Minutes 07/28/1999 EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL
(EMSAC)
INFORMAL MINUTES
July 28, 1999
2:00 P.M.
Emergency Medical Services Headquarters
3301 East Tamiami Trail
Council Members: Bob Laird Absent: J.P. Gunther-Mohr
Mike Davis
Roger Evans
Gary Young
Gail Dolan
George Leamon
Others: Chief Flagg
Operations Chief Page
Commander Aguilera
Kelly Daly
The regular monthly meeting of the Collier County EMSAC committee was called to
order at 2:00 P.M. on Wednesday July 29, 1999 by Chairman Bob Laird.
There was a discussion reference the May 26, 1999 minutes. Kelly Daly, Naples
Community Hospital was in attendance and requested a correction made to the minutes
reference Naples Community Hospital, DOR and the revenue.
The minutes as distributed stated:
OLD BUSINESS: "Chief Page stated they have not reached an agreement as to what is
billable to the hospital and what should be billed to Medicare. There is over half a million
dollars in transports that DOR has billed either correctly or incorrectly to NCH, and NCH
is refusing to pay all of it, even the ones they know they are responsible for. As of now a.
letter was sent to NCH asking them to pay the revenue that they know they are
responsible for."
In a letter from Edward Morton, Executive Vice President of NCH he is requesting the
minutes reflect:
The NCH Healthcare System has had no discussions directly with Chief Page or Collier
County EMS staff. NCH was directed to deal with the Collier County Department of
Revenue Director John Yonkosky and Division Administrator Leo Ochs.
The NCH Healthcare System has never refused to pay what is due. However what
precisely is due is the point of contention. NCH had made numerous lump sum payments
at the county's request before an audit was complete. The NCH Healthcare System
contends that it has been billed improperly, overpaid and that a refund is due.
Chief Page stated what is printed is what he said and that information was provided to him
by DOR and Leo Ochs.
Kelly Daly stated the minutes could he amended. She did not want the minutes to reflect
that NCH was refusing to pay, she stated that was not true.
Mike Davis made a motion the minutes he approved as submitted with the letter supplied
by Naples Community Hospital as an attachment to those minutes. Second by Gary
Young. Motion passed.
OLD BUSINESS:
Mike Davis inquired about the Department of Revenue and the letter that was sent.
Chief Flagg stated EMS paid to hire a consultant to review the billing and collection
process. The consultant identified several issues including defined business practices. A
review of the NCH issue, to determine if NCH has been billed correctly is being
conducted. Chief Flagg has been asked to lead in a resolution.
DOR currently does the billing for EMS at a cost of more than $200,000. They requested
an increase of 26.55% in FY2000, bringing their cost to $248,800 for this coming year.
Mike Davis inquired if out source is the answer, what would happen to the existing
accounts?
Chief Flagg stated, if the decision is made to out source the collections, the existing
accounts on the books could also be managed by the company selected.
Chief Flagg stated Chief Page and Kelly Daly are working to resolve the transport bills in
question.
Chief Page was under the impressions, talking to John Yonkosky, if there was a situation
where they had billed inappropriately, they had up to 18 months to bill.
Kelly Daly stated you have to the end of the calendar year following the date of service to
bill Medicare. If someone had services in February 1998, you only have until 12/3 1/99. If
you wait until January, 2000, you can't bill any of 1998. You can say it is eighteen
months, but it is really the end of the calendar year following the date of service.
Chief Flagg stated she hopes to have this review completed in three weeks.
Mike Davis requested if money has been lost due to not being billed when they should
have been billed he would like to see what that amount would be. He would like to make
a motion that the Board be apprised of that when the information becomes available.
Seconded by Bob Laird. Motion passed.
Roger Evans requested a report from Chief Flagg at the next meeting.
Gary Young inquired when the consultants evaluation will be completed and if an RFP will
be sent. Chief Flagg stated the consultants report is complete. The Board can have copies
if requested. No -final conclusion was submitted. If billing &. collection is to be out
sourced, the commencement would probably be October 1, 1999.
NEW BUSINESS:
Chairman Laird commented on the newspaper article reference the AED's. He also stated
Chief Flagg will be the speaker at the Sunset Rotary August 5, 1999. She will speak on
the "Overview of EMS".
Gary Young commented on how user friendly the AED machine is. Commander Aguilera
gave a brief demonstration on the AED. The department has over 60 of the AED's placed
in the community with over 1,000 people trained. He stated a local foundation donated
over $50,000 which amounts to over 17 machines. The cost of each machine is
approximately $3,000.
Mike Davis inquired if a program is ongoing to educate and to place the AED in the new
golf course communities. Lt. Matthew Vila is the coordinator for the continuing
education.
Operations Chief Page informed the Board Chief Pilot Bolton has gone to part time status
and Mark Kennedy is the Acting Chief Pilot.
Chief Page has also been working with Chief Tobin and Jim Webb in starting the ALS
engine program within the next few months. North Naples looks real promising, we have
tentatively agreed to have a three member team at the Station 40 and the Pelican Bay
Station one hundred percent of the time and staff the other North Naples Fire stations with
three member teams, subject to minimum manning. The City of Naples has indicated the
are looking at putting up the second ALS engine.
Chief Page informed the Board of the office re-arrangement that is taking place. Barbara
Brown and Chief Page will he moving into new offices to make room for the AED
coordinator and a secretary. Naples Community Hospital will be providing the AED
coordinator a secretary, and a vehicle to drive.
Gated communities have been informed they have 180 days to comply to the new
ordinance. All gated communities will now be equipped with remote frequencies so all
law enforcement, fire and EMS will have gate access openers.
A Captains testing for two positions will be coming up this next month, and we will be
starting a water rescue program in September.
At the August 3, 1999 Board meeting, Dino Villani, Chief of Florida State EMS, will be
presenting the 1999 Florida State Provider of the Year Award to Chief Flagg.
Gary Young inquired to the EMS position on speed humps. The Sheriff's Office informs
any interested parties, the speed bumps curtail the response times of EMS, fire & law
enforcement. Chief Flagg stated she gives the same response.
Commander Aguilera announced they are now using Lopresser or Mytropolol on cardiac
patients. We are the only service in the State of Florida that is using this.
Mike Davis announced he turned in his letter of resignation to Commissioner Mac'Kie
today and he gave a copy to Chairman Laird. He is planning to retire soon and will be
spending seven months of the year in Georgia.
Chief Flagg informed the group approximately a year ago a Commissioner requested a
City and County Chiefs Association be formed to provide planning from a county wide
perspective. They have been meeting for about the last six months. They are comprised
of Chief Boone from City of Marco, Chief Rambosk from City of Naples, Chief Tobin
from the fire districts, Captain Storrer from the Sheriffs Office and Chief Flagg from
Emergency Services. The goal is to plan emergency services programs consistently for the
entire county, in lieu of the multiple and varied programs based upon different boundaries.
They are working on a consistent approach to water rescue, hazardous materials, and
search and rescue.
Jim Webb, North Naples Fire congratulated the Emergency Medical Services on their
award.
Meeting adjourned.