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Minutes 01/17/1983 MEMO TO: EMSAC MEMBERS FROM: W. Neil Dorrill , Public Safety Administrator DATE: January 17 , 1983 SUBJECT: Minutes of Meeting In accompaniment, please find copy of the Minutes from the regular meeting of January 11 , 1983 . Please review these in order that they can be adopted at the next meeting to be held on Thursday, February 10, 1983, at 4 :00 P.M. in the 5th Floor Conference Room. Please note that the meeting day for the EMSAC has been changed from the second Tuesday of the month to the second THURSDAY of the month. WND/bm cc : C. W. Norman, County Manager File 14-D Naples, Florida January 11 1983 • LET IT BE REMEMBERED, that the Emergency Medical Services Advisory Council met on this date at 4 :06 P.M. in the 5th Floor Conference Room, Building "F" of the Courthouse Complex with the following members as indicated below: CHAIRMAN: Egon Hill MEMBERS: Dr. Hanns Erhardt Sgt. Richard Davidson (Excused) Chief Jim Billman (Absent) Mr. David Graham (Absent) Mr. Marvin Cecil Mr. W.H. "Biff" Comte Mr. Richard Aikin (Absent) Mr. Wm. Shaughnessy Mr. Jonathan Smelko EX-OFFICIO MEMBERS : Chief Norris Ijams (Absent) Dr. John Adams for Dr. Wm. Cox C.G. Whidden for (Excused) Sheriff Rogers STAFF ADVISORS: Dr. John Adams Douglas Greenfield (Excused) Dr. Robert Tober (Absent) W. Neil Dorrill ALSO PRESENT: "Skip" Camp for Doug Greenfield, Ann Foster, Health Department, Jack Wampler, EMS Billing, and Billie Moyer. AGENDA I . Roll Call II . Reading and/or approval of minutes a) Regular meeting of December 14 , 1982 III . Advisors Reports IV. Old Business V. New Business VI. Adjourn EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL January 11, 1983 MINUTES APPROVED There being no additions or deletions, the Minutes of the meeting of the Emergency Medical Services Advisory Council held on December 14 , 1982 were approved as submitted. ADVISORS REPORTS DR. ADAMS TO RETIRE: Mr. Hill welcomed Ann Foster who was introduced to the Council by Dr . John Adams as his replacement in the Environmental Health Department when he retires within the next forty (40) days. EMS FACILITY APPROVED: Neil Dorrill advised that the request for approval of the new EMS facility had been approved by the Board of County Commis- sioners by a 3-2 vote , with Commissioner Holland and Commissioner Brown casting the descenting votes . COLLECTIONS UP: Mr. Wampler reported that the December collections amounted to $45, 839 and that the billings had been $66 ,411 , making the monthly percentage figure 62 . 6% and commented that the overall collections had "nudged up a little bit. " TIME-PAYMENTS: Mr. Hill said he had heard that arrangements had been made for people to pay in installments and asked Jack Wampler how this was handled. Mr. Wampler explained that usually through phone contact a system for payment is made with individuals after determining with them just what they think they will be able to handle and that no one pressures them to pay more than is reasonable . The patient is sent a statement each month and is expected to pay the amount agreed upon -2- EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL January 11 , 1983 some time during the next month. If a payment is missed, the com- puter printout will show "Payment Missed" and the person is then contacted to find out why. He reported that there are 126 people on time-payments at the present time and that the system is working out satisfactorily. REPORT ON NEW EMS FACILITY : Mr. Hill asked to hear more about the new EMS facility and was told by Mr. Dorrill that the proposed building will replace the cur- rent arrangement which resulted from problems arising during the transition from American Ambulance when we declined to take posession of the American Ambulance building. Mr . Dorrill stated that the current facility had been inadequate from the beginning, since the building is 25% the size which had been originally anticipated, which has ultimately resulted in the administrative office being located on Airport Road, the Billing Department being operated in a "closet" in Bldg "F" , supplies being stored in the helicopter hangar, a room in the Complex, and in a mini-storage house, with backup vehicles being stored practically unsecured behind the Motor Pool . Training is done on a "hit or miss" basis in an office which Dr. Tober has provided in the hospital and on occasion in a class-type room also at the hospital . 4�All in all, Mr. Dorrill said, "it has been a difficult situation at best. " Continuing, Mr. Dorrill said that what has been proposed in the preliminary design is 3 , 000 sq ft of administrative building which will house administrative office, billings operations, supply storage area, and during the busy time of the year when we normally provide an East Naples unit, it will also serve as an East Naples Substation. -3- EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL .January 11, 1983 He described the Lease as a 5-year Lease with an option to purchase, which will be renewable at the end of the initial 5-year term. The rate is fixed for 5 years and we can invoke our option to purchase the building for $220, 000 after the initial 6-month period. Total rent for the administration and storage building is about $1, 984 per month, which would mean we will require an additional $3, 000 rental allowance for this year, which Mr . Dorrill felt was "well worth it when you anticipate the benefits to be gained as a result of not having to run all over East Naples in order to conduct business . " Mr. Hill asked how much we would have to pay if we decide to purchase the building. Mr. Dorrill advised that it would require $220, 000 for the first year and the amount is adjustable thereafter based on the Miami Regional Index of Consumer Prices, which is based on an annual percentage increase or decrease, adding that it has been a long time however, since we have seen a decrease in the C.P. I . . The cost benefits , Mr. Dorrill said, would play out to be somewhere in the neighborhood of 10 years, which on the surface seems to indicate it would be better to buy the facility. However, as a result of a lack of working capital this year or forseeable in next year 's budget, it is probably better for us to lease at this time. We can use our option to buy at any time during the 10-year period. MEETING DAY CHANGED: Mr. Hill suggested that inasmuch as the Board of County Com- missioners had adopted to hold a meeting every Tuesday, which may prevent Mr. Dorrill from attending the EMSAC meeting, it would be wise to change the meeting day from every second Tuesday of the - 4 - EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL January 11, 1983 month to the second Thursday of the month. Everyone present was in agreement. TASK FORCE COMMITTEE: Mr. Hill advised there had, been a meeting of the sub-committee last week and that Dr . Elizabeth Handley had been added to the list of members . Since Dr. Handley has had much experience in this field, it was felt that her knowledge would be of great benefit. Mr . Dorrill was also invited to attend the next meeting to be held on January 17 , at 10 AM, in the office of Chief Ijams. Mr. Hill said he hoped the committee would come up with some kind of recom- mendation to present to the Board within the next 2-4 months . POOR ATTENDANCE: Mr . Hill expressed his disappointment in the attendance record of EMSAC members and asked to review the record to determine whether or not had unexcused absences three (3) times in a row which would have to be reported to the Board of County Commissioners. NEW BUSINESS SUGGESTION TO HOLD MEETINGS LESS OFTEN: Mr. Dorrill recommended that the EMSAC meet every other month, or even quarterly, basing his recommendation on the declining at- tendance and the lack of routine work for the Council to undertake. Mr. Dorrill also stated that this is the only citizen ' s ad-hoc com- mittee which reviews the ongoing operations of a public department or reviews and government operation to his knowledge . Advising that he was not attempting to be critical nor to remove the power or the weight of the EMSAC, but rather that he feels that since the County has taken over the service and it is now provided - 5 - EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL January 11, 1983 through a department as opposed to a contract provider, there is a question of whether or not there is enough work to attract and ne- cessitate the need for a monthly meeting requiring all members to attend. Mr. Hill felt that if meetings were limited to every 2 or 3 months we would lose touch and believed that what we have accom- plished thus far shows justification of holding the monthly meetings. Mr. Hill added that he feels very much a part of what EMS means and advised he will talk to the Commissioners about finding replace- ments for those who are not interested in being here once a month since he feels sure there is an unlimited number of persons available Dr. Adams recalled that the suggestion of holding meetings on a quarterly basis was enforced when the old Advisory Council was in operation and felt that this was the reason for the dissolution. Marvin Cecil mentioned that the EMSAC offered a forum for the problems which arise and offers difinitive guidelines for the County to use. He was of the opinion that unless meetings were held monthly the council would disintegrate. Dr. Erhardt suggested that we should have time to think it over but that the council should request attendance from the members be- their absence is degrading . ADJOURNMENT There being no further business to come before the council, the meeting was adjourned at 4 : 30 PM. Egon Hill , Chairman Minutes prepared by Billie Moyer - 6 - i M E M O R A N D U M TO: EMSAC FROM: DOUG GREENFIELD SUBJ: IMMOKALEE STATS FOR ONE QUARTER OF 1982 DATE: JANUARY 26, 1983 Sir: Here for your perusal are the computer statistics relative to the Immokalee zone of our EMS Operations. As your special committee requested, I randomly selected a recent quarter for my report analysis. I hope this information will aid you in your efforts to more clearly understand one of our more well defined but poorly fee supported service areas in this vast countywide system. IMMOKALEE STATS FOR SEPTEMBER, OCTOBER & NOVEMBER 09/82 10/82 11/82 Total runs in Immokalee 163 204 179 Total transports from Immokalee 80 94 59 Cancelled runs in Immokalee 83 110 120 Non-Emergency transports 2 3 3 Basic life support transports 40 59 29 Advanced life support transports 38 32 27 % of runs using Advanced life support 23% 16% 15% % of transports using advanced life support48% 34% 46% % Runs using basic life support 25% 29% 16% % of transports using basic life support 50% 63% 49% % of runs cancelled (requiring no x-port) 51% 54% 67% Billed $19,289 $20,212 $18,719 % Collected 12% 10% 15% Primary collection mode Medicaid Medicaid Medicaid If you have any questions , please contact this office. Respectfully, �� r alb l,i �.�',�`�i J I,T k. 'ill' I , Doug G'^eenfield Director df E.M.S. DG:mcg .,107 ON THE ,0 V/ '..,i`.T,1 GULF 11 y .. W10 94/174,4,k , 735 EIGHTH STREET,SOUTH -NAPLES, FLORIDA 33940 DEPARTMENT OF FIRE , January 28, 1983 c Dear Committee Member: Our next Task Force Committee is scheduled for Monday, February 7 , 1983, at 10: 00 A.M. in the Fire Department '.; Conference Room. N I know we are in agreement on the importance of our mission and the &mount of work involved to reach objective recommendations. a, a Due to concerns expressed by members of the County Commission, it would appear,va►e are involved to a greater degree than we first realized. It is of concern to me that t ' : since we have accepted this responsibility that we must give our very best to insure a complete job being accomplished. As in any small committee attendance and particpation by it' s members is a must, so that we will all benefit from each others ' experience. Then, we will be able to reach and make good solid recommendations. The information in this packet was requested by Dr. Handley and Dr. Ehrhadt at ,our last meeting so that we can have a better understanding of the service and to begin putting together - the total picture. Doug Greenfield has provided us with this .; nornatior and • at the last meeting willingly spoke a couple of hours with the ii Committee providing information and insight into the present service. This information is virtually impossible to relay to all members except by participation during the meetings. , 4 : as r Page 2 January 28, 1983 4 If there is any way possible to adjust our busy schedules to accommodate our next meeting on February 7th, and subsequent meetings; We really need your input and guidance. Looking forward to seeing you on the 7th. Sincerely, N ris Ijams, Fire Chief NI:se xc: Mr. Smelko • Dr. Handley k Dr. Ehrhard - t Mr. Cecil ✓ file ( 3 ) r Wi r f i i 1.a Y1 i1: i `` �r. r Syr Li