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Minutes August 1, 2005 CITY OF DENTON CITY COUNCIL MINUTES August 1, 2005 After determining that a quorum was present, the City Council convened in a Special Called Meeting on Monday, August 1, 2005 at 11:30 a.m. in the Council Work Session Room. PRESENT: Mayor Brock; Council Members Heggins, Kamp, Montgomery, Mulroy, and Thomson. ABSENT: Mayor Pro Tem McNeill 1. The Council received a report, held a discussion, and gave staff direction regarding Emergency Medical Services (EMS) Billing and outsourcing opportunities. Laura Behrens, Administrative Assistant-Fire Department, presented information regarding the emergency medical services billing. She reviewed the EMS billing history and the method of billing since 1992. Billing methods included a flat method that was a single flat charge for all ambulance services, based on total operating expenses from the prior fiscal year and did not account for allowable adjustments. The conventional method billed on set rates, mileage and supplies, the amounts were based on Medicare rates or rates of neighboring agencies, was used by most agencies and full cost recovery was difficult. Umbrella billing used pre-set or defined targets considered reasonable and customary by insurance companies, differentiated billing between insurance companies and patient direct allowed for more cost recovery and required intense research and application of statistical methods to be successful. The current Denton method of billing included a flat rate plus mileage plus supplies. Denton?s EMS billing currently had one of the highest collection rates compared to other agencies with in-house and outsourced billing. She reviewed current EMS financial statistics dealing with operational costs, administrative costs, and average cost of ambulance run and average cost of recovery per call. Council discussion included: Philosophy of sending engines out on calls with ambulances. Consider having ambulances at each station so as not to send out engines with EMS calls. Only dealing with cost of recovery of ambulance costs and not with cost of engines provided. Number of times ambulance goes out with no services provided. Behrens continued that all payers were billed the same and remaining balances after payment were forwarded to secondary insurance or the patient. Staff currently worked with 10 major insurance companies but also had 500 miscellaneous insurance companies on file. There currently was a 3% denial rate on submitted insurance claims. After reviewing internal procedures and surveying neighboring cities, it was determined that there were ways to improve billing methods. Intermedics was a firm that was being considered for Denton?s EMS billing. Using that firm?s billing methods, there would be a 22.8% impact on insurance billing, a greater cost recovery, differentiated billing of insurance and private pay, the tracking of insurance information through daily searches resulting in increased billing, statistical gathering, and addressing identified needs within the department. Outsourcing would provide increased revenue, would be more efficient with effective use of personnel, provide improved statistical City of Denton City Council Minutes August 1, 2005 Page 2 information, maintain compliances and provide cost savings. Items to consider included closeout of the current system, perceived loss of personal service, longevity of the outsourcing company, rates that would be dependent on industry standards with possible fluctuations, and collections. Council discussion included: If the service were outsourced, what would be the number of full-time employees to reassign ? one full-time employee would be maintained to work EMS billing/liaison with outsourcing firm. Consider providing information on how savings would be realized. Why were the co-pays waived - city residents already paid taxes so the co-pay was waived. This was a potential issue to consider, as there might be a substantial increase in ambulance costs. Find out more information regarding the denial of insurance claims. Consensus of the Council was that while there appeared to be a potential benefit to outsourcing, more information was needed with proposals from several companies. 2. The Council received a report, held a discussion and gave staff direction regarding the Denton Open Space Concept Plan. Janet Fitzgerald, Director of Parks and Recreation, stated that the Denton Comprehensive Plan envisioned an extensive system of open spaces for recreation, wildlife enhancement, and flood control. She reviewed the amount of open space in Denton today and the definitions of parks, open space, riparian and floodplains, Cross Timbers land, and agricultural lands. Council Member Heggins left the meeting. Fitzgerald continued with setting priorities. One was assessing the threat and resource values of land in and around Denton. Threats included areas that were most likely to be developed and potentially eliminate open space. Resources included areas that remain undeveloped and held value as open space. Major recommendations included continue trails or trail corridors, continue with regional park acquisition, protect and restore ecosystem habitats, and encourage scenic corridors. Another priority was the urgent category that included environmentally sensitive land that was under immediate threat of development. Near term priority categories were sites that were zoned for high intensity development that should be monitored for any indication of imminent planning applications. Near term general areas included Milam Creek Tributary, upper reaches of Hickory Creek, Briarcliff Park area, Cross Timbers and Lake Forest Park area. Long- term priority category included larger tracts of land that were not zoned for intensive use, but which might be developed over longer periods of time and should be considered for environmental overlay zones. These areas could be restored as prairie, maintained as riparian areas, or set aside as wooded preserves in the context of the overall development. Unique or opportunity priority areas included occasionally particularly desirable sites that would become available for acquisition and would be of substantive interest. A summary of potential implementation strategies included the transfer of development rights, conservation easement City of Denton City Council Minutes August 1, 2005 Page 3 purchase, land trust donations, fee simple purchase, open space bonds funded by property tax or dedicated sales tax. Council questioned why priority locations were removed from the document. Fitzgerald indicated that there was a concern that land values would be affected if specific sites were pointed out causing the land to be used in that manner. She continued that the recommendation was to develop a five year action/implementation plan after the adoption of the Open Space Concept Plan to include review of the organization to allow for the coordination of the plan rather than hiring of additional staff, evaluate the Park Land Dedication and development ordinance to include trail funding, and provide a red-line document prior to any public hearing at city council meetings. With no further business, the meeting was adjourned at 1:20 p.m. _____________________________________ EULINE BROCK MAYOR CITY OF DENTON, TEXAS _____________________________________ JENNIFER WALTERS CITY SECRETARY CITY OF DENTON, TEXAS