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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.