Agenda 09/24/2013 Item #11E 9/24/2013 11.E.
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.
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 Chairwoman to execute the COPCN and
permit.
CONSIDERATIONS: Big Corkscrew submitted an application to operate a non-transport
Advance Life Support service within its district boundaries. Staff supports the application based
solely on the rural nature of the Big Corkscrew, albeit a small number of past Collier County
EMS responses are outside the desired rural area typical response time guidance. The 2007
studies reported in the application are not a true indicator of the current response times by Collier
County EMS. Fractal response times (which is a detailed report of a percent of times an
emergency vehicle is on scene in a specific time period) are used for EMS response times not
averages as submitted in Big Corkscrew's application. Therefore, the response times are not a
like comparison. The EMS section of the Annual Update Inventory Report (AUIR) travel time
goal for the rural area 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. County EMS staff will continue to seek opportunities and resources to improve
the County's response times in Big Corkscrew.
Staff would like to clarify to the Board two concerns, which are not prohibitive to this COPCN
granting. First, while timely first responder Basic Life Support services are most effective in the
chain of events toward escalated patient care, County staff endorses the delivery of those first-
responder non-transport services with utility type vehicles from the fire service whenever
possible as opposed to Class A fire apparatus for general residential medical call types. The
County receives frequent consumer inquiries and complaints as to why large fire apparatus
arrives at the scene of non life-threatening residential medical calls. It is County staff's
preference that Fire Districts consider providing services referenced above in the future with
smaller vehicles for improved cost-efficiency and emergency response risk-reduction to other
motorist.
Second, 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 Public Safety Authority'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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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.
If this item is approved by the Board, the COPCN and Permit will allow operations to commence
on January 15, 2014 and expire on December 31, 2014. 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.
FISCAL 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.
GROWTH MANAGEMENT IMPACT: 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.
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(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 provided for in Section 7 above, the Board may, in its sole
discretion, appoint a Hearing Officer to hold a public hearing and to make factual findings and
conclusions as a result of the hearing. Should a Hearing Officer be appointed, said Hearing
Officer shall render a written report to the Board within 30 days of the 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. 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
Chairwoman 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
Attachments: Big Corkscrew Letter
Big Corkscrew COPCN Application—Attachment A
Corkscrew COPCN
Corkscrew Permit
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COLLIER COUNTY
Board of County Commissioners
Item Number: 11.11.E.
Item 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. (Dan
Summers, Administrative Services Bureau of Emergency Services Director)
Meeting Date: 9/24/2013
Prepared By
Name: BoniChristine
Title:Administrative Assistant, Senior,
9/6/2013 12:32:45 PM
Submitted by
Title: Administrative Assistant, Senior,
Name: BoniChristine
9/6/2013 12:32:46 PM
Approved By
Name: SummersDan
Title: Director-Bureau of Emergency Services,
Date: 9/6/2013 2:14:39 PM
Name: pochopinpat
Title:Administrative Assistant,Facilities Management
Date: 9/9/2013 9:29:01 AM
Name: BelpedioJennifer
Title: Assistant County Attorney,County Attorney
Date: 9/10/2013 9:59:25 AM
Name: PriceLen
Title:Administrator, Administrative Services
Date: 9/13/2013 9:36:31 AM
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Name: BelpedioJennifer
Title:Assistant County Attorney,County Attorney
Date: 9/16/2013 9:46:00 AM
Name: KlatzkowJeff
Title: County Attorney
Date: 9/16/2013 10:44:54 AM
Name: IsacksonMark
Title: Director-Corp Financial and Mgmt Svs,CMO
Date: 9/16/2013 11:55:48 AM
Name: OchsLeo
Title: County Manager
Date: 9/17/2013 3:11:14 PM
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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,
Rita M.Greenberg, Fire Chief
Big Corkscrew Island
Cc: Board of Fire Commissioners
Captain Eric Watson
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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:
Name: Ramon Eliseo Chao Me, J f.TtA V-2 tom;r'e C
Address: 13250 lmmokalee Road s's e d
Naples, FL.34120
Age: S LA-IN‘tx.ke �s
Name: Christopher L.Crossan
Address: 13250 Immokalee Road
Naples, FL. 34120
Age: Opt
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 4,5,6,7,8,9,16,17,18,19,20,21,25,26,27,28,29,30,31,32,33,34,35 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#1S9A18LD961003100
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 Immokalee Road
Naples, FL.34120
Big Corkscrew Island Fire Control and Rescue District(Station 10)
13240 Immokalee Road
Naples, FL.34120
Big Corkscrew Island Fire Control and Rescue District(Station 11/Maintenance Facility)
18665 Immokalee Road
Naples, FL.34120
Big Corkscrew Island Fire Control and Rescue District(Station 12)
21520 Immokalee 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
2631 4th 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-J 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 tower 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.
9
Packet Page-475-
9/24/2013 1 1 .E.
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Packet Page-476-
9/24/2013 11.E.
COLLIER COUNTY FLORIDA Areft
BIG CORKSCREW ISLAND FIRE CONTROL AND RESCUE DISTRICT
This Permit is effective January 15, 2014 and
expires December 31, 2014
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 Application 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 24th day of September, 2013
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA
, Deputy Clerk Georgia A. Hiller,Esq., Chairwoman
Approved as to form and legality:
Jennifer A. Belpedio, Assistant County Attorney C
■.S1
Packet Page -477-
9/24/2013 11 .E.
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) -V1N# 1 S9A1 BLD961003100
Sutphen 52 {primary ALS engine B) -VIN# 1S9A1BLD261003097
Sutphen CC {reserve ALS engine) -VIN#1 FVABZBS33HK63552
Packet Page-478-