STATE OF FLORIDA TL BUREAU OF EMERGENCY MEDICAL SERVICES: ~ DEPARTMENT OF HEALTH Petitioner vs. MATTHEW WILLIAMS Case No. 2002-0657 Respondent ae 2 — uo i as / ADMINISTRATIVE COMPLAINT ." COMES NOW Petitioner, Department of Health (hereinafter “Petitioner’) by and through its undersigned attorneys and files its Administrative Complaint against Respondent, MATTHEW WILLIAMS, (hereinafter “Respondent’) and alleges 1. NATURE OF THE ACTION This is an action to impose administrative penalties and assess costs (1)(f), related to the investigation and prosecution of the allegations against Respondent pursuant to Sections 401.411 (g), Florida Statutes JURISDICTION AND VENUE 2. Florida Statutes This tribunal has jurisdiction pursuant to Sections 120 569 and 120.57 3. Venue shall be determined pursuant to Rule 23-106.207, Florida Administrative Code. PARTIES 4. Petitioner is the state agency charged with regulating emergency medical services pursuant to Section 20.43, Florida Statutes, and Chapters 120 and, Florida Statutes. 5. Atall times material hereto Respondent has been licensed as a Paramedic having been issued license number 201152 on April 10, 2001, and as an emergency medical technician (EMT) having been issued license number 80942 on February 12, 1996. 6. Respondent's last known address is 24701 Highway 301 North, Lawtey, Florida 32058. FACTS 7. Respondent attended a paramedic course at Thomas Technical Institute, now known as Southwest Georgia Technical College. 8. The paramedic course at Thomas Technical Institute, now known as Southwest Georgia Technical College, was not approved by the State of Florida for an individual to obtain paramedic certification. 9. During the paramedic course, Respondent was asked to fill out the top half of the Statement of Good Standing Form. Respondent filled out the top half of the Statement of Good Standing Form and was told that the school or Paramedic Instructor Mike Taylor would obtain the proper signature on the form and submit it to the State of Florida, Bureau of Emergency Medical Services. The Statement of Good Standing Form is needed by applicants to sit for the Florida Paramedic Examination and to obtain a Florida Paramedic certification. 10. Respondent's Statement of Good Standing Form was given to State of Georgia, Emergency Medical Services Coordinator Robert Vick by Paramedic Instructor Mike Taylor. 41. Paramedic Instructor Mike Taylor asked Robert Vick to sign the Statement of Good Standing Form certifying that Respondent had passed the National Registry Exam and/or were certified in the State of Georgia so that Respondent could take the State of Florida Paramedic Exam. 12. Vick told Taylor that he could not sign the Statement of Good Standing Form as Respondent had not passed the National Registry Exam and was not certified in the State of Georgia. 13. Taylor convinced Vick to sign the form by telling him that the State of Florida, Emergency Medical Services staff told him (Taylor) that Vick should sign the form so that Respondent could take the exam and that the State of Florida would hold Respondent’s grades until Respondent provided proof that he passed the National Registry Exam from the testing agency. 14. Vick then signed the Statement of Good Standing Form without entering a certification number and expiration date for Respondent. 15. Respondent completed his Florida application for examination and certification as a paramedic and submitted his application to the State of Florida, Bureau of Emergency Medical Services. 16. In Part | of the Statement of Good Standing Form submitted by Respondent with his Florida application for examination and certification as a paramedic, Respondent stated that he was requesting Florida certification based on training and current certification in the State of Georgia or by National Registry of EMTs. 17. Part Il, A of the Statement of Good Standing Form signed and submitted by Respondent with his Florida application for examination and certification as a paramedic certified that Respondent held a current and valid paramedic certificate in the State of Georgia and/or the National Registry of EMTs. 18. Respondent signed his entire application, including the Statement of Good Standing Form, to become a Florida certified paramedic under oath on December 5, 2000. The oath signed by Respondent states that Respondent “understand[s] that any fraudulent entry may be considered as cause for rejection or subsequent voiding of certification.” 19. When Respondent signed his entire application under oath, including the Statement of Good Standing Form, Respondent was not certified in the State of Georgia as a paramedic. 20. When Respondent signed his entire application under oath, including the Statement of Good Standing Form, Respondent had not passed the National Registry examination. Respondent took and failed the National Registry Examination on or about December 12, 2000 and February 23, 2001. 21. Respondent took and passed his Florida paramedic examination on March 30, 2001. 22. As a result of the information submitted by Respondent on his licensure application and passing the Florida paramedic examination, Respondent was issued a Florida paramedic certificate on April 10, 2001. COUNT | 23. Petitioner re-alleges and incorporates by reference paragraphs one (1) through twenty-two (22). 24. Section 401.411(1)(f) of the Florida Statutes provides that the “department may deny, suspend, or revoke a license, certificate, or permit or may reprimand or fine any licensee, certificateholder, or other person operating under this part for any of the following grounds: Knowingly making false or fraudulent claims, procuring, attempting to procure, or renewing a certificate, license or permit by fakery, fraudulent action, or misrepresentation.” § 401.411(1)(f), Fla. Stat. 25. Respondent violated Section 401.411(1)(f) of the Florida Statutes as he procured his paramedic certification by fakery, fraudulent action, or misrepresentation by making false or fraudulent claims on his licensure application that he was a certified paramedic in the State of Georgia and/or passed the National Registry Examination when at the time of his application he was not a certified paramedic in the State of Georgia and had not passed the National Registry Examination; therefore, Respondent's license is subject to discipline by this Bureau. COUNT II 26. Petitioner re-alleges and incorporates by reference paragraphs one (1) through twenty-five (25). 27. Section 401.411(1)(g) of the Florida Statutes provides that the “department may deny, suspend, or revoke a license, certificate, or permit or may reprimand or fine any licensee, certificateholder, or other person operating under this part for any of the following grounds: Unprofessional conduct, including, but not limited to, any departure from or failure to conform to the minimal prevailing standards of acceptable practice as an emergency medical technician or paramedic, including undertaking activities that the emergency medical technician or paramedic is not qualified by training or experience to perform. 28. Respondent violated Section 401.411(1)(g) of the Florida Statutes by ‘ engaging in unprofessional conduct when he made false or fraudulent claims on his licensure application that he was a certified paramedic in the State of Georgia and/or passed the National Registry Examination when at the time of his application he was not a certified paramedic in the State of Georgia and had not passed the National Registry Examination; therefore, Respondent's license is subject to discipline by this Bureau. COUNT III 29. Petitioner re-alleges and incorporates by reference paragraphs one (1) through twenty-eight (28). 30. Section 401.411(1)(a) of the Florida Statutes provides that the “department may deny, suspend, or revoke a license, certificate, or permit or may reprimand or fine any licensee, certificateholder, or other person operating under this part for any of the following grounds: The violation of any rule of the department or any provision of this part.” § 401.411(1)(a), Fla. Stat. 31. Additionally Rule 64E-2.009(1)(b) of the Florida Administrative Code (F.A.C.) provides that to “be qualified for paramedic certification, an individual must: Currently hold a valid paramedic certification from the National Registry of Emergency Medical Technicians or be currently certified in another state or U.S. territory and have the certifying authority submit to the department DH form 1164, January 00, Statement of Good Standing, which is incorporated by reference in Rule 64E-2.008. F.A.C....” Rule 64E-2.009(1)(b), F.A.C. 32. Respondent violated Section 401.411(1)(a) of the Florida Statutes and Rule 64E-2.009(1)(b) of the Florida Administrative Code as Respondent was not qualified for paramedic certification because at the time he submitted his application, Respondent did not hold a valid paramedic certification from the National Registry of Emergency Medical Technicians and was not currently certified in another state as a paramedic despite his representations that he was; therefore, Respondent's license is subject to discipline by this Bureau. CLAIM FOR RELIEF WHEREFORE, Petitioner respectfully requests the BUREAU OF EMERGENCY MEDICAL SERVICES to enter an order imposing one or more of the following penalties upon Respondent pursuant to Section 401.41 1(1), Florida Statutes: a. Revocation or suspension of Respondent's license; b. Restriction of Respondent's practice; c. An administrative fine; d. A reprimand; e. Probation; and/or f. Any other penalty the Bureau deems appropriate. JA Dated this Y¥ day of _ Vette yA , 2005. Respectfully submitted, CHARLES J. CRIST, JR. Attorney General Lui. JE Brian J. Stabley=-~ Assistant Attorney General Department of Legal Affairs PL-01 The Capitol Tallahassee, Florida 32399-1050 (850) 414-3300 PCP: Jenkins, Bixler, and Mason DATE: February 25, 2005 NOTICE OF HEARING RIGHTS RESPONDENT IS HEREBY NOTIFIED THAT HE/SHE HAS THE RIGHT TO REQUEST AN ADMINISTRATIVE HEARING PURSUANT TO SECTIONS 120.569 AND 120.57, FLORIDA STATUTES. SPECIFIC OPTIONS FOR ADMINISTRATIVE ACTION ARE SET OUT IN THE ATTACHED EXPLANATION OF RIGHTS. ALL. REQUESTS FOR HEARING MUST BE MADE WITHIN 21 DAYS OF RECEIPT AND SENT TO BRIAN J. STABLEY, ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LEGAL AFFAIRS, PL-01 THE CAPITOL, TALLAHASSEE, FLORIDA 32399-1050. CERTIFICATE OF SERVICE | HEREBY CERTIFY that a true and correct copy has been served by certified mail this & day of flack, , 2005 to : Matthew Williams, 24701 Highway 301 North, Lawtey, Florida 32058. Li tcar 4p d fii Brian J. fA Assistant Attorney General

Docket for Case No: 05-001448PL

Orders for Case No: 05-001448PL