Interoffice Memorandum
DATE: July 11, 2025
TO: Mayor Jerry L. Demings and County Commissioners
THROUGH: Raul Pino, M.D., MPH, Department Director
FROM: Christian Zuver, M.D., Medical Director
CONTACT: Sandra D. Roe
PHONE: 407-836-7611
DIVISION: EMS, Office of the Medical Director
ACTION REQUESTED:
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Approval and execution of the modified Certificate of Public Convenience and Necessity for MedFleet, LLC d/b/a ATI Ambulance to provide Advanced Life Support and Basic Life Support interfacility transport services in Orange County, Florida. The term of this modified Certificate is from August 5, 2025, through August 4, 2027. There is no cost to the County. (EMS Office of the Medical Director)
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PROJECT: N/A
PURPOSE: Background. On August 6, 2019, the Board granted Affordable Transport, Inc. (“ATI”) a Certificate of Public Convenience and Necessity (COPCN) to provide interfacility advanced life support transport services from a limited number of health care facilities in Orange County. On September 27, 2022, the Board modified ATI’s COPCN to remove the limitations on facilities and authorized ATI to generally provide interfacility advanced life support and basic life support transport services in Orange County. On March 1, 2024, ATI entered into a Management Services Agreement and an Asset Purchase Agreement with MedFleet, LLC (“MedFleet”) pursuant to which MedFleet agreed to provide certain management services for ATI like billing, personnel, asset management, licensing, and medical records management, and ATI agreed to sell certain assets and equipment to MedFleet like vehicles, contracts, and intellectual property rights, respectively. Due to the substantial and material change in the status of ATI, the Orange County Emergency Medical Services Advisory Council (EMSAC) reviewed ATI’s COPCN renewal application on October 23, 2024, and recommended approval. On April 8, 2025, the Board renewed ATI’s COPCN.
Application to Modify. On March 17, 2025, ATI and MedFleet submitted an application to Orange County’s Office of the Medical Director/EMS Division (“EMS”) to modify ATI’s COPCN by transferring the COPCN to MedFleet, which included a Transfer Agreement between ATI and MedFleet dated March 5, 2025. Due to the substantial and material nature of the requested modification, and in accordance with Section 20-99 of the Orange County Code, EMS scheduled the modification application for EMSAC review and recommendation. EMS notified EMSAC, other COPCN holders, and published notice of the modification application and EMSAC meeting in the Orlando Sentinel on May 6, 2025.
EMSAC Review and Recommendation. On May 28, 2025, EMSAC met to review ATI’s modification application. At the meeting, EMS framed the issue, MedFleet presented the application, and EMSAC requested public comment. EMSAC reviewed the modification application which included all of the requirements for new COPCN applicants including, but not limited to, MedFleet’s licensing information, a business agreement between MedFleet and a health care provider in Orange County, and MedFleet’s certificates of insurance. Additionally, EMSAC reviewed the guidelines for determining the public convenience and necessity described in Section 20-95 of the Orange County Code. At the conclusion of the meeting, EMSAC recommended that the Board grant ATI’s application to modify ATI’s COPCN by transferring ATI’s COPCN to MedFleet. A copy of EMSAC’s Report and Recommendation is attached to this Memorandum.
BUDGET: N/A