§ 42-76. Certificate application/renewal.

(a)

All BLS/ALS service providers, unless exempt by state or federal law, shall obtain a certificate from the board pursuant to the provisions herein, and are subject to the rules and regulations as may be promulgated pursuant to this article. Such certificates may or may not be issued by the board, in its sole discretion. All certificated BLS/ALS service providers shall be subject to, and shall comply with, the standards for BLS/ALS service providers prescribed by the state in accordance with F.S. ch. 401 and Florida Administrative Code ch. 64E-2, as well as those standards set by the board, as may be amended from time to time.

Initial standards shall be effective upon adoption by resolution/ordinance, as deemed appropriate by the board, and may be amended from time to time by resolution or ordinance as deemed appropriate by the board. At a minimum, the standards shall include standards established by state law, if any; compliance with standards in Florida Administrative Code ch. 64E-2; and the criteria considered by the EMS review committee under subsections (e)(4)—(15).

(b)

EMS service providers desiring to obtain a BLS/ALS certificate in the county shall make applications to the county through the EMS review committee on such forms as shall be provided by the county.

(c)

All applications shall first be reviewed by the department for thoroughness and completions prior to submission to the EMS review committee.

(d)

All applications for certificates for BLS/ALS services shall be accompanied by a processing fee in the amount prescribed by resolution of the board. Unless the fee is waived by the board, no application shall be considered complete and processed until the fee is remitted.

(e)

After receiving a BLS/ALS service certificate application and processing fee, the EMS review committee shall begin its review of the application for the purpose of making a recommendation of approval or denial of a certificate to the board. The EMS review committee will consider all supporting documentation presented in the application, including, but not limited to, the following matters:

(1)

The approximate population of the area to be served;

(2)

The names of the certificate holder and governmental entities currently providing emergency medical services to the benefit unit or area, the number and type of ambulances or emergency medical rescue vehicles presently responding to emergency calls within the particular benefit unit or area, and whether the number and type of units proposed for service will adequately serve the population in the area proposed for service;

(3)

The approximate number of monthly emergency calls within the benefit unit or area applied for;

(4)

The current average response time of each service that previously served, or is currently serving, the areas or benefit unit applied for, and whether the response time is adequate to serve the public health and safety;

(5)

The type of the applicant's communication system, including its assigned frequency, call numbers, mobiles, portables, range and hospital communication capabilities, and whether the communication system is adequate to serve the area proposed for service;

(6)

The past performance or service record of the applicant, its management personnel and its principals and all of its affiliates and subsidiaries, obtained from sources such as, but not limited to, hospitals, local public safety agencies and the county fire rescue;

(7)

The financial ability of the applicant to render safe, quality services and to maintain or place the equipment required by the state and any counties and municipalities it serves;

(8)

The financial responsibility of the applicant to maintain insurance for the payment of personal injury, death and property damage claims, as set out in section 42-94 herein;

(9)

The nongovernmental applicant's willingness to hold harmless and indemnify the board/county for the service provided under any certificate approved and to name the board as an additional insured under its insurance policies;

(10)

The names and certification numbers of all EMTs and paramedics utilized by the applicant to provide emergency medical services;

(11)

The record of compliance with vehicle inspection standards under Florida Administrative Code ch. 64E (as it may be revised or amended from time to time);

(12)

Current or proposed locations of the applicant's base and substations for a determination as to whether the locations will provide additional coverage or improved response times;

(13)

The telephone communications system and equipment used in handling trip requests, cancellations and the like to determine if such systems are adequate or compatible with other systems that may interact with the applicant;

(14)

The maximum number of units which the applicant proposes to place in each area of the benefit unit to respond to emergency and routine transfers for a determination as to whether the locations will provide additional coverage or improved response times;

(15)

The type, condition, equipment and communications equipment on each vehicle of the applicant for a determination as to whether such equipment is obsolete or in good working condition;

(16)

Such information as the EMS review committee may require; and

(17)

Evaluate the proposed service rates for cost effective service delivery to the patient/taxpayer.

(f)

Prior to submission of a new, or previously disapproved transportation COPCN application, the prospective applicant must hire a consulting firm to provide an objective study outlining the impact of granting the COPCN to the applicant on the remaining EMS transportation service provided by the county.

(g)

The consulting firm must have a minimum:

(1)

The primary consultant conducting the study must have a master's degree which emphasizes organizational development, leadership, management and/or psychology;

(2)

Have ten years' experience in the administration, management and operation of an EMS system;

(3)

Have conducted at least two such studies on similar regional EMS systems as the county's, with at least one of these studies occurring within the last five years, and one of those studies having occurred within the state.

(h)

The consulting firm shall provide a report which, at a minimum, addresses the following issues:

(1)

Outline the probable financial implications to the county if the COPCN application is approved.

(2)

Outline the financial completeness, and stability of the applicant's EMS administrative/operational plan.

(3)

Outline what modifications would be necessary to the current county EMS operation.

(4)

How many ambulances/rescues, if any, would have to be left in operation in order to support the area that would be covered under the approved COPCN.

(5)

A fractile response time for the immediate area effected by the COPCN, the surrounding areas, and the second due response provided into the effected COPCN from an agency outside of the applicant's.

(i)

The applicant must provide the county fire chief, or his/her designee, a position on the "consulting team" which the applicant must create in order to provide information to the consulting firm. This county employee will provide information to the consulting firm to ensure the county's regional perspective is part of the consultant's report.

(j)

Based upon the standards established pursuant to subsections 42-76(a)(1) and (e)(4)—(15), as well as the information received in each application pursuant to subsection 42-76(e) the information obtained by further investigation, and after affording an opportunity for full comment by the applicant, the EMS review committee shall make an advisory recommendation that the board of county commissioners may grant, grant with conditions, or deny a pending application for a certificate. The advisory recommendation shall be forwarded to the board within a reasonable time but not to exceed 120 days of receipt of a complete or supplemental application for final action at a public hearing.

(k)

The board of county commissioners shall consider a pending application within 90 days after receipt of the advisory recommendation and, at its sole discretion, grant, grant with conditions, or deny the application. Any application for a certificate that is pending on the date of adoption of the amendments set forth in this section shall be reviewed and considered for approval or denial by the board of county commissioners in accordance with the provisions of and authority granted by this amended section, including the discretionary authority vested in the board by this subsection and subsection 42-76(a).

(l)

The certificate shall be valid unless revoked, suspended or modified at the sole and exclusive discretion of the board. The certificate shall obligate all holders, unless exempt by state or federal law, to operate in accordance with F.S. ch. 401 and Florida Administrative Code ch. 64E-2. In addition, the certificate holder shall operate in accordance with this article and the rules and regulations adopted pursuant to this article. In situations where this article and/or the rules and regulations adopted pursuant to the ordinance require a greater standard be met, the certificate holder shall comply with and meet the greater standards; however, the requirements of complying with the greater standards shall be without prejudice to any certificate holder which has an agreement with the board to provide ALS or BLS services to renegotiate, in good faith, additional compensation under such agreement to the extent the greater standard is required solely by the board and results in an increase in costs to the certificate holder. Likewise, the board has the right to renegotiate, in good faith, a reduction in compensation if the standards to which the board requires the certificate holder to meet results in a decrease in costs of the certificate holder. If a greater standard is imposed by an unfunded mandate of the state or federal government or agency or official thereof a certificate holder may request the board to renegotiate for additional compensation from the board and the board may grant such request and renegotiate at the option of the board. Nothing herein shall be construed to prevent any certificate holder from requesting an increase in any rates established pursuant to the rate resolution or to prevent the board from granting such increase(s). The certificate shall obligate the applicant to:

(1)

Serve the area(s) granted to the applicant;

(2)

Provide the coverage to adjoining area(s) for emergency calls when units are in-service and available, as requested by the communication center;

(3)

Post at its place of business, if applicable, a copy of the emergency fee schedule approved by the board; and

(4)

Operate in accordance with the rules and regulations adopted pursuant to this article, as well as F.S. ch. 401, Florida Administrative Code ch. 64E unless otherwise exempt by state or federal law.

(m)

Those agencies which have possessed a non-transport ALS first responder COPCN prior to October 2004, shall not have their COPCN revoked, suspended, modified, or not renewed except for just cause, for failure to comply with federal, state, and/or local standards, rules, regulations, ordinances and/or statutes.

(n)

Certificates for BLS/ALS shall authorize an EMS provider to respond to ground emergency incidents and/or interfacility transfers, subject to the superior rights of the franchise holders (authorized pursuant to this article).

(o)

A certificate shall not be effective for more than two years, and shall in any event expire on September 30th of every even-numbered year.

(p)

Renewal. No less than 90 days prior to the expiration of a certificate the holder shall request in writing from the county fire rescue a renewal of the certificate. Such request shall include a notarized statement from the certificate holder (a principal officer or elected official authorized to act by the certificate holders board of directors or its elected official, as applicable) that the certificate holder is in compliance and will continue its operations in compliance with F.S. ch. 401, Florida Administrative Code, ch. 64E, this article, and rules and regulations adopted pursuant to this article. Upon submission of the written request and the notarized statement, the county fire rescue shall forward such request to the board which shall not unreasonably withhold its approval of the renewal.

(Ord. No. 04-48, § 2, 11-30-04; Ord. No. 07-19, § 1, 5-8-07)