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Minutes 07/10/1996 EMERGENCY MEDICAL SERVICE ADVISORY COUNCIL (EMSAC) INFORMAL MINUTES July 10, 1996 3:00 P.M. EMERGENCY MEDICAL SERVICES HEALTH BUILDING 3301 East Tamiami Trail Council Mike Davis Excused Members: Roger Evans Members: Chris Nind Rhona Saunders Sharon Hanlon Bob Schank Bob Laird Unexcused Members: Robert Margraf J.P. Gunther-Mohr Sheldon Reed Palma Fuson Joe Young Others: Diane B. Flagg John Yonkosky Vickie Lynch Leo Ochs Jeff Page Barbara Brown The regular monthly meeting of the Collier County EMSAC committee was called to order at 3:00 p.m. on Wednesday, July 13, 1996 by Joe Young, Chairman. Minutes of the June 12, 1996 meeting were approved. Proxy Vote Discussion: Sharlon Hanlon mention there was an ammendment to the by- laws in order to allow for a proxy vote. The question came up last year if you give your proxy to someone, do you tell them who you want to vote for or does the person receiving the proxy have the right to exercise their own option. Attorneys have advised Sharlon if the by-laws are silent that it is assumed the offeree can exercise their own option. The by- laws were officially adopted by the committee, but Chairman Young feels the by-laws need to be approved by the Board of Commissioners. Diane will check on this issue. If a proxy vote is to be used, it needs to be determined how it will be finalized. After a brief discussion it was decided the vote would come by a sealed written proxy and delivered to the EMS Director prior to the commencement of the regular scheduled meeting. A motion was made by Bob Laird to continue with the current wording. This motion passed by ascent. EMERGENCY MEDICAL SERVICES AGENDA August 14, 1996 3:00 PM CALL TO ORDER READING OF THE MINUTES 3:15 PM PRESENTATION BY FT. MYERS BILLING 3:25 PM QUESTIONS FROM EMSAC MEMBERS 3:40 PM PRESENTATION BY D.O.R. - John Yonkosky 4:00 PM QUESTIONS FROM EMSAC MEMBERS 4:15 PM REPORT FROM MEDICARE REIMBURSEMENT 4:30 PM MEMBERSHIP APPLICATION REVIEW 4:45 PM' MISCELLANEOUS BUSINESS Membership Application Review: Diane Flagg passed out the resume's of the two candidates that have applied for the District One vacancy; Dr. Fay Biles and Paula Camposano. There was one candidate for District Two vacancy; Mr. Paul Gunther-Mohr for re-appointment. There were no candidates for District Five. Chairman Young wanted the committee to know they can recommend any individual for a District position; however, the Board has the final say as to whom they will appoint. The individual cannot be a member of more than two committess appointed by the Board of County Commissioners. Chairman Young had a proxy vote from Rhona Saunders. After a review of both of the candidates a vote was taken. The results were; Paula Camposano - 5, Fay Biles - 3. The committee also recommended unaminously that J.P. Gunther-Mohr be re-appointed to the District Two position. EMS Billing Update: A conference call was made to Medicaid, with Roger Evans, Bob Shank, Therese Reisen, Vickie Lynch and John Yonkosky in attendance. Hicfa and Medicare told DOR that they will split the process for raising the fee for DOR. They will allow DOR to increase the reimbursement for two of the catageorys because DOR never had a standard amount set for those two procedures, and the other catageory they will probably not. DOR has the option to ask the Hicfa group to preform an audit. If they come down an preform the audit a couple of things could happen. They could say DOR has been doing something wrong and might fine the county, they may say no they aren't going to increase the rate at all, and they might increase the rate, but they have told us that the possibility of doing this is just not very good. They are meeting this Friday at 10:00 A.M. and will be making a recommendation to the EMSAC committee. In reference to requesting an audit, the committee is concerned because it immediately trigger a request from Medicare to provide them with six of the 330 categorys, which is one of the non-emergency catageorys. All of the six they requested were bonafide emergencies. DOR felt there was a corolation between the reqest and the two conference calls. John's impression from Medicare after the conference call was that they will only increase the rate for the two categorys that we not had a reimbursably amount from them. John handed out a Ambulance Billing report that showed $36,100 shortfall on 6/30/96. July collections were $184,350. At this point the department is in the black, and by the end of the July should show $60,000 to the good. Cash has been caught up. Billings are not caught up as yet, but going into the slow season of 30 transports a day the billing should be caught up in approximately 2 weeks. Trip Tickets are being picked up daily with Certificate of Medical Necessity attached. Chairman Young questioned the $418,000 reported as shortfall back to 1995. Mr. Yonkosky said he was:anticipating collecting $300,000. $200,000 will show up in this FY 96 and $100,000 will show up as revenue in FY 97. Collection percentage for the National Average is 69 to 70%. John would like to have a 71% • Miscellaneous Business: The ambulance station at 4th Avenue North will move to 8th Street and the new station will be located at 26th Avenue North. They will both be housed in City of Naples Fire Departments. A three member team will also be in effect. According to the time of response from trip ticket documentation there was a greater need for an ambulance in the City of Naples area than in the Bonita Shores area. The Medic 12 station is within the budget with a donation from GAC of$50,000. Mike Davis brought up a motion that was made at the last meeting to give the Department of Revenue and an informal presentation by Ambulance Billing Medical 20 minutes each to make a presentation of their billing procedures. He thought the presentations were to be at the July meeting. Leo Ochs asked for a postponement so up to date and accurate information could be presented. It was decided that the group could now go ahead with the presentations. They will be scheduled for the August meeting. Meeting adjourned EMERGENCY MEDICAL SERVICE ADVISORY COUNCIL (EMSAC) INFORMAL MINUTES July 10, 1996 3:00 P.M. EMERGENCY MEDICAL SERVICES HEALTH BUILDING 3301 East Tamiami Trail Council Mike Davis Excused Members: Roger Evans Members: Chris Nind Rhona Saunders Sharon Hanlon Bob Schank Bob Laird Unexcused Members: Robert Margraf J.P. Gunther-Mohr Sheldon Reed Palma Fuson Joe Young Others: Diane B. Flagg John Yonkosky Vickie Lynch Leo Ochs Jeff Page Barbara Brown The regular monthly meeting of the Collier County EMSAC committee was called to order at 3:00 p.m. on Wednesday, July 13, 1996 by Joe Young, Chairman. Minutes of the June 12, 1996 meeting were approved. Proxy Vote Discussion: Sharlon Hanlon mention there was an ammendment to the by- laws in order to allow for a proxy vote. The question came up last year if you give your proxy to someone, do you tell them who you want to vote for or does the person receiving the proxy have the right to exercise their own option. Attorneys have advised Sharlon if the by-laws are silent that it is assumed the offeree can exercise their own option. The by- laws were officially adopted by the committee, but Chairman Young feels the by-laws need to be approved by the Board of Commissioners. Diane will check on this issue. If a proxy vote is to be used, it needs to be determined how it will be finalized. After a brief discussion it was decided the vote would come by a sealed written proxy and delivered to the EMS Director prior to the commencement of the regular scheduled meeting. A motion was made by Bob Laird to continue with the current wording. This motion passed by ascent. Membership Application Review: Diane Flagg passed out the resume's of the two candidates that have applied for the District One vacancy; Dr. Fay Biles and Paula Camposano. There was one candidate for District Two vacancy; Mr. Paul Gunther-Mohr for re-appointment. There were no candidates for District Five. Chairman Young wanted the committee to know they can recommend any individual for a District position; however, the Board has the final say as to whom they will appoint. The individual cannot be a member of more than two committess appointed by the Board of County Commissioners. Chairman Young had a proxy vote from Rhona Saunders. After a review of both of the candidates a vote was taken. The results were; Paula Camposano - 5, Fay Biles - 3. The committee also recommended unaminously that J.P. Gunther-Mohr be re-appointed to the District Two position. EMS Billing Update: A conference call was made to Medicaid, with Roger Evans, Bob Shank, Therese Reisen, Vickie Lynch and John Yonkosky in attendance. Hicfa and Medicare told DOR that they will split the process for raising the fee for DOR. They will allow DOR to increase the reimbursement for two of the catageorys because DOR never had a standard amount set for those two procedures, and the other catageory they will probably not. DOR has the option to ask the Hicfa group to preform an audit. If they come down an preform the audit a couple of things could happen. They could say DOR has been doing something wrong and might fine the county, they may say no they aren't going to increase the rate at all, and they might increase the rate, but they have told us that the possibility of doing this is just not very good. They are meeting this Friday at 10:00 A.M. and will be making a recommendation to the EMSAC committee. In reference to requesting an audit, the committee is concerned because it immediately trigger a request from Medicare to provide them with six of the 330 categorys, which is one of the non-emergency catageorys. All of the six they requested were bonafide emergencies. DOR felt there was a corolation between the reqest and the two conference calls. John's impression from Medicare after the conference call was that they will only increase the rate for the two categorys that we not had a reimbursably amount from them. John handed out a Ambulance Billing report that showed $36,100 shortfall on 6/30/96. July collections were $184,350. At this point the department is in the black, and by the end of the July should show $60,000 to the good. Cash has been caught up. Billings are not caught up as yet, but going into the slow season of 30 transports a day the billing should be caught up in approximately 2 weeks. Trip Tickets are being picked up daily with Certificate of Medical Necessity attached. Chairman Young questioned the $418,000 reported as shortfall back to 1995. Mr. Yonkosky said he was'anticipating collecting $300,000. $200,000 will show up in this FY 96 and $100,000 will show up as revenue in FY 97. Collection percentage for the National Average is 69 to 70%. John would like to have a 71% . Miscellaneous Business: The ambulance station at 4th Avenue North will move to 8th Street and the new station will be located at 26th Avenue North. They will both be housed in City of Naples Fire Departments. A three member team will also be in effect. According to the time of response from trip ticket documentation there was a greater need for an ambulance in the City of Naples area than in the Bonita Shores area. The Medic 12 station is within the budget with a donation from GAC of$50,000. Mike Davis brought up a motion that was made at the last meeting to give the Department of Revenue and an informal presentation by Ambulance Billing Medical 20 minutes each to make a presentation of their billing procedures. He thought the presentations were to be at the July meeting. Leo Ochs asked for a postponement so up to date and accurate information could be presented. It was decided that the group could now go ahead with the presentations. They will be scheduled for the August meeting. Meeting adjourned