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Agenda 10/11/2011 Item #17E10/11/2011 Item W.E. EXECUTIVE SUMMARY Recommendation to adopt an amendment to Ordinance No. 04-12, as amended, relating to ambulance and advanced life support services, for the purpose of clarifying/updating certain provisions and adding a new classification of Certificate of Public Convenience and Necessity (COPCN) that allows non - transport Advanced Life Support services. OBSECEM: That the Board of County Commissioners (Board) adopts an ordinance amending Ordinance No. 0442, as amended, in order to clarify and update certain provisions and add a new classification of COPCN that allows non- transport Advanced Life Support services. CONSIDERATIONS: As a prerequisite to state licensure for basic life support or advanced life support (ALS) service Section 401.25, Florida Statutes requires an applicant to show that it has obtained a COPCN from the county in which it will operate. On February 24, 2004, the Board adopted Ordinance No. 04 -12, establishing a procedure to obtain a COPCN and regulating those entities issued COPCN. Presently there are two COPCN classifications: (1) Collier County EMS (ALS tran1port and non- transport) and (2) Collier County Hospitals (Interfacility ALS transport). On January 25, 2011, the Board issued North Naples Fire Control and Rescue District (District) a COPCN so that it may provide ALS non- transport within the District's service area. Revision is now necessary to include a Class 3 COCPN that contemplates ALS non- transport and generally incorporates ALS non- transport into the Ordinance. Revisions to clarify /update the Ordinance are also proposed. Proposed revisions include: I • Addition of a Class 3 Classification for ALS non- transport. (Class 3 operators will have the option of contracting with the County for use of its Medical Director or using its own medical director.) See Pages 7 -8 of the proposed amendment. • _ If a Class 3 operator has entered into a contract with the County for use of its Medical Director its paramedics are required to be certified by the County's Medical Director and comply with Medical Director's ride time requirement. Otherwise, its own medical director will perform the certification and ride time is limited to when a Class 3 operator initiates ALS Services on the patient in order to ensure continuum of care. See Pages 9 -10 of the proposed amendment. • Joint agreement by the medical director of each operator and compliance with Florida law on the type of medical and emergency equipment on the vehicles. See Page ' 9 of the proposed amendment. • References to Chapter 401, Florida Statutes and Florida Administrative Code, where appropriate. • Revisions for clarification and internal consistency. The proposed amendment was approved by the Emergency Medical Services Policy Advisory Board on August 19, 2011. At that meeting the District had no objection. At its September 27, 2011 regular meeting, the Board of County Commissioners authorized the advertisement of the proposed ordinance for future consideration. Packet Page -1399- 10/11/2011 Item 17.E. FISCAL IMPACT: Advertising costs are approximately $270.00. GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote. - JBW RECOMMENDATION: That the Board of County Commissioners adopts the attached ordinance amending Ordinance No. 04 -12, as amended, for the purpose of clarifying/updating certain provisions and adding a new classification of Certificate of Public Convenience and Necessity that allows non - transport Advanced Life Support services. Prepared by: Artie R. Bay, Administrative Supervisor, Emergency Medical Services Jennifer B. White, Assistant County Attorney Attachments: Proposed Ordinance Ordinance No. 04 -12 Ordinance No. 05 -16 I I - EMS - 00284/15 Packet Page -1400- 10/11/2011 Item 17.E. ORDINANCE NO. 2011 - AN ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AMENDING ORDINANCE 04 -12, AS AMENDED, BY AMENDING, SECTION TWO, DEFINITIONS; SECTION FOUR, EXEMPTIONS AND EXCLUSIONS FROM CERTIFICATE REQUIREMENT; SECTION FIVE, PROCEDURE FOR OBTAINING CERTIFICATE; SECTION SEVEN, REQUIREMENT FOR BOARD APPROVAL IN GRANTING CERTIFICATE; SECTION NINE, RIGHTS AND DUTIES GRANTED BY CERTIFICATE; SECTION ELEVEN, EMERGENCY PROVISIONS; SECTION TWELVE, CLASSIFICATIONS OF CERTIFICATES; SECTION FIFTEEN, GENERAL OPERATING REGULATIONS; SECTION TWENTY, CONDUCT OF DRIVERS AND ATTENDANTS; SECTION TWENTY -ONE: PASSENGERS; SECTION TWENTY -TWO, OBEDIENCE TO TRAFFIC LAWS, ORDINANCES AND REGULATIONS; PROVIDING FOR CONFLICT AND SEVERABILITY; PROVIDING FOR INCLUSION IN THE CODE OF LAWS AND ORDINANCES; AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, Collier County Ordinance No. 2004 -12, as amended, is codified as Article n III of Chapter 50 of the Code of Laws and Ordinances of Collier County, and originally enacted through its predecessor Ordinance No. 81 -75; and WHEREAS, Collier County desires to make available to its citizens safe, professional emergency health care transportation and non - transportation services for emergency pre - hospital responses and the transfer of patients between and among local hospital facilities; and WHEREAS, Collier County desires to facilitate the provision of such services and has the necessary equipment, training, expertise, professional certifications and licenses to do so; and WHEREAS, this amendment creates a Class 3 Non - Transport ALS certificate classification that will result in a benefit to Collier County by reducing response times for certain transports and providing for the availability of more transport vehicles. NOW THEREFORE: BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA: n Words underlined added and words swaek thfeugh are deleted. Packet Page -1401- 10/11/2011 Item 17.E. SECTION ONE: Amendments to Section Two of Ordinance No. 04 -12, as amended. Section Two of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION TWO: DEFINITIONS. A. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida Administrative Code,-- Seetiei and the Collier County Medical Director's protocol. B. Administrator shall mean the County Manager or his designee. C. Ambulance means any privately or publicly owned land, air, or water vehicle that is designed, constructed, reconstructed, maintained, equipped or operated, and is used for or intended to be used for air, land, or water transportation of persons, who are sick, injured, or otherwise helpless. D. Board shall mean the Collier County Board of County Commissioners. E. Certificate means a certificate of p3Lblic convenience and necessity as authorized in Section 401.25 (2)(d), Florida Statutes. F. Emergency Call shall mean the transit of an ambulance under conditions which warrants travel with flashing lights and siren operating. G. Operator shall mean any person, organization or governmental entity providing ambulance or ALS services. H. Patient shall mean an individual who is ill, sick, injured, wounded, or otherwise incapacitated or helpless. I. Routine Call or Routine Transfer shall mean the transportation of a patient under non - emergency call conditions. Rescue Service on -ALS shall mean first response treatment of patients but does not include Advanced Life Support (ALS) or transport. SECTION TWO: Amendments to Section Four of Ordinance No. 04 -12, as amended. Section Four of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION FOUR: EXEMPTIONS AND EXCLUSIONS FROM CERTIFICATE REQUIREMENT. Certificates shall not be required for: Words underlined added and words stmek thfeugh are deleted. Packet Page -1402- 10/11/2011 Item 17.E. A. Rescue Services (Non -ALS). B. The use of a non - ambulance for any transport of a patient pursuant to the Good Samaritan Act, Section 768.13, Florida Statutes. C. Vehicles rendering ambulance -type services when requested to do so by the Board of County Commissioners or County Manager in the event of a major catastrophe or other such emergency which requires more ambulances thant are available in the county. D. Ambulances based outside the county which pick up a patient in the county and transport him out of the county, or which pick up a patient out of the county and transport him into the county. E. Vehicles used to transport persons for routine scheduled medical treatments. Vehicles transporting persons who require services en route are not covered by this exemption. SECTION THREE: Amendments to Section Five of Ordinance No. 04 -12, as amended. Section Five of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION FIVE: PROCEDURE FOR OBTAINING CERTIFICATE. An applicant for a certificate shall b ,in forms f em the reWmed to `he Division provide the Administrator with the following information in order for a request for a certificate to be considered. Each applieotien re uest shall contain: A. The name, age, and address of the owner of the ambulance or ALS preside Operator, or if the owner is a corporation, then of the directors of the corporation and of all the stockholders holding more that 25% of the outstanding shares. For governmental units, this information shall be supplied for members of the governing body. SECTION FOUR: Amendments to Section Seven of Ordinance No. 04 -12, as amended. Section Seven of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION SEVEN: REQUIREMENT FOR BOARD APPROVAL IN GRANTING CERTIFICATE. Words underlined added and words - ..,agogh are deleted. Packet Page -1403- 10/11/2011 Item 17.E. The Board of County Commissioners shall not grant a certificate unless it shall find, after public hearing and based on competent evidence that each of the following standards has been satisfied: A. That there is a public necessity for the service. In making such determination, the Board of County Commission shall consider, as a minimum, the following factors: (1) The extent to which the proposed service is needed to improve the overall €mer-gene-y— Medieal -- Ser -vises 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. SECTION FIVE: Amendments to Section Nine of Ordinance No. 04 -12, as amended. Section Nine of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION NINE: RIGHTS AND DUTIES GRANTED BY CERTIFICATE. The certificate granted by the Board shall be valid for one calendar year and shall be personal to the applicant and not transferable. In the case of a corporation, if there occurs such a transfer of stock or other incidents of ownership as to change the majority or largest stockholder, a new certificate must be applied for. Changes in the officers of the corporation will not require a new certificate. Acceptance of the certificate by the applicant shall obligate the applicant to: A. Service the entire zone granted to the applicant. B. Provide coverage to adjoining zones, if available, when requested to do so by Emer -geney Gent m' emergency dispatch for emergency calls when the certificate holder for that zone is unable to respond. C. Keep posted at his place of business a copy of the fee schedule, which must be filed with the Administrator (If applicable). D. Operate in accordance with the rules and regulations adopted pursuant to this Ordinance and any applicable County Ordinances, and Chapter 401 Florida Statutes, and any administrative regulations adopted pursuant thereto. Words underlined added and words Am& through are deleted. Packet Page -1404- 10/11/2011 Item 17.E E. Employ at all times sufficient personnel experienced in operation and management of emergency medical services to ensure proper and efficient operation. SECTION SIX: Amendments to Section Eleven of Ordinance No. 04 -12, as amended. Section Eleven of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION ELEVEN: EMERGENCY PROVISIONS. The Board may modify, suspend or revoke a certificate in the interest of the public health, safety and welfare, only at public hearing and after reasonable notice has been given to the certificate holder affected. However, if a situation exists which poses a serious threat that wee- or- - r-eseue seFviee the Operator will not be available to any certain area of Collier County, the Administrator shall have such temporary emergency powers as are necessary to provide that service. These temporary powers are intended to provide interim protection until such time as the Board meets to resolve the emergency. SECTION SEVEN: Amendments to Section Twelve of Ordinance No. 04 -12, as amended. Section Twelve of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION TWELVE: CLASSIFICATIONS OF CERTIFICATES. There shall be three twe (3) (2) classifications of service in Collier County, as follows: A. Class 1: r„'� Geuf4y EMS ALS Transport: ALS Rescue: An EMS premier Operator with the capability of rendering on the scene prehospital ALS services with transport capability and who may or may not elect to transport patients based on medical necessity. An EMS pr-evide Operator rendering this level of service for a governmental entity shall be deemed to be operating under the Class 1 - ALS rescue certificate of public convenience and necessity held by the governmental entity. An EMS pe Operator holding a Class 1 — ALS rescue certificate may provide post - hospital interfacility medical transfer services and routine ALS and BLS calls within the County. A certificate of public convenience and necessity must be obtained from the County before engaging in this level of medical service. B. Class 2: Collier County Hospitals: 1. ALS Transfer: An EMS premier- Operator who renders ALS interfacility medical transfer services. An EMS previder Operator who is awarded a Class 2 — ALS transfer certificate and does not possess a Class 1 — ALS rescue certificate shall not respond to an emergency call and provide ALS rescue services unless called upon by the appropriate Class 1 — ALS rescue pfevide Operator to provide Words underlined added and words str-usk thfou are deleted. Packet Page -1405- 10/11/2011 Item 17. E. emergency backup service. In these instances, it shall be deemed to be operating under the Class I — ALS rescue certificate of the governmental entity requesting such emergency backup service. 2. Class 2 — ALS transfer certificate holders may provide post - hospital interfacility medical transfer services and routine ALS and BLS calls within the County but only to hospitals owned by the certificate holder, however, the Class 2 certificate holder may provide out -of- County transports. Unless an EMS provider possesses a Class I — ALS Rescue certificate issued by the County, a certificate of public convenience and necessity must be obtained from the County before engaging in this level of medical service. 3. Class -2 transfer certificate holders shall contract with the Class --1 r-eseue OeFtif ea4 w l ' Meth ' D the County for the e performance of services set forth in Florida Statutes, Section 401.265 and Chapter 64J-1.004(4)(a), Florida Administrative Code. and as speeifieally set fefth herein as fellows - Words underlined added and words 4riwk4hresgh are deleted. Packet Page -1406- MI Words underlined added and words 4riwk4hresgh are deleted. Packet Page -1406- 10/11/2011 Item 17.E. C. Class 3: ALS Non - Transport: 1. ALS Non - Transport: An EMS Operator who renders Advanced Life Support pre - hospital services without transport capability_ 2. Class 3 certificate holders work in concert with applicable Class 1 providers to assure adequate and timely_ response to prehospital incidents with the intent to either reduce applicable response times or otherwise augment the level of services as requested by the associated Class 1 Operator. Unless an EMS Operator possesses a Class 1 — ALS Rescue certificate issued by the County, a certificate of public convenience and necessitv must be obtained from the Countv before encasing in this level of medical service. 3. Class -3 certificate holders shall contract with the County for a negotiated amount per year for administrative services offered by he Office of the Medical Director for the creation and update of medical protocol; and other eg neral support as requested by the Class -3 certificate holder. The Office of the Medical Director shall not be considered the medical director for a Class -3 Operator for purposes of this Ordinance or Florida Statutes unless the Class -3 Operator separately contracts with the County in order for the Words underlined added and words struelt threugh are deleted. Packet Page -1407- X MET IFNI C. Class 3: ALS Non - Transport: 1. ALS Non - Transport: An EMS Operator who renders Advanced Life Support pre - hospital services without transport capability_ 2. Class 3 certificate holders work in concert with applicable Class 1 providers to assure adequate and timely_ response to prehospital incidents with the intent to either reduce applicable response times or otherwise augment the level of services as requested by the associated Class 1 Operator. Unless an EMS Operator possesses a Class 1 — ALS Rescue certificate issued by the County, a certificate of public convenience and necessitv must be obtained from the Countv before encasing in this level of medical service. 3. Class -3 certificate holders shall contract with the County for a negotiated amount per year for administrative services offered by he Office of the Medical Director for the creation and update of medical protocol; and other eg neral support as requested by the Class -3 certificate holder. The Office of the Medical Director shall not be considered the medical director for a Class -3 Operator for purposes of this Ordinance or Florida Statutes unless the Class -3 Operator separately contracts with the County in order for the Words underlined added and words struelt threugh are deleted. Packet Page -1407- 10/11/2011 Item 17.E. County's Medical Director to serve as its medical director for the performance of services set forth in Section 401.265 Florida Statutes and Chapter 64J -2.004 4 a Florida Administrative Code. 4. The medical director for the Class -3 certificate holder shall work cooperatively with the County's Office of the Medical Director to ensure continuity of care. The medical director for the Class -3 certificate holder shall not dele ate or relinquish any responsibilities identified in Section 401.265. Florida Statutes and associated Florida Administrative Code rules. SECTION EIGHT: Amendments to Section Fifteen of Ordinance No. 04 -12, as amended. Section Fifteen of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION FIFTEEN: GENERAL OPERATING REGULATIONS. All certificate holders, operators, and drivers shall comply with all state statutes and administrative regulations as following regulations: A. Twenty -four Hour Service. Every certificate holder shall be required to operate sufficient ambulances, or relevant apparatus, as stated on the eertifieute of eperr -ation vehicle permit issued by the State Department of Health Bureau of Emergency Medical Services and det°fmin °d by the Be-a -a permit issued by the Board, on immediate call at all times. B. Prompt Service Required. Every call for ambulanee service shall be answered promptly. Patients shall be appropriately assessed, treated packaged, loaded and transported by an Operator that is licensed to transport without being subject to unreasonable delays. All calls for emergency assistance requiring over twenty (20) minutes from time of notification to arrival on scene shall be reported to the Administrator with complete documentation of the circumstances, which delayed the response. Those instances where more than three (3) minutes elapse between receipt of an emergency call and dispatch of an emergency vehicle ambulanee shall also be reported to the Administrator with documentation of circumstances. C. Bed Linens. Every Operator transporting_ patients shall provide clean Clean and sanitary bed linens shall be- pr-e for each patient carried a-Rd which shall be changed as soon as practicable after the discharge of the patient. D. Daily Log. Every eOperator trans ortin patients shall maintain in a daily log upon which shall be recorded the place or origin, time of call, time of dispatch, time of arrival at scene, time left for hospital, time of arrival at hospital, and charges for each trip made and such other operating and patient information as may be required by Ordinance. Every eOperator shall retain and preserve all i-11. daily logs for at least two (2) years, and such logs shall be available for inspection by the Administrator. Words underlined added and words stmek thfou are deleted. Packet Page -1408- 10/11/2011 Item 17.E. E. Communications. Each alaRee emergency vehicle shall maintain two -way radio communication with the location of primary dispatch from which it operates, as well as any additional communication capabilities required by Ordinance or state law. F. Vehicles and Equipment. Each Operator's vehicles shall be equipped with the proper medical and emergency equipment as r-equired bye- iointly agreed to by the medical director of each licensed provider and the laws of the State of Florida the laws ef Fier-ida and this Or-dinanee. G. Certification. 6). In addition to the State of Florida Department of Health, Bureau of Emergency Medical Services requirements for certification, each Collier County EMS paramedic, Class -2 Operator's paramedic, and Class -3 Operator that has separately entered into a contract with the County in order for the County's- Medical Director to serve as its medical director for the performance of services set forth in Section 401.265. Florida Statutes, and Chanter 64J- 2.00,44(4)(a), Florida Administrative Code, must be certified by the County Medical Director. Each Collier County EMS paramedic and Class -2 Operator paramedic must work with a Collier County EMS ambulance for a sufficient length of time pursuant to paragraph H. for the Coun 's am;;elane Q Mmedical Ddirector to properly judge the paramedic's his capability. A the p edict must , err in that „ ,.:t. not less than ,,,,e full ., nt wer4i shift afmually. Salaries of other than Collier County EMS paramedics will be paid by the agency seeking the Medical Director Certification. (ii). The Medical Director of a Class -3 Operator or a Class -1 Operator, excluding Collier County EMS, shall certify its paramedics pursuant to Section 401.265, Florida Statutes, and Chapter 64J- 2.004(4)(a), Florida Administrative Code. (iii). A Class -3 Operator that has separately entered into a contract with the County in order for the County's Medical Director to serve as its medical director for the performance of services set forth in Section 401.265, Florida Statutes, and Chapter 64J- 2.004(4)(a), Florida Administrative Code, shall be certified pursuant to the terms of such contract. H. Ride Time Requirement. Each paramedic emploved by Collier Countv EMS. a Class -1 Operator or a Class -2 Operator must work, at a minimum, with a Class -1 Operator's ambulance not less than one full month's work shift annually. Each paramedic employed by a Class -3 Operator that has its own medical director must accompany a patient on the Collier County EMS ALS transport from scene to hospital when the paramedic for such Class -3 Operator initiates ALS services on a patient prior to Collier County EMS transport arrival or if the patient's condition requires that additional level of expertise. Each paramedic employed by a Class -3 Operator that has separately entered into a contract with the County in order for � the County's Medical Director to serve as its medical director for the performance Words underlined added and words trough are deleted. Packet Page -1409- 10/11/2011 Item 17.E. of services set forth in Section 401.265 Florida Statutes and Chanter 64J- 2.004(4)(a), Florida Administrative Code shall either work with a Collier County EMS ambulance not less than one full month's work shift annually or must accompany a patient on the Collier County EMS ALS transport from scene to hospital when the paramedic for such Class -3 Operator initiates ALS services on _a patient prior to a Collier County EMS transport arrival or if the patient's condition re uires that additional level of expertise, as provided for in its contract with the County. I. Application. Each ambulance or ALS service shall be subject to those rules and regulation as promulgated by Ordinances of the Board for the purpose of carrying out this ordinance. SECTION NINE: Amendments to Section Twenty of Ordinance No. 04 -12, as amended. Section Twenty of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION TWENTY: CONDUCT OF DRIVERS AND ATTENDANTS. All drivers, EMT's and paramedics shall comply with the laws of the State of Florida, in order to meet the requirements set out in this Ordinance and no driver, EMT or paramedic registered hereunder shall: I. Operate or ride in an vehicle aanee without using seatbelts. (Personnel attending patients are exempt). SECTION TEN: Amendments to Section Twenty-One of Ordinance No. 04 -12, as amended. Section Twenty -One of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION TWENTY -ONE: PASSENGERS. No person shall be aboard ambulances when engaged in emergency or - eutiae m°'� ^�' ea4s- routine calls except the following: A. Driver, attendants and fire or law enforcement personnel; B. Patients; C. Net e than ..e- relative or- -elese ffiend -ef the patient, er if the situmien Relatives or close friends of the patient when authorized by an EMS Battalion Words underlined added and words � ^ ,R�.;reugh are deleted. Packet Page -1410- 10/11/2011 Item 17.E. Chief or position of a higher rank. These requests will only be granted under exceptional circumstances: D. Physicians and nurses; E. Personnel in an observing capacity that are being trained for ambulance or ALS service: •,-or F. Operator's supervisory personnel. SECTION ELEVEN: Amendments to Section Twenty -Two of Ordinance No. 04 -12, as amended. Section Twenty-Two of Ordinance No. 04 -12, as amended, is hereby amended as follows: SECTION TWENTY -TWO: OBEDIENCE TO TRAFFIC LAWS, ORDINANCES OR REGULATIONS. A. Under the provisions of Florida State laws Tthe driver of an ambulance or ALS vehicle when responding to an emergency call or while transporting a patient may exercise the following privileges when such driver has reasonable grounds to believe that an emergency in fact exists requiring the exercise of such privileges: n SECTION TWELVE: Conflict and Severability. In the event this Ordinance should ever conflict with any other Ordinance of Collier County or other applicable law, the more restrictive shall apply. If any phrase or portion of this Ordinance is held invalid or unconstitutional by any court of competent jurisdiction, such portion shall be deemed a separate, distinct, and independent provisions and such holding shall not affect the validity of the remaining portions. SECTION THIRTEEN: Inclusion in the Code of Laws and Ordinances. The provisions of this Ordinance shall be made a part of the Code of Laws and Ordinances of Collier County, Florida. The sections of the Ordinance may be renumbered or re- Words underlined added and words sEmele through are deleted. Packet Page -1411- 10/11/2011 Item 17.E. n lettered and internal cross - references amended throughout to accomplish such, and the word "ordinance" may be changed to "section," "article," or any other appropriate word. SECTION FOURTEEN: Effective Date. This Ordinance shall be considered adopted upon the date written below and subject to filing with the Florida Department of State. PASSED AND DULY ADOPTED by a vote of majority of the Board of County Commissioners of Collier County, Florida, this day of , 2011. ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA LN , Deputy Clerk Approved as to form and legal sufficiency: % � . Jenne r B. White Assistant County Attorney FRED W. COYLE, CHAIRMAN Words underlined added and words stFuek;hteeg# are deleted. Packet Page -1412- 10/11/2011 Item 17.E. /,y3 -_ ♦ �s# ORDINANCE NO. 2004 - 12 ry L j AN ORDINANCE AMENDING ORDINANCE 81 -75:_ ADDING SECTION TWELVE ENTITLEEI.:y 4 CLASSIFICATIONS AND CERTIFICATES; PROVIDING F&Fr' INCLUSION IN CODE OF LAWS AND ORDINANCES; PROVIDING FOR CONFLICT AND SEVERABIL.ITY; AND �f�1ZZ"L� PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, Collier County desires to make available to its citizens safe, professional emergency health care transportation services for the transfer of patients between and among local hospital facilities; and WHEREAS, Collier County desires to facilitate the provision of such services and has the necessary equipment, training, expertise, professional certifications and licenses to do so; and WIIEREAS, the amendment to Ordinance Number 81- 75 results in a benefit to Collier County by reducing response times for certain transports and providing for the availability of more transport vehicles. NOW T14EREFORE: BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA: Section 1: Purpose This ordinance is adopted pursuant to Chapters 125 and 401, Florida Statutes. The purpose of this ordinance is to provide better protection for the health, safety and welfare of the residents of Collier County, in ambulance and ALS matters, by establishing uniform county -wide standards for certification of ambulance or advanced life support or services, or operations by promulgating complete and clear rules and regulations for operation of all ambulance or rescue companies or services in Collier County. Section 2: Definitions A. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida Administrative Code, Section 64E. B. Administrator shall mean the County Manager or his designee. C. Ambulance means any privately or publicly owned land, air, or water vehicle that is designed, constructed, reconstructed, maintained, equipped or operated, and is used for or intended to be used for air, land, or water transportation of persons, who are sick, injured, or otherwise helpless. D. Board shall mean the Collier County Board of County Commissioners. E. Certificate means a certificate of convenience and necessity as authorized in Section 401.25 (2)(d), Florida Statutes. Packet Page -1413- 10-1 10/11/2011 Item 17.E. F. Emergency Call shall mean the transit of an ambulance under conditions which warrants travel with flashing lights and siren operating. G. Operator shall mean any person, organization or governmental entity providing ambulance or ALS services. H. Patient shall mean an individual who is ill, sick, injured, wounded, or otherwise incapacitated or helpless. I. Routine Call or Routine Transfer shall mean the transportation of a patient under non - emergency call conditions. 1. Rescue Service shall mean first response treatment of patients but does not include Advanced Life Support (ALS) or transport. Section 3: Requirements For Certificate It shall be unlawful for any person, firm, agency, or any other entity, including governmental units, to provide an ambulance service or provide advanced life support without first obtaining a certificate therefore from the Board of County Commissioners of Collier County. ^` Section 4: Exemptions and Exclusions From Certificate Requirement Certificates shall not be required for: A. Rescue Services B. The use of a non - ambulance for any transport of a patient pursuant to the Good Samaritan Act, Section 768.13, Florida Statues. C. Vehicles rendering ambulance -type services when requested to do so by the Board of County Commissioners or County Manager in the event of a major catastrophe or other such emergency which requires more ambulances that are available in the county. D. Ambulances based outside the county which pick up a patient in the county and transport him out of the county, or which pick up a patient out of the county and transport him into the county. E. Vehicles used to transport persons for routine scheduled medical treatments. Vehicles transporting persons who require services en route or who must be carried on a stretcher are not covered by this exemption. Words underlined -AA-A ­4 •­ - - - -- Packet Page - 1414 - are deleted. 2 10/11/2011 Item 17.E. Section 5: Procedure For Obtaining Certificate 11-�, An applicant for a certificate shall obtain forms from the department to be completed and returned to the Division Administrator. Each application shall contain: A. The name, age, and address of the owner of the ambulance or ALS provider, or if the owner is a corporation, then of the directors of the corporation and of all the stockholders holding more that 25% of the outstanding shares. For governmental units, this information shall be supplied for members of the governing body. B. The boundaries of the territory desired to be served. C. The number and brief description of the ambulances or other vehicles the applicant will have available. D. The address of the intended headquarters and any sub- stations. E. The training and experience of the applicant. F. The names and addresses of three (3) Collier County residents who will act as references for the applicant. G. A schedule of rates which the service intends to charge. H. Such other pertinent information as the administrator may require. 1. An application or renewal fee of two hundred fifty dollars ($250.00). (Exception Collier county EMS J. Financial data including assets and liabilities of the operator. A schedule of all debts encumbering any equipment shall be included. Section 6: Review of Application The Administrator shall review each application and shall investigate the applicant's reputation, competence, financial responsibility, and any other relevant factors. The Administrator shall also make an investigation as to the public necessity for an ambulance or ALS operation in the territory requested, and shall then make a report to the Board containing his recommendation whether to grant a certificate to the applicant within sixty (60) days of the time the Administrator determines the application is complete. Section 7: Requirement For Board Approval In Granting Certificate The Board of County Commissioners shall not grant a certificate unless it shall find, after public hearing and based on competent evidence that each of the following standards has been r1 satisfied: Words underline' -AA-' - -- - ' - k t}r-sugh are deleted. 3 Packet Page -1415- 10/11/2011 Item 17.E. A. That there is a public necessity for the service. In making such determination, the Board Of County Commission shall consider, as a minimum, the following factors: (1) The extent to which the proposed service is needed to improve the overall Emergency Medical Services (EMS) capabilities of the County. (2) The effect of the proposed service on existing services with respect to quality of service and cost of service. (3) The effect of the proposed service on the overall cost of EMS service in the County. (4) The effect of the proposed service on existing hospitals and other health care facilities. (5) The effect of the proposed service on personnel of existing services and the availability of sufficient qualified personnel in the local area to adequately staff all existing services. B. That the applicant has sufficient knowledge and experience to properly operate the proposed service. C. That, if applicable, there is an adequate revenue base for the proposed service. D. That the proposed service will have sufficient personnel and equipment to adequately cover the proposed service area. Section 8: Appointment of Hearing Officer In making the determinations provided for in Section 7 above, the Board may, in its sole discretion, appoint a Hearing Officer to hold a public hearing and to make factual findings and conclusions as a result of the hearing. Should a Hearing Officer be appointed, said Hearing Officer shall render a written report to the Board within 30 days of the 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. Section 9: Rights and Duties Granted By Certificate The certificate granted by the Board shall be valid for one calendar year and shall be personal to the applicant and not transferable. In the case of a corporation, if there occurs such a transfer of stock or other incidents of ownership as to change the majority or largest stockholder, Words underline" -"4A1 —4 --4- –• -k4hfeugh are deleted. 4 Packet Page -1416- 10/11/2011 Item 17. E. a new certificate must be applied for. Changes in the officers of the corporation will not require a new certificate. Acceptance of the certificate by the applicant sliall obligate the applicant to: A. Service the entire zone granted to the applicant. B. Provide coverage to adjoining zones, when requested to do so by Emergency Control for emergency calls when the certificate holder for that zone is unable to respond. C. Keep posted at his place of business a copy of the fee schedule, which must be filed with the Administrator (if applicable). D. Operate in accordance with the rules and regulations adopted pursuant to this Ordinance and any applicable County Ordinances, and Chapter 401 Florida Statutes, and any administrative regulations adopted pursuant thereto. F. Employ at all times sufficient personnel experienced in operation and management of emergency medical services to ensure proper and efficient operation. Section 10: Renewal of Certificate Each certificate holder shall file within ninety (90) days of expiration, an application for renewal of his certificate. Renewals shall be based upon the same standards, as the granting of the original certificate along with such other factors as may be relevant. The renewal application shall be accompanied by a two hundred and fifty dollar ($250.00) renewal fee. The renewal certificate may be approved routinely by the Board, upon advice of the Administrator, or the Board may hold a hearing on same. Section 11: Emergency Provisions The Board may modify, suspend or revoke a certificate in the interest of the public health, safety and welfare, only at public hearing and after reasonable notice has been given to the certificate holder affected. However, if a situation exists which poses a serious threat that ambulance or rescue service will not be available to any certain area of Collier County, the Administrator shall have such temporary emergency powers as are necessary to provide that service. These temporary powers are intended to provide interim protection until such time as the Board meets to resolve the emergency. Section 12: Classifications of Certificates There shall be two (2) classifications of service in Collier County, as follows: A. Class l: Collier County EMS: Words underlines -4,4 -4 ­4 ,,.- -•- thfough are deleted. 5 Packet Page -1417- 10/11/2011 Item 17.E. ALS Rescue: An EMS provider with the capability of rendering on the scene prehospital ALS services and who may or may not elect to transport patients An EMS provider rendering this level of service fora governmental entity shall be deemed to be operating under the Class 1 - ALS rescue certificate of public convenience and necessity held by the governmental entity. An EMS provider holding a Class I — ALS rescue certificate may provide post hospital interfacility medical transfer services and routine ALS and BLS calls within the County. A certificate of public convenience and necessity must be obtained from the Countv before engaging in this level of medical service. B. Class 2: Collier County Hospitals: 1. ALS Transfer: An EMS provider who renders ALS interfacility medical transfer services. An EMS nrovider who is awarded a Class 2 ALS transfer certificate and does not possess a Class 1 — ALS rescue certificate shall not respond to an emergency call and provide ALS rescue services unless called upon by the appropriate Class 1 — ALS rescue provider to provide emereencv backun service In these instances it shall be deemed to be operating under the Class 1 — ALS rescue certificate of the governmental entity requesting such emereencv backup service 2. Class 2 — ALS transfer certificate holders may rovide ost -hos ital interfacility medical transfer services and routine ALS and BLS calls within the County but only to hospitals owned by the certificate holder, however, the Class 2 certificate holder may provide out -of- Countv transports Unless an EMS provider possesses a Class l — ALS Rescue certificate issued by the County, a certificate of public convenience and necessity must be obtained from the County before eneaeina in this Ievel of medical service 3. Class -2 transfer certificate holders shall contract witb the Class — l rescue certificate bolder's Medical Director for the Performance -of services set forth in Florida Statutes Section 401.265 and as specifically set forth herein as follows: Words underline" art,tPA any ,.� '4. .. -k-t h are deleted. Packet Page -1418- 10/11/2011 Item 17.E. a. He shall supervise and accept direct responsibility for the medical performance of the paramedics and Emergency Medical Technicians (hereinafter EMTsI h. He shall develop medically correct standing orders or protocols relating to life support system procedures when communication cannot be established with a supervising physician or when any delay in patient care would potentially threaten the life or health of the patient. C. He shall issue standing orders and Protocols to ensure that the Class -2 transfer certificate holder transports each of its Patients to facilities that offer a tvpe and level of care appropriate to the patient's medical condition. d. He or his aPpointee shall Provide continuous 24-hour-per-day, 7- day -per -week medical direction which shall include in addition to the development of protocols and standing orders direction to the Class -2 transfer certificate holder's personnel as to the availability of "off- line" service to resolve problems system conflicts and provide services in an emergency as that term is defined by section 252.34(3). Florida Statutes. e. He shall establish a quality assurance committee to provide for quality assurance review of all EMTs and Paramedics operating under his supervision. f. He shall audit the Performance of system Personnel by use of a quality assurance Program that includes but is not limited to a prompt review of patient care records direct observation and comparison of Performance standards for drugs equipment system Protocols and procedures He shall be responsible for Participating in quality assurance Programs developed by the Class -2 transfer certificate holder. g. He shall ensure and certifv that security procedures of the Class -2 transfer certificate holder for medications fluids and Words underlined added and wnrrie Hugh are deleted. Packet Page -1419- 10/11/2011 Item 17. E. controlled substances are in com liance with chapters 401 499 and 893 Florida Statutes and cha ter .l OD -45 of the Florida Administrative Code h. He shall create authorize and ensure adherence to detailed written operating procedures regarding all aspects of the handling of medications fluids and controlled substances by the EMS ersonnel and comply with all requirements of chanters 401 499 and 893 Florida Statutes. L He shall notify the Florida Department of Health (hereinafter the "De- partment ") in writing when the use of telemetry is not necessary. i. He shall notify the department in writing of each substitution of equipment or medication k. He shall assume direct responsibility for the use by an EMT of an automatic or semi- automatic defibrillator; the Derformance of esophageal intubation by an EMT; and on routine interfacility transports, the monitoring and maintenance of non medicated I V s by an EMT. He shall ensure that the EMT is trained to perform these Procedures: shall establish written Drotocols for the performance of these procedures, shall provide written evidence to the Florida Department of Health documenting compliance with the Provisions of this paragraph. 1. He shall ensure that all EMTs and Paramedics are trained in the use of the trauma scorecard methodologies as provided in sections 64E -2.017 of the F.A.C., for adult trauma patients and 64E-2.0175, F.A.C., for Pediatric trauma Patients M. He shall participate as a crewmember on an EMS vehicle for a minimum of 10 hours Per year and complete a minimum of 10 hours per vear of continuing medical education related to Pre hospital care or teaching or a combination of both Words underlines -AA-,J - -' - k flifeugh are deleted. Packet Page -1420- 10/11/2011 Item 17.E. n. He shall ensure that all of the Class -2 transfer certificate r� holder's EMTs and paramedics have all Proper certifications and receive all training necessary to maintain their certification Section 4-2 13: Transfer Or Assignment of Certificates No certificate issued under this Ordinance shall be assignable or transferable by the person to whom issued except- unless approval is obtained from the Board in the same manner and subject to the same application, investigation, fees and public hearing as original applications for certificates. Any majority transfer of shares or stock or interest of any person or operator so as to cause a change in the directors, officers, majority stockholders or managers of such person or operator shall be deemed a transfer or assignment as contemplated in this Ordinance and subject to the same rules and regulations as any other transfer or assignment. Section 43 14: Revocation, Alteration Or Suspension Grounds A. Every certificate issued under this Ordinance shall be subject to revocation, alteration and /or suspension of operation, buy the Board, for a period of up to one year, where it shall appear that: 111—\ 1. The operator has failed or neglected for a period of thirty (30) days during any calendar year to render all services authorized by his certificate. 2. The operator has been convicted of a felony or any criminal offense involving moral turpitude. 3. The certificate was obtained by an application in which any material fact was omitted or falsely stated. 4. The operator has knowingly permitted any of its motor vehicles to be operated in violation the laws which result in conviction of the driver or operator of a misdemeanor in the second degree or greater, or has knowingly permitted a driver with more than two previous convictions to operate emergency vehicles. 5. The operator has failed to comply with any of the provisions of this Ordinance. 6. The public interest will best be served by revocation, alteration, or suspension of any certificate upon good cause shown. 7. The operator or his agent has demanded money or compensation other that that 10—S, established and prescribed under this ordinance. (If applicable). Words underlined added and wnreic . —oagh are deleted. 9 Packet Page -1421- 10/11/2011 Item 17.E. 8. The operator has without sufficient justification failed or refused to furnish emergency care and /or transportation promptly for a sick or injured person. 9. The operator or his agent has been found guilty of malpractice or willful and wanton misconduct in the operation of its service. 13. All complaints shall be investigated and a report thereon made to the Board, together with findings and recommendations, within fifteen (15) days. If revocation, suspension or alteration of any certificate appears warranted, the Board shall give notice to the operator holding the certificate that the same will be considered at a specific commission meeting, provided the date of such meeting shall not be less than five (5) days from the date of the notice. The Board shall thereupon consider the complaint and either revoke, suspend or alter the certificate or dismiss the complaint. Section 44 15: General Operating Regulations All certificate holders, operators, and drivers shall comply with all state statutes and administrative regulations as following regulations: A. Twenty -four Hour Service. Every certificate holder shall be required to operate sufficient ambulances, as stated on the certificate of operation and determined by the Board, on immediate call at all times. B. Prompt Service Required. Every call for ambulance service shall be answered promptly. Patients shall be loaded and transported without being subject to unreasonable delays. All calls for emergency assistance requiring over twenty (20) minutes from time of notification to arrival on scene shall be reported to the Administrator with complete documentation of the circumstances, which delayed the response. Those instances where more that three (3) minutes elapse between receipt of an emergency call and dispatch of an ambulance shall also be reported to the Administrator with documentation of circumstances. C. Bed Linens. Clean and sanitary bed linens shall be provided for each patient carried and shall be changed as soon as practicable after the discharge of the patient. D. Daily Log. Every operator shall maintain in a daily log upon which shall be recorded the place or origin, time of call, time of dispatch, time of arrival at scene, time left for hospital, time of arrival at hospital, and charges for each trip made and such other operating and patient information as may be required by Ordinance. Every operator shall Words underlines --1A--1 ---- - through are deleted. 10 Packet Page -1422- 10/11/2011 Item 17.E. retain and preserve all daily logs for at least two (2) years, and such logs shall be 10-1�1 available for inspection by the Administrator. E. Communications. Each ambulance shall maintain two -way radio communication with the location of primary dispatch from which it operates, as well as any additional communication capabilities required by Ordinance or state law. F. Vehicles and Equipment. Each vehicle shall be equipped with the proper medical and emergency equipment as required by the laws of the State of Florida and shall be subjected to inspection from time to time to insure compliance with the laws of Florida and this Ordinance. G. Certification. In addition to the State of Florida Department of Health, Bureau of Emergency Medical Services requirements for certification, each paramedic must be certified by the County Medical Director. Each paramedic must work with a Collier County EMS ambulance for a sufficient length of time for the ambulance service medical director to properly judge his capability. At minimum, the paramedic must work in that capacity not less than one full month's work shift annually. Salaries of other than Collier County EMS paramedics will be paid by the agency seeking the Medical Director Certification. H. Application. Each ambulance or ALS service shall be subject to those rules and regulation as promulgated by Ordinances of the Board for the purpose of carrying out this ordinance. Section 4-5-16: Central Place of Business Each operator shall maintain a central place of business which shall be entirely within his designated operating zone, at which place he shall provide two -way radio communication with his vehicles, the county emergency control communications center, and his place of business, a properly listed telephone for receiving all calls for service and at which central place of business he shall keep such business records and daily logs available for inspection or audit by the Administrator. Every operator shall keep on file with the Administrator and the County Emergency Control Communications Center a business address and telephone number at which the operator may be reached at all times. This information will be maintained at the Emergency Control Center. Words underlined sdrfi-d n" ._­ ` -r•,.k ;hr-eub'h are deleted. 1 1 Packet Page -1423- 10/11/2011 Item 17.E. Section 4-6 17: Records To Be Kept Every operator shall keep accurate records of receipts from operations, operating and other expenses, capital expenditure and such other operating and patient information as may be required by the Board. Section 44 18: Rates Every operator shall file with the Board a schedule of the rates. Such rates shall be filed as a part of each new or renewal application, and a rate schedule shall also be filed when changes in rates are proposed. All such rates shall be subject to review and approval by the Board. Section 4-8 19: Operator's Insurance Every ambulance operator shall carry bodily injury and property damage insurance with solvent and responsible insurers authorized to transact business in the State of Florida to secure payment for any loss or damage resulting from any occurrence arising out of or caused by the operation or use of any of the operator's motor vehicles. Each vehicle shall be insured for the sum of at least one hundred thousand dollars ($100,000.00) for injuries to or death of any one person arising out of any one accident and the sum of at least three hundred thousand dollars ($300,000.00) for injuries to or death or more than one person in any one accident and for the sum of at least fifty thousand dollars ($50,000.00) for damage to property arising from any one accident. They shall also have malpractice insurance. Every insurance policy or contract for such insurance shall provide for the payment and satisfaction of any financial judgment entered against the operator and present insured or any person driving the insured vehicle. Such insurance shall be obtained and certificates or certified copies of such policies shall be filed with the Board. All such insurance policies, certificates thereof or certified copies of such insurance policies shall provide for a thirty (30) day cancellation notice to the Board. Section 4.9 20: Conduct of Drivers And Attendants All drivers, EMT's and paramedics shall comply with the laws of the State of Florida, in order to meet the requirements set out in this Ordinance and no driver, EMT or paramedic registered hereunder shall: A. Fail or refuse to promptly transport, if applicable, or attend any sick or injured person after responding to a call. Words underline" -"1-4 —4 •• -a� -•--k4hFeu0 are deleted. 12 Packet Page -1424- 10/11/2011 Item 17.E. B. Demand or receive compensation other that that established and approved in accordance with this ordinance or fail to give a receipt for moneys received. (If applicable). C. Give or allow rebate, commission, discount or any reduced rate not provided in the established rate. (If applicable.) D. At any time induce or seek to induce any person engaging an ambulance or ALS service to patronize or retain the services of any hospital, convalescent home, mortuary, cemetery, attorney, accident investigator, nurse, medical doctor or other service occupation or profession. E. At any time release his patient from his care until he is assured that some responsible person is available to receive such patient. F. At any time use a siren or flashing red light unless on an emergency call. G. Disobey the lawful orders of the law enforcement officer at the scene of an accident, or other similar such emergency or at a fire scene, the fire officer in charge. N. Smoke while within the confines of an ambulance. I. Operate or ride in an ambulance without using seatbelts. (Personnel attending patients are exempt). Section 20 21: Passengers No person shall be aboard ambulances when engaged in emergency or routine medical calls except the following: A. Driver, attendants and fire or law enforcement personnel; B. Patients; C. Not more that one relative or close friend of the patient, or if the situation warrants, the paramedic in charge may authorize more than one passenger. D. Physicians and nurses; E. Personnel in an observing capacity that are being trained for ambulance or ALS service. F. Operator's supervisory personnel. Section U 22: Obedience to Traffic Laws, Ordinances or Regulations. A. The driver of an ambulance or ALS vehicle when responding to an emergency call or while transporting a patient may exercise the following privileges when such driver has Words underline" —" A -A - '-- -a- --- •- k4hfea}gh are deleted. 13 Packet Page -1425- 10/11/2011 Item 17.E. reasonable grounds to believe that an emergency in fact exists requiring the exercise of such privileges: 1. Park or stand, irrespective of the otherwise applicable provisions of law, ordinance or regulations. 2. Proceed past a red light or stop signal or stop'sign, but only after slowing down as may be necessary for safe operations. 3. Exceed the maximum speed limits permitted by law so long as he does not endanger life or property. 4. Disregard laws, ordinances or regulations governing direction or movement or turning in specified directions so long as he does not endanger life or property. B. The exemptions herein granted shall apply only when such vehicle is making use of audible and /or visible signals meeting the requirements of this Ordinance. C. The foregoing provisions shall not relieve the driver of a vehicle from the duty to drive with due regard for the safety of all persons, nor shall such provisions protect the driver from the consequences of his reckless disregard for the safety of others. Section 22 23: Violations In addition to the remedies provided herein, a violation of any provision of this ordinance shall be punishable as provided by law for the violation of County ordinances. Section 23 24: Uniformity of Application The Ordinance shall constitute a uniform law applicable in all of Collier County. Section 24 25: Authority To Enforce It is hereby declared to be the duty of the Board of County Commissioners of Collier County, its officers, agents, employees and other governmental agencies, the sheriff's department of Collier County, its deputies and agents, fire departments, as well as the police departments of the various municipalities falling under the provisions of this Ordinance to stri:tly enforce the provisions of this Ordinance. Section 25-26: Repeal and Codification Ordinance 75 -50 is hereby repealed. This Ordinance shall be codified in the Collier County Code as Chapter 4 of said Code, and said Code is hereby amended accordingly. Words underlined added and .L,,..,4. thrAl." deleted. 14 Packet Page -1426- 10/11/2011 Item 17.E. Section 26 27: Conflict and Severability In the event this Ordinance should ever conflict with any other ordinance of Collier County, or applicable ordinance of any municipaliri or other applicable law, rule or regulation the more restrictive shall apply. If any section sub - section sentence clause phrase or portion of tb`.a Ordinance is for any reason held invalid or unconstitutional by any court of competent iurisdiction, such portion shall be deemed a separate distinct and independent provision and such holding shall not affect the validity of the remainder of the Ordinance Section 37 28: Effective Date This Ordinance shall become effective upon receipt of notice that it has been filed with the Secretary of State. PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County, Florida, this Aq day of Februar -W 2004. ATTES``��Zt,�S,;.; BOARD OF COUNTY COMMISSIONERS 9. DW1C�t'RQCet9s COLLIER C TY, FLORIDA �.;�4��:,;;,y; By. �' By. sufficiency: ...•."'.. l L 111 J't—'k—,e V �c J queline Williams Hubbard Assistant County Attorney H: Ordinance /Revision of Ord 81 -75 This ordinance filed with tha ecrotory of State's Office A� e 6 ^ r day of, g - and acknowicdgeme that filing recveld this day of Cenh Mrk I item # _ �'S E Date a_aH oy Date Recd Words underlined added and wnrrfc qt-aali thmugh are deleted. 15 Packet Page -1427- 10/11/2011 Item 17.E. �-a STATE OF FLORIDA) COUNTY OF COLLIER) I, DWIGHT E. BROCK, Clerk of Courts in and for the Twentieth Judicial Circuit, Collier County, Florida, do hereby certify that the foregoing is a true and correct copy of: ORDINANCE 2004 -12 Which was adopted by the Board of County Commissioners on the 24th day of February, 2004, during Regular Session. WITNESS my hand and the official seal of the Board of I,—N County Commissioners of Collier County, Florida, this 1st day of March, 2004. DWIGHT E. BROCK Clerk of Courtss,�ar�+ ray EX- officio to,., Y y County Commt'` Q. r By: Linda u, Deputy C" .$•��,•,. Packet Page -1428- 10/11/2011 Item 17.E. 345g)8 �e 1 dPR o�' ORDINANCE NO. 2005 - 16 Q�r 'S AN ORDINANCE AMENDING ORDINANCE 04 -12 BY V �� AMENDING SECTION FOUR ENTITLED: EXEMPTIONS AND \fir_ EXCLUSIONS FROM CERTIFICATE REQUIREMENT. LZ OZV J WHEREAS, Collier County desires to make available to its citizens safe, professional emergency health care transportation services I'or the transfer of patients between and among local hospital facifities; and WHEREAS, Collier County desires to facilitate the provision of such services and has the necessary equipment, training, expertise, professional certifications and licenses to do so; and WHEREAS, the amendment to Ordinance Number 04 -12 results in a benefit to Collier County by reducing response times for certain transports and providing for the availability of more transport vehicles. NOW THEREFORE: BE IT ORDAINED BY THE BOARD (*r COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA: Section 1: Purpose This ordinance is adopted pursuant to Chapters 125 and 401, Florida te� "flttr purpose of this ordinance is to provide better protection for the health, safety and ;k1eniar of the residents of Collier County, in ambulance and ALS matters, by establishing unifonn county -wide standards for certification of ambulance or advanced life support or services, or operations by promulgating complete and clear rules and regulations for operation of all ambulance or rescue companies or services in Collier County. Section 2: Definitions A. Advanced Life Support (ALS) shall mean procedures conducted as defined in applicable Florida Statutes and Florida Administrative Code, Section 64E. B. Administrator shall mean the County Manager or his designee. C. Ambulance means any privately or publicly owned land, air, or water vehicle that is designed, constructed, reconstructed, maintained, equipped or operated, and is used for or intended to be used for air, land, or water transportation of persons, who are sick, injured, or otherwise helpless. D. Board shall mean the Collier County Board of County Commissioners. E. Certificate means a certificate of convenience and necessity as authorized in Section 401.25 (2)(d), Florida Statutes. F. Emergency Call shall mean the transit of an ambulance under conditions which warrants travel with flashing lights and siren operating. Packet Page -1429- 10/11/2011 Item 17. E. G. Operator shall mean any person, organization or governmental entity providing ambulance or ALS services. Ii. Patient shall mean an individual who is ill, sick, injured, wounded, or otherwise incapacitated or helpless. 1. Routine Call or Routine Transfer shall mean the transportation of a patient under non - emergency call conditions. J. Rescue Service shall mean first response treatment of patients but does not include Advanced Life Support (ALS) or transport. Section 3: Requirements For Certificate It shall be unlawful for any person, firm, agency, or any other entity, including governmental units, to provide an ambulance service or provide advanced life support without First obtaining a certificate therefore from the Board of County Commissioners of Collier County. Section 4: Exemptions and Exclusions From Certificate Requirement Certificates shall not be required for: A. Rescue Services. B. The use of a non - ambulance for any transport of a patient pursuant to the Good Samaritan Act, Section 768.13, Florida Statues. C. Vehicles rendering ambulance -type services when requested to do so by the Board of County Commissioners or County Manager in the event of a major catastrophe or other such emergency which requires more ambulances that are available in the county. D. Ambulances based outside the county which pick up a patient in the county and transport him out of the county, or which pick up a patient out of the county and transport him into the county. E. Vehicles used to transport persons for routine scheduled medical treatments. Vehicles transporting persons who require services en route are not covered by this exemption. Section 5: Procedure For Obtaining Certificate An applicant for a certificate shall obtain forms from the department to be completed and returned to the Division Administrator. Each application shall contain: A. The name, age, and address of the owner of the ambulance or ALS provider, or if the owner is a corporation, then of the directors of the corporation and of all the stockholders Words underlie Packet Page - 1430 -'k deetigh are deleted. 2 10/11/2011 Item 17.E. overnmental units, this holding more that 25% of the outstanding shares. For g information shall be supplied for members of the governing body. 13. The boundaries of the territory desired to be served. applicant will C. The number and brief description of the ambulances or other vehicles the have available. D. The address of the intended headquarters and any sub - stations. E. The training and experience of the applicant. F The names and addresses of three (3) Collier County residents who will act as references for the applicant. G. A schedule of rates which the service intends to charge. H. Such other pertinent information as the administrator may require. 1. An application or renewal fee of two hundred fifty dollars ($250.00). (Exception Collier County EMS.) J. Financial data including assets and liabilities of the operator. A schedule of all debts encumbering any equipment shall be included. Section 6: Review of Application The Administrator shall review each application and shall investigate the applicant's reputation, competence, financial responsibility, and any other relevant factors. The Administrator shall also make an investigation as to the public necessity for an ambulance or ALS operation in the territory requested, and shall then make a report to the Board containing his recommendation whether to grant a certificate to the applicant within sixty (60) days of the time the Administrator determines the application is complete. Section 7: Requirement For Board Approval In Granting Certificate The Board of County Commissioners shall not grant a certificate unless it shall find, after public hearing and based on competent evidence that each of the following standards has been satisfied: A. That there is a public necessity for the service. In making such determination, the Board of County Commission shall consider, as a minimum, the following factors: (1) The extent to which the proposed service is needed to improve the overall Emergency Medical Services (EMS) capabilities of the County. 11—\ (2) The effect of the proposed service on existing services with respect to quality of service and cost of service. words underl packet Page - 1431- _...,.6" are deleted. 3 10/11/2011 Item 17.E. A*—\ (3) The effect of the proposed service on the overall cost of EMS service in the County. (4) The effect of the proposed service on existing hospitals and other health care facilities. (5) The effect of the proposed service on personnel of existing services and the availability of sufficient qualified personnel in the local area to adequately staff all existing services. B. That the applicant has sufficient knowledge and experience to properly operate the proposed service. C. That, if applicable, there is an adequate revenue base for the proposed service. D. That the proposed service will have sufficient personnel and equipment to adequately cover the proposed service area. Section 8: Appointment of Hearing Officer In making the determinations provided for in Section 7 above, the Board may, in its sole discretion, appoint a Hearing Officer to hold a public hearing and to make factual findings and conclusions as a result of the hearing. Should a Hearing Officer be appointed, said Hearing Officer shall render a written report to the Board within 30 days of the 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. Section 9: Rights and Duties Granted By Certificate The certificate granted by the Board shall be valid for one calendar year and shall be personal to the applicant and not transferable. In the case of a corporation, if there occurs such a transfer of stock or other incidents of ownership as to change the majority or largest stockholder, a new certificate must be applied for. Changes in the officers of the corporation will not require a new certificate. Acceptance of the certificate by the applicant shall obligate the applicant to: A. Service the entire zone granted to the applicant. B. Provide coverage to adjoining zones, when requested to do so by Emergency Control for emergency calls when the certificate holder for that zone is unable to respond. C. Keep posted at his place of business a copy of the fee schedule, which must be filed with the Administrator (If applicable). Words underlie packet Page - 1432 -nth are deleted. 4 10/11/2011 Item 17.E. D. Operate in accordance with the rules and regulations adopted pursuant to this Ordinance and any applicable County Ordinances, and Chapter 401 Florida Statutes, and any administrative regulations adopted pursuant thereto. E. Employ at all times sufficient personnel experienced in operation and management of emergency medical services to ensure proper and efficient operation. Section 10: Renewal of Certificate Each certificate holder shall file within ninety (90) days of expiration, an application for renewal of his certificate. Renewals shall be based upon the same standards, as the granting of the original certificate along with such other factors as may be relevant. The renewal application shall be accompanied by a two hundred and fifty dollar ($250.00) renewal fee. The renewal certificate may be approved routinely by the Board, upon advice of the Administrator, or the Board may hold a hearing on same. Section 11: Emergency Provisions The Board may modify, suspend or revoke a certificate in the interest of the public health, safety and welfare, only at public hearing and after reasonable notice has been given to �\ the certificate holder affected. However, if a situation exists which poses a serious threat that ambulance or rescue service will not be available to any certain area of Collier County, the Administrator shall have such temporary emergency powers as are necessary to provide that service. These temporary powers are intended to provide interim protection until such time as the Board meets to resolve the emergency. Section 12: Classifications of Certificates There shall be two (2) classifications of service in Collier County, as follows: A. Class 1: Collier County EMS: ALS Rescue: An EMS provider with the capability of rendering on the scene prehospital ALS services and who may or may not elect to transport patients. An EMS provider rendering this level of service for a governmental entity shall be. deemed to be operating under the Class 1 - ALS rescue certificate of public convenience and necessity held by the governmental entity. An EMS provider holding a Class 1 — ALS rescue certificate may provide post - hospital interfacility medical transfer services and routine ALS and BLS calls within the County. A Certificate Of Public Convenience and Necessity must be obtained from the County before engaging in this level of medical service. Words underlin Packet Page -1433- enh are deleted. 5 10/11/2011 Item 17.E. B. Class 2: Collier County Hospitals: 1. ALS Transfer: An EMS provider who renders ALS interfacility medical transfer services. An EMS provider who is awarded a Class 2 - ALS transfer certificate and does not possess a Class I -- ALS rescue certificate shall not respond to an emergency call and provide ALS rescue services unless called upon by the appropriate Class I - ALS rescue provider to provide emergency backup service. in these instances, it shall be deemed to be operating under the Class J - ALS rescue certificate of the governmental entity requesting such emergency backup service. 2. Class 2 - ALS transfer certificate holders may provide post - hospital interfacility medical transfer services and routine ALS and BLS calls within the County but only to hospitals owned by the certificate holder, however, the Class 2 certificate holder may provide out -of- County transports. Unless an EMS provider possesses a Class 1 - ALS Rescue certificate issued by the County, a Certificate Of Public Convenience and Necessity must be obtained from the County before engaging in this level of medical service. 3. Class -2 transfer certificate holders shall contract with the Class -- 1 rescue certificate holder's Medical Director for the performance of services set forth in Florida Statutes, Section 401.265 and as specifically set forth herein as follows: a. He shall supervise and accept direct responsibility for the medical performance of the paramedics and Emergency Medical Technicians (hereinafter EMTs). b. He shall develop medically correct standing orders or protocols relating to life support system procedures when communication cannot be established with a supervising physician or when any delay in patient care would potentially threaten the life or health of the patient. C. He shall issue standing orders and protocols to ensure that the Class -2 transfer certificate holder transports each of its patients to facilities that offer a type and level of care appropriate to the patient's medical condition. d. He or his appointee shall provide continuous 24- hour - per -day, 7- day - per -week medical direction which shall include, in addition to the development of protocols and standing orders, direction to the Class -2 transfer Words underlin packet Page - 1434 - ugh are deleted. 6 10/11/2011 Item 17. E. certificate holder's personnel as to the availability of "off -line" service to resolve problems, system conflicts, and provide services in an emergency as that term is defined by section 252.34(3), Florida Statutes. C. He shall establish a quality assurance committee to provide for quality assurance review of all EMTs and paramedics operating under his supervision. f. He shall audit the performance of system personnel by use of a quality assurance program that includes but is not limited to a prompt review of patient care records, direct observation, and comparison of performance standards for drugs, equipment, system protocols and procedures. He shall be responsible for participating in quality assurance programs developed by the Class -2 transfer certificate holder. g. He shall ensure and certify that security procedures of the Class -2 transfer certificate holder for medications, fluids and controlled substances are in compliance with chapters 401, 499 and 893, Florida Statutes, and chapter IOD -45 of the Florida Administrative Code. b. He shall create, authorize and ensure adherence to, detailed written operating procedures regarding all aspects of the handling of medications, fluids and controlled substances by the EMS personnel and comply with all requirements of chapters 401, 499 and 893, Florida Statutes. i. He shall notify the Florida Department of Health, (hereinafter the "Department") in writing when the use of telemetry is not necessary. j. He shall notify the department in writing of each substitution of equipment or medication. k. He shall assume direct responsibility for the use by an EMT of an automatic or semi - automatic defibrillator; the performance of esophageal intubation by an EMT; and on routine interfacility transports, the monitoring and maintenance of non - medicated I.V.s by an EMT. He shall ensure that the EMT is trained to perform these procedures; shall establish written protocols for the performance of these procedures; and shall provide written evidence to the Florida Department of n Health documenting compliance with the provisions of this paragraph. Words underlin Packet Page -1435- ak are deleted. 2 10/11/2011 Item 17.E. 1. He shall ensure that all EMTs and paramedics are trained in the use of the trauma scorecard methodologies as provided in sections 64E -2.017 of the F.A.C., for adult trauma patients and 64E- 2.0175, F.A.C., for pediatric trauma patients. m. He shall participate as a crewmember on an EMS vehicle for a minimum of 10 hours per year and complete a minimum of 10 hours per year of continuing medical education related to pre - hospital care or teaching or a combination of both. n. He shall ensure that all of the Class -2 transfer certificate holder's EMTs and paramedics have all proper certifications and receive all training necessary to maintain their certification. Section 13: Transfer Or Assignment of Certificates No certificate issued under this Ordinance shall be assignable or transferable by the person to whom issued except unless approval is obtained from the Board in the same manner and subject to the same application, investigation, fees and public hearing as original applications for certificates. Any majority transfer of shares or stock or interest of any person or operator so as to cause a change in the directors, officers, majority stockholders or managers of such person or operator shall be deemed a transfer or assignment as contemplated in this Ordinance and subject to the same rules and regulations as any other transfer or assignment. Section 14: Revocation, Alteration Or Suspension Grounds A. Every certificate issued under this Ordinance shall be subject to revocation, alteration and /or suspension of operation, by the Board, for a period of up to one year, where it shall appear that: 1. The operator has failed or neglected for a period of thirty (30) days during any calendar year to render all services authorized by his certificate. 2. The operator has been convicted of a felony or any criminal offense involving moral turpitude. 3. The certificate was obtained by an application in which any material fact was omitted or falsely stated. 4. The operator has knowingly permitted any of its motor vehicles to be operated in violation the laws which result in conviction of the driver or operator of a Words underlin Packet Page - 1436 -944hF"h are deleted. 8 10/11/2011 Item 17. E. misdemeanor in the second degree or greater, or has knowingly permitted a driver with more than two previous convictions to operate emergency vehicles. 5. The operator has failed to comply with any of the provisions or this Ordinance. 6. The public interest will best be served by revocation, alteration, or suspension of any certificate upon good cause shown. 7. The operator or his agent has demanded money or compensation other that that established and prescribed under this ordinance. (If applicable). 8. The operator has without sufficient justification failed or refused to Furnish emergency care and/or transportation promptly for a sick or injured person. 9. The operator or his agent has been found guilty of malpractice or willful and wanton misconduct in the operation of its service. B. All complaints shall be investigated and a report thereon made to the Board, together with findings and recommendations, within fifteen (15) days. If revocation, suspension or alteration of any certificate appears warranted, the Board shall give notice to the operator holding the certificate that the same will be considered at a specific commission meeting, provided the date of such meeting shall not be less than five (5) days from the date of the notice. The Board shall thereupon consider the complaint and either revoke, suspend or alter the certificate or dismiss the complaint. Section 15: General Operating Regulations All certificate holders, operators, and drivers shall comply with all state statutes and administrative regulations as following regulations: A. Twenty -four Hour Service. Every certificate holder shall be required to operate sufficient ambulances, as stated on the certificate of operation and determined by the Board, on immediate call at all times. B. Prompt Service Required. Every call for ambulance service shall be answered promptly. Patients shall be loaded and transported without being subject to unreasonable delays. All calls for emergency assistance requiring over twenty (20) minutes from time of notification to arrival on scene shall be reported to the Administrator with complete documentation of the circumstances, which delayed the response. Those instances where more that three (3) minutes elapse between receipt of an emergency call and dispatch of an ambulance shall also be reported to the Administrator with documentation of circumstances. Words underlin P P eegh are deleted. 9 acket age -1437- 10/11/2011 Item 17.E. C. Bed Linens. Clean and sanitary bed linens shall be provided for each patient carried and shall be changed as soon as practicable after the discharge of the patient. D. Daily Log. Every operator shall maintain in a daily log upon which shall be recorded the place or origin, time of call, time of dispatch, time of arrival at scene, time left for hospital, time of arrival at hospital, and charges for each trip made and such other operating and patient information as may be required by Ordinance. Every operator shall retain and preserve all daily logs for at least two (2) years, and such logs shall be available for inspection by the Administrator. E. Communications. Each ambulance shall maintain two -way radio communication with the location of primary dispatch from which it operates, as well as any additional communication capabilities required by Ordinance or state law. F. Vehicles and Equipment. Each vehicle shall be equipped with the proper medical and emergency equipment as required by the laws of the State of Florida and shall be subjected to inspection from time to time to insure compliance with the laws of Florida and this Ordinance. G. Certification. In addition to the State of Florida Department of Health, Bureau of Emergency Medical Services requirements for certification, each paramedic must be certified by the County Medical Director. Each paramedic must work with a Collier County EMS ambulance for a sufficient length of time for the ambulance service medical director to properly judge his capability. At minimum, the paramedic must work in that capacity not less than one full month's work shift annually. Salaries of other than Collier County EMS paramedics will be paid by the agency seeking the Medical Director Certification. H. Application. Each ambulance or ALS service shall be subject to those rules and regulation as promulgated by Ordinances of the Board for the purpose of carrying out this ordinance. Section 16: Central Place of Business Each operator shall maintain a central place of business which shall be entirely within his designated operating zone, at which place he shall provide two -way radio communication with his vehicles, the County Emergency Control Communications Center, and his place of business, a properly listed telephone for receiving all calls for service and at which central place of business he shall keep such business records and daily logs available for inspection or audit by Words underlir packet Page - 1438 -e"4"'� are deleted. 10 10/11/2011 Item 17.E. the Administrator. Every operator shall keep on file with the Administrator and the County r� Emergency Control Communications Center a business address and telephone number at which the operator may be reached at all times. This information will be maintained at the Emergency Control Center. Section 17: Records To Be Kept Evcry operator shall keep accurate records of receipts from operations, operating and other expenses, capital expenditure and such other operating and patient information as may be required by the Board. Section 18: Rates Every operator shall file with the Board a schedule of the rates. Such rates shall be tiled as a part of each new or renewal application, and a rate schedule shall also be filed when changes in rates are proposed. All such rates shall be subject to review and approval by the Board. Section 19: Operator's Insurance Every ambulance operator shall carry bodily injury and property damage insurance with solvent and responsible insurers authorized to transact business in the State of Florida to secure payment for any loss or damage resulting from any occurrence arising out of or caused by the operation or use of any of the operator's motor vehicles. Each vehicle shall be insured for the sum of at least one hundred thousand dollars ($100,000.00) for injuries to or death of any one person arising out of any one accident and the sum of at least three hundred thousand dollars ($300,000.00) for injuries to or death or more than one person in any one accident and for the sum of at least fifty thousand dollars ($50,000.00) for damage to property arising from any one accident. They shall also have malpractice insurance. Every insurance policy or contract for such insurance shall provide for the payment and satisfaction of any financial judgment entered against the operator and present insured or any person driving the insured vehicle. Such insurance shall be obtained and certificates or certified copies of such policies shall be filed with the Board. All such insurance policies, certificates thereof or certified copies of such insurance policies shall provide for a thirty (30) day cancellation notice to the Board. Section 20: Conduct of Drivers And Attendants All drivers, EMT's and paramedics shall comply with the laws of the State of Florida, in order to meet the requirements set out in this Ordinance and no driver, EMT or paramedic registered hereunder shall: Words underlin Packet Page -1439- are deleted. 11 10/11/2011 Item 17.E. �. A. Fail or refuse to promptly transport, if applicable, or attend any sick or injured person after responding to a call. B. Demand or receivc compensation other that that established and approved in accordance with this ordinance or fail to give a receipt for moneys received. (If applicable). C. Give or allow rebate, commission, discount or any reduced rate not provided in the established rate. (If applicable.) D. At any time induce or seek to induce any person engaging an ambulance or ALS service to patronize or retain the services of any hospital, convalescent home, mortuary, cemetery, attorney, accident investigator, nurse, medical doctor or other service occupation or profession. E. At any time release his patient from his care until he is assured that some responsible person is available to receive such patient. F. At any time use a siren or flashing red light unless on an emergency call. G. Disobey the lawful orders of the law enforcement officer at the scene of an accident, or other similar such emergency or at a fire scene, the fire officer in charge. H. Smoke while within the confines of an ambulance. 1. Operate or ride in an ambulance without using seatbelts. (Personnel attending patients are exempt). Section 21: Passengers No person shall be aboard ambulances when engaged in emergency or routine medical calls except the following: A. Driver, attendants and fire or law enforcement personnel; B. Patients; C. Not more that one relative or close friend of the patient, or if the situation warrants, the paramedic in charge may authorize more than one passenger. D. Physicians and nurses; E. Personnel in an observing capacity that are being trained for ambulance or ALS service. F. Operator's supervisory personnel. Section 22: Obedience to Traffic Laws, Ordinances or Regulations. A. The driver of an ambulance or ALS vehicle when responding to an emergency call or while transporting a patient may exercise the following privileges when such driver has Words underlin Packet Page -1440- alF#Fa"h are deleted. 12 10/11/2011 Item 17.E. reasonable grounds to believe that an emergency in fact exists requiring the exercise of such privileges: 1, Park or stand, irrespective of the otherwise applicable provisions of law, ordinance or regulations. 2. Proceed past a red light or stop signal or stop sign, but only after slowing down as may be necessary for safe operations. 3. Exceed the maximum speed limits permitted by law so long as he does not endanger life or property. 4. Disregard laws, ordinances or regulations governing direction or movement or turning in specified directions so long as he does not endanger life or property. B. The exemptions herein granted shall apply only when such vehicle is making use of audible and/or visible signals meeting the requirements of this Ordinance. C. The foregoing provisions shall not relieve the driver of a vehicle from the duty to drive with due regard for the safety of all persons, nor shall such provisions protect the driver from the consequences of his reckless disregard for the safety of others. Section 23: Violations �1 In addition to the remedies provided herein, a violation of any provision of this ordinance shall be punishable as provided by law for the violation of County ordinances. Section 24: Uniformity of Application The Ordinance shall constitute a uniform law applicable in all of Collier County. Section 25: Authority To Enforce It is hereby declared to be the duty of the Board of County Commissioners of Collier County, its officers, agents, employees and other governmental agencies, the sheriff s department of Collier County, its deputies and agents, fire departments, as well as the police departments of the various municipalities falling under the provisions of this Ordinance to strictly enforce the provisions of this Ordinance. Section 26: Repeal and Codification Ordinance 75 -50 is hereby repealed. This Ordinance shall be codified in the Collier County Code as Chapter 4 of said Code, and said Code is hereby amended accordingly. Section 27: Conflict and Severability In the event this Ordinance should ever conflict with any other ordinance of Collier County, or applicable ordinance of any municipality, or other applicable law, rule or regulation, Words underlin Packet Page -1441- ak -dweu& are deleted. 13 10/11/2011 Item 17.E. the more restrictive shall apply. If any section, sub - section, sentence, clause, phrase or portion of this Ordinance is for any reason held invalid or unconstitutional by any court of competent deemed a separate, distinct and independent provision and such jurisdiction, such portion shall be holding shall not affect the validity of the remainder of the Ordinance. Section 28: Effective Date This Ordinance shall become effective upon receipt of notice that it has been filed with the Secretary of State. PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County, Florida, this l 3 day of e 2005. ATTEST: DWIGHT E. BROCK, Clerk Attest as to chain n't, signatrre ou►1,Z:�`� ........... o� Anwol s t '14 Ie�,AI•. Scott Assistant County 1 0 e BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA W. By: 'li Fred W. Coyle, Chairman This ordinance filed with ti-E of ,5�tot�e s Office thL day of em and acicnowledg eK1e ^t Of tf ct f received tV -is day iN Gf CWV- Words underl' added and words stnuek- tbreegl� are deleted. 14 Packet Page -1442- 10/11/2011 Item 17.E. STATE OF FLORIDA) COUNTY OF COLLIER) I, DWIGHT E. BROCK, Clerk of Courts in and for the Twentieth Judicial Circuit, Collier County, Florida, do hereby certify that the foregoing is a true and correct copy of: ORDINANCE 2005 -16 Which was adopted by the Board of County Commissioners on the 23nd day of March 2005, during Regular Session. WITNESS my hand and the official seal of the Board of n County Commissioners of Collier County, Florida, this 28th day of March, 2005. DWIGHT E. BROCK,,. r..' Clerk g�' Clerk. of Court-sNc Ex- officio to 4n hod` r County Commis: i' s`: r • i� v-•. y� ., B Linda A. Hou,:' Deputy Clerk Dep Packet Page -1443- 10/11/2011 Item 17.E. 20D • Friday, September 30, 2011 * Naples Daffy News IRDINAMfF- OFTITIONS M IeRe1NnNCr nr.Tifle NOTICE OF INTENT TO CONSIDER ORDINANCE Notice is hereby given that on Tuesday; October 11, 2011 in the Boardroom, 3rd Floor, Administration Building, Collier County Government Center, 3299 East Tami- ami Trail, Naples, Florida, the Board of County Commissioners will consider the enactment of a County Ordinance. The meeting will commence at 9:00 A.M. The title of the proposed Ordinance is as follows:. AN ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF .COLLIER COUNTY, FLORIDA, AMENDING ORDINANCE 04-12, AS AMENDED, BY AMENDING, SECTION TWO, DEFINITIONS; SECTION FOUR, EXEMPTIONS AND EXCLUSIONS FROM CERTIFICATE REQUIREMENT, SECTION FIVE, PROCEDURE FOR OBTAINING CERTIFICATE; SECTION SEVEN, REQUIREMENT'FOR BOARD: APPROVAL IN GRANTING CERTIFICATE; SECTION NINE, RIGHTS AND DUTIES GRANTED BY. CERTIFICATE; SECTION ELEVEN, EMERGENCY PROVISIONS; SECTION TWELVE, CLASSIFICATIONS OF CERTIFICATES; SECTION FIFTEEN, GENERAL OPERATING REGULATIONS; SECTION TWENTY, CONDUCT OF DRIVERS AND ATTENDANTS; SECTION . TWENTY -ONE; PASSENGERS; SECTION TWENTY -TWO, OBEDIENCE TO TRAFFIC LAWS, ORDINANCES AND REGULATIONS; PROVIDING FOR CONFLICT AND.. SEVERABILITY; PROVIDING FOR INCLUSION IN THE CODE OF LAWS AND ORDINANCES; AND PROVIDING FOR AN EFFECTIVE DATE. Copies of the proposed Ordinance are on file. with the Clerk to the Board and are available for inspection. All interested parties are invited to attend and be heard. N OT All persons wishing to speak on, any agenda item .must register ;with. the County administrator prior to ,preserrtation of the agenda: 'item to be addressed. Individual speakers will be limited to 3 minutes on any it e m The selection -of °an in dividual to speak on behalf of; an organization or group.)s: encouraged. If,r_cog- nized by the Chairman, a spokesperson for a group or organization may be allotted 10 minutes to speak on.an item. ��. Persons wishing to have written or. graphic materials induded in the Board agenda packets must submit said material a minimum of 3 weeks . prior to the'resppecCive public hearing. In any case, written materials . intended to be considered':byr ;the Board shall be submitted to the appropriate' staff a minimum of seven ":days prior to the public hearing. All material used in presentations before the `Board will become a permanent part of the record. Any person who decides to appeal a decision of the Board wAl need a record of the proceedings pertaining thereto and therefore, may need to.,ensure that a,verbatim record of the proceedings is made, which record includes the testimony and evi dente upon which the appeal is based. If you are a person with a disability who needs any accommodation in order to par- ticipate in this proceeding, you are entitled, at, no cost •to you to the provision of certain assistance. Please contact the Collier County Facilities Management. Depart- ment, located at 3335 Tamiami Trail East, Suite 101, Naples, Florida 34112 -5356, (239) 252 -8380, at least two days prior to the meeting. Assisted listening devices for the hearing impaired are available, in the Board of County Commissioners' Office.. , BOARD OF.000NTY COMMISSIONERS COLLIER COUNTY, FLORIDA FRED W. COYLE, CHAIRMAN DWIGHT E. BROCK, CLERK Byy: Martha Vergara, Deputy Clerk (SEAV Seotemher 30. 2011 No_ 1916748 Packet Page -1444-