Item H1 H1
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: H1
2023-1651
BULK ITEM: No DEPARTMENT: Fire Rescue
TIME APPROXIMATE: STAFF CONTACT: James K. Callahan
AGENDA ITEM WORDING: Approval by BOG 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 BOG 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06/21/17 (Item G.2): BOG passed Resolution 159-2017 which rescinded Resolution 114-2014 and set
forth the revised bonus (financial incentive)program.
08/21/19 (Item H.1): BOG passed Resolution 228-2019 which rescinded Resolution 159-2017 and set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.
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CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
Bonus Summary Report May 2022 to April 2023.pdf
Resolution 2019-228 Billing Bonus (Financial Incentive) Program.pdf
FINANCIAL IMPACT:
Effective Date: 10/18/2023
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%
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$14,040.00 from 101-11001 - Medical Air Transport (78%)
$ 3,960.00 from 141-11500 - Fire& Rescue Central(22%)
$18,000.00 Total
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RESOLUTION NO. 228 ; =2019
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.
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 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
Governors passed Resolution 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 GOVERNORS OF
FIRE AND AMBULANCE DISTRICT I OF MONROE COUNTY, FLORIDA, THAT:
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.
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%).
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
case of the Board of Governors) or air ambulance (in the case of the BOCC).
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
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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3378
O
PASSED AND ADOPTED by the Board of Governors of Fire and Ambulance District 1
of Monroe County, Florida this21 stday of August 2019.
Representative Bruce Halle Y e s
Representative Greg Lewis Y e s
Representative Danny Kolhage Yes
Representative David Rice Yes
Representative Sylvia Murphy '(Yes
BOARD OF GOVERNORS OF FIRE AND
'e VIN MADOK, CLERK AMBULANCE DISTRICT 1 OF MONROE
s
COUNTY, FLORIDA
Jc
% A B4
�d�4oti tour '
Deputy Clerk Chairman Bruce Halle
RO COu A ANLr
APPIAOVED
PEDRO J MERCADO
ASSISTANT C UNTY ATTORNEY I
Date l
CA
C. .. `
'. 3
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