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Item C01 C.1 Coty f � ,�� ,' BOARD OF COUNTY COMMISSIONERS �� Mayor David Rice,District 4 The Florida Keys � Mayor Pro Tem Craig Cates,District 1 y Michelle Coldiron,District 2 James K.Scholl,District 3 Ij Holly Merrill Raschein,District 5 County Commission Meeting September 21, 2022 Agenda Item Number: C.1 Agenda Item Summary #10898 BULK ITEM: Yes DEPARTMENT: Emergency Services TIME APPROXIMATE: STAFF CONTACT: Steven Hudson (305) 289-6342 N/A AGENDA ITEM WORDING: Approval to award the annual lump sum bonus to the MCFR Billing Staff in the amount of 10% of unloaded base salaries for billing collections for Monroe County Trauma Star Air and Ground Ambulance Transports; based on an average collection rate of 76.86%, for the period May 1, 2021 to April 30, 2022, as compared to the qualifying baseline collection rate of 33.70%. ITEM BACKGROUND: In December 2013, the BOCC and BOG authorized Monroe County Fire Rescue to bring EMS billings and collections in-house utilizing contract employees. In lieu of wage adjustments given to other county employees, the employment contracts specify that they will receive an annual bonus payment based upon improved billing and collections performance. PREVIOUS RELEVANT BOCC ACTION: In accordance with State Statute 215.425, which provides that any bonuses that will be paid to employees must be implemented through a policy, ordinance, rule or resolution, at the June 11, 2014, BOCC meeting, the BOCC passed Resolution 100-2014 establishing a financial incentive program in order to incentivize billing employees to increase collections. 07/15/15 (Item Not Available): MCBOCC passed Resolution 182-2015 to clarify the baseline collection time period. 06/21/17 (Item C.1): MCBOCC passed Resolution 158-2017 which rescinded Resolution 100-2014 and 182-2015 and set forth the revised bonus [financial incentive] program. 08/21/19 (Item C.34): MCBOCC passed Resolution 222-2019 which rescinded Resolution 158-2017 and set forth the revised billing bonus (financial incentive)program to clarify language to satisfy the Clerk's audit findings. CONTRACT/AGREEMENT CHANGES: N/A Packet Pg. 37 C.1 STAFF RECOMMENDATION: Approval DOCUMENTATION: MCFR-Billing Bonus Summary 05-01-2021 to 04-30-2022 v2 In House Collection Rates 05-01-2021 to 04-30-2022 Resolution 2019-222 BOCC Revised Bonus (Financial Incentive)Program FINANCIAL IMPACT: Effective Date: 09/21/22 Expiration Date: N/A Total Dollar Value of Contract: N/A Total Cost to County: $16,800 Current Year Portion: $16,800 Budgeted: Yes Source of Funds: 11001 (78%); 11500 (22%) CPI: N/A Indirect Costs: N/A Estimated Ongoing Costs Not Included in above dollar amounts: N/A Revenue Producing: N/A If yes, amount: N/A Grant: N/A County Match: N/A Insurance Required: N/A Additional Details: N/A This bonus is based upon an average collection rate of 76.86% for air and ground ambulance charges for the evaluation period from May 1, 2021 to April 30, 2022, as compared to the qualifying Baseline Collection Rate of 33.70%. In accordance with the resolution authorizing this bonus, 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 in the amount of one percent (1.0%) of the employee's unloaded base salary, up to a maximum increase of ten percent(10%). Total Cost: $ 6,800.00 (10%)Supervisor(Stitt) $ 5,200.00 (10%) Specialist(Burgess) $ 4,800.00 (10%) Specialist(Roussin) $16,800.00 Total 09/21/22 101-11001 - MEDICAL AIR TRANSPORT $13,104.00 510120 (78%) 09/21/22 141-11500 - FIRE& RESCUE CENTRAL $3,696.00 510120 (22%) Total: $16,800.00 Packet Pg. 38 C.1 REVIEWED BY: James Molenaar Completed 09/01/2022 3:04 PM Steven Hudson Completed 09/02/2022 3:17 PM Purchasing Completed 09/02/2022 3:24 PM Budget and Finance Completed 09/02/2022 3:48 PM Brian Bradley Completed 09/02/2022 4:41 PM Lindsey Ballard Completed 09/06/2022 9:04 AM Board of County Commissioners Pending 09/21/2022 9:00 AM Packet Pg. 39 C.1.a Monroe County Fire Rescue Billing Bonus Summary Report 0 Description 12 Month Period 12 Month Period 05/01/2020to 04/30/2021 05/01/2021to 04/30/2022 CL Gross-Non Medicaid Charges $21,645,965.20 $28,507,664.50 U Non- Medicaid Air ($5,379,222.90) ($11,723,261.46) Adjustments 0 Non-Medicaid Ground ($191,194.49) ($295,818.06) Adjustments Trauma Star Resident Fee ($1,421,345.58 ($1,759,609.26) Waivers Net Non-Medicaid Charges $14,654,202.23 $14,728,975.72 U Gross Non-Medicaid Deposits $61757,236.88 $11,321,236.80 _ Non-Medicaid Collection 46.11% 76.86% N Rate N C� 0 N N LO CU E E w 0 U E c� Packet Pg.40 +uoe+melen uuV 00& 2OzoE#m �&e�egaSGI A U011381100-mHm 7_9my v CL \ a o ,6 67 § § , [ 2 ) } \§/( 4- 4 ai } ¢ /\ \»/ \ � \{\ Ep u \ �o \\ \ (\\ _ : $ _ \' } - % _ _ o § / ) 72 _ ! / ] 7 / I - ,22 / ! / ! 2 2 ol IZ � ) : § k k � \/ k � � � k `� � m \\` \\\� \ f ) / � d - i § ` - ! () { _ ] - - ! } \ % _ - 2 /E o - ~ ® - - - ! E) ) ƒ lo ! / # $ ] e > o ! / ] \:! : #\) § : § ] ; 23 § 3 \ ww ƒ^ \\ ƒ` ! ; ƒ IIw } }` II ~ } I Iml ,I N } ,-- --- --- - --- --- - ) _ j .. - \ _ -om d \ - § % - \ - . - - \ \ \ : \\\ } ) } �\ : � § \ | 2 ! 22) ) \/ ! 22) 0 ) 2\ /f772 \ / 0 ; § LDJ0 \ \ ; § ; ; / // / / ; ; / // / / $ / ; .:5-. 4 C.1.c RESOLUTION NO. 222 - 2019 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA RESCINDING RESOLUTION NO. 158-2017 AND SETTING E 0 FORTH THE REVISED BONUS [FINANCIAL INCENTIVE] U PROGRAM FOR MONROE COUNTY FIRE RESCUE BILLING CONTRACT EMPLOYEES. c 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 U ambulance runs in-house; and U 00 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 No. 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 c A WHEREAS,in July 2015 the BOCC passed Resolution No. 182-205 to clarify the baseline collection time period; and U U WHEREAS, in June 2017, the BOCC passed Resolution No. 158-2017 and the Board of N Governors passed Resolution No. 159-2017 to specify that net collections will be used to measure billing collection performance; and N c WHEREAS, staff desires to clarify the definition of the "evaluation period" and the definition of"baseline collections rate"; 0 E c� Page 1 of 3 Packet Pg.42 C.1.c NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA: c Section 1. Resolution No. 158-2017 is hereby rescinded in its entirety. CL 0 Section 2. Monroe County Bonus Program U 1. For the purpose of this resolution, the terms "bonus" and "financial incentive" are used interchangeably. c 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. U 4. The evaluation period ("Evaluation Period") shall run from May 1 to April 30. U 5. The "Baseline Collection Rate" shall be 33.70%. 6. 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%). 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' E 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 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 U 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, percentage increase in Net Collections shall be used in comparison to the Baseline Collection Rate, and c 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. c� Page 2 of 3 Packet Pg.43 C.1.c 0 E PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida this 21S`day of August, 2019. ,E CL Mayor Sylvia Murphy Yes E Mayor Pro Tem Danny Kolhage Yes U Commissioner Michelle Coldiron Yes Commissioner Heather Carruthers Yes c • Commissioner David Rice Yes 4JM1`°'•. era BOARD OF COUNTY COMMISSIONERS T COUM ST: KEVIN MADOK, CLERK OF MONR& C Y, FL RIDA U U BY BY Deputy Clerk Mayor Sylvia Murphy 0 L- CL c� c O E COUNTY ORN pp VED A � ` U PEDRO J. RCADO ASSISTANT CO 7 / q l © N Date c- -12 err a. Q N CD. a CO r Cn. E c� Page 3 of 3 Packet Pg.44