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Fr- -I 800K 103 PnE 42 status, a copy of which is attached. The service is totally funded from the ambulance fees collected for services provided. Contact with the Jacksonville Medicare Office revealed no billing discrepancies or complaints filed against Coastal. Coastal currently has a total of eight transport vehicles, five of which are ALS equipped and three which are BLS equipped. A staff member from the IRC Emergency Services Department traveled to the company headquarters in Rockledge to inspect the vehicles, verify rates, examine vehicle radio equipment, inspect the medical equipment, take photographs (attached) of the isolette and ramps, and review transport protocols. The vehicles, equipment, protocols, and documents were found to be in exemplary condition and order. The rate structure was also examined and found to be commensurate with existing rates for similar services around the state. Ctrrently, when one of the medical facilities in Brevard County, such as Wuesthoff Hospital, has a request from Sebastian River Medical Center to receive and transport a neonatal patient under a doctor's order, (which occurs on the average of three (3) transports every six (6) months) Coastal is summoned to transport the isolette (a specialized, self contained, neonatal life support unit weighing between 400 to 500 pounds), a Respiratory Therapist, and a Registered Nurse, to the Sebastian River Medical Center. When they arrive at the Sebastian River Medical Center, the isolette is off loaded on ramps and the neonatal patient is prepared for transport back to Wuesthoff Hospital. Due to the fact that Coastal does not have a Certificate of Public Convenience and Necessity in Indian River County, another service, such as Able Ambulance (which has no isolette ramps) must be summoned to transport the isolette containing the neonatal patient and staff back to Wuesthoff Hospital since the call is originating in Indian River County. Wuesthoff Hospital Director of Neonatology Services Dr. Javier Diaz -Blanco, (see attached letter) would prefer to have Coastal provide the ambulance service to and from the Sebastian Medical facility to receive and transport the patient. It should also be noted that the Coastal vehicles has ramps for the isolette and a generator (inverter) on board to provide a source of energy, other than a vehicle battery, to keep the isolette life support equipment functioning so the patient remains stable during the transport. The three references listed on the application were contacted and each provided very favorable information regarding the company and its staff. As part of the investigation, each municipality, hospital, EMS provider, and each nursing home/facility in the County was contacted or corresponded with by mail. Also an informational meeting was held on September 10, 1997, with notice given so that input from the providers, municipalities, interested groups, or citizens could be obtained and questions regarding the proposed service could be answered by representatives of Coastal. Coastal has made it clear, throughout this process, that the company has no interest in providing any other type of transport service in Indian River County. The company states their only motive is to have timely and safe transport for neonatal patients to ensure their health and safety at all times. It was stated at the informational meeting that on one occasion, the Wuesthoff medical staff had to wait approximately two hours for Able Ambulance to respond and they were concerned that a wait of this length of time in some cases may endanger a neonatal patient's life unnecessarily. Dr. Roger Nicosia, the Medical Director for Indian River County, has reviewed the application and states that the concern expressed by the Wuesthoff medical staff is well founded and justified and the certificate should be issued. OCTOBER 14, 1997 36