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rJ N 24 1563 BOOK 110 WE 691 On December 20, 1988,. the Board of County Commissioners approved a proposal for the Indian River County Department of Emergency Manage- ment Services to operate and manage the EMS ALS system within the County. Since that time plans have been focused on that objective with cooperation from the Indian River Memorial Hospital in trans- ferring funds and equipment to the County for a planned start up date of February 1, 1989. Paramedics are transferring from the Hospital and staffing is complete except for two positions. Inter- views are being conducted and a full complement of staff is anti- cipated by the date referenced above. On January 10, 1989, the Board of County Commissioners approved a Certificate of Public Convenience and Necessity for the County to provide EMS ALS service on a county -wide basis. The Board also approved the organizational concept in which the respective volunteer services and the South County Fire District would operate under the County ALS umbrella license and receive an internal Certificate of Public Convenience and Necessity in lieu of the BLS license from HRS. The South County Fire District has already received approval for an internal Certificate of Public Convenience and Necessity for EMS ALS service. The matter before the Board of County Commissioners at this time is approval for amendment of the certificates prior issued to the Indian River County Volunteer Ambulance Squad and the Fellsmere Vol- unteer Ambulance Service (Fellsmere and Sebastian Divisions) to a level of EMS service from BLS to ALS in the form of internal certi- ficates issued under the County ALS license. ALTERNATIVES AND ANALYSIS The County application for the ALS license has been hand delivered to the Department of Health and Rehabilitative Services. Issuance of the license is expected within a week of the date of this memor- andum. Timely approval of this request will substantially complete the administrative tasks associated with permits, licenses, and certi- ficates. The concept of a single focus of management embraced by the Board of County Commissioners will be further enhanced with approval of this agenda item. Cooperation of the various providers is on-going and it is evident that a sincere desire for a model EMS system is the goal of everyone. RECOMMENDATION Staff recommends approval of the issuance of an amended Certificate of Public Convenience and Necessity for EMS service to the Fellsmere Volunteer Ambulance Service (Fellsmere and Sebastian Divisions) as well as the. Indian River County Volunteer Ambulance Squad upgrading the level of service from BLS to ALS. The amended certificates will be issued under the auspices and authority of the County ALS license. All providers will be subject to the authority of the EMS Director and the Medical Director as well as Rule 10D-66 F.A.C., Indian River County Ordinance 87-66, as amended, and Chapter 401, Forida Statutes. 43