Agenda 06/26/2018 Item #11B06/26/2018
EXECUTIVE SUMMARY
Recommendation to adopt the agreed upon Interlocal Agreement between the County and the City
of Marco Island in the event of approval of the Marco Island Certificate of Public Convenience and
Necessity (COPCN) application or consider alternatives for providing a second ambulance to
Marco Island. (This is a companion to Agenda Item to 11.C)
OBJECTIVE: To provide operating parameters in the form of an Interlocal Agreement between the
County and the City of Marco Island in the event the COPCN application is approved or consider other
options for providing the City of Marco a second full time ambulance.
CONSIDERATIONS: On May 22, 2018, the Board directed County staff to work with the City of
Marco Island to develop an Interlocal Agreement outlining conditions for operations if Marco Island were
granted a COPCN. County and Marco Island staff jointly negotiated an Interlocal Agreement which
includes the following conditions:
1. Requires voter approval via a Marco Island referendum in August 2018.
2. The City will provide two (2) full time, 24hours/365 days ALS transport ambulances.
3. The County and the City agree to fully participate in closest unit dispatch.
4. The City agrees to follow transport protocols for the use of Medflight.
5. The City and County agree to manage zone coverage cooperatively.
6. The City will provide ambulance coverage to Goodland without additional charges to the County.
7. The City will provide one-year notice to Collier County in the event they desire to revert
ambulance services back to Collier County.
Additionally, County and Marco Island staff developed an Operational Plan that further outlines day -to-
day operations. This Operational Plan can be modified jointly by the Department Chiefs as needed.
The Emergency Medical Authority’s (EMA) Majority Report recommended specific conditions to be
placed in the Interlocal Agreement between the County and the City of Marco Island. Some of these
conditions were mutually agreed upon in the proposed Interlocal Agreement; however, the following
proposed conditions were struck by the City of Marco Island:
1. Marco Island utilizes an Assistant Medical Director supervised by the County Medical Director.
2. Marco Island will not request reimbursement of ad valorem taxes from Collier County.
In lieu of an Interlocal Agreement and COPCN approval, staff provided alternatives for a second full time
ambulance to the City of Marco Island. On February 20, 2018 the County Manager forwarded a list of
these alternatives to the City Manager that would provide more cost-effective options to residents of
Marco Island as opposed to the overhead cost of establishing a separate EMS component within the
County. Those alternatives are as follows:
Alternative #1: Reassign Current Staff/Eliminate Swap Program
This alternative would remove the “swap component” but provide a second full time ambulance dedicated
to Marco Island by re-allocating existing employees from fire apparatus and ambulance to a second
ambulance. This will allow County EMS to maintain control of EMS services and reduce the risk of
fragmentation, while providing a second transport ambulance and equipment with no added costs for the
re-allocation of resources. If this alternative was implemented, the City would be required within 24
months to pay the County for the cost of a new ambulance and associated equipment, currently estimated
at $280,000.
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Alternative #2: Hire an additional Paramedic/Maintain Swap Program
This alternative would maintain the “swap component” but provide a second full time ambulance
dedicated to Marco Island by re-allocating one Marco employee to the ambulance and hiring an additional
County EMS employee to staff the second ambulance. This will allow County EMS to maintain control of
EMS services and reduce the risk of fragmentation, while providing a second transport ambulance for
Marco Island. The cost to the City for this alternative is approximately $514, 761.82 for three (3) FTEs
and the cost of ambulance and equipment. As suggested above, an alternative would allow the City
initially to only pay for the costs of the fully burdened FTEs, deploying them temporarily on a reserve
County ambulance, and allow the City up to 24 months from program implementation to provide funding
for a new ambulance and equipment.
Alternative #3: Cost Share Additional Unit
Keep the seasonal unit on Marco Island year-round with Marco covering the additional cost. This would
require six (6) additional FTEs for the additional seven months at a cost of $273,888.78 plus equipment
for $17,500. Eventually that ambulance will have to be replaced at an approximate cost of $250,000 and a
cost could be negotiated at that time. This alternative will provide Marco with an additional full -time
ambulance while maintaining one consolidated EMS service.
As a separate policy consideration, the Board could decide to fund the full cost of Alternative #3.
FISCAL IMPACT: Granting the COPCN and approving the Interlocal Agreement will result in loss of
revenue from patients transported by Marco Island Fire District estimated at approximately $700,000 to
$1,000,000 annually.
If the County chooses to bear the cost of adding an additional ambulance and FTEs the cost estimate is
approximately $541,388.78.
GROWTH MANAGEMENT IMPACT: There are no Growth Management Impacts associated with
this Executive Summary.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is approved as to
form and legality, and requires majority vote for approval. -JAK
RECOMMENDATION: To consider other alternatives for adding ambulance services to Marco Island
or in the event the COPCN application is approved, to approve the Interlocal Agreement.
Prepared by: Tabatha Butcher, Chief, Collier County EMS
ATTACHMENT(S)
1. Marco Island Interlocal COCPN (w CAO revisions)v2 (DOCX)
2. Collier County EMS and Marco Fire Operational Plan 6-15-18 (DOCX)
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COLLIER COUNTY
Board of County Commissioners
Item Number: 11.B
Doc ID: 6030
Item Summary: Recommendation to adopt the agreed upon Interlocal Agreement between the
County and the City of Marco Island in the event of approval of the Marco Island Certificate of Public
Convenience and Necessity (COPCN) application or consider alternatives for providing a second
ambulance to Marco Island. (This is a companion to Agenda Item 11.C) (Tabatha Butcher, EMS Chief)
Meeting Date: 06/26/2018
Prepared by:
Title: Supervisor - Accounting – Emergency Medical Services
Name: Artie Bay
06/19/2018 5:24 PM
Submitted by:
Title: Division Director - EMS Operations – Emergency Medical Services
Name: Tabatha Butcher
06/19/2018 5:24 PM
Approved By:
Review:
Administrative Services Department Len Price Level 1 Division Reviewer Completed 06/19/2018 5:26 PM
Emergency Medical Services Len Price Additional Reviewer Skipped 06/19/2018 5:34 PM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 06/19/2018 5:38 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 06/20/2018 7:08 AM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 06/20/2018 8:20 AM
Office of Management and Budget MaryJo Brock Additional Reviewer Skipped 06/20/2018 9:19 AM
County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 06/20/2018 9:26 AM
Board of County Commissioners MaryJo Brock Meeting Pending 06/26/2018 9:00 AM
11.B
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INTERLOCAL AGREEMENT BY AND BETWEEN
COLLIER COUNTY AND THE CITY OF MARCO ISLAND
FOR EMERGENCY MEDICAL SERVICES
THIS INTERLOCAL AGREEMENT, hereinafter "Agreement," is made and entered into
this _______________, 2018, by and between COLLIER COUNTY, a political subdivision of the
State of Florida, 3299 Tamiami Trail East, Naples, Florida 34112, herein referred to as “the
County,” and CITY OF MARCO ISLAND, a political subdivision of the State of Florida, 1280
San Marco Road, Marco Island, Florida 34145, herein referred to as “the City.”
WITNESSETH:
WHEREAS, this Interlocal Agreement shall be contingent upon approval by a majority of
those qualified electors residing within the City of Marco Island of a referendum supporting the
issuance of a Certificate of Public Convenience and Necessity (“COPCN”) and the associated
funding to be held on August 28, 2018; and
WHEREAS, this Interlocal Agreement supersedes the Advanced Life Support Partnership
Agreement between the County and the City dated May 22, 2007; and
WHEREAS, the parties are state licensed Emergency Medical Services (EMS) providers
and believe it is mutually advantageous and in the interest of the public health, safety and welfare
of its citizens to enter into a mutual/automatic aid agreement in instances where medical
emergencies occur, and additional equipment and/or manpower is needed to bring the emergency
under control or to aid in the rescue of persons; and
WHEREAS, this mutual aid/automatic aid shall include Advanced Life Support (ALS)
ambulances essential for the response to 911 emergencies and emergency inter-facility transports
of critically ill or injured victims or persons; and
WHEREAS, this mutual aid shall include ALS helicopter service for the transport of
critically ill or injured victims or persons if available; and
WHEREAS, the County agrees to provide County ALS ambulance services as needed, and
in compliance with this Agreement, and the City agrees to provide Fire Rescue ALS ambulance
services as needed, and in compliance with this Agreement; and
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WHEREAS, Chapter 163, Florida Statutes, permits governmental units, to enter into
Interlocal Agreements to make the most efficient use of their powers by enabling them to cooperate
with one another on a basis of mutual advantage; and
WHEREAS, the parties desire to enter into an Interlocal Agreement to define their
respective responsibilities and liabilities in the event of a request for mutual/automatic aid from
one of the parties hereto.
NOW THEREFORE, in consideration of the mutual terms, conditions and promises
hereafter set forth, the parties agree as follows:
1. The City shall provide ambulance service to Goodland without any additional
charges to Collier County.
2. The City shall follow Collier County EMS Transport protocols when requesting
helicopter mutual aid to respond to Marco Island.
3. The City will provide interfacility transport from Marco Island Urgent Care Center
and Physician’s Regional Clinic or like facilities within Marco Island boundaries.
4. The City shall provide one-year notice to Collier County in the event they desire to
revert ambulance services to Collier County.
5. The City will provide a minimum of two (2) full time, 24 hours/365 days ALS
transport ambulances with an additional squad/surge ambulance.
6. The City will employ its own Medical Director who shall work cooperatively with
the County Medical Director.
7. The City and County agree to manage zone coverage cooperatively.
8. The City and the County will fully participate in Closest Unit Dispatch protocols
consistent with the entire County response plan.
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9. The City and the County will report statistical data to the Collier County Emergency
Medical Authority Advisory Board.
10. The City and the County will immediately notify the Infectious Control Officer of
the other agency if they become aware of an exposure or potential exposure by an employee of the
other agency to an infectious disease, so they may take appropriate action.
12. County and City representatives agree to establish mutually acceptable guidelines
to conduct quality improvement review of clinical and operational procedures on calls where both
agency personnel interact and further agree to share training procedure s for their respective
employees to assure dispatching procedures are followed and to provide for the safety of any
employees working at or around the helicopter(s). Collier County and the City of Marco Island
agree to use only trained personnel as landing zone controllers or when operating in or around the
helicopter or landing zone.
13. An ALS Operations Plan will be developed, which further outlines operational
procedures and may be revised by mutual covenant between the Chief of Collier County EMS and
the Chief of Marco Island Fire Rescue. Such revisions must not conflict with the terms and
standards set forth in this Agreement.
Mutual/Automatic Aid Requests
14. If a medical emergency occurs or exists within the territorial boundaries of Collier
County or the City of Marco Island and a party to this Agreement requests additional equipment
and/or manpower to be provided by the other party to this Agreement in order to bring the medical
emergency under control, or to aid in the treatment or rescue of any person, the following
provisions shall apply.
a. The Chief of Marco Island Fire Rescue and the Chief of Collier County
Fire/EMS, or their designees, shall determine among themselves the operational procedures to be
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employed by their respective agencies in the implementation of a mutual/automatic aid response
and shall instruct the Emergency 911 Dispatch Operators on the operational procedures for the
routing of mutual/automatic aid responses to the requesting party.
b. All requests for Mutual Aid pursuant to this Agreement shall include a
statement of the amount and type of equipment needed and/or the number of personnel needed and
shall specify the location and type of condition or situation to which the equipment and personnel
shall be dispatched. The decision as to the amount and type of equipment and the number of
personnel actually sent shall rest in the sole discretion of the responding agency.
c. Each party shall, if possible, respond to a request for mutual/automatic aid
with the appropriate manpower and equipment, regardless of whether the site of the medical
emergency lies outside the territorial borders of that party's jurisdiction, subject to weather
conditions, mission commitment, crew availability and maintenance requirements.
d. The County shall notify the City of Marco Island thru the CAD anytime the
ALS helicopter is expected to be out of service.
15. In addition to the above, the following provisions shall apply to mutual/automatic
aid requests:
a. The terms "requesting party" or "requesting agency" as used in this
Agreement shall mean the party requesting mutual/automatic aid in accordance with the terms of
this Agreement, or the party within whose jurisdiction a medical emergency occurs. The terms
"responding party" or "responding agency" shall mean the party or agency responding to a request
for mutual/automatic aid located in the other party's jurisdiction in accordance with the terms of
this Agreement.
b. The responding agency shall report to the person from the requesting
agency, if any, who is in charge at the location to which the equipment and/or personnel are
dispatched. Personnel of the responding agency shall obey any lawful order given by the person
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from the requesting agency that is in charge. The personnel and/or equipment of the responding
agency shall be released by the requesting agency when the services of the responding agency are
no longer required or when the personnel and/or equipment of the responding agency is needed in
its own jurisdiction.
c. If the responding agency is unable to provide mutual/automatic aid to the
requesting agency due to an emergency or other extenuating circumstance, then it shall not be
deemed to be a violation of this Agreement. The determination of what constitutes an emergency
or extenuating circumstance shall be determined solely by the Chief of the responding agency or
his/her designee. If the responding agency is unable to render mutual/automatic aid, it shall
promptly notify the requesting agency that it will be unable to aid in or respond to the requesting
agency's emergency.
d. A responding agency under this Agreement shall bear the cost of any loss
or damage to its own equipment and shall be solely responsible for any expenses incurred in the
operation and maintenance of its equipment. The terms of this paragraph shall not be construed to
prevent a responding agency from recovering those costs permissible under the law from any third
party.
Legal Matters
16. Dispute Resolution. Before the commencement of any proceedings, in the event
that the Parties disagree regarding the interpretation of this Agreement, or the fulfillment of
obligations required hereunder, either Party must first request an appeal in which the issues will
be discussed by the City Manager and the County Manager. Should the dispute not be resolved,
the Chair of each of the governing parties shall meet in an effort to resolve the dispute. Should the
dispute still not be resolved, the parties may then pursue their legal remedies.
17. Governing Law. This Agreement shall be governed by, and construed in
accordance with, the laws of the State of Florida, and may be signed in counterpart.
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18. Except as otherwise provided herein, this Agreement shall only be amended by
mutual written consent of the parties hereto or by their successors in interest. All notices and other
communications required or permitted hereunder shall be in writing and shall be sent by Certified
Mail, return receipt requested, or by a nationally recognized overnight delivery service, and addressed
as follows:
If to Collier County: County Manager
3299 Tamiami Trail E
Naples, Fl 34112
With a copy to:
EMS Chief
Emergency Medical Services
8075 Lely Cultural Pkwy Ste 267
Naples, Fl 34113
City of Marco Island: City Manager
50 Bald Eagle
Marco Island, Fl 34145
With a copy to: City of Marco Island Fire Rescue Chief
50 Bald Eagle Dr.
Marco Island, Fl. 34145
19. This Agreement constitutes the entire agreement between the parties with respect
to the activities noted herein and supersedes and takes the place of any and all previous agreements
entered into between the parties hereto relating to the transactions contemplated herein. All prior
representations, undertakings, and agreements by or between the parties hereto with respect to the
subject matter of this Agreement are merged into, and expressed in, this Agreement, and any and
all prior representations, undertakings, and agreements by and between such parties with respect
thereto hereby are canceled. Nothing contained herein shall be deemed or construed to create
between or among any of the parties any joint venture or partnership nor otherwise grant to one
another the right, authority or power to bind any other party hereto to any agreement whatsoever.
20. Collier County and the City of Marco Island each agree to be fully responsible for
their own respective negligent acts or omissions, and agree to be liable to the statutory limits for
any damages proximately caused by said acts or omissions. Nothing contained in this section shall
be construed to be a waiver by either Collier County or the City of Marco Island of any protections
under sovereign immunity, Section 768.28, Florida Statutes, or any other similar provision of law.
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Nothing contained herein shall be construed to be a consent by either Collier County or City of
Marco Island to be sued by third parties in any matter arising out of this or any other agreement.
21. In the event any provision of this Agreement shall be held invalid and
unenforceable, the remaining provisions shall be valid and binding upon the parties. One or more
waivers by either party of any breach of any provision, term, condition or covenant shall not be
construed as a waiver of a subsequent breach by the other party.
22. This Agreement shall begin as of the effective date of the Certificate of Public
Convenience and Necessity issued by the County to the City, and is predicated on the City
maintaining the Certificate in good standing.
23. Each party (1) shall maintain insurance in the minimum amounts and types required
by Florida State Statutes; (2) shall be solely responsible for the compensation of its own employees
at all times during this Agreement, including any amounts paid or due for compensation for
personal injury or death which occurs while said employees are rendering ai d pursuant to this
Agreement, and (3) will charge the patient serviced by said agency directly for any treatment or
transport provided to the patient under the terms of this Agreement.
24. Neither party nor its employees shall have claim against the other party arising from
any aid provided or prolonged response times pursuant to this Agreement.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
SIGNATURE PAGE TO FOLLOW
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IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed
by their appropriate officials, as of the date first above written.
ATTEST BOARD OF COUNTY COMMISSIONERS
LAIRD A. LILE, CLERK AD INTERIM COLLIER COUNTY, FLORIDA
______________________________ By: ________________________________
, Deputy Clerk ANDY SOLIS, CHAIRMAN
Approved as to form and legality:
_______________________________
Jeffrey A. Klatzkow, County Attorney
ATTEST: CITY OF MARCO ISLAND, FLORIDA
______________________________ By: ________________________________
Laura M. Litzan, City Clerk JARED GRIFONI, CHAIRMAN
Approved as to form and legal sufficiency:
___________________________
Alan L. Gabriel, City Attorney
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COLLIER COUNTY EMERGENCY MEDICAL SERVICES AND CITY OF MARCO
ISLAND OPERATIONAL PLAN
REFERENCE: INTERLOCAL AGREEMENT, _______________________, 2018
This operational plan is established to provide operational efficiencies while maintaining coverage
in each parties’ respective boundaries.
OPERATIONAL PROCEDURES
a. The County Battalion Chief 80 and City Battalion Chief 50 will consult openly to
assure continuity and efficiency.
b. It is recognized by the County and the City that harmonious and productive
relationships between all personnel are necessary. Teamwork and cooperation is
encouraged and expected.
c. County and City staff will assure all personnel operate in accordance with Computer
Aided Dispatch (CAD) and the CCFCA Communications Manual.
d. The County and City will be responsible for responding to calls for service in
their respective boundaries except for units that are recommended as closest unit
dispatch. Any deviations from this practice will be decided between Battalion
Chiefs.
e. The City will provide a minimum of two (2) full time, 24hours/365 days ALS
transport ambulances with an additional squad/surge ambulance.
f. The City and the County agree to manage zone coverage cooperatively. The
County Battalion Chief will work directly with the City’s Battalion Chief to
ensure adequate zone coverage for the City and the County.
g. The City will be responsible for the purchase and maintenance of ambulances,
medications and equipment. The County will not be responsible for providing
back-up equipment or medications, unless mutually agreed upon and beneficial
for both agencies.
h. The City will be responsible for all staffing of Marco Island ambulances. The City
and County will be responsible staffing their respective agencies.
i. The City will appoint a member to participate in the County Quality Assurance
Committee.
j. Patient care concerns reported by either agency shall be made in writing to e ach
agency whenever possible and including pertinent specific details.
k. The City will follow County transport protocols regarding the use of the helicopter.
Collier County helicopter will be utilized for transport of critically injured
patients.
11.B.2
Packet Pg. 135 Attachment: Collier County EMS and Marco Fire Operational Plan 6-15-18 (6030 : Marco Island Interlocal COPCN)