Agenda 02/14/2012 Item #16F42/14/2012 Item 16. F.4.
EXECUTIVE SUMMARY
Recommendation to renew Collier County's Certificate of Public Convenience and
Necessity for Advanced Life Support Transport for one year and authorize the Chairman
to execute the Permit and Certificate.
OBJECTIVE: To receive approval from the Board of County Commissioners (Board) for the
renewal of Collier County's Certificate of Public Convenience and Necessity ( "COPCN ") for
Advanced Life Support ( "ALS ") transport and authorize the Chairman to execute the permit and
COPCN.
CONSIDERATIONS: On behalf of Collier County Emergency Medical Services (EMS) is
currently operating under a COPCN for ALS transport. Section 10 of Collier County Ordinance
No. 04 -12, as amended, allows renewal certificates to be approved routinely by the Board upon
advice of the County Manager or designee. The Director of the Bureau. of Emergency Services
is the County Manager's designee.
In addition, Section 10 provides that renewals be based on the same standards as the granting of
the original COPCN along with such other factors as may be relevant. The minimum
requirements for an application to be deemed complete are set forth in the Collier County
Ordinance No. 04 -12, as amended, Section 5. The application is back -up to this item.
In accordance with Section 10 of Ordinance No. 04 -12, as amended, the Director of the Bureau
of Emergency Services recommends approval based on his finding that there is a public necessity
for EMS to provide the service and that all other requirements under Ordinance No. 04 -12 have
been met.
If this item is approved by the Board, the renewal COPCN and Permit will commence on
January 1, 2012 and expire on December 31, 2012.
FISCAL IMPACT: There is no fiscal impact associated with this action.
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact.
LEGAL CONSIDERATIONS: The Ordinance allows the renewal COPCN to be approved
routinely by the Board without a hearing. If a hearing is held the standards set forth in
Ordinance No. 04 -12, Section 7 apply. Section 7 states:
"The Board of county Commissioners shall not grant a certificate unless it shall find, after public
hearing and based on competent evidence that each of the following standards has been satisfied:
A. That there is a public necessity for the service. In making such determination, the Board
of County Commissions shall consider, as a minimum, the following factors:
(1) The extent to which the proposed service is needed to improve the overall
Emergency Medical Services (EMS) capabilities of the County.
(2) The effect of the proposed service on existing services with respect to quality of
service and cost of service.
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2/14/2012 Item 16. F.4.
(3) The effect of the proposed service on the overall cost of EMS service in the
County.
(4) The effect of the proposed service on existing hospitals and other health care
facilities.
(5) The effect of the proposed service on personnel of existing services and the
availability of sufficient qualified personnel in the local area to adequately staff all
existing services.
B. That the applicant has sufficient knowledge and experience to properly operate the
proposed service.
C. That, if applicable, there is an adequate revenue base for the proposed service.
D. That the proposed service will have sufficient personnel and equipment to adequately
cover the proposed service area."
Ordinance No. 04 -12, Section 8 provides:
"In making the determinations provided for in Section 7 above, the Board may, in its sole
discretion, appoint a Hearing Officer to hold a public hearing and to make factual findings and
conclusions as a result of the hearing. Should a Hearing Officer be appointed, said Hearing
Officer shall render a written report to the Board within 30 days of the hearing, which report
shall contain the officer's findings and conclusions of fact, and a recommended order. The
findings and conclusions of fact shall be binding upon the Board, but the recommended order
shall be advisory only."
This item is legally sufficient and requires a majority vote for Board action. - JBW
RECOMMENDATION: That the Board of County Commissioners:
1. Accept the Director of the Bureau of Emergency Services' findings;
2. Approve and authorize the Chairman to execute a Permit and renewal COPCN to Collier
County Emergency Medical Services for ALS Transport.
Prepared by: Dan Summers, Director, Bureau of Emergency Services
Packet Page -1987-
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.F.4.
2/14/2012 Item 16.F.4.
Item Summary: This item requires that ex parte disclosure be provided by Commission
members. Should a hearing be held on this item, all participants are required to be sworn in.
Recommendation to renew Collier County's Certificate of Public Convenience and Necessity for
Advanced Life Support Transport for one year and authorize the Chairman to execute the
Permit and Certificate.
Meeting Date: 2/14/2012
Prepared By
Name: BayArtie
Title: Supervisor - Accounting,EMS Operations
2/1/2012 1:27:21 PM
Approved By
Name: KopkaWalter
Date: 2/1/2012 2:55:04 PM
Name: SummersDan
Title: Director - Bureau of Emergency Services,
Date: 2/1/2012 4:56:34 PM
Name: WhiteJennifer
Title: Assistant County Attomey,County Attorney
Date: 2/2/2012 8:26:26 AM
Name: PryorCheryl
Title: Management/ Budget Analyst, Senior,Office of Management & Budget
Date: 2/2/2012 11:56:48 AM
Name: KlatzkowJeff
Title: County Attorney,
Date: 2/6/2012 3:24:45 PM
Name: IsacksonMark
Title: Director -Corp Financial and Mgmt Svs,CMO
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Date: 2/7/2012 8:31:23 AM
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2/14/2012 Item 16.F.4.
2/14/2012 Item 16.F.4.
Memorandum
To: Leo Ochs, County Manager
From: Walter Kopka, Assistant Chief
Emergency Medical Services Department
Date: January 18, 2012
Subject: Certificate of Convenience and Necessity for Collier County
Emergency Medical Services Department
Per Collier County Ordinance Number 04 -12, as amended, please accept the following information for
renewal of this required certificate:
1. Collier County Emergency Medical Services Department is operated by the County's Board of
County Commissioners located at:
3299 East Tamiami Trail
Naples, Florida, 34112
The Board of County Commissioners is comprised of the following individuals:
Donna Fiala, District 1
Georgia A. Hiller, District 2
Tom Henning, District 3
Fred W. Coyle, District 4
Jim Coletta, District 5
The age of each member may be located at the Board of County Commissioner's Office.
2. Collier County Emergency Medical Services Department will continue to provide service to the
2,032 square miles encompassing Collier County.
3. Collier County Emergency Medical Services Department has a total of forty-seven (47) State
licensed vehicles. Thirty-four (34) of these are licensed ground transport vehicles and one (1)
medivac helicopter. There are also twelve (12) licensed ALS Engines (non - transport). Of the
above, twenty -four (24) licensed ground transports, twelve (12) licensed ALS Engines and the
medivac helicopter operate 24 hours and day, seven days a week. One (1) additional ground
Emergency Medical Services
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2/14/2012 Item 16.F.4.
transport licensed vehicle may operate 12 hours a day, seven days a week (as needed) during the
seasonal months and is taken out of the reserve units. The remaining, ten (10) licensed ALS
ground transport vehicles are held in reserve. (Attachment A).
4. Collier County Emergency Medical Services Department has one main office and twenty -one
(21) substations located throughout Collier County at the following locations:
Headquarters
8075 Lely Cultural Pkwy.
Naples, Florida
Station 1
8358 th Avenue South
Naples, Florida
Station 2
977 26th Avenue
Naples, Florida
Station 10
14756 Immokalee Road
Naples, Florida
Station 21
11121 E. Tamiami Trail
Naples, Florida
Station 22
4375 Bayshore Drive
Naples, Florida
Station 23
7227 Isle of Capri Road
Naples, Florida
Station 24
2795 Airport Road North
Naples, Florida
Station 30
112 South 1st
Immokalee, Florida
Station 32
4819 Ave Maria Blvd.
Ave Maria, Florida
Station 40
1411 Pine Ridge Rd.
Naples, Florida
Station 42
7010 Immokalee Road
Naples, Florida
Station 43
16325 Vanderbilt Drive
Naples, Florida
Station 44
766 Vanderbilt Beach Road
Naples, Florida
Station 46
3010 Pine Ridge Road
Naples, Florida
Medic Res 50
1280 San Marco Road.
Naples, Florida
Station 61
201 Buckner Avenue
Everglades, Florida
Station 70
4741 Golden Gate Parkway
Naples, Florida
Station 71
95 13th Street SW
Naples, Florida
Station 75
4590 Santa Barbara Blvd.
Naples, Florida
Medic Res 90
175 Isle of Capri Road
Naples, Florida
Med- Flightl
2375 Tower Drive
Naples, Florida
5. Collier County Emergency
Medical Services Department has been licensed and certified to
provide Advanced Life Support ambulance service in Collier
County since April 6, 1981.
6. Three (3) Collier County residents to act as references:
Dr. Douglas Lee 2614 Tamiami Trail, #255 Naples, Florida 34110
Nancy Laschied 4500 Gulfshore Blvd. N. - #903 Naples, Florida 34103
Dr. James Hampton 823 Bentwood Drive Naples, Florida 34108
7. Collier County Emergency Medical Services Department schedules of service fees
(Attachment B).
8. January 18, 2012 Memorandum from Dan Summers, Director of Bureau of Emergency Services
to County Manager Ochs stating no further information required.
9. Collier County Emergency Medical Services Department financial statement is available in
Collier County's Finance Department
Attachments
Emergency Medical Services
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2/14/2012 Item 165.4.
Attachment B ` 1.
RESOLUTION NO.08 - 27
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, PROVIDING FOR UP -DATED EMS USER
FEES FOR COLLIER COUNTY AMBULANCE SERVICES, UP -DATED
BILLING AND COLLECTION PROCEDURE, HOSPITAL TRANSPORT
BILLING AND FEES, ADJUSTMENTS OF EMS USER FEES PURSUANT
TO COLLIER COUNTY ORDINANCE NO. 96-36, WAIVER OF EMS USER
FEES FOR SPECIAL EVENTS, AND AN UPDATED PROCEDURE FOR
APPROVING HARDSHIP CASES AND PAYMENT PLANS; SUPERSEDING
RESOLUTION NO. 07-192; AND PROVIDING FOR AN EVVECTIVE DATE,
WHEREAS, Collier County Emergency Medical Services (hereinafter referred to as
"EMS ") provides ambulance services to the residents and visitors of Collier County; and
WHEREAS, the Collier County EMS operating budget is funded exclusively through ad
valorem taxes and user fccs; and
WHEREAS, the Board of County Commissioners recently entered into an Agreement with
Advanced Data Processing, Inc. (hereinafter referred to as to "Billing Consultant ") to provide
collection services for ambulance services and associated fees; and
WHEREAS, this Resolution Is Intended to apply irrespective of whether EMS billing staff,
Advanced Data Processing, Inc., or any other billing consultant is responsible for the collection of
fees for ambulance services; and
WHEREAS, Collier County Ordinance No. 96 -36 § 5 provides that the user fees for
ambulance services may be established by Resolution of the Board of County Commissioners
(11610WW referred to as to "the Board ").
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that
SECTIQN ONE: EMS USER FEES
BASE RATES:
SERVICE LEVELS CODES
BASS CHARGES
A. EMS — BLS NON - EMERGENCY A0428 $ 700.00
B. EMS —BLS EMERGENCY A0429 $ 700,00
C. EMS —ALS 1 NON- EMERGENCY A0426 S 740.00
D. EMS — ALS I EMERGENCY A0427 $ 700.00
E. EMS — ALS 2 EMERGENCY A0433 $ 750.00
F, EMS — SPECIALTY CARE A0434 $ 800.00
G. EMS — TREATMENT W/O TRANSPORT A0098 $ 175.00
H. EMS -- HELICOPTER A0431 $ 5,900.00
MILEAGE RaF$..,
SERVICE LEVELS CODES MILEAGE CHARGE
A. EMS —GROUND UNIT A042S S 12.25
(Minimum Charge of I mile and no cap)
B. EMS — AIR UNIT A0436 $ 110.00
SPECIAL EVENTS AND MI5CULLANEQIJS RTES:
SERVICE LEVEL$ RATES
A TWO (2) MEDICS /ONE ALS VEHICLE (PER HOUR) $ 150.00
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2/14/2012 Item 16.F.4.
B. ONE (1) MEDIC/NO VEHICLE (PSR HOUR) $ 50.00
COPIES*-,
Subject to statutory exemptions, "public records" are required by Chapter 119, F.S to be
open to inspection and copying. Consistent with Chapter 119, Resolution No. 07 -327 establishes
copying fees as follows:
COP IES-OF DOCUMB RZATES
A. One -sided copy which is 14 inches by g % inches or less S .15
B. Two -sided copy which is 14 inches by g %, inches or less .20
COPY
The actual cost of duplication for all other copies will be charged. The first hour of cost of
duplication will not be charged. "Actual cost of duplication" is defined in § 119.07(1), FS as "the
cost of the material and supplies used to duplicate the record," but does not include the labor cost
and overhead cost associated with such duplication.
*Copying fees are subject to change only to the extent that either Chapter 119, FS or
Resolution No. 07 -327, or both, are amended, replaced, or superseded.
PA51 DUE ACCOUNTS
INTEREST ON PAST DUE ACCOUNTS $ 1% monthly
SECTION TWO: BILLING COLLECTION PROCEDURE
The following shall be the minimum guidelines for billing and collection procedures for
ambulance service fees and charges:
A. initial fees and charges for ambulance service(s) shall be assessed either prior to or
following the provision of service, as service dynamics reasonably allow. Unpaid fees and
charges, subsequent to time of service shall be reflected in an accounts receivable subsidiary
ledger system to be maintained by the EMS Dopattment,
B. EMS Billing Staff will transmit all data necessary to Billing Consultant to process the claim.
i, Billing Consultant will send an initial bill to the service recipient's or responsible
party's Insurance carrier as soon as insurance information has been received,
validated, and entered by the billing Consultant on the account.
2. When a valid patient address is present, the Billing Consultant will follow the patient
statement cycle outlined below.
I. An Initial statement for ambulance services, including the HIPAA notice of
privacy practices shall be sent fourteen (14) or more days after the data is
entered by the Billing Consultant, but no later than 30 days after service has
been provided.
ii. If a non - Medicaid account remains unpaid, statements will be sent to the
patient no later than every 60 days from the last filed &to. If a claim is denied,
a bill will be sent to the service recipient or responsible party.
Ill. For Medicaid accounts, if the claim is dented NO= of no coverage at the
time of service, or because it was determined to be not medically necessary to
W transported by ambulance, a bill will be sent to the service recipient or
responsibly party.
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2/14/2012 Item 16.F.4.
iv. In the event the service recipient or responsible party does not have or does not
Provide proof of insurance coverage, statements will be sent to the patient no
later than every 60 days from the last statement date.
C. The Billing Consultant will provide a file with patients to be sent to collections to the
County's contracted collection agency when all attempts to collect on the account have been
exhausted by the Billing Consultant, The County may direct the Billing Consultant to not
send a patient to collections at any time. Billing Consultant may send a patient to
collections prior to exhaustion of all collection efforts when:
1. The patient account has an invalid address,
2. Billing Consultant Is directed by County to send a patient to collections,
D. Interest will be assessed at 1% per month on all accounts that are sent to the County's
contracted collection agency.
E. A reasonable and customary payment plan will be made available for all service recipients
or responsible parties, Should the service recipient or responsible party at the time fail to
meet the terns and conditions of the payment plan for a period of (60) sixty days, the unpaid
balance shall reenter the collections process set forth in Section C. above at the point in the
collections process at which it was taken out for a payment plan to be administered.
F. When ambulance service bill(s), at the any stage in this billing and collection procedure, are
returned because the Postal Service cannot effectuate delivery, the EMS Billing Section
shall make reasonable effort to ascertain the correct mailing address. If reasonable efforts to
ascertain a correct address fail, the ecoount(s) may be considered for other collection
alternatives.
G. Nothing contained in this Section shall preclude reasonable telephone or other appropriate
contact for billing and collodion purposes, in accordance with all applicable laws.
H. Throughout the fiscal year, the EMS Billing Section shall review all past duo accounts and
report to the Board of County Commissioners on an annual basis, of all past due accounts
which are believed to he uncollectible.
1. The Hoard nuty, after reviewing these past due accounts and after finding that diligent
efforts at collection have proven unsuccessful, remove these past due accounts from active
accounts receivable in accordance with generally accepted accounting procedures and
pursuant to law by Resolution.
J. Probate Estate Cates: Should a decedent have an unpaid balance for ambulance services,
the following shall occur:
1. The decedent's Personal Representative will notify EMS Billing Staff that a
probate estate has been filed with the Probate Court,
2. EMS Billing Staff shall ensure that a Notice of a Claim is timely flied with the
Probate Court.
3. EMS Billing Staff shall ensure that the Office of the County Attorney is timely
notified of such claim and provided with: l) a copy of ambulance bill(a), 2) all
correspondence between EMS Billing Staff/Billing Consultant) and Personal
Representative, 3) Notice of Claim filed with the Probate Estate, and any other
information necessary to pursue the claim.
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2/14/2012 Item 16.F.4.
4. The Office of the County Attorney shell take all reasonable actions that are
necessary to pursue such claim, including but not limited, to filing a lawsuit in
the County Court to pursue such claim,
5. If the estate has assets and $10,000 or less is owed for ambulance services, the
EMS Director and the County Attorney (or his designee) are authoked to talc
reasonable actions to reach a settlement with the Personal Representative or his
attorney, Should a settlement be reached, the EMS Director and the County
Attorney (or his designee) are authorized to execute a satisfaction and/or release
on behalf of the County. If the estate has assets and in excess of $10,000 is owed
for ambulance services, any negotiated settlement/compromise of the ambulance
billing claim shall be approved by the Board of County Commissioners. If the
estate has nominal assets or no assets, the County Manager may waive the rates,
fees, and charges as set forth in Ordinance No. % -36, as it may be amended,
replaced, or superseded.
K. All accounts with a balance of $10 or less will be written off
SECTION THREE. HOSPITAL TRANSPORT BILLING AND FEES
A. The fees set forth in Section One of this Resolution shall apply to ambulance transports that
occur between a hospital's facilities.
B. Should a hospital within the boundaries of Collier County have the need for a transport of a
patient between hospital facilities located within the boundaries of Collier County,
ambulance transport will be provided.
C. Should a hospital within the boundaries of Collier County have the need for a transport of a
patient to hospital facilities located ouiside the boundaries of Collier County, the County,
will subject to equipment and manpower availability, at its sole discretion, utilize Its
resources to provide patient transport,
D. Hospitals requesting ambulance transports shall be invoiced directly for ambulance transport
service on a monthly basis.
SECTION FOUR: ADJUSTMENT OF EMS USER FEES
The following shall be minimum guidelines for adjustments to ambulance service fees. The
Board of County Commissioners, in accordance with criteria established by the enabling Ordinance,
may authorize other adjustments.
A. Medicare and Medicaid �1j r>,s meats. Contractual adjustments under Medicare and/or
Medicaid assignment will be made In accordance with applicable Medicare and/or
Medicaid rules and regulations.
B. Victim's Commntlon Contractual Adiustments Contractual adjustments will be
made in accordance with applicable state, federal and local rules and regulations,
C. Walker's QOMI ensation Contractual Adjustments, Contractual adjustments will be
made in accordance with applicable state, federal and local rules and regulations.
D. Cotntv Employee Adjustments. Board of County Commissioners and Constitutional
Officers' employees that have Primary coverage under Collier County's insurance policy
will be responsible for any deductibles, co-payments or unpaid balances. An employee
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2/14/2012 Item 16. F.4.
may dispute his/her ambulance charge in accordance with procedures set forth in
Ordinance No. 96 -36.
E. (iMpus/i'ricare Adjustments. Contractual adjustments will be made In accordance
with applicable ChampuslTricare rules and regulations.
F. Railroad Reti=at Adjustments. Contractual adjustments w111 be made in accordance
with applicable state, federal and local rules and regulations pertaining to Railroad
Retirement Adjustments.
(3. Social Services Adjustments. Contractual adjustments will be made in accordance with
rules established by the County Manager and memorialized by a memorandum of
understanding executed by the Social Services Director and the EMS Director.
SECTION FIVEt WAIVER OF EMS USER FEE FOR SPECIAL EVENTS.
Pursuant to Ordinance No. 96 -36, and from the effective date of this Resolution, user fees
for EMS ambulance stand -by services may be waived if the Board finds that a valid public purpose
has been established in recognition of their charitable contributions to the Community.
SECTION SIX, HARDSHIP CASES AND PAYMENT PLANS.
The Board recognizes that certain service recipients may need to be identified and processed
as hardship cases. Payment plans will be established pursuant to the minimum guidelines set
forth in this Resolution.
A. Hardship cases will be established in accordance with Are Federal Poverty guidelines, as
used by the Social Services Department of Collier County,
B. Payment plans for hardship Cason will be set up on a monthly basis, with a minimum
payment of S 10.00 per month. Hardship eases, placed on a payment plan will not accrue
interest or be placed into collection. Notwithstanding the foregoing, if a service
recipient has a payment plan and does not make the agreed scheduled payments for a
period longer than two (2) months, the account will be turned over to the County's
contracted collection agency and interest will begin to accrue.
SECTION SEVEN: SUPERCISION OF WOLUTION 07 -192
This Resolution shall supersede Resolution No, 07 -192
SECTI!QN EIGHT: EFFECTIVE DATE
This Resolution shall become effective on January 29, 2008
PASSED AND DULY ADOPTED by the hoard of County Commissioners of Collier
County, Florida, this day of `Stiy,t, .2008.
ATTEs.T!
DWIGHT E. j3ROCK;`CLERK ru
taforlr'
legal sufficiency:
) � �
Jenni�padlb
Assistant County Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, F ORIDA
, j29 /fl?
TO NNIN , CilAil MAr
._.. Packet Page -1998-
2/14/2012 Item 16. F.4.
ATTACHMENT "C"
MEMORANDUM
TO: Leo Ochs, County Manager
FROM: Dan Summers, Director Bureau of Emergency Services Division
DATE: January 18, 2012
REF: Certificate of Convenience and Necessity for Collier County
Emergency Medical Services Department
After review of the application to renew this certificate for Collier County Emergency
Medical Services Department, no further information is required at this time. The
application is complete and sufficient.
Packet Page -1999-
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2/14/2012 Item 16.F.4.
COLLIER COUNTY FLORIDA
Renewal of Class 1 COPCN
This Permit Expires December 31, 2012
Name of Service: Collier County Emergency Medical Services
Name of Owner or Manager: Collier County Board of County Commissioners
Principal Address of Service: 8075 Lely Cultural Parkway, Naples Florida 34113
Business Telephone: 239 252 -3740
Emergency Telephone: 9 -1 -1
Description of Services Area: The 2,032 square miles encompassing Collier County
Number of Ambulances on 24 hour duty: 24 ground units (ambulances)
Number of Ambulances on 12 hour duty: 1 ground unit (as needed during season _taken from reserve fleet).
Number of reserve Ambulances: 10
Number of non - transport ALS engines 12
Number of Medivac helicopter: 1
See attachment "A" for description of vehicles.
This permit, as provided in Ordinance 04 -12, as amended, shall allow the above named Ambulance Service to
operate Emergency Medical Services for a fee or charge for the following area(s): Collier County until the
expiration date hereon, except that this permit may be revoked by the Board of County Commissioners of Collier
County at any time the service named herein shall fail to comply with any local, state or federal laws or regulation
applicable to the provision of Emergency Medical Services.
Issued and approved this day of
ATTEST:
Dwight E. Brock, CLERK
, Deputy Clerk
Approved as to form & legal sufficiency:
JennifFrB. White, Assistant County Attorney
2012.
BOARD OF COUNTY COMMISSSIONERS
COLLIER COUNTY, FLORIDA
Fred W. Coyle, Chairman
Packet Page -2001-