Item F06 F.6
G BOARD OF COUNTY COMMISSIONERS
County of Monroe Mayor Sylvia Murphy,District 5
The Florida.Keys l'U � � Mayor Pro Tern Danny Kolhage,District 1
�pw° Michelle Coldiron,District 2
Heather Carruthers,District 3
David Rice,District 4
County Commission Meeting
November 20, 2019
Agenda Item Number: F.6
Agenda Item Summary #6188
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 163 accounts
receivable covering the time period of 2014 through August 2019 totaling $1,826,378.80 for Monroe
County residents who qualified for the Trauma Star Air Ambulance Waiver Program. From January
1, 2014 through August 31, 2019, the amount of $28,225,039.08 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 163 qualified Monroe County
resident's accounts receivable totaling $1,826,378.80 (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.
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
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F.6
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. On November 14,
2017, Resolution 304-2017 authorized the write-off of 105 Trauma Star air ambulance resident
waivers totaling $1,086,179.69. On November 20, 2019 Resolution 406-2018 authorized the write-
off of 177 Trauma Star air ambulance resident waivers totaling $2,294,120.96.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
Resolution FYI
Exhibit A
FINANCIAL IMPACT:
Effective Date:
Expiration Date:
Total Dollar Value of Contract:
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds: Fund 101, Cost Center 11001
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details:
N/A
REVIEWED BY:
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Mark Thompson Completed 10/18/2019 2:32 PM
Pedro Mercado Completed 10/21/2019 2:43 PM
James Callahan Completed 10/23/2019 10:52 AM
Budget and Finance Completed 10/24/2019 4:48 PM
Maria Slavik Completed 10/25/2019 9:03 AM
Kathy Peters Completed 10/25/2019 9:24 AM
Board of County Commissioners Pending 11/20/2019 9:00 AM
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F.6.a
RESOLUTION NO. -2019
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, a report was provided by Monroe County Billing Department on these accounts and
it was determined that all third party payments have been received and applied to their accounts; that the
balances constituted the amount remaining 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
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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 163 accounts listed on attached Exhibit A in the
amount of S1,826,378.80 shall be deleted from the Fine and Forfeiture Fund(101).
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida,
at a regular meeting of said Board held on the 20th day of November, 2019.
U-
Mayor
Mayor Pro Tem
Commissioner U)
Commissioner
Commissioner
E
(Seal) BOARD OF COUNTY COMMISSIONERS
ATTEST: KEVIN MADOK,CLERK OF MONROE COUNTY,FLORIDA
By: By:
Deputy Clerk Mayor/Chairman
MONROE COUNTY ATTORNEY:
By:
Assistant County Attorney
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EXHIBIT A
Monroe County Fire Rescue
Air Ambulance (Trauma Star)
Account Receivable Resident Waiver Write Offs
TRAUMA STAR RESIDENT FEE WAIVERS
(01/27/2017 - 08/31/2019)
Trip Date RUN# CHARGES ADJUSTMENTS PAYMENTS REFUNDS BALANCE DUE
2017-01-27 281 $24,800.00 $0.00 $23,413.69 $1,386.31
2017-03-24 875 $18,560.00 $11,089.63 $7,339.27 $131.10
2017-07-01 1902 $17,840.00 $3,153.93 $10,000.00 $4,686.07
2017-08-26 2451 $21,110.00 $0.00 $4,886.08 $16,223.92
2017-09-12 2667 $21,110.00 $0.00 $0.00 $21,110.00
2017-09-18 2596 $24,800.00 $0.00 $7,596.00 $17,204.00
2017-11-22 3420 $16,660.00 $0.00 $0.00 $16,660.00
2018-02-19 529 $22,600.00 $0.00 $0.00 $22,600.00
2018-03-22 900 $21,110.00 $12,698.83 $8,161.17 $250.00
2018-04-10 1088 $24,800.00 $15,161.96 $9,388.04 $250.00
2018-04-17 1161 $17,540.00 $0.00 $5,272.80 $12,267.20
2018-04-19 1185 $24,800.00 $0.00 $0.00 $24,800.00
2018-04-20 1193 $25,200.00 $0.00 $7,517.06 $17,682.94
2018-04-24 1222 $25,200.00 $0.00 $7,724.00 $17,476.00
2018-04-30 1273 $16,810.00 $0.00 $15,959.94 $850.06
2018-05-04 1323 $24,800.00 $0.00 $8,177.59 $16,622.41
2018-05-11 1383 $21,110.00 $12,698.83 $8,161.17 $250.00
2018-05-14 1410 $21,110.00 $0.00 $19,669.34 $1,440.66
2018-05-31 1559 $20,000.00 $0.00 $10,870.94 $9,129.06
2018-06-04 1602 $21,110.00 $4,007.20 $10,706.00 $6,396.80
2018-06-21 1775 $25,200.00 $15,391.31 $9,773.69 $35.00
2018-06-26 1808 $25,200.00 $0.00 $0.00 $25,200.00
2018-06-28 1823 $25,200.00 $0.00 $11,794.78 $13,405.22
2018-07-02 1862 $22,600.00 $13,676.41 $7,053.73 $1,869.86
2018-07-07 1906 $23,100.00 $0.00 $7,052.00 $16,048.00
2018-07-17 2001 $24,800.00 $0.00 $20,318.81 $4,481.19
2018-07-19 2015 $25,200.00 $0.00 $7,724.00 $17,476.00
2018-07-26 2107 $21,110.00 $0.00 $13,601.58 $7,508.42
2018-07-26 2110 $24,100.00 $0.00 $24,005.90 $94.10
2018-07-26 2111 $24,800.00 $0.00 $13,152.78 $11,647.22
2018-07-31 2156 $23,100.00 $14,007.11 $7,244.74 $1,848.15
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2018-08-01 2162 $17,060.00 $0.00 $4,534.52 $12,525.48
2018-08-05 2189 $24,800.00 $0.00 $7,596.00 $17,204.00
2018-08-09 2220 $25,200.00 $15,231.82 $7,527.25 $2,440.93
2018-08-09 2221 $25,200.00 $0.00 $7,724.00 $17,476.00
2018-08-09 2222 $17,200.00 $0.00 $0.00 $17,200.00
2018-08-10 2235 $25,200.00 $0.00 $7,724.00 $17,476.00
2018-08-13 2268 $25,200.00 $0.00 $20,677.29 $4,522.71
2018-08-14 2276 $21,110.00 $0.00 $3,549.12 $17,560.88
2018-08-22 2328 $20,000.00 $0.00 $12,839.50 $7,160.50
2018-08-25 2358 $24,400.00 $14,864.00 $7,597.79 $1,938.21
2018-08-28 2388 $25,200.00 $0.00 $10,429.43 $14,770.57
2018-08-31 2412 $23,100.00 $0.00 $7,894.94 $15,205.06
2018-09-04 2455 $25,200.00 $0.00 $7,724.00 $17,476.00
2018-09-06 2475 $24,800.00 $0.00 $0.00 $24,800.00
2018-09-08 2500 $17,930.00 $0.00 $5,397.60 $12,532.40
2018-09-08 2510 $23,100.00 $0.00 $21,354.91 $1,745.09
2018-09-10 2532 $19,990.00 $0.00 $6,060.00 $13,930.00
2018-09-11 2535 $23,100.00 $0.00 $0.00 $23,100.00
2018-09-12 2543 $22,600.00 $0.00 $6,892.00 $15,708.00 Z
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2018-09-14 2568 $24,400.00 $0.00 $0.00 $24,400.00
2018-09-18 2610 $25,200.00 $0.00 $0.00 $25,200.00
2018-09-19 2658 $25,200.00 $15,391.31 $9,773.69 $35.00
2018-09-24 2653 $21,110.00 $12,724.62 $8,135.38 $250.00
2018-09-25 2670 $25,200.00 $0.00 $7,724.00 $17,476.00
2018-09-25 2671 $25,200.00 $0.00 $0.00 $25,200.00
2018-09-26 2681 $21,500.00 $0.00 $0.00 $21,500.00
2018-09-27 2686 $24,400.00 $0.00 $5,500.00 $18,900.00
2018-09-29 2707 $23,100.00 $14,039.07 $8,810.93 $250.00
2018-10-01 2735 $24,800.00 $0.00 $0.00 $24,800.00
2018-10-16 2876 $24,800.00 $0.00 $6,590.19 $18,209.81
2018-10-17 2883 $25,200.00 $0.00 $0.00 $25,200.00
2018-10-20 2917 $18,530.00 $0.00 $5,280.00 $13,250.00
2018-10-22 2927 $16,810.00 $0.00 $5,036.00 $11,774.00
2018-10-22 2933 $25,200.00 $15,388.38 $9,628.62 $183.00 E
2018-10-23 2949 $25,200.00 $0.00 $7,724.00 $17,476.00
2018-10-27 2974 $24,800.00 $0.00 $0.00 $24,800.00
2018-10-28 2994 $16,810.00 $9,861.11 $5,536.51 $1,412.38
2018-10-31 3021 $18,100.00 $0.00 $0.00 $18,100.00
2018-11-02 3036 $25,200.00 $15,231.82 $9,948.18 $20.00
2018-11-02 3037 $25,200.00 $0.00 $7,724.00 $17,476.00
2018-11-11 3147 $16,810.00 $9,861.11 $5,536.51 $1,412.38
2018-11-14 3174 $25,200.00 $0.00 $20,677.29 $4,522.71
2018-11-15 3187 $25,200.00 $0.00 $0.00 $25,200.00
2018-11-18 3214 $16,810.00 $0.00 $0.00 $16,810.00
2018-11-22 3245 $17,590.00 $0.00 $5,292.00 $12,298.00
2018-11-22 3249 $25,200.00 $0.00 $0.00 $25,200.00
2018-11-24 3268 $16,140.00 $0.00 $0.00 $16,140.00
2018-11-25 3279 $25,200.00 $15,391.31 $7,815.05 $1,993.64
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2018-11-26 3292 $23,000.00 $0.00 $7,020.00 $15,980.00
2018-11-27 3308 $23,100.00 $13,859.26 $5,818.09 $3,422.65
2018-12-02 3344 $20,640.00 $0.00 $5,129.31 $15,510.69
2018-12-02 3351 $23,300.00 $14,171.17 $8,878.83 $250.00
2018-12-03 3369 $25,200.00 $15,391.31 $7,815.05 $1,993.64
2018-12-03 3373 $23,100.00 $0.00 $0.00 $23,100.00
2018-12-04 3380 $25,200.00 $0.00 $0.00 $25,200.00
2018-12-05 3387 $23,100.00 $0.00 $0.00 $23,100.00
2018-12-06 3398 $16,640.00 $9,637.01 $6,982.99 $20.00
2018-12-19 3513 $22,300.00 $0.00 $11,933.08 $10,366.92
2018-12-22 3546 $16,810.00 $0.00 $10,457.33 $6,352.67
2018-12-23 3551 $24,400.00 $0.00 $21,924.64 $2,475.36
2018-12-26 3570 $18,200.00 $0.00 $17,225.27 $974.73
2018-12-27 3600 $23,100.00 $0.00 $7,052.00 $16,048.00
2018-12-30 3637 $25,200.00 $0.00 $8,404.80 $16,795.20
2018-12-31 3647 $25,200.00 $0.00 $12,092.42 $13,107.58
2018-12-31 3649 $23,100.00 $13,068.94 $10,011.06 $20.00
2019-01-04 30 $25,200.00 $0.00 $7,724.00 $17,476.00
2019-01-06 60 $23,100.00 $0.00 $3,526.00 $19,574.00 Z
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2019-01-06 65 $21,500.00 $0.00 $13,878.70 $7,621.30
2019-01-07 72 $21,500.00 $0.00 $6,540.00 $14,960.00
2019-01-14 151 $25,200.00 $0.00 $4,579.20 $20,620.80
2019-01-15 166 $21,130.00 $0.00 $0.00 $21,130.00
2019-01-15 170 $21,130.00 $12,369.05 $6,570.72 $2,190.23
2019-01-16 175 $21,460.00 $0.00 $4,539.43 $16,920.57
2019-01-19 212 $24,800.00 $0.00 $0.00 $24,800.00
2019-01-22 248 $25,200.00 $15,202.76 $9,767.24 $230.00
2019-01-30 302 $23,100.00 $13,798.71 $7,410.78 $1,890.51
2019-02-05 362 $25,200.00 $15,166.59 $7,994.10 $2,039.31
2019-02-07 377 $20,000.00 $0.00 $12,381.30 $7,618.70
2019-02-07 385 $23,000.00 $0.00 $18,400.00 $4,600.00
2019-02-08 393 $25,200.00 $15,166.59 $7,994.10 $2,039.31
2019-02-08 394 $21,500.00 $0.00 $6,540.00 $14,960.00
2019-02-16 471 $25,400.00 $15,296.86 $8,049.66 $2,053.48 E
2019-02-17 504 $16,810.00 $9,701.61 $5,663.59 $1,444.80
2019-02-21 527 $25,200.00 $0.00 $0.00 $25,200.00
2019-02-21 534 $23,100.00 $0.00 $7,052.00 $16,048.00
2019-02-24 565 $17,540.00 $10,174.15 $5,721.33 $1,644.52
2019-03-03 650 $20,230.00 $11,929.28 $6,613.58 $1,687.14
2019-03-04 658 $25,200.00 $0.00 $7,374.00 $17,826.00
2019-03-10 721 $23,100.00 $0.00 $0.00 $23,100.00
2019-03-14 771 $25,200.00 $0.00 $4,038.88 $21,161.12
2019-03-17 794 $16,810.00 $9,701.61 $5,663.59 $1,444.80
2019-03-17 801 $23,100.00 $13,798.71 $7,410.78 $1,890.51
2019-03-21 841 $24,700.00 $0.00 $0.00 $24,700.00
2019-03-23 861 $24,800.00 $0.00 $0.00 $24,800.00
2019-03-24 875 $23,100.00 $0.00 $7,022.92 $16,077.08
2019-03-24 878 $25,200.00 $15,166.59 $7,994.10 $2,039.31
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2019-03-25 883 $24,700.00 $14,872.96 $9,426.27 $400.77
2019-03-29 933 $23,700.00 $0.00 $6,894.00 $16,806.00
2019-03-30 942 $21,500.00 $12,756.52 $6,966.35 $1,777.13
2019-03-31 949 $25,200.00 $15,166.59 $7,994.10 $2,039.31
2019-04-01 966 $21,500.00 $12,753.56 $6,821.31 $1,925.13
2019-04-02 982 $25,200.00 $0.00 $7,724.00 $17,476.00
2019-04-03 999 $25,200.00 $15,163.63 $9,851.37 $185.00
2019-04-04 1006 $24,400.00 $0.00 $16,251.56 $8,148.44
2019-04-06 1020 $25,200.00 $0.00 $10,196.56 $15,003.44
2019-04-12 1079 $24,700.00 $0.00 $7,564.00 $17,136.00
2019-04-15 1111 $21,930.00 $13,033.65 $6,940.75 $1,955.60
2019-04-27 1407 $25,200.00 $0.00 $0.00 $25,200.00
2019-04-30 1242 $25,200.00 $15,164.42 $9,900.07 $135.51
2019-05-02 1255 $25,200.00 $15,166.59 $7,994.10 $2,039.31
2019-05-04 1281 $20,730.00 $0.00 $0.00 $20,730.00
2019-05-07 1306 $16,850.00 $0.00 $0.00 $16,850.00
2019-05-08 1326 $21,180.00 $0.00 $6,437.60 $14,742.40
2019-05-10 1343 $23,400.00 $0.00 $20,685.57 $2,714.43
2019-05-10 1348 $25,200.00 $0.00 $24,443.53 $756.47 Z
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2019-05-12 1361 $25,200.00 $15,166.59 $7,994.10 $2,039.31
2019-05-12 1363 $16,850.00 $0.00 $4,686.00 $12,164.00
2019-05-19 1421 $18,190.00 $0.00 $5,484.00 $12,706.00
2019-05-20 1434 $23,700.00 $14,186.58 $7,432.40 $2,081.02
2019-05-21 1442 $24,700.00 $0.00 $13,341.08 $11,358.92
2019-05-28 1498 $23,700.00 $14,189.54 $9,123.86 $386.60
2019-05-30 1521 $25,200.00 $15,166.59 $7,994.10 $2,039.31
2019-06-01 1542 $23,700.00 $0.00 $19,823.98 $3,876.02
2019-06-10 1624 $25,200.00 $15,202.76 $9,767.24 $230.00
2019-06-20 1766 $25,200.00 $15,166.59 $7,994.10 $2,039.31
2019-06-26 1768 $25,200.00 $15,165.49 $7,940.13 $2,094.38
2019-07-04 1846 $21,620.00 $0.00 $0.00 $21,620.00
2019-07-04 1849 $18,980.00 $0.00 $4,305.00 $14,675.00
2019-07-06 1865 $21,130.00 $0.00 $6,995.14 $14,134.86
2019-07-10 1912 $25,200.00 $0.00 $0.00 $25,200.00 E
2019-07-13 1940 $23,700.00 $0.00 $0.00 $23,700.00
2019-07-17 1980 $23,400.00 $0.00 $19,182.24 $4,217.76
TOTAL 163 $3,706,340.00 $681,792.02 $1,198,169.18 $0.00 $1,826,378.80
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