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1982 EMSAC Miscellaneous EASIERN 422 W.Onon;laga SI PO Box 671.Syracuse NY 13201 • `\ OBSERVATIONS AND RECOMMENDATIONS FOR THE COLLIER COUNTY EMS • NAPLES , FLORIDA .r Prepared by: Martin A. Yenawine Chief Executive Officer Eastern Ambulance Service, Inc. Syracuse, New York February 22 , 1982 EllIAGTEIN 44.' 422 W Onondaga St.PO Box 671.Syracuse.NY 13201 OBSERVATIONS: The current operations of Collier County EMS is of high quality. The quality of patient care, response time, equipment, human resources, and supervision were all exceptional . ,4( The direct and indirect compensation of medical staff and supervisors is among the industry' s highest. This adds to the high cost per call but reduces employee turnover, plaguing many other providers, and increases . the consistency of care. The vastness of the county' s landmass and its low density of population makes service delivery difficult. The requirements to provide reasonable response times to remote regions dictates a variety of expensive equipment, i.e. , helicopters, 4-wheel drive vehicles, and placement of sub-stations in sparsely populated, low volume areas. • Much of the population is uninsured or under-insured '' "' for proper pre-hospital medical care and transportation._ , „ The migrant worker is uninsured. The state ' s Medicaid 4t program pays only a small fraction of the cost per call for eligible clients. The area' s large number of over 65 ' s covered by Medicare, without additional co-insurance, are under-insured. This results from' the arbitrary rate formula model. A poorly designed accounts receivable system has resulted in an inadequate collection experience. Inade- quate and inaccurate billing information is retrieved by field medical staff at the time of the call. Possible third party payer relationships are underdeveloped, i.e. , v HRS, Baker Act. Accounts Receivable staff have poor 1 I(EigirillEIPIJNI 4"'�`, 422 W Onondaga St PO Box 671.Syracuse NY 13201 i - research resources and under-utilize research tools, i.e. , telephones. There is a lack of directive super- vision and monitoring to ensure meaningful productivity. The existing staff do not feel a part of the EMS team. The public policy makers are committed to quality EMS but are unclear about how much of the public tax revenues should be spent to support those services. No firm objectives seem to be set concerning the balance of user fees and tax revenues to support the EMS function. The general public is aware of the quality, but unaware of the resulting costs of the EMS system. The telephone inquires regarding billing average about 15 to 20 calls weekly. Of these, one or two are hostile. This may indicate a significant public acceptance of the rates . However, the per unit base rate is 28 percent of the actual cost per ctjll . The tax support of Collier `*— County EMS is more than three_ times what national experts --jam say governments should pay for EMS systems. : . 1 2 Agli %111A61111ERN 422 W.Onondaga St.PO Box 671.Syracuse.NY 13201 / RECOMMENDATIONS: Communications 1 . Develop general public understanding. Create a general information piece to be mailed with billing explaining the EMS system. 2 . Continue to expand speaking engagements to Kiwanis, Rotary, seniors, et al. Initiate a junior EMT program designed for elementary and junior high school students and a Girl Scout/Boy Scout Explorer troop for senior . high students. 3. Promote the Vial of Life, with senior citizens being ,> your primary marketing target. 4 . Develop a stronger understanding of the choices in EMS funding with public policy makers and administra- tors of the City of Naples and Collier County. A 4 clear statement of direction is necessary. You can't demand lower public expenditures on one hand and artificially hold down user fees on the other. 5. Place in each initial bill a comment card to be returned by the user regarding the quality of the service. It urges the users to evaluate the response time, competence of the medical personnel, the manner in which the vehicle was driven, and the cleanliness of the supplies. When one does that evaluation, it is very easy to understand the cost of the ambulance service. 6 . Set up a community advisory board composed of 10 „k`, to 12 people to review rates and help interpret to the community the realities of the EMS business. 3 1.. 4 Eld6611110N 422 W Onondaga St.PO 6o,671,Syracuse.NY 13201 . I 1 Make sure the board has representation from senior citizens, medical , business and governmental segments. You must not apologize for the cost of your service if it is of high quality and efficiently managed. • , 4 616611eN 422 W Onondaga St..PO Box 671.Syracuse.NY 13201 Accounts Receivable System 1 . Strongly enforce the requirement of the EMT' s and Paramedics to get accurate and complete billing in- formation. Mandatory in-service training for new personnel on the accounts receivable system is essen- tial. Failure to complete this aspect of the job should result in disciplinary action. 2 . Billing information should include: PATIENT 'S NAME D.O.B. AGE PHONE AUTO. SEX M or F ADDRESS BILLING ADDRESS (if cliff.) INS. CODE MEDICARE # MEDICAID # SS# NAME OF MED. INS. CARRIER MED. INS. # WAS THIS A WORKMEN ' S COMP. INJURY? YES NO 4 EMPLOYER PHONE EMPLOYER'S ADDRESS T RESPONSIBLE PARTY PHONE 4] ADDRESS RELATION , . SIGNATURE OF PATIENT OR RESPONSIBLE PARTY X 3 . Upgrade the research resources available to the field staff and the accounts receivable staff. A criss- cross directory, a Polk directory, working relation- ships with the billing departments of the clinics and hospitals and with law enforcement agencies are a must. These resources should be utilized to locate current employer, member of the family or any other information to ensure that a responsible party is correctly identified. 5 4x y .1666111011:N.... 422 W.Onondaga SI.PO Box 671.SyraCuse NY 13201 4 . Increase the efficiency of the billing and shorten the timetable for turnover. The beginning of each day a clerk must review yesterday' s business, properly screen the accounts and assign a proper account code, i.e. , Private Pay, Workmen' s Compensation, Estate, Medicaid, Over 65, Special Event. A detailed receivable plan must be adopted for each of these codes . Included in the plan must be a strictly adhered-to timetable, appropriate forms or notices, and appropriate research tract. The flow and distribution of work to staff is then monitored daily. 5. An accounts receivable management system is only as good as its supervision. It is a system that requires constant monitoring, adjustment, and respon- siveness to change. It is too complex to treat as a simple clerical function. It is not similar to sending out water bills. The supervision of the EMS billing system should be the responsibility of the EMS director. If the director is being held accountable for this function, he/she should have direct and complete authority over the system' s design and implementing personnel . 6 . The timetable of the current system is too long in duration. With good research, ,effective screening, good accounts receivable plan implementation, and daily monitoring, turnovers to the collection agency should be ready by not later than the 120th day. Obvious "skips" and uncorrectable addresses found • in the mail returns should be sent immediately. 7 . The telephone should be used to verify information, offer assistance with insurance forms, and to determine 6 / b. �v 422 W Onondaga St PO Box 671.Syracuse,NY 13201 hardship cases where part-payment arrangements must be made. 8. All non-emergency transports should be screened for past due accounts or Medicaid pre-authorizations when scheduled. Payment at the time of service should be solicited. All calls for non-emergency work should be received on an alternative number from that of the Sheriff ' s dispatch so that these calls can be appropriately screened. ' 9. When a billing is mailed, the patient should be advised that if paid receipts are needed, a stamped, self- addressed envelope should be enclosed for that purpose. This will slightly reduce your postage costs. However, this may result in loss of good will. 10. The computerization of the accounts receivable system alone is not warranted at this time. With the current volume, two full-time clerks should be able to handle the workload with the help of a part-time supervisor. However, to develop an EMS management package that includes accounts receivable, the cost could be justified, especially if it frees up the Director to devote time to the management of the accounts receivable system. Additional clerks and/or supervisors are unnecessary with current and projected volume. 11 . The current line operations staff of the EMS system seems very capable and at full complement. The Direc- tor must now shift daily hands-on management to the business function of the EMS. This will allow "space" for his operation supervisors to develop, and, with the current director' s significant skills and abilities, quickly put on line a competent accounts receivable effort. 7 616611111EM 422 W Onondaga St.PO Bo.671,Syracuse.NY 13201 12 . Develop a politically-based task force to demand from the State government a fair and reasonable rate for Medicaid clients. This must be done in conjunction with similar task forces in other areas of the State. 13. Engage a Medicare Reimbursement Consultant to review your Medicare allowable charge and reimbursement rate. Because of your logistical challenges, your system may be eligible for an "equity adjustment" . The current accounts receivable system also is most probably incorrectly billing on those accounts where assignments are taken. Refunds on those billings over the last six months are possible. The American Ambulance Association has the names of two qualified consultants that could be retained. i 4 8 i i 645111ERN 422 W Onondaga St.PO Box 671.Syracuse.NY 13201 .t VITAE MARTIN A. YENAWINE Martin A. Yenawine Chief Executive Officer Eastern Ambulance Service, Inc. P.O. Box 671 Syracuse, NY 13201 (315) 471-0102 EDUCATION Bachelor of Arts: University of Louisville Political Science & Urban Studies Further Graduate Studies: State University of New York at Buffalo Urban Studies ASSOCIATION AFFILIATIONS Member - Board of Directors American Ambulance Association Alternate - Region I Chairman - Membership Development Committee American Ambulance Association Member - Onondaga County EMS Advisory Board Chairman - Onondaga County Manpower Development Advisory Board (CETA) Consultant - American Ambulance Association United Way of America Rape Crisis Center Cultural Resources Council Volunteer Leadership Positions - United Way of Central New York Volunteer Center Greater Syracuse Chamber of Commerce .a Better Business Bureau Everson Art Museum Syracuse Symphony WCNY - Public Broadcasting System eJDe e/( € 4, Ceemmaideanerd COLLIER COUNTY COURTHOUSE COMPLEX NAPLES, FLORIDA 33942 DAVID C. BROWN JOHN A. PISTOR MARY FRANCES KRUSE COMMISSIONER COMMISSIONER COMMISSIONER CLIFFORD WENZEL C. R. "RUSS" WIMER WILLIAM J. REAGAN COMMISSIONER COMMISSIONER CLERK May 14, 1982 Mr. Marvin Cecil P. 0. Box 2507 Naples, Florida 33939 RE: Emergency Medical Services Advisory Council Dear Mr. Cecil: While convened in regular session on May 11, 1982 , the Board of County Commissioners motioned to appoint you (as a regular member) to fulfill the term of Dr. Daniel B. Langley on the above referenced advisory committee. Your appointment will expire on August 31, 1982 , or at such time as the Board reappoints you or appoints your successor. As with any ancillary group, the primary purpose is to assist and advise the Board of County Commissioners. By law, however, the ulti- mate decisions rest with the Commission. At times, the Commission' s decisions may not reflect the recommendation of the advisory group because of the many facts which must be taken into consideration. By copy of this letter, we are advising Neil Dorrill , Public Safety Administrator, of your appointment and requesting that he provide you with any information you may need as a member of this advisory commit- tee. Words cannot express our appreciation for your willingness to serve the residents of Collier County in this capacity. We feel you will do a commendable job. Sincerely, C/A) C. R. "Russ" Wimer Chairman ge s cc: C. William Norman, County Manager Neil Dorrill, Public Safety Administrator Mr. Egon Hill, Chairman, EMSAC Mr. William Crone, Naples Community Hospital MEMO TO: EMSAC MEMBERS FROM W. Neil Dorrill, Public Safety Administrator DATE September 7 , 1982 SUBJECT: Postponement of Meeting of September 14 , 1982 4 Be advised that the above regular meeting has been postponed and will be held instead on TUESDAY, SEPTEMBER 21, 1982 5th Floor Conference Room - Bldg "F" Courthouse 4PM If you will be unable to attend, please call this office (774-8468) or Mr. Hill at 261-0569. Sincerely, W. Neil Dorrill Public Safety Administrator WND/bm MEMORANDUM DATE : September 3 , 1982 TO Chairman Hill , Members of EMSAC FROM: W. Neil Dorrill , Public Safety Administrator RE Certificate of Convenience and Necessity, Air Ambulance This office is in receipt of a petition by Ambassador Airways , Inc . of Naples as it relates to the above reference . The Emergency Medical Services Ordinance (81-75) provides criteria related to ambulance services and Certificates of Convenience and Necessity as required by FL Statutes and as prerequisites to State Certi- fication . This particular petition is for an air ambulance, which would be the first such service located in Naples . The Board had previously granted a Certificate for an Air Ambulance to a firm in Ft Myers . The new Ordinance however does not require out of county ambulances serving this area to posess such a certificate . Attached are various correspondence related to this petition , in addition to the processing fee ($250) which has also been received . The petitioner has , in staff ' s opinion, met the requirements of the Ordinance in addition to filling a void in private air ambulance capability serving this area. As a result of the review of this petition and contingent on confirmation from local references , it is the Staff ' s recommendation that this petition, be approved by EMSAC and forwarded to the Board of County Commissioners with a re- commendation for approval. WND/bm Please send check to I I BOARD OF COUNTY COMMISSIONERS NAPLES COLLIER COUNTY FLORIDA 33942 RECEIVED FROM(.�?,[. / ADDRESS � '' DATE ' 1 UND (>20,57 L FOR: w , � , _ = SIGNAT R . t.� i i , ! "_.- . ACCOUNT FUND AMOUNT 6 i miv�-��� C K DESCRIPTION Es v 0 � ,00.� 6.s--' 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 MI 7 7:1 J i OFFICER P) I 1 1 1 CUSTCPviER'S COPY MICHAEL J. NYWENING (8131 263-4200 AMBASSADOR AIRWAYS, INC. 24 HOUR AIRCRAFT CHARTER P. 0. BOX 1497 • NAPLES, FLORIDA 33939 August 30 , 1982 Mr . W. Neil Dorrill Public Safety Administrator Collier County Government Complex i3uildinc F Naples , Florida 33942 Re ; Certificate of Convenience and Necessity, Air Ambulance Dear 71r . Dorrill: This is to confirm receipt of your letter requesting additional information as required by Ordinance to complete our petition to be a locally based air ambulance carrier . In the order of requested information: 1 . Michael J. Nywening, age 29 601 W. Lake Drive Naples , Fl . 33940 100 Stockholder in Corporation. • 2 . Collier County airports to be utilized : Naples Municipal , Marco Island , Immokalee , Everglades. 3 . Only plan to use the Piper Seneca N31383 , at this time . 4. Ambassador Airways , Inc . 601 W. Lake Drive Naples , Fl. 33940 5. Michael J. Nywening; United Airlines emergency training with annual courses required for the flight crew. Joseph Magri ; Paramedic Certificate #6747. James Brantley; Paramedic Certificate #0320 . Barry Flagg; Paramedic Certificate #8212 . Diane Flagg; Paramedic Certificate ,/0039 . Scott Martin; Paramedic Certificate ;#6748 . Bernice M. Todd ; Intensive Care Registered Nurse #1151892 . MICHAEL J. NYWENING (813) 263-4200 AMBASSADOR AIRWAYS, INC. 24 HOUR AIRCRAFT CHARTER P. O. BOX 1497 • NAPLES, FLORIDA 33939 r°`r . Neil jorrill - 8/30/82 Page 2 . 6. Stanley J. Lieberfarb, Attorney At Law ( 262-7748) 1400 Gulf Shore Blvd . , No. Suite 214 Naples , Fl . 33940 William C . Brigham, Vice President ( 261-8811) Southeast Sank, N.A . 1010 Fifth Avenue South Naples , Fl . 33940 Arthur A . Cox , Sr . , M .D . ( 394-3196) 985 Caxambus Drive - Yarco Island , Fl . 33937 - 7 . Ambassador Airways, Inc . currently plans to charge a 11 .20 per statue mile based on roundtrip milage . 8 . Michael J. Nywening, Pilot , 5000+ hours logged Airline Transport Pilot Certificate #266192528 Airplane Nulti and Single Engine Land Flight Instructor Airplane and Instruments Flight Engineer Turbojet Rated 9 . Financial Data: Cash on hand ;x3 , 000 . 00 Accounts receivable 2 , 743 . 20 Furniture & Fixtures 600. 00 ;6, 343 ,20 Credit line available 110 ,000 . 00 Accounts Payable - 0 - Total Liability - 0 - The Piper Seneca is leased from Seneca I Assoc . in which 1Tichael J. Nywening is a Partner . 10 . Application fee of X250 .00 is attached , check number 205. Please be advised the above information is strictly confidential . If any further information is required , please don't hesitate to contact me . Thank you for expediting our request : f \\„7 R e s t f 4"Y FP4 / u i P M l J. Nyvening 'resident • SE Ambassador Airways , Inc . J� gY: _ ;6 14,, gLoiecii 4,12o We;Inwt&tio~90, 4'{=< COLLIER COUNTY GOVERNMENT COMPLEX .y 3.1,.,,1•_, August 26, 1982 Mr. Michael J . Nywening President Ambassador Airway, Inc. P.O. Box 1497 Naples FL 33939 Re: Certificate of Convenience and Necessity, Air Ambulance Dear Mr. Nywening: This will confirm receipt of your letter of August 23, 1982 as it relates to the above reference. At this time, to our know- ledge, there is no locally based air ambulance serving this area and as such we welcome your petition. The Board of County Commissioners has adopted guidelines (OR 81-75) which relate to this particular process. Upon re- ceipt of your full application your request will be presented to the Emergency Medical Services Advisory Council for review/ action and subsequently forwarded to the Board for approval. The next meeting of the Advisory- Council will be Tuesday, Sep- tember 14, 1982 at 4 : 00 PM. In order for your petition to be on their agenda for that date I will need the remainder of your application by Friday, September 3, 1982. Additional information as required by Ordinance to complete your petition entails the following: 1. Names, age and local address of the owner (s) of the company or directors and major stockholders if a corporation. 2 . List of county airports to be utilized in the provision of the proposed service. 3. Number and description of any aircraft other than the Piper Seneca to be utilized in this service. 4. Address of the local headquarters. 3301 TAMIAMI TRAIL EAST NAPLES, FLORIDA 33942-4977 813-774-8999 Michael Nywening - /26/82 Page 2 5. Training or previous experience of the applicant and initial list of any paramedics or nurses to be util- ized. 6. Name, address and phone number of three (3) Collier County residents, not affiliated with your company, to act as references . 7 . Schedule of existing or proposed rates the service intends to charge. 8. Name, pilot certificate numbers and ratings held by the proposed pilots/co-pilots of your aircraft. 9. Pertinent financial data including assets and liabil- ities of the company; and a schedule of debts encumber- ing your aircraft. 10. An application fee payable in advance of $250 . 00 . If you, upon review of these requirements, have any additional questions or need further explanation, please don' t hesitate to contact me. Very rul • .Ai • l W. Ne A lair Publi• Saf- Administrator • WND/bm cc: C. W. Norman, County Manager 4 MEMO TO : EMSAC MEMBERS FROM W . Neil Dorrill /Public Safety Administrator DATE October 4 , 1982 SUBJECT : EMSAC Meeting of September 31 , 1982 In the absence of a quorum the meeting scheduled for September 21 was not held . A copy of the Agenda for the next regularly scheduled meeting is attached . NEXT MEETING Tuesday , October 12 , 1982 Board of County Commissioners Chambers 4 : 00 P . M . If you will be unable to attend , please call this office (774-8468) or Mr . Egon Hill at 261 -0569 . Attached also is a copy of Ordinance No . 82- , as part of the agenda . WND/bm Attachments : 2 AGENDA EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL MEETING OF OCTOBER 12 , 1982 I . Roll Call II . Reading and/or approval of minutes a) Regular meeting of August 10 , 1982 III . Advisors Reports IV . Old Business V . New Business a) Petition for Certificate of Convenience and Necessity , Air Ambulance - Ambassador Airway , Inc . (Neil Dorrill ) VI . Adjourn /bm ORDINANC'.; NO. 82— AN E9FRC C7 : ); d'c C ? ;f PNDI P (; EC'J IO :S , ;_ AND 5 , 01' ORD 1 I1A;C NO. 8i -75 TO ni:nV'_i1'E I'OE TIiT CER'iIFICATICU (._'I' OP1J _TORS OF NON--Liil;k�ENCY NEDIC?`.L TRANSPORTATION SERVICES , PROVIDING DEFINITIONS AND EFFECTIVE DATE; AND DECLARING TEE EXITENCE, • OF AN EMERGENCY. BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONIRS OF COLLIER COUNTY, FLORIDA: Section A. Section 1 of Ordinance 81-75 shall be amended to read as follows : This ordinance is adopted pursuant to Chapters 125 , and 403 Florida Statutes and--S ton-°`_{-1-.-2�-(- -)--Fror4.- -•S-azi-.0-''JL: : The purpose of this ordinance is to provide better protection for the health, safety and welfare of the residents of Collier County , in ambulance, anel- A--S advanced life support , and non•-eme_rgenc,7 medical transportation matters , by establishing uniform county-wide standards for certification of ambulance, or advanced life support; and non-emergency medical transportation services er--sso -r-ie-e-z7--or-op -a•t-.•. :,i-s by promulgating eomptiete- __al-e-a-r rules and regulations for operation of all ambulance, ef° rescue companies, ©r and non-emergency medical transportation services in Collier County. SECTION B. Section 2 of Ordinance 81-75 is amended by adding the following definition of non-emergency medical transportation . services. * * * K. Non-emergency medical transportation services shall include the provision of transportation services by publicly or privately owned land , air or water vehicle that is designed, constructed, reconstructed, maintained , equipped, or operated for, and is used for or intended to be used for air , land , or water transportation of persons with non-emergency conditions requiring specialized transportation, including vehicles 2er.ated by a wheelchair ambulance service coinpany2 * * * * f SECTION C . Section 5 of Ordinance 81--75 is amended as follows: * * * * . An applicant for a certificate to operate an ambulance service , advanced life support service , or non-emergency medical transportation service shall obtain forms from the department to be completed and returned to the Division Administrator. Each application shall contain: * * * * SECTION D. Conflict and Severability. In the event this Ordinance conflicts with other applicable law, the more restrictive shall apply. If any section , subsection, sentence, clause , phrase , or portion of this Ordinance is , for any reason, held invalid or unconstitutional by any court of competent jurisdiction, such portion shall be deemed a separate , distinct and independent provision of such holding and shall not affect the validity of the remaining portion thereof. SECTION E. Declaration of Emergency and Effective Date. This Board does hereby declare that an emergency exists and that immediate enactment of this Ordinance is necessary, and by no less than four-fifths (4/5ths) vote of the membership of the Board does hereby waive notice of intent to consider this Ordinance. • A certified copy of this Ordinance, as enacted, shall be filed by the Clerk of the Board with the Department of State of the State of Florida, . as soon after enactment as is practicable by depositing the same with the postal authorities of the government of the United States by certified mail, postage prepaid, to the Florida Department of State. 2 This Ordinance snail become effective October 1 , 1.982 . PASSED AND DULY ADOPTED by the Board of County Cimuni_ssioners of Collier County , Florida , this day of September , 1982 . ATTEST: BOARD OF COUNTY COMMISSIONERS WILLIAM J. REAGAN, Clerk COLLIER COUNTY, FLORIDA • By: C. R. "RUSS" WIMER Chairman Approved as to form and sufficiency: Burt L. Saunders Collier County Attorney • { • 4 .4. c y toagtfjeer(Weun6fe Ce01,1 1(JJ(OsaeYYa COLLIER COUNTY COURTHOUSE COMPLEX NAPLES. FLORIDA 33942-4977 w DAVID C. BROWN JOHN A. PISTOR MARY FRANCES KRUSE COMMISSIONER COMMISSIONER COMMISSIONER CLIFFORD WENZEL C. R, "RUSS" WIMER WILLIAM J. REAGAN COMMISSIONER COMMISSIONER CLERK • October 13 , 1982 • Mr. William Crone, Administrator Naples Community Hospital P. O. Box 2507 Naples, Florida 33939 Dear Mr. Crone : The subject of a medical supply purchase agreement has been brought to my attention by our Director of E.M.S. , Mr. Doug Greenfield. • It would be appreciated if you could take a few minutes to review the attached correspondence on this subject and let me know your reaction to this proposal. I will be out of the office until Monday , but would be pleased to discuss the matter with you at that time. Sincerely /4„ C. R. "Russ" Wimer Chairman RW:ni cc: Mr. Marvin Cecil ‘-' (dictated - not read) Attachments MEMORANDUM 4. w TO: Honorable Chairman Russ Wimer • FROM: Doug Greenfield, Director of E.M.S. REF: Medical Supply Purchase Agreement M DATE: October I, 1982 Dear Russ: For the entirety of our existence as an E.M.S. provider, we have had to depend on the graces of Naples Community Hospital and other various medical supply vendors to furnish our system with the necessary items we need for daily .operations. Our hospital relation- ship as a vendor has been fragile and expensive to say the least. We must also keep in mind that NCH is and has been our only avenue for medicines largely due to the sensitivity and legal authority needed to handle and dispense these items. It doesn't take a financial genious to realize that if we could figure a way to legally purchase both medicines and expendible medical supplies in large volume, that a savings could be recognized. I took a suggestion to Mark Thiele that we approach Hillsborough County with our need and purchase concern to attempt an inter-county purchase agreement by which we could make two or three bulk purchases annually through their Tampa General Hospital county stores. This agreement would assure us best possible prices on all necessary goods from a volume bid purchaser (Hillsborough County Hospital) that is competitively equal in item for item price scale to the largest hospital chain in the United States. I was encouraged in my conversation with Mr. Thiele which led to a formal meeting in Tampa with Mr. Clayton Parker, Director of Purchasing for Hillsborough County Hospital Authority on Thursday, September 30, 1982. In this meeting I provided Mr. Parker with an itemized list of our needs and got his concurrance that they stock most, if not all, of the items we specified. I told him that we are a small and relatively young county that always looks for ways of improving, . sharing ideas and efficient operational avenues. I also explained that we area county run system under the Board of County Commissioners and thusly could share the advantages of the bid process. It was stressed during the meeting that our intentions were not to make several frequent trips for supplies, instead, we will strive to reduce their burden by making only two or three bulk pick ups annually. This seemed to satisfy Mr. Parker and he stated that he would start the process through his superiors to seek an answer to this county's request. I asked him if there was something that we could do on our end to assist and hopefully expedite this decision process. He stated that a letter from our Board Chairman to Chairman George Jackman of Hillsborough County Hospital Authority which would encourage and support this request purchase cooperative agreement would certainly be in order and would enhance our chances of approval and process expedition. Chairman Jackman's address is: Tampa General Hospital, Davis Islands, Tampa, Florida 33606. Your support and written correspondence on this issue is something that I personally feel is a critical step in making this purchase agreement a success. As always, your attention t thi matter is appreciated and I thank you in advance for your cooperation. S w. l yj 9 .04- 't Id c: M r. Norman, Mr. Dorrili, Mr. Thiele MEMORANDUM OCT 6 1982 TO: Chairman Russ Wimer • FROM: Doug Greenfield, Director of E.M.S. Ed.0 'tiCarran`ss ne" • SUBJ: FOLLOW UP MEMO REGARDING PURCHASE AGREEMENT • DATE: October 6, 1982 Dear Russ: Per our previous conversation, I am hereby outlining specific topics of interest concerning recognizable savings with the proposed purchase agreement and available security measures that must be taken into affect. The current year-to-date medical supplies expenses without final recording from September's close out will approximate $52,000. These expenses are broken down into two primary categories. Category One being medicines and solutions. Category Two representing expendable medical supplies. The source in Hillsborough County would be able to supply the greater majority if not all of our necessities in these two categories. After reviewing the basic cost that Hillsborough County EMS pays for the same items that we purchase, we should be able to recognize between 30-50% savings on our more commonly used items. This would probably recognize in an annual reduction in medical supply expenses of $10,000-12,000 overall. There is no immediate county owned facility to properly secure a six months supply of bulk storage of these medical supplies, however, a storage garage could be leased from a local vendor for approximately $240 every six months and would be accessible to EMS within minutes of our existing location. This would prove to be ideal in that a controlled temperature environment would not be necessary to store the items in question. Those individual medicines that would require temperature maintenance could be secured at our present operation's location. If there is any further information on this subject that comes to mind, please feel free to reach me at my ext. 459. Sincerely, o g re nfield DG:mcg • MEMO TO: Members of EMSAC FROM W. Neil Dorrill, Public Safety Administrat DATE October 27 , 1982 SUBJECT: Minutes of Meeting of October 12 , 1982 In accompaniment, please find copy of the Minutes from the Regular Meeting of October 12 , 1982 . Please review these in order that they can be adopted at the next meeting on November 9, 1982 , at 4: 00 PM. WND/bm cc: C. W. Norman, County Manager File 14D M E M O R A N D U M TO: All Members of EMSAC FROM: Neil Dorrill, Public Safety Administrator SUBJ: SPECIAL EMSAC MEETING 11/15/82 - 4 PM DATE: November 3, 1982 There will be a special meeting of the EMSAC council on Monday, November 15, 1982 at 4 pm at the Collier Government Complex, Building F, 5th Floor conference room for the purpose of mediating a private complaint concerning a bill for treatment of a patient transported in May of this year. Information concerning this particular call and the complaint will be made available to each of you during the regular meeting on November 9, 1982. The purpose of the special meeting is to accomodate for the presence of the Medical Director who will be absent for the November 9th meeting. We would appreciate good attendance on this particular occasion as this particular type of situation is considered of special importance and function with all EMSAC members. Sincere 41 Neil Do, ill Publ Safet 'sministrator • ND:mcg MEMORANDUM TO: EMSAC MEMBERS FROM : W . Neil Dorrill , Public Safety Administrator SUBJECT: Regular Monthly Meeting DATE : November 5 1982 Be advised that the next regular meeting of the Emergency Medical Services Advisory Council will be held on Tuesday , November 9 , 1982 5th Floor Conference Room - 520 4 :00 PM If for any reason you will be unable to attend , please notify my office ( 774-8468) or Chairman Hill (261 -0569) so that your absence will be considered as excused . WND/bm e=ee,do/Ceaeeo2 iee Cieanam4Qeaneyrt COLLIER COUNTY COURTHOUSE COMPLEX NAPLES, FLORIDA 33942-4977 DAVID C. BROWN JOHN A. PISTOR MARY FRANCES KRUSE COMMISSIONER COMMISSIONER COMMISSIONER CLIFFORD WENZEL C. R. "RUSS" WIMER WILLIAM J. REAGAN COMMISSIONER COMMISSIONER CLERK November 10 , 1982 Mr. Marvin Cecil P. 0. Box 2507 Naples, Florida 33939 RE: Emerg y Medical Services Advisory Council Dear Mr. cil: While convened in regular session on November 9, 1982 , the Board of County Commissioners motioned to reappoint you as a regular member of the above referenced advisory committee. Your appointment will expire on August 31, 1985, or at such time as the Board reappoints you or appoints your successor. As with any ancillary group, the primary purpose is to assist and advise the Board of County Commissioners. By law, however, the ultimate deci- sions rest with the Commission. At times, the Commission' s decison may not reflect the recommendation of the advisory group because of the many facts which must be taken into consideration. By copy of this letter, we are requesting Mr. Neil Dorrill, Public Safety Administrator, provide you with you with any pertinent information you will need as a member of this committee. Words cannot express our appreciation for your willingness to serve the residents of Collier County in this capacity. We feel you will do a commendable job. Sincerel , C R. "Russ" Wimer Chairman cc: W. Neil Dorrill, Public Safety Administrator