page present the update to the Board because Mr. Summers was unavailable due to surgery. Chief Metzger questioned how long NCH had a COPCN and who handled their inter- facility transports prior. The response was three years and EMS provided the service. Chief Metzger asked why NCH received a COPCN for inter-facility transports. Chief Page stated NCH claimed it would save approximately $1 M if allowed to do so and it had the ability to transport outside Collier County because EMS would not. 10 January 21,2011 Chief Metzger asked what would be the result ifNCH's application to renew its COPCN was not approved and the response was that EMS would take over the service. He noted EMS does currently transport outside the County if it is an emergency situation. EMS currently transports for HMA to Lee County. Dr. Tober stated there have been problems moving stable patients from Marco Island - if the wait time for the hospital is four-hours, for example, a call is placed to him to upgrade it to emergency status. When EMS ambulances are pulled from Marco, it is a significant step backwards for coverage in Marco. He stated it would be easier to take it over completely. 6. Public Comment: (as noted in Item #5-A) 7. Board Member Discussion: · Commissioner Coyle was present before the meeting began. He is the liaison assigned by the BCC to attend the Policy Advisory Board's meeting. o It was unfortunate that Commissioner Coyle was put in a position where he had to leave. o When asked to remain, Commissioner Coyle replied he did not want to risk a violation of the Sunshine Laws as the reason for leaving. o It was noted it would not have been appropriate for Commissioner Coyle to hear Commissioner Hiller's comments not permissible since the subject will be presented to the BCC for a decision. o It was suggested future meeting notices contain language that one or more Commissioners may be in attendance. · A request was made for Jennifer Florin, Administrative Assistant, to draft a letter for Chairman Talano's signature advising the BCC of the Policy Board's recommendation concerning the North Naples COPCN Application. Chairman Talano moved for approval to request the Staff Liaison draft a letter to the BCC for his signature and the letter reflect the Advisory Board's vote. Second by Vice Chairman Kopka. Carried unanimously, 5 - O. · Jennifer Florin noted the North Naples COPCN application was approximately 500 pages and would make hard copies available for the members. 8. Next Meeting Date: March 25, 2011 at 3:30 P.M. There being no further business for the good of the County, the Meeting concluded by order of the Chair at 5:22 PM. )1 January 21,2011 COLLIER COUNTY EMERGENCY MEDICAL SERVICES POLICY ADVISORY BOARD James Talano, M.D., Chairman The Minutes were approved by the Board/Committee Chair on as presented _ , or as amended ,2011, 12 ORDINANCE NO. 2011 - AN ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AMENDING ORDINANCE 04-12, AS AMENDED, BY AMENDING, SECTION TWO ENTITLED: DEFINITIONS; SECTION TWELVE ENTITLED: CLASSIFICATIONS OF CERTIFICATES; SECTION FIFTEEN ENTITLED: GENERAL OPERATING REGULATIONS; SECTION TWENTY-TWO ENTITLED: OBEDIENCE TO TRAFFIC LAWS, ORDINANCES AND REGULATIONS; PROVIDING FOR CONFLICT AND SEVERABILITY; PROVIDING FOR INCLUSION IN THEtCODE OF LAWS AND ORDINANCES; AND PROVIDING FOl AN EFFECTIVE DATE. WHEREAS, Collier County desires to make available to its citizens safe, professional emergency health care transportation and non-transportation services for emergency pre-hospital responses and the transfer of patients between and among local hospital facilities; and WHEREAS, Collier County desires to facilitate the provision of such services and has the necessary equipment, training, expertise, professional certifications and licenses to do so; and WHEREAS, this amendment creates a Class 3 Non-Transport ALS certificate classificationthaf will result in a benefit to Collier County by reducing response times for certain transports and providing for the availabil~ty of more transport vehicles; NOW THEREFORE: BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA: SECTION ONE: PURPOSE. This ordinance is adopted pursuant to Chapters 125 and 401, Florida Statutes. The purpose of this ordinance is to provide better protection for the health, safety and welfare of the residents of Collier County, in ambulance and ALS matters, by establishing uniform county-wide standards for certification of ambulance or advanced life support or services, or operations by Words underlined added and words stmek throtlgh are deleted. Page I of21 promulgating complete and clear rules and regulations for operation of all ambulance or rescue companies or services in Collier County. SECTION TWO: DEFINITIONS. A. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida Administrative Code, Section 641-1 E. B. Administrator shall mean the County Manager or his designee. C. Ambulance means any privately or publicly owned land, air, water vehicle that is designed, constructed, reconstructed, maintained, equipped or operated,a:n:d is used for or intended to be used for air, land, or water transportationdf persons, who are sick, injured, or otherwise helpless. D. Board shall mean the Collier County Boatd of County Commissioners. E. Certificate means a certificate of public convenience and necessity as authorized In Section 401.25 (2)( d), Florida Statutes. F. Emergency Call shall mean the transit of an ambulance under conditions which warrants travel with flashing lights and siren operating. G. Operator shall mean any person, organization or governmental entity providing ambulance or ALS services. H. Patient shall mean an individual who IS ill, sick, injured, wounded, or otherwise incapacitated or helpless. I. Routine Call or Routine Transfer shall mean the transportation of a patient under non- emergency call conditions. J. Rescue Service shall mean first response treatment of patients but does not include Advanced Life Support (ALS) or transport. Words underlined added and words struek through are deleted. Page 2 of21 SECTION THREE: REQUIREMENTS FOR CERTIFICATE. It shall be unlawful for any person, firm, agency, or any other 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 FOUR: EXEMPTIONS AND EXCLUSIONS FROM CERTICATE REQUIREMENT. Certificates shall not be required for: A. Rescue Services. B. The use of a non-ambulance for any transport of a patient pursuant to the Good Samaritan Act, Section 768.13, Florida Statues. C. Vehicles rendering ambulance-type services when requested to do so by the Board of County Commissioners Or County Manager in the event of a major catastrophe or other such emergency which requires more ambulances thant are available in the county. D. 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. E. Vehicles used to transport persons for routine scheduled medical treatments. Vehicles transporting persons who require services en route are not covered by this exemption. SECTION FIVE: PROCEDURE FOR OBTAINING CERTIFICATE. An applicant for a certificate shall obtain forms from the department from the County to be completed and returned to the Division Administrator. Each application shall contain: Words underlined added and words struek tlHough are deleted. Page 3 of21 A. The name, age, and address of the owner of the ambulance or ALS provider, or if the owner is a corporation, then of the directors of the corporation and of all the stockholders holding more that 25% of the outstanding shares. For governmental units, this information shall be supplied for members of the governing body. B. The boundaries of the territory desired to be served. C. The number and brief description of the ambulances or other vehicles the applicant will have available. D. The address of the intended headquarters and any sub-stations. E. The training and experience of the applicant. F. The names and addresses of three (3) Collier County residents who will act as references for the applicant. G. A schedule of rates which the service intends to charge. H. Such other pertinent information as the administrator may require. I. An application or renewal fee of two hundred fifty dollars ($250.00). (Exception Collier county EMS.) J. Financial data including assets and liabilities of the operator. A schedule of all debts encumbering any equipment shall be included. SECTION SIX: REVIEW OF APPLICATION. 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 recommendation whether to grant a certificate to the applicant within sixty (60) days of the time Words underlined added and words struck through are deleted. Page 4 of21 the Administrator determines the application is complete. SECTION SEVEN: REQUIREMENT FOR BOARD APPROVAL IN GRANTING CERTIFICATE. The Board of County Commissioners shall not grant a certificate unless it shall find, after public hearing and based on competent evidence that each of the following standards has been satisfied: A. That there is a public necessity for the service. In making such determination, the Board of County Commission shall consider, as a minimum, the following factors: (1) The extent to which the proposed service is needed to improve the overall Emergency Medical Services emergency medical services (EMS) capabilities of the County. (2) The effect of the proposed service on existing services with respect to quality of service and cost of service. (3) The effect of the proposed service on the overall cost of EMS service in the County. (4) The effect of the proposed service on existing hospitals and other health care facilities. (5) The effect of the proposed service on personnel of existing servIces and the availability of sufficient qualified personnel in the local area to adequately staff all existing services. B. That the applicant has sufficient knowledge and expenence to properly operate the proposed service. C. That, if applicable, there is an adequate revenue base for the proposed service. Words underlined added and words struck through are deleted. Page 5 of21 D. That the proposed service will have sufficient personnel and equipment to adequately cover the proposed service area. SECTION EIGHT: APPOINTMENT OF HEARING OFFICER. In making the determinations provided for in Section 7 above, the Board may, in its sole discretion, appoint a Hearing Officer to hold a public hearing and to make factual findings and conclusions as a result of the hearing. Should a Hearing Officer be appointed, said Hearing Officer shall render a written report to the Board within 30 days of the llearing, which report shall contain the officer's findings and conclusions of fact, and a recommen~ed order. The findings and conclusions of fact shall be binding uponthe Board, but the recommended order shall be advisory only. SECTION NINE: 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 nottransferable. 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. Acceptance of the certificate by the applicant shall obligate the applicant to: A. Service the entire zone granted to the applicant. B. Provide coverage to adjoining zones, if available, when requested to do so by Emergency Control emergency dispatch for emergency calls when the certificate holder for that zone is unable to respond. C. Keep posted at his place of business a copy of the fee schedule, which must be filed with the Administrator (If applicable). Words underlined added and words struek thnH;\gh are deleted. Page 6 of21 D. Operate in accordance with the rules and regulations adopted pursuant to this Ordinance and any applicable County Ordinances, and Chapter 401 Florida Statutes, and any administrative regulations adopted pursuant thereto. E. Employ at all times sufficient personnel experienced in operation and management of emergency medical services to ensure proper and efficient operation. SECTION TEN: RENEWAL OF CERTIFICATE. Each certificate holder shall file within ninety (90) days of expiration, an application for renewal of his certificate. Renewals shall be based upon the same standards, as the granting of the original certificate along with such other factors as may be relevant. The renewal application shall be accompanied by a two hundred and fifty dollar ($250.00) renewal fee. The renewal certificate may be approved routinely by the Board, upon advice of the Administrator, or the Board may hold a hearing on same. SECTION ELEVEN: EMERGENCY PROVISIONS. The Board may modify, sU~pend 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 ambulance or rescue service the Operator will not be available to 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. SECTION TWELVE: CLASSIFICATIONS OF CERTIFICATES. There shall be three twe ill f2j classifications of service in Collier County, as follows: A. Class 1: Collier County EMS ALS Transport: Words underlined added and words stmek through are deleted. Page 7 of21 ALS Rescue: An EMS provider Operator with the capability of rendering on the scene prehospital ALS services and who mayor may not elect to transport patients. An EMS provider 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 EMS provider 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. B. Class 2: Collier County Hospitals: 1. ALS Transfer: An EMS provider who renders ALS interfacility medical transfer services. An EMS provider who is awarded a Class 2 - ALS transfer certificate and does not possess a Class 1 - ALS rescue certificate shall not respond to an emergency call and provide ALS rescue services unless called upon by the appropriate Class 1 - ALS rescue provider to provide emergency backup service. In these instances, it shall be deemed to be operating under the Class 1 - ALS rescue certificate of the governmental entity requesting such emergency backup service. 2. Class 2 - ALS transfer certificate holders may provide post-hospital interfacility medical transfer services and routine ALS and BLS calls within the County but only to hospitals owned by the certificate holder, however, the Class 2 certificate holder may provide out-of-County transports. Unless an EMS provider possesses a Class 1 - ALS Rescue certificate issued by the County, a Certificate Words underlined added and words strode tlmmgA are deleted. Page 8 of21 Of Public Convenience and Necessity must be obtained from the County before engaging in this level of medical service. 3. Class-2 transfer certificate holders shall contract with the Class 1 rescue certificate holder's Medical Director the County for the performance of services set forth in Florida Statutes, Section 401.265 and Chapter 64E-2.004(4)(a), F.A.C. and as specifically set forth herein as follo\vs: a. He shall supervise and accept direct responsibility for the medical performance of the paramedics and Emergency Medical Technieians (hereinafter EMTs). b. He shall develop medically correct standing orders or protocols relating to life support system. .pmcedures when.. oommunication cannot be established with a supervising physioian or'Nhen any delay in patient care would potentially threaterithe lif-e or health of the patient. c. He shall issue standing orders and protocols to ensure that the Class 2 transfer certificate holder transports each of its patients to facilities that offer a type and level of Oafe appropriate to the patient's medical condition. d. He or his appointee shall provide continuous 21 hour per day, 7 day per week medical direction which shall include, in addition to the development of protocols and standing orders, direction to the Class 2 transfer certificate holder's personnel as to the availability of "off line" service to resolve problems, system conflicts, and provide services in an emergency as that term is defined by section 252.31(3), Florida Statutes. Words underlined added and words struck through are deleted. Page 9 of 21 e. He shall establish a quality assurance committee to provide for quality assurance review of all EMTs and paramedics operating under his superVIsIOn. f. He shall audit the performance of system personnel by use of a quality assurance program that includes but is not limi.tedto a prompt review of patient care records, direct observation, and comparison of performance standards for drugs, equipment, system protocols andprooedures.Heshall be responsible for participating in quality assurance programs developed by the Glass .2 transfer certificate holder. g. He shall ensure and certify that security procedures of the Class 2 transfer certificate holder for medications, fluids and controlled substances are in compliance with chapters 101, 199 and 893, Flerida Statutes, and chapter 10D 15 of the Florida Administrative Code. h. He shall create, authorize and ensure adherence to, detailed written operating procedures regarding all aspects of the handling of medications, fluids and controlledsubstanees ay the EMS personnel and comply with all requirements ofchupters 101,499 and 893, Flerida Statutes. 1. He shall notify the Florida Department of Health, (hereinafter the "Department") in \.vriting '.vhen the use of telemetry is not necessary. J. He shall notify the department in writing of each substitution of equipment or medication. k. He shall assume direct responsibility for the use by an EMT of un automatic or semi automatic defibrillator; the performance of esophageal intubation Words underlined added and words stnlCk through are deleted. Page 10 of21 by an EMT; and on routine interfacility transports, the monitoring and maintenance of non medicated I.V.s by an EMT. He shall ensure that the EMT is trained to perform these procedures; shall establish written protocols for the performance of these procedures; and shall pro','ide '.witten e'lidence to the Florida Department of Health documenting compliance "'lith the provisions of this paragraph. 1. He shall ensure that all EMTs andpatl.ti1-l:edics are trained in the use of the trauma scorecard methodologies as provided.in sectioFlsME 2.017 611 2.001 of the Florida Administrative Code {F.l\.C.}, for adult trauma patients and ME 2.0175 611 2.005, F.A.C., for pediatric trauma patients. m. He shall participate as a cre'llmember on an EMS ','ehicle for a minimum of 10 hours per year andcofl1plete a minimum of 10 hours per year of continuing medical educationtelated. to . · pre hosPital care or teaching or a combination of both. n. He shall ensure that all of the Class 2 transfer certificate holder's EMTs and paramedics have all proper certifications and receive all training necessary to maintain their certification. C. Class 3: ALS Non-Transport: 1. ALS Non-Transport: An EMS operator who renders Advanced Life Support pre-hospital services without transport capability. 2. Class 3 certificate holders work in concert with applicable Class 1 providers 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 provider. Unless an EMS provider possesses a Class 1 - ALS Words underlined added and words struck through are deleted. Page 11 of21 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. Class-3 certificate holders shall contract with the County for the performance of services set forth in Florida Statutes. SectionA01.265 and Chapter 64E- 2.004(4)(a), F.A.C. SECTION THIRTEEN: TRANSFER OR ASSIGNMENT OF CERtlFICATES. No certificate issued under this Ordinance 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 Ordinance and subject to the same rules and regulations as any other transfer or assignment. SECTION FOURTEEN : REVOCATION, AL TERA TION OR SUSPENSION GROUNDS. A. Every certificate issued under this Ordinance 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 his certificate. 2. The operator has been convicted of a felony or any criminal offense involving moral turpitude. Words underlined added and words struclc through are deleted. Page 12 of21 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 previous convictions to operate emergency vehicles. 5. The operator has failed to comply with any of the provisions of this Ordinance. 6. The public interest will best be served by revocation, alteration, or suspension of any certificate upon good cause shown. 7. The operator or his agent has demanded money or compensation other than that established and prescribed underthi~ ordinance. (I fappHcab Ie ). 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 his agent has been found guilty of malpractice or willful and wanton misconduct in the operation of its service. B. All complaints shall be investigated and a report thereon made to the Board, together with findings and recommendations, within fifteen (15) days. If revocation, suspension or alteration of any certificate appears warranted, the Board shall give notice to the operator holding the certificate that the same will be considered at a specific commission meeting, provided the date of such meeting shall not be less than five (5) days from the date of the notice. The Board shall thereupon consider the complaint and either revoke, suspend or alter the certificate or dismiss the complaint. SECTION FIFTEEN: GENERAL OPERATING REGULATIONS. Words underlined added and words stmek through are deleted. Page 13 of 21 All certificate holders, operators, and drivers shall comply with all state statutes and administrative regulations as following regulations: A. Twenty-four Hour Service. Every certificate holder shall be required to operate sufficient ambulances, or relevant apparatus, as stated on the certificate of operation vehicle permit issued by the State Department of Health, Bureau of Emergency Medical Services and determined by the Board permit issued by the Board, on immediate call at all times. B. Prompt Service Required. Every call for ambulanoe. .setvice shall be answered promptly. 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 umbulunce shall also be reported to the Administrator with documentation of circumstances. C. Bed Linens. Everyoperatot transporting patients shall provide clean Glean and sanitary bed linens shall be ptd>.Tided for each patient carried and which shall be changed as soon as practicable after the discharge of the patient. D. Daily Log. Every operator transporting patients shall maintain in a daily log upon which shall be recorded the place or origin, time of call, time of dispatch, time of arrival at scene, time left for hospital, time of arrival at hospital, and charges for each trip made and such other operating and patient information as may be required by Ordinance. Words underlined added and words stmek through are deleted. Page 14 of21 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. E. Communications. Each ambulance 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. F. Vehicles and Equipment. Each vehicle shall be equipped with the proper medical and emergency equipment as required by the Class ~ 1 medical directotand 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 Ordillance. G. Certification. In addition to the State of Florida. Department of Health, Bureau of Emergency Medical Services requirements for certification, each paramedic must be certified by the County Medical Director. Each paramedic 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, or in the case of non- transport ALS providers, must accompany and attended patients on a minimum of all ALS. transports from scene to hospital. Salaries of other than Collier County EMS paramedics will be paid by the agency seeking the Medical Director Certification. H. Application. Each ambulance or ALS service shall be subject to those rules and regulation as promulgated by Ordinances of the Board for the purpose of carrying out this ordinance. SECTION SIXTEEN: CENTRAL PLACE OF BUSINESS. Words underlined added and words struck through are deleted. Page ]5 of21 Each operator shall maintain a central place of business which shall be entirely within his designated operating zone, at which place he shall provide two-way radio communication with his vehicles, the County Emergency Control Communications Center, and his place of business, a properly listed telephone for receiving all calls for service and at which central place of business he shall keep such business records and daily logs available for inspection or audit by the Administrator. Every operator shall keep on file with the Aaministrator and the County Emergency Control Communications Center a business address and telephone number at which the operator may be reached at all times. This information will be maintained at the Emergency Control Center. SECTION SEVENTEEN: 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 EIGHTEEN: RATES. Every opehuor shall file\vith the Bdarda 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. SECTION NINETEEN: OPERATOR'S INSURANCE. Every ambulance operator 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 one hundred thousand dollars ($100,000.00) for injuries to or death of anyone Words underlined added and words struck threHgh are deleted. Page 16 of21 person arising out of anyone accident and the sum of at least three hundred thousand dollars ($300,000.00) for injuries to or death or more than one person in anyone accident and for the sum of at least fifty thousand dollars ($50,000.00) for damage to property arising from anyone 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..ofsuch insurance policies shall provide for a thirty (30) day cancellation notice to the Board. SECTION TWENTY: CONDUCT OF DRIVERS AND ATTENDANTS. All drivers, EMT's and paramedics shallcotnply 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: A. Failor refuse to promptly transport, if applicable, or attend any sick or injured person after responding to a call. B. Demand or receive compensation other than that established and approved In accordance with this ordinance or fail to gIve a receipt for moneys received. (If applicable). C. Give or allow rebate, commISSIOn, discount or any reduced rate not provided in the established rate. (If applicable.) D. At any time induce or seek to induce any person engaging an ambulance or ALS service to patronize or retain the services of any hospital, convalescent home, mortuary, Words underlined added and words struck through are deleted. Page ] 7 of 2 1 cemetery, attorney, accident investigator, nurse, medical doctor or other servIce occupation or profession. E. At any time release his patient from his care until he is assured that some responsible person is available to receive such patient. F. At any time use a siren or flashing red light unless on an emergency call. G. Disobey the lawful orders of the law enforcement officer a.tthe scene of an accident, or other similar such emergency or at a fire scene, the fire officer in charge. H. Smoke while within the confines of an ambulance. I. Operate or ride in all vehicle ambulance without using seatbelts. (Personnel attending patients are exempt). SECTION TWENTY-ONE: PASSENGERS. No person shall be aboard ambulances when engaged in emergency or routine medical calls routine call except the following: A. Driver, attendants and fire or law enforcement personnel; B. Patien.ts; C. Not more than one relative d:t'close friend of the patient, or if the situation warrants, the paramedic in charge may authorize more than one passenger. Relatives or close friends of the patient. when authorized by an EMS Battalion Chief or position of a higher rank. These requests will only be granted under exceptional circumstances. D. Physicians and nurses; E. Personnel in an observing capacity that are being trained for ambulance or ALS service. F. Operator's supervisory personnel. Words underlined added and words strudc through are deleted. Page 18 of 21 SECTION TWENTY-TWO: OBEDIENCE TO TRAFFIC LAWS, ORDINANCE OR REGULA TIONS. A. Under the provisions of Florida State law, +!he driver of an ambulance or ALS vehicle when responding to an emergency call or while transporting a patient 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: 1. Park or stand, irrespective of the otherwise applicable provisions of law, ordinance or regulations. 2. Proceed past a red light or stop signal orstop sign, but only after slowing down as may be necessary for safe operations. 3. Exceed the maximum speed limits permitted by law so long as he does not endanger life or property. 4. Disregard laws, ordinances or regulations governing direction or movement or turning in specified directions so long as he does not endanger life or property. B. 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. 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 reckless disregard for the safety of others. SECTION TWENTY-THREE: VIOLATIONS. In addition to the remedies provided herein, a violation of any provision of this ordinance shall be punishable as provided by law for the violation of County ordinances. SECTION TWENTY-FOUR: UNIFORMITY OF APPLICATION. Words underlined added and words struek through are deleted. Page \9 of 2\ The Ordinance shall constitute a uniform law applicable in all of Collier County. SECTION TWENTY -FIVE: AUTHORITY TO ENFORCE. It is hereby declared to be the duty of the Board of County Commissioners of Collier County, 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 theproVlsions of this Ordinance to strictly enforce the provisions of this Ordinance. SECTION TWENTY-SIX: CONFLICT AND SEVERABILITY. In the event this Ordinance should ever conflict with any other Ordinance of Collier County or other applicable law, the more restrictive shall apply. If any phrase or portion of this Ordinance is held invalid or unconstitutional by any court of competent jurisdiction, such portion shall be deemed a separate, distinct, and independent proVisions and such holding shall not affect the validity of the remaining portions. SECTION TWENTY-SEVEN: INCLUSION IN THE CODE OF LAWS AND ORDINANCES. The provisions of this Ordinance shall be made a part of the Code of Laws and Ordinances of Collier County, Florida. The sections of the Ordinance may be renumbered or re- lettered and internal cross-references amended throughout to accomplish such, and the word "ordinance" may be changed to "section," "article," or any other appropriate word. SECTION TWENTY-EIGHT: EFFECTIVE DATE. This Ordinance shall be considered adopted upon the date written below and subject to filing with the Florida Department of State. Words underlined added and words struck througfl are deleted. Page 20 of21 PASSED AND DULY ADOPTED by a vote of majority of the Board of County Commissioners of Collier County, Florida, this _ day of , 2011. ATTEST: DWIGHT E. BROCK, Clerk BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA By: By: , Deputy Clerk Fred W. Coyle, .Chairman Approved as to form and legal sufficiency: Jennifer B. White Assistant County Attorney Words underlined added and words struck throl:lgh are deleted. Page 21 of21 ,:;\\\i'i V-~ ~ J. ~ 'V U '~!"i'.:.'.~..~' 1~l~1 e~',,~ "( &' .' ~1fVi(J- COLLIER COUNTY SHERIFF'S OFFICE Communications Group Memorandum .,. -.,.-~ ..~ .,.~.-.---,.-. To; Communications Members/OT members From: Cmdr. Bill Rule, Communications Group Date: 18 February 2010 Subj; Release of information On the advice oflegal counsel, Florida Statute 365.171 (12) prohibits the release of an address of a person requesting emergency service or reporting an emergency by accessing an emergency communications E91l system All patrol deputies dispatched to 911 call emergencies have an AED in their vehicle. CUlTently, our CAD system lists the location of all registered AEDs should a deputy or our fire or EMS members need this information. ill compliance with the law, we will not release the address where emergency assistance is requested except to a public safety agency. Guardhouses in private communities may be notified only that there is an emergency in their respective community in order to allow Emergency Services an expedited entry on an emergency call We are making modifications to the CAD to ensure that we are in compliance with this state statute. Please contact me with any questions.