Minutes 03/25/1998 EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL
(EMSAC)
INFORMAL MINUTES
March 25, 1998
2:00 P.M.
EMERGENCY MEDICAL SERVICES HEADQUARTERS
3301 East Tamiami Trail
Council Members
Present: Bob Laird Excused: Rhona Saunders
Roger Evans Mike Davis
Paul Gunther Mohr
Gary Young
Gail Dolan
Leo Ochs
Chief Flagg Unexcused: George Leamon
John Yonkosky Commander Reed
Theresa Risen Fay Biles
Commander Rockey Tim Smith
Commander Page Chief Tobin
The regular monthly meeting of the Collier County EMSAC committee was called to
order at 2:00 P.M. on Wednesday, February 25, 1998 by Bob Laird, Chairman.
Roger Evans stated he had inquired where the liability for the new AED program resided,
and he thought the response initially was with the County. The minutes describe a lot
more detail with respect to it being a part of the Good Samaritan Act. He inquired if it
came under the County's general sovereign immunity and/or Good Samaritan.
Chief Flagg reported it falls under both. The personnel is the Good Samaritan, the training
is the County.
Roger Evans requested the minutes to reflect the personnel falls under the Good
Samaritan Act, and the training falls under the County's sovereign immunity.
With no further corrections motion was made and 2nd to except the minutes of the
February 25, 1998 meeting. Motion passed.
OLD BUSINESS
Chief Flagg handed out the update of the EMS Salary Review and the Organizational
Data. The two primary issues was losing qualified people between the three and five year
time frame, going to other systems for higher compensation and benefits. The second
issue was being unable to recruit individuals into the system that were quality individuals.
Quality individuals were going to other systems. The County Commissioners have been
very supportive of the plan, and it was Mr. Ebben's recommendation, of the Productivity
Committee, to move forward immediately with the pay plan.
Mr. Paul Gunther-Mohr remarked on the vast difference of the pay plans with other cities
and wanted to know if the benefits were comparable or not? Chief Flagg stated they are
not, but they were not taken into consideration.
Chief Flagg reported on the community AED Program. That program is in the final stages
in terms of writing the Instructor Course. The National American Heart Association is
waiting for Collier County EMS to implement this course. They will use it to model AED
courses across the nation. The Ordinance is scheduled to go before the Board, May 12`h.
After is goes before the Board, EMS will begin placing AED throughout the community
and training people on how to use them.
NEW BUSINESS
Leo Ochs stated Mr. Yonkosky had a brief presentation on the ambulance billing for Fiscal
Year 99.
Mr. Yonkosky stated the current ambulance rate is $302 with no mileage rate. The
funding options he handed out went over the different options with different mileage
charges with a 7 mile cap. Mr. Yonkosky explained on the "Fee Screen" hand out the
mileage that Medicare will give 80% of is $4.16 per mile. For our locality, there are seven
counties in our locality, the customary charge is $6.00 per mile. Five of the seven counties
in our locality charge mileage. The base rate in our locality range from $285 to $342.
Mr. Yonkosky stated the recent trend shows Medicare as a percentage of transports is
dropping. He will be doing another 6 month comparison to see how the percentage
figures for the next six months. For some reason he feels the revenue stream is changing
and may have an impact on how the rates are to be figured in the future.
A discussion followed on the impact of Medicaid and their future payment schedule.
Leo Ochs informed the committee the recommendation at the staff level, to the Board of
County Commissioners, would be Option #3, User fees of$300 with a $5 per mile charge
and a 7 mile cap.
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Chief Flagg informed the committee the projected FY99 budget would be $10,000,000
and the Funding Options that Mr. Yonkosky provided the group were the different
options that had been looked at. Providing the Board accepts everything that is being
recommending, placement of a unit in Golden Gate Estates, placement of a unit at Isles of
Capri, the pay plan adjustment and the special risk, the projected budget of FY99 will be
$10,000,000.
Chief Flagg stated the general public has.some concern that they do not receive a bill when
the Sheriff shows up, they do not receive a bill when the Fire Department shows up, their
concern is why do they receive a bill when EMS shows up.
North Naples Fire Department is telling North Naples if their fire department provides
service to their district, they will not receive a bill. In reality, they won't receive a bill,
because they are paying twice as much in their taxes. In North Naples through their taxes
they are paying a $100 per year. If we didn't send a bill they would be paying $49 a year.
Chairman Laird wanted to bring up new member Chief Tobin has missed two unexcused
meetings, and the executive committee can make recommendations that they be removed
from the membership. I am making that motion_ Gail Dolan asked if he shouldn't be
talked to before removing. Chairman Laird mention that the first meeting he was to attend
he sent a substitute, Mr. Orly Stolts, he was given a copy of the rules and regulations.
Gary Young inquire to Chief Tobin's position. Chairman Laird stated he is on the Board
as President of the Collier County Fire Chief's Association. He also stated, he has missed
three meetings if you count the meeting he sent someone. Roger Evans stated the
distinction is, is it the organization or the person. Chairman Laird stated the by-laws state
the President of the Collier County Fire Chief's Association as an ex-officio non voting
member. Gary Young stated maybe a letter should be sent and explain that if he cannot
attend he needed to send a representative. Gail Dolan suggested Chairman Laird call him
and explain. Chairman Laird stated he went into detail with Mr. Stolts and felt that was
sufficient. In the past the Fire Chief's tried to attend the meetings. Roger Evans pointed
out the by-laws state the President of the Fire Chief's Association is an ex-officio non
voting member. Then it states if three meetings in a year are missed they may be replaced.
He suggested the Chairman talk with the Chief and tell him he has to attend, in the
meantime he recommended a statement be made in the by-laws that either or should
attend. It was Chairman Laird's understanding if he were removed, there would be no
representation from the Fire Chief's Association, until a new president is elected. It was
Chairman's Laird recommendation a letter be sent to the County Commissioners for their
recommendation. Gary Young recommended a letter be sent to the Commission saying
we have a member who doesn't show up and he is suppose to be here, please advise. Leo
Ochs, stated in that case they would refer you to your own by-laws. Chairman Laird
stated the by-laws have been approved by the Board of Commissioners. Chairman Laird
read from the by-laws, two unexcused consecutive or three unexcused total within one
year. We have had three missed meetings with two consecutive missed meetings and one
meeting with an alternate. Gary Young stated if someone can't make a meeting all they
have to do, is pick up the telephone and call. Chairman Laird also brought up Mike
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Davis, as he wanted a regular meeting date in lieu of a changing one so he could attend the
meetings, and he is not in attendance, however, he was excused.
Chairman Laird brought up the recent article in the newspaper. The Commission has been
asked to consider a Public Safety Division. Chairman Laird was under the impression that
Chief Flagg did this and he did not understand what he was doing. He asked Chief Flagg
if this was something they should get into as the Advisory Council. Chief Flagg, did not
know. Leo Ochs stated the right now there are four operating division that report to the
County Administrator. The proposal was to create a fifth division of Public Safety as part
of larger re-organization plan. That is where it was left, he has no other information. He
has no idea when it will go back before the Commission.
Chairman Laird went back to the Fire Chiefs absenteeism and the motion he had made.
Gary Young asked, if he wanted to write a letter to him. Chairman Laird stated he did not
want to write a letter to the Chief, he would to write a letter to the Commissioners. Gary
Young stated he would second it. Roger Evans asked if the letter to the Commissioners
was to ask for their recommendation as to what to do? Chairman Laird stated he would
recommend termination pending the Commissioners recommendation. Motion passed,
four vote's approving with one dissenting vote.
Chief Flagg wanted to inform the committee that the partnership program EMS has been
doing started in Everglades City, three years ago it was started in Marco, and a year ago it
started in the City of Naples. The partnership consists of instead of both a medic unit and
a fire truck going to a 911 call, one of the firefighters ride on a medic unit and just the
medic unit goes on a 911 call. That program has worked out very well, it has been very
successful and the community has been very receptive to it. One of the reasons for this
partnership was to eliminate the duplication of two emergency vehicles, one that is not
designed to respond to medical calls to leave in the station to respond to fire calls, and
send the medic unit with the fire fighter on it. This also reduces cost by sending only one
unit. The fire fighter and the two paramedics work well together as a part of the team.
The other advantage is with the two people in the back of the medic unit taking care of the
patient you enhance the level of patient care as opposed to the current staffing which is
one. Chief Rambosk has been working with Chief Flagg the last few months to do an
augmentation to that program. The City of Naples would still continue to do the single
vehicle response, one call one vehicle, but there is probably less than 10% of their time,
we have two medic units in the city, one at each of the fire stations. Less thank 10% of
the time the primary unit is already on a call and then another 911 call comes in, so a
program that I am going to meet with the City Manager and the County Administrator,
and Chief Rambosk are going to sit down and discuss another program where we continue
to do one call, one vehicle, but in the second program we take one of our crossed trained
paramedics, and place them on one of their pumpers and taking one of their people who is
crossed trained, a firefighter/paramedic, and put them on a medic unit to work under a
EMS Lieutenant who will then train them. We have exchanged people and enhanced
service. The only time the secondary unit would take effect would be if the primary unit
was out. Again, that is less than 10% of the time. The advantage of this program is you
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are utilizing existing resources to enhance the level of services to the community. This
program has the approval of the City Manager it has to be approved by the County
Administrator and then the respective Boards.
Chief Flagg informed the group, it came to her attention, Chief Tobin, Fire Chief of North
Naples has picked a group of Advisory Board members to serve as the North Naples Fire
Control Rescue District. These seven individuals have written to the Board of County
Commissioners, as a representative of the position they hold, that they support the North
Naples Fire Control and Rescue District in providing paramedics on their fire companies.
They are requesting a Certificate of Need for paramedic service in North Naples.
Meeting Adjourned
pectfully submitted
Barbara Brown, EMS Secretary
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