HomeMy WebLinkAbout1995-031/24/95(ord\amaraarv)WOIe
ORDINANCE NO. 95-03
AN ORDINANCE OF INDIAN RIVER COUNTY, FLORIDA,
AMENDING CHAPTER 304, LIFE SUPPORT SERVICES OF
THE INDIAN RIVER COUNTY CODE.
WHEREAS, the Emergency Services District Advisory Committee, as
directed by the Board of County Commissioners, met on January 5, 1995, in a
workshop meeting to consider revisions to Chapter 304, Life Support Services;
WHEREAS, as a result of the information received the Advisory
Committee recommended the revisions which appear in Exhibit "A" to this
ordinance in the form of additions as indicated by underlining and deletions
as strike throughs;
NOW, THEREFORE, BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS
OF INDIAN RIVER COUNTY, FLORIDA, that:
SECTION 1. AMENDMENT
Chapter 304 is amended as set forth in Exhibit "A" with additions
being indicated by underlining and deletions as strike throughs.
SECTION 2. EMERGENCY
This ordinance was advertised with only 13 days notice. Action on
this item at this time was necessitated by the fact that the interim
governing ordinance was about to expire, thus leaving EMS without any
regulatory ordinance. Hence, an emergency was found to exist by the
unanimous vote of the Board of County Commissioners.
SECTION 3. SEVERABILITY
If any section, sentence, clause, or phrase of this ordinance is
held to be invalid or unconstitutional by any court of competent
Jjurisdiction, then said holding shall in no way affect the validity of the
remaining portions of this ordinance.
SECTION 4. EFFECTIVE DATE
This ordinance shall become effective on becoming law.
Approved and adopted by the Board of County Commissioners of Indian
River County, Florida, on this 24 day of January , 1995*
ORDINANCE NO. 95- 03
This ordinance was advertised in the Vero Beach Press Journal on
the 13 day of January , 1995, for a public hearing to be held on the
24 day of January , 1995, at which time it was moved for adoption by
Commissioner Eggert and the motion was seconded by Commissioner
Tip pin , and, upon being put to a vote, the vote was as follows:
Chairman Kenneth R. Macht Aye
Vice Chairman Fran B. Adams Aye
Commissioner Richard N. Bird Aye
Commissioner Carolyn K. Eggert Aye
Commissioner John W. Tippin Aye
The Chairman thereupon declared the ordinance duly passed and
adopted this 2'4 daYLI January 1995.
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ONINDIAN RIVER COUNTY, F DA
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t,�` Kenneth R. Macht
Bar n, Clerk e Chairman
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"Attachmenti:,Exh1b1t "A" - Ch. 34, Life Support Services
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ACKNOWLEDGMENT by the Department of State of the State of Florida, this 2 nd�;
day of February 1995.
EFFECTIVE DATE: Acknowledgment for the Department of State received
on this 7th day of February , 1995, at 9 e 30 a.m./pUM and filed in
the Office of the Clerk of the Board of County Commissioners of Indian River
County, Florida.
Indian River Ca Approved Dale
Admin.
Legal C) 2s'-c�
Budget
Dei) i.
Risk Mgr.
CHAPTER 304. LIFE SUPPORT SERVICES
Sec. 304.01. Title.
Sec. 304.02. Authority and Purpose.
Sec. 304.033. Definitions.
Sec. 304.04. Classification of Certificates
Sec. 304.035 Application -Information and fee required.
Sec. 304.06. Exemptions
Sec. 304.047. Same -Investigation; staff recommendation.
Sec. 304.068. Contents of certificate.
Sec. 304.090 Inspections.
Sec. 304.0610. Expiration and transferability.
Sec. 304.0-711. Renewal,
Sec. 304.0912. Revocation, alteration or suspension.
Sec. 304.13. Penalties.
This chapter may will be known as the certificate of
public convenience and necessity standard ordinance.
Section 304.02. Authority and Purpose.
This ordinance is promulgated_ pursuant to Chapter
401, Florida Statutes. The purpose of this ordinance is to
promote the health, safety, and welfare of residents of Indian
River County in need of emergency medical services by
establishing standards for issuing certificates of public
convenience and necessity for Emergency Medical Transport
Services, Advanced Life Support Services, and Basic Life
Support Services; by providing for the adoption of regulations
governing the operation of Emergency Medical Transport
Services, Advanced Life Support Services, and Non -
Emergency Medical/Interfacility Transport Services.
The Board specifically intends that the Indian River
County Department of Emergency Services shall he
responsible for providing emergency pre -hospital ALS and
BLS -services within the County, with the exception of the
Town of Indian River Shores, and that the role of private ALS
and BLS services shall be to provide, on request,
interfacility/interhospital non -emergency transportation.
Section 304.02 3. Definitions.
The following words shall have the definutions as
follows
r��. �' ' �•� �' Servicearea means the geographical
area listed on a service provider's certificate of public
convenience and necessity.
EMS director means the director of emergency
services of Indian River County, Florida charged with
responsibility and authority to supervise, direct, and adnunister
the EMS, ALS and BLS system on a county -wide basis to
effectuate delivery of-{4ehesp4a4 e;me;Fgenc , m Pdic-al EMS
services. If a situation exists which poses a serious or
inuninent threat to the health, safety, welfare, or public need
and convenience, the EMS director shall have such temporary
emergency powers as are necessary to remedy the situation.
Medical director means the licensed physician
contracted pursuant to section 401.025, Florida Statutes, to
give medical direction to and establish medical protocols for
emergency medical services persotmel including paramedics
and emergency medical technicians.
Emergency service providers means basic and
advanced life support services operators holding a valid
certificateof public convenienceand necessity issued by Indian
River County.
Ambulance means any private or publicly owned land
or water vehicle that is designed, constructed, reconstructed,
maintained, equipped or operated, and is used for, or intended
to be used for responding to emergency, non -emergency, or
interfacility medical calls.
Medical Call means any request for medical
assistance or transportation which does not require the
immediate or prompt dispatch of an ambulance or advanced
life support services vehicle, or any situation which does not
require the immediate or prompt provision of medical
assistance or transportation.
Patient means any person who is inneedof, or may
need, medical assistance or transportation,
Inspection means the routine or periodic examination
and audit of the records, personnel, vehicles, and staffing, of
the certificate holder.
Note-emergencylInterfacility Transfer means the
ambulance transportation of a patient between two facilities
licensed under Chapter 395, Florida Statutes,
Supp, No. 1 304/1 r �p
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Section
304.01.
Title.
This chapter may will be known as the certificate of
public convenience and necessity standard ordinance.
Section 304.02. Authority and Purpose.
This ordinance is promulgated_ pursuant to Chapter
401, Florida Statutes. The purpose of this ordinance is to
promote the health, safety, and welfare of residents of Indian
River County in need of emergency medical services by
establishing standards for issuing certificates of public
convenience and necessity for Emergency Medical Transport
Services, Advanced Life Support Services, and Basic Life
Support Services; by providing for the adoption of regulations
governing the operation of Emergency Medical Transport
Services, Advanced Life Support Services, and Non -
Emergency Medical/Interfacility Transport Services.
The Board specifically intends that the Indian River
County Department of Emergency Services shall he
responsible for providing emergency pre -hospital ALS and
BLS -services within the County, with the exception of the
Town of Indian River Shores, and that the role of private ALS
and BLS services shall be to provide, on request,
interfacility/interhospital non -emergency transportation.
Section 304.02 3. Definitions.
The following words shall have the definutions as
follows
r��. �' ' �•� �' Servicearea means the geographical
area listed on a service provider's certificate of public
convenience and necessity.
EMS director means the director of emergency
services of Indian River County, Florida charged with
responsibility and authority to supervise, direct, and adnunister
the EMS, ALS and BLS system on a county -wide basis to
effectuate delivery of-{4ehesp4a4 e;me;Fgenc , m Pdic-al EMS
services. If a situation exists which poses a serious or
inuninent threat to the health, safety, welfare, or public need
and convenience, the EMS director shall have such temporary
emergency powers as are necessary to remedy the situation.
Medical director means the licensed physician
contracted pursuant to section 401.025, Florida Statutes, to
give medical direction to and establish medical protocols for
emergency medical services persotmel including paramedics
and emergency medical technicians.
Emergency service providers means basic and
advanced life support services operators holding a valid
certificateof public convenienceand necessity issued by Indian
River County.
Ambulance means any private or publicly owned land
or water vehicle that is designed, constructed, reconstructed,
maintained, equipped or operated, and is used for, or intended
to be used for responding to emergency, non -emergency, or
interfacility medical calls.
Medical Call means any request for medical
assistance or transportation which does not require the
immediate or prompt dispatch of an ambulance or advanced
life support services vehicle, or any situation which does not
require the immediate or prompt provision of medical
assistance or transportation.
Patient means any person who is inneedof, or may
need, medical assistance or transportation,
Inspection means the routine or periodic examination
and audit of the records, personnel, vehicles, and staffing, of
the certificate holder.
Note-emergencylInterfacility Transfer means the
ambulance transportation of a patient between two facilities
licensed under Chapter 395, Florida Statutes,
Supp, No. 1 304/1 r �p
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§304.04
Non-emergencyMedical Transportation Servicemeans
any privately or publicly owned service intended to be used or
ALS or BLS interfacility transfer, or facility to home, or
home to facility. It does not include patients who have
accessed the 911 emergency response system to summon the
emergency medical services provider.
Emergency Medical Services means the transportation
and emergency treatment of persons who are in need of
emergency medical attention upon any street or upon the
waterways of the county under either basic life support (BLS)
license or advanced life support (ALS) license issued pursuant
to or applied for pursuant to 4401.25, Florida Statutes.
Inter -Hospital Transfer means the transportation of a
patient requiring an ambulance with Basic Life Support or
Advanced Life Support level of medical assistance between
two facilities licensed under Chapter 401, Florida Statutes.
Transfer means the transportation of a patient by
ground ambulance as a result of a request for response to a
medical call.
Advanced Life Support means treatment of life
threatetning medical emergencies through the use of techi ques
such as endotracheal intubation, the administration of drugs,
intravenous fluids, telemetry, cardiac monitoring, and cardiac
defibrillation by a paramedic as defined in Rule IOD -66,
Florida Adn- nistrative Code.
Advanced Life Support Vehicle means any ambulance
or emergency medical services vehicle which provides
advanced life support.
Certificate holder means any person or persons named
as owner, officer, director, or shareholder on the applicatiotn
for certificate of public convenience and necessity.
Deficiency Correction Notice means a notice issued by
the EMS director or his designee notifying a certificate holder -
of any infraction with the infraction specified and a specified
time period allowed for correction.
Section 304.04. Classification of Certificates
There shall be four (4) categories of certificates of
public convenience and necessity in Indian River County,
1. Certificates of public convenience and
Supp. No. 1 304/2
necessity for govermnental entities that use advanced life
support vehicles to conduct a pre -hospital EMS advanced life
support or basic life support service, titled Class A.
2 Certificates of public convenience and
necessity for businesses, agencies and hospitals that use
ambulances to conduct a non -emergency interfacility medical
transport or transfer service at the ALS or BLS level, titled
Class B.
3. Certificates of public conveivence and
necessity for businesses, agencies, hospitals, and govertmiental
entities who use ambulances to conduct non -emergency
interfacility medical transport or transfer services requiring on-
board clinical capabilities which may exceed those of a
conventionally equipped and staffed advanced life support
ambulance and which originate in the county, under a
physician's order, titled Class C.
4. Certificates of public convenience and
necessity for businesses and agencies that use ambulances
based outside the county to provide specific non -emergency
medical services as identified on the certificate and limited to
transports out of the county, titled Class D.
Section 304.03 05. Application -Information and fee
required.
No person, firm, corporation, or partnership shall
operate any of the services as described in Section 4 unless a
certificate of public convenience and necessity is first obtained
from the Board. Each application for a certificate of public
convenience and necessity shall be accompatued by a non-
refundable filing fee in the amount of One Hundred Dollars
($100.00) to be paid to Indian River County, Florida, at the
same time said application is filed or submitted with the
County to cover costs and expenses incurred on behalf of the
County in the processing of said application. No filingfee ee is
required for a renewal application or a volunteer service who
do not charge a fee for the- service. Any applicant--for-an
initial certificate of public convenience and necessity from the
county shall apply to the board in writing and complete a form
provided by the board containing the following information:
The name and address of the applicant; the
business name of the partnership and the
name and address of each partner; the names
and residences of all officers, directors, and
stockholders if the applicant is a corporation;
§ 304.04 INDIAN RIVER COUNTY CODE
2. The diqtr;it service area which the applicant recommendation and any input from other service providers,
desires to serve, municipalities, or interested groups or citizens and may grant
or deny the requested certificate of public convenience and
3. The location and description of the place or necessity. In making his recommendation, the EMS director
places from which the applicant will operate; shall consider the following factors:
The source of funds which will enable the
applicant to continence operation, and a
schedule of any rates which the applicant
intends to charge,
The names and addresses of at least three
(3) local references;
6. The need for the proposed service in the
requested service area.
67, Such other reasonable information as may be
required by EMS director.
Section 304.06. Exemptions
A vehicle rendering services as an ambulance in the
event of a maior catastrophe or emergency when ambulances
with permits based in the locality of the catastrophe or
emergency as defined in the Statewide Mutual Aid Agreement
are incapacitated or insufficient in number to render the
services needed and any ambulance owned and operated by the
federal government are exempt from the provisions of this
Ordinance.
Section 304.0* 7. Same -Investigation;. staff
recommendation.
After an application has been received by the county,
the EMS director shall cause an investigation to be made into
the application, including a determination of the public need
for the proposed service in the geographical area requested.
The -EMS director shall contact the medical director,
all other service providers in the county, and any municipality
in which the applicant desires to provide service. Within sixty
(60) days from receipt of the completed application, the EMS
director shall schedule a public hearing before the board of
county commissioners with notice to all other service
providers in the requested service distpist area, any
municipality in the requested service district area and to the
general public by publication in the local newspaper with at
least one week's notice. At the public hearing the board of
county commissioners shall consider the EMS director's
Supp. No. 1
(a) The population density and composition of
the likely areas within which the proposed ALS, BLS, or
nonemergency medical transport service will operate.
The need of the people in the area for ALS,
BLS, or non -emergency medical transport service.
(c) A comparison of estimated annual requests
for service in the particular certificate category with the
current number of vehicles satisfying requests.
(d) Such other factors as may be considered
important by the EMS Director,
Section 304.0-5 8. Contents of certificate.
Any certificate issued under this division shall require
the service provider and all employees, including paramedics
and emergency medical technicians, to comply with the
following:
Agree to respond only to emergency prehospital calls
in the service area and, when units
are available, to provide response to other disw icts
service areas in the county when requested to do so
by the other providers or by the EMS director. jQgLs
A only)
2. Post a copy of standard operating procedures which
the service provider will use to give general specific
instructions to its personnel concerning the nature of
their duties and responsibilities. These procedures
must be reviewed by the EMS director prior to the
effective date of the certificate.
Comply with all lawful directive of the EMS director
and medical director, including any medical protocols
and traitting directives not preempted by the state.
4. Provide continuous and uninterrupted service within
the dist i , service area. be, in ggplic@ And
V11 rolltg ;;1411
appropnate staff, and provide, avorag
§ 304.04 INDIAN RIVER COUNTY CODE
a. Sehastion area., Ten (m , law.
h rnd;,,,, River QoP42„ T-( it (10)
�- Section 304.09. Inspections.
G44yr-o &wee ama.-* Few—(10)
yceept ft exty-eme Wes The EMS Director, or his designee, shall inspect each
,,,,,... r„nS r ,lent„ (20 n,;.,, tee service prior to, and as a continuing part of, the certificate
d -i .14.on m area. Ten "^` ,, iautHs process. This inspection shall determine the continuing
oxGopt Y-00 v, r„nrr;,,,, an,, 01G compliance of this Ordinance and State Law and Rules and
Tumpike7 „-P., fifty rcm . Regulations by the certificate holder as a condition of
certificate issuance.
5. Maintain the number of vehicles notod on
tho-conificat which shall be the number Inspections shall be conducted periodically and may
determined by the EMS director and the be conducted with or without notice to the certificate holder at
medical director considering the population reasonable times and whenever such inspection is deemed
and geographical distance of the v-,em3ified necessary by the EMS Director. Inspections shall be
distr-ist, service area, but in any event shall conducted without impeding patient care.
not be less than one fully staffed operating
vehicle. -pe£-Statiet7 If, during the course of an inspection, a situation is
found which in the determination of the EMS Director, will
6. Ensure that its vehicles are driven in a safe jeopardize the safety or welfare of the service personnel or
and lawful manner at all times, patient care, the EMS Director may exercise die powers
necessary to ensure the certificate holder's compliance with the
7. Use its lights and sirens only for properly ordinance.
authorized mercy events and in
compliance with state law and local law Section 304.06 10. Expiration and transferability.
enforcement policy.
A certificate shall be valid for a period not to exceed
8. Keep posted at all business locations a copy two (2) years and shall not be transferable without the prior
of a the certificate including the approved written consent of the county. The certificate holder shall
rate schedule;_ „,h;,-', s'"" not bo exGeede- inmmediately notify the county of any changes of ownership or
vA Board approval. The certificate holder control.
may adiust the rate schedule up to ten
percent (10%) a year without Board Section 304.09 11. Renewal.
approval, however the adiusted rate must be
maintained for one year and the EMS The certificates may be renewed routinely by the
Director must be notified in writing of the board on application by the certificate holder. However if the
rate change. Rate increases in excess of ten board has reason to believe that the public health, safety, and
percent (10%) must be reviewed and welfare requires it, a public hearing may be ordered by the
approved by the Board of County board to consider not renewing any certificate. Before any
Commissioners with -the approved rate being such action can occur, the board must first comply with the
maintained for one year by the certificate notice and hearing provisions of section 304.08.
holder.
Application for renewal of existing certificates of
9. Operate in compliance with all federal, state public convenience and necessity shall be made by written
and local laws, rules, and regulations. request to the EMS Director. This request shall be filed no
more than nhinety (90) days prior to the expiration date of the
10. Provide copies of vehicle run sheets and provider certificate of public convenience and necessity.
radio logs to the EMS director upon request,
to the extent permitted by the public records
Supp. No. 1 304/4
Section 304.40 12. Revocation, alteration or suspension.
1. Generally. Every certificate issued under this
division shall be subject to revocation, alteration or suspension
by the board where it shall appear that the certificate holder
has not complied with the requirements of the certificate and
the public interest so required.
It shall be a violation of this ordinance, for any
person, business entity, hospital, or governmental agency to:
A. intentionally obstruct, bar or otherwise
interfere with an inspection conducted under the purview of
this Ordinance;
B. knowingly make an onussion of a material
fact or a false statement in any application or other document
filed with the EMS Director;
C. knowingly, by telephone or otherwise, cause
to be placed or place a false emergency medical call;
D. knowingly violate or fail to observe any
requirement of this ordinance, or any rule, regulation or order
under the provision of this ordinance;
E. represent herself, himself, or itself as an
emergency medical transport service, an advanced life support
service, or a special limited service, or engage in the business
of conducting an emergency medical transport service, an
advanced life support service, or a special limited service
without first obtaining an appropriate certificate of public
convenience and necessity from the Board as provided herein
and obtaining the necessary State of Florida licenses, as
applicable; or
F. operate an ambulance or emergency medical
services vehicle that does not meet the requirements of this
Ordinance and Chapter 401, Florida Statutes.
A separate and distinct offense shall be deemed to
occur each day a prohibited act occurs.
2. Complaint Procedure
Complaints about a certificate holder will be in
writing and shall be reviewed for sufficiency by the EMS
Director. Should the review substantially verify that a
violation of this Ordinance or State law has occurred, the
Supp. No. 1 304/5
EMS Director may conduct an investigation. The EMS
Director shall be provided access to the certificate holder's
business, personnel, and documents to assist in said
investigation. The EMS Director shall forward a copy of the
investigation and enforcement action taken to the State EMS
Office.
2 3, Proceedings. Proceedings for revocation,
alteration, or suspension of a certificate shall be undertaken by
the board at a public hearing with notice to all certificate
holders and after publication of notice not less than one week
before the hearing date-, where it is found that;
A. the certificate holder has failed or neglected
to abide by this Ordinance or the Rules and Regulation
promulgated by the Board, or Chapter 401, Florida Statutes;
or
B. the application submitted to secure a
certificate of public convenience and necessity from the Board
of County Conunissioners contains false representation or
omitted material facts; or
C. the certificate holder, or its agent, has
demanded money or other compensation in excess of that
established in its schedule of fees filed with the Board pursuant
to this Ordinance; or
D. the certificate holder has failed to comply
with a correction order issued under Section 12 of this
Ordinance; or
E. the certificate holder has been adiudicated
guilty of a felony provided his/her civil rights have not been
restored; or
F. the certificate holder has been found by a
court of competent iurisdiction guilty of any criminal offense
involving moral turpitude; or
G. the certificate holder has been found guilty
of malpractice or negligence in the operation of its service; or
H. the certificate holder has had their/its state
license revoked or suspended.
Section 304.44 13 Penalties
A violation of any provision of this Ordinance shall
be deemed a nusdemeanor and, upon conviction, the violator
shall be subject to a fine not to exceed Five Hundred
($500.00) Dollars and/or imprisonment in the County Jail for
not more than sixty (60) days, or both such fine and
imprisonment.
Supp. No. I