| Taney County Ambulance District Board Meeting Tuesday, October 16, 2007 Chairman Kenny Nave called the meeting of the Taney County Ambulance District to order at 19:00 on October 16, 2007. Attendance: Chairman Kenny Nave, Treasurer David Rozell, Vice Chairman Tim Ford, Board Member Scott Novak, Board Member Dale Sanders and Board Member Rod Romine present. Others present Steve Harris, Melissa Stiffler, Katie Sharpe, Robin Fisher, Kevin Tweedy, Kent Vanderpool, Richard Cotter, Jeremy Goodwin, Jeff Hawkins, Caleb Berkstresser and Nathan Rogers. APPROVAL OF PRIOR MINUTES Director Novak made a motion to approve prior Board minutes dated September 18, 2007. Director Ford seconded the motion. The motion passed by vote: Director Nave (Yes), Director Rozell (Yes), Director Ford (Yes), Director Novak (Yes), Director Sanders (Absent), Director Romine (Yes). APPROVAL OF FINANCIALS Director Rozell made a motion to approve financials. Director Romine seconded the motion. The motion passed by vote: Director Nave (Yes), Director Rozell (Yes), Director Ford (Yes), Director Novak (Yes), Director Sanders (Absent), Director Romine (Yes). Old Business Steve advised that he talked to Frank Foster about viewing incident reports. Frank did advise that they are open to viewing but not to copying. Frank suggested that each Board member sign a confidentiality agreement. Steve advised that he understood that all of the Board members should sign it as it would include closed session topics also. Steve advised about the dedication of the Education Center to Walter Cobb. It will be Friday October 19 from 11:45 to 12:45. We have talked to Terry Cobb, his brother Jerry and daughter Tracy. We are not sure if the sign will be completed by Friday but we will have a banner. John Winkert is providing BBQ. Terry has advised that he would like to say a few words. Emails were sent to the crews today with the details. Cash receipts Steve advised we budgeted just over $1.6 million dollars for receipts for 2007. So we have just over $440,000 to collect the rest of the year to meet budget. We should be very close. Melissa presented graphs showing September 2007 receipts are $150,427.99. Year to date we are at $1,169,449.75. Melissa advised that year to date approved write off accounts total $415,509.16. Disallowed accounts total $189,187.59. MOTION - write off Director Rozell made a motion to write off 165 accounts totaling $55,486.26. Director Romine seconded the motion. The motion passed by vote: Director Nave (Yes), Director Rozell (Yes), Director Ford (Yes), Director Novak (Yes), Director Sanders (Absent), Director Romine (Yes). Operations Kevin advised we still do not have a date for the new truck. Kevin advised Shawn has begun work on the other truck. We have talked to Shawn and he is running out of room to work. We are going to move him to this building. Nave inquired what had to be done on TCA 5. Novak inquired about clean up at the East medic building. Kevin advised that he believes everything is gone but the 5th wheel. Steve advised of the work Danny has been doing and what he is planning to do this winter. Steve stated that K & R is putting 4 security lights in. Dispatch Kent advised he has been working on QA. Kent stated we lost Josh to the road. He will be replaced by Jennifer Vanderpool. Education Richard advised we have EMT class running right now. We have applications for spring class already. Nave inquired how long first responders have to do ride time after class completion. Richard advised they have 12 hours of ride time and we give them 60 days to complete it. IT Caleb advised we solved one of our communication hurdles last month. We have achieved some good results. Budget Steve advised the proposed budget is $5.3 million dollars for next year. We have a projected net income of $177,000. The proposed budget for payroll is figured at a 5% raise for all employees. Cash receipts Melissa explained 2008 estimated receivables. Explained the figures in red reflect charges that will need to be increased January 1, 2008 based on projected Medicare allowable increases. Melissa gave the information on the 5 rates in which our current charges will be below the Medicare allowable in 2008. She presented figures for what the rates are currently and what amount is estimated for 2008. Melissa advised that bad debt is figured into this projection as well as allowance for an estimated 5% for Medicare not covered. Medicare is increasing greatly on the number of denials each year. The total figure does include a call volume increase using a 6.75% increase for base rates and 6.6% for mileage based on the percent of increase from 2005 to 2006. Dale Sanders arrived during this. Operations Kevin explained operations budget items. Kevin advised the process with the shifts and supervisors for deciding items to purchase. Discussion about Rad 57. Jeff advised that by-products of combustion cause cyanide poisoning. You don't know if it is a problem without this tool. Rozell inquired about the $4000 refrigerator. Kevin stated that on the pharmaceutical side they have to be within 2 degrees of the temperature range and we currently have 3 of them. Novak inquired about the Halmatro tools, is that to outfit the 2 new trucks? Kevin advised yes. Nave inquired on the weight limit on our cots vs the bariatric cot. Kevin advised 350 pounds vs 850 pounds and it is wider it is more stable. Rozell inquired about Drive Cam. Further discussion was held. Discussion about monitor batteries. Inquiry about the blue tooth monitor upgrade. Jeff advised that the Tablet and the 12 lead would interface without cable. It saves time and makes transmission time faster and stops the loss of use of $90 cables. Kevin advised about $60,000 budgeted for monitors. They are $32,000 to $35,000 each. They should last 5-8 years. Kevin advised that we would have to replace them all at once. We would like to look at it this fall and look at a lease purchase agreement possibly over a 3 year period. Discussion about the remount. We are looking at a 2 ton for Danny with a dump bed to haul equipment and supplies in. Inquiry about MCI deployment. Jeff advised it includes equipment such as; vests, tags, forms… Education Inquiry was made about the instructor tool kit. Richard advised HA material, instructor guides, haz mat… Building maintenance Kevin presented the budgeted items. Mechanical maintenance Kevin explained budgeted items. Communications Budget Kent advised the flat screen monitors are to replace the large picture map on the wall. The prices reflects a 47 to 52 inch screen with a wall mount. Steve advised that Dispatch Pro is one of the last software purchases for the Zoll suite. We signed paperwork for half price to be paid in January. Kent explained about street smart routing that pinpoints where they are and where their call is. It starts learning traffic flows to allow it to pick the closest car for the call. As it is now a call at the end of T Hwy the Forsyth car would be closer. This new product would eliminate the as the crow flies problem. Rozell inquired where we get our mapping. Kent advised Patsy at the county. We do have to send them off once a quarter for degradation. Discussion about the audio sound panels. IT Budget Steve presented the breakdown provided. Caleb advised the IT department is used to facilitate interdepartment/intradepartment communications. One of the greatest intangible benefits would be reducing potential litigation. How many lawsuits do we prevent because documentation was good? We are able to set required fields and reviews have gone down. HIPAA compliance is improved by not carrying paper trip tickets in the ambulances. Caleb stated that Lea Ann is now scheduling 2 months ahead. Caleb advised that a former employer of his used 10% of their budget for IT. White River runs at 3.5%. Our proposed IT budget is 3% of the total budget including wages. Novak inquired about clocking in East. Caleb advised we are looking at DSL that should improve speed and should also reduce the cost from cable. Nave inquired about the numbers of computers budgeted to purchase. Caleb advised we used to do lifecycle budgeting. Melissa advised we have 67 computers. You can generally expect to get 5 years out of a computer, meaning you would replace 13 per year. This year we looked at the amount of computers purchased last year and tried to estimate the amount we would need for 2008. Inquiry was made about the dollar amount increasing so much from last year. Melissa advised that the largest factor is software support. That was not included in the IT budget last year. Caleb advised that if we could save hiring even 1 employee it would be a cost savings for the District. Katie agreed. Payroll Steve advised that last year we discussed a straight across the board percentage increase. He stated that we talked about a lump sum percentage payout for those who had reached their cap. This would not apply to overtime hours. Katie advised that the cost of living conjecture is 1.7 to 2%, it has not been set yet. Steve advised that last year we did talk about not using cost of living as the % raise. Steve stated that the budget estimates sales tax for 2008 to be at $3.7 million. This would cover payroll and benefits. Steve advised that pay increases reflected in the 2008 budget are based on a 5% raise. For each percent change that budgeted figure would increase or decrease about $30,000. Currently our health insurance is locked in until Jan 2009. Discussion about our work comp experience mod. Last year about 77% of our budget was for pay and benefits. Discussion about projected cash receipts and sales tax next year. Steve advised that for the Branson Landing, Home Depot and Wal Mart areas the city takes 50% of our sales tax back. Steve advised he estimates paying $200,000 back to the City but that is $200,000 we collect also. According to the city, the TIF is projected to end earlier than 23 years. Rozell inquired about extra crews and employees. Steve advised it comes down to how busy we are in March or April. Currently we are not projecting any new employees. Kevin advised you saw a reduction in overtime this year. EXECUTIVE SESSION Director Rozell made a motion to go into Executive Session to discuss personnel matters authorized by RSMo 610.021 and in compliance with RSMo 610.022. Director Novak seconded the motion. The motion passed by vote: Director Nave (Yes), Director Rozell (Yes), Director Ford (Yes), Director Novak (Yes), Director Sanders (Yes), Director Romine (Yes). |