Item O2 County of Monroe
"G BOARD OF COUNTY COMMISSIONERS
Mayor Sylvia Murphy,District 5
oz, Mayor Pro Tern Danny Kolhage,District 1
The Florida Keys k;; Michelle Coldiron,District 2
Heather Carruthers,District 3
David Rice,District 4
County Commission Meeting
March 21, 2019
Agenda Item Number: 0.2
Agenda Item Summary #5179
REVISED BACKUP DAY OF MEETING: Added Attachments:
Added c) letter from City Marathon d)letter from Jack Bridges, P.A.
BULK ITEM: No DEPARTMENT: Emergency Services
TIME APPROXIMATE: STAFF CONTACT: James Callahan (305) 289-6088
3:00 P.M. PUBLIC HEARING
AGENDA ITEM WORDING: A public hearing to consider an application for issuance of a Class
A and Class B Certificate of Public Convenience and Necessity (COPCN) to Rapid Response
Medical Transportation for the operation of ALS and BLS Transport Services in the zones of Key
West & Adjunct Keys; Islamorada; Key Largo and Marathon for the period 3/21/19 through 3/20/21
for responding to requests for inter-facility transports.
ITEM BACKGROUND: Monroe County Code Sections 11-171 et seq., requires the BOCC to
hold a public hearing to consider the application for a new certificate. At the hearing, the Board may
receive a report from the County Administrator or his designee, testimony from the applicant or any
other interested party, and other relevant information. The Board will consider the public's
convenience and necessity for the proposed service and whether the applicant has the ability to
provide the necessary service(s). The Board shall then authorize the issuance of the certificate with
such conditions as are in the public's interest or deny the application, setting forth the reason(s) for
denial.
PREVIOUS RELEVANT BOCC ACTION: On January 23, 2019, item C.8,the Board granted
approval to advertise for a Public Hearing to be held on February 20, 2019, to consider the
application of Rapid Response Medical Transportation. On February 20, 2019, agenda item R.10
was continued to March 21, 2019.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION:
DOCUMENTATION:
Class A and B COPCN Rapid Response 3/21/19 - 3/20/21
Application Rapid Response
Letter from City of Marathon dated 3 18 2019 re PH 01 and 02 re COPCNs
2019.02.19 Letter to Commissioner Rice from Jack Bridges, P.A.
FINANCIAL IMPACT:
Effective Date: 2/21/19
Expiration Date: 2/20/21
Total Dollar Value of Contract:
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: No If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details:
N/A
REVIEWED BY:
Pedro Mercado Completed 02/01/2019 11:42 AM
James Callahan Completed 02/01/2019 11:46 AM
Kathy Peters Completed 02/04/2019 10:55 AM
Board of County Commissioners Completed 02/20/2019 9:00 AM
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( _,;,;..,,,,„:, EMERGENCY MEDICAL SERVICES i ' .;.
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CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY
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c 4 _ WHEREAS, the Monroe County Code allows for the issuance of Certificates of Public Convenience and
Necessity for Emergency Medical Services by the Board of County Commissioners of Monroe County; ,.
and,- WHEREAS, the Rapid Response Medical Transportation provides quality emergency medical servicesato the citizens of Monroe County; and, 1 WHEREAS, there has been demonstrated that there is a need for the above named service to operate )-
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in this County to provide essential emergency medical services to the citizens of this County; and, .
WHEREAS, the above named service has indicated that it will comply with all the requirements of the
Monroe County Code and Chapter 401 Florida Statutes, the Board of County Commissioners of
..),
l Monroe County hereby issues a Certificate of Public Convenience and Necessity to this service for the
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period beginning March 21, 2019 and ending March 20, 2021. 1
In issuing this certificate it is understood that the above named service will meet the requirements of a ��
❑BLS or ►1ALS, 11 Transport orONon transport service, and provide service on a twenty-four hour
�s.'ti9, basis for the following area(s): Na,
itg Key West and Adjunct Keys, Islamorada, Key Largo and Marathon _ r
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Certificate #: 19-01
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March 21,2019 °)
0 DATE OF ISSUANCE
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�r> NON-EMERGENCY MEDICAL TRANSPORTATION SERVICE
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s CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY 1 `€\)
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f ,., : WHEREAS, the Monroe County Code allows for the issuance of Certificates of Public Convenience and •,� f
Necessity for Non-Emergency Medical Transportation Services by the Board of County Commissioners
of Monroe County; and, �j).OP ,,
/, WHEREAS, the Raped Response Medical Transportation desires to provide quality non-emergency \
t ° `',. medical transportation services to the citizens of Monroe County; and, ti )
? : WHEREAS, the above named service has indicated that it will comply with all the requirements of the • ' i,
i �^^., I Monroe County Code, the Board of County Commissioners of Monroe County hereby issues a ! , '
‘�, ;,� Certificate of Public Convenience and Necessity to this service for the period beginning March 21, 2019 ;41:'''.'''::::::::
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and ending March 20, 2021.
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In issuing this certificate it is understood that the above named service will meet the requirements of a,, non-emergency medical transportation service, and provide service for the following area(s): '
"4eii. ' Key West and Adjunct Keys, Islamorada, Key Largo and Marathon t ,,;,� . \
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„'r Certificate#: 19-03
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March 21,2019 ,,,,
1%.; DATE OF ISSUANCE w"°
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MONROE COUNTY,FLORIDA
APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NElPCN)
CLASS A EMERGENCY MEDICAL SERVICE
(PRINT OR TYPE) DEC 1 0 2018
Si INITIAL APPLICATION-S50.00 ❑ RENEWAL APPI1CAIttel/WhgEll y Fire Rescue
IF RENEWAL,PLEASE LIST NUMBER OF PREVIOUS CERTIFICATE:#
1. NAME OF SERVICE RP Pip Potusc= MCDi.CR 712_aJSP0a-Toct crfcA)
BUSINESS MAILING ADDRESS 8 S R- S LI, V 3 3 3 V-I
BUSINESS PHONE NUMBER 954- J 2-.S 5JgEMERGENCY PHONE NUMBER i S-2)O-y? Jq
2. TYPE OF OWNERSHIP(i.e.,Sole Proprietor,Partnership,Corporation,etc.) -L. C
DATE OF INCORPORATION OR FORMATION OF THE BUSINESS ASSOCIATION /0`/9- 2 0/ S
3. LIST ALL OFFICERS,DIRECTORS,AND SHAREHOLDERS(Use separate sheet if necessary):
NAME AGE ADDRESS TELEPHONE# POSITION/TITLE
`T`E V E (PO tZ-kJ O U It?J-2 l• G�9-*- -2-1°--�f
���,e, pC.- 3�sz� e�Q
N NA ? T Nn04 q t v'V r,-5 0�'- 7-t 1.-moo`t 5Q.D/"1/Alt'Scrr�4
teo1VA 1LD �. pow y6( 7`Faav Ar is l - ' --4 i� 'I" 1L
4. LEVEL OF CARE TO BE PROVIDED: BLS or 51 ALS
IF ALS:RP TRANSPORT or❑NON TRANSPORT
5. DESCRIBE THE ZONES(S)THAT YOUR SERVICE DESIRES TO SERVE(Use separate sheet if necessary):
Esi— yprizpvc\-- -r)
" 'sC P414
-E t-O
6. LIST THE ADDRESS AND/OR DESCRIBE THE LOCATION OF YOUR BASE STATION AND ALL SUB-
STATIONS(Use separate sheet if necessary):BASE STATION 54 2 N. `P--ooSevE &iv j) k , We-1-r O .
SUB-STATION
Page 1 of 6
7. DESCRIIBE'YOUR COMMUNICATION SYSTEM(Attach copy of all FCC licenses):
FREQUENCIES CALL NUMBERS #OF MOBILES #OF PORTABLES
C.ett. pGLo 7,1S - 230-y Z.3(.f f _
CL f t.o A-e- - - - g6 l I
S. LIST THE NAMES AND ADDRESSES OF THREE(3)U.S.CITIZENS WHO WILL ACT AS REFERENCES FOR
YOUR SERVICE:
NAME ADDRESS
Do v4 Posh Do 2)336 P�P-e_.s.s Piz ve. Zee-Rve. 2e
DE. 20 t 84_ 6(g61 No,.: g-e'De a-Lve. 4-1O` kf ,wes�- &C.
I)OA),v 4 C��-a i-o 930 AAA/2 sr; 't'�Q. )4- J-if o 4) mac.._.
9. ATTACH A SCHEDULE OF RATES WHICH YOUR SERVICE WILL CHARGE DURING THE COPCN PERIOD.
10. PROVIDE VERIFICATION OF ADEQUATE INSURANCE COVERAGE DURING THE COPCN PERIOD.
11. ATTACH A COPY OF YOUR SERVICE'S CONTRACT WITH A MEDICAL DIRECTOR
12. ATTACH A COPY OF ALL STANDING ORDERS AS ISSUED BY YOUR MEDICAL DIRECTOR
13. ATTACH A CHECK OR MONEY ORDER IN THE APPROPRIATE AMOUNT,MADE PAYABLE TO THE
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS.
I,THE UNDERSIGNED REPRESENTATIVE OF THE ABOVE NAMED SERVICE,DO HEREBY ATTEST MY SERVICE
MEETS ALL OF THE REQUIREMENTS FOR OPERATION OF AN EMERGENCY MEDICAL SERVICE IN MONROE
COUNTY AND THE STATE OF FLORIDA. I FURTHER ATTEST THAT ALL THE INFORMATION CONTAINED IN
THIS APPLICATION,TO THE BEST OF MY KNOWLEDGE,IS TRUE AND CORRECT.
2 . ,-
SIGNATURE "ft'PLICANT/AUTHORIZED REPRESENTATIVE
rp.ex3th-) j
< 6lJJf ib t_
�,s� Nno^tuY PubU Stato of Roil
E ' �0nn C8rrar
NOTARY SEAL My Commission GO 014090
pia, EIVrea 10/22/2020
0.01tAmi. &V\CLAL--
. — A— I �
NOTARY SIGNATURE .,, DATE
.1--)Or1 t'\ox.
Page 2 of 6
PERSONNEL—PARAMEDICS
NAME •-, PARAMEDIC CERTIFICATION
First Middle Last SOCIAL SECURITY# CERTIFICATION# EXPIRATION DATE
SrE vE .0 c TNof 52- � 33o 2- 1 — 2—o 2-0
NIENE-2-Sfr 1-1om-t,/ 537-S2ti !z - i -Zoz43
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Page 3 of 6
.
PERSONNEL-EMERGENCY MEDICAL TECHNICIANS
NAME EMT CERTIFICATION
• Middi Last SOCIAL SECURITY# CERTIFICATION# EXPIRATION DATE
WA ReFn1 1-P. LoND ManJ 5-Z6C 5--7 12 -Or -zLW
ci_Pc►pin s C. S k DA G,'.s 552 z-0-0 0 I-2 to
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Page 4 of 6
PERSONNEL DRIVERS
NAME STATE •
First,Middle,Last SOCIAL SECURITY# DATE OF BIRTH DRIVER LICENSE# OF ISSUANCE EXPIRATION DATE
ma c . c-f'oe_-F.vo j n.3 - zs- �9� '6.Z.c4`36 0/oso (73- -zo 2,s-
V\142-12..cn1 Hi. CawDc-stT U7 - 7 r)- 32 SSg72Z6o6 FL. 07 -- 24 -ZOz3
`T`tioT y ? Ng), 0 11 -1 9 f9s5" 6208/0 S5Z990 FL 7 -/ 9 z049
lHC2P-behS C 06-27-19g0 S23002210 f 06- e.0
I DO HEREBY A p-a ,ST,TO THE BEST OF MY KNOWLEDGE,THAT ALL OF THE ABOVE NAMED DRIVERS DO MEET ALL OF THE REQUIREMENTS OF
CHAPTER 401.281 F.S.AND CHAPTER 64E-2.012 MC FOR AMBULANCE DRIVERS.
4 �
Notmy Putt. State Fo or ma NOTARY SEAL
! DMy Cossion GO 014090
+a ri ExPlrea 100 NOTARY SIGNATURE 1 g--
Page 5 of 6
VEHICLES
For Each Ambulance Operated By Your Service,Please Provide the Following Information(Use Separate Sheet If Necessary)
HRS SPECIFY
LICENSE VEHICLE SPECIFY TRANSPORT or
AMBULANCE TYPE MODEL YEAR MILEAGE CHASSIS# TAG NUMBER PERMIT# ALS or BLS NON TRANSPORT
%`(PE II( FOLD Lao 5 II ., 444am MIaLi Z A`S SPoQ.-
TI P E t I: Fo e D E6150'zoo 1-' i`-t. J MSS.,'-11 J G$trS TP-4 v POKY
Page 6 of 6
"41'11' CITY OF
.: MARATHON,FLORIDA
+ 9805 Overseas I Iighway Marathon, FL 33050
Phone (305) 743-0033 I wwwci.marathon.fLus
VIA EMAIL AND U.S. MAIL
March 18, 2019
The Honorable Danny Kolhage
Monroe County Board of County Commissioners
530 Whitehead Street
Key West,Florida 33040
RE: March 21, 2019 County Commission Meeting—Items 0.1 and 0.2
Dear Mayor Pro Tem Kolhage:
I am writing on behalf of the City of Marathon regarding agenda items 0.1 and 0.2 on the March
21, 2019 County Commission meeting. These agenda items regard an application for issuance of
a Class A Certificate of Public Convenience and Necessity (COPCN) for Falck Southeast II
Corporation d/b/a American Ambulance Service, and an application for issuance of a Class A
and Class B COPCN for Rapid Response Medical Transportation, respectively. Both of these
applications propose such services within the City of Marathon.
Section 11-173(d)(2) of the Monroe County Code, which addresses such matters, provides in
relevant part:
"The board will consider the public's convenience and the necessity for the
service in the zone or area requested and whether the applicant has the ability to
provide the necessary service. The board will consider recommendations from
municipalities within the applicant's requested service zone or area."
The City has reviewed the applications and recommends that the Commission deny both
applications based on the first two criteria listed in Section 11-173(d)(2): the public's
convenience and necessity for the service in the zone or area requested.
1. The Public's Convenience
Granting these applications does not make things more convenient for the public. To the
contrary,there is the potential for the public's convenience to be negatively impacted.
In the past when other companies were granted the ability to provide services to our City
they would cause our fire department to scale down in size, only to have to expand when
they were unable to provide the service for multiple reasons, including but not limited to:
personnel, cost of running the service in the Keys, etc. Our Fire Chief has been with the
city for over 7 years and has seen this happen twice. Our Fire Chief is responsible for
providing the citizens and visitors of Marathon with the highest level of medical care
from home to hospital, hospital to hospital, and scene to Trauma Star if required.
Because the city provides all of the above services, our Fire Chief can ensure that our
equipment, personnel, and system meet theses high standards and provide required
services to anyone who needs it.
2. Necessity for the Service
There is no need for these additional companies, as the current providers in Monroe
County are more than adequate for the amount of emergencies that we have. Our Fire
{ Chief has spoken to Fishermen's Hospital and asked if they requested additional services.
They responded that they had not. We did not ask or require any additional assistance for
our services. Thus, we do not know of any reason why there is the need for additional
services.
Additionally, Florida Keys Ambulance, Inc. has already provided you with written
correspondence that gives its arguments as to why the COPN applications should be denied, and
the City agrees with the reasoning in its letter.
Based upon the above, it is the City of Marathon's recommendation, in accordance with Section
11-173(d)(2) of the Monroe County Code, that the COPCN applications for both Falck Southeast
II Corporation d/b/a American Ambulance Service and Rapid Response Medical Transportation
be denied for the reasons set forth herein.
Respec ,
David Migut
City Attorney
Copy: Marathon City Council
Chuck Lindsey, City Manager
John Johnson, Fire Chief
Roman Gastesi, Monroe County Administrator
Bob Shillinger, Monroe County Attorney
James Callahan, Monroe County Fire Chief/Emergency Services Division Director
Law Office of Jack Bridges, P. A.
Post Office Box 1714
Tavernier, Florida 33070-1714
(305) 664-9690
Jack@JackBridges.us
February 19, 2019
The Hon. David R. Rice
District Four Commissioner
Monroe County Board of County Commissioners
9400 Overseas Highway, Suite 210
Marathon, Florida 33050
RE: Certificates of Public Convenience and Need
Dear Commissioner Rice:
This office represents Florida Keys Ambulance, Inc., a provider of non-emergency, inter-facility
medical transport. Florida Keys Ambulance (FKA) serves the Upper Keys, Marathon, and Key
West.
I urge you to oppose the requests for certificate of public convenience and need for two
additional ambulance companies which are on the Board's agenda for tomorrow's meeting. As
you know, bringing in more ambulance companies will not result in more demand for inter-
facility, non-emergency transport. What it will result in is a reduction in business for FKA and a
reduction of business opportunity for the other companies.
FKA currently equips its trucks with the latest cutting-edge technology. In fact, FKA has
invested 1.7 million dollars in new equipment since 2017. Considering that other ambulances
are highly unlikely to compete for less than FKA charges (which is the same as the County and
Medicaid rates for the uninsured),this additional competition will likely prevent any of the
competitors from earning enough in revenue to continuously reinvest in technology. As a result,
the increased competition will actually harm, not benefit, Monroe County residents and visitors.
Currently, FKA complements Marathon Fire Rescue and TraumaStar. This is a healthy level of
competition which brings out the best in all competitors. Too much competition, however, will
only bring down the level of service as the competitors are forced to cut costs. The additional
ambulance services will also likely cost Monroe County money, as TraumaStar is
February 19, 2019
Letter to Commissioner Rice
Page Two:
the backup used by Lower Keys Medical Center for inter-facility transport when FICA is unable
to handle a request in Key West. With more trucks available, the demand for TraumaStar will be
reduced.
Florida Keys Ambulance has been serving Monroe County for many years. Locally owned and
operated, it pays out nearly$100,000.00 in payroll each month. It has transported patients more
than two million miles with no accidents and without complaints by any of the three (3) Monroe
County hospitals. It contributes to local not-for-profit organizations, including investing in
Leadership Monroe. It has never sent a nonpaying patient to collections. Its experience is
unsurpassed. In fact, it is my understanding that at least one of the proposed service providers
has little or no experience in medical transport, having just been incorporated in October.
Florida law provides that the governing board of the County has a certain level of discretion in
granting or denying requests for certification. For instance, the County is required to consider
the opinions of municipalities. Other factors, such as the duplicitousness of service, the
negative impact on financial feasibility of the service providers and quality of care, may
also be relevant.
Given the above considerations, I respectfully urge this esteemed Board to deny the requests for
certificates of public convenience and need.
Respectfully,
LAW OFFICE OF JACK BRIDGES, P. A.
/s/Jack Bridges
Jack Bridges
Attorney at Law
0.2
G BOARD OF COUNTY COMMISSIONERS
County of Monroe Mayor Sylvia Murphy,District 5
The Florida Keys l'U � � Mayor Pro Tern Danny Kolhage,District 1
�pw° Michelle Coldiron,District 2
Heather Carruthers,District 3
David Rice,District 4
County Commission Meeting
March 21, 2019
Agenda Item Number: 0.2
Agenda Item Summary #5179
BULK ITEM: No DEPARTMENT: Emergency Services
TIME APPROXIMATE: STAFF CONTACT: James Callahan (305) 289-6088
3:00 P.M. PUBLIC HEARING
AGENDA ITEM WORDING: A public hearing to consider an application for issuance of a Class
A and Class B Certificate of Public Convenience and Necessity (COPCN) to Rapid Response
Medical Transportation for the operation of ALS and BLS Transport Services in the zones of Key
West & Adjunct Keys; Islamorada; Key Largo and Marathon for the period 3/21/19 through 3/20/21
for responding to requests for inter-facility transports.
ITEM BACKGROUND: Monroe County Code Sections 11-171 et seq., requires the BOCC to
hold a public hearing to consider the application for a new certificate. At the hearing, the Board may
receive a report from the County Administrator or his designee, testimony from the applicant or any
other interested party, and other relevant information. The Board will consider the public's
convenience and necessity for the proposed service and whether the applicant has the ability to
provide the necessary service(s). The Board shall then authorize the issuance of the certificate with
such conditions as are in the public's interest or deny the application, setting forth the reason(s)for
denial.
PREVIOUS RELEVANT BOCC ACTION: On January 23, 2019, item C.8, the Board granted
approval to advertise for a Public Hearing to be held on February 20, 2019, to consider the
application of Rapid Response Medical Transportation. On February 20, 2019, agenda item R.10
was continued to March 21, 2019.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION:
DOCUMENTATION:
Class A and B COPCN Rapid Response 3/21/19 - 3/20/21
Application Rapid Response
Packet Pg. 1866
0.2
FINANCIAL IMPACT:
Effective Date: 3/21/19
Expiration Date: 3/20/21
Total Dollar Value of Contract:
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: No If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details:
N/A
REVIEWED BY:
Pedro Mercado Completed 02/01/2019 11:42 AM
James Callahan Completed 02/01/2019 11:46 AM
Kathy Peters Completed 02/04/2019 10:55 AM
Board of County Commissioners Completed 02/20/2019 9:00 AM
Packet Pg. 1867
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. I COUNTY,MONROE FLORIDA 1
APPLICATION FOR CERTIFICATE
CLASS A EMERGENCY MEDICA CONVENIENCE
AND NE� `,� "� PCN)
(PRINT OR TYPE)
DEC C III � '�� i °18��
IN INITIAL APPLICATION-$50.00 [] RENEWAL APP'I CAIWWWOSM Flre Rescue
IF RENEWAL,PLEASE LIST NUMBER OF PREVIOUS CERTIFICATE:#
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BUSINESS PHONE NUMBER �jj*MFRGENCY PHONE NUMBER T 1 fS-2j0-Ll2-,9'q u)
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2. TYPE OF OWNERSHIP(Le.,Sole Proprietor,Partnership,Corporation, .) U)
DATE OF INCORPORATION OR FORMATION OF THE BUSINESS ASSOCIATION 10-19- 2018 :2
separate3. LIST ALL OFFICERS,DMECTORS,AND SHAREHOLDERS(Use sheet if necessary):
NAME AGE ADDRESS TELEPHONE# POSITION/TITLE z
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(Use separate sheet i °):
BASESTATION
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7. DESCRIBEVOUR COMMUNICATION SYSTEM(Attach y of all FCC licenses):
PORTABLES
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8. LIST THE NAMES AND ADDRESSES OF THREE(3)U.S.CITIZENS WHO WELL ACT AS REFERENCES FOR
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9. ATTACH A SCHEDULE OF RATES WHICH YOUR SERVICE WILL CHARGE DURING THE COPCN
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12. ATTACH A COPY OF ALL STANDING ORDERS AS ISSUED BY YOUR MEDICAL DIRECTOR
1 . ATTACH A CHECK OR MONEY ORDER IN THE APPROPRIATE AMOUNT,MADE PAYABLE TO THE U)
COMMISSIONERS.MONROE COUNTY BOARD OF COUNTY
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I,THE UNDERSIGNED REPRESENTATIVEF THE ABOVE NAMED SERVICE,DO HEREBY ATTESTSERVICE U)
MEETSTHE REQUIREMENTS FOR OPERATION OF AN EMERGENCY E IA SERVICE IN MONROE
COUNTY AND THE STATE OF FLORIDA. I FURTHER ATTESTTHE INFORMATION CONTAINED IN
THIS APPLICATION,TO THE BEST OF MY KNOWLEDGE,IS TRUE AND CORRECT.
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I F PIC T I AU REPRESENTATIVE
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