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HomeMy WebLinkAbout18-Fire Department CI1'Y'OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION From: Larry Pitzer, Fire Chief Subject: Public Hearing -- EMS Transport Rates Dept: Fire Department Date: March 20, 1997 ORIGINAL Synopsis of Previous Council action: 11/21/90 Resolution No. 90-471 adopted establishing emergency medical fees to be charged by.the Fire Department. 10/07/96 -- Mayor and Common Council directed the Fire Department to begin providing emergency medical transport services effective May 1, 1997. Recommended motion: That the Mayor and Common Council: 1. Close public hearing; and, 2. Adopt resolution. Contact person: Larrv Pitzer, Fire Chief Phone: 384-5286 Supporting data attached: Yes Ward: FUNDING REQUIREMENTS: Amount: N/A Source: (Acct. No.) (Acct. Descriotion) Finance: Council Notes: Res 97- r7 If/7/97 Agenda Item No.lJ 75-0262 ~ Staff Report Backaround On October 7, 1996, Mayor and Common Council directed that the Fire Department begin EMS transport services effective May 1, 1997. The consultant who completed the EMS Transport Feasibility Study, Mr. Jim Page, was retained to provide oversight and guidance through the process of implementing the study's plan for transport. Current Fees Resolution 90-471 sets fees for the emergency medical services currently provided by the Fire Department. Section l(A) of the resolution sets user fees of $100 per call for emergencies requiring Basic Life Support (BLS) services, and $200 per call for emergencies requiring Advanced Life Support (ALS) services. These fees are projected to generate $380,000 in revenue to the General Fund in FY 1997-98. In addition to the user fees, Section 1 (B) of the resolution establishes a voluntary membership fee of $24 per year per household, and $12 per year per household for qualifying low-income residents. Membership in the program entitles all permanent residents of the household to a waiver of the deductible portion of the cost of the user fee, or to a waiver of the entire fee if the patient has no insurance. Membership fees are proj ected to generate $40,000 in revenue to the General Fund in FY 1997-98. In addition to the user fees and membership fee, Resolution 90-471 also sets administrative late fees and delinquency fees related to the membership program and user fees. Proposed Fee Structure Under the proposed fee structure, the EMS user fees of $100 for BLS service and $200 for ALS service will be charged onlv when a patient receives treatment but is not transported. If a patient is transported, they will instead pay the ALS base rate or ALS all- inclusive rate, as well as mileage and oxygen. Deliquency fees are also set by the resolution. The voluntary membership program will continue as it has in the past, with the waiver of the patient's deductible or fee extended to cover EMS transportation. In the coming year, the EMS division will review the voluntary membership program, and determine if the program should be modified in light of the transport service that is now provided. . The chart below details the fee schedule for the first year, including the current EMS user fees: BLS service (non-transport) $100.00 ALS service (non-transport) $200.00 ALS Base $463.28 ALS All-inclusive $687.50 Mileage $13.05/mi Oxygen $76.96 Built into these rates is the cost of paying back what was drawn down from the initial $1.4 million loan made available from various City funds to provide for start-up costs. A charge of $25.03 is incorporated into the ALS Base and ALS All-inclusive transport rates for this purpose. The loan will be repaid within seven years. This fee structure is much more simplified than the structure currently used by Courtesy/AMR and most other private ambulance companies. Depending upon the circumstances, AMR currently has additional charges for unscheduled emergencies, waiting time, night service, and EKG monitoring. Because AMR's billing information is not available, a direct comparison of average bill amounts under this fee structure versus AMR's fees cannot be made. It should be noted that Resolution 90-471, which sets the current $100 and $200 EMS fees, will remain in place. If the transport service is stopped by a court order or other legal action, customers would continue to pay these charges. Given current call volume and estimated collection rates, the proposed fee schedule will allow for the recovery of the projected incremental cost of providing EMS transportation service. Other Issues As the feasibility study indicated, 15 existinq firefighter/paramedics will be used to staff the EMS transport program in addition to the 21 new positions. Up to the full cost for those 15 positions could be charged to the EMS Fund. However, the EMS Fund could not sustain the full cost in its beginning years; consequently, only 38% of the cost of these 15 positions will be transferred to that fund at this time. In future years, as the EMS Fund approaches or actually becomes self-sustaining, the full cost of these 15 positions could potentially be shifted to the EMS fund until all EMS transport expenditures are accounted for. It should be noted that since EMS fees will now be collected by the EMS enterpise fund, the General Fund would sustain a loss of . approximately $380,000 in revenue per year beginning in 1997-98. By moving the 38% of the cost of the 15 existing paramedic/firefighters into the EMS fund, the General Fund sees a corresponding reduction in expenditures so that there is no net effect on either fund. The EMS transportation service is a new service that will be constantly evolving. The health care industry is in a state of flux, and this service must continually shift and grow to meet the needs of both the customers (our residents and visitors to the city) and the payors (the health care insurers). In addition to changes in the health care field, there may also be changes in call volume and service demands. Because of continued problems with the accuracy of data available from the current CAD system, call data was collected manually from fire station logs. As the new CAD system comes on line, new information may become available that will impact the operation. In order to maintain the viability of the service in this dynamic environment, the EMS rates will be brought to the Mayor and Council each year for review. At that time, adjustments will be recommended as needed to provide for the recovery of increased costs or to reflect reduced costs. Recommendations It is recommended that the Mayor and Council adopt the resolution setting emergency medical transportation fees. ~ITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION From: Larry Pitzer, Fire Chief Subject: Emergency Medical Fees Dept: Fire Department ORIGINAL Date: March 10, 1997 Synopsis of Previous Council action: 11/21/90 Resolution No. 90-471 adopted, establishing emergency medical fees to be charged by the Fire Department. 10/07/96 -- Mayor and Common Council directed the Fire Department to begin providing emergency medical transport services effective May 1, 1997. Recommended motion: That a public hearing be set for 10:00 a.m. on April 7, 1997, to set fees related to emergency medical transport services provided by the Fire Department. .') ,. / ~. Contact person: Larry Pitzer. Pi re ~h i pf Phone: 384-5286 All Supporting data attached: Ward: FUNDING REQUIREMENTS: Amount: Source: (AccL No.) IAcct. DescriPtion) Finance: Council Notes: previousl.y :iJ:~ I (}3)7 If 7 I ' J//~ . tJ'I ~7 fl7 . I Agenda Item No. :' 75-0262 JII, . . CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION STAFF REPORT The Fire Department will begin providing emergency medical transportation service on May 1, 1997. Prior to the start of the service, fees for ambulance transportation must be set by the Mayor and Council. It is recommended that the Mayor and Council approve the motion to set the public hearing regarding emergency medical services fees for 10:00 a.m. on Monday, April 7, 1997.