Chapter 158 - EMERGENCY AND NONEMERGENCY MEDICAL TRANSPORTATION SERVICES

Sec. 156.112. - Severability. Chapter 160 - AMUSEMENT DEVICES AND CARNIVALS Chapter 158 - EMERGENCY AND NONEMERGENCY MEDICAL TRANSPORTATION SERVICES[1]

Footnotes: --- (1) ---

State Law reference— Medical transportation services, F.S. § 401.2101 et seq.

State rule reference—Emergency medical services, F.A.C. Ch. 64E-2.

PART 1. - FINDINGS AND INTENT OF COUNCIL; EXERCISE OF COUNTY POWERS; DEFINITIONS

Sec. 158.101. - Findings and intent of Council.

It is the intent of the Council in enacting this Chapter to assure that adequate and reliable emergency medical transportation services are available throughout Duval County and to assure that such services and their personnel and equipment comply with applicable State laws, rules, orders, standards and requirements in order to achieve an adequate level of proper care. The Council finds and determines that this Chapter is necessary in order to promote and protect the health, welfare and safety of the public. The Council intends for the Fire and Rescue Department to provide emergency primary response medical care and emergency medical transportation services. The Council also intends for private provider ALS and BLS services to provide emergency response under certain conditions, secondary response, and other medical transportation and services as requested by their clientele. In cases of mass casualty incidents and natural disasters the Council intends for the private provider to render mutual aid for benefit of the citizens of Jacksonville where possible. Emergency medical services provided within Duval County shall be accomplished in accordance with the provisions of this Chapter. Therefore, in evaluating and considering applications for a certificate, such evaluation and consideration shall be given to such criteria as will ensure an adequate level of care and ensure equipment safety and reliability. It is the further intent of the Council to exercise the full authority given to counties by State law to certify and permit emergency medical transportation services and promulgate a process for ensuring adherence to State law. The Council finds that the referral of patients by a certificate holder to a medical facility affiliated with such certificate holder, or by a medical facility to a certificate holder affiliated with such medical facility represents a potential conflict of interest and may even eliminate viable competitive alternatives, with serious risks of damage to effective patient choice. Such referral practices may also violate State and federal laws. It is the intent of the Council to eliminate such conflicts of interest and anti-competitive referral practices and to provide for and to promote affordable competitive emergency transportation services, advanced life support services and basic life support services to protect and enhance the public health, safety and welfare.

(Ord. 97-450-E, § 1)

Sec. 158.102. - Exercise of County powers.

In the enactment of this Chapter, the City of Jacksonville is exercising its powers under F.S. Ch. 401 and under F.S. Ch. 162 as a charter County as authorized and provided for under Laws of Fla. Ch. 67-1320, as amended, being the Charter of the Consolidated City of Jacksonville, so that this Chapter shall be applicable and enforced throughout Duval County.

(Ord. 97-450-E, § 1)

Sec. 158.103. - Definitions.

As used in this Chapter:

(a)

Advanced life support (ALS), basic life support (BLS) and Air Ambulance Service and license therefor shall have the same meanings as are assigned to them by State law.

(b)

Affiliate means any or all of the following:

(1)

A certificate holder that directly or indirectly through one or more intermediaries, owns all or any part of, or controls, or is under common control with, or has officers or directors in common with, a medical facility; or

(2)

A medical facility that directly or indirectly through one or more intermediaries, owns all or any part of, or controls, or is under common control with, or has officers or directors in common with, a certificate holder; or

(3)

A person that directly or indirectly through one or more intermediaries, owns all or any part of, or controls, or is under common control with, or has officers or directors in common with, a certificate holder and a medical facility.

(c)

Ambulance or emergency medical services vehicle shall have the same meanings as are assigned to them by F.S. Ch. 401, and shall include air ambulances as that term is defined by F.S. Ch. 401.

(d)

Ambulance driver means any person who meets the requirements of State law as it relates to drivers.

(e)

Ambulance service means the transportation and emergency treatment of persons who are in need of medical attention.

(f)

Base of operations means the permanent location in or from which a licensee solicits, accepts, or conducts business under the provisions of this Chapter.

(g)

Certificate means a certificate of public convenience and necessity issued for emergency medical transportation service pursuant to the provisions of this Chapter.

(h)

Director means the Director of Fire and Rescue Department.

(i)

Emergency medical dispatcher (EMD) is any dispatcher who has successfully completed a nationally recognized EMD course.

(j)

Emergency medical technician (EMT) shall have the same meaning assigned to it under F.S. Ch. 401.

(k)

Emergency medical transportation service (EMTS) means an entity licensed to conduct emergency medical transportation of the sick and injured pursuant to and as authorized by F.S. Ch. 401.

(l)

Emergency response (primary response) shall mean the response of an ambulance to a request for emergency assistance or transportation for or on behalf of a victim or victims of an accident or illness and which response necessitates the use of either lights or siren or both to expedite arrival.

(m)

FRCC means the City's Fire and Rescue Communication Center.

(n)

Medical director shall have the same meaning assigned to it under F.S. Ch. 401.

(o)

Medical facility means a hospital, physician's office, nursing center, health care system, hospital systems facility, clinic or any other facility as defined in F.S. Ch. 395 or F.S. Ch. 400, offering medical treatment to the general public.

(p)

Medical transportation means and includes any transportation which requires or may require ALS or BLS services during transportation.

(q)

Paramedic shall have the same meaning assigned to it under F.S. Ch. 401.

(r)

Secondary response means the response of a licensed provider called by an emergency response provider already on the scene.

(s)

F.S. Ch. 401 means the "Raymond H. Alexander, M.D. Emergency Medical Transportation Services Act" as codified as F.S. Ch. 401, Pt. III, as it may be amended from time to time, and shall include all rules and regulations contained in the Florida Administrative Code, which interpret or implement such Act, as such rules and regulations may be amended from time to time.

(Ord. 97-450-E, § 1; Ord. 2008-513-E, § 1)

PART 2. - EMERGENCY MEDICAL TRANSPORTATION SERVICES

Sec. 158.201. - Certificate required to operate business.

No person or entity shall, directly or indirectly, operate, conduct or otherwise engage in or profess to be engaged in prehospital emergency medical transportation service, unless that person shall first secure a certificate in accordance with this Chapter. Separate certificates shall be required for air and ground transportation.

(Ord. 97-450-E, § 1)

Sec. 158.202. - Exemptions and prohibitions regarding certificates.

(a)

No certificate shall be required of any ambulance service business which is exempt under F.S. Ch. 401.

(b)

No person or other legal entity shall have an ownership interest directly or indirectly in more than one certificate holder of ground emergency medical transportation services.

(c)

In addition to other provisions of this Chapter, no initial certificate shall be issued if, within a period of ten years prior to the date of the initial application, the EMTS applicant shall have been subject to any civil, administrative or quasi-judicial proceedings that have caused any restrictions of operations, fines or other punitive or remedial actions to be brought against the EMTS applicant as a result of improper, undesirable or unlawful operations of emergency medical transportation services.

(d)

Section 158.202(c) shall not apply to renewal certificates if all civil, administrative or quasi-judicial, fines, restrictions or remedial actions have been paid or resolved respectively.

(Ord. 97-450-E, § 1)

Sec. 158.203. - Availability of ground certificates; current certificate holders.

Ground certificates shall be issued for ground transportation ambulance services and shall become available as follows:

(a)

All persons or entities who, on November 26, 1997, hold certificates of public convenience and necessity for ground transportation shall be entitled to apply for and be issued a certificate under the following conditions:

(1)

Application must be filed within 60 days of November 26, 1997.

(2)

Applicants must meet all of the qualifications set forth in this Chapter at the time of filing the application.

(3)

Applicants have been in continuous operation over the last 180 days.

(b)

After certificates available pursuant to subsection (a) of this Section are granted, a ground transportation certificate shall become available at any time the total number of valid, outstanding certificates falls below four, not including the certificate issued to the Fire and Rescue Department, which number is based on a current ratio of one certificate per 200,000 people or fraction thereof residing in Duval County as determined by the Director. This ratio and requirement shall be subject to modification by the Council. Certificates for air transportation shall not be limited although the Council may at any time limit their number.

(c)

When certificate(s) becomes available pursuant to subsection (b) of this Section, the Director shall advertise that fact and set a deadline for filing applications. From the applicants judged by the Director to be preliminarily qualified, the Director will publicly choose, by merit, as determined by the Director, one application, for each certificate, to be forwarded to the Council for further review and approval.

(d)

The limitation set forth in this Section does not apply to not for profit medical facilities who have contracts with the City of Jacksonville to provide indigent care and provide those services in facilities owned by the City of Jacksonville.

(Ord. 97-450-E, § 1; Ord. 2024-628-E, § 1)

Sec. 158.204. - Application; contents; fee.

The fees listed below can be found electronically on the following City of Jacksonville webpage: www.coj.net/fees.

(a)

Every person owning or acting as an agent for the owner of any emergency medical transportation service shall submit a written application to the Director along with a filing fee to obtain a certificate. If the certificate is not issued the applicant shall receive a refund as noted in refund of fees.

(b)

The application shall include all information required by this Chapter and shall be on such forms as are prescribed by the Director. Upon receipt of the application the Director shall determine by investigation and review the accuracy and completeness of all information requested. The information on the application shall include:

(1)

The name of the applicant;

(2)

The date of the application;

(3)

Certification that applicant has applied or will apply to the Florida Department of Health for all licenses required by F.S. Ch. 401;

(4)

A list of violations of any federal, State or local statutes, ordinances, rules and regulations, during the past ten years (regardless of whether such violations are being appealed) including those described and defined in Sections 158.207, 158.215, and 158.216 that may cause denial of certificate;

(5)

A list of all principals, owner, agents, officers and current employees of the applicant and if the applicant is:

(i)

An individual, then his or her name, social security number, business and home addresses and business and home telephone numbers; or

(ii)

A partnership, then the full name of the partnership and the names, social security numbers, and business and home addresses and business and home telephone numbers of all partners, whether general or limited, accompanied by the partnership instrument or a certified copy thereof, and the business address and telephone number of the partnership; or

(iii)

A corporation, then the exact corporate name and state of incorporation and the names of all the officers and directors and all stockholders owning five percent or more of the outstanding voting stock with a notation of percentage of ownership, accompanied by articles of incorporation, or certified copies thereof, and the business address of the corporation that may be amended from time to time;

(6)

A statement of intent that the emergency medical transportation service is to be conducted under a name other than that of the applicant. If that is the case, the business name, the County of registration, under the Florida Statutes, and a copy of any registration of a fictitious name shall be provided;

(7)

A list of all vehicles (as required by Section 158.208) to be operated as an emergency medical transportation vehicle under the certificate, giving for each the make, type, year of manufacture, passenger accommodations, ownership and a copy of the vehicle registration issued by the State of Florida, Division of Highway Safety and Motor Vehicles and designating which vehicles are to be operated as ALS vehicles and which are to be operated as BLS vehicles;

(8)

A list of all personnel who are to be used as ambulance drivers, EMTs and paramedics, certified by the applicant that all such persons meet the requirements specified in Section 158.210;

(9)

A certificate of insurance as required by Section 158.212;

(10)

The name, business address, telephone number, license number as well as the DEA number of the medical director;

(11)

A Duval County occupational license; and

(12)

If the emergency medical transportation service is already operating in another County in the State of Florida, that fact shall be stated and the name of the County or Counties, along with the business address in the other counties, and the DEA number of the service shall be provided.

(Ord. 97-450-E, § 1; Ord. 2017-665-E, § 10)

Sec. 158.205. - Grant of certificate.

(a)

After the application has been reviewed and determined by the Director to be complete, in the proper form, and the Director has verified the statements on the application, to the best of the Director's ability, the Director shall forward findings and recommendations to the Council Secretary for submission to the Public Health and Safety Committee ("PHS"). After the PHS has voted to recommend or deny the application for a certificate, PHS shall communicate those recommendations to the Council Secretary for appropriate action.

(b)

Before making recommendations to the Council, PHS shall review all information submitted to the Director and such information that may be submitted to PHS. PHS shall consider all matters required by State law including but not limited to F.S. Ch. 401 and other matters it may consider relative including, but not limited to, the following:

(1)

The population density and composition of the City and the likely areas within which the proposed ALS, BLS, or nonemergency medical transportation service will operate.

(2)

The need of the people of the City for ALS or BLS service.

(3)

Recommendations of any local or regional trauma agency created pursuant to F.S. Ch. 395, as applicable.

(4)

Recommendations of the Urban Services Districts.

(5)

Qualifications and experience of owners, officers, directors, staff and employees including, but not limited to, paramedics, emergency medical technicians and drivers.

(6)

Financial resources and responsibility, including but not limited to insurance coverages.

(7)

Efficiency, safety and reliability of the business.

(8)

Compliance with all applicable statutes, ordinances and rules at any level of regulation.

(9)

Results of graded performance, if any, by any agency at any level of regulation.

(10)

Such other factors as may be considered important by the Director or PHS.

(c)

The Council shall consider the best interests of the community in granting or denying a certificate based on the recommendations of the Director, PHS, the Urban Services Districts, a local or regional trauma agency created pursuant to F.S. Ch. 395 (as applicable) and on all information submitted to the Director, PHS and the Council.

(d)

Every owner of any emergency medical transportation service that obtains a certificate shall operate its respective service consistent with and pursuant to this Chapter and all applicable State laws and regulations. The acceptance of a certificate from the City shall be deemed to be an agreement on the part of the certificate holder that the certificate holder shall operate its business strictly in accordance with all such laws and rules, and amendments thereto. Failure to do so will be cause for investigations that may result in fines, suspension and/or revocation.

(e)

Certificates are not property but are evidence of the grant of a privilege by the City. All certificates shall be subject to the right of the Council to terminate the emergency medical transportation services system created hereunder and any or all certificates granted hereunder. The Director shall notify all certificate holders of any such legislative proposal 120 days before the Director proposes such action.

(Ord. 97-450-E, § 1)

Sec. 158.206. - Certificate term and renewal.

(a)

A certificate shall become effective upon the date of issuance and shall be subject to recertification by the certificate holder every 24 months thereafter.

(b)

Upon recertification, a certificate shall be extended by the Director for successive 24-month periods. Ninety days before expiration of 24 months of certificates issued hereunder, the certificate holder shall submit with the Director a written application for recertification together with application filing fee specified in Section 158.204. If the certificate is not extended, $1,000 of the filing fee shall be refunded.

(c)

In the event that the recertification application is not filed by the application deadline, the Director shall notify the certificate holder who shall have 14 additional days after the application deadline set forth herein to file an application. There shall be a $100 penalty for each day after the application deadline that the application is filed late. If the application is not filed within the 14 days after the application deadline then the certificate holder will suspend operations at the end of the current 24-month term until the Director has completed review of any other applications to provide EMTS.

(d)

A certificate shall be renewable upon receipt of the renewal application which will provide information on changes and additions to the emergency medical transportation service since the previous issuance of a certificate. The certificate shall be renewed upon the presentation of the renewal application and a current (renewed) license, issued by the State of Florida, to the Director. The Director shall then note the adjusted date on the appropriate form.

(Ord. 97-450-E, § 1; Ord. 98-119-E, § 1)

Sec. 158.207. - Certificate denial.

In addition to other provisions for certificate denial:

(a)

No certificate shall be issued and any certificate shall be revoked if the EMTS applicant made any material false statement on its application or to the Director, the Council or any of the Council's committees.

(b)

No certificate shall be issued if the EMTS applicant shall have been convicted of any offense under the laws or ordinances, rules or regulations of the United States, any state or local government, pertaining to emergency medical transportation services.

(c)

No certificate shall be granted to any EMTS applicant who has previously held a license, issued by the State of Florida, and that license has been revoked or suspended.

(d)

For purposes of this Part, the terms EMTS applicant shall mean the EMTS; any person or company that owns or controls, directly or indirectly, the EMTS; or any partner, officer, director, or stockholder of more than five percent of the capital stock of the EMTS or any company that owns or controls, directly or indirectly. Also, for purposes of this Part, the term convicted shall include a finding of guilt, a plea of guilty or a plea of nolo contendere, notwithstanding a suspension of sentence or a withholding of adjudication.

(Ord. 97-450-E, § 1)

Sec. 158.208. - Vehicles design and equipment.

(a)

Each EMTS vehicle listed on the EMTS application pursuant to Section 158.204, shall be owned or leased to the EMTS and shall be required to adhere to, and be maintained in accordance with, all applicable vehicle design criteria required by State law, and shall be required to meet all applicable criteria set forth in this Section. In addition, such vehicles must meet all applicable vehicle safety standards pursuant to the Florida Statutes. All equipment in use while a certificate is in force, shall, at all times, be in proper working order. The certificate holder shall maintain all records of inspection for the life of the vehicle.

(b)

Each EMTS for ground transportation shall have at least three fully equipped ground transportation vehicles. At least two of these ground transportation vehicles must be licensed by the State of Florida as ALS vehicles.

(Ord. 97-450-E, § 1)

Sec. 158.209. - Dispatch center.

The EMTS certificate holder shall maintain a base of operations which shall contain a dispatch center. The dispatch center shall be staffed at all times by either a certified emergency medical dispatcher or an EMT or a paramedic. The dispatcher must have direct and immediate communications capabilities with all persons who call for ambulance service as well as with ambulance staff should they be away from the vehicle. All emergency telephone numbers listed for the certificate holder shall be answered at the dispatch center, and all telephones shall be staffed and manned 24 hours a day. Answering machines and answering services are not sufficient to comply with this Section.

(Ord. 97-450-E, § 1)

Sec. 158.210. - EMTS drivers, emergency medical technicians and paramedics.

The EMTS certificate holder shall not use, at any time, in its operations, any person who fails to meet the requirements of State law. The EMTS certificate holder shall, at all times, maintain adequate and accurate documentation concerning all such personnel at its primary local business office.

(Ord. 97-450-E, § 1)

Sec. 158.211. - EMTS business records.

EMTS certificate holders shall maintain all records required to be maintained by this Chapter or by State law for a period of not less than five years.

(Ord. 97-450-E, § 1)

Sec. 158.212. - Liability insurance.

No owner shall permit an emergency medical transportation services vehicle to be driven or operated on the streets of the City, unless the owner shall have first procured and have on file in his business office proof of a liability insurance policy which complies with applicable State statutes and regulations. Failure to produce appropriate evidence of insurance shall be grounds for immediate suspension of a certificate.

(Ord. 97-450-E, § 1)

Sec. 158.213. - Inspections.

(a)

All certificate holders must meet all standards as required by the State of Florida in State law, and shall submit to any inspections required by the Florida Department of Health as well as the Director or designee. These inspections will be conducted at reasonable times and places and not more than annually unless there is reason to believe that patient care may be compromised. There shall be no charge to the EMTS for these inspections, except for charges under Chapter 680.

(b)

Failure to submit to inspections, by properly identified and appointed individuals at the appropriate times and circumstances, shall be cause for investigation by PHS or its designee; provided however there shall be no inspection conducted or demanded when patient care will be interrupted or delayed.

(c)

Inspectors shall exhibit proper identification and act in a professional manner at all times. Complaints with regard to inspection personnel shall be submitted to the Director.

(d)

Compliance with all appropriate vehicle inspections as well as those of personnel, personnel records and facilities as required by all applicable Florida Statutes, rules and regulations and/or local ordinances, rules and regulations, shall be mandatory.

(e)

Inspection of facilities and records will be scheduled at least five working days in advance and will be performed on an annual basis unless there is reason to believe patient care is being compromised.

(f)

Inspection personnel, at the discretion of the certificate holder, may be assisted by personnel designated by the management of the service being inspected.

(g)

No information shall be copied, taken, transmitted, faxed or otherwise removed from the premises of the inspected service without the permission of the management. This permission shall not be withheld when specific violations are discovered. Any information that is deemed by the management of the service being inspected to be competitively sensitive shall be kept confidential, but only to the extent permitted by F.S. Ch. 119.

(h)

Inspection of the base of operations and dispatch center shall include all requirements of State law, as well as cleanliness, repair and safety.

(i)

Inspection of personnel records, ambulance and emergency medical service vehicles, shall be limited to ensuring compliance with applicable State and local statutes, ordinances, rules and regulations.

(Ord. 97-450-E, § 1)

Sec. 158.214. - Transfer or assignment.

No certificate issued under this Chapter shall be assignable or transferable by the holder of the certificate except upon approval by the Council. A transfer or assignment shall require the submission of a new application and be subject to the same investigation, examination, fees and standards as original applications; provided however the provisions of Section 158.203(c) shall not apply.

(Ord. 97-450-E, § 1)

Sec. 158.215. - Suspension and termination of certificate.

(a)

When the Director determines that the holder of a certificate has failed to obtain a State license to operate in Duval County or to comply and maintain compliance with the standards set out in State law or this Chapter, the Director shall give written notice to the certificate holder, stating which requirements are not being complied with, and afford the holder such reasonable time for compliance as may be set by the Director. A copy of this notice shall be forwarded to the Council Secretary and reported to the Council at its next ensuing regular meeting. If, at the end of this reasonable time, the holder is not in compliance as stated by the notice of noncompliance, a hearing shall be held before the appropriate committee of the Council, at which the holder shall be entitled to be heard, in person or by counsel, and to present such evidence or present such information as he deems necessary. Within ten days after conclusion of the hearing, the appropriate committee of the Council shall issue its findings of fact and recommendations, which it shall transmit to the Council, with a copy to the certificate holder.

(b)

The Council shall consider the findings of fact and recommendations of the committee and may:

(1)

Determine that the certificate holder is in compliance with all State and local laws, ordinances, rules and regulations; or

(2)

Determine and cite specific violations, by the certificate holder, and issue an order to correct such violations within a reasonable period of time; or

(3)

Order the suspension of the certificate for such time as it deems necessary and advisable, not to exceed six months; or

(4)

In the event of danger to the public health, safety or welfare or in the event of repeated or continued violations, terminate the certificate; or

(5)

Impose such other reasonable penalties as deemed appropriate.

(c)

Upon suspension or termination of a certificate, the holder shall immediately cease all operations as an EMTS.

(Ord. 97-450-E, § 1)

Sec. 158.216. - Obedience to traffic laws and regulations.

(a)

The driver of a ground transportation emergency vehicle, when responding to an emergency call or when transporting an emergency patient, may, exercise the privileges set forth in this Section, but subject to the conditions herein stated, and only when such driver has reasonable grounds to believe that a bona fide emergency in fact exists requiring the exercise of such privileges.

(b)

Subject to the provisions of subsection (a) of this Section, the driver of such vehicle, except when otherwise directed by a law enforcement officer, may:

(1)

Park or stand to receive a patient irrespective of the otherwise applicable provisions of law or regulation, and whether or not the patient is an emergency or routine transfer case.

(2)

In an emergency case, proceed past a red or stop signal or stop sign, but only after slowing down as may be necessary for safe operation.

(3)

In an emergency case, exceed by 20 miles per hour the maximum speed limits permitted by law or regulation so long as the driver does not endanger life or property.

(4)

Use emergency lights and sirens, pursuant to F.S. Ch. 316, as it may be amended from time to time.

(Ord. 97-450-E, § 1)

Sec. 158.217. - Conformance with State and local laws, ordinances, rules and regulations.

(a)

The emergency medical transportation services authorized by this Chapter shall, at all times, conform to all the requirements of State law and all other federal and Florida statutes, rules, regulations and local ordinances, rules and regulations, a violation of such State law, statutes, ordinances and rules at any level of government, shall be a violation of this Chapter.

(b)

The rules and regulations that may be promulgated by the Director shall be adopted only after notice to all EMTS certificate holders. Such EMTS certificate holders will be allowed to comment and have input on all such proposed rules and regulations.

(c)

The proposed rules and regulations shall be reviewed and approved or disapproved by PHS prior to implementation, in conformity with procedures specified in Section 158.306.

(d)

The Director is authorized to promulgate rules and guidelines for the interpretation and implementation of this Chapter, subject to the provisions and conditions set forth in this Chapter.

(Ord. 97-450-E, § 1)

Sec. 158.218. - Penalties.

Unless otherwise provided in this Chapter, any person violating or refusing or failing to comply with the provisions of this Chapter shall be guilty of a class D offense against the City. Each day such violation, refusal or failure to comply occurs shall constitute a separate offense.

(Ord. 97-450-E, § 1)

Sec. 158.219. - Prohibited referrals.

(a)

No certificate holder shall directly or indirectly refer a patient to a medical facility, which is an affiliate of such certificate holder, for medical treatment, to the exclusion of other medical facilities. No certificate holder shall accept a referral of a patient, for the provision of emergency or non-emergency medical transportation services, ALS service or BLS service, from a medical facility which is an affiliate of such certificate holder, where such affiliated medical facility has made such referral to the exclusion of other certificate holders. No medical facility, which is an affiliate of a certificate holder, shall directly or indirectly refer a patient to such affiliated certificate holder for the provision of emergency or non-emergency medical transportation service, ALS service or BLS service, to the exclusion of other certificate holders. Nor shall any medical facility or certificate holder make any referral in violation of any State or federal law, including but not limited to the Florida patient Self Referral Act of 1992, the Ethics in Patients Referral Act of 1989, and the Medicare and Medicaid Patient and Program Act of 1987.

(b)

Violation of this Section by a medical facility or by a certificate holder shall, in addition to any other penalties provided in this Chapter, constitute grounds for suspension or termination of the certificate held by the affiliated certificate holder.

(c)

Alleged violations of this Section shall be initially investigated by the Director. Notice of such investigation shall be sent to the certificate holder and affiliated medical facility and to the Council Secretary who shall report it to the Council at its next ensuing regular meeting. A hearing will then be set before the appropriate committee of the Council after reasonable notice to the certificate holder. The certificate holder shall be entitled to be heard, in person or by counsel, and may present such evidence and other information as the certificate holder deems necessary. Within ten days after the conclusion of the hearing, the appropriate committee of the Council shall issue its findings of facts and recommendations which shall be sent to the Council and to the certificate holder.

(d)

Council shall proceed in the manner prescribed by Section 158.215(b); and the certificate holder shall be governed by Section 158.215(c).

(Ord. 97-450-E, § 1)

PART 3. - CITY MEDICAL TRANSPORTATION SERVICES

Sec. 158.301. - Authority to provide.

The Fire and Rescue Department is authorized to establish, operate and maintain emergency response medical care and emergency medical transportation to the citizens of the City.

(Ord. 97-450-E, § 1)

Sec. 158.302. - Charge.

The charges for transportation and medical services rendered by the Fire and Rescue Department are established at the rates set forth in Section 123.102(a). These rates shall remain at or near prevailing Medicare/Medicaid rates. The person receiving the services by the Fire and Rescue Department and any person contracting for same shall be responsible for payment of the charge. The Director of Finance and Administration shall be authorized to adjust the patient's share of the cost of any rescue transport service rendered to Medicaid/Medicare recipients in accordance with existing contracts, workers covered by Workers' Compensation Laws of the State of Florida and for other qualified low-income persons in accordance with F.S. § 154.101, based on the eligibility criteria promulgated by the State of Florida, Department of Health under Rule 64F-10, F.A.C., when the patient has elected to participate in the financial eligibility determination process applicable to the Duval County Public Health Clinics. The adjustment of the patient share of the rescue transport shall comply with the corresponding sliding fee scale used to classify patients at the Duval County Public Health Clinics and/or the Hill Burton criteria contained in the Indigent Care Contract between the City and Shands Jacksonville Hospital. The Director of Finance and Administration, upon recommendation of the Revenue Manager shall be authorized to write-off and treat as uncollectible those charges that have been through the billing process, and the referral of which to a collection agency or General Counsel, when applicable, is not justified as cost effective; and where it can be determined that the charges are the responsibility of the Sheriff pursuant to Sections 901.35 and 951.032 F.S.

(Ord. 97-450-E, § 1; Ord. 2004-990-E, § 6; Ord. 2016-140-E, § 16)

Editor's note— Ordinance 2007-839-E, § 18, authorized updated department/division names pursuant to reorganization.

Sec. 158.304. - Duties of Director of Finance and Administration.

The Director of Finance and Administration is authorized and directed to establish a proper system of inventory control, recording, billing, collecting and accounting for Fire and Rescue Department services.

(Ord. 97-450-E, § 1; Ord. 2016-140-E, § 16)

Editor's note— Ordinance 2007-839-E, § 18, authorized updated department/division names pursuant to reorganization.

Sec. 158.305. - Ground transportation emergency services.

(a)

In the event any City agency receives a call necessitating emergency response by ground transportation, FRCC shall be advised immediately of the call and the nature and location of the emergency. The FRCC shall dispatch the closest City Fire Company or rescue unit. Secondary response shall be provided by a private sector certificate holder.

(b)

Except as set forth in subsection (c) of this Section, in the event any certificate holder receives a call necessitating emergency response, FRCC shall be advised immediately of the call and the nature and location of the emergency. The FRCC may dispatch a closer City Fire Company or rescue unit. If the City responds, the FRCC shall inform the certificate holder of the City's response. Secondary response shall be provided by the certificate holder who first received the call for emergency transportation.

(c)

Emergency response may also be made by a private certificate holder, to places other than to medical facilities, under the following circumstances:

(1)

The certificate holder informs FRCC of the emergency; and

(2)

The injured or ill person is under the direct care of a physician or under the direct care of a registered nurse; or

(3)

The physician directs that a private EMTS be contacted to make an emergency response;

(4)

The private EMTS shall record the name of the requesting physician and, where appropriate the attending physician or attending nurse.

(Ord. 97-450-E, § 1)

Sec. 158.306. - Authority to promulgate rules.

(a)

The Director is authorized to promulgate reasonable rules which shall govern the operation of emergency medical transportation services in the City. Such rules shall be made with input from the Director/Fire Chief of the Fire and Rescue Department and from the EMTS certificate holders. Acceptance of a certificate is acceptance of the responsibility to follow and to be governed by reasonable rules and regulations promulgated to implement this Chapter and State law.

(b)

Before becoming effective, any rule or amendment to a rule affecting private emergency medical transportation providers shall be forwarded to each certificate holder for input and comment. After receipt of such input and comments, the proposed rule or amendment shall be sent to PHS. A public hearing shall be held before PHS at which time all interested persons shall be afforded an opportunity to speak on the proposed rule or amendment. The Director is authorized to implement a rule or rule amendment seven calendar days subsequent to PHS approval, and after the Director has notified the certificate holders by mail. The Council may amend, repeal or enact a rule by ordinance.

(Ord. 97-450-E, § 1)

Sec. 158.307. - Memoranda of understanding.

The Director/Fire Chief of the Fire and Rescue Department is authorized to enter into memoranda of understanding with certificate holders in the private sector to address emergency response activities contemplated in this Part 3. Such memoranda of understanding shall, at a minimum, address:

(a)

Transportation issues;

(b)

Mass casualty incidence response; and

(c)

Extrication.

(Ord. 97-450-E, § 1)

Sec. 158.308. - Judicial remedies.

The Director may request the Office of General Counsel to institute a civil action in a court of competent jurisdiction to seek injunctive relief to enforce compliance with a rule promulgated by the Director pursuant to Section 158.306.

(Ord. 97-450-E, § 1)

Sec. 158.309. - Release of emergency medical reports.

(a)

The Director/Fire Chief of the Fire and Rescue Department or his designee is declared to be the custodian of the emergency medical reports of the Fire and Rescue Department. Emergency medical reports shall be released by the Fire and Rescue Department in accordance with the following procedures:

(1)

Emergency medical reports shall be released in accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to a requesting and legally authorized party who presents a request and valid authorization to the Fire and Rescue Department for the inspection and release of the emergency medical report and who makes a payment of a research and copy fee per report, as found in www.coj.net/fees. The request for an emergency medical report must be signed by the patient or a person legally authorized to act on behalf of the patient, such as the patient's parents, legal guardian, attorney, etc.

(2)

The statistical information contained in the emergency medical report shall be released to any requesting party.

(b)

All fees paid to the Fire and Rescue Department pursuant to this Section shall be paid to the Tax Collector weekly.

(Ord. 97-450-E, § 1; Ord. 2017-665-E, § 10)

Sec. 158.310. - Availability of emergency services during City functions.

It shall be the responsibility of the Director/Fire Chief of the Fire and Rescue Department to determine the adequate level of stand-by emergency rescue services that may be required for any City function. The Director/Fire Chief of the Fire and Rescue Department is empowered to direct that both the City, as to City-sponsored events, and private promoters, as to non-City sponsored events, provide the level of stand-by emergency rescue service as he determines to be necessary and appropriate. It shall be unlawful and a violation of this Part for any person or business entity sponsoring a City function to permit the event to occur without the provision of stand-by emergency medical services as required by the Director/Fire Chief of the Fire and Rescue Department. These services may be provided by the City or private certificate holders.

(Ord. 97-450-E, § 1)

PART 4. - LOCATION OF APARTMENTS

Sec. 158.401. - Diagrams required.

All owners and managers of multifamily dwellings and apartment complexes containing more than four dwelling units shall furnish the Director/Fire Chief of the Fire and Rescue Department and the Sheriff, upon request, a diagram of the location of each single-family dwelling unit contained within the multifamily dwelling or apartment complex showing the street address of the building and the location of each apartment therein, clearly specifying the apartment number. The diagrams shall conform to the specifications of the Director/Fire Chief of the Fire and Rescue Department and the Sheriff.

(Ord. 97-450-E, § 1)

Sec. 158.402. - Penalty.

Notwithstanding any other provision in this Chapter to the contrary, failure to furnish the diagram specified in Section 158.401 within 30 days of receipt of the request from the Director of Fire and Rescue or Sheriff shall constitute a class A offense.

(Ord. 97-450-E, § 1)

PART 5. - NON-TRANSPORTATION ADVANCED LIFE SUPPORT SERVICES

Sec. 158.501. - Definition.

As used in this Part 5, and notwithstanding any provision of this Chapter to the contrary, the term "certificate" means a certificate of public convenience and necessity issued for non-transportation ALS service, pursuant to provisions in this Part.

(Ord. 2006-1057-E, § 2)

Sec. 158.502. - Non-transportation ALS Certificates for Municipal corporations.

The municipal corporations (Urban Services Districts 2 through 5) may apply for certificates to provide non-transportation ALS within their respective jurisdictions, notwithstanding any provisions in this Chapter to the contrary.

(Ord. 2006-1057-E, § 2)

Sec. 158.503. - Procedures for Award of Certificate.

Any such municipal corporation that desires a certificate for non-transportation ALS, shall apply for the same to the Jacksonville Fire and Rescue Department, Division Chief of Rescue. Application will be on a form approved by the Division Chief of Rescue. Upon receipt of the application, the Division Chief of Rescue shall prepare a certificate containing all terms, conditions and limitations for the performance of non-transportation ALS service. Such certificate shall have a term of ten years, from its date of issuance and shall be presented to the Council as part of an ordinance for review and award. Such certificate must be renewed, by the certificate holder every ten years after the initial date of issuance.

(Ord. 2006-1057-E, § 2)

Sec. 158.504. - Minimum Terms, Conditions and Limitations of Certificate.

At a minimum, the certificate holder must comply with the following terms, conditions and limitations:

(a)

Follow all procedures for provision of emergency medical services, as codified in the most recent edition of the Florida Administrative Code, Part 64-E; and

(b)

Follow operating guidelines, consistent with those of the City of Jacksonville Fire and Rescue Department, for provision of emergency medical services, including ALS, approved by the Division Chief of Rescue.

(Ord. 2006-1057-E, § 2)

Sec. 158.505. - Certificate holder responsible for drugs/medications.

The certificate holder shall provide, at its sole and exclusive cost and expense, all drugs, including, but not limited to narcotic medications, which are needed to perform ALS services. The City of Jacksonville, through its Fire and Rescue Department shall have no responsibility for the drugs used by the certificate holder, by cost or expense, through provision, purchase, reimbursement, replacement, exchange or otherwise. All such drugs, used by the certificate holder, must be approved by the Division Chief of Rescue.

(Ord. 2006-1057-E, § 2)

Sec. 158.506. - Memoranda of understanding.

The Director/Fire Chief, of the Jacksonville Fire and Rescue Department or its Division Chief of Rescue are authorized to make and enter into memoranda of understanding and amendments and revisions thereto, form approved by the Office of General Counsel, in order to implement this Part 5.

(Ord. 2006-1057-E, § 2)

Sec. 158.507. - Suspension and termination of Certificate.

Certificates under this Part may be suspended or terminated using the procedures specified in Section 158.215(a) and (b); provided however, in Section 158.215, whenever the term "Director" is used, that term shall mean the Division Chief of Rescue. Upon suspension or termination of a certificate, issued under this Part, the certificate holder shall immediately cease all non-transportation ALS operations.

(Ord. 2006-1057-E, § 2)

Sec. 156.112. - Severability. Chapter 160 - AMUSEMENT DEVICES AND CARNIVALS