Item C01BOARD OF COUNTY COMMISSIONERS
C ounty of M onroe A(I Mayor George Neugent, District 2
T he Fl orida Keys 4� �� m Mayor Pro Tem David Rice, District 4
l Danny L. Kolhage, District I
„ Y
„; ° W Heather Carruthers, District 3
Sylvia J. Murphy, District 5
County Commission Meeting
June 21, 2017
Agenda Item Number: C.1
Agenda Item Summary #2787
BULK ITEM: Yes DEPARTMENT: Fire
TIME APPROXIMATE: STAFF CONTACT: Gary Boswell (305) 289 -6004
N/A
AGENDA ITEM WORDING: Approval of a resolution rescinding Resolutions 100 -2014 and 182-
2015 and setting forth the revised bonus [financial incentive] program for Monroe County Fire
Rescue Billing Contract Employees.
ITEM BACKGROUND: A revision of the financial incentive program in order to define Net
Collections and to specify that net collections will be used to measure billing collection
performance.
PREVIOUS RELEVANT BOCC ACTION: At the July 2015 meeting the Board of County
Commissioners passed Resolution 182 -2015 to clarify the baseline collection time period. At the
June 2014 meeting the Board of County Commissioners passed Resolution 100 -2014, and the Board
of Governors passed Resolution 114 -2014, in order to establish a financial incentive program in
order to incentivize the employees to increase collections.
CONTRACT /AGREEMENT CHANGES:
Rescinding BOCC Resolutions 100 -2014 and 182 -2015
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
BOCC Resolution No. 182 -2015 adopted 7/15/15 rescinding Resolution No. 100 -2014
Fire Rescue - Bonus (financial incentive) program - Revised BOCC Resolution 2017 v4 clean
Fire Rescue - Bonus (financial incentive) program - Revised BOCC Resolution 2017 v4 (VERSION
SHOWING EDITS)
FINANCIAL IMPACT:
Effective Date:
Expiration Date:
Total Dollar Value of Contract:
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing:
Grant:
County Match:
Insurance Required:
Additional Details:
If yes, amount:
N/A
REVIEWED BY:
Gary Boswell
Completed
05/15/2017 1:37 PM
James Callahan
Completed
05/15/2017 1:39 PM
Pedro Mercado
Completed
05/15/2017 8:56 PM
Budget and Finance
Completed
05/16/2017 10:03 AM
Maria Slavik
Completed
05/16/2017 10:09 AM
Kathy Peters
Completed
05/16/2017 12:09 PM
Board of County Commissioners
Pending
06/21/2017 9:00 AM
RESOLUTION NO. 182 -2015
A RESOLUTION BY THE MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS AMENDING RESOLUTION
100 -2014 REGARDING THE BONUS [FINANCIAL
INCENTIVE] PROGRAM FOR MONROE COUNTY FIRE
RESCUE BILLING CONTRACT EMPLOYEES TO
CLARIFY THE BASELINE COLLECTION TIME PERIOD.
WHEREAS, in February 2014, the Monroe County Board of County Commissioners
( "BOCC ") and the Board of Governors of Fire and Ambulance District No. 1 ( "Board of
Governors ") approved an employment agreement for the position of Billing Supervisor, in order to
bring the function of billing and collection for Monroe County Fire Rescue ground and air
ambulance runs in- house; and
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WHEREAS, in April 2014, the BOCC and the Board of Governors approved an CD
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employment agreement for the position of Billing Specialist, also for the purpose of bringing the
function of ambulance billing and collection in- house; and
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WHEREAS, both employment agreements set a base salary for each position, and then
state that in lieu of any annual merit or cost -of- living adjustment, the employees will be eligible
for a financial lump sum incentive based upon billing and collections performance; and
WHEREAS, in July 2014, the BOCC passed Resolution 100 -2014 and the Board of
Governors passed Resolution 114 -2014 in order to establish a financial incentive program in order
to incentivize the employees to increase collections; and
WHEREAS, paragraph 4 of Resolution 100 -2014 stated that in the 12 months through
February 2014, excluding Medicaid, Monroe County had collected $2.3 million out of $6.8
million total billed by ADPI for combined ground and air ambulance runs, which translated to
33.7% of amounts billed; and
WHEREAS, it has come to the attention of staff that the 33.7% collection rate mentioned
in the paragraph above was based on fiscal year 2013 and not for past -l2- months ending February
28, 2014 and staff wishes to correct this scrivener's error.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COMMISSIONERS
OF MONROE COUNTY, FLORIDA, THAT
1. Paragraph 4 of Resolution 100 -2014 is revised to read as follows:
The average collection rate for air and ground ambulance combined during the - fiscal
ending September 30, 2013, not including Medicaid accounts was 33.70% ( "Baseline
Collection Rate ").
2. In all other respects, Resolution 100 -2014 is unchanged.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, this 15 th
day of July 2015.
Mayor Danny L. Kolhage
Mayor Pro Tern Heather Carruthers
Commissioner George Neugent
Commissioner David Rice
Commissioner Sylvia Murphy
(SEAL)
ATTEST: AMY HEAVILIN, CLERK
Yes
Yes
Yeg
Yes
Yes
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
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Deputy Clerk Mayor, DAny L. Kolhage
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MONROE COUNTY ATTORNEY
APPROVED AS TO FORM
Oigitally signed by Cynthia L Hall
V ON: cn=Cynthla L Hall, o =Monroe
County Attorney's ORice, ou =County
Aa—ey,emad=hall-
cynthzmo— county -0.gm, -US
Date: 2015.06.2616:27:44 - 04'00'
Assistant County Attorney
2
RESOLUTION NO. 00
A RESOLUTION BY THE MONROE COUNTY`BOARD OF CtDUNTY"
C011IISSIONERS °SETTING UP A BONUS [FINANCIAL INCEN'T'IVE]
PROGRAM FOR MONROE COUNTY FIRE RESCUE BILLING
CONTRACT EMPLOYEES
WHEREAS, in February 2014, the Monroe County Board of County Commissioners
( "BOCC ") and the Board of Governors of Fire and Ambulance District No. I ( "Board of
Governors ") approved an employment agreement for the position of Billing Supervisor, in order
to bring the function of billing and collection for Monroe County Fire Rescue ground and air
ambulance runs in- house; and
WHEREAS, in April 2014, the BOCC and the Board of Governors approved an
employment agreement for the position of Billing Specialist, also for the purpose of bringing the
function of ambulance billing and collection in- house; and
WHEREAS, both employment agreements set a base salary for each position; and
WHEREAS, both employment agreements then state that in lieu of any annual merit or
cost -of- living adjustment, the employees will be eligible for a financial lump sum incentive
based upon billing and collections performance; and
WHEREAS, the billing and collections functions were brought in -house by the BOCC
and the BOG in order to increase collections; and
WHEREAS, a portion of the salary for each of the two positions (Billing Supervisor and
Billing Specialist) is paid from the BOCC budget and a portion is paid by Board of Governors
budget, because air ambulance' rev trues are led into the BOCC budget and ground
..
ambulance revenues are deposited in the Board of Govemors budget; and
WHEREAS, the BOCC and the Board of Governors wish to establish a financial
incentive program in order to incentivize the employees to increase collections; and
WHEREAS, Section 215.425, Florida Statutes, provides that any bonuses that will be
paid to employees for work already performed must be implemented through a policy, ordinance,
rule or resolution, which notifies the employees who will be eligible for the bonus in advance of
evlauation period of the performance standards and the evaluation process by which the bonus
will be awarded, and
WHEREAS, Section 409.913(10), Florida Statutes, provides that payments for the
services of billing agents or persons participating in the preparation of a Medicaid claim shall not
be based on amounts for which they bill or on the amount the provider receives from Medicaid
(Note: only 3.6 percent (3.6 %) of Monroe County's collection revenues in the past twelve
months ending February 2014 came from Medicaid); and
Page 1 of 3
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WHEREAS, in the past 12 months excluding Medicaid, Monroe County collected S3.3
million for combined ground and air ambulance runs, which translates to 33.7% of amounts
billed before adjustments; and
WHEREAS, it is the intent of the legislative body to describe the financial incentive
program for Fire Rescue billing personnel through this resolution.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF
COMMISSIONERS OF MONROE COUNTY, FLORIDA., THAT
1. For the purpose of this resolution, the terms and "financial incentive" are used
interchangeably.
2 For the purpose of this resolution, the term "Collections" refers to collections from nll
sour�cs not c eluding- a icatd _
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3. The initial time period covered by this financial incentive program for Billing Supervisor C '
and Billing Specialist shall run from lulay i, �f}I � Eo �1Fr[ 3t}, ?p l Thereafter, each CD
year, the evaluation period ( "Evaluation Period ") shall run from May I to April 30.
4. The a erage collection rate for air and ground mbulance `co itbuced' during the time
eno March 1 2 013 through February 2 � ilia" '
p , . �ti ry _8, _014 of includin`'Medicatd accounts was
33.70 ( "Baseline Collection Rate ").
5. For every one (1) percentage point increase in Collections as n percentage of non -
Medicaid billed amounts over Baseline Collection Rate achieved by the end of the
Evaluation Period, each employee shall receive a one -time lump sum bonus ("Bonus
Amount ") in the amount of one percent (1.0 %) of the employee's unloaded base salary,
up to a maximum increase of ten percent (10 %) of the Baseline Collection Rate, which
will translate to a maximum bonus of ten percent (10 uftllutrattoi►, if
Collections increase from 33.70% at the beginning of the Evaluation E'eriod "to` 38:70%
measured at the end of the Evaluation Period, which is an increase of live (5) percentage
points, each employee would receive a bonus in the amount of five percent (5 %) of the
unloaded base salary tot' for tI+R 1 ` �rc ori +a F e percenmgc
of thtg t point
i s t d()e tons would total approximately X3:10,041# tit d
said ould equate t a lump sum bonus of S5,300 for the nvo a pG es combined i he
first year.
S. The bonus amounts will be calculated one time annually, at the end of the Evaluation
Period. The bonus amounts will not be added to the base salary and will not be used for
computing average weekly wage for any other purpose, including but not limited to FRS,
unemployment or workers' compensation.
7. The bonus amounts shall be paid by the BOCC and the BOG in proportion to the amounts
collected by and for each entity at the end of the Evaluation Period. Each bonus program
must be approved by the BOCC and the BOG. if, for any reason, the bonus program is
Page 2of3
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not approved by resolution by both entities, then each entity will be responsible for
paying its portion of the Bonus Amount, i.e., the total Bonus Amount, multiplied by the
percentage of Collections attributable to ground ambulance (in the case of the Board of
Governors) or air ambulance (in the case of the BOCC).
8. This bonus program shall continue from year to year until revised by the BOCC and shall
apply to whatever personnel hold the position of Billing Supervisor and Billing
Specialist. In subsequent years, the starting point, i.e., the Baseline Collection Rate, shall
be the collection rate for the preceding twelve months, i.e., May 1 to April 30.
9. To be eligible for the bonus, the employee must be employed by Monroe County on the
day that the Bonus Amount is paid out, following the end of the Evaluation Period.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, this
11th day of . June 2014.
Mayor, Sylvia Murphy Yes
Mayor Pro Tern, Danny Kolhage Yes
Commissioner Heather Carruthers
Commissioner George Neugent
Commissioner David Rice
TATS OF FLORIDKi
HEAVE.IN, CLERK
Yes
Yes
Ye s
:OUNTY OF MONROE Deputy Clerk
'lib Copy Is a True Copy of the
lrtginal on File to this OtBci Witness
ty hand and Ol[fcf;i Stet.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By.
Mayor, Sylvia Murphy
'bb —1 �r day ot ! :4— Page 3 of 3
AMY REA ALIN
Ckrk Circuit Court
MONROE COUNTY ATTORNEY
AVtO VED ASS FO
- AT YNTHIA L. HALL
ASSISTA T COUNTY ATTORNEY
y-
y r
RESOLUTION NO. -2017
A RESOLUTION BY THE MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS RESCINDING
RESOLUTIONS 100 -2014 AND 182 -2015 AND SETTING
FORTH THE REVISED BONUS [FINANCIAL INCENTIVE]
PROGRAM FOR MONROE COUNTY FIRE RESCUE
BILLING CONTRACT EMPLOYEES.
WHEREAS, in February 2014, the Monroe County Board of County Commissioners
( "BOCC ") and the Board of Governors of Fire and Ambulance District No. 1 ( "Board of
Governors ") approved an employment agreement for the position of Billing Supervisor, in order
to bring the function of billing and collection for Monroe County Fire Rescue ground and air
ambulance runs in- house; and
WHEREAS, in April 2014, the BOCC and the Board of Governors approved an
employment agreement for the position of Billing Specialist, also for the purpose of bringing the
function of ambulance billing and collection in- house; and
WHEREAS, both employment agreements set a base salary for each position, and then
state that in lieu of any annual merit or cost -of- living adjustment, the employees will be eligible
for a financial lump sum incentive based upon billing and collections performance; and
WHEREAS, in July 2014, the BOCC passed Resolution 100 -2014 and the Board of
Governors passed Resolution 114 -2014 in order to establish a financial incentive program in
order to incentivize the employees to increase collections; and
WHEREAS, in July 2015 the BOCC passed resolution 182 -2015 to clarify the baseline
collection time period; and
WHEREAS, staff desires to revise the financial program in order to define net
collections, and to specify that net collections will be used to measure billing collection
performance.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF
COMMISSIONERS OF MONROE COUNTY, FLORIDA, THAT:
Section 1. Resolutions 100 -2014 and 182 -2015 are hereby rescinded in their entirety.
Section 2. Monroe County Bonus Program
1. For the purpose of this resolution, the terms "bonus" and "financial incentive" are
used interchangeably.
2. For the purpose of this resolution, the term "Collections" refers to collections from all
sources not including Medicaid.
3. For the purpose of this resolution, the term "Net Collections" refers to gross
collections from all sources not including Medicaid, net of all non - collectable
(mandatory) contractual allowances, refunds, and the write -off portion of Trauma Star
resident waivers.
4. For the purpose of this resolution, and calculation of the bonus award, the transition
from the previous performance standard and evaluation process to the standard set
forth in this resolution shall occur on July 1, 2017.
5. To account for the transition from the previous Financial Incentive Resolution
Program to this revision, the transitional evaluation time period used to calculate the
bonus award employing the previous performance standard and evaluation process set
forth in Resolution 100 -2014 and 182 -2015 shall run from May 1 2015 to June 30,
2017. Thereafter, each year, the evaluation period ( "Evaluation Period ") shall run
from July 1 to June 30.
6. The average collection rate for air and ground ambulance combined during the fiscal
year ending September 31, 2013, not including Medicaid accounts was 33.70%
( "Baseline Collection Rate ").
7. For every one (1) percentage point increase in Collections as a percentage of non
Medicaid billed amounts over Baseline Collection Rate achieved by the end of the
Evaluation Period, each employee shall receive a one -time lump sum bonus ( "Bonus
Amount ") in the amount of one percent (1.0 %) of the employee's unloaded base
salary, up to a maximum increase of ten percent (10 %) of the Baseline Collection
Rate, which will translate to a maximum bonus of ten percent (10 %). By way of
illustration, if Collections increase from 33.70% at the beginning of the Evaluation
Period to 38.70% measured at the end of the Evaluation Period, which is an increase
of five ( 5) percentage points, each employee would receive a bonus in the amount of
five percent (5 %) of the unloaded base salary. Note, for the purposes of this
illustration, a five percentage point increase in collections would total approximately
$340,000 in additional billing revenues and would equate to a lump sum bonus of
$5,300 for the two employees combined in the first year.
8. The bonus amounts will be calculated one time annually, at the end of the Evaluation
Period. The bonus amounts will not be added to the base salary and will not be used
for computing average weekly wage for any other purpose, including but not limited
to FRS, unemployment or workers' compensation.
9. The bonus amounts shall be paid by the BOCC and the BOG in proportion to the
amounts collected by and for each entity at the end of the Evaluation Period. Each
bonus program must be approved by the BOCC and the BOG. If, for any reason, the
bonus program is not approved by resolution by both entities, then each entity will be
responsible for paying its portion of the Bonus Amount, i.e., the total Bonus Amount,
multiplied by the percentage of Collections attributable to ground ambulance (in the
case of the Board of Governors) or air ambulance (in the case of the BOCC).
10. This bonus program shall continue from year to year until revised by the BOCC and
shall apply to proprietary function bill collections and whatever personnel hold the
position of Billing Supervisor and Billing Specialist. In subsequent years, percentage
increase in Net Collections shall be used in comparison to the Baseline Collection
Rate, and shall be the collection rate for the preceding twelve months, i.e., July 1 to
June 30.
11. To be eligible for the bonus, the employee must be employed by Monroe County on
the day that the Bonus Amount is paid out, following the end of the Evaluation
Period.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
this day of June 2017.
Mayor George Neugent
Mayor Pro Tem David Rice
Commissioner Danny Kolhage
Commissioner Heather Carruthers
Commissioner Sylvia Murphy
(SEAL)
ATTEST: KEVIN MADOK, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
IM
Deputy Clerk
Im
Mayor George Neugent
RESOLUTION NO. -2017
A RESOLUTION BY THE MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS RESCINDING
RESOLUTIONS 100 -2014 AND 185 -2015 AND SETTING
FORTH THE REVISED BONUS [FINANCIAL INCENTIVE]
PROGRAM FOR MONROE COUNTY FIRE RESCUE
WHEREAS, in February 2014, the Monroe County Board of County Commissioners
( "BOCC ") and the Board of Governors of Fire and Ambulance District No. 1 ( "Board of
Governors ") approved an employment agreement for the position of Billing Supervisor, in order
to bring the function of billing and collection for Monroe County Fire Rescue ground and air
ambulance runs in- house; and
WHEREAS, in April 2014, the BOCC and the Board of Governors approved an
employment agreement for the position of Billing Specialist, also for the purpose of bringing the
function of ambulance billing and collection in- house and
WHEREAS, both employment agreements set a base salary for each position, and then
state that in lieu of any annual merit or cost -of- living adjustment, the employees will be eligible
for a financial lump sum incentive based upon billing and collections performance; and
WHEREAS, in July ; 2014, the BOCC passed Resolution 100 -2014 and the Board of
Governors passed Resolution 114 -2014 in order to establish a financial incentive program in
order to incentivize the employees to increase collections; and
WHEREAS, in July 2015 the BOCC passed resolution 182 -2015 to clarify the baseline
collection time period_ and
WHEREAS, staff desires to revise the financial program in order to define net
collections, and to specify that net collections will be used to measure billing collection
performance.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF
COMMISSIONERS OF MONROE COUNTY, FLORIDA, THAT:
Section 1. Resolutions 100 -2014 and 182 -2015 are hereby rescinded in their entirety.
Section 2. Monroe County Bonus Program
1. For the purpose of this resolution, the terms "bonus" and "financial incentive" are
used interchangeably. CO
I
2. For the purpose of this resolution, the term "Collections" refers to collections from all
U)
sources not including Medicaid.
For ffie purpose of dds resoIutjioni, ffie terry - " , ,let C011ectiol reIers to gross W
C011ectiol froll a-HI soul 1-Mt I'nc'udinp 0
I 'g N/ledicald, nm of aHI nay z
(aria a6 conaractuali aHlm jai - Wes, refunids, anid ffie - ,alts-off portloi of I Stal
i l dei 0
- es - 'a - vN, , aIVers, X
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`'or the purpose ofthis rcso4rdon, and calculadon ofthe bonus award, the transidon z
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froni the previous perfortnance standard and evaluation process to the standard set U)
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fbrth in this resolution shall occur on july 1, 201 W
6. I accouna for ffie tranIsItIonI fi the previous 1-i Incentive Reso1utioll
PrOL I I i I ly
grall to dds revIS101 ffie trai evaluation ti - ie pei°ijod used to calculate the
bonus award cmployin the previous perfortyOance standard and evaluadon process set
forffi 'n Reso'uflon 100-')014 and 18' shall run - Froiri klay 1 2 015 to june wl
'01' _�Iereafter, eacl� veal ffie evakation period '"Ev,
1�_ 11 L , 1 .11 1 i � I k i ion� Perlod"') sl�a-11 run�
fi juIV I to jul _30,
7. The average collection rate for air and ground ambulance combined during the fiscal
year ending September 31, 2013, not including Medicaid accounts was 33.70%
("Baseline Collection Rate").
8. For every one (1) percentage point increase in Collections as a percentage of non
Medicaid billed amounts over Baseline Collection Rate achieved by the end of the
Evaluation Period, each employee shall receive a one-time lump sum bonus ("Bonus
Amount") in the amount of one percent (1.0%) of the employee's unloaded base
salary, up to a maximum increase of ten percent (10%) of the Baseline Collection
Rate, which will translate to a maximum bonus of ten percent (10%). By way of
illustration, if Collections increase from 33.70% at the beginning of the Evaluation
Period to 38.70% measured at the end of the Evaluation Period, which is an increase
of five ( 5) percentage points, each employee would receive a bonus in the amount of
five percent (5%) of the unloaded base salary. Note, for the purposes of this
illustration, a five percentage point increase in collections would total approximately
$340,000 in additional billing revenues and would equate to a lump sum bonus of
$5,300 for the two employees combined in the first year.
9. The bonus amounts will be calculated one time annually, at the end of the Evaluation
Period. The bonus amounts will not be added to the base salary and will not be used
for computing average weekly wage for any other purpose, including but not limited
to FRS, unemployment or workers' compensation.
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10. The bonus amounts shall be paid by the BOCC and the BOG in proportion to the
amounts collected by and for each entity at the end of the Evaluation Period. Each
bonus program must be approved by the BOCC and the BOG. If, for any reason, the
bonus program is not approved by resolution by both entities, then each entity will be
responsible for paying its portion of the Bonus Amount, i.e., the total Bonus Amount,
multiplied by the percentage of Collections attributable to ground ambulance (in the
case of the Board of Governors) or air ambulance (in the case of the BOCC).
11. This bonus program shall continue from year to year until revised by the BOCC and
shall apply to proprietary fui —1 loi - 1 b 111 coHlectlo bs -lid whatever personnel hold the
position of Billing Supervisor and Billing Specialist. In subsequent years, percentage
increase in Net Collections shall be used in comparison to the Baseline Collection
Rate, and shall be the collection rate for the pre
months i.e. my 1
iyed'by County on
the end of the Evaluation
oners of Monroe County,
'OUNTY COMMISSIONERS
COUNTY, FLORIDA
George Neugent
to ATT4 jui-W 30.
12. To be eligible for the bonus, the employee must be en
the day that the Bonus Amount is paid out, fallow
Period.