Resolution 188-2015RESOLUTION NO. 188 -2015
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA, REVISING RESOLUTION NO.
152 -2009; DISPENSING WITH THE REQUIREMENT THAT
PROPERTY OWNERS PRODUCE A MONROE COUNTY DRIVER'S
LICENSE IN ORDER TO QUALIFY FOR A FEE WAIVER FOR
TRAUMA SCENE AND CRITICAL CARE INTERFACILITY
FLIGHTS; REMOVING THE REFERENCE TO AN EXTERNAL
BILLING COMPANY; SETTING AN EFFECTIVE DATE; AND
DIRECTING THE CLERK TO SEND A COPY OF THE RESOLUTION
TO THE MONROE COUNTY SHERIFF.
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 above and beyond user service
fees is funded by ad valorem property taxes paid by Monroe County citizens; and
WHEREAS, on May 20, 2009, the Board of County Commissioners adopted Resolution
152 -2009, creating a program whereby Monroe County property owners and their tenants
(collectively, "Residents ") may qualify for a waiver of that portion of Trauma Star fees above
and beyond the amount of reimbursement obtained from third -party payors (including but not
limited to private insurance, Medicare and Medicaid) in return for the property taxes paid by the
property owners to support the Trauma Star program; and
WHEREAS, Resolution 152 -2009 includes a requirement that property owners show a
current Monroe County driver's license in order to qualify for the fee waiver; and
WHEREAS, the Board of County Commissioners recognize that many property owners
who are seasonal or part-time residents do not hold drivers' licenses issued by Monroe County,
and the Commissioners now wish to dispense with this requirement in order to extend the fee
waiver program to those taxpaying property owners; and
WHEREAS, the Board of County Commissioners also wish to update Resolution 152-
2009 to reflect the fact that billing is now performed in -house by Monroe County employees
rather than by an external billing company; and
WHEREAS, the Board of County Commissioners also wish to update Resolution 152-
2009 to dispense with the requirement that air ambulance write -offs attributable to resident fee
waivers be presented to the BOCC for approval in the form of a resolution as currently set forth
in Section 1 of Resolution 152 -2009.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA THAT:
1. Section 1, paragraph D (which currently reads "Write -offs of out -of- pocket expenses will
be completed by annual resolution of the Board of County Commissioners ") is repealed
in its entirety and replaced with the following language:
D. Write -offs of out -of- pocket expenses attributable to fee waivers will be
reported to the Board of County Commissioners in the form of yearly agenda
items.
2. Section 3, paragraphs C and D in Resolution 152 -2009 are revised to read as follows:
C. Monroe County will continue to process 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 beginning on November 1,
2009, and that the qualifying individual meets the other requirements as set
forth in Section 3.A., above. The qualifying individual must submit proof of
qualification 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.2, an individual must provide a copy of
a long -term lease and/or utility bills at the address held by the property owner.
D. Residents who have met the waiver requirements will not be invoiced during
the time that Monroe County continues to seek third party payments.
3. In all other respects, Resolution 152 -2009 remains unchanged.
4. The effective date of this Resolution shall be July 15, 2015.
5. The Clerk is directed to send a copy of this Resolution to the Monroe County Sheriff.
f
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida,
at a regular meeting of the Board held on the 15 day of July, 2015.
Mayor Danny L. Kolhage
Yes
Mayor Pro Tern Heather Carruthers
Yes
Commissioner George Neugent
Yes
Commissioner David Rice
Yes
Commissioner Sylvia Murphy
Yes
HEAVILIN, CLERK BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
vp & &CI SM By:
ler Mayor
MONROE COUNTY ATTORNEY
PRO ED S�RM:
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MONROE COUNTY ATTORNEY
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IERSION B
RESOLUTION NO. 152 2009
RESOLUTION OF THE BOARD OF COU TY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, ADOPTING A FEE WAIVER
POLICY AND PROCESS FOR TRAUMA STAR BILLING FOR
TRAUMA SCENE AND CRITICAL CARE INTERFACILITY
FLIGHTS.
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 Qualification 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. Resident Qualification 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 Monroe 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
B. A non - qualifying individual is any individual who does not contribute towards the
financing of the Trauma Star service, such as visitors and part -time or seasonal
residents, and all others who do not meet tl�e criteria in section 3.A.
C. The billing company will continue to process 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 beginning on November 1, 2009, and that
the qualifying individual meets the other requirements 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.1., 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.
D. 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.
Section 4. Other Providers Excluded.
A. 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.
B. 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.
Section 5. 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 20 day of May, 2009.
Mayor George Neugent Yes
Mayor Pro Tem Sylvia Murphy No
Commissioner Heather Carruthers Yes
mmissioner Mario Di Gennaro Yes
mmissioner Kim Wigington Yes
KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS
OF MO ROE COUNTY, FLORIDA
By: Y.
c Mayor
MONROE COUNTY ATTORNEY
PROV 9S 0 OR
CYNTHIA AL`
ASSTS AN COUNTY A ORNEY
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