Item C18
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: November 20. 2001
Division: Public Safety
Bulk Item: Yes X
No
Department: Public Safety
AGENDA ITEM WORDING: Approval of Resolution adopting amendment to the Rules and
Regulations for Emergency Medical Transportation Services concerning prehospital services zones of
operation
ITEM BACKGROUND: The attached Resolution amends the Class A Rules and Regulations for
Emergency Medical Transportation Services by revising the assigned zones to correspond with the
geographical service area of the ambulance service providers.
PREVIOUS RELEVANT BOCC ACTION: None
CONTRACT/AGREEMENT CHANGES: Not a contract
STAFF RECOMMENDATIONS: Approval
TOTAL COST:
BUDGETED: Yes
No
COST TO COUNTY:
REVENUE PRODUCING: Yes
No
AMOUNTPERMONTH_ Year
APPROVED BY: County Arty YES OMB/Purchasing N/ A Risk Management N/ A
DIVISION DIRECTOR APPROVAL:
DOCUMENTATION:
Included X
To Follow
Not Required
DISPOSITION:
AGENDA ITEM # / -- elf
OCT-31-01 10,48 FROM,MONROE COUNTY ATTY OFFICE 10,3052823516
PAGE 2/2
James R. Paros
Public Safety Division
RESOLUTION NO.
- 2001
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA IN ORDER TO AMEND THE CLASS A
RULES.\NO REGULATIONS FOR EMERGENCY MEDICAL SERVICES
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COliNTYI FLORIDA, that the Class A Rules and Regulations for Emergency
Medical Service.. be amended. as follows:
1. Rule 1, Prehc.spital Services, shall be revised to read:
1. PREUOSPIT AI.. SERVICES
1.1 A (:lass A certificate holder shall provide prehospital basic life support
and/or advanced life support services, whichever is applicable, within its assigned zone,
the geographical service area within Monroe County, Florida, of the emergency medical
service.
2. All other roles and regulations, as shown in Exhibit A, shall remain in full force and
effect.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe
County, Florida, at a regular meeting of said Board held on the day of
, 2001.
Mayor Neugent
Mayor Pro Tern. Williams
Commissioner Spehar
Commissioner McCoy
Commissioner Nelson
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Chairman
(Seal)
Attest:
Deputy Clerk
EXHIBIT A
RULES AND REGULATIONS:
MONROE COUNTY, FLORIDA
EMERGENCY MEDICAL SERVICES
CLASS A
PURPOSE: These rules and regulations are issued under the provisions of Chapter 6.5,
Monroe County Code (M.C.C.), to establish standards for prehospital care and transportation of
persons needing emergency medical attention and interfacility transfers. Moreover, these rules
and regulations are promulgated to implement and interpret the above referenced County Code.
These rules shall be used in conjunction with Chapter 6.5, M.C.C., Chapter 401, Florida Statutes
(F.S.), and Chapter 64E-2, Florida Administrative Code (F.A.C.), for the regulation of emergency
medical services and personnel, as the rules and regulations do not generally repeat requirements
which are specific in Chapter 6.5, M.C.C., Chapter 401, F.S., and 64E-2, F.A.C. Definitions
provided in Chapter 6.5 M.C.C., Chapter 401, F.S., and 64E-2, F.A.C., shall apply to this rule.
1. PREHOSPITAL SERVICE
1.1 The Zones for prehospital service will be as follows. A Class A certificate holder shall
provide prehospital basic life support and/or advanced life support services. whichever is
applicable. within its assigned zone: the geographical service area within Monroe County.
Florida of the emergency medical service.
1. 1. 1 Zone 1: City of Key West, Florida
1.1.2 Zone 2: From the ',vest end of Cow Key Channel to the '.vest end of ChaRflel2, from the
west-ead ofTavermer Creek to Somh Bay Harbor Drive ed Lobster Laae, including the
cities of Key ColoRY Beaeh ed Layton, Florida
1.1.3 ZOfle 3: Islamorada, Village of Islaads, Florida
1.1.1 Zone 1: From South Bay Harbor Dri"e aad Lobster Lane north to the Dade County Line
on U.S. Highway 1 an:d North on C 905 to the interseetion of Card SOUBd Road
(C 905.\)
1.1.5 Zone 5: From the intersection ofC 905 and Card Sound Road (C 905) North on C 905
to ed ine1uding Ocee Reef ed \Vest on Card Sound Road (C 905) to the Dade County
Line
1.1.6 Zone 6: All other properties situated in the unincorporated areas of Monroe County,
Florida not ineluded \vitmn any of the above delineated five zones, iaeluding in said Zone
6 all of those properties situated on the maimed of the State of Florida between Dade
and Collier Counties
1.2 It shall be a violation of these Rules and Regulations for any ambulance to respond for
the purpose of providing prehospital care and transportation of persons needing
emergency medical attention in the zone of another emergency medical service (EMS),
unless:
1.3 The ambulance is requested by the dispatch center to respond as a back-up unit or for
mutual aid to the EMS provider responsible for the zone, or for a mass casualty incident;
or
1.4 The ambulance, for whatever reason, is at or near an accident (or other situation requiring
an ambulance) in the zone of another emergency medical service. Any questions relative
to responding in another zone without the dispatch center's direction should be resolved
in a manner which is in the best interest of the person( s) needing emergency medical
attention. Thus, the EMT or Paramedic may transport the patient after stabilization, if
that is deemed necessary in his judgment. However, the EMT or Paramedic will notify
the dispatch center as soon as possible to avoid another ambulance having to respond
unnecessarily.
1.5 The aforementioned shall apply only to prehospital care and transportation of persons
needing emergency medical attention.
2. INTERFACILITY TRANSFERS AND NON-EMERGENCY MEDICAL
TRANSPORTATION
2.1 Contingent upon local municipal rules, regulations and ordinances, any ambulance may
go anywhere within the County when requested to do so by a private citizen or his agent
(hospital, doctor, nurse, relative, etc.) for that private citizen's benefit for the purposes of:
2.1.1 Conducting an interfacility transfer.
2.1.2 Conducting nonemergency medical transportation of persons whose condition is such that
they do not need, nor are likely to need, immediate medical attention during transport.
3. OPERATING PROCEDURES
3. 1 Each emergency medical service shall maintain a business office in Monroe County and
sufficient ambulance substation sites to provide optimum coverage of its service area.
3. 1. 1 A copy of these rules and regulations shall be posted in a conspicuous place at the
business office and each ambulance substation site for all employees to review.
3.2 Each emergency medical service shall be required to operate a sufficient number of
staffed vehicles at all times to insure immediate response to no less than 95% of the calls
for prehospital care and transportation of persons needing emergency medical attention in
its assigned zone( s) per calendar month.
2
3.2.1 The minimum number of ambulances required shall be one (1). (It is strongly
recommended that a maintenance back-up ambulance be available.) Governmentally
owned emergency medical services are exempt from this provision.
3.3 The County's Emergency Medical Services Department shall have the authority to
coordinate and control all emergency medical services resources during disasters, major
emergencies and other major incidents requiring the response of multiple agencies and/or
resources. Each emergency medical service shall have the duties and responsibilities in
its respective service area which are applicable to pre-hospital services and specified in
the various plans and procedures adopted by Monroe County, dependent upon resource
availability.
4. COMMUNICATIONS EQUIPMENT
4.1 All ambulances must possess functional operating capabilities of direct two-way radio
communication with Board approved Dispatch Centers.
4.1.1 All emergency medical services and ambulances shall have the capability of being
dispatched by the Dispatch Center in their respective area, i.e., telephone, alert units, two-
way radio, etc.
4.1.2 All ambulances must have, as a minimum, two-way voice radio communication with all
hospitals to which they routinely transport patients.
5. MUTUAL AID, DISASTERS AND MASS CASUALTY INCIDENT RESPONSES
5.1 Each emergency medical service will be responsible to respond for mutual aid, disaster
and mass casualty incidents when requested to do so by a dispatch center, ifvehicles and
personnel are available without leaving its prehospital service zone unattended.
5.2 The order of dispatching ambulances shall be as follows:
(a) Ambulances of the Emergency Medical Service of the prehospital service zone
from which the call originated;
(b) Ambulances of the Emergency medical services of the adjacent prehospital service
zones from which the emergency medical call originated, determined by the
proximity of the service/unit to the patient.
6. RESPONSE TIMES
6.1 Every call for prehospital care and transportation of persons needing emergency medical
attention shall be answered promptly. All such calls requiring over ten (10) minutes from
the dispatch of the ambulance to its arrival at the scene shall be recorded with complete
documentation of the circumstances which delayed the response.
3
6.2 Those instances where more than three (3) minutes elapse between the dispatch ofthe
ambulance and its response shall be recorded with complete documentation of the
circumstances which delayed the response.
6.3 In any situation where an ambulance cannot respond when dispatched, such shall be
recorded with complete documentation of the circumstances which prevented the
response.
6.4 All response records as listed in paragraphs 6.1,6.2, and 6.3 above shall be kept on file in
the emergency medical services' business office and are subject to examination by and a
copy made available to the Administrator or his designee, monthly.
7. COMPLIANCE WITH STATE LAW
7.1 It is the responsibility of each Emergency Medical Service provider to be knowledgeable
of and in compliance with any and all Florida Statutes and rules regarding Emergency
Medical Services.
.;/.2 A conviction for violating any State of Florida Statute or rule or regulation regarding
emergency medical services, may result in the revocation of the Monroe County
Certificate of Public Convenience and Necessity.
8. RECORDS
8.1 Each emergency medical service shall be responsible for the supervision, preparation,
filing and maintenance of all records required by these rules. The records should be
handled in such a manner as to insure reasonable safety from water and fire damage and
be safeguarded from unauthorized use.
8.2 Each emergency medical service shall submit to the County's Emergency Medical
Services Department, on a monthly basis, for the purposes of statistical analysis and
supporting documentation for grants, a detailed operational report, including, but not
limited to, the total number of service response and patients transported, by appropriate
categories and average response time. Such reports shall be submitted in a format
approved by the Monroe County Emergency Medical Services Department.
9. Am AMBULANCES
9.1 Any person desiring to provide air ambulance services from a service location in Monroe
County shall, prior to operation, obtain a Class A Certificate of Public Convenience and
Necessity from the Board as either an interfacility provider, a prehospital provider, or
both.
4
9.2 An air ambulance provider who does not operate in Monroe County a basic life support
and/or advanced life support services-ground, whichever is applicable, and therefore has
not been assigned a prehospital service zone, shall enter into mutual aid agreements with
the emergency medical services for the respective prehospital service zones in which it
desires to operate. This does not prohibit a licensed air ambulance provider from
responding to mass casualty incidents as requested by the dispatch centers.l
5