Resolution 152-2009
IERSION B
1$2 2009
RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, ADO~TING A FEE WAIVER
POLICY AND PROCESS FOR TRAUMA STAR BILLING FOR
TRAUMA SCENE AND CRITICAL CARE INTERFACILITY
FLIGHTS.
RESOLUTION NO.
WHEREAS, Monroe County provides a rapid-transport air ambulance to provide air
transportation of trauma, critically injured and ill patients, hereafter called "Trauma Star"; and
WHEREAS, Trauma Star provides air transportation from emergency scenes in Monroe
County to specialized hospitals and treatment centers out-of-county, and Trauma Star also
provides air transportation from remote areas such as Fort Jefferson to Monroe County hospitals,
hereinafter called "trauma scene flights"; and
WHEREAS, Trauma Star provides air transportation from Monroe County hospitals to
specialized hospitals and treatment centers out-of-county upon physician authorization,
hereinafter called "critical care interfacility flights"; and
WHEREAS, the annual cost of operation of Trauma Star has been approximately
$1,800,000 per year in excess of revenues collected from third party insurance through the
billing of user service fees; and
WHEREAS, a referendum on November 4,2008 for the establishment of two special
taxing districts for the operation of Trauma Star passed with 54.5 percent of the vote; and
WHEREAS, the Board of County Commissioners has determined that it is in the best
interests of its residents to support trauma scene flights and critical care interfacility flights for
qualifying residents via a fee waiver program; and
WHEREAS, the Board of County Commissioners have found that residents support the
Trauma Star program through the payment of ad valorem property taxes; and
WHEREAS, nonresidents of the County make frequent use of the Trauma Star program
but do not directly pay any portion of the expenses through the County's real property taxes to
pay for Trauma Star, including maintenance, operating costs, and the salaries of employees
required to provide the Trauma Star program; and
WHEREAS, the Board of County Commissioners has opted to establish a policy and set
certain restrictions on billing for Trauma Star, particularly with respect to the potential for
service fee waivers; now, therefore
VERSION B
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE
COUNTY, FLORIDA THAT:
Section 1. The following policy is hereby established with respect to Trauma Star.
A. The County will continue to seek reimbursement from third-party payers, including
but not limited to liability insurance, automobile insurance, health care insurance,
Medicare, and Medicaid, to offset a portion of Trauma Star's operational costs.
B. For qualifying individuals, the County Commission will eventually write off any and
all balances remaining after receipt of third party payments, even in cases when the
qualifying individual does not have any third party insurance.
C. The waiver of out-of-pocket expenses is made effective retroactive to November 4,
2008, the date of passage of the voter referendum.
D. Write-offs of out-of-pocket expenses will be completed by annual resolution of the
Board of County Commissioners.
Section 2. Administrative Waiver Oualification. To be eligible for a waiver of service fees,
the qualifying individual and the air ambulance transport must meet all of the following criteria:
A. The waiver includes the cost of trauma scene flights and critical care interfacility
flights.
B. The patient must be a qualifying resident as defined in Section 3 below.
C. The individual transported must not have been injured while involved in the
commission of felony criminal activity.
Section 3. R.esident Oualification. The waiver process requires qualification as a resident and
submission of documentation by the person seeking the waiver:
A. A qualifying individual is a resident who defined as either of the following:
1. Any property owner, or immediate member of his or her household, who
is current in paying property taxes in Mowoe County, including the Trauma Star
tax. For the purposes of this paragraph, the term "property tax" includes the tax
on real and personal property authorized by Monroe County Ordinance 030-2008.
For the purposes of this paragraph,. The term "immediate member of his or her
household" means (a) residing at the same address as the property owner, and
(b) son, daughter, father, mother, brother, sister, mother-in-law, father-in-law,
uncle, aunt, nephew, niece, brother-in-law, sister-in-law, stepfather, stepmother,
stepdaughter, stepson, half brother, half sister, grandchild, or domestic partner.
2. A resident of Monroe Couonty, or immediate member of his or her
household, who rents property subject to the Trauma Star tax. For the purpose of
this paragraph, the term "immediate member of his or her household" means
(a) residing at the same address as the property owner, and (b) son, daughter,
father, mother, brother, sister, mother-in-law, father-in-law, uncle, aunt, nephew,
niece, brother-in-law, sister-in-law, stepfather, stepmother, stepdaughter, stepson,
half brother, half sister, grandchild, or domestic partner.
VERSION B
Section 4.
A.
Section 5.
B.
A non-qualifying individual is any individual who does not contribute towards the
financing of the Trauma Star service, such ~s visitors and part-time or seasonal
residents, and all others who do not meet t~e criteria in section 3.A.
The billing company will continue to procclss billing as in current practice, but
will provide a waiver request form in the billing package. To be considered for
the write-off or waiver of out-of-pocket expenses, the patient is required to show
documentation to prove that the property owner has paid all applicable property
taxes, including any Trauma Star tax beginlning on November 1, 2009, and that
the qualifying individual meets the other r~quirements as set forth in Section 3.A.,
above. The qualifying individual must submit proof of qualification to the billing
company for review and validation. Documents to substantiate qualification must
include a copy of the property tax bill showing that all taxes, including the
Trauma Star tax, have been paid and are current. In addition, to qualify under
Section 3 .A.I., an individual must provide a copy of a current Monroe County
driver's license showing residency at the address held by the property owner. To
qualify under Section 3.A.2, an individual must provide a copy of a long-term
lease and/or utility bills at the address held by the property owner.
Residents who have met the waiver requirements, as documented by the billing
company, will not be invoiced during the time that the billing company continues
to seek third party payments and while pending the BOCC approval of the write-
off.
C.
D.
B.
Other Providers Excluded.
The fee waiver program is not applicable to any other transport provided by any
other helicopter provider, even in the event Trauma Star is out of service or
unavailable.
The County does not subsidize the operations of other providers, and the County
is not responsible for any fees incurred by residents from other providers'
servIces.
The Clerk is directed to send a copy of this Resolution to the Monroe County
Sheriff.
VERSION B
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida,
at a regular meeting of the Board held on the 20th day of May, 2009.
Mayor George Neugent ~
Mayor Pro Tem Sylvia Murphy ~
Commissioner Heather Carruthers~
ommissioner Mario Di Gennaro ~
,mmissioner Kim Wigington ~
, . KOLHAGE, CLERK
~
BOARD OF COUNTY COMMISSIONERS
OF M<1"ROE COUNTY, FLORIDA
BY:~~~c ';[)oI.A4.,e.J-
Mayor
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