Okaloosa County BOCC — 2013 meeting #1141 (date undetermined) — reading text

Packet Pg. 406  BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST DATE: July 16, 2013 TO: Honorable Chairman and Members of the Board FROM: Dino J. Villani SUBJECT: EMS User Fee Resolution 2013 DEPARTMENT: Public Safety BCC DISTRICT: All STATEMENT OF ISSUE: Resolution Approving Emergency Medical Services User Fees for County Ambulance services. BACKGROUND: EMS is operated through a combination of user fees and ad valorem taxes. EMS user fees are established by the BCC to include base rates, mileage charges and other services such as standbys, treatment without transport, and specialty care transports. The last time EMS user fees were adjusted was in March of 2008. A recent rate comparison has revealed that our rates have fallen below the average of regional and national EMS fees. Consequently, EMS has the potential to generate more revenue to offset tax support and still be in line with prevailing EMS transport fees. OPTIONS: In discussions with our current EMS billing provider, staff developed three options that consider how our rates would compare with others along with their resulting revenue projections: 1) Increasing transport fees to the average, doubling standby fees for special events, and increasing Treatment Not Transported to $250 would increase the County’s collections by $370,000 annually. 2) Increasing the transport fees by 30%, doubling standby fees for special events, increasing mileage to $12 and Treatment Not Transported to $250 would increase the County’s collections by $445,000 annually 3) Setting the base transport fee for all levels of service at $800, mileage to $15, Treatment Not Transported to $250, and doubling standby fees for special events would increase the County’s collections by $900,000 annually RECOMMENDATIONS: Option 3 provides the best revenue potential because it impacts one of our higher revenue sources (commercial and self pay) while not producing excessive required write offs due to established Medicare reimbursement rates. It also simplifies our rate structure with respect to the current challenging health care reimbursement environment, helps minimize the effects of coding errors and ensures we are more in line with what other systems are Packet Pg. 407 charging. RECOMMENDED BY: APPROVED BY: Ernie Padgett, County Administrator Packet Pg. 408  RESOLUTION No. RESOLUTION APPROVING EMERGENCY MEDICAL SERVICES USER FEES FOR OKALOOSA COUNTY AMBULANCE SERVICES (OPTION 1) WHEREAS, the Okaloosa County Department of Public Safety, Division of Emergency Medical Services (EMS) provides ambulance services to the residents and visitors of Okaloosa County; and WHEREAS, the Okaloosa County EMS operating budget is an enterprise fund consisting of a combination of ad valorem taxes and user fees; and WHEREAS, increasing demand for services require additional ambulances, equipment, and trained personnel; and WHEREAS, increasing costs for staffing and medical supplies continue to increase the costs of providing theses services; and WHEREAS, Okaloosa County EMS is required to be a Medicare Provider at a cost reimbursement rate that is established by Medicare; and WHEREAS, it is necessary, expedient, and in the best interest of the citizens to adjust EMS user fees to properly asses a portion of the cost to the users of this service; NOW, THEREFORE BE IT RESOLVED, by the Board of County Commissioners of Okaloosa County, Florida, that: THE OKALOOSA COUNTY EMS FEE SCHEDULE EFFECTIVE AUGUST 1. 2013, IS AS FOLLOWS: SERVICE FEE Non-Emergency Medical Transportation Service $175.00 (+Mileage) Base Rate for BLS (Resident) $570.00 (+Mileage) Base Rate for BLS (Non-resident) $680.00 (+Mileage) Base Rate for ALS-1 (Resident) $650.00 (+Mileage) Base Rate for ALS-1 (Non-resident) $790.00 (+Mileage) Base Rate for ALS-2 (Resident) $736.00 (+Mileage) Base Rate for ALS-2 (Non-resident) $1,000.00 (+Mileage) Specialty Care Transport (Resident) $830.00 (+Mileage) Specialty Care Transport (Non-Resident) $1,129.00 (+Mileage) Mileage (Resident & Non-resident) $11.00 per mile Treatment/No Transport $125.00 Ambulance Standby $200.00 per hour Non-profit Organization Ambulance Standby $100.00 per hour Quick Response Vehicle Standby (with 1 Staff Member) $100.00 per hour EMT (No Vehicle) $75.00 per hour Paramedic (No Vehicle) $100.00 per hour Packet Pg. 409 DULY PASSED AND ADOPTED in regular session this 16th day of July 2013. BOARD OF COUNTY COMMISSIONERS OKALOOSA COUNTY, FLORIDA _________________________________ Don R. Amunds, Chairman ATTEST DON W. HOWARD CLERK OF CIRCUIT COURT By:_____________________ Deputy Clerk 2 Packet Pg. 410  RESOLUTION No. RESOLUTION APPROVING EMERGENCY MEDICAL SERVICES USER FEES FOR OKALOOSA COUNTY AMBULANCE SERVICES (OPTION 2) WHEREAS, the Okaloosa County Department of Public Safety, Division of Emergency Medical Services (EMS) provides ambulance services to the residents and visitors of Okaloosa County; and WHEREAS, the Okaloosa County EMS operating budget is an enterprise fund consisting of a combination of ad valorem taxes and user fees; and WHEREAS, increasing demand for services require additional ambulances, equipment, and trained personnel; and WHEREAS, increasing costs for staffing and medical supplies continue to increase the costs of providing theses services; and WHEREAS, Okaloosa County EMS is required to be a Medicare Provider at a cost reimbursement rate that is established by Medicare; and WHEREAS, it is necessary, expedient, and in the best interest of the citizens to adjust EMS user fees to properly asses a portion of the cost to the users of this service; NOW, THEREFORE BE IT RESOLVED, by the Board of County Commissioners of Okaloosa County, Florida, that: THE OKALOOSA COUNTY EMS FEE SCHEDULE EFFECTIVE AUGUST 1. 2013, IS AS FOLLOWS: SERVICE FEE Non-Emergency Medical Transportation Service $175.00 (+Mileage) Base Rate for BLS (Resident) $556.00 (+Mileage) Base Rate for BLS (Non-resident) $756.00 (+Mileage) Base Rate for ALS-1 (Resident) $660.00 (+Mileage) Base Rate for ALS-1 (Non-resident) $898.00 (+Mileage) Base Rate for ALS-2 (Resident) $957.00 (+Mileage) Base Rate for ALS-2 (Non-resident) $1,301.00 (+Mileage) Specialty Care Transport (Resident) $1,080.00 (+Mileage) Specialty Care Transport (Non-Resident) $1,468.00 (+Mileage) Mileage (Resident & Non-resident) $12.00 per mile Treatment/No Transport (Resident & Non-resident) $250.00 Ambulance Standby $200.00 per hour Non-profit Organization Ambulance Standby $100.00 per hour Quick Response Vehicle Standby (with 1 Staff Member) $100.00 per hour EMT (No Vehicle) $75.00 per hour Paramedic (No Vehicle) $100.00 per hour Packet Pg. 411 DULY PASSED AND ADOPTED in regular session this 16th day of July 2013. BOARD OF COUNTY COMMISSIONERS OKALOOSA COUNTY, FLORIDA _________________________________ Don R. Amunds, Chairman ATTEST DON W. HOWARD CLERK OF CIRCUIT COURT By:_____________________ Deputy Clerk 2 Packet Pg. 412  RESOLUTION No. RESOLUTION APPROVING EMERGENCY MEDICAL SERVICES USER FEES FOR OKALOOSA COUNTY AMBULANCE SERVICES (OPTION 3) WHEREAS, the Okaloosa County Department of Public Safety, Division of Emergency Medical Services (EMS) provides ambulance services to the residents and visitors of Okaloosa County; and WHEREAS, the Okaloosa County EMS operating budget is an enterprise fund consisting of a combination of ad valorem taxes and user fees; and WHEREAS, increasing demand for services require additional ambulances, equipment, and trained personnel; and WHEREAS, increasing costs for staffing and medical supplies continue to increase the costs of providing theses services; and WHEREAS, Okaloosa County EMS is required to be a Medicare Provider at a cost reimbursement rate that is established by Medicare; and WHEREAS, it is necessary, expedient, and in the best interest of the citizens to adjust EMS user fees to properly asses a portion of the cost to the users of this service; NOW, THEREFORE BE IT RESOLVED, by the Board of County Commissioners of Okaloosa County, Florida, that: THE OKALOOSA COUNTY EMS FEE SCHEDULE EFFECTIVE AUGUST 1. 2013, IS AS FOLLOWS: SERVICE FEE Non-Emergency Medical Transportation Service $175.00 (+Mileage) Base Rate for BLS $800.00 (+Mileage) Base Rate for ALS-1 $800.00 (+Mileage) Base Rate for ALS-2 $800.00 (+Mileage) Specialty Care Transport $800.00 (+Mileage) Mileage (Resident & Non-resident) $12.00 per mile Treatment/No Transport (Resident & Non-resident) $250.00 Ambulance Standby $200.00 per hour Non-profit Organization Ambulance Standby $100.00 per hour Quick Response Vehicle Standby (with 1 Staff Member) $100.00 per hour EMT (No Vehicle) $75.00 per hour Paramedic (No Vehicle)