Backup Documents 03/25/2011
EMS POLICY
ADVISORY BOARD
MEETING
BACKUP
DOCUMENTS
MARCH 25, 2011
Patricia L. Morgan
From:
Sent:
To:
HernandezMaria [MariaHernandez@colliergov.net]
Monday, April 04, 2011 4:52 PM
ButcherTabatha; Chief Robert Metzger; Douglas Lee; Dr. Talano; Jerry Pinto; Kopka, Walter;
Patricia L. Morgan; Robert Tober; Rosemary LeBaille; Tucker, Samuel; Walter Kopka;
WatsonWayne
Page,Jeff
FW: COPCN Ordinance
Ordinance amending 04-12 - 4-1-11_docx.docx; Ordinance as codified in Municode_.rtf
Cc:
Subject:
Attachments:
Good Afternoon to all,
Please see attached.
This is just an FYI, so please do not reply to " all" .
Thank you.
Maria Hernandez
Collier County EMS
Administrative Assistant
8075 Lely Cultural Parkway, Ste 267
Naples, FL 34113
Ph: 239-252-3759
Fx: 239-252-3298
From: PageJeff
Sent: Monday, April 04, 2011 4:15 PM
To: HernandezMaria
Subject: FW: COPCN Ordinance
Maria,
Please forward to the Policy Board members, reminding them not to reply back to flail". This is just an FYI at this point.
From: WhiteJennifer
Sent: Monday, April 04, 2011 3:59 PM
To: PageJeff; SummersDan
Subject: FW: COPCN Ordinance
Just an FYI
From: WhiteJennifer
Sent: Monday, April 04, 2011 3:59 PM
To: 'Laura Donaldson'
Subject: COPCN Ordinance
Laura,
Please see the attached draft ordinance amendment. These changes were made in light of my understanding of
recommendations made by the EMSAC and comments Jorge Aguilera provided Jeff Page.
Please note that due to scheduling I used the County Attorney's paralegal who reformatted the draft ordinance into a
format that the County Attorney frequently uses. In summary, the draft ordinance amendment only includes those
provisions that are currently proposed to be amended. As such, also attached is the complete version of the ordinance.
I encourage you to comment on the entirety of the provisions; not just those in the ordinance amendment.
I will leave it to you as to how you'd prefer to provide me with your comments/proposed revisions. I'm here bye-mail
or direct dial at 239-252-5709.
Jennifer B. White
Assistant County Attorney
(239) 252-8400 phone
(239) 252-6300 fax
Under Florida Law. e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request. do not send
electronic mail to this entity. Instead. contact this office by telephone or in writing.
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, DEFINITIONS;
SECTION FOUR, EXEMPTIONS AND EXCLUSIONS FROM
CERTICATE REQUIREMENT; SECTION FIVE, PROCEDURE FOR
OBTAINING CERTIFICATE; SECTION SEVEN, REQUIREMENT
FOR BOARD APPROVAL IN GRANTING CERTIFICA,rE; SECTION
NINE, RIGHTS AND DUTIES GRANTED BY: CERTIFICATE;
SECTION ELEVEN, EMERGENCY PROVJ;SI()NS; SECTION
TWELVE, CLASSIFICATIONS OF CERTIFICAT}:S; SECTION
FIFTEEN, GENERAL OPERATING REG~ATIONS;,. SECTION
TWENTY, CONDUCT OF DRIVERS ANJ?.A1-'TENDANTS~::~~CTION
TWENTY-ONE: PASSENGERS;S:reCTION TWENrJ;Y7TWO,
OBEDIENCE TO TRAFFIC LAWS, QRDINANCESii)n;AND
REGULATIONS; PROVIDING~':'~~R ',~pNFLICT '>.A:ND
SEVERABILITY; PROVIDING FOR INdJJjlJSION"IN THE CODE OF
LAWS AND ORDINANCES; AND PROVID~~..FOR AN EFFECTIVE
DATE. "::;.
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WHEREAS, Collier County desir~~:~6H*~e,available t6::hs;:Citizens safe, professional
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emergency health care transp(?rtation and no~~tr~pbrta~64;~erVices for emergency pre-hospital
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responses and the transfef'~f p~H~~t~ between an.~ among lo~al hospital facilities; and
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WHEREAS, ColliefGount}t"4~sires to facilit~te the provision of such services and has the
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necessary eqUiptnent,training;':~~p.~rtise, pidf'essional certifications and licenses to do so; and
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'.WEREAS, thi~"':~endrrie~~[iiicteates a Class 3 Non-Transport ALS certificate
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c1assificatio'ri:,th~t will resultlJi,a benefit to Collier County by reducing response times for certain
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transports and pi()'~~~Ing fm#I~ availability of more transport vehicles.
NOW THEREf'bRE: BE IT ORDAINED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA:
SECTION ONE: Amendments to Section Two of Ordinance No. 04-12, as amended.
Section Two of Ordinance No. 04-12, as amended, is hereby amended as follows:
SECTION TWO: DEFINITIONS.
Words underlined added and words struck tbrOl:lgh are deleted.
Page I of 14
A. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable
Florida. Statutes and Florida Administratiye Code, Section 61E the Collier County
Medical Director's protocol.
B. Administrator shall mean the County Manager or his designee.
C. Ambulance means any privately or publicly owned land, ai1,,]:,?r water vehicle that is
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designed, constructed, reconstructed, maintained, equipper'b,r operated, and is used for or
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intended to be used for air, land, or water transportation of persoii~, who are sick, injured,
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or otherwise helpless.
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D. Board shall mean the Collier County BoardBfjtp()~nty Copnnissioners.
E.
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Certificate means a certificate of public conveh.i~~~;F. and necessity as authorized in
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Section 401.25 (2)(d), Florida StatUte~.'.
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Emergency Call shall mean the tran~it of ahanl:p~hwce under conditions which warrants
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travel with flashingllghts'~Hld siren oper~ting.
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Operator shall <h}ean any' person, orgapization or governmental entity providing
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ambulan~~ or ALS s'~rvice's:<,1;
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inc~pacitated or helpXe$s.
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Routiriei!M,!=l-g or Routme Transfer shall mean the transportation of a patient under non-
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emergency"d~l'Agr,ditions.
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1. Rescue Service shall mean first response treatment of patients but does not include
Advanced Life Support (ALS) or transport.
SECTION TWO: Amendments to Section Four of Ordinance No. 04-12, as amended.
Section Four of Ordinance No. 04-12, as amended, is hereby amended as follows:
Words underlined added and words strode tm-sugh are deleted.
Page 2 of 14
SECTION FOUR: EXEMPTIONS AND
REQUIREMENT.
EXCLUSIONS
FROM
CERTICATE
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 Statules.
C.
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Vehicles rendering ambulance-type services when reque:stedto do so by the Board of
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County Commissioners or County Manager in the~yent of a majbr catastrophe or other
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such emergency which requires more ambul.ances thagt are available iri the county.
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D. Ambulances based outside the county which piclClJ,p a.p~1:ient in the county and transport
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him out of the county, or which picl\. up a patient otltibfJhe county and transport him into
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the county.
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E. Vehicles used to transport persons f()~Fo-gtin.e~:cl1~~w.~d medical treatments. Vehicles
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transporting per~bns whofe~pire services'rn route are not covered by this exemption.
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SECTION THREE: AmeJ:ldmentsJo Section FiV~of Ordinance No. 04-12, as amended.
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Section Fiv~rdfOrd.~apce ~~:::'b4h~,2,'~"~~~Wde'd, is hereby amended as follows:
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SECTION FIVE: PROCEDURE FC)'R:OBTAINING CERTIFICATE.
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An a~I>gcant for a cert~ficate shall obtain forms from the department from the County to
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be complet~~ ~d rewfued to the Division Administrator. Each application shall contain:
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The name, age~iliid address of the owner of the ambulance or ALS provider, or if the
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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.
*****
Words underlined added and words struek through are deleted.
Page 3 of 14
SECTION FOUR: Amendments to Section Seven of Ordinance No. 04-12, as amended.
Section Seven of Ordinance No. 04-12, as amended, is hereby amended as follows:
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 fpJ16\lVing standards has been
satisfied:
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A. That there is a public necessity for the service. In.making such &~termination, the Board
of County Commission shall consider, as atpJ11imum, th,e following factor~:
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(1) The extent to which the proposed serviqe is'irteeded to improve the overall
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Emergency Medical Servic;~s emergency meaical services (EMS) capabilities of
(2)
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the County." '., "/":,,
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The effect of~e proposed sei-y~ce,9n' existip.g'services with respect to quality of
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service atid cost or ~brvice.
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SECTION.FIVE:ti1\Jnend@~p.~s to Se~f~b~:Nine of Ordinance No. 04-12, as amended.
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Section Nine ofOrdinanceNp. o4-i2,i,ias, amended, is hereby amended as follows:
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SECTION NINE: RIGHTS AND DUTIES GRANTED BY CERTIFICATE.
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The certifi'c.~t~. gran~~d by the Board shall be valid for one calendar year and shall be
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personal to the applicalli:and not transferable. In the case of a corporation, if there occurs such a
transfer of stock or other incidents of ownership as to change the majority or largest stockholder,
a new certificate must be applied for. Changes in the officers of the corporation will not require
a new certificate.
Acceptance of the certificate by the applicant shall obligate the applicant to:
Words underlined added and words struek through are deleted.
Page 4 of 14
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).
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D. Operate in accordance with the rules and regulations a.doptedpurs}l,ant to this Ordinance
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and any applicable County Ordinances, anq:Chapter 401 Florida L~t,atutes, and any
administrative regulations adopted pursuatHfuereto.
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E. Employ at all times sufficient personnel experienced. in operation and management of
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emergency medical services to en~W"e;.pr9per and efficient.~peration.
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SECTION SIX: Amendments to SectionEleveno.fQ..di!1ance)~'o. 04-12, as amended.
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Section Eleven of Ordinal}ceN'qi:Q4-12, as ameIl~ed, is here~yamended as follows:
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SECTION ELEVEN:~KmRGEN~:~ PROVISIONS.
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The B~~rdlTIay modi:fy, .suspenc:l.qr:!'f~~oke a certificate in the in~erest of the public
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health'~l3fety and welfaJ:~'Rnly 'aiH?llplic hearing and after reasonable notice has been given to
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ambulance or 'r~sc'lle servicelthe Operator will not be available to any certain area of Collier
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County, the Admin:is~~tor 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 SEVEN: Amendments to Section Twelve of Ordinance No. 04-12, as amended.
Section Twelve of Ordinance No. 04-12, as amended, is hereby amended as follows:
Words underlined added and words struck through are deleted.
Page 5 of 14
SECTION TWELVE: CLASSIFICATIONS OF CERTIFICATES.
There shall be three twe ill ~ classifications of service in Collier County, as follows:
A. Class I: Collier County EMS ALS Transport:
ALS Rescue: An EMS provider Operator with the capability of rendering on the
scene prehospital ALS services and who mayor mllY not elect to transport
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patients. An EMS provider rendering this leve~;p"f:~ervice for a governmental
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entity shall be deemed to be operating under 'the Clas~:!i";i*l;<\LS rescue certificate
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of public convenience and necessity hylc1'by"the governmeIli~l,~,ntity. An EMS
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provider Operator holding a Class'T,;,,1~,LS rescHe certificate may:pr~vide post-
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hospital interfacility medical transfer se~me~and routine ALS and BLS calls
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within the County. A Certi:l:i. ~6. ,~t.}~. ,,of Public C()b:ve~ence and Necessity must be
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obtained from the County before engagiligiIlthis level of medical service.
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Class 2: CollierCOlmty Hospitals:"
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1. Ags Transf~t.; An EMS pro,~~q~r who renders ALS interfacility medical
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i,,1f~sfer serVic~s~:',:J\n':EmSl,p~p~ider who is awarded a Class 2 - ALS transfer
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!; . certifi6~te'!':~d d6e$'npt possess a Class 1 - ALS rescue certificate shall not
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"; ':1, respond to~f~tnergend~'~all and provide ALS rescue services unless called upon
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;!B~'P1e appropri'~te Class I - ALS rescue provider to provide emergency backup
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servidb.'Inihese 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
Words underlined added and words struek threugh are deleted.
Page 6 of 14
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
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 con'ttact with the Class 1 rescue
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certificate holder's Medical Director the COul1ty for the't>s:rformance of services
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set forth in Florida Statutes, Section,i40t265 and Ch~bf6r
F .A.C. and as specifically set forth h'~f~fIJ, as folldws:
a. He shall supervise and acc6Pt"Hirect responsibility for the medical
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performance of the pararrie(,ii9,s; ,and Emergency '1Jedical Technicians (hereinafter
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EMTs).
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b.;!';~~':~~all develop;rriedically ~~6ftect standing orders or protocols
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relatirigt?:life sri.#port system' *()~7dures v:hen communication cannot be
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potential1),thteatentnt;).,life or health of the patient.
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He shall 'issue standing orders and protocols to ensure that the
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Class 2 transfer, certificate holder transports each of its patients to facilities that
offer a t)y~an'd level of care appropriate to the patient's medical condition.
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d. He or his appointee shall provide continuous 21 hour per day, 7
day per 'Neek medical direction '.vhich 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
Words underlined added and words struck through are deleted.
Page 7 of 14
resolve problems, system conflicts, and provide services in an emergency as that
term is defined by section 252.31(3), Plorida Statutes.
e. He shall establish a quality assurance committee to provide for
quality assurance review of all EMTs and paramedics operating tmder his
supervIsIon.
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f. He shall audit the performance of system persormel by use of a
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quality assurance program that includes but is'jl:ot lim.lt~~Jo a prompt re'/iew of
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patient care records, direct observation,illici comparison of p&formance standards
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for drugs, equipment, system protoco~s':and procedures. He shall he: responsible
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for participating in quality assurance progt~ developed by the Class 2 transfer
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certificate holder.
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He shall ensuie!and'd~~~:fYthat security procedures of the Class 2
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transfcr certifictite"~'lOlder for m~q.ic~tions, fluid~ and controlled substances are in
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comp1i~ce!vt'ith chp.1'fers 101, 199~dS93, Plorida Statutes, and chapter laD 15
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of the FloriCl~j\...ctnimtJtfdti~te'Code:\'"
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~pera.ting proc~qpres regarding all aspects of the handling of medications, fluids
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of chaPter~A.of, 199 and 893, Plorida Statutes.
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1. He shall notify the Florida Department of Health, (hereinafter the
"Department") in \vriting v:hen the use of telemetry is not necessary.
J. He shall notify the department in vlfiting of each substitution of
equipment or medication.
Words underlined added and words struck through are deleted.
Page 8 of 14
Ie. He shall assume direct responsibility for the use by an EMT of an
automatic or semi automatic defibrillator; the performance of esophageal intubation
by an EMT; and on routine interfacility transports, the monitoring and maintenance
of non medicated LV.s by an EMT. He shall ensure that the EMT is trained to
perform these procedures; shall establish written protoc()Js. for the performance of
these procedures; and shall provide '.witten evide~r.eto the Florida Department of
Health documenting compliance with the proYisi6hs ofthis.pt:J;I'agraph.
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He shall ensure that all.?MTs and paramedics rn;e~ained in the use
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of the trauma scorecard methodologi~~ ~s>provid~d~l1 sections 61E'2;q:17 61J 2.001
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of the Florida .^..dministrative Code {F..'\.t.1:fo~ adult trauma patients and 61E
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2.0175 61J 2.005, F.AC., foip~qil,ltric trauma patiert~~.
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m. He shall partIcipate "~;::~Rr~!~vmember on an EMS vehicle for a
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minimum ot lQI!!l1?m~ per year ~tomplete~~minimum of 10 hours per year of
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continuirlgmedical ~':~ducation relt{t~dto pre hospital care or teaching or a
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compination ~fbOth:;: Iii
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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
Words underlined added and words struck through are deleted.
Page 9 of 14
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 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 direction
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and care of all certified ALS personnel to maintain stahdardize(t'~~aining and patient care
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in Collier County. The County's Office of t~eMedical Director sh~ILdelegate medical
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oversight to individual program MedicaYDirectors to oversee the CoUnty's Medical
protocols, implementation of equipment and coididiW~~ion of system-wide patient care
programs.
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SECTION EIGHT: Amendments to Section Fitt~ert:Q,f9rdin~ri.ce No. 04-12, as amended.
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Section Fifteen ofOrdin~nq~:~o;'04-12, as amended, is hereby amended as follows:
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SECTION FIFTEEN:G-ENERALOPERATING REGULATIONS.
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All certificate hold~f$~,~p~tators',:~~ dpiv~rs shall comply with all state statutes and
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administrative regulatiorikas fol1'6Wmg regulations:
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A.
TweIlty- four Hour Seryice. EYthy certificate holder shall be required to operate sufficient
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issued by tH~i:;~~teD~Partment of Health, Bureau of Emergency Medical Services and
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ambulciliRes,~ or relevah.t apparatus, as stated on the certificate of operation vehicle permit
;:1:
determined by the Board permit issued by the Board, on immediate call at all times.
B. Prompt Service Required. Every call for ambulance service 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
Words underlined added and words struek threugh are deleted.
Page 10 of 14
calls for emergency assistance requmng 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 ambulance shall also be reported t<;>the Administrator with
documentation of circumstances.
C. Bed Linens. Every operator transporting patients shall provide 'clean Gletm and sanitary
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bed linens shall be pro'/ided for each patient,s~~d ana which Sh~mR~,p~anged as soon
as practicable after the discharge of the pati~rit~:::"
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Daily Log. Every operator transporting patients '~m~n:p1aintain in a daily log upon which
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shall be recorded the place or o'tlgip"tgne of call, tiIh~.Qf dispatch, time of arrival at
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scene, time left for hospital, time of.arrival'~tb.o~pital, and charges for each trip made
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and such other opehitirig..and patientipformation .as may be required by Ordinance.
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Every operator'~han retain.and preserve al~::~aily logs for at least two (2) years, and such
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logs sha.ll be availaBr~:fqr,iIispeqtipJ,'1pytblAdministrator.
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Cofuinunicatiohs':":E~ch 'rihiBqlance emergency vehicle shall maintain two-way radio
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. cOrlununication with:my locatipn of primary dispatch from which it operates, as well as
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F. Vehicles and' :E9-~ipfuent. Each vehicle shall be equipped with the proper medical and
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emergency equipment as required by the Class -1 medical director and 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.
Words underlined added and words struck tm-oagh are deleted.
Page 11 of 14
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 parlWledic must work in that
capacity not less than one full month's work shift annp~l1y, or in the case of non-
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transport ALS providers, if ALS services are provideBprior to E~S transport arrival, or
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if the patient's condition requires that additibnal.level of experti'se, the ALS non-
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transport provider will accompany thep~tient on the, ALS transport ;from scene to
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hospital. Salaries of other than Collier Count)riiE;N1:S paramedics will be paid by the
agency seeking the Medical Direc~Rr'~~rtification.
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Application,
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Each ambulance or:.(\LSCs~ryiqc:;~hall be subject to those rules and
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regulation as pro.mulgatf1qby Ordinance~..of the Board for the purpose of carrying out
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this ordinance,'
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SECTION N~E,:
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Amend.n1.ents to;S~ction;:rwenty of Ordinance No. 04-12, as amended.
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All drivers, .EMT's and paramedics shall cOIllply with the laws of the State of Florida, in
order to meet thet~quirem.ents set out in this Ordinance and no driver, EMT or paramedic
registered hereunder shall:
* * * * *
I. Operate or ride in an vehicle ambulance without using seatbelts. (personnel attending
patients are exempt).
Words underlined added and words struck through are deleted.
Page 12 of 14
SECTION TEN: Amendments to Section Twenty-One of Ordinance No. 04-12, as
amended.
Section Twenty-One of Ordinance No. 04-12, as amended, is hereby amended as follows:
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. Patients;
C. Not more than one relative or close friend,ofthe patient, or if the situat;oJl';;arrants, the
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paramedic in charge'may authorize more than onepas~~llger. Relatives or close friends of
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the patient when authorized bY"8n EMS Battalion'Cmef or position of a higher rank.
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These requests will only be grantedniIiderexceptional circumstances.
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D.
Physicians and nurses;
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Personnel in al1,ob~~rvi~~'~fl.pacity that at~being trailled for ambulance or ALS service.
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Operator's supe~i~drY per~,6hny1.
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SECTIO~::~IJEVEN:,.AmeIl~ments to Section Twenty-Two of Ordinance No. 04-12, as
,;:'H ' ii' amended~.
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SectionTw:eIlty-Two'ofOr(ii~ance Nckb4-12, as amended, is hereby amended as follows:
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SECTION TWENTY - TWO: II,; OBEDIENCE TO TRAFFIC LAWS, ORDINANCES OR
"!:!, REGULATIONS.
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A. Under the proviSions of Florida State law, +1he 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:
* * * * *
Words underlined added and words strnek through are deleted.
Page 13 of 14
SECTION TWELVE:
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 sllch,holding shall not affect
the validity of the remaining portions.
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SECTION TIDRTEEN:
Inclusion in The Code of Laws And ()~dinances.
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T~e provisions of this Ordinance shall be <made a part of theC.ode of Laws and
Ordinances of Collier County, Florida. The sectionscq~Jhe OrdiP:~ce may be renumbered or re-
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BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
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By:
, Beputy Clerk
By:
FRED W. COYLE, CHAIRMAN
Approved as to form
and legal sufficiency:
Jennifer B. White
Assistant County Attorney
Words underlined added and words struek tlrrough are deleted.
Page 14 of 14 .
Comer Count\!'. Florida, Code of Oi"ciimmces PAin i-CODE Chat:1ter 50 - EMFRGENCY SERVICES
ARTICLE ill. - MEDICAL TRANSPORTA TIQN SERVICES
ARTICLE III. - MEDICAL TRANSPORTATION SERVICES [66]
Sec. 50-51. - Purpose.
Sec. 50-52. - Definitions.
Sec. 50-53. - Requirements for certificate.
Sec. 50-54. - Exemptions and exclusions from certificate requirement.
Sec. 50-55. - Procedure for obtaininq certificate.
Sec. 50-56. - Review of application.
Sec. 50-57. - Requirement for board approval in qrantinq certificate.
Sec. 50-58. - Appointment of hearinq officer.
Sec. 50-59. - Riqhts and duties qranted by certificate.
Sec. 50-60. - Renewal of certificate.
Sec. 50-61. - Emerqency provisions.
Sec. 50-62. - Classifications of certificates.
Sec. 50-63. - Transfer or assiqnment of certificates.
Sec. 50-64. - Revocation, alteration or suspension qrounds.
Sec. 50-65. - General operatinq requlations.
Sec. 50-66. - Central place of business.
Sec. 50-67. - Records to be kept.
Sec. 50-68. - Rates.
Sec. 50-69. - Operator's insurance.
Sec. 50-70. - Conduct of drivers and attendants.
Sec. 50-71. - Passenqers.
Sec. 50-72. - Obedience to traffic laws, ordinances or requlations.
Sec. 50-73. - Violations.
Sec. 50-74. - Uniformity of application.
Sec. 50-75. - Authority to enforce.
Secs. 50-76-50-100. - Reserved.
Sec. 50-51. - Purpose.
This article is adopted pursuant to F .s. chs. 125 and 401. The purpose of this article is to provide better protection for the
health, safety and welfare of the residents of Collier County, in ambulance and ALS matters, by establishing uniform county-wide
standards for certification of ambulance or advanced life support or services, or operations by promulgating complete and clear
rules and regulations for operation of all ambulance or rescue companies or services in Collier County.
fOrd No 04-12,~\n
Sec. 50-52. - Definitions.
The following words, terms and phrases, when used in this article, shall have the meanings ascribed to them in this section,
except where the context clearly indicates a different meaning:
Advanced life support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida
Administrative Code, Section 64E.
Administrator shall mean the county manager or his designee.
Ambulance means any privately or publicly owned land, air, or water vehicle that is designed, constructed, reconstructed,
maintained, equipped or operated, and is used for or intended to be used for air, land or water transportation of persons, who are
sick, injured or otherwise helpless.
Board shall mean the Collier County Board of County Commissioners.
Certificate means a certificate of convenience and necessity as authorized in F.S. ~ 401.25(2)(d).
Emergency call shall mean the transit of an ambulance under conditions which warrants travel with flashing lights and siren
operating.
Operatorshall mean any person, organization or governmental entity providing ambulance or ALS services.
Patient shall mean an individual who is ill, sick, injured, wounded or otherwise incapacitated or helpless.
Routine call or routine transfershall mean the transportation of a patient under nonemergency call conditions.
Rescue service shall mean first response treatment of patients but does not include advanced life support (ALS) or transport.
(Olel No 0-1-12. ~ 2)
Sec. 50-53. - 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.
iOrd!Vo 04-12. s: 3)
Sec. 50-54. - Exemptions and exclusions from certificate reQuirement.
Certificates shall not be required for:
(1 )
Rescue services.
(2)
The use of a nonambulance for any transport of a patient pursuant to the Good Samaritan Act, F.S. ~ 768.13.
(3)
Vehicles rendering ambulance-type services when requested to do so by the board of county commissioners or
county manager in the event of a major catastrophe or other such emergency which requires more ambulances that
are available in the county.
(4)
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.
(5)
Vehicles used to transport persons for routine scheduled medical treatments. Vehicles transporting persons who
require services en route are not covered by this exemption.
(Or<:l No 04-11. S 4. Orc! No 05-16, S 4)
Sec. 50-55. - Procedure for obtaininQ 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:
(1 )
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 percent of the outstanding shares. For
governmental units, this information shall be supplied for members of the governing body.
(2)
The boundaries of the territory desired to be served.
(3)
The number and brief description of the ambulances or other vehicles the applicant will have available.
(4)
The address of the intended headquarters and any substations.
(5)
The training and experience of the applicant.
(6)
The names and addresses of three Collier County residents who will act as references for the applicant.
(7)
A schedule of rates which the service intends to charge.
(8)
Such other pertinent information as the administrator may require.
(9)
An application or renewal fee of $250.00. (Exception Collier County EMS).
(10)
Financial data including assets and liabilities of the operator. A schedule of all debts encumbering any equipment shall
be included.
(O/d iVo 04-12, ~ 5)
Sec. 50-56. - 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 60 days of the time the administrator determines the application is complete.
C()ld No M. 12. ~; 6)
Sec. 50-57. - ReQuirement for board approval in QrantinQ 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:
(1 )
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:
a.
The extent to which the proposed service is needed to improve the overall emergency medical services (EMS)
capabilities of the county.
b.
The effect of the proposed service on existing services with respect to quality of service and cost of service.
c.
The effect of the proposed service on the overall cost of EMS service in the county.
d.
The effect of the proposed service on existing hospitals and other health care facilities.
e.
The effect of the proposed service on personnel of existing services and the availability of sufficient qualified
personnel in the local area to adequately staff all existing services.
(2)
That the applicant has sufficient knowledge and experience to properly operate the proposed service.
(3)
That, if applicable, there is an adequate. revenue base for the proposed service.
(4)
That the proposed service will have sufficient personnel and equipment to adequately cover the proposed service
area.
'()ic( IVi) o,~,. i2 S: 7i
Sec. 50-58. - Appointment of hearinQ officer.
In making the determinations provided for in section 50-57 above, the board may, in its sole discretion, appoint a hearing
officer to hold a public hearing and to make factual findings and conclusions as a result of the hearing. Should a Hearing Officer be
appointed, said hearing officer shall render a written report to the board within 30 days of the hearing, which report shall contain the
officer's findings and conclusions of fact, and a recommended order. The findings and conclusions of fact shall be binding upon the
board, but the recommended order shall be advisory only.
lOrd No. 04-12. S 8)
Sec. 50-59. - RiQhts and duties Qranted bv 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 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:
(1 )
Service the entire zone granted to the applicant.
(2)
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.
(3)
Keep posted at his place of business a copy of the fee schedule, which must be filed with the administrator (if
applicable).
(4)
Operate in accordance with the rules and regulations adopted pursuant to this article and any applicable county
ordinances, and Chapter 401 Florida Statutes, and any administrative regulations adopted pursuant thereto.
(5)
Employ at all times sufficient personnel experienced in operation and management of emergency medical services to
ensure proper and efficient operation.
((l:"d [\10 04-12. fj 9} .
Sec. 50-60. - Renewal of certificate.
Each certificate holder shall file within 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 $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.
lard No 04-12. S 10)
Sec. 50-61. - Emer~encv provisions.
The board may modify, suspend or revoke a certificate in the interest of the public health, safety and welfare, only at public
hearing and after reasonable notice has been given to the certificate holder affected. However, if a situation exists which poses a
serious threat that ambulance or rescue service 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.
(Ort:/. No. 04-12. ~~ 11)
Sec. 50-62. - Classifications of certificates.
There shall be two classifications of service in Collier County, as follows:
(1 )
Class 1: Collier County EMS; ALS Rescue: An EMS provider 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 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.
(2)
Class 2: Collier County Hospitals:
a.
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.
b.
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 of public convenience and necessity must be
obtained from the county before engaging in this level of medical service.
c.
Class-2 transfer certificate holders shall contract with the Class-1 rescue certificate holder's medical director
for the performance of services set forth in F.S. 9 401.265 and as specifically set forth herein as follows:
1.
He shall supervise and accept direct responsibility for the medical performance of the paramedics and
emergency medical technicians (hereinafter EMTs). .
2.
He shall develop medically correct standing orders or protocols relating to life support system
procedures when communication cannot be established with a supervising physician or when any delay
in patient care would potentially threaten the life or health of the patient.
3.
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 care appropriate to the patient's
medical condition.
4.
'He or his appointed shall provide continuous 24-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 F.S. ~ 252.34(3).
5.
He shall establish a quality assurance committee to provide for quality assurance review of all EMTs and
paramedics operating under his supervision.
6.
He shall audit the performance of system personnel by use of a quality assurance program that includes
but is not limited to a prompt review of patient care records, direct observation, and comparison of
performance standards for drugs, equipment, system protocols and procedures. He shall be responsible
for participating in quality assurance programs developed by the Class-2 transfer certificate holder.
7.
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 401, 499 and 893, Florida
Statutes, and chapter 100-45 of the Florida Administrative Code.
8.
He shall create, authorize and ensure adherence to, detailed written operating procedures regarding all
aspects of the handling of medications, fluids and controlled substances by the EMS personnel and
comply with all requirements of chapters 401, 499 and 893, Florida Statutes.
9.
He shall notify the Florida Department of Health, (hereinafter the "department") in writing when the use
of telemetry is not necessary.
10.
He shall notify the department in writing of each substitution of equipment or medication.
11.
He shall assume direct responsibility for the use by an EMT of an automatic or semi-automatic
defibrillator; the performance of esophageal intubations 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 provide written evidence to the Florida Department of Health documenting
compliance with the provisions of this paragraph.
12.
He shall ensure that all EMTs and paramedics are trained in the use of the trauma scorecard
methodologies as provided in sections 64E-2.017 of the FAC., for adult trauma patients and
64E-2.0175, FAC:, for pediatric trauma patients.
13.
He shall participate as a crewmember on an EMS vehicle for a minimum of ten hours per year and
complete a minimum of ten hours per year of continuing medical education related to pre-hospital care
or teaching or a combination of both.
14.
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.
fOnl No 04-12. g 12)
Sec. 50-63. - Transfer or assiQnment of certificates.
No certificate issued under this article shall be assignable or transferable by the person to whom issued except unless
approval is obtained from the board in the same manner and subject to the same application, investigation, fees and public hearing
as original applications for certificates. Any majority transfer of shares or stock or interest of any person or operator so as to cause
a change in the directors, officers, majority stockholders or managers of such person or operator shall be deemed a transfer or
assignment as contemplated in this article and subject to the same rules and regulations as any other transfer or assignment.
(Ord No 04-12 $ 13)
Sec. 50-64. - Revocation. alteration or suspension Qrounds.
(a)
Every certificate issued under this article shall be subject to revocation, alteration and/or suspension of operation, buy [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 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.
(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 article.
(6)
The public interest will best be served by revocation, alteration, or suspension of any certificate upon good cause
shown.
(7)
The operator or his agent has demanded money or compensation other that established and prescribed under this
article (if applicable).
(8)
The operator has without sufficient justification failed or refused to fumish 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 15 days. If revocation, suspension or alteration of any certificate appears warranted, the board shall give notice to the
operator holding the certificate that the same will be considered at a specific commission meeting, provided the date of such
meeting shall not be less than five days from the date of the notice. The board shall thereupon consider the complaint and
either revoke, suspend or alter the certificate or dismiss the complaint.
lCkd PJc; 04-12 S; ,'4)
Sec. 50-65. - General operatinQ reQulations.
All certificate holders, operators, and drivers shall comply with all state statutes and administrative regulations as following
regulations:
(1)
24-hour service. Every certificate holder shall be required to operate sufficient ambulances, as stated on the certificate
of operation and determined by the board, on immediate call at all times.
(2)
Prompt service required. Every call for ambulance service shall be answered promptly. Patients shall be loaded and
transported without being subject to unreasonable delays. All calls for emergency assistance requiring over 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 minutes
elapse between receipt of an emergency call and dispatch of an ambulance shall also be reported to the administrator
with documentation of circumstances.
(3)
Bed linens. Clean and sanitary bed linens shall be provided for each patient carried and shall be changed as soon as
practicable after the discharge of the patient.
(4)
Daily log. 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 information as may be required by ordinance. Every operator shall retain
and preserve all daily logs for at least two years, and such logs shall be available for inspection by the administrator.
(5)
Communications. Each ambulance shall maintain two-way radio communication with the location of primary dispatch
from which it operates, as well as any additional communication capabilities required by ordinance or state law.
(6)
Vehicles and equipment. Each 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 article.
(7)
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. Salaries of other than Collier County EMS paramedics will be paid by the agency seeking the
medical director certification.
(8)
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 article.
(Ord. No. 04-12. & 15)
Sec. 50-66. - Central place of business.
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 administrator 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.
\,(:11(",'. i'1n. OuSr 12, ;~ 16)
Sec. 50-67. - 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.
(Ord. No 04-12.9 17)
Sec. 50-68. - Rates.
Every operator shall file with the board a schedule of the rates. Such rates shall be filed as a part of each new or renewal
application, and a rate schedule shall also be filed when changes in rates are proposed. All such rates shall be subject to review
and approval by the board.
(0/11 No 04-'/2 S: 18)
Sec. 50-69. - 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 $100,000.00 for injuries to or death of anyone person arising out of anyone accident and the sum of at least $300,000.00
for injuries to or death or more than one person in anyone accident and for the sum of at least $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 of such insurance policies shall provide for a
30-day cancellation notice to the board. '
{Z)tlj ;Vo ('lLL12. ~9 '19)
Sec. 50-70. - Conduct of drivers and attendants.
All drivers, EMT's and paramedics shall comply with the laws of the State of Florida, in order to meet the requirements set
out in this article and no driver, EMT or paramedic registered hereunder shall:
(1 )
Fail or refuse to promptly transport, if applicable, or attend any sick or injured person after responding to a call.
(2)
Demand or receive compensation other that established and approved in accordance with this article or fail to give a
receipt for moneys received (if applicable).
(3)
Give or allow rebate, commission, discount or any reduced rate not provided in the established rate (if applicable.)
(4)
At any time induce or seek to induce any person engaging an ambulance or ALS service to patronize or retain the
services of any hospital, convalescent home, mortuary, cemetery, attorney, accident investigator, nurse, medical
doctor or other service occupation or profession.
(5)
At any time release his patient from his care until he is assured that some responsible person is available to receive
such patient.
(6)
At any time use a siren or flashing red light unless on an emergency call.
(7)
Disobey the lawful orders of the law enforcement officer at the scene of an accident, or other similar such emergency
or at a fire scene, the fire officer in charge.
(8)
Smoke while within the confines of an ambulance.
(9)
Operate or ride in an ambulance without using seatbelts (personnel attending patients are exempt).
(Ord. No.. 04-12, S 20)
Sec. 50-71. - Passenqers.
No person shall be aboard ambulances when engaged in emergency or routine medical calls except the following:
(1 )
Driver, attendants and fire or law enforcement personnel;
(2)
Patients;
(3)
Not more that one relative or close friend of the patient, or if the situation warrants, the paramedic in charge may
authorize more than one passenger.
(4)
Physicians and nurses;
(5)
Personnel in an observing capacity that are being trained for ambulance or ALS service.
(6)
Operator's supervisory personnel.
f~Jr(lrvo O.:J.. L2 :~) :'j)
Sec. 50-72. - Obedience to traffic laws. ordinances or requlations.
(a)
The 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 or stop 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 article.
(e)
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.
{Ord No 04-12,!i 22J
Sec. 50-73. - Violations.
In addition to the remedies provided herein, a violation of any provision of this article shall be punishable as provided by law
for the violation of county ordinances.
(Ore1. No 04-12. :~ 23)
Sec. 50-74. - Uniformity of application.
The article shall constitute a uniform law applicaljle in all of Collier County.
(Orej No. 04-12, :J 24.)
Sec. 50-75. - Authoritv 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 sheriffs department of Collier County, its deputies and agents, fire departments, as well as
the police departments of the various municipalities falling under the provisions of this article to strictly enforce the provisions of this
article.
(Ord No 04-12. S 25)
Sees. 50-76-50-100. - Reserved.
FOOTNOTE(S):
IbbJ Editor's note- Ord. No. 04-12,926, adopted Feb. 24, 2004, repealed divs. 1 and 2 of art. III, 9950-51-50-68,
50-76-50-86, in their entirety. Sections 1-25 of said ordinance enacted similar provisions to read as herein set out.
(Back)
(66) Cross reference- Businesses, ch. 22; health and sanitation, ch. 66 (Back)
(66) State Law reference- Medical transportation services, F.S. 9401.2101 et seq. (Back)