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Agenda 12/14/2021 Item #16E 3 (Renewal of annual COPCN)16.E.3 12/14/2021 EXECUTIVE SUMMARY Recommendation to renew the annual Collier County's Certificate of Public Convenience and Necessity (COPCN) for Collier County Emergency Medical Services to provide Class 1 Advanced Life Support Transport (ALS) for one year and authorize the Chairman to execute the Permit and Certificate. OBJECTIVE: To allow Emergency Medical Services to continue to provide Advanced Life Support (ALS) services to the citizens and visitors to Collier County. CONSIDERATIONS: Collier County Emergency Medical Services (EMS) is currently operating under a COPCN for ALS transport. Section 50-60 of Collier County Code of Laws and Ordinances allows renewal certificates to be approved routinely by the Board upon advice of the County Manager or designee. The Director of Emergency Management is the County Manager's designee. In addition, Section 50-60 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 Section 50-57 of the Code of Laws and Ordinances. The application is back-up to this item. Section 50-60 of the Code of Laws and Ordinances provides: Each certificate holder shall file within 90 days of expiration, an application for renewal of his certificate. Renewals shall be based upon the same standards, as the granting of the original certificate along with such other factors as may be relevant. The renewal certificate may be approved routinely by the board, upon advice of the administrator, or the board may hold a hearing on same. The Director of Emergency Management recommends approval based on his finding that there is a public necessity for EMS to provide the service and that all other requirements have been met. If this item is approved by the Board, the renewal COPCN and Permit will commence on January 1, 2022, and expire on December 31, 2022. This item was reviewed by the Emergency Medical Authority prior to submission to the Board of County Commissioners. FISCAL IMPACT: There is no fiscal impact associated with this action. GROWTH MANAGEMENT IMPACT: None LEGAL CONSIDERATIONS: A hearing is not required for renewal. If a hearing is held, the Board must find that the standards set forth in Section 50-57 of the Code of Laws and Ordinances have been satisfied based on competent evidence as follows: (1) That there is a public necessity for the service. In making such determination, the Board of County Commissioners shall consider, as a minimum, the following factors: a. The extent to which the proposed service is needed to improve the overall emergency medical services (EMS) capabilities of the County. b. The effect of the proposed service on existing services with respect to quality of service and cost of service. Packet Pg. 2060 12/14/2021 16.E.3 C. The effect of the proposed service on the overall cost of EMS service in the county. d. The effect of the proposed service on existing hospitals and other health care facilities. e. 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. (2) That the applicant has sufficient knowledge and experience to properly operate the proposed service. (3) That, if applicable, there is an adequate revenue base for the proposed service. (4) That the proposed service will have sufficient personnel and equipment to adequately cover the proposed service area. This item is approved as to form and legality and requires a majority vote for approval. JAB RECOMMENDATION: That the Board of County Commissioners accepts the Director of the Bureau of Emergency Services' findings; and approves and authorizes the Chairman to execute a Permit and renewal COPCN to Collier County Emergency Medical Services for Class 1 ALS Transport. Prepared by: Tabatha Butcher, EMS Chief ATTACHMENT(S) 1.2022 CCEMS COPCN Renewal Application (PDF) Packet Pg. 2061 16.E.3 12/14/2021 COLLIER COUNTY Board of County Commissioners Item Number: 16.E.3 Doe ID: 20580 Item Summary: Recommendation to renew the annual Collier County's Certificate of Public Convenience and Necessity (COPCN) for Collier County Emergency Medical Services to provide Class 1 Advanced Life Support Transport (ALS) for one year and authorize the Chairman to execute the Permit and Certificate. Meeting Date: 12/14/2021 Prepared by: Title: Accounting Technician — Emergency Medical Services Name: Erin Page 11/04/2021 12:01 PM Submitted by: Title: Division Director - EMS Operations — Emergency Medical Services Name: Tabatha Butcher 11/04/2021 12:01 PM Approved By: Review: Emergency Management Emergency Medical Services Agenda Clerk Preview County Attorney's Office Office of Management and Budget Office of Management and Budget County Attorney's Office County Manager's Office Board of County Commissioners Daniel Summers Additional Reviewer Tabatha Butcher Director Review Michael Cox Agenda Clerk Preview Jennifer Belpedio Level 2 Attorney of Record Review Debra Windsor Level 3 OMB Gatekeeper Review Laura Wells Additional Reviewer Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Sean Callahan Level 4 County Manager Review Geoffrey Willig Meeting Pending Completed 11/04/2021 12:18 PM Completed 11/04/2021 12:58 PM Completed 11/08/2021 3:06 PM Completed 11/09/2021 9:15 AM Completed 11/09/2021 9:27 AM Completed 11/09/2021 2:20 PM Completed 11/10/2021 10:21 AM Completed 12/06/2021 8:49 AM 12/14/2021 9:00 AM Packet Pg. 2062 16.E.3.a Memorandum To: Mark Isackson, County Manager From: Tabatha Butcher, Chief Emergency Medical Services Division Date: October 15, 2021 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: Rick Locastro, District 1 Andy Solis, District 2 Burt Saunders, District 3 Penny Taylor, District 4 William L. McDaniel, Jr., 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 fifty-six (56) State permitted vehicles. forty-three (43) of these are licensed ground transport ambulances and two (2) air ambulances (helicopters). There are also thirteen (13) licensed ALS vehicles (non - transport). Of the above, twenty-six (26) licensed ground ambulances, and one (1) air ambulance (helicopter) operate 24 hours a day, seven days a week. At least two (2) additional ground transport permitted ambulances may operate 12 hours a day, seven days a week (as needed) during the seasonal months and are taken out of the reserve ambulances. The remaining, seventeen (17) licensed ALS ground transport ambulances are held in reserve. (Attachment A). Collier County Emergency Medical Services Packet Pg. 2063 16.E.3.a 11 5. N 7. 9 Collier County Emergency Medical Services Department has one main office and twenty-six (26) substations located throughout Collier County at the following locations: Headquarters Station 1 Station 2 Station 10 Station 20 Station 21 (2 units) Station 22 Station 23 Station 24 Station 25 Station 30 Station 31 Station 32 Station 40 Station 42 Station 43 'Station 44 Station 46 Station 48 Station 50 Station 60 Station 70 Station 71 Station 75 Station 76 Station 90 MedFlight 8075 Lely Cultural Pkwy. 835 8t' Avenue South 977 26t' Avenue 14756 Immokalee Road 4798 Davis Blvd. 11121 E. Tamiami Trail 4375 Bayshore Drive 7227 Isle of Capri Road 2795 Airport Road North 3675 The Lords Way 112 South 11' 1107 Carson Road 4819 Ave Maria Blvd. 1411 Pine Ridge Rd. 7010 Immokalee Road 16325 Vanderbilt Drive 766 Vanderbilt Beach Road 3010 Pine Ridge Road 16280 Livingston Road 1280 San Marco Road. 201 Buckner Avenue 4741 Golden Gate Parkway 95 13t' Street SW 4590 Santa Barbara Blvd. 490 Logan Blvd 175 Isle of Capri Road 2375 Tower Drive Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Immokalee, Florida Immokalee, Florida Ave Maria, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Marco Island, Florida Everglades, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida Naples, Florida 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. Three (3) Collier County residents to act as references: Nancy Laschied 4500 Gulfshore Blvd. N. - #903 Naples, Florida 34103 Dr. James Hampton 823 Bentwood Drive Naples, Florida 34108 Scott Lowe 6101 Pine Ridge Rd Naples, Florida 34119 Collier County Emergency Medical Services Department schedules of service fees (Attachment B). October 15, 2021 Memorandum from Dan Summers, Director of Emergency Management to County Manager Mark Isackson stating no further information required (Attachment Q. Collier County Emergency Medical Services Department financial statement is available in Collier County's Finance Department, Collier County Emergency Medical Services Packet Pg. 2064 u s 16.E.3.a F w U w z c z w U z w z w z O U U a 5 a Lr. 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F fi = N N O ECd N N U w= w E z .a e w C � � E G cc w w w 2° == 3 Packet Pg. 20 571 16.E.3.a COLLIER COUNTY FLORIDA Renewal of Class 1 COPCN This Permit Expires December 31, 2022 Name of Service: Collier County Emergency Medical Services Name of Owner or Manager: Collier County Board of County Commissioners 3 m c Principal Address of Service: 8075 Lely Cultural Parkway, Naples, Florida 34113 z Business Telephone: 239 252-3740 v a O Emergency Telephone: 9-I-1 co 2 Description of Services Area: The 2,032 square miles encompassing Collier County v U i Number of Ambulances on 24- hour duty: 26 ground units (ambulances) Q Ln 0 Number of Ambulances on 12- hour duty: 2 ground units (as needed during season taken from reserve fleet). Number of reserve Ambulances: 17 2 Number of non -transport ALS vehicles 13 i Number of Medivac helicopter: 2 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 ATTEST: Crystal K. Kinzel, CLERK Deputy Clerk Approved as to form & legality: Jennifer A. Belpedio Assistant County Attorney day of , 2022. BOARD OF COUNTY COMMISSSIONERS COLLIER COUNTY, FLORIDA Penny Taylor, Chairman P Packet Pg. 2066 EXHIBIT ,_,...i......--- Page , of,..r.�..,._ Permit# ALS : Year - Make Model VIN As 1453 T 1999 EUROCOPTER EC135 N911CK MHQ 2022 T 2019 AIRBUS H135 N911CB MHQ 22340 T 2019 FORD F550 1 FDUF5GT9KDA04460 Truck 41 23189 T 2020 FORD F550 1 FDUF5GT9LDA03369 Truck 7 23192 T 2020 IFORD F550 1FDUF5GT9LDA03372 Truck22 23190 T 2020 FORD F550 1FDUF5GT5LDA03370 Truck 17255 T 2012 FORD F550 1FDUF5GT8CEB23691 Truck 1 17256 T 2012 FORD F550 1 FDUF5GTXCEB23692 Truck 25 17257 T 2012 FORD F550 1FDUF5GT10EB23693 Truck27 17258 T 2012 FORD F550 1 FDUF5GT3CEB23694 Truck 37 18087 T 12013 FORD F550 1 FDUF5GTODEA35168 Truck 38 18088 T 2013 FORD F550 1 FDUF5GT7DEA35166 Truck 24 18089 T 2013 FORD F550 1 FDUF5GT2DEA35169 Truck 15 18090 T 2013 FORD F550 1FDUF5GT9DEA35167 Truck 18866 T 2015 FORD F550 1 FDUF5GT7FEA64024 Truck 14 18867 T 2015 IFORD F550 1FDUF5GT9FEA64025 Truck31 18868 T 2015 FORD F550 1 FDUF5GTOFEA64026 Truck 39 18869 T 2015 FORD F550 1FDUF5GT2FEA64027 Truck40 23191 T 2020 FORD F550 1 FDUF5GT7LDA03371 Truck 18 19044 T 2015 FORD F550 1FDUF5GT8FEC82389 Truck 19046 T 2015 FORD F550 1 FDUF5GT6FEC82391 Truck 43 19047 T 2015 FORD F550 1FDUF5GT8FEC82392 Truck30 19048 T 2015 IFORD F550 1FDUF5GTXFEC82393 Truck42 20437 T 2015 FORD F650 3FRWF6GZ1FV675309 Truck33 20443 T 2016 FORD F550 1FDUF5GT8GED28644 Truck 3 20444 T 2016 FORD F550 1FDUF5GT6GED28645 Truck 11 20445 T 2016 FORD F550 1FDUF5GTXGED28643 Truck 19 20548 T 2015 FORD F550 1FDUF5GT4FEC82390 Truck20 20549 T 2019 FREIGHTLINER M2EC 2FZACFDJ18AZ51747 Truck 35 20550 T 2007 STERLING ACETERA 2FZACFCS17AY33965 Truck 34 22299 T 2019 FORD F550 1 FDUF5GT1 KEE37245 Truck 44 22298 T 2019 FORD F550 1FDUF5GTXKEE37244 Truck 21169 T 2017 FORD F550 1FDUF5GT5HDA02856 Truck21 21170 T 2017 FORD F550 1FDUF5GT9HDA02858 Truck 16 21171 T 2017 FORD F550 1 FDUF5GT7HDA02857 Truck 36 22300 T 2019 FORD F550 1FDUF5GT3KEE37246 Truck 17 22301 T 2019 FORD F550 1FDUF5GT5KEE37247 Truck 10 21405 T 2017 FORD F550 1FDUF5GT1HEF21218 Truck 21403 T 2017 FORD F550 1FDUF5GT1HEF21221 Truck 32 21404 T 2017 FORD F550 1FDUF5GT3HEF21219 Truck29 21709 T 2017 FORD F550 1FDUF5GTXHEF21220 Truck 12 21861 T 2019 FORD F550 1 FDUF5GT4KDA01 138 Truck 02 21862 T 2019 FORD F550 1FDUF5GT6KDA01139 Truck23 21863 T 2019 FORD F550 1 FDUF5GT2KDA01 140 Truck 26 21864 T 2019 FORD F550 1FDUF5GT4KDA01141 Truck28 20438 N 2017 FORD EXPLORER 1FM5K8AROHG664925 CC2-1628 20439 N 2017 IFORD EXPLORER 1FM5K8AR2HGB64926 CC2-1630 20440 N 2017 FORD EXPLORER 1FM5K8AR4HGB64927 CC2-1629 20441 N 2017 FORD EXPLORER 1FM5K8AR6HGB64928 CC2-1632 19797 N 2016 FORD EXPLORER 1FM5K8ARXGGAO8079 CC 1130 19303 N 2015 FORD EXPLORER 1FM5K8AROFGC26952 CC2-1076 19304 N 2015 FORD EXPLORER 1FM5K8AR2FGC26953 CC2-1085 21084 N 2013 IFORD EXPLORER 1FM5K8R8DGA18380 CC2-668 21085 N 2016 FORD EXPLORER 1 FM5K8AR2GGA46941 CC2-1135 21086 N 2017 FORD EXPLORER 1FM5K8AR7HGC57022 CC2-1631 21087 N 2017 FORD EXPLORER 1FM5K8AR3HGA36372 CC2-1401 21088 N 2016 FORD EXPLORER 1FM5K8AR5GGC07850 CC2-1314 21089 N 2020 FORD EXPLORER 1FM5K8AWOLGC13670 CC2-2547 O 00 u7 O C O r w v .Q a 3 d C O Z V a O V Cl) 2 W V U N N O N C d E t v O r Q r Packet Pg. 2067 16.E.3.a EAl�f� F RESOLUTION NO.2021 - 17 5 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, PROVIDING FOR UPDATED EMS USER FEES FOR COLLIER COUNTY AMBULANCE SERVICES, UPDATED BILLING AND COLLECTION PROCEDURE, HOSPITAL TRANSPORT BILLING AND FEES, ADJUSTMENTS OF EMS USER FEES PURSUANT "3 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 Z RESOLUTION NO.08-27; AND PROVIDING FOR AN EFFECTIVE DATE. a O U WHEREAS, Collier County Emergency Medical Services (hereinafter referred to as (n M "EMS") provides ambulance services to the residents and visitors of Collier County; and v U WHEREAS, the Collier County EMS operating budget is funded through ad valorem taxes 0 and user fees; and c N WHEREAS, the Board of County Commissioners has an Agreement with Digitech c Computer, Inc. (hereinafter referred to as to "Billing Consultant") to provide collection services for ambulance services and associated fees; and Q a WHEREAS, this Resolution is intended to apply irrespective of whether EMS billing staff, Q �a Digitech Computer, Inc., or any other billing consultant is responsible for the collection of fees for c ambulance services; and WHEREAS, Collier County Ordinance No. 96-36 §5 provides that user fees for ambulance v a. services may be established by Resolution of the Board of County Commissioners (hereinafter Q co referred to as to "the Board"). 2 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 A. EMS — BLS NON -EMERGENCY B. EMS — BLS EMERGENCY C. EMS — ALS I NON -EMERGENCY CODES BASE CHARGES A0428 $ 800.00 A0429 $ 800.00 A0426 $ 800.00 ,CAP) 121-EMS-0 1060/ 165 9114 / 11 Packet Pg. 2068 16.E.3.a I D. EMS — ALS 1 EMERGENCY A0427 $ 800.00 E. EMS — ALS 2 EMERGENCY A0433 $ 850.00 F. EMS — TREATMENT W/O TRANSPORT A0098 $ 175.00* G. EMS — HELICOPTER A0431 $ 7,500.00 MILEAGE RATES: SERVICE LEVELS CODES MILEAGE CHARGE A. EMS —GROUND UNIT A0425 $ 15.00 c (Minimum Charge of 1 mile and no cap) z U B. EMS —AIR UNIT A0436 $ 185.00 O U * There shall be no Treatment W/O Transport (F) charges for third party calls, public assistance calls, or traffic accidents where only assessments are performed, and no treatment is required. v U SPECIAL EVENTS AND MISCELLANEOUS RATES: o 00 SERVICE LEVELS RATES Ln c N A TWO (2) MEDICS/ONE ALS VEHICLE (PER HOUR) $ 150.00 r_ 0 B. ONE (1) MEDIC/NO VEHICLE (PER HOUR) $ 50.00 COPIES: Copying fees will be consistent with Resolution No. 07-327, as amended from time to time. PAST DUE ACCOUNTS IN COLLECTIONS 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 Division. Billing Consultant shall follow all applicable rules and regulations set forth by Centers for Medicare/Medicaid (CMS) that pertain to ambulance billing. B. EMS Billing Staff will transmit all data necessary to Billing Consultant to process the claim. [2 1 -EMS-01 060/1659114/ 11 2 Packet Pg. 2069 16.E.3.a 1. Billing Consultant will send an initial bill to the service recipient's or responsible parry'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 seven (7) or more days after the data is entered z by the Billing Consultant, but no later than (30) thirty days after service has v a been provided. ii. In the event the service recipient or responsible party does not have or does not w provide proof of insurance coverage after three billing cycles (30-day cycles) v for a total of (90) ninety days, their account will be sent to the County's CO LO Collection Agency vendor. N C. The Billing Consultant will provide a file with patients to be sent to collections to the o .2 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 Q send a patient to collections at any time. Billing Consultant may send a patient to 3 collections prior to exhaustion of all collection efforts when: tr 1. The patient account has an invalid address. z 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. If a time payment plan is established with collection agency, no bureau reporting will occur unless the account goes into default after (60) sixty days of non-payment. 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 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 any stage in this billing and collection procedure, are returned because the Postal Service cannot effectuate delivery, the Billing Consultant shall make reasonable effort to ascertain the correct mailing address. If reasonable efforts to [21-1---MS-01060/1659114/11 3 Packet Pg. 2070 16.E.3.a i G. H. J. ascertain a correct address fail, the account(s) may be considered for other collection alternatives. Nothing contained in this Section shall preclude reasonable telephone or other appropriate contact for billing and collection purposes, in accordance with all applicable laws. Throughout the fiscal year, the EMS Billing Section shall review all past due accounts and -- report to the Board of County Commissioners on an annual basis, of all past due accounts which are believed to be uncollectible. z The Board may, after reviewing these past due accounts and after finding that diligent a efforts at collection have proven unsuccessful, remove these past due accounts from active accounts receivable in accordance with generally accepted accounting procedures and w pursuant to law by Resolution. v Probate Estate Cases: Should a decedent have an unpaid balance for ambulance services,00 Ln the following shall occur: N 1. The decedent's Personal Representative or Attorney representing their estate will o r notify EMS Billing Staff that a probate estate has been filed with the Probate Court. a a 2. Collier County Clerk of Courts Probate Department sends Collier County EMS a 3 monthly Probate summary report. c as 3. Collier County EMS's contracted billing vendor reviews the summary report for z 0 any accounts with unpaid balances and notifies EMS of accounts with balances a. O due. co co 4. EMS Billing Staff shall ensure that a Notice of a Claim is timely filed with the v Probate Court. v N N 5. EMS Billing Staff shall ensure that the Office of the County Attorney is timelyCD N 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. 6. 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. [21-EMS-01060/1659114/1) 4 Packet Pg. 2071 16.E.3.a 7. If the estate has assets and $10,000 or less is owed for ambulance services, the EMS Chief and the County Attorney are authorized to take reasonable actions to reach a settlement with the Personal Representative or his attorney. Should a settlement be reached, the EMS Chief and the County Attorney 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 this Resolution or in Ordinance No. 96-36, as it may be amended, replaced, or superseded. K. All accounts with a balance of less than $10 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 hospital 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 outside the boundaries of Collier County, the County will, subject to equipment and manpower availability and 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. [2 1 -EMS-0 1060/1659114/11 l,1 Packet Pg. 2072 16.E.3.a A. Medicare and Medicaid Adjustments. 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 Compensation Contractual Adjustments. Contractual adjustments will be made in accordance with applicable state, federal and local rules and regulations. C. Worker's Compensation Contractual Adjustments. Contractual adjustments will be made in accordance with applicable state, federal and local rules and regulations. D. Champus/Tricare Adjustments. Contractual adjustments will be made in accordance with applicable Champus/Tricare rules and regulations. E. Railroad Retirement Adjustments. Contractual adjustments will be made in accordance with applicable state, federal and local rules and regulations pertaining to Railroad Retirement Adjustments. F. Bankruptcy: After receipt of a signed Discharge of Debtor notice, any account balances prior to the discharge date will be adjusted off. G. 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 Service Director and the EMS Director. SECTION FIVE: WAIVER OF EMS USER FEE FOR SPECIAL EVENTS. 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 for hardship cases will be set up on a monthly basis, with a minimum payment of $25.00. 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) months, the account will be turned over to the County's contracted collection agency and interest will begin to accrue. 121-EMS-01060/1659114/1] 6 Packet Pg. 2073 16.E.3.a SECTION SEVEN: SUPERCISION OF RESOLUTION NO.08-27. This Resolution shall supersede Resolution No. 08-27. SECTION EIGHT: EFFECTIVE DATE This Resolution shall become effective on October 1, 2021. PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County, Florida, this _1401 day of September, 2021. ATTEST: BOARD OF OUNTY COMMISSIONERS CRYSTAL K. KINZ' Tt,-CLERK COLLIER 0 , FLORIDA� By: ��.�(�-�- By: Deputy d k - Atfest as to Chairr►iap s siq> or# Ink t :; Approved Ns tk fFrr fiand !W,%4ty: Jeffrey A. tzk jq,-Munty Attorney Penny Ta} tbr, Chair [21-EMS-01060/1659114/11 7 Packet Pg. 2074 16.E.3.a ATTACHMENT C MEMORANDUM TO: Mark Isackson, County Manager FROM: Dan Summers, Director Emergency Management DATE: October 23, 2021 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 Pg. 2075