Agenda 05/13/2008 Item #16F 1
Agenda Item No, 16F1
May 13, 2008
Page 1 of 15
EXECUTIVE SUMMARY
Recommendation to approve a Certificate of Public Convenience and Necessity for the
Collier County Emergency Medical Services Department at a renewal rate for FY 08 of
$250.00.
OBJECTIVE: That the Board of County Commissioners approve the Certificate of Public
Convenience and Necessity for the Collier County Emergency Medical Services Department and
authorize the Chairman to execute the certificate,
CONSIDERATIONS: Collier County Emergency Medical Services is currently operating
under a Certificate of Public Convenience and Necessity, Collier County Ordinance 81-75
requires that Collier County Emergency Medical Services renew its original Certificate of Public
Convenience and Necessity 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 81-75 Section 5, are provided and are
specifically addressed in the attached memorandum,
Furthermore, the renewal certificate may be approved routinely by the Board of County
Commissioners upon advise of the Administrators.
FISCAL IMPACT: Pursuant to Collier County Ordinance 81-75, Section 5.1, an annual
renewal fee of $250 is to be paid. Funds are available in Fund 490 for FY 08.
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated
with this action.
RECOMMENDATION: That the Board of County Commissioners:
I. Approve the Certificate of Public Convenience and Necessity for the Collier County
Emergency Medical Services Department; and,
2, Authorize the Chaimlan to execute said certificate.
Prepared by: Artie Bay, Operations Analyst, Emergency Medical Services
.-
Page I of I
Agenda Item No. 16F1
May 13, 2008
Page 2 of 15
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
Item Number:
16F1
Item Summary:
Recommendation to approve a Certificate of Public Convenience and Necessity for the
Collier County Emergency Medical Services Department at a renewal rate for FY 08 of
$25000.
5/13/2008 90000 AM
Meeting Date:
Prepared By
Artie Bay
Bureau of Emergency
Services
Senior Administrative Assistant
Date
EMS
4114/200811 :00:22 AM
Approved By
Jeff Page
EMS Chief
Date
Bureau of Emergency
Services
EMS
4114/200811:14AM
Approved By
Jennifer A. Belpedio
Assistant County Attorney
Date
County Attorney
County Attorney Office
4/14/20083:05 PM
Approved By
Dan E. Summers
Bureau of Emergency Services Director
Date
County Manager's Office
Bureau of Emergency Services
4/25/20083:57 PM
Approved By
OMS Coordinator
OMS Coordinator
Date
County Manager's Office
Office of Management & Budget
4/28/2008 10:22 AM
Approved By
Sherry Pryor
Management & Budget Analyst
Date
County Manager's Office
Office of Management & Budget
4/28/20082:50 PM
Approved By
James V. Mudd
County Manager
Date
Board of County
Commissioners
County Manager's Office
4/30/20084:37 PM
file://C:\AflendaTest\ExDort\ 1 07 -Mav%20] 3.%202008\ 16.%20CONSENT%20AGENDA \ 16... 5/7/2008
Agenda Item No. 16;: 1
May 13. 2008
Page 3 of 15
Memorandum
To:
James V. Mudd County Manager
From:
Jeff Page, Chief
Emergency Medical Services Department
Date:
April 10. 2008
Subject:
Certificate of Convenience and Necessity for Collier County
Emergency Medical Services Department
Per Collier County Ordinance Number 81-75, 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 loc.ated at:
3301 East Tamiami Trail, BIJilding F
Naples, Florida, 34112
2. Collier County Emergency Medical Services Department provides service to the 2,032
square miles encompassing Collier County.
3. Collier County Emergency Medical Services Department has a total of fifty-nine (59)
State licensed vehicles. Thirty-five (35) of these are licensed ground transport vehicles
and one (1) medivac helicopter. There are also twenty-three (23) licensed ALS Engines
(non-transport). Of the above, Twenty-five (25) licensed ground transports, fifteen (15)
licensed ALS Engines and the m -:divac helicopter operate 24 hours and day, seven days a
week. One (1) additional ground transport licensed vehicle operates 12 hours a day, seven
days a week (as needed) during ,he seasonal months and is taken out of the reserve units.
The remaining, ten (10) licenSe( ALS ground transport vehicles are held in reserve, while
the eight (8) licensed ALS Eng.nes are placed in service as staffing allows. (Attachment
A)
Emergency Services Division
Agenda Item No. 16F1
May 13, 2008
Page 4 of 15
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
Medic I
Medic 2/ALS E-2
Medic 10
Medic 21
Medic 22
Medic 23
Medic 24
Medic 30
Medic 31
Medic 32
Medic 40
Medic 42
Medic 43
Medic 44
Medic 46
Medic Res 50
ALS Engine 50
Medic 61
Medic 70
Medic 71
Medic 75
Medic Rescue 90
ALS ENG 90
Medic 800
Mcdic 80
Medic 81
Medic 82
Medic 83
ALS ENG 20
ALS ENG 44
Med-Flightl
2705 S. Horseshoe Drive
835 8th Avenue South
977 26th Avenue
14756 Imrnokalee Road
11121 E. Tamiami Trail
4375 Bayshore Drive
6055 Collier Blvd
2795 Airport Road North
112 South 1st
112 South 1st
4819 Ave Maria Blvd
1411 Pine Ridge Rd.
70 I 0 hnmokalee Road
16325 Vanderbilt Drive
766 Vanderbilt Beach Road
3010 Pine Ridge Road
1280 San Marco Road.
1280 San Marco Road
201 Buckner Avenue
4741 Golden Gate Parkway
95 13th Street SW
4590 Santa Barbara Blvd
175 Islc of Capri Road
175 Isle of Capri Road
*** Extra unit! HOC
4741 Golden Gate Parkway
766 Vanderbilt Beach Road
11121 E Tamiami Trail
4590 Santa Barbara Blvd
4798 Davis Boulevard
8970 Hammock Oak Drive
2375 Tower Drive
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Immokalee, Florida
Immokalee, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Everglades, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naplcs, Florida
Naples, Florida
Naples, Florida
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. Jeffrey Albritten 1945 Empress Ct.
Nancy Laschied 4500 Gulfshore Blvd. N. - #903
John Valenti 1180 Camelot Circle
Emergency Services Division
Naples, Florida 34110
Naples, Florida 34103
Naples, Florida 34119
Agenda Item No. 16F1
May 13. 2008
7. Collier County Emergency Medical Services Department schedules of service fees Page 5 of 15
(Attachment B).
8. April I 0,2008 Memorandum from Dan Summers, Director of Bureau of Emergency
Services to County Manager Mudd stating no further information required (Attachment
C).
9. Renewal fee of$250.00 by jownal entry of an interfund transfer from Fund 490-144610-
649010 to Fund 490-144610-366900.
10. Collier County Emergency Medical Services Department financial statement is
available in Collier County's Finance Department
JPPlbb
Attachments
Emergency Services Division
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Agenda Item No. 16F1
May 13, 2008
A IT ACHlvlEN'Jl!fB1l of 15
RESOLUTION NO. 08 - ...1L
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 HARDSffiP CASES AND PAYMENT PLANS; SUPERSEDING
RESOLUTION NO. 07-192; AND PROVIDING FORAN EFFECTIVE DATE.
WHEREAS, Collier County Emergency Medical Services (hereinafter referred to as
"EMS") provides ambulance services to the residents and visitors oreollier County; and
WHEREAS, the Collier County EMS operating budget is funded exclusively through ad
valorem taxes and user fees; and
WHEREAS, the Board of County Commissioners recently entered into an Agreement with
Advanced Data Processing, Inc. (hereinafter referred to as to l'Bil1ing Consultant") to provide
collection gervices fOr ambulance services and associated fees; and
WHEREAS, this Resolution is intended to apply irrespective of whother EMS billing staff,
Advanced Data Processing. Inc., or any other billing consultant is responsib~e for the collection of
fees for ambulance services; and
WHEREAS, Collier County Ordinam;e No. 96-36 9 5 provides that the user feos for
ambulance services may be established by Resolution of the Board of County Commissioners
(hereinafter referred to as (0 "the Board").
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
SECTION ONE: EMS USER FEES
BASE RATES:
SERVICE LEVELS
BASE CHARGES
A. EMS-BLSNON-EMERGENCY
D. EMS-BLSEMERGENCY
C. EMS - ALS I NON-EMERGENCY
CODES
A0428
.1'.0429
A0426
$ 700.00
$ 700.00
$ 700.00
$ 700,00
$ 750.00
$ 800.00
$ 175.00
$ 5.900.00
D. EMS-ALS I EMERGENCY
E. EMS - ALS 2 EMERGENCY
F. EMS - SPECIALTY CARE
G. EMS - TREATMENT WIO TRANSPORT
H. EMS - HELICOPTER
MILEAGE RATES:
SERVICE LEVELS
A. EMS - GROUND UNIT
(Minimum Charge of 1 mile and no cap)
B. EMS-AlRUNlT
A0427
A0433
.1'.0434
.1'.0098
A043 I
CODES
.1'.0425
MlLEAGE CHARGE
$ 12.25
A0436
$
110.00
SPECIAL EVENT'S AND MISCELLANEOUS RATES:
SERVICE LEVELS
A TWO (2) MEDICSIONE ALS VEHICLE (pER HOUR)
RATES
$ 150.00
B. ONE (I) MEDICINO VEHICLE (PER HOUR)
COPIES':
Agenda Item No. 16F 1
May 13. 2008
Page 9 of 15
$ 50.00
Subject to statutory exemptions, "public records" aro required by Chapter 119, FS. to be:
open to inspection and copying. Consistent with Chapter 119, Resolution No. 07-327 establishes
copyinB fees as follows:
COPIES OF DOCUMENTS
A. Oncwsided copy which is 14 inches by 8 Y2 inches or Jess
B. Two-sided copy which is 14 inches by 8 Y;;: inches or less
COPY SERVICES
The actual cost of duplication for all other copies" ill be charged. The first hour of cost of
duplication will not be charged. "Actual cost of duplic,tion" is defined in S 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, F.S. or
Resolution No. 07-327, or both. are wnended, replaced, or superseded.
PAST DUE ACCOUNTS
INTEREST ON PAST DUE ACCOUNTS
SECTION TWO: BILLING COLLECTION PROCEDURE
RAlES
$ .15
$ .20
$
I % monthly
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 s.ervice(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 hy the EMS Department.
B. EMS Billing Staf'f\'.till tr.msmit all dala ne;:.essary to Billing Consultant to process the claim.
1. Billing Consultant will send an illtial bill to the service recipient's or responsible
party's insurance camer as so(.n as insurance information has been received,
validated, and entered by the Bilrng Consultant on the acCOWlt,
2. When a valid patient address is pre.sent. the Billing Consultant will follow the patient
statement cycle outlined below.
I. An initial statement for ambulance services, including the IDPAA 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.
11. If a nun-Medicaid account remains unpaid, statements will be sent to the
patient no latL'T than t:very 60 days from the last filed date. If a claim is denied,
a bili v,,-iU be sent to the service recipient or responsible part)'.
HI. For Medicaid accounts, if the claim is denied because of no coverage at the
time of sen'ice, or because it was determined to be not medically necessary to
be transported by am'Julance, a bill \\orill be sent to !be service recipient or
responsibly party,
Agenda Item No. 16F1
May 13, 2008
Page 10 of 15
iv. In the event the service recipient or responsible party does not have or does nDt
provide proof of insurance coverage, statements will be sent to the patient no
later than every 60 days from the last stalement date.
C. The Bitting Consultant witt provide a file with patients to be sent to collections to the
COlmty's contracted collection agency when aU attempts to collect OD the account have been
exhausted by the Billing Consultant. The County may dircct the Billing Consultant to Dot
send a paticDt to collections at any time. Billing Consultant may send a patient to
collections prior to exhaustion of all collection efforts when:
I. 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 lo/u per month an 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 tenns 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
coHections 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 account(s) may be considered for oilier 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. Tbroughout the fiscal year, the EMS Billing Section shall review all past due accounts and
report [0 the Board of County Commissioners un i:1Il annual basis, of all past due accounts
which are believed to be uncollectible.
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 generaIly accepted accounting procedures and
pursuant to law by Resolution.
J. Probate Estate Cases: 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 filcd with the Probate Court.
2. EMS Billing Staff shall cnsure that a Notice of a Claim is timely filed with the
Probate Court.
3. EMS Billing Staif sbatl eru;ure that the Office of the County Attorney is timely
notified of such claim and proyided with: I) a copy of ambulance bil1(,), 2) all
correspondence between EMS Billing StafElBilling Consultant) and Personal
Representative, 3) Notice of Claim liltd with the Probate Estate, and any other
information necessary to pursue the claim_
Agenda Item rio. 16F1
May 13, 2008
Page 11 of 15
4. The Office of the County Attorney shall 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 seliIiccs, the
EMS Director and the County Attorney (or his designee) are authorized to take
reasonable actions to reach a settlement with the Personal Representative or his
attorney. Should a settlement be reached, the EMS Director and the COWlty
Attorney (or his designee) are authorized to execute a satisfaction andlor 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 COWlty 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. 96-36. as it may be amended,
replaced, or sup~rseded,
K. All accounts with a balance of $1 0 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 n~d 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 Counly have the need for a transport of a
patient to hospital facilities located ou/side the boundaries of Collier County, the County,
v.'ill 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 v.rilh criteria established by the enabling Ordinance,
may authorize othcr adjustmcnts.
A, Medicare and Medicaid Adjustments. Contractual adjustments under Medicare and/or
Medicaid assignment ",ill be made in accordance v.;th applicable Medicare and/or
Medicaid rules and regulations.
B. Victim's ComDensation Contractual Ad1ustments. Contracrual adjustments will be
made in accordance with applicable state, federal and local rules and regulations.
C. Worker's Comnensation Contractual Adjustments. Contractual adjustments will be
made in accordance with applicabte stale, fetieral and local rules and regulations.
D. County Emplovee Adiustments, Board of County Commissioners and Constitutional
Officers' employees that have Primary coverage Wlder Collier County's insurance policy
\viU be responsible for any deductibles, co-puyment.<; or ll..'1paid balances. .1\n employee
Agenda Item No. 16F1
May 13, 2008
Page 12 of 15
may dispute hislhcr ambulance charge in accordance with procedures set forth in
Ordinance No. 96-36.
E. ChBmuusfTricare Adiustments. Contractual adjustments will be made in accordance
with .pplicable Champusffricare rules and regulations,
F, Railroad Retirement Adiustments, Contractual adjustments will be made in accordance
with applicable state, federal and local rules and regulations pertaining to Railroad
Retirement Adjustments,
G. Social Senrices Adiustments. 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 date of this Resolution, user fees
for EMS ambulance stand-by services may be waived iftbe 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 ~ 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 the Federal Poverty guidelines, as
used by the Social Services Department of Collier County,
B. Pa)lIlent plans for hardship cases will be set up on a monthly basis, with a minimum
payment of$lO.oo 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 make the agreed scheduled payments for a
period longer than two (2) montbs, 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-] 92
SECTION EIGHT: EFFECfIVE 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 :2-r day of :::Jnvlil Ct '2J ,2008.
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AITESlY" . . :'/' 0...
DWIGflT E. BRaCK;~LERK
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lcgal sufficiency:
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
;oLb~
I J2'ID~
By:
~ O,?, ~ re ,..1.......,
Jenni r A. Belpedi
Assistant Comty Attorney
Agenda item No. 16F1
May 13. 2008
Page 13 of 15
MEMORANDUM
ATTACHMENT "C"
TO:
J ames V. Mudd, County Manager
FROM:
Dan Summers, Director Bureau of Emergency Services Division
DATE:
April 10, 2008
REF:
Certificate of Public 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.
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Agenda Item t"o. 16F1
rv'!ay 13, 2008
Page 15 of 15
COLLIER COUNTY FLORIDA
EMERGENCY SERVICES PERMIT #1
This Permit Expires December 31,2008
Name of Service:
Collier County Emergencv Medical Services
Name of Owner or Manager: Collier County Board of Countv Commissioners
Principal Address of Service: 2705 South Horseshoe Drive. NavIes. Florida 34104
Business Telephone:
(239) 252-8459
Emergency Telephone:
9-1-1
Description of Services Area: The 2.032 square miles encomvassing Collier County
Number of Ambulances on 24 hour duty: 25 ground units (ambulanc~
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 23
Number of Medivac helicopter: 1
See attachment "A" for description of vehicles.
This permit, as provided in Ordinance 81-75 shall allow the above named Ambulance
Service to operate Emergency Medical Services for a fee or charge for the following
area(s): Collier Countv 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
,21)08.
ATTEST:
COMMISSSIONERS
Dwight E. Brock, CLERK
BOARD OF COUNTY
COLLIER COUNTY FLORIDA
Clerk
Tom Henning, Chairman
Approved as to form & legal sufficiency:
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