Item C41 BOARD OF COUNTY COMMISSIONERS, MONROE COUNTY FLORIDA
AGENDA ITEM SUMMARY
Meeting Date: December 11, 2013 Division: Emergency Services
Bulk Item: Yes X No Department: Fire Rescue
Staff Contact Person: Holly Pfiester 289-6088
AGENDA ITEM WORDING: Approval to create positions of EMS Billing Supervisor and EMS Billing
Specialist as Monroe County contract employees and to hire individuals into those positions; authority for Fire
Chief to execute contracts.
ITEM BACKGROUND: Prior to 2000, Monroe County employed in-house billing personnel. Monroe County
Emergency Services began outsourcing ambulance transport billing and collections in the year 2000, shortly after
formation of Monroe County Fire Rescue. In 2005, a contract was entered into between Monroe County and Advanced
Data Processing (ADPI) to perform medical billings and account receivable management services,which has been
renewed through competitive bidding. Trauma Star air-ambulance operations and billing, as well as the Trauma Star
Resident Waiver Program began in 2006. The BOCC approved a consultant's evaluation of the current billing and
collections processes which was completed in 2013. The results of the evaluation determined that current ground- and air-
ambulance collections were not effective, did not maximize potential revenue collections, and there was a lack of ADPI
managerial oversight. The number one recommendation, for effective and productive ground- and air-ambulance
transport billing and collections,was to make the function an integral component of the Emergency Services Division. As
a result of the most recent consultant's evaluation, it is recommended Monroe County ceases outsourcing billing and
collections for ground- and air-ambulance billing and conduct these revenue-generating activities in-house through the
creation of two full-time positions. Funds totaling S121,000 are budgeted in FY 2014 for the payment to outside
contractors for the outsourcing of billing and collections. Staff recommends these budgeted funds be transferred from
operating services to personnel services to fund the two newly created positions.
PREVIOUS RELEVANT BOCC ACTION: At November 20, 2013 BOCC meeting agenda item was presented asking
for authorization for Emergency Services/Monroe County Fire Rescue to cease outsourcing billing and collections for
ground- and air-ambulance billing and collections and conduct these revenue generating activities in-house through the
creation of two (2) full-time Emergency Services positions: EMS Billing Supervisor and EMS Billing Specialist. At the
meeting, Commissioners requested additional information to determine whether to hire individuals as a regular employee
or contract employee, or as a vendor(independent contractor).
A chart is attached which outlines the three choices. Staff is recommending option 2, contract employees. This option
allows the County to pay the person a combination of salary plus commission based on monies collected. A contract
employee is not a Career Service position, so the person could be terminated if the person is not successful or if the
program is discontinued. Creation of the positions requires BOCC approval. The position would be advertised and the
person(s)hired following normal Monroe County hiring procedures.
CONTRACT/AGREEMENT CHANGES: N/A
STAFF RECOMMENDATIONS: Approval
TOTAL COST: $121,000 BUDGETED: Yes X No COST TO COUNTY: $121,000
SOURCE OF FUNDS: 11001-530340= $75,500 and 13001-530340 = $45,500 Totaling $121,000
REVENUE PRODUCING: Yes X No AMOUNT PER MONTH TBD
APPROVED BY: County Atty_ OMB/Purchasing Risk Management
DOCUMENTATION: Included X Not Required
DISPOSITION: AGENDA ITEM#
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