HomeMy WebLinkAboutDocumentation_Miscellaneous_Tab 8_9/16/1996 ST. '
(1) TEQUESTA FIRE-RESCUE
`i a,,,o Phone: (407)575.6250 • Fax: (407)575-6203 James M.Weinand,Fire Chief
September 10, .1996
John C. Randolph, Esq.
Jones, Foster, Johnston & Stubbs, P.A.
P.O. Box 3475
West Palm Beach, Florida 33402-3475
Re: EMS Certificate of Public Convenience and Necessity
Dear Skip:
Enclosed please find copy of Robert Butterfield's response to Captain Nathanson's
September 6, 1996 letter to him, copy of which was forwarded to you on Friday,
along with a copy of the Palm Beach County EMS Ordinance. In particular, please
see Mr. Butterfield's response in No. 3. Do you think we have legal grounds to
apply for this type of C.O.N. if we have a written contract with North County
Ambulance to provide transport for the Village?
I would appreciate your letting me know what the legalities are.
Sincerely,
DICTATED BUT NOT READ TO
EXPEDITE. O./W.--
James M. Weinand
Fire Chief
JMW/cm
Post Office Box 3273 • :357 Tequesta Drive • Tequesta. Florida 33469-0273
Board of County Commissioners County Administrator
Ken L.Foster,Chairman Robert Weisman
Burt Aaronson,Vice Chairman
Karen T.Marcus
Carol A.Roberts Department of Public Safety
Warren H.Newell
Mary McCartyB Division of Emergency Management
Maude Ford Lee CS"
, Office of Emergency Medical Services
•
September 9, 1996 Fire-Rescue
Captain Alex Nathanson $EP 11 1996
Tequesta Fire-Rescue
Post Office Box 3273
Fire Chiefs ()' Ce
Tequesta,Florida 33469-0273
Dear Captain Nathanson:
In response to your letter of September 6, 1996, I submit the following to your three questions
regarding the EMS Certificate of Public Convenience and Necessity (COPCN)process:
1. Section 4.C., of the EMS Ordinance(96-16)states that in order to provide ALS and
BLS response and routine transport, EMS agencies must apply for, and obtain, an"ALS
Transport"endorsement to their COPCNs. Pursuant to Section 5.D., the Administrator
shall accept applications for COPCNs only during the time specified in the public notice.
If you do not apply for an ALS Transport COPCN during the September 3, to October 2,
1996, application period, you will have to wait until the four-year"window" for
COPCN applications presents itself again.
2. If Jupiter Medical Center were to cease its ambulance service, Tequesta Fire-Rescue
would be able to"take over the transport" only if it had the obvious ability (ALS
transport units and appropriate personnel in place)to do so. Section 7.E., of 96-16,
allows the Board to ..."grant, at its discretion, and at any time, a temporary COPCN for a
period not to exceed six(6)months in order to safeguard and protect the public health,
safety and welfare. This temporary Certificate may be renewed." If your agency had the •
ability to provide ALS transport at the time, you would have to operate under temporary
COPCN(s)until the next four-year application period. At that time, a four-year COPCN
could be applied for. There would be no "competition." Section 4.F., of 96-16, speaks
to this and the Board has.historically acquiesced with the municipalities in that regard.
"An Equal Opportunity-Affirmative Action Employer"
3323 Belvedere Road,Building 503 West Palm Beach,Florida 33406
printed on recycled paper (407)233-4840 FAX:(407)233-4859
pg. 2, Tequsta Fire-Rescue
3. You could apply for an ALS Transport Certificate now and not use it. However, to do so
you must have the ability to provide the service reflected on said Certificate at the time
•
of application.• You cannot possess an ALS Transport Certificate and not be able to
transport.
Please contact me if you have any questions or if I may further assist you.
Sincerely, •
Robert A. Butterfi
EMS Manager
c: Paul Milelli, Director of Public Safety
Dawn Wynn, Assistant County Attorney
•
Memo
To: Skip Randolph, Village Attorney
From: Alex Nathanson, Fire Rescue Captai
Thru: James Weinand, Fire Chief
Date: September 6, 1996
Re: Palm Beach County EMS Ordinance
Mr. Randolph, Chief Weinand has asked me to get you this copy of the County-Wide EMS (Emergency
Medical Services)Ordinance. He would like you to review it,in reference to the Village looking at the
upcoming CON (Certificate of Need)process for our EMS license. Today I sent a letter to Robert
Butterfield, Director of Palm Beach County EMS Office,asking for clarification on the CON process,
(Attached). The CON process allows a municipality or private service,to apply for a certificate to
provide Emergency Medical Services. These certificates are issued for the following types of services
an agency wants to provide,and are good for four years. •
1. ALS non transport-this is designed to allow municipalities to provide the paramedic service, without
actually having a transport ambulance. This service is considered the'primary provider and is currently
the CON that Tequesta has. Our paramedics do ride in with the patient,so that a consistent level of care
is given. The transport provider is Jupiter Medical Center.
2. ALS transport-same service as above, but the ALS provider uses it's own ambulances to provide
transport. This can be further divided into two sub categories: 1. ALS and BLS transport which states
the certificate holder can transport both minor injuries and illnesses, and critical patients (Example is
• West Palm Beach Fire Department). 2. The other transport certificate only allows the provider to
transport critical patients, all minor injuries or illnesses go by private provider(Example is Palm Beach
County Fire Rescue).
3. Interfacility Transport-this allows for the transportation of pt's between hospitals, nursing homes etc...
Any agency with this endorsement, must also be available to provide ambulance transport service to
back up the designated area in which they operate. Example is Jupiter Ambulance must be able to
provide back-up to Palm Beach County Fire Rescue North of Donald Ross Road. Currently municipalities
cannot provide interfacility transport, except in an emergency situation.
4. Air Ambulance-this is for Aircraft ambulances like 'Trauma Hawk'or Fixed Wing for long inter
facility transports.
We will continue to be the ALS provider, but the Chief will be presenting the facts and looking for
direction at the Public Safety Meeting on September 16, 1996. He wants you to have a copy of the
ordinance to answer any legal issues that may arise. Our application must be received by Palm Beach
County EMS, no later than October 2, 1996. If you should have any questions, please call Chief
Weinand or me at 575-6250.Thank you.
C.
Fire Chief James Weinand
Fsr.
f TEQUESTA FIRE-RESCUE
`tMo' Phone: (407) 575-6250 • Fax: (407) 575.6203 James M.Weinand,Fire Chief
September 6, 1996
Robert Butterfield, Director
Palm Beach Co. EMS
3323 Belvedere Road
West Palm Beach,Fl. 33406
Dear Mr.Butterfield,
I respectfully write this letter to you to insure our options are understood for the upcoming CON
(Certificate of Need)process. On September 16, 1996, our Public Safety Council will be
meeting. Chief Weinand will be presenting all of the options to them about the CON process
(transport and non transport). We need to be able to present the facts about the different options,
and if you could answer a few questions before this date,we would be very grateful.
1. If we do not to apply for a transport CON what options do we have during the four years of
the CON to obtain a transport certification,if we decide we want to transport?
2. If Jupiter Medical Center gets out of the transport business, or sells to another agency, do we
automatically have first right to take over the transport, or do we have to compete with other
agencies to get that endorsement ?
3. We are currently looking at remaining a non-transport ALS provider, but do not want to be
locked out for the entire four years of the CON. Can we apply for a transport CON, and not
immediately use it? If yes, are there any requirements per the EMS office or the new
Ordinance, that will allow us this option?
Please respond by September 14, 1996. Sorry about the short notice,but this meeting was just
scheduled today.If you should have any questions,please call me or Chief Weinand at
(561 75-6250.
',Inc- y, f,
/ ;
•l ex ,athanson
Captain\EMS Coordinator
C.
Fire Chief James Weinand
Skip Randolph,Attorney for The Village of Tequesta
•
Post office Box 2273 • 357 Tequesta Drive • Tequesta. Florida 33459-0272
'Board of County Commissioners County Administrator
Ken L.Foster,Chairman Robert Weisman
Burt Aaronson,Vice Chairman
Karen T.Marcus Department of Public Safety
Carol A. Roberts P
Warren H.Newell
Mary McCarty B�, Division of Emergency Management
Maude Ford Lee a� k Office of Emergency Medical Services
MEMORANDUM
TO: EMS Council
EMS Providers
EMS Medical Directors
Hospital Administrators
Emergency Room Nurses Forum
FROM: Robert A. Butterfield, Manager
Emergency Medical Services Office (\\-
DATE: June 26, 1996
RE: EMS Ordinance No. 96-16 and Rules Er Regulations
Enclosed is EMS Ordinance No. 96-16 and the Rules and Regulations approved by the Board of County
Commissioners on May 7, 1996, and filed with the Department of the State on May 13, 1996.
The application and certification process for obtaining a Certificate of Public Convenience and Necessity
(COPCN) shall become effective August 1, 1996, with the remaining provisions of this Ordinance taking
effect January 1, 1997.
A COPCN renewal packet and notice shall be sent to each EMS Provider,following the time-frame indicated
in the Ordinance (Section 5).
Should you have any questions, they may be addressed at the next EMS Council meeting (July 18, 1996)
or call our office at 233-4840.
RAB:lbm
enclosure
c Paul W. Milelli, Director, PBC Public Safety Department
B.T. Kennedy, Director, PBC Emergency Management Division
Jack Horniman, Exec. Dir., Municipal League of Palm Beach County
Esther Hamlet, Dir. of Clinical Er Trauma Svcs, PBC Health Care District
"An Equal Opportunity-Affirmative Action Employer"
3323 Belvedere Road,Building 503 West Palm Beach,Florida 33406
ornteo on recycled page, (407)233-4840 FAX:(407)233-4859
1
2
3 PALM BEACH COUNTY
4 ORDINANCE NO. 96- 16
5
6
7 RULES AND REGULATIONS
8 OF THE
9 DEPARTMENT OF PUBLIC SAFETY
10 EMERGENCY MEDICAL SERVICES SECTION
11
12
13
14 PURPOSE •
15
16 These rules and regulations are issued as authorized by Palm Beach
17 County Ordinance No. 96- , for the purpose of improving the
18 quality of pre-hospital emergency medical care to the residents and
19 visitors of the County. Further, it is the purpose of these rules
20 and regulations to promote the policy of the County to reduce the
21 morbidity and mortality of trauma, to maintain a level of care and
22 service in which quality and accessibility are paramount, and to
23 speed the healing of persons who are sick or otherwise in need of
24 pre-hospital emergency medical services.
•
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1
2 SECTION L. GENERAL 1
3 A. APPLICATIONS
4 1. An "Application for EMS Certificate Form" (PBC Form
5 0988) shall be completed by the applicant. This form shall
6 accompany every application for Certificate of Public Convenience
7 and Necessity and ie submitted to the Division of Emergency
8 Management, EMS Office.
9 2. Applications for Certificates of Public Convenience
10 and Necessity shall include copies of the appropriate State of
11 Florida Department of Health and Rehabilitative Services EMS
12 application forms and shall accompany the applicant's request for
13 Certification.
14 B. COMPLAINTS AND INVESTIGATIONS
15 1 . Complaints about a Certificate Holder shall be
16 reviewed after the complaint has been submitted in writing to the
17 Administrator or his designee. The complaint should state the
18 date, time, nature of the incident, location of the incident, and
19 any other information relative to the incident which may assist the
20 Administrator in his review.
21 2. The Administrator shall review the complaint, and if
22 warranted, conduct an investigation. The Administrator may present
23 the findings to the EMS Council.
24 C. OPERATING PROCEDURES
25 1. Each Certificate Holder shall maintain a central
26 place of business and any additional places within the District(s)
27 or Area(s) calculated to provide minimum response time to emergency
28 medical calls. At the central place of business there shall be:
29 1 . 1 a filing system and adequate storage space for
30 all records required by this Ordinance;
C31 1.2 a copy if all pertinent laws, rules and regulations
32 regulating emergency medical services in Palm Beach
33 County;
34 1.3 a conspicuously posted. schedule of all rates
35 charged by the Certificate Holder;
36 1.4 the Certificate of Public Convenience and
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J
1 Necessity conspicuously posted; and
2 1.5 the State License conspicuously posted.
3 2. Every Certificate Holder shall be required to
4 operate a sufficient number of staffed ambulances or vehicles of
5 the type designated and Permitted on their Certificate Endorsement,
6 at all times, to ensure a three (3.0) minute average "en route"
7 response to emergency medical calls occurring within their District
8 or Area per calendar month.
9 3. A schedule of rates shall be provided or made
10 available to each patient upon request.
11 3.1 Under no circumstances shall payment be required
12 prior to emergency transportation of those patients
13 requiring further medical treatment at a hospital.
14 3.2 The Certificate Holder may request payment prior to
15 transport when responding to medical calls or when
16 higher medical 'authority has determined and the
17 patient examination record states that ambulance
18 transportation is not required.
19 4. Any request for modification or alteration of the
20 requirements of this section must be submitted in writing to the
21 Administrator or his designee and be approved by the Administrator
22 or his designee. All requests shall clearly state the reason(s)
23 for the modification or alteration and shall be exact in the detail
24 identifying the benefit to the patient. The Administrator may deny
25 or approve any request for modification or alteration and report
26 the actions to the EMS Council.
27 D. COMMUNICATIONS EQUIPMENT
28 1. .All ambulances or vehicles which respond to
29 emergency medical or medical calls shall possess functional
30 operating capability of direct two-way radio communication with
31 MedCom and be in compliance with the State of Florida Emergency
32 Medical Services Communications Plan.
33 2. All Certificate Holders shall have the availability
34 of two-way radio contact with their ambulances or vehicles which
35 respond to emergency medical or medical calls.
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1 3. Ambulances or vehicles responding to emergency
2 medical calls dispatched by MedCom shall. notify MedCom when en
3 route to a call, arrival at a call, en route to the hospital, and
4 when available for another call.
5 4. Any requests for modification or alteration to the
6 requirements of this section must be submitted in writing to the
7 Administrator. All bequests .shall clearly state the reason(s) for
8 the modification or alteration and shall be exact in the detail
9 identifying the benefit to the patient. The Administrator may deny
10 or approve any request for modification or .alteration and shall
11 report the actions to the EMS Council.
12 E. ) PATIENT ATTENDANTS
13 1. Every ALS service vehicle or ambulance shall be
14 staffed according to the standards identified in the Rules and
15 Regulations of Florida Statute Chapter 401 as it pertains to
16 paramedic and emergency medical technician patient attendants.
17 2. Duties of Patient Attendants:
18 2.1 provide medical assistance to the patient as
19 required through oral or written protocol;
20 2.2 ensure that each patient in need of additional
21 medical care is offered a means of transportation
22 from the scene to an appropriate medical facility;
23 and
24 2.3 determine appropriate medical facility destination
25-- from the agency Medical Director or through oral or
26 written protocols when transport is required.
27 3. Personnel attending a patient shall:
28 3. 1 not direct any patient to any specific facility,
29 agency or other service occupation or
P profession
30 for the private or personal gain of the ambulance
31 driver or attendant;
32 3.2 not smoke in vehicles that are used, or that may be
33 used, to transport patients; and
34 3.3 not ask for remuneration in excess of, or in
35 additioln to, that listed in the fee schedule of
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1 rates provided to the Administrator and posted in
2 the central place of business.
3 4 . When a patient attendant is evaluating the
4 appropriate mode of patient transport to a medical facility, the
5 choice shall be made in consideration of patient condition and the
6 availability of ambulances, or the direction of higher medical
7 authority or patient preference.
8 F. VEHICLES
9 1. Every ALE service vehicle or ambulance purchased for
10 use, or intended for use, within Palm Beach County shall be
11 inspected by the Administrator or his designee to assure that each
12 vehicle or ambulance meets all applicable laws of the State of
13 Florida and Palm Beach County laws as it pertains to ambulances and
14 ALS service vehicles.
15 2. The Certificate Holder shall notify the
16 Administrator or his designee when a new vehicle or ambulance is
17 placed into operation and shall, within five (5) days of placing
18 the vehicle or ambulance into operation, have the vehicle or
19 ambulance inspected.
20 2. 1 Vehicles and ambulances found to be in compliance
21 with all applicable laws of the State of Florida
22 and Palm Beach County shall be granted authority to
23 operate in Palm Beach County by being issued a
24 Permit.
25 3. Each authorized vehicle and ambulance shall also
26 meet current State of Florida motor vehicle safety standards.
27 G. RECORDS
28 1. Emergency medical service response and other records
29 maintained by the service as required by the State of Florida and
30 this Ordinance, shall be accessible to the Administrator or his
31 designee.
32 2. Insurance policies, or certificates thereof, or
33 certified copies of such insurance policies shall be provided to
34 the Administrator and shall provide for a thirty (30) day
35 cancellation notice to the Division of Emergency Management, EMS
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1 Office. Agencies which are self-insured shall provide evidence
2 that the .insurance plan has been approved by the Department of
3 Insurance, State of Florida.
4 H. INSPECTIONS
5 1. The Administrator, or his designee, shall inspect
6 each holder of an EMS Certificate prior to, and as a continuing
7 part of, the Certification process. This inspection shall
8 determine the continuing compliance to the Ordinance, these Rules
9 . and Regulations and State Law by the Certificate Holder as a
10 condition of Certificate and Permit issuance.
11 2. Inspections shall be conducted periodically and may
12 be conducted without notice .to the Certificate Holder at reasonable
13 times and whenever such inspection is deemed necessary by the
14 Administrator. Inspections shall be' conducted without impeding
15 patient care.
16 3. If, during the course of an inspection, a situation
17 is found which, in the determination of the Administrator, will
18 jeopardize the safety or welfare of the EMS personnel or patient
19 care, the Administrator may exercise the powers available
20 identified in Section 15 of the Ordinance to ensure compliance of
21 the Certificate Holder with the Ordinance.
22 I. RESPONSE TIMES
23 1. Certificate Holders shall promptly dispatch an
. 24 ambulance or vehiclelto every emergency medical call.
25 1. 1 An ambulance or vehicle shall be en route to each
26 emergency call within three (3.0) minutes of
27 receipt of the call by the Certificate Holder.
28 Each Certificate holder must maintain an average
29 time of at least three (3.0) minutes, from receipt
30 of call to an ambulance or vehicle going en route
31 to the call, for all of the Certificate Holder's
32 emergency responses within each District or Area on
33 a monthly basis. Every emergency medical call in
34 which an ambulance or vehicle takes longer than
35 three (3.0) minutes to be en route, or which cannot
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1 be responded to by the Certificate Holder, shall be
2 recorded by the Certificate Holder and kept on file
3 at its central place of business and made
4 available to the Administrator or designee upon
5 request. Excluded from these requirements are all
6 calls not received as an emergency, all
7 interfacility transports, all calls responded to
8 for stand-by, and all calls with a disposition of
9 "cancel" or "assist."
10 1.2 Any Certificate Holder, dispatched or otherwise
11 requested to respond by MedCom, shall notify MedCom
12 when they are unable to have en route, an ambulance
13 or vehicle within three (3.0) minutes of receipt of
14 a call. This notification to MedCom shall
15 indicate: when an ambulance or vehicle will be
16 available to respond and its estimated time of
17 arrival; and the actual location of the ambulance
18 or vehicle available to respond. MedCom may allow
19 the next available ambulance or vehicle of the
20 Certificate Holder to respond or may secure
21 response from another adjoining District
22 Certificate Holder.
23 1.3 An ambulance or vehicle which is operated by a
24 Primary Provider shall arrive on the scene of each
25 emergency medical call within eight (8.0) minutes
26 of receipt of the call by the Certificate Holder.
27 Each Primary Provider Certificate Holder must
28 maintain an average time of at least eight(8.0)
29 minutes, from receipt of call to arrival at scene
30 with an ambulance or vehicle, for all of the
31 Certificate Holder's emergency responses within
32 each District or Area on a monthly basis. Every
33 emergency medical call in which a Primary
34 Provider's ambulance or vehicle takes longer than
35 eight (8.0) minutes to-arrive at the scene shall be
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1
recorded and kept on file for review by the
2
Administrator. Excluded from these requirements
3 are all calls not received as an emergency, all
4 interfacility transports, all calls responded to
5 for stand-by, and all calls with a disposition of
6 "cancel" or "assist. "
7 1.4 A first responding unit of a Certificate Holder,
8 having arrived at the emergency scene and
9 ascertained the medical severity of the patient(s) ,
10 may slow or cancel the response of the responding
11 ALS unit.
12 1.5 An ambulance which is operated by a Secondary
13 Provider shall arrive at the scene of each
14 emergency medical call within ten ( 10.0) minutes of
15 receipt of the call by the Certificate Holder.
16 Each Secondary Provider Certificate Holder must
17 maintain an average of at least ten ( 10.0) minutes,
18 from the receipt of call to arrival at the scene
19 with an ambulance, for all of the Certificate
20 Holder's emergency responses within each District
21 or Area on a monthly basis. Every emergency
22 medical call in which an ambulance takes longer
23 than ten (10.0) minutes to arrive at the scene
24 shall be recorded and kept on file for review by
25 the Administrator. Excluded from these
26 requirements are all calls not received as an
27 emergency, all interfacility transports, all calls
28 responded to for stand-by, all calls with the
29 disposition of "cancel" or "assist", delays en
30 route as approved by the Administrator, and all
31 calls in which the response is delayed due to being
32 slowed by MedCom or an on-scene Primary Provider.
33 2. Every Certificate Holder shall provide the
34 Administrator, upon request, with a monthly recording of the
35 following:
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1 •
2. 1 the time each emergency call was received by the
2 agency;
3 2.2 the time an ambulance or vehicle was dispatched;
4 2.3 the time the responding ambulance or vehicle was en
5 route; and
6 2.4 the arrival time of the respective ambulance or
7 vehicle.
8 3. Patient transport by a Certificate Holder in a
9 vehicle other than a Permitted ambulance shall be recorded by the
10 Certificate Holder and a copy shall be forwarded to the
11 Administrator for review within ten ( 10) days of any such
12 occurrence. This recording shall indicate the date, time, and
13 location of the incident and a statement of the justification for
14 the transport
15 4 . Priority Dispatch
16 4 . 1 Agencies using a nationally recognized priority
17 dispatch system may apply for a waiver to modify
18 the time limits imposed by these rules. The
19 determination to grant the waiver shall rest with
20 the Administrator, and must have the approval of
21 the EMS Council. Any • waiver granted by the
22 Administrator must establish the specific time
23 limits that will be met by the agency receiving the
24 waiver.
25 4.2 For calls classified by the priority dispatch
26 system as "life threatening", the time limits
27 established in the waiver shall not be more than
28 those contained in Section I, 1. 1 through part 1.5,
29 of these rules.
30 4.3 A waiver for response times may be revoked by the
31 Administrator at any time.
32 5. Response Times for Air Ambulance.
33 5. 1 When requested by MedCom and when flight conditions
34 permit, Certificate Holders shall promptly dispatch
35 an Air Ambulance to emergency medical calls.
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1 5.2 An Air Ambulance shall be en route to emergency
2 medical calls within an average of five (5.0)
3 minutes of the Air Ambulance crew's receipt of the
4 call. Excluded from these requirements are all
5 calls not received as an emergency, all
6 interfacility transports, all calls responded to
7 for stand-by, and all calls with a disposition of
8 "cancel" or "assist. " This shall be calculated on
9 a calendar month basis for the Certificate Holder.
10 5.3 An Air Ambulance responding to emergency medical
11 calls shall arrive on the scene of an emergency
12 medical call within an average of twenty (20.0)
13 minutes of that unit's receipt of the call. This
14 average shall be calculated on a calendar month
15 basis for the Certificate Holder.
16 5.4 The number of emergency medical calls responded to
17 by the Certificate Holder in which response time
18 exceeds twenty (20.0) minutes shall not be greater
19 than 20% of the total number of emergency medical
20 calls responded to in each calendar month.
21 6. If the Certificate Holder is not able to dispatch an
22 Air Ambulance within five (5.0) minutes of receipt of the call, the
23 Certificate Holder shall notify MedCom. This notification to
24 MedCom shall indicate:
25 6.1 When an aircraft will be available to respond; and
26 6.2 The actual location of the available aircraft to
27 respond. •
28 7. Response Times for Interfacility / Interhospital
29 Transfers.
30 7. 1 Requests for transport of emergency medical patients
31 must be responded to by having an ambulance at the
32 requesting facility within eight (8.0) minutes after
33 receipt of the call.
34 7.2 Requests for transport of an urgent nature, but
35 which are not of an emergency medical classification
•
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1 and have not been pre-scheduled, must be responded
2 to within thirty (30.0) minutes of the agreed upon
3 time. This response must be maintained for an
4 average of 90% of the calls for each calendar month.
5 7.3 Response times for routine scheduled calls shall be
6 responded to by having an ambulance at the
7 requesting facility within ten ( 10.0) minutes of the
8 agreed scheduled time. This response must be
9 maintained for an average of 90% of the calls for
10 each calendar month.
11 Upon request of the Administrator, non-governmental EMS agencies
12 shall provide response time information pertaining to all or any
13 portion of their interfacility / interhospital transfers, for any
14 given period of time.
15
16 J. DRIVERS AND PILOTS
17 1. Drivers shall comply with the law of the State of
18 Florida as it pertains to emergency vehicle operators.
19 2. It is the duty of every driver of an ambulance or
20 vehicle to:
21 2. 1 promptly respond to emergency medical calls;
22 2.2 when dispatched or requested to respond by MedCom,
23 establish and maintain two-way radio contact with
24 MedCom; and •
25 2.3 obey all traffic laws.
26 3. Drivers of ambulances and vehicles shall not:
27 3. 1 direct, prescribe, or manipulate a patient to
28 choose any particular facility, agency or other
29 service, occupation or profession for the personal
30 gain of the driver, patient attendant, or owner or
31 operator of the Primary or Secondary service;
32 3.2 smoke in any vehicle in which patients are, or may
33 be, transported; and
34 3.3 ask for remuneration in excess of or in addition
35 to that listed in the fee schedule provided to the
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1 Administrator.
2 4. Air Ambulance pilots shall comply with the law of
3 the State of Florida as it pertains to Air Ambulance pilots. It is
4 the duty of every Air Ambulance pilot to:
5' 4. 1 promptly respond to emergency medical calls;
6 4.2 establish and maintain two-way radio contact with
7 MedCom; and
8 4.3 obey all appropriate Air Ambulance laws.
9 SECTION II: RESPONSE OUTSIDE a DISTRICT O13 AREA
10 1. Certificates of Public Convenience and Necessity shall be
11 valid only within the District or geographic Area specified on
12 the Certificate.
13 2. Certificate Holders shall not respond to an emergency
14 medical call in the District or geographic Area of another
15 Certificate Holder, unless:
16 2.1 the service is requested, by MedCom or the affected
17 adjoining service, to respond into the affected District
18 or Area; or
19 2.2 an ambulance or vehicle of the Certificate Holder finds
20 itself at or near an emergency medical call in the
21 District or Area of another Certificate Holder, the
22 Ambulance or vehicle operator shall:
23 (a) advise MedCom of the proximity to the call and
24 that it intends to respond and render aid.
25 (b) MedCom will advise the responsible Certificate
26 Holder that another ambulance or vehicle is
27 on-scene rendering aid. The responsible
28 Certificate Holder may respond to assist the
29 on-scene ambulance or vehicle.
30 2.3 Certificate Holders receiving emergency medical
31 calls requesting a response into an adjoining
32 District(s) from agencies or persons other than
33 MedCom shall:
34 (a) obtain all pertinent information from the
35 caller, including the name of the caller,
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1 phone number, address of the call, and a
2 brief nature of the emergency; and
3 (b) respond to the call if the location and time
4 to arrive will benefit patient care; and
5 (c) relay the information to MedCom subsequent to
6 the call.
7 3. Each Certificate Holder shall be responsible to
8 provide emergency medical response to calls outside of their
9 assigned District(s) when required by MedCom, if staffed and
10 equipped ambulances or vehicles are available, without leaving
11 their assigned District(s) or Area unattended.
12 4. MedCom shall assign ambulances or vehicles to
13 respond to calls outside of their assigned District(s) by the
14 proximity of the units to the patient.
15
16 SECTION III: AREAS AND SECONDARY PROVIDER DISTRICTS
17 1. Certificates of Public Convenience and Necessity shall
18 be valid only .within the District(s) or geographic Area(s)
19 specified on the Certificate.
20 2. Certificate Holders with an ALS Transport and
21 Interfacility/Transfer Endorsement may respond to medical calls and
22 provide inter-hospital transfers and transfers anywhere within the
23 County, depending upon the Permitted level of the vehicle.
24 3. The EMS_Certificate Districts for holders of ALS
25 Transport Endorsements are as follows:
26 3.1 District 1: All of the unincorporated territory bounded
27 on the North by the Martin-Palm Beach County Line; on the
28 west by the range line dividing Ranges 39E/40E; on the
29 south by the centerline of Donald Ross Road and its
30 extension west to the range line dividing Ranges 39E/40E
31 and its extension east to the Atlantic Ocean; excluding
32 the platted subdivision of Caloosa; on the east by the
33 Atlantic Ocean. AND all of the incorporated territory
34 of:
35
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1
a. The Town of Jupiter
2 b. The Village of Tequesta
3 c. The Town of Jupiter Inlet Colony
4 3.2 District 2: All of the unincorporated territory bounded
5 on the North by the centerline of Donald Ross Road and
6 its extension west to the range line dividing Ranges
7 39E/40E and its extension east to the Atlantic Ocean,
8 including the platted subdivision of Caloosa; on the west
9 by the range line dividing Ranges 39E/40E from the
10 westerly extension of Donald Ross Road south to SR-80,
11 then east along its centerline to the intersection with
12 the L-8 Canal, then south along the L-8 Canal to its
13 intersection with the L-40 Canal, then south along the L-
14 40 Canal to the westerly extension of Lantana Road and
15 its extension to the L-40 Canal, and on the east by the
16 Atlantic Ocean; AND all of the incorporated territory
17 of:
18 a. The Town of Juno Beach
19 b. The City of Palm Beach Gardens
20 c. The Village of North Palm Beach
21 d. The Town of Lake Park
22 - e. The City of Riviera Beach
23 f. The Town of Palm Beach Shores
24 g. The Town of Mangonia Park
25 h. The City of West Palm Beach
26 I. The Town of Golfview
27 j. The Town of Cloud Lake
28 k. The Town of Glen Ridge
29 1. The Town of Lake Clarke Shore
30 m. The Village of Palm Springs
31 n. The City of Lake Worth
32 o. The Town of Hypoluxo
33 p. The City of Atlantis
34 q. The Town of Lantana
35 r. The Town of Manalapan
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1 s. The Town of South Palm Beach
2 t. The Town of Haverhill
3 u. The City of Greenacres
4 v. The Village of Royal Palm Beach
5 w. The Town of Palm Beach
6 X. The Village of Wellington
7 3.3 District 3: Bounded on the north by Lantana Road and its
8 extension west to the L-40 Canal; on the west by the L-40
9 Canal from its intersection with the westerly extension
10 of Lantana Road, south to its intersection with the
11 Broward County line; on the east by the Atlantic Ocean;
12 AND all of the incorporated territory of:
13 a. The City of Boynton Beach
14 b. The Town of Ocean Ridge
15 c. The Town of Briny Breezes
16 d. The Town of Gulf Stream
17 e. The City of Delray Beach
18 f. The Village of Golf
19 g. The Town of Highland Beach
20 h. The City of Boca Raton
21 3.4 District 4: Bounded on the north by the Palm
22 Beach/Martin County Line; on the west by the Palm
23 Beach/Hendry County Line; on the south by the Palm
24 Beach/Broward County Line; on the east by the range line
25 dividing Ranges 39/40E, south from the Palm Beach/Martin
26 County Line to its intersection with the L-8 Canal; then
27• south to its intersection with the L7/6 Canal, to its
28 intersection with the Palm Beach/Broward County Line; AND
29 all of the incorporated territory of:
30 a. The City of Pahokee
31 b. The City of Belle Glade
32 c. The City of South Bay
33
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•
2 _ --
• - 3 oRDINAN I iO1 96 16
4
5 AN ORDINANCE OF THE BOARD OF COUNTY • .
6 COMMISSIONERS OF PALM BEACH COUNTY, FLORIDA,
7 TO BE KNOWN AS THE PALM BEACH COUNTY EMERGENCY
8 MEDICAL SERVICES ORDINANCE OF 1996, PROVIDING
9 FOR: SHORT TITLE; AUTHORITY AND PURPOSE;
10 DEFINITIONS; CERTIFICATES AND - ENDORSEMENTS
11 REQUIRED; PROCEDURES FOR REQUESTING
12 CERTIFICATE; INVESTIGATION AND REVIEW OF
13 APPLICATION; REQUIREMENT FOR BOARD APPROVAL IN
14 GRANTING A CERTIFICATE OF PUBLIC CONVENIENCE •
15 AND NECESSITY; RIGHTS AND DUTIES GRANTED BY .
. 16 CERTIFICATE; . PROVISION OF PATIENT OUTCOME
17 DATA; VEHICLE PERMITS; RULES AND REGULATIONS;
18 GENERAL PROHIBITION; DEFICIENCIES;
19 CERTIFICATION, REVOCATION, MODIFICATION,
20 SUSPENSION; COMPLAINT PROCEDURE; EMERGENCY
21 POWERS; EXCLUSION FROM CERTIFICATE OR PERMIT
22 REQUIREMENT; PENALTIES; INCLUSION IN CODE;
23 APPLICABILITY; REPEAL OF" LAWS IN CONFLICT;
24 SEVERABILITY; EFFECTIVE DATE AND
25 IMPLEMENTATION.
26
27
28 WHEREAS, the Board of County Commissioners of Palm Beach
29 County, Florida, adopted the Palm Beach County Emergency Medical
30 Services Ordinance of 1987, Ordinance No. 87-27; and
31 WHEREAS, the Board of County Commissioners of Palm Beach
32 County, Florida, desires to repeal Palm Beach County Ordinance No.
33 87-27 and replace it with the following Ordinance; and
34 WHEREAS, Chapter 401, Florida Statutes, authorizes the
35 Board of County Commissioners of Palm Beach County to provide and
36 maintain for the citizens of said County standards which ensure
37 their health, welfare and well being; and •
38 WHEREAS, the Board of County Commissioners of Palm Beach
39 . County recognizes that the public health and safety of the
40 residents of the County will best be served by enacting emergency
41 medical services legislation; and
42 WHEREAS, in order to effectively promote the health,
43 safety, and welfare of the residents of Palm Beach County in need
.44 of emergency medical services, it is necessary to establish
45 reasonable standards for issuing Certificates of Public Convenience
46 and Necessity for Advanced and Basic Life Support Services, Air
47 Ambulance Services, and Advanced Life Support Transportation
48 Services.
49 •
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1- NOW, THEREFORE, BE IT ORDAINED BY THE BOARD OF`COUNTY
2 COAQ(ISSIONERS OF PALM BEACH COUNTY, FLORIDA, that:
3 ,SECTION 1. SHORT TITLE
4 This Ordinance shall be known and may be cited as the
5 "Palm Beaoh County Emergency Medical Services Ordinance of 1996. "
6 SECTION 2. AUTHORITY AND PURPOSE
7 This Ordinance is promulgated pursuant to Chapter 401,
8 Florida Statutes. The purpose of this Ordinance is to promote the
9 health, safety, and welfare of residents of Palm Beach County in
10 need of emergency medical services by establishing standards for
11 issuing Certificates of Public Convenience and Necessity for
12 Advanced Life Support Transportation Services, Advanced Life
13 Support Services, and Air Ambulance Services and by providing for
14 the adoption of Rules and Regulations governing the Districts,
15 Areas, and operation of the services as described herein.
16 SECTION 3. DEFINITIONS
17 A. "Administrator" means the Palm Beach County
18 Administrator or his designee.
19 B. "Advanced Life Support" or "ALS" means treatment of
20 life-threatening medical emergencies through the use of techniques
21 such as endotracheal intubation, the administration of drugs or
22 intravenous fluids, telemetry, cardiac. monitoring, and cardiac
23 defibrillation by a person qualified in accordance with Chapter
24 401, Florida Statutes.
25 C. "Advanced Life Support Service" means any person,
26 firm, corporation, association, or governmental entity owning or
27 acting as an agent for the owner of any business or service which
28 furnishes, operates, conducts, maintains, advertises, engages in,
29 proposes to engage in, or professes, to engage in the business or
30 service of providing Advanced Life Support.
31 D. "Advanced Life Support (ALS) Transportation Service"
32 means any person, firm,• corporation, association, or governmental
33 entity owning or acting as an agent for the owner of any business
34 or service which furnishes, operates, conducts, maintains,
35 advertises, engages in, proposes to engage in, or professes to
•
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v 1 engage in. the business or''service of responding" to medical or
2 emergency medical calls with, ambulances and which its endorsed by
3 the County to routinely transport patients.
4 E. "Air Ambulance" means any aircraft used for, or
5 intended to be used for, air transportation of sick or injured
6 persons requiring or likely to require medical attention during
7 transport.
8 F. "Air Ambulance Service" means any person, firm,
9 corporation, association, or governmental entity owning or acting
10 as an agent for the owner of any business or service which
11 furnishes, operates, conducts, maintains, advertises, engages in,
12 proposes to engage in, or professes to engage in the business or
13 service of responding to medical or emergency medical calls with
14 Air Ambulances.
15 G. "Ambulance" means any land, air or water vehicle
16 that is designed, constructed, reconstructed, maintained, equipped
17 or operated and is used for or intended to be used for air, land,
18 or water ALS and BLS transportation of sick or injured persons
19 requiring or likely to require medical attention or emergency
20 medical attention.
21 H. "Area" means a geographical division of Palm Beach
22, County that is clearly defined by distinct borders and/or municipal
23 boundaries within which a Primary Provider will provide services.
24 I• "Basic Life Support" or "BLS" means treatment of
25 medical emergencies by a qualified person through the use of.
26 techniques such as patient assessment, cardiopulmonary
27 resuscitation (CPR) , splinting, obstetrical assistance, bandaging,
28 administration of oxygen, application of medical antishock
29 trousers, administration of a subcutaneous injection using a
30 premeasured autoinjector of epinephrine to a person suffering an
31 anaphylactic reaction, and other techniques described in the
32 Emergency Medical Technician Basic Training Course Curriculum of
33 the United States Department of Transportation.
34 J. "Basic Life Support Service" means any emergency
35 medical service which only uses BLS techniques.
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,.
•
K. "Board" means the Board of County Commissioners of
2 Palm Beach County, Florida.
3 L. "Certificate Holder" means any person, firm,
4 corporation, association, or governmental entity owning or acting
5 as an agent for the owner of any business or service which has
6 been issued a Certificate •of Public Convenience and Necessity by
7 Palm Beach County.
8 M. "Certificate of Public Convenience and Necessity
" or
9 "Certificate" or "EMS Certificate" means a Certificate with
10 Endorsements issued by the Board of County Commissioners of Palm
11 Beach County, Florida, deeming it to be in the public convenience
12\ and necessity for the named Advanced Life Support Transportation
13 Service, Advanced Life Support Service, or Air Ambulance Service to
14 operate within the confines of Palm Beach County, as authorized in
15 Section 401.25, Florida Statutes.
16 N. "County" means the incorporated and unincorporated
17 areas of Palm Beach County, Florida.
18 0. "Emergency Medical Call," means any request for the
19 immediate and prompt dispatch of an ambulance or vehicle for the
20 purpose of providing immediate medical assistance or transportation
21 of a sick, injured or otherwise incapacitated patient.
22 P. "Emergency Medical Services Council" or "EMS
23 Council" means the agency appointed by the Board of County
24 Commissioners to advise and provide comment on matters relating to
25 emergency medical services within Palm Beach County.
26 Q. "Endorsement" means the type(s) of service a
27 Certificate Holder is authorized to provide and the respective
28 Area(s) or District(s)in which it may provide said service, as
•
29 shown on an EMS Certificate issued by the Board.
30 R. "Evacuation" means the withdrawal and transport of
31 ill or incapacitated persons who reside in threatened areas and
32 . require transportation, to or from a Board established shelter,
33 utilizing ambulances, when required by the Board due to a local
34 state of emergency.
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1 -6-. "Inter?aaili=y Transfer" means the-transportation
2 of a patient requiring an ambulance, as licensed under Chapter 401,
3 Florida Statutes, between two facilities licensed under Chapter
4 395, Florida Statutes, or Chapter 401, Florida Statutes.
5 T. "MedCom" means the Palm Beach County Medical
6 Communications Center.
7 U. "Medical Call" means any request for medical
8 assistance or transportation which does not require the immediate
9 or prompt dispatch of an ambulance or vehicle, or any situation
10 which does not require the immediate or prompt provision of medical
11 assistance or transportation.
12 V. "Medical Control" means direct physician supervision
13 through two-way voice communication or through established written
14 standing orders.
15 W. "Medical Director" means a Florida licensed
16 physician who shall become an active member of the Palm Beach
17 County EMS Council's Medical Director's Standing Subcommittee and
18 is employed or contracted to' provide medical supervision for the
19 daily operations and training of Advanced Life Support
20 transportation services, Advanced Life Support services, or Air
21 Ambulance services, as defined in Chapter 10D-66,0505 (F.A.C. ) .
22 X. "Medical Director's Standing Subcommittee" means a
23 perennial subcommittee of the EMS Council comprised of medical
24 directors of ALS transportation services, ALS services, or Air
25 Ambulance services.
26 Y. "patient" means any person who requires, or may
27 require, medical assistance and/or transportation.
28 Z. "Permit" means the adhesive decal issued by the
29 County to an ALS transportation service, ALS service, or Air
30 Ambulance service, acid which must be affixed to a vehicle or
31 ambulance authorized by the Administrator to operate in Palm Beach
32 County. No vehicle or ambulance shall operate in Palm Beach County
33 without obtaining said Permit. •
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1 - -AKA_. 'primary P1b r£tge- iseans the agency designated by
2 the Board to provide Advanced Life Support emergency medical
3 services and/or transport within the Area stated upon their COPCN.
4 BB. " Response Time" means the time beginning when a
5 Certificate Holder's dispatch center receives a call requesting
6 emergency response to the time an ambulance or vehicle of the
7 Certificate Holder arrives at the reported address of the
8 emergency.
9 CC. "Secondary Provider" means the agency designated by
10 the Board to provide secondary Advanced Life Support or Basic Life
11 Support emergency medical services and/or transport within a
12 geographically defined District.
13 DD. "Secondary Provider District" or "District" means a
14 geographical division of Palm Beach County that is clearly defined
15 by distinct borders within which a Secondary Provider will provide
16 service.
17 EE. "Transfer" means the transportation of a patient by
18 ambulance as a result of a request for response to a medical call.
19 FF. "Vehicle" means any vehicle which is staffed and
20 equipped to provide Advanced Life Support and Basic Life Support
21 treatment, but not used for transport.
•
22
23 SECTION 4. CERTIFICATE AND ENDORSEMENTS REQUIRED
24 A. Palm Beach County shall issue Certificates of Public
25 Convenience and Necessity titled "EMS Certificates" . Every person,
26 firm, corporation, association, or governmental entity owning or
27 acting as an agent for the owner of any business or service,
28 wishing to respond to emergency and medical calls, which furnishes,
29 operates, conducts, maintains, advertises, engages in, proposes to
30 engage in, or professes to engage in the business or service of
31 providing Advanced Life Support transportation, Advanced Life
32 Support, Basic Life Support, Basic Life Support transportation
33 service, inter-facility transfer, inter-hospital or Air Ambulance
34 services, must obtain an EMS Certificate. Due to the standards
-6 •
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•
1 established by this Ordinance, no "EMS Certificates" shall issue
2 with a BLS Endorsement.
3 B. EMS agencies which intend to provide ALS and BLS
4 response but not routine transport of patients must apply for, and
5 obtain, an "ALS" Endorsement to their respective Certificate of
6 Public Convenience and Necessity.
7 C. EMS agencies which intend to provide ALS and BLS
8 response and routine transport of patients must apply for, and
9 obtain, an "ALS Transport" Endorsement to their respective
10 Certificate of Public Convenience and Necessity.
11 D. Only non-governmental EMS agencies may provide
12 interhospital or interfacility transfer services. Governmental
13 agencies shall not provide interhospital or interfacility transfer
14 services unless, based on an emergency call as defined in
15 Section 3.0 herein and originating from the County's Emergency
16 9-1-1 Telephone System, the patient's condition requires a response
17 from the nearest available EMS agency. Emergency interhospital or
18 interfacility transports shall meet the same response time
19 requirements as an emergency medical call.
20 E. Only those agencies which possess a Palm Beach
21 County Certificate of Public Convenience and Necessity may provide
22 Advanced Life Support transportation, Advanced Life Support, Basic
23 Life Support, Basic Life Support transportation service, inter-
24 facility transfer, inter-hospital transport, Air Ambulance
25 services, and/or respond to medical calls in Palm Beach County,
26 except as otherwise provided in §401.33, Florida Statutes.
27 F. Governmental entities having a public mandate to
28 provide emergency medical services within their jurisdiction may be
29 granted a Certificate by the Board and may serve said jurisdiction
30 as the Primary Provider. • Any governmental entity requesting a
31 Certificate of Public Convenience and Necessity must comply with
32 all the requirements set forth in this Ordinance including, but not
33 limited to, Section 5. The Endorsement(s) on the Certificate shall
34 reflect the service which is authorized by the Board.
35
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1 BECTION 5. PROCEDURES FOR RE9UESTINO CERTIFICATE
2 A. Each applicant requesting a Certificate .of Public
3 Convenience and Necessity shall submit a copy of a completed
4 application as required by Chapter 401, Florida Statutes, and any
5 rules promulgated pursuant thereto. This application must also
6 include:
7 1. such other forms and information that the
8 Administrator may require for full and complete disclosure of
9 information for consideration by the Board of County Commissioners
10 including, but not limited to, information as to Districts, Areas,
11 rate schedules, current financial statement prepared by an
12 independent accounting firm or, in the case of a governmental unit,
13 the funds budgeted for this service; and
14 2. the specific service Endorsement sought and
15 Area or District in which the applicant intends to provide the
16 service; and
17 3. a non-refundable application fee as
18 established by the Board of County Commissioners, by resolution.
19 B. Public notice shall be given by the Administrator no
20 earlier than one hundred fifty (150) days and no later than one
21 hundred twenty (120) days prior to the expiration date of all
22 Certificates of Public Convenience and. Necessity. This notice
23 shall state that the County will be accepting applications for
24 Certificates for all Districts and Areas of operation within the
25 County.
26 C. Applications shall be submitted to the Administrator
27 or his designee no earlier than one hundred twenty (120) days and
28 no later than ninety (90) days prior to the expiration date of the
29 Certificate of Public convenience and Necessity.
30 D. Applications for Certificates shall be accepted only
31 during the time specified in the public notice.
32 SECTION 6. INVESTIGATION AND REVIEW OF APPLICATION
33 A. Upon receipt of an application, the Administrator
34 shall review the application, conduct an investigation, and obtain
35 verification that the applicant meets the requirements of all
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1 applicable federal, state and local laws. The investigation shall
2 include consideration of:
3 1. the need for the proposed service in the
4 requested Area or District;
5 2. the financial information of the applicant to
6 ensure continued service to the Area or District;
7 3. the proposed rate structure as it relates to
8 those currently charged in the County;
9 4. the applicant's assurance that it has met or
10 can meet all federal, state and local requirements; however, said
11 requirements must be met prior to the issuance of a Certificate;
12 5. the professional and personal integrity of the
13 applicant;
14 6. the applicant's past performance in this Area
15 or District, as well as in other jurisdictions, Districts or Areas;
16 7. other information deemed relevant by the
17 Administrator.
18 B. The Administrator shall forward all investigative
19 reports to the Palm Beach County Emergency Medical Services Council
20 for its review. A copy of the Administrators report shall,
21 concurrently, be forwarded to the applicant. After said review,
22 the EMS Council shall provide the Board with its recommendations as
23 to Primary and Secondary Providers. Prior to the review of the
24 applications by the EMS Council, the Administrator may request the
25 Board to set a date for a public hearing, as described in Section
26 7, to consider the applications and the EMS Council ' s
27 recommendations.
28 C. The applicant shall cooperate with the Administrator
29 in producing or causing to be produced any information appropriate
30 to the investigation and report. Failure to provide any
31 information requested by the Administrator may result in rejection
32 of the application.
33 D. The Administrator's report concerning the
34 application shall be forwarded to the Board for the Public Hearing.
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1
SECTION 7, REQUIREMENT FOR BOARD APPROVAL IN GRANTING A
2 - CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY
3 A. The Board shall schedule public hearings to consider
4 all applications for Certificates. The Administrator shall notify
5 all applicants and current Certificate Holders ,of the date, time,
6 and place of the public hearing at least ten ( 10) days prior to
7 said hearing. All applicants shall appear before the Board at the
8 public hearing on the same day.
9 B. At the hearing, the Board shall receive the report •
10 of the Administrator, report of the EMS Council, testimony from the
11 applicant(s) or any other interested party, and any other relevant
12 information. For all Certificates, the Board will consider the
13 public's convenience and the necessity for the service in the
14 District or Area requested. The Board will consider whether the
15 applican't has the ability to provide the necessary service based
16 upon the criteria set forth in this Ordinance and Chapter 401,
17 Florida Statutes. The Board shall also consider the
18 recommendations of any municipality or municipalities applying for
19 a Certificate or affected by the issuance of a Certificate.
20 C. At said public hearing, after consideration of the
21 aforementioned information, the Board shall determine, based upon
22 the criteria and guidelines of this Ordinance and Chapter 401,
23 Florida Statutes, which agencies shall serve all or a portion of
24 the District or Area requested. The agencies determined_ by the
25 Board as most qualified to serve all or a portion of the District
26' or Area shall be identified as "Primary" or "Secondary" providers.
27 D. The Board shall then authorize the issuance of the
28 Certificate with such conditions, restrictions and/or Endorsements
29 as are in the public's interest or deny the application setting
30 forth the reasons for the denial.
31 D. 1 The Board of County Commissioners may limit or
32 define the extent to which a "Primary" or "Secondary"
33 provider may provide service within the District or Area.
34 D.2 All Certificate Holders shall provide "backup" to
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- a Primary-'Providet-'if requested by MedCom, unless it will remove
2 all coverage from its assigned Area or District.
3 E. Notwithstanding the procedures and substantive
4 requirements for the issuance of a Certificate, the Board may
5 grant, at its discretion, and at any time, a temporary Certificate
6 of Public Convenience and Necessity for a period not to exceed six
7 (6) months in order to safeguard and protect the public health,
8 safety and welfare. This temporary Certificate may be renewed.
9 SECTION 8. TERM AND ASSIGNABILITY OF CERTIFICATES
10 Certificates of Public Convenience and Necessity, granted by the
11 Board pursuant to this Ordinance shall be valid for four (4)
12 calendar years. All Certificates shall be personal to the
13 applicant and may, with the approval of the Board of County
14 Commissioners at a public hearing, be assigned or transferred,
15 contingent upon the completion of requirements set forth in this
16 Ordinance including, but not limited to, Section 6. All EMS
17 Certificate Holders within the County shall be provided with
18 notice, at least ten (10) days prior, of any Public Hearing
19 regarding the assignment or transfer of a Certificate.
20 SECTION 9. RIGHTS AND DUTIES GRANTED BY CERTIFICATE
21 A. Acceptance of a Certificate with an "ALS"
22 Endorsement shall obligate the applicant. to:
23 1. provide Advanced Life Support and Basic Life
24 Support to the entire geographical Area as stated on the
25 . Certificate of Public Convenience and Necessity;
26 2. respond to all emergency medical calls;
27 3. when requested by MedCom, provide backup
28 coverage to emergency medical calls in an adjoining Area or
29 District when the Certificate Holder for that Area is unable to
30 respond, unless it will remove all coverage from its assigned Area
31 or District;
32 4. abide by all requirements of this Ordinance
33 and Rules and Regulations adopted by the Board and all applicable
34 federal, state and local laws;
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1 .5. provide access to the applicant's business,
2 vehicles and ambulances for inspection by the Administrator
3 pursuant to Sections 11, 15 and 16 of_ this Ordinance;
4 6. post, at the place of business, a copy of the
5 fee schedule required under this Ordinance;
6 7. submit to the Administrator any changes or any
7 requested changes in the fee schedule at least sixty (60) days
8 prior to the effective date of such change, and all documentation
9 which justifies the fee change;
10 8. notify the Administrator at least ninety (90)
11 days prior to the termination or reduction of any service;
12 9. not transport patients unless the agency also
13 carries an "ALS Transport" Endorsement;
14 10. perform only those services specifically
15 authorized by its Certificate Endorsement(s) , and abide by all
16 restrictions, limitations, and exclusions as identified on the
17 Certificate;
18 11. provide the Administrator with copies of
19 updated, current records and/or data which pertain to Certificate
20 application, personnel certification, and vehicle data, within
21 thirty (30) days of any change to said records; and
22 12. adopt the minimum standard pre-hospital
23 treatment/transport protocols approved and adopted by the Palm
24 Beach County EMS Council. However, a Certificate Holder may
25 implement protocols which exceed the minimum standards adopted by
26 the EMS Council.
27 B. Acceptance of a Certificate with an ALS Transport
28 Endorsement shall obligate the applicant to:
29 1. provide ALS response and transportation
30 service to the entire 'District or geographical Area as stated on
31 the Certificate of Public Convenience and Necessity;
32 2. provide coverage to an adjoining District or
33 Area, when requested to do so by MedCom for emergency medical calls
34 when the Certificate Holder for that District or Area is unable to
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.. _... _
1 respond, uniesi 1tAiill remove all coverage from its assigned
2 District or Area; - -
3 3. respond to all emergency medical calls unless
4 all vehicles in service are on other emergency medical or medical
5 calls; •
6 4. abide by all requirements of this Ordinance
7 and Rules and Regulations adopted by the Board and all applicable
8 federal state and local laws;
9 5. provide access to the applicant's business,
10 vehicles and ambulances for inspection by the Administrator
11 pursuant to Sections 11,15 and 16 of this Ordinance;
12 6. post at the place of business a copy of the
13 fee schedule required under this Ordinance;
14 7. submit to the Administrator any changes or any
15 requested changes in the fee schedule at least sixty (60) days
16 prior to the effective date of the change and all documentation
17 which justify the fee change;
18
19 8. provide emergency medical service and patient
20 transport at no cost to the patient when requested by the
21 Administrator or his designee because an emergency evacuation of
22 persons from an Area or District is required by a declaration of a
23 local state of emergency by the Board;
24 9. notify the Administrator at least ninety (90)
25 days prior to termination or reduction of any service;
26 10. perform ohly those services specifically
27 authorized by its Certificate Endorsement(s) , and abide by all
28 restrictions, limitations, and exclusions as identified on the
29 Certificate;
30. 11. provide the Administrator with copies of
31 updated, current records and/or data which pertain to Certificate
32 application, personnel certification, and vehicle data, within
33 thirty (30) days of any change of said records; and
34 12. adopt the minimum standard pre-hospital
35 treatment/transport protocols approved and adopted by the Palm
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J
•
1 Beach County EMS Council. However, a Certificate Holder may
2 implement protocols which exceed the minimum standards adopted by
3 the EMS Council.
4 SECTION 10. PROVISION OF PATIENT OUTCOME DATA
5 Hospitals shall, upon request of an EMS provider agency,
6 provide outcome data to the EMS provider, agency on individual
7 patients that were transported to said hospital by that agency for
8 the purpose of statistical analysis by the agency's quality
9 assurance and management/improvement program. The outcome data
10 shall consist of admissiop and/or discharge diagnoses on any and
11 all patients transported to said hospital by the requesting EMS
12 provider agency. An EMS provider agency may not request outcome
13 data on any patients other than those which were treated initially
14 and/or transported by said EMS provider agency. All such requests
15 for outcome data shall be used exclusively by the individual EMS
16 provider agency's quality management/improvement program, and as
17 such, are confidential and protected from discovery as specified by
18 Florida Statutes 395.401, 401.265, and 401.425.
19 SECTION 11. VEHICLE PERMITS
20 A. Certificate Holders shall be subject to random and
21 routine inspections of their ambulances and vehicles. Ambulances
22 and vehicles found acceptable by the Administrator shall be issued
23 a Permit, in the form of an adhesive decal, which shall be affixed
24 to the ambulance or vehicle. Permits shall be valid for one ( 1)
25 year from date of issue.
26 B. A fee, as established by resolution of the Board of
27 County Commissioners, shall be required for each Permit issued.
28 C. If, during an inspection, the Administrator
29 ascertains that an ambulance or vehicle or its equipment does not
30 comply with the standards as set forth in Chapter 401, F.S. , or
31 this Ordinance, the Administrator may suspend or revoke its
32 respective Permit until the Certificate Holder can establish that
33 the ambulance or vehicle is once again in compliance. The
34 Administrator shall allow the Certificate Holder a maximum of
35 thirty (30) days to comply and shall report all Permit suspensions
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1 - or revocations -and pertinent information to the Emergency Medical
2 Services Council.
3 D. Ambulances or vehicles with suspended Permits which
4 are not brought into compliance within the time specified by the
5 Administrator, shall have its Permit revoked. It shall be a
6 violation of this Ordinance for an ambulance or vehicle with a
7 suspended or revoked Permit to operate within the County.
8 •
E. A Certificate Holder which has had a Permit revoked
9 must apply to the Administrator for a new Permit and shall pay the
10 required fee.
11 F. A Certificate Holder may appeal the revocation of
12 Permit by appearing before the EMS Council at one of its regularly
13 scheduled meetings. A Certificate Holder seeking to appeal a
14 Permit revocation shall make said request in writing to the EMS
15 Council through the Administrator. The Administrator shall then
16 advise the Certificate Holder of the date and time the appeal may
17 be heard.
18 G. The EMS Council shall hear the appeal and vote to
19 either uphold or rescind the revocation. All decisions of the EMS
20 Council shall be final.
21 SECTION 12. RULES AND REGULATIONS
22 The Administrator, in consultation with the EMS Council,
23 is hereby authorized to prepare such Rules and Regulations
24 necessary to carry out the purpose of this Ordinance, and shall
25 present these Rules and Regulations for consideration to the Board
26 of County Commissioners at .a public hearing.
27 The Board may adopt and subsequently amend Rules and
28 Regulations adopted hereunder at a public hearing, provided notice
29 of the proposed change has been presented to the EMS Council and to
30 the Certificate Holder's for review no later 'than thirty (30) days
31 prior to consideration by the Board.
32 SECTION 13. GENERAL PROHIBITION
33 It shall be a violation of this Ordinance, and shall be
34 reported to the Emergency Medical Services Council, for any person,
35 business entity or governmental agency to:
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1 A. • obstruct, bar or otherwise interfere with an
2 inspection conducted under the purview of this Ordinance;
3 B. make an omission of a material fact or a false
4 statement in any application or other document filed with the
5 Administrator;
6 C. by telephone or otherwise, cause to be placed or
7 place a false emergency medical call;
8 D. violate or fail to observe any requirement of this
9 Ordinance, or any rule, regulation or order under the provision of
10 this Ordinance;
11 E. represent herself, himself, or itself as an Advanced
12 Life Support transportation service, an Advanced Life Support
13 service, Air Ambulance service, or engage in the business of
14 conducting an Advanced Life Support transportation service,
15 Advanced Life Support service, Basic Life Support transportation
16 service, Basic Life Support service, inter-facility transfer,
17 inter-hospital transport, Air Ambulance services, and/or respond to
18 medical calls in Palm Beach County without first obtaining an
19 appropriate Certificate of Public Convenience and Necessity from
20 the Board as provided herein and the necessary State of Florida
21 licenses,except as otherwise provided
pursuant to §401.33, Florida
22 Statutes.
23 F. operate an ambulance or vehicle that does not meet
24 the requirements of this Ordinance; or
25 G. obstruct, bar, or otherwise interfere with patient
26 care.
27 Violations of this Ordinance shall be punishable in
28 accordance with §125.69, Florida Statutes. Each day of continuing
29 violation shall be considered a separate offense.
30 SECTION 14. ' DEFICIENCIES
31 A. Whenever the Administrator determines; by inspection
32 or otherwise, that a Certificate Holder is not in compliance with
33 requirement under this Ordinance or its Rules and Regulations,
34 Chapter 401, F.S., Rule 10D-66 (F.A.C. ) or any other applicable
•
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1 law, the Administrator='ihall- order` the Certificate Holder to
2 correct such deficiency.
3 B. Every such correction order, whether verbal or
4 written, shall include a statement of the deficiencies found, the
5 period prescribed within which a deficiency must be corrected, and
6 the provision of the law relied upon. The affected Certificate
7 Holder may file a written request with the Administrator for
8 reconsideration of the order or any portion thereof, within five
9 (5) calendar days of the receipt of such order. Failure of the
10 Administrator to respond to the Certificate Holder's written
11 request for reconsideration within seven (7) calendar days of
12 receipt shall void the correction order. All information shall be
13 forwarded to the Emergency Medical Services Council.
14 SECTION 15. COMPLAINT PROCEDURE
15 A. All Complaints filed against a Certificate Holder
16 shall be reviewed. The Certificate Holder who is the subject of
17 said complaint shall be immediately notified of same. The
18 Administrator may designate a Committee to conduct this review.
19 The findings of said Committee will be submitted to the
20 Administrator. If this review substantially verifies that a
21 violation of this Ordinance or any applicable law has occurred, the
22 Administrator may conduct an investigation. The Administrator
23 shall be provided access to the Certificate Holder's business
24 records for inspection to assist in said investigation. Upon
25 completion of the investigation, the Administrator may. present
26 his/her recommendation to the Emergency Medical Services Council
27 for their review and recommendation prior to submittal to the
28 County Commissioners.
29 B. If the Administrator or Emergency Medical Services
30 Council finds through an investigation that revocation, suspension,
31 or modification of a Certificate is warranted, the Administrator
32 shall notify the Certificate Holder by certified mail, and the
31 Board of County Commissioners in writing, of such investigative
34 findings. This notice shall state the reasons for any finding and
35 establish a Public Hearing date. The Public Hearing shall be held
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1 by the Board of County Commissioners for the purpose of considering
2 the Administrator's investigation and recommendation. The
3 Administrator shall forward the public hearing results to the State
4 EMS office.
5 SECTIQN 16. CERTIFICATION REVOCATION, MODIFICATION,
6 SUSPENSIQH
7 A. Every Certificate issued pursuant to this Ordinance
8 is subject to revocation, modification or suspension where it is
9 found that:
10 1. the Certificate Holder has failed or neglected
11 to adhere to this Ordinance or the Rules and Regulations
12 promulgated by the Board, Chapter 401, Florida Statutes and any
13 other applicable law: or
14 2. the application submitted to secure a
15 Certificate of Public Convenience and Necessity from the Board of
16 County Commissioners contains a false representation or omitted
17 material facts; or
18 3. the Certificate Holder, or its agent, has
19 demanded money or other compensation in excess of that established
20 in its schedule of fees filed with the Board pursuant to this
21 Ordinance; or
22 4. the Certificate Haider has failed to comply
23 with a correction order issued under Section 14 of this Ordinance;
24 . or
•
25 5. the Certificate Holder has been adjudicated
26 guilty of a felony, unless the Certificate Holder's civil rights
27 have been restored; or
28 6. the Certificate Holder has been found guilty,
29 by a court of competent jurisdiction, of any criminal offense
30 involving moral turpitude; or
31 7. the Certificate Holder has committed malpractice
32 or negligence in the operation of its service; or
33 8. the Certificate Holder has had their/its State
34 license revoked or suspended.
35
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:• B. The EMS Council shall review and make recommendation
2 to the Board of County Commissioners regarding Certificates subject
3 to revocation, modification, or suspension. The Board of County
4 Commissioners may either accept or reject the recommendation of the
5 EMS Council.
6
7 SECTION 17. EMERGENCY POWERS
8 If a situation exists which poses a serious or imminent
9 threat to the health, safety, welfare, or public need and
10 convenience, the Administrator shall have such temporary emergency
11 powers as• are necessary to remedy the situation.
12
13 SECTION 18. EXCLUSION FROM CERTIFICATE OR PERMIT
14 P.EOUIREMENT
15 'Certificates or Permits shall not be required for:
16 A. the transport of a patient or passenger pursuant to
17 the Good Samaritan Act, Chapter 768. 13, Florida Statutes;
18 B. ambulances based outside the County which pick up a
19 patient outside the County and transport them into the County, or
20 which pick up a patient inside the County and transport them out of
21 the County;
22 C. all vehicles which serve primarily as administrative
23 vehicles;
24 D. those vehicles and services identified in Chapter
25 401.33, Florida Statutes;
26 E. vehicles or ambulances providing mutual or automatic
27 aid to a District or Area when the District or Area's permitted
28 vehicles or ambulances are unable to respond, or when the patient' s
29 condition necessitates immediate transportation as identified in
30 the minimum standard p.re-hospital treatment protocols as approved
31 and adopted by the Palm Beach county EMS Council, or as confirmed
32 by Medical Control; or
33
34
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1 F. vehicles or ambulances from another county which
2 respond when requested through an officially executed mutual aid
3 agreement. •
4 SECTION 19. PENALTIES
5 A violation of any provision of this Ordinance shall be
6 prosecuted in the same manner as a misdemeanor pursuant to y
7 125.69, Florida Statutes, and, upon conviction, the violator shall
8 be subject to a fine not to exceed Five Hundred Dollars ($500)
9 and/or imprisonment in the County Jail for not more than sixty (60)
10 days, or both such fine and imprisonment. Each day that a
11 , violation continues shall be considered a separate offense.
12 SECTION 20. INCLUSION IN CODE OF LAWS AND ORDINANCES
13 The provisions of this Ordinance shall become and be made
14 a part of the Code of Laws and Ordinances of Palm Beach County,
15 Florida. The sections of this Ordinance may be renumbered or
16 relettered to accomplish such; the word "Ordinance" may be changed
17 to "section, " "article" or other appropriate word.
18 SECTION 21. APPLICABILITY
19 It is hereby provided that this Ordinance shall
20 constitute a uniform law applicable in all the unincorporated and
21 incorporated areas of Palm Beach County, Florida, as authorized by
22 Chapter 401, Florida Statutes.
23 SECTION 22. REPEAL OF LAWS IN CONFLICT
24 Any laws or ordinances in conflict with this Ordinance
25 which Palm Beach County is authorized to repeal are hereby
26 repealed. Specifically, Ordinance No. 87-27, is repealed in the
27 manner described in this Ordinance.
28 SECTION 23. SEVERABILITY
29 If any section, paragraph, sentence, clause, phrase or
30 word of this Ordinance is, for any reason, held or declared by a
31 court to be unconstitutional, inoperative or void, such holding
32 shall not affect the remainder of this Ordinance.
33
34
35
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I!
r i! —
1 t SECTION 24. EFF CT fl!E DATE AND IMP E NTATION
2. I!
3 Ij Any provision relating to the application and
4 : certification process for obtaining a COPCN shall become effective
5 11 August 1, 1996, at 12:00 A.M. The remaining provisions of this
6 11 Ordinanceshall take effect January 1, 1997, at 12:00 A.M.
7 II All Class A and Class C Certificate Holders licensed for
1
8 1: the years 1996-1997 shall be issued a three (3) year extension to
9 /11the term of their respective COPCNs upon submittal of an updated
10 ; application, subject to approval by the Board of County
11 lCommissioners, in accordance with this Ordinance. After the
ii
12 expiration of said extended term, all Certificates issued shall be
1
13 valid for four (4) years as provided in Section 8.
14
15 APPROVED AND ADOPTED by the Board of County Commissioners
16 of Palm Beach County, Florida, on the 7 day of May ,
17 . 1996.
18 DOROTHY H. WILKEN, CLERK PALM BEACH COUNTY, FLORIDA, BY ITS
19 BOARD OF COUNTY COMMISSIONERS_-
21
22 23 By: //do Y- o ‘:y !Ilikt
`
24 Deputy Clerk --`b.- - r', ��
26 QP�8E4'%.� Chairman
:.c, i .r: •
27 APPROVED AS TO FORM AN ' C O U N T Y, :
28 LEGAL SUFFICIENCY .:7::29 •
�'y�•. 4 0R1V l' p
30 '+d�j• _. --��_
31 ''4.'* Sd r ._
32
33 By
34 st. Count Attorney
35
36
37 Filed with the Department of State on the 13th day of
38 May , 1996.
39
•
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