Ambulance Advisory Committee

AMBULANCE ADVISORY COMMITTEE MEETING MINUTES February 21, 2013 9:00 AM Meeting held at: Division of Public Health & Community Services 18 Mulberry Street Nashua, NH 03060 Meeting called to order at 9:02 a.m. by Kerran Vigroux, DPHCS Director AAC Members Present: Kerran Vigroux, Director, Public Health & Community Services Richard Conway, Captain, Nashua Fire Department Jeff Bukunt, Captain, Nashua Police Department Mark Hastings, Southern NH Medical Center Fran Dupuis, St. Joseph Hospital AMR Representatives: Christopher Stawasz, AMR Roland Vaillancourt, AMR Public Present: David Fredette, Treasurer/Tax Collector – City of Nashua Members were given Minutes from the December 20, 2012 meeting; the AMR Reports for December 2012 and January 2013; and the Agenda for the February 21, 2012 meeting. Motion made to accept the Minutes from the December 20, 2012 meeting as amended, showing that Chief Galipeau was present and not Captain Conway. Mark Hastings accepted the Motion. Jeff Bukunt seconded the Motion All in favor – Unanimous Minutes Approved Motion made to accept the Minutes from the February 4, 2013 meeting. Fran Dupuis accepted the Motion. Richard Conway seconded the Motion All in Favor – Unanimous Minutes Approved Chris Stawasz  AMR December 2012 and January 2013 Reports o During December and January we dealt with snow emergencies/blizzards.  It was actually quiet and we had very few calls for ambulance services during these storms. o Rick - Are you noticing a pattern when you need to add a 4th or 5th truck?  Chris: No; this occurrence is less than 1.5% o Mark: The numbers of mutual aid coming to town have doubled  Chris: Cumulatively it is .85% of system volume; anything over 1% is a trigger for additional resources. o Kerran – Are there any additional questions.  None o Kerran asked if Chris had sent her the personnel spreadsheet  Chris stated would forward that.  Kerran opened up the meeting to comments and discussion regarding questions that had been previously asked about the contract. o She met with Steve Bennett and asked him if we were to amend the paragraphs regarding the balanced billing piece, would this be something we could do as an addendum or would it be a material change that would require an RFP and opening up to bid. Steve said because it didn’t change the nature of the contract, it’s his opinion that it doesn’t require a new RFP or new contract. AMR would have to be amenable to that change, but he did say that he considered it an important material change, and because of that, he said a communication would still need to be sent to the Board of Aldermen recommending the change. They would then move to accept, place on file and approve. It’s not enough to open up for a new contract, but still  enough that the Board of Aldermen would need a vote to approve it. This all relies on AMR considering those types of changes, as it would affect their revenue.  Chris o Chris responded to a question regarding how many Rockingham employees were brought over, and handed out an explanation to everybody.  We received 73 employment applications during our job fairs, and we hired 72 out of those 73 former Rockingham employees.  Chris stated that he doesn’t know how many of those people are still with AMR. o Chris responded to a question regarding AMR’s footprint shrinking.  Footprints are always changing; however, our footprint is unmatched by anybody.  Kerran – I think that the comment was trying to get to the point that there have been closures in certain areas and municipalities, and how would that affect backup.  Chris – We have not closed any facilities in NH, some in Mass, but we do not pull from them.  Kerran – Would you pull from Manchester, etc.  We pull from our AMR ambulances that are on the road, based upon where they are; for example Exit 10 in Merrimack. o Chris responded to a questions regarding Medicare rates  CMS publishes those rates yearly and changes usually take place on January 1st, unless Congressional legislation triggers things happening, ie, during the last budget cycle, the physicians and ambulances were scheduled for a 3% reduction, but were given a grace period for the next 6 months.  CMS publishes these changes whenever they occur and they are available online. o Chris handed out these rates and codes.  Kerran – for those who are not involved in this billing, this is important when a patient is billed Medicare plus 25%.  Chris - Impacts self-pays and those with a large deductable. o Chris responded to a request to have the usual and customary rates, which he passed to everyone.  Kerran – The first item is mileage, and Medicare would reimburse $7.09 out of the $35.00 that you would charge. o Kerran – Does anyone have any additional questions?  David asked Kerran about the question that was asked at the 2/4/13 meeting concerning extending the contract for a year versus an RFP. The notes stated that Kerran was going to ask Steve about that.   I believe you would still need to get approval from the Finance Committee, is that right?  Kerran – Because it’s not a financial sort of service, and we are not paying for that, I didn’t ask that.  David – I believe that you do still need to get their approval in order to extend it.  Kerran – I will follow up  Kerran – The Mayor asked us to meet to discuss the pros and cons of going out to bid versus extending the current contract. I will meet with the mayor next week and share what we have discussed today with her.  Most of the calls we have dealt with concern billing and not about care received. o Mark wanted to make sure that the Mayor would be notified that he and Fran recommended going out to bid. Kerran assured him that she would convey this and that the Mayor had already received the minutes from the 2/4/13 meeting. Kerran Vigroux requested a motion to adjourn. Mark Hastings moved to adjourn the meeting. Richard Conway seconded the motion to adjourn All in favor: Aye Meeting ended at 9:35 a.m. The next AAC Meeting will be held on Thursday, April 18, 2013 at 9:00 a.m., at the City of Nashua, Public Health and Community Services building, located at 18 Mulberry Street, Nashua. Respectfully Submitted, Barbara Scacco Administrative Assistant II City of Nashua