Item I1 1.1
Coty f � ,�� ,' BOARD OF COUNTY COMMISSIONERS
�� Mayor David Rice,District 4
The Florida Keys � Mayor Pro Tem Craig Cates,District I
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: I.1
Agenda Item Summary #11017
BULK ITEM: No DEPARTMENT: Emergency Services
TIME APPROXIMATE: STAFF CONTACT: Steven Hudson (305) 289-6342
N/A
AGENDA ITEM WORDING: Approval by the Board of Governors (BOG) to award the annual
lump sum bonus to the 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 BOG passed Resolution 114-2014 establishing a
financial incentive program in order to incentivize billing employees to increase collections.
07/15/15 (Item Not Available): MCBOG passed Resolution 183-2015 to clarify the
baseline collection time period.
06/21/17 (Items G.1): MCBOG passed Resolution 159-2017 which rescinded Resolution
100-2014 and 182-2015 and set forth the revised bonus [financial incentive] program.
08/21/19 (Item H.1): MCBOG passed Resolution 228-2019 which rescinded Resolution
159-2017 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
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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 2019-228 BOG 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
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REVIEWED BY:
James Molenaar Completed 09/01/2022 2:56 PM
Steven Hudson Completed 09/01/2022 4:30 PM
Purchasing Completed 09/01/2022 4:32 PM
Budget and Finance Completed 09/02/2022 9:43 AM
Brian Bradley Completed 09/02/2022 10:32 AM
Lindsey Ballard Completed 09/02/2022 10:41 AM
Board of County Commissioners Pending 09/21/2022 9:00 AM
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1.1.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 t0
Non- Medicaid Air ($5,379,222.90) ($11,723,261.46) U)
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
Gross Non-Medicaid Deposits $6,757,236.88 $11,321,236.80 M
Non-Medicaid Collection 46.11% 76.86% N
Rate N
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RESOLUTION NO. 228 ; =2019 00
A RESOLUTION BY THE BOARD OF GOVERNORS OF
FIRE AND AMBULANCE DISTRICT 1 OF MONROE
COUNTY, FL RESCINDING RESOLUTION 159-2017 AND
SETTING FORTH THE REVISED BONUS [FINANCIAL
INCENTIVE] PROGRAM FOR MONROE COUNTY FIRE
RESCUE BILLING CONTRACT EMPLOYEES. U
0
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
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 0
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, in June 2017, the BOCC passed Resolution 158-2017 and the Board of 00
00
Governors passed Resolution 159-2017 to specify that net collections will be used to measure N
billing collection performance; and '
N
WHEREAS, staff desires to clarify the definition of the "evaluation period" and the
definition of"baseline collections rate";
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NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF GOVERNORS OF 00
FIRE AND AMBULANCE DISTRICT I OF MONROE COUNTY, FLORIDA, THAT:
0
Section 1. Resolution 159-2017 is hereby rescinded in its entirety.
Section 2. Monroe County Bonus Program
1. For the purpose of this resolution,the terms "bonus" and "financial incentive" are used
interchangeably. U
2. For the purpose of this resolution, the term "Collections" refers to collections from all
sources not including Medicaid. 0
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. The evaluation period ("Evaluation Period") shall run from May 1 to April 30.
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 0
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%).
7. 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. _
8. 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 00
00
case of the Board of Governors) or air ambulance (in the case of the BOCC). N
9. 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 N
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., May 1 to April 30.
10. 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.
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PASSED AND ADOPTED by the Board of Governors of Fire and Ambulance District 1
0
of Monroe County, Florida this21 stday of August 2019.
Representative Bruce Halle Yes
Representative Greg Lewis Yes
Representative Danny Kolhage Yes U
Representative David Rice Yes
Representative Sylvia Murphy 'Yes 0
BOARD OF GOVERNORS OF FIRE AND
'e VIN MADOK, CLERK AMBULANCE DISTRICT 1 OF MONROE
COUNTY, FLORIDA
4 B
�d�4otr tour
Deputy Clerk Chairman Bruce Halle
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