Item C10 CIO
BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE Mayor Craig Cates,District 1
The Florida Keys Mayor Pro Tern Holly Merrill Raschein,District 5
Michelle Lincoln,District 2
James K.Scholl,District 3
m' David Rice,District 4
Board of County Commissioners Meeting
October 18, 2023
Agenda Item Number: CIO
2023-1568
BULK ITEM: Yes DEPARTMENT: Fire Rescue
TIME APPROXIMATE: STAFF CONTACT: James K. Callahan
AGENDA ITEM WORDING: Approval by BOCC to award the annual lump sum bonus to the
Monroe County Fire Rescue Billing Staff in the amount of 10% of the unloaded base salaries for billing
collections for Monroe County Trauma Star Air and Ground Ambulance Transports. The bonus is based
on an average collection rate of 80.48% for the period May 1, 2022 to April 30, 2023 as compared to
the qualifying baseline collection rate of 33.70%.
ITEM BACKGROUND:
Monroe County Fire Rescue(MCFR) is requesting approval by the BOCC to award the annual lump
sum bonus to the MCFR Billing Staff in the amount of 10% ($18,000) of the unloaded base salaries for
billing collections for Monroe County Trauma Star Air and Ground Ambulance Transports. The bonus
is based on an average collection rate of 80.48% for the period May 1, 2022 to April 30, 2023 as
compared to the qualifying baseline collection rate of 33.70%.
In December 2013, the BOCC and BOG authorized MCFR 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.
06/21/17 (Item C.1): BOCC passed Resolution 158-2017 which rescinded Resolution 100-2014 and set
forth the revised bonus (financial incentive)program.
08/21/19 (Item C.34): BOCC passed Resolution 222-2019 which rescinded Resolution 158-2017 and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.
708
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
Bonus Summary Report May 2022 to April 2023.pdf
Resolution 2019-222 Revised Billing Bonus (Financial Incentive) Program.pdf
FINANCIAL IMPACT:
Effective Date: 11/08/23
Expiration Date: N/A
Total Dollar Value of Contract: N/A
Total Cost to County: $18,000
Current Year Portion: $18,000
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:
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 the 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%) as follows:
Supervisor(Stitt, Dina) 10%
Specialist (Burgess,Nina) 10%
Specialist (Roussin, Sandy) 10%
709
$14,040.00 from 101-11001 - Medical Air Transport (78%)
$ 3,960.00 from 141-11500 - Fire& Rescue Central(22%)
$18,000.00 Total
710
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RESOLUTION NO. 222 - 2019
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA
RESCINDING RESOLUTION NO. 158-2017 AND SETTING
FORTH THE REVISED BONUS [FINANCIAL INCENTIVE]
PROGRAM FOR MONROE COUNTY FIRE RESCUE
BILLING CONTRACT EMPLOYEES.
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
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
WHEREAS,in July 2015 the BOCC passed Resolution No. 182-205 to clarify the baseline
collection time period; and
WHEREAS, in June 2017, the BOCC passed Resolution No. 158-2017 and the Board of
Governors passed Resolution No. 159-2017 to specify that net collections will be used to measure
billing collection performance; and
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 COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA:
Section 1. Resolution No. 158-2017 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.
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.
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 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'
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
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
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.
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713
;
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida this 21S`day of August, 2019.
Mayor Sylvia Murphy Yes
Mayor Pro Tem Danny Kolhage Yes
Commissioner Michelle Coldiron Y e s
Commissioner Heather Carruthers Yes
. Commissioner David Rice Yes
BOARD OF COUNTY COMMISSIONERS
4
T COUM
ST: KEVIN MADOK, CLERK OF MON C Y, FL RIDA
BY BY
Deputy Clerk Mayor Sylvia Murphy
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pEDRO J. RCADO
ASSISTANT CO 7 / q
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714