Loading...
Backup Documents 11/12/2019 Item #16E 7 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 E TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. 2. 3. County Attorney Office County Attorney Office JAK 11/12/19 4. BCC Office Board of County la(`n b � _)j Commissioners . J l� rI 5. Minutes and Records Clerk of Court's Office I VJG iirt I %VS* PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Tabatha Butcher, Director of EMS Contact Information 239-252-3740 Contact/Department Operations Agenda Date Item was November 12,2019 Agenda Item Number 16E7 Approved by the BCC 12G3Type of Certificate of Public Convenience and Number of Original 1 Document Attached Necessity(COPCN) Documents Attached PO number or account N/A number if document is to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column, whichever is Yes N/A(Not appropriate. (Initial) Applicable) I. Does the document require the chairman's original signature STAMP OK JAK 2. Does the document need to be sent to another agency for additional signatures? If yes, J JAK provide the Contact Information(Name; Agency;Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAK signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's JAK Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the JAK document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JAK signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip JAK should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 11/12/19 and all changes made during JAK N/A is not the meeting have been incorporated in the attached document. The County an option for Attorney's Office has reviewed the changes, if applicable. this line. 9. Initials of attorney verifying that the attached document is the version approved by the JAK N/A is not BCC, all changes directed by the BCC have been made, and the document is ready for the an option for Chairman's signature. this line. 7 MEMORANDUM Date: November 14, 2019 To: Tabatha Butcher, EMS Chief Emergency Services From: Martha Vergara, Sr. Deputy Clerk Minutes & Records Department Re: Emergency Medical Services - COPCN Attached is one (1) original of the document as referenced above, (Agenda Item #16E7) as approved by the Board of County Commissioners on Tuesday, November 12, 2019. The Board's Minutes & Records Department has kept the original as part of the Board's Official Records. If you have any questions, please contact me at 239-252-7240. Thank you. Attachment 16E7 en jo. d-2 = _ • c Y coo ttoo nY Z Z Z Z .� •• Iv •=v " �� Cil CrJ rr1 CD o to ' vo t� M ) 8'•• -3 vD 74 7Z › ° --�- �i-'. T NO i `7 .. ___Q - ---meg/. , U) N n .- _ ;in Q r Z 5, r m n rci .-h o.n A) 0- CDa tY e o c -a y T ^3 a oo 4 el N 5,• Ct] p W n Q Cil CD T CA Cto -1 O O� �" CD A) "�C rQ A) 0. - O Q' cn N c�D n r 5' o mon ° < a /'Li CD c• y. y cn °: to Cyiy7 3 M " N t - 0 C) C) -• p /r O l�7 NO Q O pmt ry, n `Sf r_1 p� N A 0 �_ CD 2 ,ti n r ril .r O co co') N = " O N < r n M K N til r -- O o ? -: ° oa O t� �` " ' • o. o �` n n z v 7. z o- o • cu r o v C • oy z ivm _ h AD AD CD -c -3 r CD = v Cr r- C17 a en o 4 r4 W CD At N p O 11 -0 CA r...) : iv-. 2 -I o < _ . _ O O rC y O I " y CD --... cr < = On A)• CD C) C)CD CD CD o = A) O.. UQ .: ._ N 0 : itaX Y w �k .0,--,r-....21,_, ..--,,n__--;- . _� . -✓`°t � ` _ _ _ '0M-__ _ fir. __ .n. < , � ,. 16E 7 COLLIER COUNTY FLORIDA Renewal of Class 1 COPCN This Permit Expires December 31, 2020 Name of Service: Collier County Emergency Medical Services Name of Owner or Manager: Collier County Board of County Commissioners Principal Address of Service: 8075 Lely Cultural Parkway,Naples, Florida 34113 Business Telephone: _(239)252-3740 Emergency Telephone: 9-1-1 Description of Services Area: The 2,032 square miles encompassing Collier County Number of Ambulances on 24-hour duty: 26 ground units (ambulances) Number of Ambulances on 12-hour duty: 2 ground units (as needed during season taken from reserve fleet). Number of reserve Ambulances: 21 Number of non-transport ALS vehicles 12 Number of Medivac helicopter: 1 See attachment"A" for description of vehicles. This permit, as provided in Ordinance 04-12, as amended, shall allow the above named Ambulance Service to operate Emergency Medical Services for a fee or charge for the following 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 Ig'' day of "k V'Q,rnbr, 2019. ATTEST: BO ' , •eCOUNT .OM SIONERS CrystaFK. Kinzel, Clerk • r`0 TY F I • DA AO „maw- Airy Attest as to hairrrlan, , Deputy 1e& +illiam L. McDaniel, Jr., Chairman signature nature a1Y. - 9Approved as td form and legality: J Jeffrey A. KlAtzkow, County Attorney Attachment A 16E 7 Permit# ALS Year Make Model VIN Assigned 1453 AT 1999 EUROCOPTER EC135 N911CK MHQ 12441 T 2004 STERLING ACETERA 2FZACFCSX4AM52868 Truck 9 12442 T 2004 STERLING ACETERA 2FZACFCS84AM52867 Truck 10 13312 T 2003 INTERNATIONAL 4400 1HTMRAAMX3H573348 Truck 7 13313 T 2005 INTERNATIONAL 4300 1HTMNAAM85H689274 Truck 22 14635 T 2008 STERLING ACETERA 2FZACFDJ78AZ51753 Truck 18 17255 T 2012 FORD F550 1FDUF5GT8CEB23691 Truck 1 17256 T 2012 FORD F550 1FDUF5GTXCEB23692 Truck 25 17257 T 2012 FORD F550 1FDUF5GT10EB23693 Truck 27 17258 T 2012 FORD F550 1FDUF5GT3CEB23694 Truck 37 18087 T 2013 FORD F550 1FDUF5GTODEA35168 Truck 38 18088 T 2013 FORD F550 1FDUF5GT7DEA35166 Truck 24 18089 T 2013 FORD F550 1FDUF5GT2DEA35169 Truck 15 18090 T 2013 FORD F550 1FDUF5GT9DEA35167 Truck 6 18866 T 2015 FORD F550 1FDUF5GT7FEA64024 Truck 14 18867 T 2015 FORD F550 1FDUF5GT9FEA64025 Truck 31 18868 T 2015 FORD F550 1FDUF5GTOFEA64026 Truck 39 18869 T 2015 FORD F550 1FDUF5GT2FEA64027 Truck 40 18870 T 2015 FORD F550 1FDUF5GT8FEA98764 Truck 41 18881 T 2008 STERLING ACETERA 2FZACFDJ58AZ51749 Truck 8 19044 T 2015 FORD F550 1FDUF5GT8FEC82389 Truck 4 19046 T 2015 FORD F550 1FDUF5GT6FEC82391 Truck 43 19047 T 2015 FORD F550 1FDUF5GT8FEC82392 Truck 30 19048 T 2015 FORD F550 1FDUF5GTXFEC82393 Truck 42 19303 N 2015 FORD EXPLORER 1FM5K8AROFGC26952 CC2-1076 19304 N 2015 FORD EXPLORER 1FM5K8AR2FGC26953 CC2-1085 19305 T 2004 STERLING ACETERA 2FZACFCS44AM52865 Truck 17 19797 N 2016 FORD EXPLORER 1FM5K8ARXGGAO8079 CC2-1130 20437 T 2015 FORD F650 3FRWF6GZ1FV675309 Truck 33 20438 N 2017 FORD EXPLORER 1FM5K8AROHGB64925 CC2-1628 20439 N 2017 FORD EXPLORER 1FM5K8AR2HGB64926 CC2-1630 20440 N 2017 FORD EXPLORER 1FM5K8AR4HGB64927 CC2-1629 20441 N 2017 FORD EXPLORER 1FM5K8AR6HGB64928 CC2-1632 20443 T 2016 FORD F550 1FDUF5GT8GED28644 Truck 3 20444 T 2016 FORD F550 1FDUF5GT6GED28645 Truck 11 20445 T 2016 FORD F550 1FDUF5GTXGED28643 Truck 19 20548 T 2015 FORD F550 1FDUF5GT4FEC82390 Truck 20 20549 T 2008 STERLING ACETERA 2FZACFDJ18AZ51747 Truck 35 20550 T 2007 STERLING ACETERA 2FZACFCS17AY33965 Truck 34 21084 N 2013 FORD EXPLORER 1FM5K8R8DGA18380 CC2-668 21085 N 2016 FORD EXPLORER 1FM5K8AR2GGA46941 CC2-1135 21086 N 2017 FORD EXPLORER 1FM5K8AR7HGC57022 CC2-1631 21087 N 2017 FORD EXPLORER 1FM5K8AR3HGA36372 CC2-1401 21088 N 2016 FORD EXPLORER 1FM5K8AR5GGC07850 CC2-1314 21169 T 2017 FORD F550 1FDUF5GT5HDA02856 Truck 21 Page 1 of 2 16E7 21170 T 2017 FORD F550 1FDUF5GT9HDA02858 Truck 16 21171 T 2017 FORD F550 1FDUF5GT7HDA02857 Truck 36 21405 T 2017 FORD F550 1FDUF5GT1HEF21218 New Truck 05 21403 T 2017 FORD F550 1FDUF5GT1HEF21221 New Truck 32 21404 T 2017 FORD F550 1FDUF5GT3HEF21219 New Truck 29 21709 T 2017 FORD F550 1FDUF5GTXHEF21220 Truck 12 21861 T 2019 FORD F550 1FDUF5GT4KDA01138 Truck 02 21862 T 2019 FORD F550 1FDUF5GT6KDA01139 Truck 23 21863 T 2019 FORD F550 1FDUF5GT2KDA01140 Truck 26 21864 T 2019 FORD F550 1FDUF5GT4KDA01141 Truck 28 22298 T 2019 FORD F-550 1FDUF5GTXKEE37244 Truck 09 22299 T 2019 FORD F-550 1FDUF5GT1KEE37245 Truck 44 22300 T 2019 FORD F-550 1FDUF5GT1KEE37246 Truck 17 22301 T 2019 FORD F-550 1FDUF5GT1KEE37247 Truck 10 22340 T 2019 FORD F-550 1FDUF5GT9KDA06464 Truck 41 Page 2 of 2 16E7 Attachment B RESOLUTION NO.08- 27 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY,FLORIDA,PROVIDING FOR UP-DATED EMS USER FEES FOR COLLIER COUNTY AMBULANCE 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, WAIVER OF EMS USER FEES FOR SPECIAL EVENTS, AND AN UPDATED PROCEDURE FOR APPROVING HARDSHIP CASES AND PAYMENT PLANS;SUPERSEDING RESOLUTION NO.07-192;AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, Collier County Emergency Medical Services (hereinafter referred to as "EMS")provides ambulance services to the residents and visitors of Collier County;and WHEREAS, the Collier County EMS operating budget is funded exclusively through ad valorem taxes and user fees;and WHEREAS,the Board of County Commissioners recently entered into an Agreement with Advanced Data Processing, Inc. (hereinafter referred to as to "Billing Consultant") to provide collection services for ambulance services and associated fees;and WHEREAS,this Resolution is intended to apply irrespective of whether EMS billing staff, Advanced Data Processing, Inc.,or any other billing consultant is responsible for the collection of fees for ambulance services;and WHEREAS, Collier County Ordinance No. 96-36 § 5 provides that the user fees for ambulance services may be established by Resolution of the Board of County Commissioners (hereinafter referred to as to"the Board"). NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY,FLORIDA,that: SECTION ONE: EMS USER FEES BASE RATES: SERVICE LEVELS CODES BASE CHARGES A. EMS—BLS NON-EMERGENCY A0428 $ 700.00 B. EMS—BLS EMERGENCY A0429 $ 700.00 C. EMS—ALS i NON-EMERGENCY A0426 $ 700.00 D. EMS—ALS I EMERGENCY A0427 $ 700,00 E. EMS—ALS 2 EMERGENCY A0433 $ 750.00 F. EMS—SPECIALTY CARE A0434 $ 800.00 G. EMS—TREATMENT W/O TRANSPORT A0098 $ 175.00 H. EMS—HELICOPTER A0431 $ 5,900.00 MILEAGE RATES: SERVICE LEVELS CODES MILEAGE CHARGE A, EMS—GROUND UNIT A0425 $ 12.25 (Minimum Charge of I mile and no cap) B. EMS—AIR UNIT A0436 $ 110.00 SPECIAL EVENTS AND MISCELLANEOUS RATES: SERVICE LEVELS RATES A TWO(2)MEDICS/ONE ALS VEHICLE(PER HOUR) $ 150.00 16E B. ONE(1)MEDIC/NO VEHICLE(PER HOUR) $ 50.00 COPIES*: Subject to statutory exemptions, "public records" are required by Chapter 119, F.S. to be open to inspection and copying. Consistent with Chapter 119, Resolution No. 07-327 establishes copying fees as follows: COPIES OF DOCUMENTS RATES A. One-sided copy which is 14 inches by 81/2 inches or less $ .15 B. Two-sided copy which is 14 inches by 8'A inches or less $ .20 COPY SERVICES The actual cost of duplication for all other copies will be charged. The first hour of cost of duplication will not be charged. "Actual cost of duplication"is defined in§ 119.07(1),F.S. as"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 that either Chapter 119, F.S. or Resolution No.07-327,or both,are amended,replaced,or superseded. PAST DUE ACCOUNTS INTEREST ON PAST DUE ACCOUNTS $ 1%monthly SECTION TWO: BILLING COLLECTION PROCEDURE The following shall be the minimum guidelines for billing and collection procedures for ambulance service fees and charges: A. Initial fees and charges for ambulance service(s) shall be assessed either prior to or following the provision of service,as service dynamics reasonably allow. Unpaid fees and charges,subsequent to time of service shall be reflected in an accounts receivable subsidiary ledger system to be maintained by the EMS Department. B. EMS Billing Staff will transmit all data necessary to Billing Consultant to process the claim. 1. Billing Consultant will send an initial bill to the service recipient's or responsible party's insurance carrier as soon as insurance information has been received, validated,and entered by the Billing Consultant on the account. 2. When a valid patient address is present,the Billing Consultant will follow the patient statement cycle outlined below. i. An initial statement for ambulance services, including the HIPAA notice of privacy practices shall be sent fourteen (14) or more days after the data is entered by the Billing Consultant, but no later than 30 days after service has been provided. ii. If a non-Medicaid account remains unpaid, statements will be sent to the patient no later than every 60 days from the last filed date. If a claim is denied, a bill will be sent to the service recipient or responsible party. iii. For Medicaid accounts, if the claim is denied because of no coverage at the time of service,or because it was determined to be not medically necessary to be transported by ambulance, a bill will be sent to the service recipient or responsibly party. 16E 7 iv. In the event the service recipient or responsible party does not have or does not provide proof of insurance coverage, statements will be sent to the patient no later than every 60 days from the last statement date. C. The Billing Consultant will provide a file with patients to be sent to collections to the County's contracted collection agency when all attempts to collect on the account have been exhausted by the Billing Consultant. The County may direct the Billing Consultant to 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: 1. The patient account has an invalid address. 2. Billing Consultant is directed by County to send a patient to collections, D. Interest will be assessed at I% per month on all accounts that are sent to the County's contracted collection agency. E. A reasonable and customary payment plan will be made available for all service recipients or responsible parties. Should the service recipient or responsible party at the time fail to meet the terms and conditions of the payment plan for a period of(60)sixty days,the unpaid balance shall reenter the collections process set forth in Section C. above at the point in the collections process at which it was taken out for a payment plan to be administered. F. When ambulance service bill(s),at the any stage in this billing and collection procedure,are returned because the Postal Service cannot effectuate delivery, the EMS Billing Section shall make reasonable effort to ascertain the correct mailing address. If reasonable efforts to ascertain a correct address fail, the account(s) may be considered for other collection alternatives. G. Nothing contained in this Section shall preclude reasonable telephone or other appropriate contact for billing and collection purposes,in accordance with all applicable laws. H. Throughout the 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. The Board may, after reviewing these past due accounts and after finding that diligent efforts at collection have proven unsuccessful, remove these past due accounts from active accounts receivable in accordance with generally accepted accounting procedures and pursuant to law by Resolution. J. Probate Estate Cases: Should a decedent have an unpaid balance for ambulance services, the following shall occur: 1. The decedent's Personal Representative will notify EMS Billing Staff that a probate estate has been filed with the Probate Court. 2. EMS Billing Staff shall ensure that a Notice of a Claim is timely filed with the Probate Court. 3. EMS Billing Staff shall ensure that the Office of the County Attorney is timely notified of such claim and provided with: I) a copy of ambulance biIl(s), 2) all correspondence between EMS Billing Staff/Billing Consultant) and Personal Representative, 3)Notice of Claim filed with the Probate Estate, and any other information necessary to pursue the claim. 16E 4. The Office of the County Attorney shall take all reasonable actions that are necessary to pursue such claim, including but not limited,to filing a lawsuit in the County Court to pursue such claim. 5. If the estate has assets and$10,000 or less is owed for ambulance services,the EMS Director and the County Attorney (or his designee) are authorized to take reasonable actions to reach a settlement with the Personal Representative or his attorney. 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. If the estate has assets and in excess of$10,000 is owed for ambulance services,any negotiated settlement/compromise of the ambulance billing claim shall be approved by the Board of County Commissioners. If the estate has nominal assets or no assets,the County Manager may waive the rates, fees, and charges as set forth in Ordinance No. 96-36, as it may be amended, replaced,or superseded. K. All accounts with a balance of$10 or less will be written off. SECTION THREE: HOSPITAL TRANSPORT BILLING AND FEES A. The fees set forth in Section One of this Resolution shall apply 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 boundaries of Collier County, ambulance transport will be provided. C. Should a hospital within the boundaries of Collier County have the need for a transport of a patient to hospital facilities located outside the boundaries of Collier County, the County, will subject to equipment and manpower availability, at its sole discretion, utilize its resources to provide patient transport, D. Hospitals requesting ambulance transports shall be invoiced directly for ambulance transport service on a monthly basis. SECTION FOUR: ADJUSTMENT OF EMS USER FEES The following shall be minimum guidelines for adjustments to ambulance service fees. The Board of County Commissioners,in accordance with criteria established by the enabling Ordinance, may authorize other adjustments. A. Medicare and Medicaid Adjustments. Contractual adjustments under Medicare and/or Medicaid assignment will be made in accordance with applicable Medicare and/or Medicaid rules and regulations. B. Victim's Compensation Contractual Adjustments. Contractual adjustments will be made in accordance with applicable state,federal and local rules and regulations. C. Worker's Compensation Contractual Adjustments. Contractual adjustments will be made in accordance with applicable state,federal and local rules and regulations. D. County Employee Adjustments. Board of County Commissioners and Constitutional Officers'employees that have Primary coverage under Collier County's insurance policy will be responsible for any deductibles, co-payments or unpaid balances. An employee 16E 7 may dispute his/her ambulance charge in accordance with procedures set forth in Ordinance No.96-36. E. Chamnusarjare Adjustments. Contractual adjustments will be made in accordance with applicable Champus/Tricare rules and regulations. F. Railroad Retirement Adjustments. Contractual adjustments will be made in accordance with applicable state, federal and local rules and regulations pertaining to Railroad Retirement Adjustments. G. Social Services Adjustments. Contractual adjustments will be made in accordance with rules established by the County Manager and memorialized by a memorandum of understanding executed by the Social Services Director and the EMS Director, SECTION FIVE: WAIVER OF EMS USER FEE FOR SPECIAL EVENTS. Pursuant to Ordinance No. 96-36, and from the effective date of this Resolution, user fees for EMS ambulance stand-by services may be waived if the Board finds that a valid public purpose has been established in recognition of their charitable contributions 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 set forth in this Resolution. A. Hardship cases will be established in accordance with the Federal Poverty guidelines,as used by the Social Services Department of Collier County. B. Payment plans for hardship cases will be set up on a monthly basis, with a minimum payment of$10.00 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, the account will be turned over to the County's contracted collection agency and interest will begin to accrue. SECTION SEVEN: SUPERCISION OF RESOLUTION 07-192 This Resolution shall supersede Resolution No.07-192 SECTION EIGHT: EFFECTIVE DATE This Resolution shall become effective on January 29,2008 PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County,Florida,this X71+ day of ,2008. ATTEST:' BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK;;CLERK COLLIER COUNTY,FLORIDA By: �JL.- 2' �s aA TO RENNIN ,CHA I I 9546*to forhi. legal sufficiency: Jennifer A.Belpedib ark Assistant County Attorney 16E 7 ATTACHMENT C MEMORANDUM TO: Leo Ochs, County Manager FROM: Dan Summers, Director Bureau of Emergency Services Division DATE: October 16, 2019 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. The application is complete and sufficient.