Loading...
Minutes 12/17/1997 EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL (EMSAC) INFORMAL MINUTES December 17, 1997 1:30 P.M. EMERGENCY MEDICAL SERVICES HEADQUARTERS 3301 East Tamiami Trail Council Members: Bob Laird Excused Members: Gary Young Fay Biles J.P. Gunther-Mohr Rhona Saunders Sheldon Reed Palma Fuson Bob Schank George Leamon Others: Bob Fernandez Leo Ochs Diane B. Flagg Jeff Page John Yonkosky Theresa Reisen The regular monthly meeting of the Collier County EMSAC committee was called to order at 1:30 P.M. on Wednesday, December 17, 1997 by Bob Laird, Chairman. Fay Biles made a motion to accept the minutes. Commander Reed requested to amend the minutes from November 24, meeting. The minutes stated Chief Jim Tobin would be attending the EMSAC meeting as the elected President of the North Naples Fire Commission. Chief Tobin will be attending the EMSAC meeting as the elected President of the Collier Fire Chief's Association. Fay Biles amended the motion for the minutes to be accepted with the correction included. Rhona Saunders seconded the motion. Minutes were accepted. • • Chief Bob Schank expressed his appreciation, as President of the Collier Fire Chief Association, for the opportunity to serve on the EMSAC Board. This is one of the most aggressive board's he has seen, and he would like to again state that the EMS service in this county is second to none in the State of Florida. NEW BUSINESS: Chairman Laird inquired as to the medic who handled the accident on Saturday night, involving Deputy Joe Jones. Chief Flagg informed the committee Captain Ortega was the medic on scene. Chief Flagg reported there has been an enormous increase in fatalities in a short period of time, than she could recall in the past. This can be attribute this to the holidays and also the tremendous increase in traffic this year. Gordon River Bridge: Chief Flagg reported she had met with Chief Rambosk and they are looking at additional options such as pre-exemption devices. A pre-exemption device is a device that is used on the siren of the ambulance. When the emergency vehicle approaches an intersection a certain mode is used that changes the light to green in the direction they are traveling, and it changes the light to red in all other directions. It allows the traffic pattern to flow through.the intersection in the direction the ambulance is traveling. Another option would be to put additional officers at the bridge. The emergency vehicles would have radio contact with the officer, letting the officer know the direction they are approaching and the estimated time of arrival to the location. We are expecting a much higher volume of traffic this coming season, which will result in more traffic accidents. Fay Biles wanted to know if this information, in statistical form, had been given to the Collier County Commissioners and FOCUS. Chief Flagg stated the Collier County Commissioners had received the AIUR (Ambulance Inventory Update Report). This report reflects the population update projections and the capital needs to meet the population. Based on the Growth Management plan the EMS organization is running at a deficit of one unit. It was recommended a unit be placed in Golden Gate Estates this past October. That unit was not approved, so we will see that area stressed heavily this year. When we prepare the budget for the next Fiscal Year we will recommend that unit for the Estates area, plus another unit. Chief Flagg said she would provide a copy of the AIUR report to be sent with the minutes. Chief Flagg informed the group Commander's Epright and Rockey have developed information in regards to salary and benefit's and as the information progresses further she will come to the group with more information. Chairman Laird wanted the committee to know Commander Wilson did a presentation for the Rotary Club last week and he did a fantastic job. County Administrator Bob Fernandez asked the group if they had taken a position on Special Risk Legislation? Chief Flagg explained the Special Risk Legislation. Law Enforcement Officers, & Fire Fighters receive approximately 50% more benefits in retirement than the Paramedics receive, even though they all work together on the same scene and do the same activities. Special Risk came to be many years ago, when Paramedic's were not actually a profession. The Paramedic has only become a profession in the career field in the last 20 years. The medics work daily with increased exposure to HIV and Aids. The Collier County Commissioners will be asked in the future to pass a resolution of support for the Special Risk for the Paramedics. Chief Flagg also stated EMS would certainly appreciate the Advisory Board's support of this legislation. Commission Hancock is in support of the Special Risk. Ultimately it takes approval from the Florida legislature. Many counties have passed resolution of support and sent these to the Florida Legislature. County Administrator Fernandez informed the Advisory Board the employee makes no contribution to the State towards retirement. This is all paid by the counties and the state. The difference the county would pay between an employee without special risk and one that is with the special risk is about I 1%. The County Administrator is of the opinion if an employee is exposed to the dangers of high risk, they should receive the special risk benefits. Commander Reed stated the Naples Police and Emergency Services have a policy they do not certify anyone that is a firefighter in the State of Florida that smokes, or a user of tobacco. With the heart lung bill and the presumptions of cancer, and those types of risk, they have been very pro-active making sure the benefits go to who deserves them. Chief Flagg passed out a chart on Special Risk that had been compiled by Lt./Paramedic Walter Kopka, who has worked very diligently on getting this billed passed. He has contacted various counties to get their positions and impact. He was notified that Senator Campbell who is the Vice Chair of the Governmental Reform and Oversight Committee has agreed to sponsor the bill. This is the first committee the bill will go to. The bill will not need to go to a committee in the House, because it passed the House last year. It will go straight to the floor this year. Chief Flagg stated the EMS Department very much appreciates Commission Hancock and County Administrator Fernandez support. BUDGET: John Yonkosky passed out the Ambulance Billing Status Report. The biggest months for cash flow is January, February, March and April. It looks like we are $160,295 behind but in actuality we are ahead. We are on track from a cash flow perspective. From the billing portion , this is the eighth month we are below the Ordinance requirement in getting the bills out. The report from Medicare that will show whether Medicare will increase their reimbursement for- EMS services has not been received. It will be the end of January before the report is received. John Yonkosky will not make a recommendation for EMS Department rates until he know what the Medicare reimbursement rates will be. Fay Biles and Rhona Saunders both felt a PR statement needed to be released to inform the public the rates are no longer $1 200. County Administrator Bob Fernandez is under the impression that the actual cost for providing the service is essentially written down by the amount of ad valorem support. There is a decision made every year of how much of the cost is paid through taxes and how much is paid directly thought the charges we levy. Some counties have made the decision to set the charges higher, to more accurately reflect what it actually costs to provide the services. So the amount of taxes that go to the service are minimized. Medicare payments are maximized with the theory that most will be eligible. The problem is with those who are not eligible. Chief Flagg, explained several years ago that community members went to the County Commissioners over the high cost of the ambulance bills. There was very strong support to getting no bill at all, and being totally supported by Ad Valorem dollars as the other public safety agencies are specifically police and fire departments. There was also support to utilize insurance dollars. At that time Medicare reimbursement was $200, the bill was for $250 and the patient was billed for $50.00. Since that time the fee charged to patients has gone from $250 to $302. Medicare still reimburses $200 but may increase the amount to some other number and we will not know until January. John Yonkosky stated a fee of$250 was set on September 27, 1994. At that time they were 9 months into the eighteen month cycle. The fee increased to $302 in June of 1996. Leo Ochs wanted the committee to understand there are agencies within our Medicare region that are receiving a higher reimbursement than we are. John suggested that the committee consider taking the cost of living increase every year and add that on to the fee, that way you maintain maximizing the revenue from Medicare. Medicare only represents 40% of our total revenue. Leo Ochs informed the committee ola recent Medicaid audit of the Department of Revenue. He asked John Yonkosky to explain the audit to the committee. John informed the committee Medicaid came in and went over a random sampling of trip tickets. Their audit covers a period from 2/1/93 to 2/1/97. They presented an unwritten demand for • $280,000 in overpayments. Three of our Paramedics were asked by the Department of Revenue to, using the same criteria, perform a separate audit and based on Medicaid's criteria, the Paramedic's felt the overpayment should be $130,000. Medicaid disagreed with the level of service; example Medicaid felt that a child with a severely severed thumb should not be a transport, they could have gone by private vehicle. After several discussions, between DOR, County Attorney's Office and Medicaid, $160,000 payable over a three year period with no interest was agreeable to all parties. When this agreement is signed by the Board a $30,000 payment will be made and $10,000 every other month until full payment. This will be presented to the Board on January 13, 1998. The committee expressed their "thanks" for the Christmas luncheon. The meeting adjourned. Respectfully submitted, Barbara Brown