Lee County Board Of County Commissioners Agenda Item Summary



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1. REQUESTED MOTION: Lee County Board Of County Commissioners Agenda Item Summary ACTION REOUESTED: Adopt a resolution to amend Administrative Code AC-3-10; External Fees & Charges Manual, External Fee # Ex: 22-l Ambulance Service Fees. WHY ACTION IS NECESSARY: Approval is necessary in order for Lee County EMS user fee rates to be in line with the National Ambulance Fee Schedule implemented by the Health Care Finance Administration (HFCA). WHAT ACTION ACCOMPLISHES: Approval will authorize EMS hilling vendor Advanced Data Processing to hill appropriate ambulance transport fees based on service levels provided by EMS personnel. The revised fee schedule is expected to increase EMS revenue collections by $900,000.00. 2. DEPARTMENTAL CATEGORY: 7 3. MEETING DATE: COMMISSION DISTRICT #: CW mgmq#g ~~~~ ff+$?+&yq 4. AGENDA: 5. REQUIREMENT/PURPOSE: 6. REQUESTOR OF INFORMATION: fmhv~ X CONSENT STATUTE A. COMMISSIONER ADMINISTRATIVE ORDINANCE B. DEPARTMENT Public Safety APPEALS ADMIN. CODE PUBLIC X OTHER De uv, si% Wii.on,* WALK ON TIME REQUIRED: I. BACKGROUND: In 1997, Congress passed the Balanced Budget Act and placed in section 1834 (I) to the Social Security Act, a mandate to implement a national fee schedule for ambulance services furnished as a he&it under Medicare Part B. Ambulance services were the last medical providers in the nation directed by the Health Care Finance Administration (HFCA) to replace prevailing rate method of charges to a national fee schedule that is determined on reasonable charges. The new fee structure provides seven levels service categories for reimbursement by Medicare Part B (Attachment A). The reimbursement of all revised fees by Medicare will he phased in over a S-year period. The first year EMS providers will be reimbursed on 20% of new fee schedule and 80% of current fee schedule. Years two thru five will reflect reimbursement percentages of 40/60,60/40, 80120 and 100% respectively. The impact of the Fee Schedule on Lee County EMS appears to nominally favorable over the 5-year phase in period. The Department of Public Safety anticipates a $900,000.00 increase in EMS revenues in the first year of the Fee Schedule implementation. * Note, the proposed EMS helicopter fee schedule will not be implemented until the aircraft is certified under Part I35 of the FAA. The helicopter transport fees are considered low in the air ambulance industry and are expected to generate an approximate $500,000.00 in revenue when in&ne@d. 8. MANAGEMENT RECOMMENDATIONS: Management recommends approval. 9. RECOMMENDED APPROVAL: APPRO ED DENlED

LEE COUNTY RESOLUTION NO. A RESOLUTION OF THE LEE COUNTY BOARD OF COUNTY COMMISSIONERS RELATING TO AMENDMENTS TO THE LEE COUNTY ADMINISTRATIVE CODE AS ADOPTED BY LEE COUNTY ORDINANCE NO. 97-23; PROVIDING FOR APPROVAL OF CERTAIN AMENDMENTS TO THE LEE COUNTY ADMINISTRATIVE CODE; PROVIDING FOR SEVERABILITY; PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, the Board of County Commissioners is the governing body in and for Lee County, a political subdivision of the State of Florida; and, WHEREAS, the Board of County Commissioners has previously enacted Lee County Ordinance No. 96-01, creating a charter form of government for Lee County pursuant to Section 125.80 and ff., Florida Statutes, and which was approved and ratified by the Electorate of Lee County on November 5, 1996; and, WHEREAS, the Board of County Commissioners has previously enacted Lee County Ordinance No. 97-23, which adopted the Lee County Administrative Code pursuant to Section 2.2.E. of Ordinance No. 96-01, the Lee County Charter; and, WHEREAS, Lee County Ordinance No. 97-23 at Section Ill allows and provides for amendments to the Lee County Administrative Code to be made by Resolution of the Board of County Commissioners at a regularly scheduled Board of County Commissioners meeting: and, WHEREAS, certain amendments to the Lee County Administrative Code are now being proposed, and the Board of County Commissioners finds that such proposed

amendments are acceptable, serve a public purpose and are consistent with the terms and conditions of Lee County Ordinance No. 96-01, the Lee County Charter. NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS THAT: 1. The above preamble is hereby accepted and approved as being true and accurate, and is adopted and incorporated herein as if set out further at length. 2. The proposed amendment(s) to the Lee County Administrative Code 3-10 (attached hereto as Exhibit A), is (are) approved, and are hereby directed to be incorporated into the Lee County Administrative Code as indicated in the amendment(s). 3. The provisions of this Resolution are severable, and it is the intention to confer to the whole or any part of this Resolution, the powers herein provided for. If any of the provisions of this Resolution shall be held unconstitutional by any court of competent jurisdiction, the decision of such court shall not affect or impair any of the other remaining provisions of this Resolution. It is hereby declared to be the Board s legislative intent that this Resolution would have been adopted had such an unconstitutional provision not been included herein. 4. This Resolution shall become effective immediately upon its adoption by the Board of County Commissioners. 91.23RES 2

The foregoing Resolution was offered by Commissioner moved its adoption. The motion was seconded by Commissioner, who and, being put to a vote, the vote was as follows: ROBERT JANES DOUGLAS ST. CERNY RAY JUDAH ANDREW COY JOHN E. ALBION DULY PASSED AND ADOPTED this day of,20-. ATTEST: BOARD OF COUNTY COMMISSIONERS CHARLIE GREEN, CLERK OF LEE COUNTY, FLORIDA By: By: Deputy Clerk Chairman APPROVED AS TO FORM: By: Office of the County Attorney

DEPARTMENT: EXTERNAL FEE NUMBER: EX Z-I DIVISION: PURPOSE: Public Safety I EMS Program Ambulance Service Fees BASIS FOR FEE: Balanced Budge Act - National Ambulance Fee Schedule DATE APPROVED: AMBULANCE SERVICE TRANSPORT FEES 1) Basic Life Support (BLS -Non emergency) 2) Basic Life Support (BLS - Emergency) 3) Advanced Life Support (ALS 1 -Non Emergency) 4) Advanced Life Support (ALS 1 - Emergency) 5) Advanced Life Support (ALS 2) 6) Special Care Transport @CT) 7a) Loading Fee for Non Rural Helicopter Transport 7b) Loading Fee for Rural Helicopter Transport $200.00 $325.00 $350.00 $375.00 $550.00 $650.00 $2,900.00 $4.050.00 MILEAGE FEES Ambulance Transport Mileage Charge (Non Rural) Ambulance Transport Mileage Charge (Rural) Helicopter Transport Mileage Charge (Non Rural) Helicopter Transport Mileage Charge (Rural) $7.00 per mile $9.00 per mile $19.00 per air mile $30.00 per air mile TREAT NON TRANSPORT FEES Special Medical Fee (Paramedic Treatment I Non Transport) Treat Non Transport (BLS Intervention I Non Transport) $60.00 $30.00

EXTERNAL FEE NUMBER: EX 22-l DIVISION: PURPOSE: Public Safety I EMS Program Ambulance Service Fees BASIS FOR FEE: Balanced Budqe Act - National Ambulance Fee Schedule DATE APPROVED: AMBULANCE SERVICE TRANSPORT FEES 1) Basic Life Sw~ort (BLS -Non emerqencv) $200.00 2) Basic Life Sw~ort (BLS - Emerqencv) $325.00 3) Advanced Life Support (ALS 1 - Non Emerqencv) er+500-4) Advanced Life Suo~oti (ALS I- Emerqencv) $375.00 5) Advanced Life Swport (ALS 2) $550.00 6) Special Care Transport @CT) $650.00 7a) Loadinq Fee for Non Rural Helicopter Transport $2.900.00 7b) Loadina Fee for Rural Helicopter Transoorl $4.050.00

MILEAGE FEES Ambulance Transport Mileaqe Charqe (Non Rural) Ambulance Transport Mileaqe Charge (Rural) Helicopter Transport Mileaqe Charqe (Non Rural) Helicopter Transport Mileaqe Charqe (Rural) $7.00 per mile $9.00 per mile $19.00 per air mile $30.00 per air mile TREAT NON TRANSPORT FEES SDecial Medical Fee (Paramedic Treatment I Non Transport) $80.00 Treat Non Transport (ELS Jntewention / Non Transport) $30.00