EMA board recommends conditional COPCN for Marco Island
The decision to grant the city of Marco Island a Certificate of Public Convenience and Necessity has always been in the hands of the Collier County Board of Commissioners, but if it declines to do so, it will have to go against the recommendation of one its advisory boards.
The Emergency Medical Authority voted to recommend a conditional COPCN for Marco Island by a 3-2 vote after holding a special session Tuesday at the Collier County Government Center.
The EMA's recommendation comes with the conditions of approval by the voters for local control of emergency medical services at the Aug. 28 referendum, Marco Island not seeking to recover ad valorem taxes and approval of an inter-local agreement.
"I'm not at all sure in the past that the county has held other applicants to the absolute necessity standard and I for one want to take a fair look at this and see if there is a way that truly would be a win-win for both sides," Chairman Edwin Fryer said.
The Marco Island City Council approved moving forward with a three-prong plan in June last year in hopes of securing a second full-time ambulance for the island.
Council Chairman Jared Grifoni noted that Marco's attempts to secure additional resources have failed in the past after county officials deemed that there wasn't a need.
The City Council's plan included negotiating with the county for the second ambulance, working with state legislators on a local bill to bypass the need for county authorization and submitting a COPCN application.
Gov. Rick Scott signed a bill in March that will allow Marco Island residents the opportunity to vote Aug. 28 on whether they want local control of emergency medical services.
As part of the state's conditions, Marco needs to hold the referendum, have a third-party financial analysis done and submit a COPCN application to the county.
Two out of three conditions have been met already with the vote on Aug. 28 the last step in the process.
After the city submitted its application to the county late last year, on two separate occasions, Feb. 6 and April 12, the county sent official letters to Marco Island officials asking for responses to questions related to its COPCN application and how it would affect the county.
The first correspondence, sent by Director of Collier County Bureau of Emergency Services Dan Summers, received no response. The second correspondence, sent by Fryer, asked for responses by April 26 in preparation for Tuesday’s meeting.
"We received some brief answers back from those and I don't find any of the 14 answers satisfactory or in sufficient detail," Summers said.
On Tuesday, Marco Island Fire-Rescue Chief Mike Murphy said the addition of resources would only benefit both parties and downplayed concerns of fragmentation should a COPCN be granted.
"We are out together to make sure this system works and functions appropriately," Murphy said. "We've stated in our report about some of our expectations in reference to all paramedics being trained to equal level and between the two medical directors, we will assure that between residents of Marco and (the county) that the services they receive when our paramedics arrive on the scene are equal to the service the county is providing in areas off of the county."
Long-time Marco resident Len Schuman agreed that the addition of resources would improve response times and provide residents with the type of the service residents want.
"From my perspective, we can do better," Schuman said.
But for county officials, the responses they sought still left questions to be answered, especially with how an inter-local agreement would look.
Collier County EMS Chief Tabatha Butcher said the county needed to have additional details so that it could have a greater understanding how the proposal would impact its system.
"If you are expecting our unit to go there automatically every single time, that's going to have a play where we put that unit," Butcher said. "Liability-wise, if we are coming from far away, who's going to be responsible for that?"
Butcher also took issue with the one-sided nature of the way Marco Island was releasing information about the COPCN issue when there were materials to explain hot-button issues like why the county chose to move the ambulance off Marco Island during Hurricane Irma or how the drug protocol was determined.
While EMA members spent a good portion of the meeting trying to flesh out answers to questions, the majority of the board was swayed into finding a solution that would be beneficial to both parties.
"We need to look at a very conditional COPCN that meets the Collier County needs as well as those of Marco," board member Gary McNally said.
The motion approved by the board came after member Janet Vasey's motion to recommend denial of the COPCN application failed.
In voting against recommending the COPCN application, Board member Robert Chalhoub said he didn't believe city officials understood what they were getting themselves into with regards to costs of the operations and whether that would be worth it to its residents.
"You may marginally increase something, but I don't think the people of Marco Island are going notice that much except the ambulance says Marco Island on the side rather than Collier County," Chalhoub said. "Be careful of what you're asking for."
Chalhoub conceded that there were issues with the current system, including how Marco paramedics had their hands tied as far as administering certain drugs, but said there weren't any issues that couldn't be ironed out.
Fryer expressed his desire to facilitate conversations between the county and Marco Island on a mutually beneficial inter-local agreement ahead of the COPCN vote.
The Board of Commissioners will take up Marco Island's COPCN application at its May 22 meeting.