Agenda 01/14/2014 Item # 11A 1/14/2014 11 .A.
EXECUTIVE SUMMARY
Recommendation to issue Big Corkscrew Island Fire and Rescue District a Certificate of
Public Convenience and Necessity for Advanced Life Support non-transport services for
one year and authorize the Chair to execute the Permit and Certificate.
OBJECTIVE: To issue Big Corkscrew Island Fire and Rescue District ("Big Corkscrew")
a Certificate of Public Convenience and Necessity ("COPCN") for Advanced Life Support
("ALS") non-transport services and authorize the Chair to execute the COPCN and permit.
CONSIDERATIONS: On September 24, 2013, Agenda Item No. 11. E., the Board of
County Commissioners ("Board") directed staff to have the Public Safety Authority ("PSA")
review Big Corkscrew's COPCN application for ALS non-transport and provide comments
to the Board. On November 13, 2013, the PSA heard this item and a brief presentation from
Big Corkscrew. A motion was made to recommend approval and it carried with nine votes
in favor and 5 votes against. The summary minutes of the Public Safety Authority meeting
are attached.
Big Corkscrew submitted an application to operate a non-transport Advance Life Support service
within its district boundaries. In accordance with Section 6 of Ordinance No. 04-12, as amended,
the Director of the Bureau of Emergency Services recommends approval based on his finding
that there is a public necessity for Big Corkscrew to provide the service and that all other
requirements under Ordinance No. 04-12 have been met. The Board adopted level of EMS
response service established for the rural area of the County is 12 minutes or less, 90% of the
time. For the one year time-period from July 2012 to June 2013, EMS achieved the travel time
goal for the rural area of Big Corkscrew 87% of the time.
Notwithstanding the primary staff recommendation, other potentially viable options may exist as
an alternative to awarding a COPCN to the Big Corkscrew Island Fire and Rescue District. One
alternative would be to enter into an interlocal agreement to establish an Advanced Life Support
Engine swap program. EMS staff have indicated to the District its ability to provide the required
level of trained paramedic-firefighters that have the skill sets needed to meet the District's
requirements and is prepared to discuss alternatives and options with BCIFR. Additionally EMS
staff recently made operational staffing changes that immediately improved response times in Big
Corkscrew. In the first two months (Nov 1 through Dec 31, 2013), this change resulted in a five
percent year-to-year increase (from 87% to 92%) in meeting response times of 12 minutes or
less. An additional period of time to further evaluate the sustained impact on response times in
the District may be in order.
Finally, the application reports Big Corkscrew will use its Medical Director instead of the
County's Medical Director. Staff would prefer the utilization of the County Medical Director.
It should be noted that the PSA's Medical Director's subcommittee is now active and meeting
regularly on protocols and various issues. County staff received a letter dated September 6, 2013
from Big Corkscrew Island Fire and Rescue District's Chief Greenberg assuring County Staff
that its medical director will become fully engaged and act in good faith with both the County
Medical Director and the Public Safety Authority. The letter has been attached as back-up to this
item.
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If this item is approved by the Board, the COPCN and Permit will allow operations to commence
on April 15, 2014 and expire on April 14, 2015. Subsequent renewal applications are the
responsibility of Big Corkscrew to submit 90 days prior to the expiration date.
It should be noted that the application is too large for inclusion in the agenda package.
Attachment A from the application is included as it provides the relevant overview of the
application. The entire application may be viewed at the Collier County Emergency Services
Center located at 8075 Lely Cultural Parkway, Naples, FL between the hours of 8:30 am and
4:30 pm by contacting 239-252-3622. A copy will also be provided to the Clerks' office of
Minutes and Records.
k1SCAL IMPACT: There is no fiscal impact to the Board for granting this certificate. The
Board is requested to accept and recognize as revenue in Fund (490) the $250.00 application fee
with the corresponding application.
GROWTHMANAGEMENTIMPACT: There is no Growth Management Impact.
LEGAL CONSIDERATIONS: The standards set forth in Ordinance No. 04-12, Section 7
apply. Section 7 states:
"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 Commissioners 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(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.
(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."
Ordinance No. 04-12, Section 8 states:
"In making the determinations provic Packet Page -164- 7 above, the Board may, in its sole
1/14/2014 11 .A.
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."
This item has been approved as to form and legality and requires a majority vote for Board
action. —JAB
RECOMMENDATION: That the Board of County Commissioners:
1. Accepts the findings of the Director of the Bureau of Emergency Services;
2. Accepts the recommendations of the PSA;
3. Approves the issuance of a COPCN and Permit to the Big Corkscrew Island Fire and
Rescue District for ALS Non-Transport for a period of one year and authorizes the Chair
to execute same.
3. Recognizes the $250.00 application fee for the Certificate of Public Convenience and
Necessity within the EMS Fund 490.
Prepared by: Dan E. Summers, Director of Bureau of Emergency Services
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COLLIER COUNTY
Board of County Commissioners
Item Number: 11.11.A.
Item Summary: This item to be heard at 10:00 a.m. This item requires that ex parte disclosure
be provided by Commission members.Should a hearing be held on this item, all participants are
required to be sworn in. Recommendation to issue Big Corkscrew Island Fire and Rescue District a
Certificate of Public Convenience and Necessity for Advanced Life Support non-transport services for
one year and authorize the Chair to execute the Permit and Certificate. (Dan Summers, Bureau of
Emergency Services)
Meeting Date: 1/14/2014
Prepared By
Name: HeinrichsbergKathy
Title: Legal Administrative Secretary,County Attorney
12/23/2013 4:20:51 PM
Submitted by
Title: Director-Bureau of Emergency Services,
Name: SummersDan
12/23/2013 4:20:52 PM
Approved By
Name: SummersDan
Title: Director-Bureau of Emergency Services,
Date: 12/23/2013 4:41:58 PM
Name: PriceLen
Title: Administrator, Administrative Services
Date: 12/26/2013 8:01:49 AM
Name: KopkaWalter
Date: 12/30/2013 8:58:59 AM
Name: BelpedioJennifer
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1/14/2014 11 .A.
Title: Assistant County Attorney,County Attorney
Date: 12/30/2013 11:35:33 AM
Name: PriceLen
Title: Administrator, Administrative Services
Date: 1/3/2014 2:00:57 PM
Name: BelpedioJennifer
Title: Assistant County Attorney,County Attorney
Date: 1/6/2014 8:56:58 AM
Name: KlatzkowJeff
Title: County Attorney
Date: 1/6/2014 9:37:53 AM
Name: GreenwaldRandy
Title: Management/Budget Analyst,Office of Management&B
Date: 1/6/2014 11:49:20 AM
Name: KlatzkowJeff
Title: County Attorney
Date: 1/6/2014 1:16:37 PM
Name: OchsLeo
Title: County Manager
Date: 1/8/2014 5:36:27 PM
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1/14/2014 11 .A.
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COLLIER COUNTY FLORIDA
BIG CORKSCREW ISLAND FIRE CONTROL AND RESCUE DISTRICT
This Permit is effective April 15, 2014 and
expires April 14, 2015
Name of Service: Big Corkscrew Island Fire Control and Rescue District
Name of Owner: Big Corkscrew Island Fire Control and Rescue District
Principle Address of Service: 13240 Immokalee Road,Naples, FL 34120
Business Telephone: 239-455-1204
Description of Service: Non-Transport Advanced Life Support
Number of Vehicles: 3 Ground Units available.
See Attachment "A"for description of vehicles.
This permit, as provided by Ordinance No, 2004-12, as amended, shall allow the above
named Non-transport ALS Service to operate within the Big Corkscrew Island Fire
Control response boundary and pursuant to a mutual-aid agreement until the expiration
date hereon, except that that this permit may be revoked by the Board of County
Commissioners of Collier County at any time the service named herein shall fail to
comply with any local, state or federal laws or regulation applicable to Big Corkscrew
Fire Control and Rescue District.
Issued and approved this 14th day of January, 2014.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA
, Deputy Clerk Tom Henning, Chairman
Approved as to form and legality:
Jennifer A. Belpedio, Assistant County Attorney
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BIG CORKSCREW ISLAND FIRE CONTROL AND RESCUE DISTRICT
13240 IMMOKALEE ROAD,NAPLES,FL.34120
239-455-1204
Application for a Certificate to Provide Advanced Life Support(Non-Transport)
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 than 25 percent of the outstanding shares. For governmental units,this information
shall be supplied for members of the governing body.
Name: Paul M. Plamondon
Address: 13250 lmmokalee Road
Naples, FL. 34120
Age: ,P
Name: Ramon Eliseo Chao ft 1d i„,,1 ✓` t ;r.p
Address: 13250 lmmokalee Road l G� u
Naples, FL. 34120 14.Ni`'i d --
Age: «t-+►� 5 ulwh IPA a •CS
Name: Christopher L.Crossan
Address: 13250 lmmokalee Road
Naples, FL.34120
Age: ilk
2) The Boundaries of the territory desired to be served
All that area of land located in Collier County, Florida,described as: Range 27 East,Township 47
South; Range 28 East,Township 47 South; Range 27 East,except Sections 29,30,31 and 32,
Township 48 South; Range 28 East,Township 48 South; Range 29 East,except Section
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17, and 18,Township 48 South; range 28 East,except
Sections 4,5,6,7,8,9,16,17,18,19,20,21,2.5,26,27,28,29,30,31,32,33,34,35 and 36,Township 49
South; Range 29 East,except Sections 25,26,27,28,29,30,31,32,33,34,35,and 36,Township 49
South;all of said lands being located in Collier County as set forth in public records(Attachment
A). Including all areas in which the District has current executed mutual and auto aid
agreements within the County(Attachment B). Allowing the District to provide ALS non-
transport response service to these areas will augment and enhance the County's provision of
Emergency Medical Care and transport services.
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3) The number and brief description of the ambulances or other vehicles the applicant will have
available.
This is a request to provide ALS non-transport response services within the service area of the
Big Corkscrew island Fire Control and Rescue District("District"). Accordingly,there will be no
ambulances provided by the District. Transport will remain the responsibility of Collier County
EMS. The District will provide ALS non-transport response services through state licensed and
District trained paramedics to those in need of ALS non-transport response services until Collier
County EMS paramedics arrive and can take over care of the patient. We rotate our fleet
through our facilities to balance mileage,wear and tear,and staffing capabilities. All of our
engines will be licensed as ALS non-transport response units, but only one engine will be in
service as an ALS non-transport response unit at any given time. To support the ALS engines a
ALS non-transport response supervisory vehicle will be in service as well.
The engines that will be licensed and utilized by the District,to maintain ALS non-transport
response services are:
Sutphen S2 (primary ALS engine A)—VIN#1S9A1BLD961003100
Sutphen S2(primary ALS engine B)—VIN#1S9A1BLD261003097
Sutphen CC(reserve ALS engine)—VIN#1FVABZBS33HK63552
4) The address of the intended headquarters and any sub-stations.
Big Corkscrew Island Fire Control and Rescue District(Administrative Building)
13250 lmmokalee Road
Naples, FL.34120
Big Corkscrew Island Fire Control and Rescue District(Station 10)
13240 lmmokalee Road
Naples, FL. 34120
Big Corkscrew Island Fire Control and Rescue District(Station 11/Maintenance Facility)
18665 lmmokalee Road
Naples, FL.34120
Big Corkscrew Island Fire Control and Rescue District(Station 12)
21520 lmmokalee Road
Naples, FL.34120
5) The training and experience of the applicant.
The Big Corkscrew Island Fire Control and Rescue District has been involved in providing Fire
Rescue and Emergency Medical Services since 1977. The District's leadership team is composed
of the following members:
• Rita M.Greenberg, Fire Chief(21 years experience) Florida certified
Firefighter/Emergency Medical Technician
• Michael T.Ginson,Assistant Chief Operations and Administration(23 years experience)
Florida certified Firefighter/Emergency Medical Technician
* Eric Watson,Captain Operations and Training (25 years experience),formerly with
Collier County EMS, Florida certified Firefighter/Paramedic
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6) The names and addresses of three Collier County residents who will act as references for the
applicant.
• Robert E. Buck
3307 Potomac Court
Naples, FL.34120
• Karen M.Acquard
441 24th Ave NE
Naples, FL.34120
• Michael Ramsey
26314th St NW
Naples, FL. 34120
7) A schedule of rates which the service intends to charge.
The Big Corkscrew Island Fire Control and Rescue District is requesting a Certificate to provide
Advanced Life Support non-transport response services. Currently there is no charge for the
Basic Life Support non-transport response services being provided by the District,and the
District seeks to continue with this practice while providing ALS non-transport response services.
8) Financial data including assets and liabilities of the operator. A schedule of all debts
encumbering any equipment shall be included.
• Attachment C
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Requirement for board approval in granting certification
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 standards has been satisfied.
1) That there is a public necessity for the service. In making such a 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.
The Big Corkscrew Island Fire Control and Rescue District has been providing BLS first
response non-transport services within its District boundaries since 1977. The Districts
enabling act,77-535, Laws of Florida,and all subsequent special acts of the District were
codified in 2000 pursuant to section 191.015, Florida Statutes; 2000-395, Laws of Florida
Section 2 Status and Purpose states`The Big Corkscrew Island Fire Control and Rescue
District,an independent special district,is organized and exists for all purposes set forth
in this act and chapters 189 and 191, Florida Statutes. " In accordance with Florida
Statutes 191.008(1)—Special Powers allows the District to "establish and maintain
emergency medical and rescue response services and acquire and maintain rescue,
medical, and other emergency equipment, pursuant to the provisions of chapter 401
and any certificate of public convenience and necessity or its equivalent issued
thereunder. " (Attachments A and G) Over the years the District has proven its ability
to provide quality BLS service with a response time of less than 4:08 minutes to
positively augment the Collier County Emergency Medical Services ALS response.
(Attachment D). The District employs 10 state certified firefighter/paramedics that
would be utilized to support the ALS non-transport response service program. The
successful enhancement(the use of ALS non-transport response service programs)to
the existing Collier County Emergency Medical Services system has been thoroughly
documented and further supported by two independent groups. Both of these groups'
studies and/or reports have been previously provided to the Board of County
Commissioners for their review,and have also been included as part of this application
as reference material.
The first report was prepared in 2007 by Emergency Services Consulting, Inc. at the
request of the Collier County Emergency Medical Services Department. This report
titled 2007 EMS Master plan was financed by the Collier County Emergency Medical
Services Department through the utilization of available State of Florida grant funds.
To further answer the question as to what extent the proposed service is needed to
improve the overall emergency medical services(EMS)capabilities of the County, please
refer to page 3 of the 2007 EMS Master Plan. The author states, "ESCI's findings support
this concept,as data indicates the ALS Engine Program provides quantifiable benefit to
the overall delivery of the emergency medical services,particularly when system
demand is high." Furthermore on page 141,the author states"The ALS engines should
be utilized to increase the capability of the EMS system in general."(Attachment E).
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The second report was prepared and presented by the Collier County Productivity
Committee in August 2008, and presented to the Collier County Board of Commissioners
as part of the FY 2008-09 final budget preparations. On the second page of the
summary report the author indicates that existing ALS engine programs within Collier
County have made a significant improvement in response times—"In particular,the
seven ALS units provided by North Naples Fire District have made a big improvement in
response times in north collier." (Attachment F). Even though these reports are greater
than 3 years old,the statistical value of these reports demonstrating the enhancement
of Advanced Life Support first response non-transport to the current Collier County
Emergency Medical Service System is still valid today.
The granting of a certificate to provide Advanced Life Support non-transport response
services within the Big Corkscrew Island Fire Control and Rescue District will improve the
level of service to a rural portion of Collier County, provided by Collier County EMS,
which currently has a response time criteria of 12 minutes 90%of the time (Naples Daily
News, Chief Walter Kopka, March 4, 2013),which is nearly eight(8)minutes greater
than the Districts current response time average of 4:08 minutes for medical calls
(Attachment D). The issuance of a certificate will also aid in fostering a more positive
relationship with the Collier County Office of the Medical Director by allowing the
District to contract with a Medical Director,which can act as the liaison between the
District and the County Medical Director.
The 2007 EMS Master Plan(Attachment E)also identified a potential for cost savings to
the County, by either eliminating existing transport units from areas which are already
well serviced or relocating transport units to other areas in the County which are
currently under serviced. These options have yet to be exercised by Collier County
therefore granting a certificate to the Big Corkscrew Island Fire Control and Rescue
District to provide ALS non-transport response service will be of significant benefit to
the resident's of the rural community. The certificate will allow the District to offer an
enhanced level of service to the area,while not disrupting the current level of service to
the urban areas. The Productivity Committee report(Attachment F)indicates the
existing ALS Engine program in North Naples Fire Control and Rescue District has been a
savings to the Collier County Taxpayer,which was an already well serviced area. It
stands to reason that savings to the Collier County Taxpayer would be realized by the
implementation of an ALS non-transport response services program in the Big
Corkscrew Island Fire Control and Rescue District, located in the rural area of Collier
County currently covered with a single medic unit"assigned"to the 194 square mile
service area of the Big Corkscrew Island Fire Control and Rescue District.
b. The effect of the proposed service on existing services with respect to quality of
service and cost of service.
The granting of this certificate will have no impact on the cost of the current Collier
County EMS services. ALS non-transport response services are already being provided
to residents throughout Collier County by North Naples Fire,City of Naples and City of
Marco Island at no additional cost. The granting of this certificate will allow for that
same level of ALS non-transport response service to be provided to the residents of the
Big Corkscrew Island Fire Control and Rescue District,and areas served by automatic or
mutual aid,at no additional cost. This practice is expected to continue unless a change
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to the County fee ordinance provides opportunities for billing for such services. The
District is not requesting a change to the billing system for ALS services.
In respect to the quality of service,the granting of a certificate to provide ALS non-
transport response services will allow the Big Corkscrew island Fire Control and Rescue
District to increase the level of medical services to residents and visitors alike. The
intent will be to integrate many,if not all,aspects of our program,with the established
and effective ALS non-transport response services provided by the North Naples Fire
Control District. We will"increase training and cooperative effort,will ensure
consistency among all ALS providers,and ensure that these same providers
demonstrate an ability to perform their various skills and procedures adequately, prior
to certifying them to function within the system" (Attachment F). This integrated
program will also foster the same level of education and training,regardless of the
organization for which the paramedics operate within and furthermore,by allowing the
Big Corkscrew Island Fire Control and Rescue District to provide ALS non-transport
response services,there will be a quantifiable benefit to the overall delivery of
emergency medical services to the residents in the rural District of Big Corkscrew Island
Fire Control and Rescue District,especially when system demand exceeds the current
supply.
It is the intention of the District by obtaining a certificate,to provide ALS non-transport
response services to contract with a medical director whom shall meet all F.S.401 and
F.A.0 64-3 requirements. The District's Medical Director's primary responsibility shall be
to assist the District in expanding its training opportunities, and assuring the
competency of all District paramedics to not only continue to meet,but exceed all State
and Local expectations and guidelines.
The District is fully aware and agrees with the County Commissioners concerns of
fragmentation in the delivery of out-of-hospital Basic and Advanced Life Support, as
currently created by the Office of the Medical Director. As stated in the 2007 EMS
Master Plan, "ALS Engine personnel are not allowed to carry the same medications and
equipment as does Collier County EMS,creating a fragmentation of patient care". The
report goes on to mention "To further confuse this issue, many of the personnel
currently functioning within the ALS engine program or employed by Fire Districts are
current and/or former Collier County EMS personnel with equal or greater training,
education,and experience as those operating on the county transport units." Lastly,
"With a more consistent training and orientation program of all ALS personnel,
regardless of the agency,the system can begin to function more uniformly in regards to
pre-hospital medical care for the citizens of Collier County." (Attachment E). Moreover,
the District is strongly considering utilizing the same Medical Director and the
established team of doctor's working with him currently providing Medical Direction
services to one of the three ALS non-transport response programs in Collier County. In
utilizing the same Medical Director there will be less fragmentation and greater
consistency with the ALS programs currently in place within Collier County. The goal is
to assure that fragmentation is minimized,or lack of parity in the delivery of Emergency
Medical Care is non-existent within the Big Corkscrew Island Fire Control and Rescue
District. In addition,the District Medical Director shall be required through contractual
agreement with the District to work closely with the Office of the Collier County Medical
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Director to assure that residents and visitors of the District can benefit from a well
organized, comprehensive, non-fragmented and highly sophisticated system delivering
quality medical services.
The number of employees(firefighter/EMTs and firefighter/paramedics)the District has
is much lower than some other areas within the County that currently operate ALS
engine programs. While we have sufficient numbers to operate an ALS non-transport
response service program with our own certificate,the requirements proposed in
affiliation with Collier County EMS and under the direction of the County Medical
Director over the past years have created several concerns. in 2001 the District passed
resolution 2001-01 clearly identifying its intent to provide ALS non-transport response
services. The District supported personnel in their efforts to acquire their State of
Florida Paramedic certifications and continued to develop an adequate number of
personnel to effectuate the transition to the provision of ALS non-transport response
services. This goal continues to exist and various methods to deliver this service and the
associated costs have been reviewed in subsequent years. In 2008,the District
presented a pilot program to the District 5 Commissioner,all costs to be borne by the
District,which was a more practical and fiscally responsible approach for an
organization of our size. After the initial meeting, no further action was initiated or
taken by the Commissioner to share this concept with fellow Board members or County
Staff. The expansion of services was placed on "hold" in 2009 due to the economical
issues the District,State and Country were facing. In late 2011,the District once again
researched the concept of providing ALS non-transport response services. We held
several meetings with Collier County EMS personnel to work on what was called a "rural
response program",that would allow the provision of intermediate level paramedic care
to the residents of Big Corkscrew Island Fire Control and Rescue District. The
intermediate level is not consistent with the recommendations found on page 30 of the
2007 EMS Master Plan"Increase training, education and practice consistency among all
providers and ensure that all providers are able to perform equal skills and procedures
prior to"certifying"them to function within the system" (Attachment E). it is this
intermediate care level,the costs associated with mandatory ride time, swap programs,
and the subsequent overtime that have impeded our ability to provide ALS non-
transport response services to the residents and visitors of our District. The awarding of
a certificate to Big Corkscrew Island Fire Control and Rescue District for ALS non-
transport response services, will allow for the opportunity to establish a training and
education program in house, in conjunction with our Medical Director, that is consistent
with the protocols of the Office of the Collier County Medical Director, but allows for the
flexibility needed to limit the overtime expense while providing for a consistent level of
enhanced quality care to the residents and visitors of the Big Corkscrew Island Fire
Control and Rescue District,
c.The effect of the proposed service on the overall cost of EMS service in the County.
The granting of a certificate for the provision of Advance Life Support non-transport
response services shall have no negative impact on the overall cost of the Collier County
Emergency Medical Services system. ALS non-transport response services are currently
being provided by three different agencies within Collier County,at no cost to the Collier
County Emergency Medical Services Department. The Big Corkscrew Island Fire Control
and Rescue District currently provides Basic Life Support non-transport response
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services and is completely funded to continue to offer this level of service. If the
Certificate is granted,the District is in the financial position to implement Advance Life
Support non-transport response services to the residents and visitors of Big Corkscrew
Island Fire Control and Rescue District, in addition to maintaining current BLS services
provided.
d.The effect of the proposed service on existing hospitals and other health care
facilities.
Currently there are no hospitals within the boundaries of the Big Corkscrew Island Fire
Control and Rescue District.There are four recognized hospitals within Collier County.
The granting of a certificate to provide Advance Life Support non-transport response
services to the Big Corkscrew Island Fire Control and Rescue District could potentially
improve the operations of the hospital emergency rooms through the delivery of a
higher level of ALS care and service. Hence, patients that are transported to the
hospitals could arrive with less acuity of illness or injuries,which could require less
intensive hospital resources and potentially lessening the length of stay of patients in
the hospital. These are two critical benchmarks that can result in a positive impact to
the operations of the hospitals and emergency rooms.
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.
The Big Corkscrew Island Fire Control and Rescue District currently operates 5 Basic Life
Support non-transport response apparatus utilizing 10 paramedics and 14 Emergency
Medical Technicians.The District will place 1 apparatus (engine) and 1 quick response
vehicle(supervisor) in service as ALS non-transport response service capable units and
maintain 3 BLS non-transport response apparatus. The District currently employs a
sufficient number of Paramedics and Emergency Medical Technicians to provide the
level of service being requested. it shall have no impact on the staffing levels of the
existing services.
2) That the applicant has sufficient knowledge and experience to properly operate the proposed
service.
The Big Corkscrew island Fire Control and Rescue District has been providing Fire and
Emergency Medical Services within its boundaries since 1977. Our management staff
has a combined 69 years of experience in providing excellence in service to its
community.
The District responds to approximately 650 9-1-1 medical calls per year, providing
personnel with ample experience in the provision of Basic Life Support care. With the
number of paramedics currently employed and the number of medical calls responded
to there will be ample opportunity for the Paramedics to provide Advance Life Support
care. Additionally,of the 10 paramedics 3 have Bachelor's Degrees and 4 have
Associates'degrees. Two of the District's paramedics worked in EMS Systems prior to
joining the fire service—one with Hendry County EMS for 4 years,attaining the rank of
Lead Medic and one with Collier County EMS for 15 years attaining the ranks of Field
Training Officer,Training Captain and Battalion Chief. This same individual taught the
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Paramedic program through Edison College for 10+years and more. Presently 3 of the
District's paramedics currently work in a hospital setting part time. Lastly,all of the
District's EMT's and Paramedics meet or exceed all of the State of Florida Department of
Health certification requirements.
3) That,if applicable,there is an adequate revenue base for the proposed services.
The Big Corkscrew Island Fire Control and Rescue District is seeking a certificate to
provide Advance Life Support non-transport response service in addition to the Basic
Life Support non-transport response services currently provided within the District's
boundaries. The District has consistently funded all Fire Operations and Prevention
services, as well as Basic Life Support non-transport response services, utilizing its
millage cap (or lower) as approved by a vote of the people within the District. Due to
the size of the area served and the increase in demand for service,the approved
maximum millage rate has gone from 1 mil(as approved in 1977)to 3.75 mils today(as
approved in 2010). The District is currently operating at a millage rate of 3.50 for FY
2013 and anticipates this rate to remain the same or decrease in the future. No change
to this funding source is either necessary or expected.
4) That the proposed service area will have sufficient personnel and equipment to adequately
cover the proposed service area
The Big Corkscrew Island Fire Control and Rescue District currently operates 5 Basic Life
Support non-transport response apparatus along with 4 additional apparatus, utilizing
10 paramedics and 14 Emergency Medical Technicians. The District has taken the
necessary budgetary measures to continue the provision of Basic Life Support non-
transport response services,in addition to plan for the purchase and maintenance of the
equipment required for the provision of Advance Life Support non-transport response
services,through a Certificate of Public Convenience and Necessity granted to the Big
Corkscrew Island Fire Control and Rescue District. Response to both fire and medical
calls averages 6:38 minutes and response to medical calls only average is 4:08 minutes—
significantly lower than current CCEMS response time goal of"8 minutes or less,90%of
the time,for properties west of Collier Boulevard and 12 minutes of less 90%of the time
for properties east of Collier Boulevard" (Naples Daily News, March 4,2013),as well as
the "9 minutes 90%of the time countywide" (Attachment E). The entire population
(approximately 13,850 residents)of the Big Corkscrew island Fire Control and Rescue
District lies within the "12 minutes or less"zone,the provision of ALS non-transport
response service will allow for a more timely response and the provision of care to those
residing in and traveling through the District.
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Attachment A
Big Corkscrew Island Fire Control and Rescue District
The engines that will be licensed and utilized by the District to maintain ALS non-
transport response services are:
Sutphen 52 {primary ALS engine A) -VIN# 1S9A1BLD961003100
Sutphen 52 {primary ALS engine B) -VIN# 1S9A1BLD261003097
Sutphen CC {reserve ALS engine) -VIN#1FVABZBS33HK63552
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November 13, 2013
MINUTES OF THE MEETING OF THE COLLIER COUNTY PUBLIC
SAFETY AUTHORITY MEETING
Naples, Florida November 13, 2013
LET IT BE REMEMBERED, the Public Safety Authority in and for the County of Collier,
having conducted business herein, met on this date at 10:00 A.M. in REGULAR SESSION
at Collier County Growth Management Division Building, Conference Room#609/610,
2800 N. Horseshoe Drive Naples, Florida with the following members present:
Chairman: Reg A. Buxton, Citizen Representative
Vice Chairman: Janet H. Vasey, Citizen Representative
Joseph Bernard, Hospital Administrator
Captain Robert Montagano, Naples Police Department
Chief Walter Kopka, Collier County EMS Chief
David Mennini, EMT, Collier County EMS
Mr. Justin Gibson, Paramedic, Outside Collier County EMS
Dr. Todd Bethel, Active ER Physician
Bobby Allen, Paramedic, Collier County EMS
Dr. Robert B. Tober, Collier County Medical Director
Dr. Matt Everett, Active ER Physician
Chief James S. Bloom, Collier County Sheriffs Office
Chief Michael D. Murphy, Collier County Fire Chiefs Assoc.
Jose Santana, EMT, Outside Collier County EMS
Phillip C. Dutcher, Hospital Administrator
Dr. Jeffrey A. Panozzo, Medical Director - COPCN Holder
(Vacancy)
ALSO PRESENT: Maria Franco, Administrative Assistant, EMS
Scott Teach, Deputy County Attorney
Len Golden Price, Administrator, Administrative Ser. Div.
Dan Summers, Director, Bureau of Emergency Man. Services
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November 13, 2013
1. Call to Order and Pledge of Allegiance
Chairman Buxton called the meeting to order at 10:00am.
A quorum was established.
The Pledge of Allegiance was recited.
2. Agenda and Minutes
a. Approval of Today's Agenda
Mr. Dutcher moved to approve the Agenda subject to hearing item 5.a before item 3. Second by
Ms. Vasey. Carried unanimously 12- 0
b. Approval of Minutes from the September 30, 2013 PSA Meeting
Chief Kopka moved to approve the minutes of the September 30, 2013 meeting as presented.
Second by Ms. Vasey. Carried unanimously 12—0.
Dr. Panozzo arrived at 10:05am
Chief Bloom arrived at 10:05am
Dr. Everett arrived at 10:10am
5. New Business
a. BCIFD COPCN application- (Note this is a large volume of materials... too big to print and
document. (Time sensitive— To be heard first)
The following documents were provided in addition to the application:
• Executive Summary "Recommendation to issue Big Corkscrew Island Fire and
Rescue District a Certificate of Public Convenience and Necessity for Advanced Life
Support non-transport services for one year and authorize the Chairwoman to execute the
Permit and Certificate. "
• Letter dated April 23, 2013 from Dan Summers, Director of Bureau of Emergency Services
to Rita Greenberg Fire Chief, Big Corkscrew Island Fire Control and Rescue District-Re:
COCPN Application.
• Letter dated May 1, 2013 from Rita Greenberg, Fire Chief, Big Corkscrew Island to Dan
Summers, Director of Bureau of Emergency Services -Re: COPCN application response.
• Letter dated September 6, 2013 from Rita Greenberg, Fire Chief, Big Corkscrew Island to
Dan Summers, Director of Bureau of Emergency Services -Re: COPCN application.
Chief Rita Green, Big Corkscrew Island Fire Control and Rescue District presented the
Slideshow "Big Corkscrew Island Fire Control and Rescue District COPCN 2013" dated
November 13, 2013. The presentation included:
• An overview of the training and continuing education undertaken by BCIFD personnel.
• How the service will adhere to Collier County EMS medical protocols.
• How the District currently utilizes reserve monies to assist in funding operating expenses.
• A review of the response time data and the goals for program.
• How there are incidents where the District is awaiting ALS service due to overlaps in
coverage during emergency events when the out of District ALS provider is assisting in
other emergency calls.
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November 13, 2013
She reported the overall goal is to support Collier County EMS and improve emergency treatment
for the citizens in the community District and achieve a 90 percent rating for a 12 minute or less
response time in the service.
Dr. Panozzo reported he has a conflict of interest in the application and will be abstaining from
voting.
Speaker
Eric Watson,Big Corkscrew Fire Control and Rescue District, EMS Coordinator reported
response times are critical to a patient who is in distress (especially respiratory) and requires ALS
treatments. The program is designed to augment the service provided by County EMS in an area
currently requiring the need for improved service.
Mr. Santana arrived at 10:33am
Dr. Tober expressed concern the requested would fragment the current service provided by the
County given the program will add another COCPN provider not directly under the supervision of
Collier County EMS. A better option may be to initiate an ALS swap program between Collier
County EMS and the BCIFD to address the needs of the citizens.
Chief Murphy outlined the positive aspects of the request and noted the program will provide a
valuable service to the residents in the District. He noted the application is for a 1 year term with
renewal whereby the item may be revisited if necessary.
Ms. Vasey expressed concern the applicant has not met the requirement of the application for
demonstrating an adequate revenue base for the proposed service. The District is currently utilizing
reserve funds for operations and intends to in 2014. This practice may not be sustainable over the
long term.
Chief Greenberg reported, in order to address financial concerns, the District obtained price quotes
for service from the Collier County Medical Director and the North Naples Medical Director. She
provided an overview of the quotes and reported after review of the data, the District determined it
would be more cost effective for the North Naples Medical Director to provide the service. The
request is for one year, and the FY14 the budget accounts for the additional expense required to
provide the service.
Discussion occurred on the feasibility of developing a"swap"program between the County and
District(as currently exists between the County and the City of Marco Island). It was reported the
current requirement for"pump operators" in the District(minimum 2 years of operation experience
with BCIFD) may not lend itself to establishing the program.
Chief Murphy moved to recommend the Board of County Commissioners approve the Big
Corkscrew Island Fire Control and Rescue District's application for COPCN for ALS non
transport. Second by Mr. Bernard
Speakers
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November 13, 2013
Mike Ramsey, Golden Gate Estates Area Civic Association reported the Association requests
the District focus their resources on extinguishing brush fires and does not support the request
given the service is currently provided by the County.
Chris DelaCroix, Big Corkscrew Fire Control and Rescue District Fire Commissioner the
District is not attempting to "fragment"the current system but upgrade the existing level of service
provided to the citizens of the District.
Ramon Chao,Big Corkscrew Fire Control and Rescue District Fire Commissioner reported
faster response times (even minutes) are critical for the residents of the District and supports the
request.
Discussion occurred on if personnel from the Golden Gate Fire District and East Naples Fire
District could adequately service the BCIFD "pumps" at this point in time.
Kirkman Schuldt, Chief, East Naples Fire Control and Rescue District reported the personnel
would need training to perform all functions adequately as the some of the pumping system are
different.
Motion carried 9 "yes"—5 "no." Dr. Bethel,Dr. Tober,Mr. Allen, Mr. Dutcher and Ms. Vasey
voted "no." Chief Bloom abstained. Dr. Panozzo was not present for the vote and previously
reported he was abstaining from the vote.
3. Elect Chair/Vice Chair
Chief Kopka nominated Janet Vasey for Chairman of the Public Safety Authority.
Chief Murphy nominated Reg Buxton for Chairman of the Public Safety Authority.
** Chairman Buxton requested a show of hands to determine the number of votes for each
nominee.
Ms. Vasey received 7 votes;Mr. Buxton received 8 votes. Mr. Buxton was declared Chairman of
the Public Safety Authority.
Mr. Buxton nominated Janet Vasey for Vice Chairman of the Public Safety Authority.
Nominations were closed
Ms. Vasey was declared Vice Chairman of the Public Safety Authority.
** After review of the video of the meeting, the minute taker has determined Ms. Vasey and Mr.
Buxton both received 8 votes for Chairman of the Public Safety Authority.
Chief Bloom,Mr. Mennini,Dr. Bethel,Mr. Allen, Chief Kopka, Mr. Dutcher,Dr. Tober and Ms.
Vasey voted for Ms. Vasey.
Chief Montagano, Mr. Gibson,Dr. Panozzo, Mr. Santana,Dr. Everett, Chief Murphy, Mr.
Bernard and Mr. Buxton voted for Mr. Buxton.
Chairman Buxton left the meeting at 11:30am
Ms. Vasey assumed the Chair
4. Old Business
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November 13, 2013
a. PSA Logo
Chief Kopka submitted the proposed PSA Logo for consideration.
Chief Murphy moved to approve the Logo as proposed. Second by Mr. Dutcher. Carried
unanimously 15-0.
b. Office of the Medical Director Re-Organization
Continued
5. New Business (Continued)
b. Establishment of a schedule for 2014 meetings
Staff submitted the document "Collier County Public Safety Authority Schedule of Meetings for
2014"for consideration.
Chief Kopka moved to approve the 2014 meeting Schedule as proposed Second by Mr. Gibson.
Carried unanimously 15—0.
6. Staff Reports
a. Board Direction regarding Advisory Committees -Len Price
Ms. Price requested the Authority review the powers and duties of the Public Safety Authority and
provide input to Staff/BCC on if the Advisory Board as currently exists, is structured and
functioning adequately. The request is based on concerns raised on voting vs. non voting members,
potential Sunshine Law violations of County Staff, etc. The review should include any
recommended changes to the Ordinance.
b. Ordinance Changes—Scott Teach
Mr. Teach reported:
• He is preparing amendments to the Ordinance governing the PSA for consideration by the
Board of County Commissioners.
• The amendments include expanding the powers and duties to include Community Outreach
and Education.
• Other issues to be addressed include if a representative of an Agency should be a liaisons as
opposed to a voting member, correcting scrivener's errors (i.e. number of members required
to constitute a quorum), and removal of allowing "alternate members."
• Staff is also reviewing the requirements of the Sunshine law to address the concerns raised
by members on inadvertently creating a Sunshine Law violation.
He reported a "strike through"version of the amended Ordinance will be disseminated to the
Authority 14 days prior to the meeting where it will be considered
Dr. Everett left the meeting at 11:55am
c. Mass Medical Incident Initiative —Dan Summers
Mr. Summers presented the document"Medical Ambulance Bus"which outlined the County's
proposal to obtain a vehicle(s) designed to transport multiple patients during an emergency event.
He noted:
• The primary purpose is to provide a vehicle to transport multiple patients during mass
causality events, hazardous transportation incidents, mass transportation accidents, etc.
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November 13, 2013
• The vehicle(s) could also be utilized during public events, fire fighting, etc. as an aid station
for fire personnel and the public.
• It could also provide training and education of County Staff or other interested parties.
Authority discussion occurred noting it may be prudent to utilize smaller capacity vehicles vs. one
large capacity vehicle so the patients may be transported to different emergency providers during an
event. This observation is based on the smaller size hospitals in the region and their individual
limitations for provision of emergency room services should they receive a large influx of patients
at one time.
Mr. Dutcher left the meeting at 12:20pm
The Authority recommended Staff consider soliciting Stakeholder input on design of the
vehicle(s).
Ms. Vasey moved to find the PSA strongly supports acquisition of 1 or more medical ambulance
buses and recognizes the need to handle multiple patients incidents. Consideration be given to
obtaining multiple vehicles to ensure a single hospital is not overwhelmed by too many patients
and the PSA would be willing to assist in any medical aspect of the design of the vehicles if
requested by Staff. Second by Dr. Tober. Carried unanimous 13—0.
7. Public Comment
a. NNFD/EMS Council Update—Jorge Aguilera
None
Speakers
Mike Ramsey wants to ensure any monies obtained from raising funds for Outreach are
specifically directed to the purpose intended.
The Authority reported the concept is for the funds to be used in public education programs such as
fall prevention, drowning prevention, etc.
8. Board Member Discussion
None
9. Establish Next Meeting Date
a. January 29, 2014 @ 10:00 AM
There being no further business for the good of the County,the meeting was adjourned by
order of the chair at 12:25P.M.
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November 13, 2013
Collier County Public Safety Authority
Chairman, Reg A. Buxton
These minutes approved by the Board/Committee on
as presented or as amended
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Big Corkscrew Island Fire Control and Rescue District
Office of the Fire Chief
Rita M.Greenberg,CDM, MPA
September 6, 2013
Director Dan Summers
Collier County Bureau of Emergency Services
8075 Lely Cultural Pkwy
Naples, FL. 34113
RE: COPCN Application
Director Summers:
We would like to add the following information as consideration for the Big Corkscrew Island Fire
Control and Rescue District's COPCN Application.
In addition to the information provided in the application, it should be noted that it is the full intent of
the District, if given the opportunity,to work in conjunction with all interested parties in the provision of
emergency medical care.
In the selection of a Medical Director, it will be understood that the District's medical director, alongside
the District,will work in cooperation with the Public Safety Authority's Medical Director Subcommittee,
the Office of the Collier County Medical Director and Collier County EMS as it pertains to policy and
protocol for the consistent quality and provision of pre-hospital emergency medical care.
Your review and consideration of this request are greatly appreciated. We look forward to building this
harmonious relationship as we enhance the level of emergency medical care afforded to the residents
and visitors of the Big Corkscrew Island Fire Control and Rescue District.
Thank you, e.,2,A.4-e/�
Rita M.Greenberg, Fire Chief ((�J
Big Corkscrew Island
Cc: Board of Fire Commissioners
Captain Eric Watson
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