§ 2-13-55. Applications for certificates, renewals and amendments.

(a)

Application. Every application for a certificate, renewal of a certificate or an amendment to a certificate shall be filed with the county's public safety department, on a form approved by the county and include all the required supporting information identified in the application. The application shall include the requisite nonrefundable application fee as set by resolution. Upon the complete filing of an application, a notice of the application shall be transmitted by the county to all current certificate holders in Manatee County.

(b)

Administrative review of application. The public safety director shall review the application and the attached documents.

(1)

The investigation and review of the application for a non-governmental entity shall include the following:

a.

The financial responsibility of the applicant;

b.

The applicant's past performance and service record, if any, in providing services within Manatee County;

c.

Local and state criminal records;

d.

Except for applications for ALS non-transport services, a current version of the certificate holder's medical and trauma transport protocols;

e.

Except for applications for ALS non-transport services, documentation of academic credentials, the most current medical director contract, medical director's current Florida license, and a drug enforcement agency certification; and

f.

Any other facts the applicant has submitted for consideration.

(2)

The investigation and review of the application for a governmental entity shall include the following:

a.

A copy of the applicant's most recent Comprehensive Annual Financial Report (CAFR);

b.

Except for applications for ALS non-transport services, a current version of the certificate holder's medical and trauma transport protocols;

c.

Except for applications for ALS non-transport services, documentation of academic credentials, the most current medical director contract, medical director's current Florida license, and a drug enforcement agency certification; and

d.

Any other facts the applicant has submitted for consideration.

If the application is missing information, the information or supporting documentation is untrue or falsified, the applicant failed to include all required supporting information, or if the required fees have not been paid, the public safety director may reject the application.

(c)

Board consideration of applications. Complete applications shall be reviewed by the board of county commissioners ("board") at a duly noticed public hearing. At the hearing, the Board shall consider the application, the public safety director's report on the factors referenced in section 2-13-55(b) and recommendation, and all matters presented at the public hearing. These factors shall include the following criteria:

(1)

For an applicant that is a non-governmental entity:

a.

The financial responsibility of the applicant to maintain safe, comfortable services, maintain or replace medical equipment, and maintain all insurance coverage required under this article based on the following criteria:

1.

Audited financial statements or federal tax returns or, for newly formed corporations, personal audited financial statements from the principal(s);

2.

Pro forma statements;

3.

Credit and bank references;

4.

A current official credit report; and

5.

Disclosure of all pending liabilities;

b.

The adequacy of the standard operating procedures of the applicant;

c.

The past performance and service record of the applicant;

d.

The number and type(s) of service(s) currently being provided to the area;

e.

The effect of the proposed services on the quality of existing life support transport or non-transport services;

f.

The effect of the proposed service on the overall cost of life support transport and non-transport services to the County;

g.

The community's need for the proposed service. The applicant shall bear the burden of proving there is a need for the proposed service. The basis for determination shall include:

1.

A computation of the ratio of estimated annual requests for service in the certificate category, to the current number of ambulances satisfying requests;

2.

A computation of the ratio of ambulances per one thousand (1,000) population; and

3.

A benchmark comparison with other entities of similar size and geography providing emergency medical services;

h.

The extent to which the applicant and all proposed equipment and personnel conform to the requirements of Chapter 401, Florida Statutes, any amendments thereto, and any rules promulgated thereunder; and

i.

Any other facts the applicant submitted for consideration.

(2)

For an applicant that is a governmental entity, the board shall approve the application for a certificate upon the applicant's complete submittal of the following information:

a.

A completed form application and documentation submitted in support of the application;

b.

The application fee, if applicable;

c.

EMS policy and procedures as approved by the county EMS medical director; and

d.

An annual report of its services, to include information as to the ALS and BLS service time per permitted vehicle.

(d)

Issuance of certificate. After consideration of the criteria set forth in subsection (c) of this article, if the board finds that public convenience and necessity will be promoted by the approval of the application, then the application shall be approved, subject to any limitations or restrictions reasonably required by the board.

(1)

Following board approval, the public safety director shall issue the applicant a certificate. Services approved by the board shall not begin until the county's receipt of the following from the certificate holder:

a.

Documentation of operational approval by all appropriate state agencies;

b.

An estimated number of drivers, emergency medical technicians, and paramedics;

c.

A list of all permitted vehicles by the Department of Health;

d.

Documentation that the insurance required by this article is current;

e.

Documentation that the certificate holder has passed all the inspections required by Chapter 401, Florida Statutes;

f.

Documentation that the certificate holder has passed county inspection of ambulances and air ambulances; and

g.

Documentation that the certificate holder has received vehicle operating permits as required by section 2-13-60 for its ambulance and air ambulances authorized by the certificate (if applicable).

(2)

A certificate holder may elect to phase in the operation of the total number of authorized ambulances so long as no less than two (2) ambulances are active at all times. If a certificate holder elects to phase into operation the number of ambulances approved by the board, the certificate holder is required to have county vehicle operating permits on all board-approved active and reserve ambulances, on or before two (2) years following the date of approval of the certificate.

(3)

If the applicant fails to comply with the requirements of this subsection within one hundred twenty (120) days after notification of board approval, such approval shall be automatically revoked and a certificate shall not be issued. For good cause shown, the public safety director may extend this time frame so long as the total time period does not exceed one hundred and eighty (180) days.

(4)

Certificates shall be issued for a term not to exceed two (2) years. The two (2) year term shall begin to run on the date of receipt of the items specified in (d)(1) of this section.

(e)

Certificate forms. Each certificate shall contain, at minimum:

(1)

The name and address of the applicant;

(2)

The maximum number of active ambulances authorized to operate;

(3)

The maximum number of reserve ambulances or air ambulances permitted to serve as temporary replacement for active vehicles;

(4)

The date on which the certificate expires;

(5)

The boundaries of the territory to be served, and if the certificate holder is a governmental entity, such certificate shall include the governmental entity's jurisdiction and any areas in which the governmental entity has an automatic aid or mutual aid agreement for fire and emergency medical services or in accordance with a closest unit response agreement; and

(6)

Such additional terms, conditions, provisions, and limitations as were authorized in the approval process.

The certificate holder must recognize that a permitted ALS non-transport vehicle may operate as a BLS vehicle when the vehicle is not staffed by a certified paramedic or licensed physician in accordance with Rule 64J-1.003, Florida Administrative Code, as amended, provided the vehicle service time is 70 per cent ALS non-transport services annually.

(f)

Renewal of certificates. The renewal of certificates shall follow the same process as set forth in this section, using such renewal application forms as may be promulgated by the county public safety director.

(1)

Application for renewals shall be submitted no later than ninety (90) days prior to the expiration of the current certificate(s), and shall be accompanied by the applicable fee.

(2)

No formal application for renewal shall be required for governmental entities that have been granted a certificate prior to the adoption of this article. The certificate issued shall stay in effect throughout the governmental entity's licensure period, including all renewals.

(g)

Amendment of certificates. Following a minimum of six (6) months in operation, a non-governmental entity certificate holder may submit the county's ambulances addition form and a letter to the public safety director stating the need and reason for the increase in active ambulances.

(1)

An increase shall not be authorized unless the certificate holder submits verifiable documentation which demonstrates that the certificate holder's trips-to-car ratio is equivalent to or exceeds five (5) trips per active vehicle, per average weekday, for the sixty (60) consecutive weekdays (Monday through Friday) preceding the date of application. The 5:1 trips-to-car ratio shall be calculated as follows: total number of trips where a patient is transported for the sixty (60) weekdays, divided by sixty (60) weekdays, divided by the number of authorized ambulances.

(2)

The public safety director shall only authorize the number of additional active ambulances necessary to lower the applicant's average weekday trips per active ambulances vehicle ratio below the 5:1 threshold.

(3)

All increases in the number of active ambulances shall be reported to the public safety director on a semiannual basis. The applicant may also request a proportional increase in reserve ambulances or air ambulances in accordance with the provisions of this article.

(Ord. No. 17-041 , § 3, 4-25-17)