Agenda 12/16/2008 Item #16F 2
Agenda Item No. 16F2
December 16, 2008
Page 1 of 14
EXECUTIVE SUMMARY
Recommendation to approve a Certificate of Public Convenience and Necessity for the
Collier County Emergency Medical Services Department.
OBJECTIVE: That the Board of County Commissioners approve the renewal of the Certificate
of Public Convenience and Necessity ("Certificate") for the Collier County Emergency Medical
Services Department and authorize the Chairman to execute the pennit and certificate.
CONSIDERATIONS: Collier County Emergency Medical Services is currently operating
under a Certificate. Collier County Ordinance No. 04-12, as amended requires that Collier
County Emergency Medical Services renew its original Certificate each year.
In addition, renewals are based on the same standards as the granting of the original Certificate.
Therefore, the requirements for Board of County Commissioners approval in granting
certificates, as set forth in the Collier County Ordinance No. 04-12, as amended, Section 5, are
provided and are specifically addressed in the attached memorandum from the EMS Chief.
Furthermore, Collier County Ordinance No. 04-12, as amended, Section 10 does not require a
hearing for the Board of County Commissioners to consider the renewal Ccrtifieate allowing it to
be approved routinely by the Board of County Commissioners upon advice of the Administrator.
-
In accordance with Collier County Ordinance No. 04-12, as anlended, Section 10, the Director of
the Bureau of Emergency Services Division recommends approval based on his finding that
there is a public necessity for EMS to provide the service based on the factors set forth therein.
FISCAL IMPACT: There is no fiscal impact associated with this action.
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated
with this action.
LEGAL CONSIDERA nONS: The Permit and renewal Certificate have been signed for
legally sufficiency. Although this itcm is quasi-judicial, ex parte disclosure is only required
should there be a hearing on the item (i.e. the item is moved to the Board's regular agenda for
consideration). This item requires a m~ority vote only. - JAB
RECOMMENDATION: That the Board of County Commissioners:
1. Accept the Director of the Bureau of Emergency Services Division's finding of public
necessity;
2. Approve and authorize tbe Chaimlan to execute the Emergency Services Pemlit #1 and
the renewal of the Certificate of Public Convenience and Necessity for the ColIier
County Emergency Medical Services Department.
Prepared by: Artie Bay, Supervisor - Accounting, Emergency Medical Services
'..<._'_~'N'_
Page I of I
Agenda Item No. 16F2
December 16. 2008
Page 2 of 14
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
Item Number:
16F2
Item Summary:
This item requires that all participants be sworn in and ex parte disclosure be provided by
Commission members Recommendation to approve a Certificate of Public Convenience and
Necessity for the Collier County Emergency Medical Services Department
Meeting Date:
12/16120089:0000 AM
Prepared By
Artie Bay
Senior Administrative Assistant
Date
Bureau of Emergency
Services
EMS
121212008 4:28:43 PM
Approved By
Jeff Page
Bureau of Emergency
Services
EMS Chief
Date
EMS
1213/20088:50 AM
Approved By
Jennifer A. Belpedio
County Attorney
Assistant County Attorney
County Attorney Office
Date
121312008 1 :21 PM
ApprO\!ed By
Dan E. Summers
BUf€.au of Emergency Services Director
Date
County Manager's Office
Bureau of Emergency Services
12/4120083:10 PM
Approved By
OMS Coordinator
Applications Ana!yst
Information Technology
Date
Administrative Services
1214/20084:29 PM
Approved 8y
Sherry Pryor
County Manager's Office
Management & Budget Analyst
Office of Management & Budget
Date
12151200810:43 AM
A pproved By
James V. Mudd
County Manager
Date
Board of County
Commissioners
County Manager's Office
1216/200812:13 PM
tile://C:\AgendaTest\Export\ 1 I 8-December%20 16,%202008\ I 6,%20CONSENT%20AGL.
121! 0/2008
Agenda Item No. 16;::2
December 16, 2008
Page 3 of 14
Memorandum
To:
James V. Mudd County Manager
From:
Jeff Page, Chief
Emergency Medical Services Department
Date:
November 19, 2008
Subject:
Certificate of Convenience and Necessity for Collier County
Emergency Medical Services Department
Per Collier County Ordinance Number 04-1 L please acccpt the following infomlation for
renewal of this required certificate:
1. Collier County Emergency Medical Services Department is operated by the County's
Board of County Commissioners located at:
3301 East Tamiami Trail. Building F
Naples, Florida. 34112
2. Collier County Emergency Medical Services Department provides service to the 2,032
square miles encompassing Collier County.
3. Collier County Emergency Medical Services Department has a total of fifty-nine (59)
State licensed vehicles. Thirty-five (35) of these are licensed ground transport vehicles
and one (I) medivac helicopter. There are also twenty-three (23) licensed ALS Engines
(non-transport). Of the above. Twenty-four (24) licensed ground transports. thirteen (13)
licensed ALS Engines and the medivac helicopter operate 24 hours and day, seven days a
week. One (I) additional ground transpOli licensed vehicle may operate 12 hours a day.
seven days a week (as needed) during the seasonal months and is taken out of the reserve
units. The remaining, ten (10) licensed ALS ground transpOli vehicles are held in
resen'c, \-vhile the ten (10) licensed j\LS Engines arc placed in service as staffing allows.
(Attachment A).
4. Collier County Emergency ~v1cdical Services Department has one 111all1 office and
p.;,.1..,,'-...."'''' (1 Q) C'"h....t.-,i-;on" 1"""-'1"".-1 th"''''''''''fh('''.+ t'oll;,~_I"'"..~t.. ~"l'l"_'p r-,",v-U'j'nG l"-Ji~q<-,','V--"-'
......bu~..........u \JU ..:>UVJlUll J.:'> H.'....Ul.....U lllluubll IUl '--_'--1111..-1 '---_.UUl1lJ..... ..... ILL ,,' b '-"'...... ....
Emergency Services Division
Headquarters
Station I
Station 2
Station 10
Station 21
Station 22
Station 23
Station 24
Station 30
Station 32
Station 40
Station 42
Station 43
Station 44
Station 46
Medic Res 50
Station 61
Station 70
Station 71
Station 75
Medic Res 90
ALS Eng 20
ALS Eng 44
ALS Eng 45
Med-Flightl
2705 S. Horseshoe Drive
835 8th Avenue South
977 26m Avenue
14756 Immokalee Road
11121 E. Tamiami Trail
4375 Bayshore Drive
7227 Isle of Capri Road
2795 Airport Road North
112 South 1 ,t
4819 Ave Maria Blvd.
1411 Pine Ridge Rd.
7010 Immokalee Road
16325 Vanderbilt Drive
766 Vanderbilt Beach Road
3010 Pine Ridge Road
1280 San Marco Road.
201 Buckner Avenue
4741 Golden Gate Parkway
95 13m Street SW
4590 Santa Barbara Blvd.
175 Isle of Capri Road
4798 Davis Boulevard
8970 Hammock Oak Drive
1885 Veterans Park Drive
2375 Tower Drive
Agenda Item No. 16F2
December 16, 2008
Page 4 of 14
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Immokalee, Florida
Ave Maria, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Everglades, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
Naples, Florida
5. Collier County Emergency Medical Services Department has been licensed and certified
to provide Advanced Life Support ambulance scrvice in Collier County since Aplil 6,
1981.
6.
Three (3) Collier County residents to act as references:
Dr. Douglas Lee 2614 Tamiami Trail, #255
Nancy Laschied 4500 Gulfshore Blvd. N. - #903
Dr. James Hampton 823 Bentwood Drive
Naples, Florida 34110
Naples, Florida 34103
Naples, Florida 34108
7. Collier County Emergency Medical Services Department schedules of service fees
(Attachment B).
8. November 19, 2008 Memorandum from Dan Summers, Director of Bureau of Emergency
Services to County Manager Mudd stating no further information required.
9. Collier County Emergency Medical Services Department financial statement is available
in Collier County's Finance Department
Attachments
Emergency Services Division
..--'"-.-
/\genda Item r~o. 16F2
December 16. 2008
Page 5 of 14
COLLIER COUNTY FLORIDA
EMERGENCY SERVICES PERMIT #1
This Pennit Expires December 31, 2009
Name of Service:
Collier County Emereency Medical Services
Name of Owner or Manager: Collier County Board of County Commissioners
Principal Address of Service: 2705 South Horseshoe Drive. Naples. Florida 34104
Business Telephone:
(239) 252-8459
Emergency Telephone:
9-1-1
Description of Services Area: The 2.032 square miles enconmassing Collier County
Number of Ambulances on 24 hour duty: 24 ground units (ambulances)
Number of Ambulances on 12 hour duty: I ground unit (as needed during season taken from reserve fleet).
Number of reserve Ambulances: 10
Number of non-transport AL5 engines 23
Number of Medivac helicopter: ..1
See attachment "A" for description of vehicles.
This pennit, as provided in Ordinance 04-12 shall allow the above named Ambulance Service to operate
Emergency Medical Services for a fee or charge for the followmg area(s): Collier County until the expiration date
hereon, except that this permit may be revoked by the Board of County Commissioners of Collier County at any
time the service named herein shall fail to comply with any local, state or federal laws or regulation applicable to
the provision of Emergency Medical Services.
Issued and approved this __'_
day of
.2008.
A ITEST:
DWIGHT E. BROCK, CLERK
BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA
By:.
TOM HENNING, CHAIRMAN
Approval as to form and legal SuffiCIency:
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Agenda Item No. 16F2
AITJ(NW'M,1,6,2D,Q8
~H"PatJ'e' 8 ~61'14
RESOLUTION NO. 08 - -E-
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, PROVIDING FOR UP-DATED EMS USER
FEES FOR COLLIER COUNTY AMBVLANCt: SERVICES, UP-DATED
BILLING AND COLLECTION PROCEDURE, HOSPITAL TRANSPORT
BILLING AND FEES, ADJUSTMENTS OF EMS USER FEES PURSUANT
TO COLLIER COUNTY ORDINANCE NO. 96-36, W AlVER OF EMS USER
FEES FOR SPECIAL EVENTS, AND AN UPDATED PROCEDURE FOR
APPROVING HARDSHIP CASES AND PAYMENT PLANS; SUPERSEDING
RESOLUTION NO. 07,191; AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, Collier County Emergeney Medi"'" Services (hercinof\er refeJTed 10 as
"EMS") provides ambulance services to the residents and visilors of Collier County; and
WHEREAS, the Collier County EMS operaling budget is funded exelu.ively through ad
valorem taxes and user fees; and
WHEREAS, the Board of County Commissioner. reecnUy enler1:d into an Agreement with
Advanced Data Processing, Ine. (hereinafter referred to as to "Billing ConSUIIanI") to provide
collection services for ambulance 9ervicea and associated fees; and
WHEREAS, this Resolution i. intended to appiy irrespective of whether EMS bming s1aft',
Ad vaneed Data Processing, Inc., or any other billing consultant is responsible for the collection of
fees for ambulance service~ and
WHEREAS, Collier County Ordinanee No. 96-36 ~ 5 provides that the user fees for
ambulance services may be established by ResoJution of the Board of County Commissioners
(bereinafter referred to as to "the Board").
NOW THEREFORE, BE IT RESOLVED BY THE
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, lb.t:
SECTION ONE: EMS USER FEES
BASE RATES:
SERVICE LEVELS
BASE CHARGES
A. EMS - BLS NON-EMERGENCY
B. EMS-BLSEMERGENCY
C. EMS-ALS I NON-EMERGENCY
D. EMS - ALS I EMERGENCY
E. EMS - ALS 2 EMERGENCY
F. EMS - SPECIALTY CARE
G. EMS - TREATMENT WIO TRANSPORT
H. EMS - HELICOPTER
MILEAGE RATES:
SERVICE LEVELS
A. EMS - GROUND UNIT
(Minimum Charge of J mile and no cap)
B. EMS -AIR UNIT A0436
SPECIAL EVENTS AND MISCELLANEOUS RATES:
BOARD OF COUNTY
~
A0428
A0429
A0426
A0427
A0433
$ 700.00
$ 700.00
S 700.00
$ 700.00
$ 750.00
$ 800.00
$ 175.00
$ 5,900.00
A0434
A0098
A043 I
CODES
A0425
MILEAGE CHARGE
S 12.25
$ 110.00
SERViCE LEVELS
A TWO (2) MEDICS/ONE ALS VEHICLE (pER HOUR)
~
$ 150.00
.~---"1~
,A,genda Item No. 16F2
December 16. 2008
Page 9 of 14
B. ONE (1) MEDIClNO VEHICLE (PER HOUR) $ 50.00
COPIES':
Subject 10 statutory exemptions, "public reconls" arc required by Chapter 119, F.S. to be
open to illBpcction and copying. Consistent with Chapter 119, Resolution No. 07-327 establishes
copying fees as foUows:
COPIES OF DOCUMENTS
A. One-sided copy which is 14 inches hy 8 Y, inches or less
B. Two-sided oopy which is 14 inches by 8 y, inches or less
COpy SERVICES
The actual cost of duplication for all olher copies will be charged. The first hour of cost of
duplication will not be charged. "Actual cost of duplication" is defined in 9 119.07(1), F.s. lIS "the
cost of the material and supplies used to duplicate the record/' but does not include the labor cost
and overhead cost associated with such duplication.
"'Copying fees are subject to change only to the extent lhat either Chapter 119, FS. or
Resolution No. 07-327, or both, arc amended, replaced, or superseded.
PAST DUE ACCOUNTS
INTEREST ON PAST DUE ACCOUNTS
SECTION TWO: BILLING COLLECTION PROCEDURE
The following sball be the minimum guidelines for billing and collection procedures for
ambulance service fees and charges:
A. Initial fecs and charges for ambulance service(s) shall be assessed either prior to or
following the provision of service, as senrice dyn8Illics reasonably allow. Unpaid fee! and
charges. subsequent to time of service shall be retlectr:d in an accounts receivable subsidiary
ledger system to be maintained by the EMS Department.
EMS Billing Staff will transmit all data nCC"-ssary to Billing Consultant to process the claim.
I. Billing Consultant "ill send an initial bill to the service recipient's or responsible
party's insurance carrier as soon os insurance infonnation has been received,
vuJidatcd, and entered by the Billing Consultant on the accounL
When a valid patient address is present, the Billing Consultant will follow the patient
statement cycle outfined below.
\, An initial statement for ambulance services. including the HlPAA notice or
privacy practices shall be sent fourtecD (14) or more day, after the data is
entered by the Billing Consultant. but no later than 30 days after service has
RAm
S .15
$ .20
$
I % monthly
B.
2.
been provided.
ii. (f a non-Medicaid account remains unpaid, statements will be sent 10 the
patient no later than every 60 days from the last filed dale. Ifa claim is denied,
II blll win be sent to the service recipient or responsibie party.
iii. For Medicaid accounts, if the claim is denied because of no coverage at the
time of !Jervice, or because it WM detennincd to be not medically necessary to
be transported by IlIIlbulance,. a bill will be sent to the service recipient or
responsibly pllrty.
Agenda Item No. 16F2
December 16. 2008
Page 10 of 14
iv. In the event the service recipient Or responsible party does not have Dr doe. not
provide proof of insurance covCI1Ige, statements will be sent to the patient no
later than every 60 days from the last stalemeot date.
C. The Billing Consultant will provide a file with patients to be sent to collections to the
Count)" oS contracted collection agency when all attempts to coUect on the account have been
exhausted by the Billing Consultant. The COlDlly may direct the Billing Consultant 10 not
send a patient to collections at any time. Billing Consultant may send a patient to
collections prior to exhaustion of all collection efforts when:
I. The patient acCOWlt has on inV1liid address.
2. Billing Consultant is directed by COWlly to send a patient to conections.
D. Interest will be assessed at ] % per month on all accounts that are sent to ~c County's
contracted collection agency.
E. A reasonable and customary payment plan will be made available for an service recipients
or responsible parties. Should the service recipient or responsible party at the time fail to
meet the terms and conditions oflhe payment plan for a period of(60) sixty days, the unpaid
baJance shaJll'CC!nter the collectWns process set fonh in Section C. above at the point in the
collections process at which it Was taken out for a payment plan to be admlnistered.
F. When ambulance service bill(s), at the any stage in this biJIing and collection procedure, "'"
returned because the Postal Service cannot effectuale delivery, the EMS Billing Section
shall make reasonable effort to ascertain the COlTCCt mailing address. If reasonable etfurls to
ascertain a correct address fail, the account(s) may be considered. for other coUection
alternatives.
G. Nothing contained in this Section shall preclude reasonable telephone or other appropriate
contaA;t for billing and collection purpo.es, in accordance with all applicable laws.
H. Throughout tbe fiscal year, the EMS Billing Section shall review all past due accounts and
report to the Board of County Commissioners on an annual basis, of all past due accounts
which are believed to be uncollectible.
1. The Board may, after reviewing these past due account. and after finding that diligent
efforts at collcc::tion have proven unsuccessful, remove these past due accounts from active
accounts receivable in accordance with generally accepted accounting procedures and
pursuant to Jaw by Resolution.
J. Probate Estate Cases' Should 8 decedent have an unpaid balance for ambulance services,
the following shall occur:
t. The decedent's Penonal Repr....,tative will notify EMS Billing Staff that a
probate e.tate has beon filed with the Probate Court.
2. EMS Billing Staff shall ensure that a Notice of. Claim is timely filed with the
Probate Court.
3. EMS Billing Staff shall ensure that the Office of the COWlty Auomey is timely
notified of such claim and provided with: I) a copy of ambulance bill{s), 2) all
correspondence between EMS Billing StafflBilling Consultant) and Personal
Representative, 3) Notice of Claim filed with the Probate Estate. and any olher
information necessary to pursue the cJaim.
"""--'T'
P,genda Item r"o. 16F2
December 16 2008
Page 11 of 14
4. The Office of the County Attorney sholl take all reasooabIe actiOllS that ""'
necessary to pursue such claim. including but not limited. to faling a lawsuit in
the COWlty Court to pursue such claim.
5, If the es1ate has ....ts and $10,000 or less is owed for ambulance servie..., the
EMS Director lUld the County Attorney (or hi, designee) are authorized to lake
reasonable actions to reach a settlement with the Personal Representative or his
aIlomey. Should a settlement be reached, the EMS Director and the County
Attorney (or his designee) are authorized to execute a satisfaction and/or release
on behalf of the County. lflhe esWe OIlS....ts and in excess of$lO.OOO is owed
for ambulance services. any negotiated settlement/compromise of the ambulance
billing claim shall be approved by the Board of County Conunissioners. If the
estate has nominal 8:iSets or no asscta, the County Manager may waive the rates,
fees, and charges ss set forth in Ordinance No. 96-36, as it may be amended,
replaced. or superseded.
K. All accounts with a balance of S 1 0 or less win be written ofT.
SECTION THREE: HOSPITAL TRANSPORT BILLING AND FEES
A. The fees set forth in Section One of this Resolution shal1l1Jl!1ly to ambulance transports that
occur between a hospital's facilities.
B. Should a hospital within the boundaries of Collier County have the need for a tranSport of a
patient between hospital facilities located within the boWldaries of ColUer County,
ambullUlee transport will be provided.
C. Should a hospital within the boundaries of Collier County have the need for a transport ofa
patient to hospital facilities iocated o"/Side the boundaries of Collier County, the County,
wiU subject to equipment and manpower availability, at its sole discretion, utilize its
resources to provide palient transport.
D. Hospitals requesting ambulance trlUlSporls &ball be iovoiced directly for ambulance tnIIlSport
service on a monthly basis.
SECTION FOUR: ADJUSTMENT OF EMS USER FEES
The following shall be minimum guidelines for adju.<tments to ambulance service fee.. The
Board of County Commissioners, in accordance with criteria established by the enabling Ordinance.
may authorize other adjustments.
A. Medic,,", and Medicaid AdiUSlments. Contractual adjustments under Medicare and/or
Medicaid assignment wLll be made in accordance with applicable Medicare and/or
Medicaid rules and regulations.
B. Victim's Comnensat:ion Contractual Adjustments. ConlIBctua1 adjustments will be
made in ""cordonce with appliOllble sIote, Ji:deral and local rules and regulations,
C. Worker'~ Comnensalion Conttactual Adlustments. Contractual adjustments will be
made in accordance with applicable state, federal and local rules and fc:gulations.
D, County Emnlovee Adiwtments. Board of County Commi!:Sioners and Constitutional
Officers' employee!! that have Primary coverage under Collier County's insurance policy
will be responsible for any deductibles, co.payments or unpaid balances. An employee
!\genda Item No. 16F2
December 16, 2008
Page 12 of 14
may di.pute hiolher ambulance charge in accordance with procedun:o .et forth in
OnIinance No. 96.36.
E. ChzlDlDusfTricare Adiustments. Conlractual adjustments will be made: in accordance
with applicable ChampllSlTricarc rules and regulatioos.
F. Railroad Rctircmeat AdiUSllnel'lts. Contractual acljusonents will be made in accordance
willi applicable state, federal and local rule. and lCgulmions pertaining to Railroad
Retirement Adjustments.
G. Social Service. Adiustments. Contractual adjustments will be made in accordance with
rules establi.hed by the County Manager and memorialized by a memo"",dum of
UDd....tanding cxecuted by the Social Service. Director and the EMS Director.
SECTION FIVE: WAIVER OF EMS USER FEE FOR SPECIAL EVENTS.
Pur,uant to Ordinance No, 96-36, and from the cffective date of thi, Resolution, user fees
for EMS ambulance stand-by ,ervices may be waived if the Board find. that a valid public purpo,e
has been established in recognition of their charitable contribulions to the Community.
SECTION SIX: HARDSHIP CASES AND PAYMENT PLANS.
The Board recognizes that certain service recipients may need to be identified and processed
as hardship cases. Payment plans will be established pursuant to the minimum guidelines SC't
forth in this Resolution.
A. Hardship case, will be established in accordance with the Federal Poverty guidelines. as
used by the Social Scrvices Dcpanmcnt DfCollier County.
B. Payment plans for hardship cases will be set up on a monthly basis. with a minimum
payment ofSIO.OO per month. Hardship cases, placed on a payment plan will not accrue
interest or be placed into collection. Notwithstanding the foregoing, if a service
recipient has a payment plan and does not make the agreed scheduled payments for a
period longer than two (2) months, thc account will be turned over to the County's
contracted collection lIBency and interest will begin to aCCNe,
SECTION SEVEN: SUPERCISION OF RESOLUTION 07-192
Thi, Resolution shall supersede Resolulion No. 07-192
SECTION EIGHT, EFFECTIVE DATE
This Resolution shali become effective on January 29, 2008
PASSED AND DULY ADOPTED by the Board of County CommissionelS of Collier
Counly, Florida, this :2/11'1 clay of '}'"/"I, t'\ 'j ,2008,
A TIES:r:' . "
DWIGHT E. BROCK;::<,::LERK
~~~J
legal sufficiency:
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: L Ai IM"~
TOMHENNlN~~
~Cl A 9 ~,Lt.o
leon; A. Belpcdi
Assistant County Attorney
.i\aellda Item t'Jo. 16F2
~ December 16, 2008
Page 13of14
ATTACHMENT "C"
MEMORANDUM
TO:
James V. Mudd, County Manager
FROM:
Dan Summers, Director Bureau of Emergency Services Division
DATE:
November 19, lOOS
REF:
Certificate of Convenience and Necessity for Collier County
Emergency Medical Services Department
After review of the application to renew this certificate for Collier County Emergency
Medical Services Department, no further information is required at this time.
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