Item F10M
C ounty of f Monroe
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BOARD OF COUNTY COMMISSIONERS
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Mayor George Neugent, District 2
The Florida. Ke Se
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Mayor Pro Tern David Rice, District 4
Danny L. Kolhage, District I
Heather Carruthers, District 3
Sylvia J. Murphy, District 5
County Commission Meeting
November 14, 2017
Agenda Item Number: F.10
Agenda Item Summary #3501
BULK ITEM: Yes DEPARTMENT: Emergency Services
TIME APPROXIMATE: STAFF CONTACT: James Callahan (305) 289 -6088
N/A
AGENDA ITEM WORDING: Approval of Resolution authorizing the write -off of 105 accounts
receivable covering the time period of 2014 through August 2017 totaling $1,086,179.69 for Monroe
County residents who qualified for the Trauma Star Air Ambulance Waiver Program. From January
1, 2014 through August 31, 2017, the amount of $12,007,635.70 was collected and deposited into
accounts receivable for Trauma Star services.
ITEM BACKGROUND: On May 20, 2009 Resolution No. 152 -2009 was passed establishing the
Trauma Star Air Ambulance Fee Waiver Program effective November 4, 2008. Residents who
qualify for this program are authorized to have all out -of- pocket fees waived for Trauma Star
emergency and /or inter - facility air - transports after any third party payments have been received.
The attached Resolution authorizes the write -off of the balances of 105 qualified Monroe County
resident's accounts receivable totaling $1,086,179.69 (See attached Exhibit A). On April 1, 2014 air
and ground billing was brought in -house and is now handled by Monroe County Fire Rescue. Once
billing was brought in -house the department did an in -depth analysis of the open patient accounts
held by the prior vendor. It was discovered that Trauma Star Air Ambulance Fee Waivers were not
being distributed to patients who were Monroe County residents. The in -house billing department
mailed out waivers to 125 patient accounts with dates of service from 2011 -2014. This created an
influx of fee waivers in FY 2014, which continued into FY 2015. There were a total of 1,807
Trauma Star transports from 2009 -2015 and on March 18, 2015 the write -off of 85 Fire Rescue air
ambulance resident waivers totaling $712,326.92 was authorized. 67 fee waivers accepted and
approved in FY 2015 totaling $388,998.33. In July 2015, the Board of County Commissioners
voted to extend this waiver program to all Monroe County property owners, regardless of residency,
for all air transports on or after July 15, 2015. (See attached Exhibit A).
PREVIOUS RELEVANT BOCC ACTION: On May 20, 2009 the Board approved Resolution
No. 152 -2009 adopting a fee waiver policy and process for trauma star billing for trauma scene and
critical care inter - facility flights for qualifying Monroe County residents for flights that occurred
after November 4, 2008. On August 18, 2010 Resolution No. 247 -2010 authorized the write -off of
22 Fire Rescue air ambulance resident waivers totaling $150,437.61. On October 19, 2011
Resolution No. 248 -2011 authorized the write -off of 25 Fire Rescue air ambulance resident waivers
totaling $180,916.58. Forty approved applications received in FY 2012 totaling $336,969.86. On
November 20, 2013 Resolution No. 384 -2013 authorized the write -off of 15 Fire Rescue air
ambulance resident waivers totaling $114,799.77. On March 18, 2015 Resolution No. 067 -2015
authorized the write -off of 85 Fire Rescue air ambulance resident waivers totaling $712,326.92. On
November 17, 2015 Resolution 384 -2015 authorized the write -off of 67 Trauma Star air ambulance
resident waivers totaling $388.998.33. On November 22, 2016 Resolution 283 -2016 authorized the
write -off of 92 Trauma Star air ambulance resident waivers totaling 695,317.54.
CONTRACT /AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
Resolution
EXHIBIT A
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 10/24/2017 10:09 AM
Pedro Mercado Completed 10/27/2017 4:08 PM
James Callahan
Budget and Finance
Maria Slavik
Kathy Peters
Board of County Commissioners
Completed
10/27/2017 4:11 PM
Completed
10/27/2017 4:25 PM
Completed
10/30/2017 7:34 AM
Completed
10/30/2017 9:02 AM
Pending
11/14/2017 9:00 AM
RESOLUTION NO. -2017
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA AUTHORIZING THE WRITE -OFF OF
TRAUMA AIR AMBULANCE RESIDENT WAIVER ACCOUNTS RECEIVABLE
WHEREAS, Monroe County Fire Rescue Services provides air ambulance service; and
WHEREAS, on May 20, 2009 the Board approved Resolution No. 152 -2009 adopting a fee
waiver policy and process for trauma star air ambulance billing or trauma scene and critical care inter -
facility flights for qualifying Monroe County residents for flights that occurred after November 4, 2008;
and
WHEREAS, the accounts shown on Exhibit A have applied for the resident waiver; and
WHEREAS, the Board of County Commissioners of Monroe County contracted with Advance
Data Processing, Inc. (ADPI) for trauma air ambulance billing and related professional services until
March 31, 2014 as which time the billing was brought in- house; and
WHEREAS, a report was provided by Advanced Data Processing, Inc. and in -house billing on
these accounts and it was determined that all third -parry payments have been received and applied to their
accounts; that the balances constituted the amount remains after all third party payments had been
credited to the account; and that residents submitted sufficient documentation to qualify for the resident
trauma air ambulance waiver; and
WHEREAS, it is desired that these resident waiver trauma air ambulance service accounts
receivable be written -off at this time;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY:
1. Receivables for resident waiver air ambulance service 105 accounts listed on attached Exhibit A in the
amount of $1,086,179.69 shall be deleted from the Fine and Forfeiture Fund.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida,
at a regular meeting of said Board held on the 14' day of November, 2017.
Mayor
Mayor Pro Tem
Commissioner
Commissioner
Commissioner
(Seal)
ATTEST: KEVIN MADOK, CLERK
By:
Deputy Clerk
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By:
Mayor / Chairman
MONROE COUNTY ATTORNEY:
ma
Pedro Mercado
EXHIBIT A
Monroe County Fire Rescue
Trauma Star Fee Waiver 2017
Account Receivables Write-Off
TRAUMA STAR RESIDENT FEE WAIVERS
(DOS: 8/22/2014 - 08/31/2017)
TRIP DATE
RUN NUMBER
CHARGES
PAYMENTS
I ADJUSTMENTS
REFUNDS
BALANCE
2014-08-22
2006
$12,028.00
$6,111.20
$0.00
$5,916.80
2015-01-05
57
$16,060.00
$0.00
$0.00
$16,060.00
2015-01-30
296
$11,916.00
$0.00
$0.00
$11,916.00
2015-05-23
1411
$13,268.00
$6,780.51
$4,757.77
$0.00
$1
2015-08-27
2302
$12,076.00
$0.00
$0.00
$12,076.00
2015-09-16
2474
$15,740.00
$7,596.00
$0.00
$8,144.00
2015-11-07
2885
$10,724.00
$5,582.75
$0.00
$5,141.25
2015-11-13
2951
$9,660.00
$0.00
$0.00
$9
2015-12-23
3283
$25,200.00
$22,692.00
$0.00
$2,508.00
2016-01-17
192
$21,110.00
$6,551.42
$12,834.14
$0.00
$1,724.44
2016-01-26
263
$25,100.00
$6,822.80
$0.00
$18,277.20
2016-02-02
326
$16,820.00
$5,042.40
$0.00
$11,777.60
2016-03-09
709
$21,710.00
$0.00
$0.00
$21,710.00
2016-03-17
814
$20,300.00
$1,000.00
$0.00
$19,300.00
2016-03-22
862
$20,300.00
$6,156.00
$0.00
$14,144.00
2016-04-11
1071
$23,100.00
$12,360.72
$0.00
$10,739.28
2016-04-13
1096
$23,100.00
$5,001.60
$0.00
$18
2016-04-15
1111
$17,200.00
$17,150.00
$0.00
$50.00
2016-04-15
1117
$20,230.00
$8,003.85
$0.00
$12,226.15
2016-05-02
1274
$18,530.00
$18,480.00
$0.00
$50.00
2016-05-07
1292
$20,300.00
$0.00
$0.00
$20,300.00
2016-05-07
1298
$24,800.00
$0.00
$0.00
$24,800.00
2016-06-18
1633
$20,300.00
$18,588.54
$0.00
$1,711.46
2016-06-19
1655
$18,190.00
$0.00
$0.00
$18,190.00
2016-06-25
1704
$25,200.00
$8,948.15
$15,555.10
$0.00
$696.75
2016-06-28
1732
$18,550.00
$0.00
$0.00
$18,550.00
2016-06-28
1742
$18,190.00
$6,402.78
$10,892.48
$0.00
$894.74
2016-07-09
1834
$21,110.00
$0.00
$0.00
$21,110.00
2016-07-10
1837
$21,110.00
$6,462.95
$12,832.34
$0.00
$1,814.71
2016-07-10
1840
$25,200.00
$25,150.00
$0.00
$50.00
2016-07-19
1916
$21,350.00
$0.00
$0.00
$21,350.00
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2016 -07 -23
1947
$25,200.00
$19,601.96
$0.00
$5,598.04
2016 -07 -25
1977
$23,100.00
$8,805.37
$0.00
$138.01
2016 -07 -27
1998
$21,350.00
$4,422.97
$0.00
$16,927.03
2016 -08 -05
2105
$23,100.00
$7,052.00
$0.00
$16,048.00
2016 -08 -12
2200
$16,810.00
$5,446.21
$9,974.45
$0.00
$1,389.34
2016 -08 -17
2214
$24,800.00
$24,650.00
$0.00
$150.00
2016 -08 -18
2236
$21,350.00
$7,397.07
$12,992.74
$0.00
$960.19
2016 -08 -24
2280
$24,400.00
$7,468.00
$0.00
$16,932.00
2016 -08 -30
2313
$19,800.00
$0.00
$0.00
$19,800.00
2016 -09 -04
2354
$20,710.00
$6,287.20
$0.00
$14,422.80
2016 -09 -05
2372
$23,100.00
$0.00
$0.00
$23,100.00
2016 -09 -25
2541
$24,900.00
$7,603.94
$15,356.27
$0.00
$1,939.79
2016 -09 -28
2568
$24,800.00
$5,596.00
$0.00
$19,204.00
2016 -10 -04
2613
$25,200.00
$22,478.16
$0.00
$2,721.84
2016 -10 -14
2696
$23,100.00
$6,993.72
$14,156.17
$0.00
$1
2016 -10 -15
2705
$25,200.00
$0.00
$0.00
$25,200.00
2016 -10 -20
2739
$20,300.00
$6,156.00
$0.00
$14,144.00
2016 -10 -22
2757
$25,200.00
$22,478.16
$0.00
$2,721.84
2016 -10 -23
2765
$25,200.00
$7,683.96
$15,555.84
$0.00
$1,960.20
2016 -10 -24
2776
$23,700.00
$0.00
$0.00
$23,700.00
2016 -10 -28
2803
$25,200.00
$22,478.16
$0.00
$2,721.84
2016 -10 -28
2811
$22,800.00
$8,535.32
$13,989.68
$0.00
$275.00
2016 -10 -31
2842
$24,800.00
$7,596.00
$0.00
$17,204.00
2016 -11 -08
2911
$22,500.00
$22,450.00
$0.00
$50.00
2016 -11 -26
3060
$17,840.00
$0.00
$0.00
$17,840.00
2016 -11 -27
3065
$22,600.00
$0.00
$0.00
$22,600.00
2016 -11 -30
3105
$23,100.00
$0.00
$0.00
$23,100.00
2016 -12 -06
3161
$24,100.00
$23,950.00
$0.00
$150.00
2016 -12 -07
3168
$16,660.00
$11,054.84
$0.00
$5,605.16
2016 -12 -23
3326
$23,100.00
$0.00
$0.00
$23,100.00
2016 -12 -29
3404
$25,200.00
$20,280.29
$0.00
$4,919.71
2016 -12 -30
3425
$23,100.00
$0.00
$0.00
$23,100.00
2017 -01 -01
8
$20,300.00
$6,156.00
$0.00
$14,144.00
2017 -01 -01
11
$25,200.00
$9,706.73
$15,493.27
$394.58
$394.58
2017 -01 -10
87
$24,400.00
$0.00
$0.00
$24,400.00
2017 -01 -12
96
$24,800.00
$9,533.99
$15,266.01
$50.00
$50.00
2017 -01 -13
113
$25,200.00
$19,601.96
$0.00
$5,598.04
2017 -01 -22
210
$25,200.00
$0.00
$0.00
$25,200.00
2017 -01 -26
270
$21,710.00
$6,796.41
$13,179.81
$0.00
$1,733.78
2017 -01 -30
313
$21,110.00
$9,246.77
$0.00
$11,863.23
2017 -01 -30
314
$23,100.00
$0.00
$0.00
$23,100.00
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2017 -02 -02
332
$20,220.00
$15,923.52
$0.00
$4,296.48
2017 -02 -06
370
$25,200.00
$7,733.82
$15,493.27
$0.00
$1,972.91
2017 -02 -07
379
$25,200.00
$20,677.29
$0.00
$4,522.71
2017 -02 -10
421
$23,100.00
$7,169.76
$14,101.22
$0.00
$1,829.02
2017 -02 -18
490
$21,110.00
$7,248.87
$12,779.15
$0.00
$1,081.98
2017 -02 -20
516
$23,100.00
$7,026.29
$14,098.29
$0.00
$1,975.42
2017 -02 -24
558
$21,710.00
$0.00
$0.00
$21,710.00
2017 -03 -01
615
$20,710.00
$5,590.40
$0.00
$15,119.60
2017 -03 -04
655
$25,200.00
$0.00
$0.00
$25,200.00
2017 -03 -07
695
$23,100.00
$0.00
$0.00
$23,100.00
2017 -03 -09
720
$25,200.00
$9,618.29
$15,531.71
$0.00
$50.00
2017 -03 -19
817
$21,110.00
$8,292.92
$12,782.08
$0.00
$35.00
2017 -03 -20
828
$20,300.00
$7,785.82
$12,114.18
$0.00
$400.00
2017 -03 -25
889
$25,200.00
$7,733.82
$15,493.27
$0.00
$1,972.91
2017 -03 -26
895
$25,200.00
$7,724.00
$0.00
$17,476.00
2017 -03 -29
942
$25,200.00
$0.00
$0.00
$25,200.00
2017 -04 -01
974
$16,810.00
$4,838.85
$11,433.50
$0.00
$537.65
2017 -04 -05
1023
$21,110.00
$6,491.78
$12,779.15
$0.00
$1,839.07
2017 -04 -05
1028
$17,640.00
$5,304.80
$0.00
$12,335.20
2017 -04 -09
1063
$25,200.00
$13,810.40
$0.00
$11
2017 -04 -19
1147
$25,200.00
$18,125.96
$0.00
$7,074.04
2017 -04 -29
1232
$23,100.00
$7,169.76
$14,101.22
$0.00
$1,829.02
2017 -05 -07
1310
$24,800.00
$7,626.38
$15,228.11
$0.00
$1,945.51
2017 -05 -09
1337
$25,200.00
$7,590.35
$15,490.34
$0.00
$2,119.31
2017 -05 -11
1348
$24,800.00
$7,626.38
$15,228.11
$0.00
$1,945.51
2017 -05 -25
1474
$24,400.00
$9,436.94
$14,962.96
$1,918.00
$1,918.10
2017 -05 -26
1507
$21,110.00
$18,710.00
$0.00
$2,400.00
2017 -05 -30
1557
$21,110.00
$5,132.16
$0.00
$15,977.84
2017 -05 -31
1561
$21,710.00
$6,796.41
$13,179.81
$0.00
$1,733.78
2017 -06 -15
1716
$25,200.00
$0.00
$0.00
$25,200.00
2017 -06 -27
1842
$16,820.00
$0.00
$0.00
$16,820.00
2017 -07 -05
1920
$25,200.00
$0.00
$0.00
$25,200.00
2017 -08 -05
2249
$23,100.00
$0.00
$0.00
$23,100.00
TOTAL
$2,285,182.00
$779,575.83
$407,632.44
$2,362.58
$1,086,179.69
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