BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY. REQUESTED BY: DEPARTMENT: PREPARED BY: Name: Joseph V. Ferrara Fire Rescue Margy Mills

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1 8C1 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY PLACEMENT: DEPARTMENTAL PRESET: TITLE: AEROMEDICAL TRANSPORT AGREEMENT AND FEE RESOLUTION AGENDA ITEM DATES: MEETING DATE: 12/16/2014 COMPLETED DATE: 12/4/2014 COUNTY ATTORNEY: 11/24/2014 ASSISTANT COUNTY ADMINISTRATOR: 12/1/2014 REQUESTED BY: DEPARTMENT: PREPARED BY: Name: Joseph V. Ferrara Fire Rescue Margy Mills Name: Fire Rescue Chief Procedures: None EXECUTIVE SUMMARY: Executive Aide The Fire Rescue Department, based upon previous board direction, has negotiated a draft agreement for the provision of aeromedical services by PHI Air Medical to Martin County. The department is seeking approval from the County Commissioners for the contract with PHI Air Medical L.L.C and approval of the resolution to set aeromedical transport rates. The contract was negotiated by the team of Roger Baltz, Assistant County Administrator; Joseph Ferrara, Fire Rescue Chief; and Sarah Woods, Senior Assistant County Attorney. APPROVAL: LEG CA BACKGROUND/RELATED STRATEGIC GOAL: 8065af1d 1 of 23

2 1. Agreement/Contract drafted by: Martin County staff and PHI Air Medical L.L.C. staff 2. Parties to the Agreement/Contract: PHI Air Medical L.L.C. and Martin County Board of County Commissioners. 3. Purpose of the Agreement/Contract: To provide aeromedical transportation services. 4. New I Renewal I Modified: New 5. Duration: 5 year contract with (2) 1 year renewal clauses 6. Benefits to Martin County: Maintain a high level of medical service, quality control and rate control. 7. Cost to Martin County (annual and potential total): $2,387,120 Martin County started an aeromedical transport program on October 1, The program transports critically ill and injured patients to specialty care facilities throughout Florida. This service is needed to meet Trauma Transport requirements set by the State of Florida and provide specialized care and rapid transportation to hospitals not in our local area. This proposed contract requires PHI Air Medical L.L.C. to provide a certified Part 135 medical helicopter and all associated functions to provide 24 hour 7 day a week aeromedical services. This includes aircraft operations, pilots, aircraft maintenance, and mechanics. Since February 1, 2014, personnel from the aeromedical program have been used by Fire Rescue to reduce overtime in the field. To date, it has reduced overtime by 1,658.5 hours for an estimated savings of $60, ISSUES: The annual program cost is tabulated below based upon the negotiated costs, the County s fixed annual costs and anticipated revenue: Aircraft Type Traditional Model (County provides two Medical Staff) Bell 407 Fixed Monthly* Hourly* -County s Fixed Annual Costs (Based upon contract and 300 hrs. of flight time)* -Annual fuel cost (Invoiced from PHI) -County s Personnel and Operating Costs -Hangar Lease Paid to Airport Total Annual Expense Projected Annual Revenue Projected Annual Ad Valorem $ 110, $ $ 1,545, $ 75, $ 767, $ 34, $ 2,421, ( $ 1,400,000.00) $ 1,021, af1d 2 of 23

3 The county would collect revenue from insurance companies and private billing based upon the rates set by the County. Billing would occur through the already established mechanism with the Martin County Tax Collector (already doing ambulance billing). The County would need to collect an average $9, per patient transport; based upon a 250 transport per year estimate; to cover all of the annual program costs. The difference between revenue collected and program costs would be made up with County Ad Valorem. The recommended rates needed to generate adequate revenue would be a $9,000 lift off fee and $100 per patient loaded mile. These rates are based upon a combination of established Medicare rates, Personal Injury Protection (PIP) rates and private insurance limits. A modest revenue estimate is $1,300,000 to $1,500,000 annual collections. The estimated revenue figures are based upon historic collections from the previous program, payer mix and revenue history for ground ambulance. LEGAL SUFFICIENCY REVIEW: This item has been reviewed for legal sufficiency to determine whether it is consistent with applicable law, has identified and addressed legal risks, and has developed strategies for legal defensibility. RECOMMENDED ACTION: RECOMMENDATION 1. Move that the Board authorize the Chairman to execute the contract with PHI Air Medical L.L.C. to Martin County and; 2. Move that the Board approve the Resolution setting aeromedical transport rates. ALTERNATIVE RECOMMENDATIONS Move to continue requesting Saint Lucie County Fire District s helicopter for trauma transports in Martin County and provide staff direction. FISCAL IMPACT: RECOMMENDATION The anticipated revenue would offset Ad Valorem funding based upon volume, rates and collection rates. Funding Source County Funds Non-County Funds Authorization General Fund $1,021, Billing Revenue $1,400, Subtotal $2,421, Project Total $2,421, ALTERNATIVE RECOMMENDATIONS N/A 8065af1d 3 of 23

4 DOCUMENT(S) REQUIRING ACTION: Budget Transfer / Amendment Chair Letter X Contract / Agreement Grant / Application Notice Ordinance X Resolution Other: ROUTING: _ ADM _ BLD _ CDD _ COM _ ENG _ FRD _ GMD _ GSD _ ITS _ LIB _ MCA _ MPO _ PRD _ USD X CA _ ACA X LEG 8065af1d 4 of 23

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22 BOARD OF COUNTY COMMISSIONERS MARTIN COUNTY, FLORIDA RESOLUTION NO. A RESOLUTION OF THE BOARD OF COUTNY COMMISSIONERS OF MARTIN COUNTY, FLORIDA, AMENDING RESOLUTION NO a IN ITS ENTIRETY AND RE-ESTABLISHING EMERGENCY MEDICAL SERVICES (EMS) USER FEES; PROVIDING AN EFFECTIVE DATE. WHEREAS, Local governments that provide EMS, charge user fees that are submitted to insurance companies for reimbursement of services rendered; WHEREAS, pursuant to Section , General Ordinances, Martin County Code, the Board of County Commissioners has the authority to establish by resolution certain user fees and charges for County fire rescue services; and WHEREAS, the Board of County Commissioners of Martin County, Florida adopted Resolution No a which established such user fees and charges; and WHEREAS, the Board of County Commissioners of Martin County, Florida wishes to amend such Resolution No a in its entirety to include user fees and charges for aeromedical transport services; and WHEREAS, the Board of County Commissioners of Martin County, Florida wishes to adjust the rate schedule annually by the consumer price index with adjusted rates effective on October 1 st of each year until amended by resolution. NOW THEREFORE, BE IT RESOLVED: That the following rate schedule for EMS user fees will be in effect with annual adjustment as provided above: Basic Life Support - $ Advanced Life Support 1 - $ Advanced Life Support 2 - $ Specialty Care Transport - $ Ground Mileage - $11.13 per mile Aeromedical Lift-off Fee - $9, of 23

23 Aeromedical Mileage - $ per mile DULY PASSED AND ADOPTED THIS 16th DAY OF DECEMBER, ATTEST: CAROLYN TIMMANN, CLERK OF THE CIRCUIT COURT AND COMPTROLLER BOARD OF COUNTY COMMISSIONERS MARTIN COUNTY, FLORIDA ED FIELDING, CHAIRMAN APPROVED AS TO FORM & LEGAL SUFFICIENCY: MICHAEL D. DURHAM COUNTY ATTORNEY 23 of 23

BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY. REQUESTED BY: DEPARTMENT: PREPARED BY: Name: Joseph V. Ferrara Fire Rescue Margy Mills

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