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N ®v 7 1984 soap 58 FnE ass A. Request for Renewal of Certificate of Need - C & J Ambulance Attorney Brandenburg presented the Board with copies of the following letter received from Indian River Memorial Hospital, which indicates their concern re C & J Ambulance Company's failure to respond to their needs on many occasions. Gary Brandenburg County Attorney Administration Building 1840 - 25th Street Vero Beach, FL 32960 Dear Gary: /nd1w River Memorial Hospitaf 1000 36th Street * 305-567-4311 Vero Beach, Florida 32960 November 6, 1984 Executive Director Alan C. Gorr It is my understanding that the County Commission will take up the issue of the renewal of the Certificate of Need for C & J Ambulance Company at their regular meeting on Novem- ber 7, 1984. That being the case, I would like to submit some "food for thought" in that regard. The C & J Ambulance Company has refused to accept referrals for patient transfers from time to time, depending on the availability of a unit to use for the transportation. Historically, this has not been a pro- blem of any substantive nature; however, during the past year we have become concerned at the number of refusals. As you will note on the attached, some 56 referrals were refused during the period January 3, 1984 through this date. During the period of January through July 20, 1984, 21 out of 46 total referrals were refused. The result of C & J's inability to accept referrals causes two immediate results of concern to us. First, a patient's discharge from the Hospital may be delayed. This may cause additional expense, not to mention inconvenience to the patient and the patient's family. Secondly, the vast majority of the transfers were subsequently performed by the Indian River Volunteer Ambulance Squad. This clearly is beyond the stated goal of the Volunteer Ambulance Squad to provide emergency transportation services. Conceivably, it could result in a unit being unavailable at a time when it was needed for other purposes, and a well intentioned gesture could result in a delay in care or worse. We have maintained a dialogue with the C & J Ambulance Service throughout the period of time in question. We are concerned, not that their Certificate of Need should or should not be renewed, but rather that the level of service to the residents of Indian River County appears to be marginal. It is our hope, therefore, that in its deliberations regarding the renewal, the Board of County Commissioners would attempt to 20