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Item H3 BOARD OF GOVERNORS LOWER AND MIDDLE KEYS FIRE AND AMBULANCE DISTRICT AGENDA ITEM SUMMARY Bulk Item: Yes No X Division: Public Safety Department: Emergency Medical Services Meeting Date: March 21-22.2001 AGENDA ITEM WORDING: Approval of Resolution authorizing the write off of EMS Accounts Receivable, in behalf of Steven Murphy, in the amount of $352.61 ITEM BACKGROUND: On March 29, 2000, Mr. Murphy attempted to go from the office of his physician to Fishermen's Hospital, for treatment of an allergic reaction. However, because of the major fire that day at the Buccaneer Lodge, the road was blocked and traffic on US 1 was limited to emergency vehicles only. He was forced to use an ambulance to get to the emergency room, even though his medical condition did not warrant it. Mr. Murphy has requested that his bill be waived because of the extenuating circumstances. The County Attorney's Office suggested that we bill Mr. Murphy the mileage charge only, in the amount of $28.56. This charge would cover the cost of the basic transportation, as the patient did not require any assistance from the EMS personnel. PREVIOUS RELEVANT BOG ACTION: None STAFF RECOMMENDATION: Approval TOTAL COST: COST TO COUNTY: REVENUE PRODUCING: Yes BUDGETED: Yes No No AMOUNT PER MONTH APPROVED BY: County Attorney YES OMB/Purchasing N/ A Risk Management N/ A DMSION DIRECTOR APPROVAL: DOCUMENTATION: Included: X To Follow: - Not Required: - , _ H -3 F~tj-40~-\Ol J\O;J.:;j rt<U(",I;I"'IUNKU~ l....UUN.1. 1-'\.1.l. Ulrl.'-L. '6.J....)IlU~~;:JI~...)O,.l,U Emergency Medical Services RESOLUTION NO. -1001 A RESOLUTION OF THE BOARD OF GOVERNORS OF THE LOWER AND MIDDLE KEYS FIRE AND AMBULANCE DISTRICT OF MONROE COUNTY, FLORIDA AUmORIZING THE WRITE-OFF OF EMS ACCOUNTS RECEIVABLE WHEREAS, Monroe County Emergency Medical Services provides ambulance sefVice; and WHEREAS, the below named service recipient only utilized an ambulance because the road was blocked due to a major fire in Marathon, allowing only emergency vehicles to travel on US I; and WHEREAS, the service recipient needed to get to Fishermen's Hospital for treaUOent of an allergic reaction, but an ambulance was otherwise not necessary for his condition; and WHEREAS, it is desired to write off the account receivable because patient was required to use an ambulance although his medical condition did not warrant it; now, therefore BE IT RESOLVED BY TIIE BOARD OF GOVERNORS 1HE LOWER AND MIDDLE KEYS FIRE AND AMBULANCE DISTRICT OF MONROE COUNTY, FLORIDA: Stephen Murphy's account receivable in the amount of$352.61 be deleted from the County's Emergency Medical Services Department accounts receivable list, and he be responsible for the mileage charge only, in the amount of$28.56. PASSED AND ADOPTED by the Board of Governors of the Lower and Middle Keys Fire and Ambulance District of Monroe County, Florida, at a regular meeting of said Board held on the day of > 2001. Chairperson Yvonne Harper Mayor George Neugent Commissioner Nora Williams Commissioner Murray Nelson Commissioner Dixie Spehar (SEAL) BOARD OF GOVERNORS OF THE LOWER AND MIDDLE KEYS FIRE AND AMBULANCE DISTRICT OF OF MONROE COUNlY, FLORIDA Attest: DANNY L.KOLHAGE, Clerk By: Mayor/Chairperson By Deputy Clerk STATEMENT DATE 11/0:3/00 ~5030"/ 4 ....01 MONROE COUNTY EMS PU BOX: 02601:1. MIAMI, F.L 33:1.02-6011 ACCOUNT NUMBER ~.'j()~I074"'.Ol AMOUNT PAID $ UUR PHUNE NUMBER IS. :1. ....BOO....4:1. /....216~:.'j MAKE CHECKS PAYABLE IN U.S. DOLLARS TO: !:;.rE PHFN MU r~ PH'( PU BOX 10B~;5 LONG KEY, FL 33001 MUNRUE COUNTY EMS PO BOX: 0;:1.(:)011 MIAMI, FL 33102-6011 TO INSURE PROPER CREDIT TO YOUR ACCOUNT. PLEASE DETACH AND RETURN THIS STUB WITH YOUR CHECK PATIENT NAME: ~:ITEPHEN MURPHY PHONE NUMBER: ~:10~.:j"..664.".;?f:16;.:.) REFERRING DR.: PLACE OF SERVICE: FH 3/29/00 FIRE RESCUE TRANSPORT MILFAGE CHc~RGE 4.0 (\1 jl; 7.:1.4 3~.'j;;>'. 61 ;;? El . ~;:i 6 *, *******.*. ......................*.....***...*.***...**..***.******...*.*****.** I r::. ''''-OU f. AI)E MED I C(.~ RE, MED ICA I D, U I~ ANY PR 1 VATE 1 N~:IUFI. NCE . . . .A. ./0: :I.. PLE(SE CALL US, OR COMPLETE THE INSURANCE FURM U THE FRUNT (.ND BACK * U F .. HIS S T (.~ T E MEN T. A C CJ P Y (] F '( U U R H E (.~ I... T H I N ~:; U R (.~ N ( . [: C (~ R n I!:; HE: L P r:: U L , ./0: ./0: :::.>. MAlI. IT BPICK TO US IN THE L..JHITE ENlyJELOPE PI~OI)IDEII AND L.JE WILl.. FILE (.~ ..01.. CLA1M UN YOUR BEHALF. * "J': IF YOU 1:0 NOT HI~I)E MEDICc~FIE, ME[)ICI~I[), Ol~ (.~NY PRII)C;TE: IN!:;UFlc;NCE, ./0: PI._EA~3E~: FAY 'T'~IE: AM(:Jl.JN"'" INI)]:CA'r'E~(:), J:)AYME~:N'I. F)l_AN~; (::AN 131~. Af~I~AN(31~:f:) "fO( ASS1:S"r" * YOU BY CONTACTING OUR OFFICE AT :I.-BOO-417-2165. · 1* 00 NOT MAIL CASH *. · *~*********. *********************.***********.**********. ***********,.********** PAY THIS AMOUNT ~:lEn . 1. 7 PRINT YOUR MEDICARE NUMBER HERE MEDICAID # PRINT YOUR HOME PHONE NUMBER HERE BUSINESS PHONE # IF YOU HAVE INSURANCE OR PARTICIPATE IN ANY PROGRAM WHICH WILL PAY FOR THESE SERVICES. PLEASE COMPLETE AND SIGN THE REVERSE SIDE OF THIS BILL AND RETURN IN THE ENCLOSED ENVELOPE. IF THERE IS ANY PROBLEM REGARDING THE PAYMENT OF THIS BILL. CONTACT OUR OFFICE AT ( 1 .... BOO.... 4 1 "/ .... ;;.) 1 6 ~:.'i ) WITHIN 5 DAYS TO MAKE ARRANGEMENTS PLEASE SHOW ACCOUNT NUMBER ON ALL CHECKS. IMPORTANT YOU MUST SIGN REVERSE SIDE TO RECEIVE INSURANCE PAYMENT ACCOUNT I "50:::1074....0:!. NUMBER " Stacy DeVane, Executive Assistant Public Safety Division Suzanne A. Hutton, Assistant County Attorney ~ December 11, 2000 o~~!" 3"'~~E (30S12ll<l~' Office of the County Attorney PO Box 1026 Key West, FL 33041-1026 305/292-3470 - Phone 305/292-3516 - Fax TO: FROM: DATE: BOARD OF COUNTY COMMISSIONERS Mayor George Neugent, District Z Mayor Pro tern Nora Williams, District 4 Charles McCay. District 3 Murray Nelson, District 5 Dixie Spehar, District 1 . MEMORANDUM ~ . l ~1.[!A~ RE: Bankruptcy Notices. With regard to your December 6th memo please be advised that the Notices of Discharge of Debtor for Susan Atkinson and Erik Geele indicate that we are going to have to write those particular debts off. The Notice of Chapter 7 Bankruptcy case for Frank Lichtenstein merely needs to be held on file. I will retain the copy which you sent in our records. Regarding your December 6th memo asking for advice on a records subpoena pertaining to Kathleen Dante and Albert Kryger, the attorney needs to be advised that under Section 395.3025(4)(d), Florida Statutes, your records are confidential and can only be released upon issuance of subpoena and proper notice by the party seeking the records of the patient. Under Florida Rules of Civil Procedure 1.351, the attorney is required to provide us with certification that proper notice was served on the party (ies) and that no objection was received from same. Please call if you have any additional questions. Regarding your December 4th memo concerning IrisYadira Fernandez, you may send records to James G. Gilmour and/or Cindy Post Massion at Museum Tower, Suite 2800, 150 West Flagler Street, Miami FL 33130. They have provided us with appropriate documentation. However Edward Hernandez of the Law office of Parenti, Falk, Waas, Hernandez & Cortina, 113 Almeria Avenue, Coral Gables, FL 33134, still needs to provide us with the Certificate of Non- objection. Regarding Steven Murphy, the subject of your December 4th memo, I would suggest that you draw up a resolution for the County Commission to approve writing off the debt. Perhaps. you sho.uld write-off $352.61 and leave the mileage charge of $28.56. That would at least cover the basic cost of the transportation since it does not appear from Mr. Murphy's letter that he actually needed any kind of assistance from the EMS Technicians. You can only write this off!f the County Commission approves it and I would include a copy of the October 19th letter as well as the statement as backup for. the resolution. If you have any additional questions, please feel free to call. SAH/ak 2