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Agenda 01/26/2010 Item #16F1Agenda Item No. 16F1 January 26, 2010 Page 1 of 14 EXECUTIVE SUMMARY Recommendation to approve the annual renewal of a Certificate of Public Convenience and Necessity for the Collier County Emergency Medical Services Department. OBJECTIVE: To receive approval from the Board of County Commissioners for the renewal of the Certificate of Public Convenience and Necessity ( "Certificate ") for the Collier County Emergency Medical Services Department and authorize the Chairman to execute the permit and certificate. CONSIDERATIONS: Collier County Emergency Medical Services is currently operating under a Certificate. Collier County Ordinance No. 04 -12, as amended requires that Collier County Emergency Medical Services renew its original Certificate each year. In addition, renewals are based on the same standards as the granting of the original Certificate. Therefore, the requirements for Board of County Commissioners approval in granting certificates, as set forth in the Collier County Ordinance No. 04 -12, as amended, Section 5, are provided and are specifically addressed in the attached memorandum from the EMS Chief. Furthermore, Collier County Ordinance No. 04 -12, as amended, Section 10 does not require a hearing for the Board of County Commissioners to consider the renewal Certificate allowing it to be approved routinely by the Board of County Commissioners upon advice of the Administrator. In accordance with Collier County Ordinance No. 04 -12, as amended, Section 10, 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 based on the factors set forth therein. FISCAL IMPACT: There is no fiscal impact associated with this action. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this action. LEGAL CONSIDERATIONS: This item has been reviewed and approved by the County Attorney's Office and is legally sufficient. - JBW RECOMMENDATION: That the Board of County Commissioners: 1. Accept the Director of the Bureau of Emergency Services' finding of public necessity; 2. Approve and authorize the Chairman to execute the Emergency Services Permit #1 and the renewal of the Certificate of Public Convenience and Necessity for the Collier County Emergency Medical Services Department. Prepared by: Artie Bay, Supervisor - Accounting, Emergency Medical Services Agenda Item No. 16171 January 26, 2010 Page 2 of 14 COLLIER COUNTY BOARD OF COUNTY COMMISSIOf Item Number. 16F1 Item Summary: Recommendation to approve the annual renewal of a Certificate of Public Convenience and Necessity for the Collier County Emergency Medical Services Department. Meeting Date: 1/26/2010 9:00:00 AM Prepared By Artie Bay Senior Administrative Assistant Date Bureau of Emergency Services EMS 11512010 1:55:43 PM Approved By Jeff Page Chief - Emergency Medical Services Date Bureau of Emergency Services EMS Operations 115/2010 4:47 PM Approved By Jennifer White Assistant County Attorney Date County Attorney County Attorney 1/111201011:28 AM Approved By Dan E. Summers Director of Emergency Services Date Bureau of Emergency Bureau of Emergency Services and Services and Emergency Emergency Management 1/1112010 11:55 AM Management Approved By Jeff Klatzkow County Attorney Date 111312010 9:41 AM Approved By OMB Coordinator Date County Manager's Office Office of Management & Budget 1/14/2010 9:04 AM Approved By Sherry Pryor Management! Budget Analyst, Senior Date Office of Management & Budget Office of Management & Budget 1/1412010 11:38 AM Approved By Mark lsackson Management/Budget Analyst, Senior Date Office of Management & Budget Office of Management & Budget 111712010 9:35 AM Agenda Item No. 16F1 January 26, 2010 Page 3 of 14 Memorandum To: Leo Ochs, County Manager From: Jeff Page, Chief Emergency Medical Services Department Date: December 31, 2009 Subject: Certificate of Convenience and Necessity for Collier County Emergency Medical Services Department Per Collier County Ordinance Number 04 -12, please accept the following information for renewal of this required certificate: Collier County Emergency Medical Services Department is operated by the County's Board of County Commissioners located at: 3301 East Tamiami Trail, Building F Naples, Florida, 34112 2. Collier County Emergency Medical Services Department provides service to the 2,032 square miles encompassing Collier County. Collier County Emergency Medical Services Department has a total of fifty -seven (57) State licensed vehicles. Thirty -four (34) of these are licensed ground transport vehicles and one (1) medivac helicopter. There are also six (6) licensed ALS Engines (non - transport). Of the above, Twenty -four (24) licensed ground transports, six (6) licensed ALS Engines and the medivac helicopter operate 24 hours and day, seven days a week. One (1) additional ground 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, nine (9) licensed ALS ground transport vehicles are held in reserve. (Attachment A). 4. Collier County Emergency Medical Services Department has one main office and eighteen (18) substations located throughout Collier County at the following locations: Emergency Medical Services Agenda Item No. 16F1 January 26, 2010 Headquarters 8075 Lely Cultural Pkwy. Naples, Florida Page 4 of 14 Station 1 835 8a' Avenue South Naples, Florida Station 2 977 26s' 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 1" 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 1P Street SW Naples, Florida Station 75 4590 Santa Barbara Blvd. Naples, Florida Medic Res 90 175 Isle of Capri Road Naples, Florida ALS Eng 61 25000 Tamiami Trail East 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. December 31, 2009 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 LL co g O n$g81q(oj �$p g5 �g(Ms1 �$p �8p 8${g�Igl S�gp yS�y$��gpg SSQapQ � A I # - c- juli , z S W LL Wq NN W IL 6 G6 LL , W LL 4 &���t �zF- zzzzzzzz zzzzzz I - zzzr L E m m c d m Q a r rrrrrrrrrrrzz Agenda Item No. 16F1 ATTA�nuar N 2010 rdf,3# RESOLUTIONNO.08- 27 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, PROVD)ING 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_A WAIVER OF EMS USER FEES FOR SPECIAL EVENTS, AND AN UPDATED PROCEDURE FOR APPROVING HARDSHIP CASES AND PAYMENT PLANS; SUPERSEDING RESOLUTION N0.07 -192; AND PROVIDING FORAN EFFECTIVE DATE. WHEREAS, Collier County Emergency Medical Services ( heroinafter 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 fees; and WHEREAS, the Bond Of County Commissioners recently entered into an Agreement with Advanced Data Processing, Inc. (hereinafter referred to as to "Billing Conaultanin) 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 Commissionen (hereinafter referred to as to "the Board'). NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, ibat: SECTION ONE: EMS USER FEES BASE RATE 3 .RVIC FVR1 S CODES BASE CHARGES A. EMS — BLS NON-EMERGENCY A0429 S 70000 B. EMS — BLS EMERGENCY A0429 $ 700.00 C. EMS —ALS 1 NON - EMERGENCY A0426 $ 70000 D. EMS — ALS I EMERGENCY A0427 S 700.00 E. EMS — ALS 2 EMERGENCY A0433 $ 750.00 F. EMS — SPECIALTY CARE A0434 S 80000 G. EMS — TREATMENT W/O TRANSPORT A0098 S 175.00 H. EMS — HELICOPTER A0431 $ 5,900,00 MILEAGE RATES- SERVICE I EVELq CODES MILEAGE CHARGE A. EMS — GROUND UNIT A0425 $ 1225 (Minimum Charge of 1 mile and no cap) B. EMS —AIR UNIT A0436 $ 110.00 SPECIAL EVENTS AND MSSCE I -ANEOUS RATE& SERVICE LEVELS RATES A TWO (2) MEDICS/ONE ALS VEHICLE (PER HOUR) S 150.00 Agenda Item No. 16171 January 26, 2010 Page 8 of 14 B. ONE (1) MEDICINO VEHICLE (PER HOUR) S 50.00 COPIES*, Subject to statutory exemptions, "public records- arc required by Chapter 119, F,& to be open to inspection and copying. Consistent with Chapter 119, Resolution No. 07.327 establishes copying fees as follows: COPIES OF DOCUMENTS RATES A. One -sided copy which is 14 inches by 8 h inches or less S .15 B. Two-sided copy which is 14 inches by 8 44 inches or less S .20 COPY SERVICES 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). F.S. as "the cost of the material and supplies used to duplicate the record," but does not inchhde the labor cost and overhead cost associated with such duplication. 'Copying fees are subject to change only to the extent that either Chapter 119, F.S. or Resolution No. 07- 327, or both, we amended, replaced, or superseded PAST DUE ACCOUNTS rNTS INTEREST ON PAST DUE ACCOUNTS S 1% monthly SECTION TWO: BILLING COLLECTION PROCEDURE The following shall be the minimma guidelines for billing and collection procedures for ambulance service fees and charges: A. Initial fees mad charges for ambulance service(s) shall be assessed either prior to or following the provision of service, as service dynamics reasoaebly 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 Department B. EMS Billing Staff will transmit all data necessary to Billing Consultant to process the claim. 1. 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. Wben a valid patient addreas 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 frmn the last filed date, if a claim is denied, a bill will he sent to the service recipient or responsible party. iii. For Medicaid accounts, if the claim is denied because of no coverage at the time of service, or because it was determined to be not medically necessary to be transported by ambulancq a bill will be sent to the service recipient or responsibly party. Agenda Item No. 16F1 January 26, 2010 Page 9 of 14 iv. In the event the service recipient or responsible party does not have or does not Provide proof of insurance coverage, statements will be sew 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 sgenoy when an 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 it 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 see sent to the County's contracted collection agency. E. A reasonable and customary payment plan will be mate available for all service recipients or responsible patties. Should the service recipient or responsible party at the time fail to meet the terms 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 snake reasonable effort to ascertain the correct mailing address. If reasonable etTotts to ascertain a correct address fail, the accoun(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 collection purposes, in accordance with all applicable laws. H. Throughout the fiscal year, the EMS Billing Section shall review all past due accounts and report to the Bard of County Commissioners on an annual basis, of all past due accounts which are believed to be uncollectibe. 1. The Board may, 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 CAan• Should a decode* have an unpaid balance for ambulance services, the following shall occur: I. 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 ease that a Notice of a Claim is timely filed 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: 1) a copy of ambulance bill(s), 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. Agenda Item No. 16F1 January 26, 2010 Page 10 of 14 4. The office of the County Atmency shill take all reasonable actions that an "clsary to pursue such claim, including but not limited, to tiling 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 authorized to take reasonable actions to reach a settlement with the Personal Reprcsmtative or his attorney. Should a settlement be reached, the EMS Director and the County Arrann (or his dc3ignee) are authorized to execute a satisfaction and/or release on behalf of the County. If the estate has assets and in excew of 510,000 is owed for ambulance services, any negotiated setrlement/oompromuc 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, few, and charges as art forth in Ordinance No. 9636, as It may be amended, repleced,orsuperseded. K. All accounts with a balance of $ 10 or less will be written off. SECTION THREE: HOSPITAL TRANSPORT BILLING AND FEES A. The few 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 bounderim of Collier County have the mead for a tmnepott of a Patient to hospital facilities located outside the boundaries of Collier County, the County, will subject to equipment and manpower availability, at its solo discretion, utilize its resources to provide patient transport. D. Hospitals requesting ambulance transports shell 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 few. The Board of County Commissioners, in accordance with criteria established by the enabling Ordinance, may authorize other adjustments. A. Medicare and Medicaid Adimgmcul& Contractual adjusaments under Medicare and/or Medicaid assignment will be made in accordance with applicable Medicare and/or Medicaid rules and regulations. B. EWMIL r`omneidljq Contractual Adivamren. Contractual adjustments will be made in accordance with applicable state, federal and local rules and regulations. C. Worker's Comtdmsation C pa l Ad' .e mmits. Contractual adjustments will be made in accordance with applicable state, federal and local rules and regulations. D. COnnty Employee Adiyat ._ems, Board of County Commissioners and Constitutional Officers' employees that have Primary coverage under Collier Coumty's insurance policy will be responsible for any deductibles, co-payments or unpaid balances. An employee Agenda Item No. 16F1 January 26, 2010 Page 11 of 14 may dispute his w ambulance charge in acconk= with procedures set forth in Ordinance No. 96 -36. E• C MMl M Ad; ,cr rn f . Contractual adjustments will be made in accordance with applicable ChampuslTricam rules and regulations. F. is Contractual adjustments will be made in accordance with applicable state, federal and local rules std regulations pertaining to Railroad Retirement Adjustments. O. Social Services AOJUKmcntL 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 FIVE: WAIVER OF EMS USER FEE FOR SPECIAL EVENTS. Pursuant to Ordinance No. 96-36, and from the effective dare 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 SDr: 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 accords= with the Federal Poverty guidelines, as used by the Social Services Department of Collier County. B. Payment plans for hardship calm will be set up on a monthly basis, with a minimum Payment of $10-00 per month. Hardship cases, 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 nuke 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 RESOLUTION 07 -192 This Resolution shall supersede Resolution No. 07 -192 SECTION EIGHT: EFFECTIVE DATE This Resolution shall become effective on January 29, 2008 PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County, Florida, this day of ) jjig j) . 2008. ATTEST: ` DWIGHT E. BROCK„CLERK f., a vtrlystofurlri legal Sufficiency: Jeami*A. Bel —� Assistant Comity Attorney BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, RIDA By . //79/t•� TOh NNIN , CHAIItM Agenda Item No. 16171 January 26, 2010 Page 12 of 14 ATTACHMENT "C" MEMORANDUM TO: Leo Ochs, County Manager FROM: Dan Summers, Director Bureau of Emergency Services Division DATE: December 31, 2009 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. Agenda Item No. 16F1 January 26, 2010 Page 13 of 14 COLLIER COUNTY FLORIDA EMERGENCY SERVICES PERMIT #1 This Permit Expires December 31, 2010 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: 9 Number of non - transport ALS engines 6 Number of Medivac helicopter: 1 See attachment "A" for description of vehicles. This permit, as provided in Ordinance 04 -12 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 ATTEST: Dwight E. Brock, CLERK Clerk Approved as to form & legal sufficiency: of 2010. BOARD OF COUNTY COMMISSSIONERS COLLIER COUNTY, FLORIDA Fred Coyle, Chairman e d 74 .V. a Z a Irl w a cr cs cn CA JI La At 3 8 O O a, U W U U F � !�auu y y�•Qa � v � w ai s co U m o u w A a G U U o w° v] � d U ,0 cc cc 3 3 3 a