HomeMy WebLinkAbout32-Bureau of Franchises
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~IY~ OF SAN BE~ARDINO - REQUES,o.OR COUNCIL ACTION
STAFF REPORT
At their meeting of May 9, 1989, the Bureau of Franchises received the
attached proposal from Courtesy Services of San Bernardino for an increase
in the rates for ambulance services and to index ambulance rates to those
established by the County of San Bernardino. The Bureau of Franchises
considered the proposal and then unanimously recommended to the Mayor and
Common Council that the following rate structure be adopted with the stipu-
lation that the issue of indexing ambulance rates to those established by the
County of San Bernardino be reviewed by the City Attorney to address the
legality of this process.
Present Rate
City of San Bernardino
Proposed Rate
County.
A. Ambulance Rates
1. Basic life support response
to a routine non-emergency
2. Unscheduled emergency call
additional
3. Additional Charges:
A. Each mile or fraction
of a mil e
B. Waiting time after first
fifteen minute period;
for each subsequent fif-
teen minute period, or
fraction thereof there-
after
C. Night surcharge, 7:00 P.M.
to 7:00 A.M. Monday through
Friday or weekend services
D. Each additional patient
fifty percent over charge
for one patient
E. Paramedic Rates:
1. Advanced life support
response to a call
2. E.K.G. monitoring
3. All inclusive advanced
life support service
75-0264
$143.88
$169.30
$ 65.35
$ 76.90
$ 7.19
$ 8.46
$ 13.18
$ 15.51
$41. 97
$49.49
$218.83
$257.49
$ 29.97
$324.83
$ 35.26
$382.22
3~
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. CITY OF SAN BE.QARDINO - REQUESTOOR COUNCIL ACTION
STAFF REPORT
Present Rate Proposed Rate
City of San Bernardino County
F. Oxygen Administration $ 17.99 $ 21.17
G. Response to a call for $ 15.00 -0-
ambulance not used
H. Rigid Collar $ 45.00 -0-
75-0264
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o
o
Effects of Indexed Resolution Amendment
Current
Citv Rates
A. Ambulance Rates
1.
Basic Life Support
response to a routine
non-emergency
$143.88
2.
Unscheduled emergency call
additional
65.35
3. Additional Charges:
a.
Each mile or fraction 7.19
of a mile
b.
Waiting time after 13.18
first fifteen minute
period; for each sub-
sequent fifteen minute
period, or fraction
thereof thereafter
c.
Night surcharge, 7:00 PM 41.97
to 7:00 AM Monday through
Friday, or weekend service
d. Each additional patient,
fifty percent over
charge for one patient
e. Paramedic Rates:
1.
Advanced Life
Support Response
to a Call
218.83
2.
3.
EKG Monitoring
29.97
324.83
All Inclusive
Advanced Life
Support Service
Current
countv Rates
$169.30
76.90
8.46
15.51
49.49
257.49
35.26
382.22
o
f.
Oxygen Administration
g.
h.
Response to a call for
Rigid Collar
L
Carrier shall be permitted
in its discretion to fix the
rates for other special
services not specified herein
o
17.99
21.17
15.00
o
45.00
o
o
o
o
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NARRATIVE
Courtesy Services is requesting the City of San Bernardino to
index ambulance. rates to those established by the County of San
Bernardino.
The County, acting on behalf of the State, itself, and the
Inland Counties Emergency Medical Authority (ICEMA) has accepted
the authority and responsibility for control of the delivery of
emergency medical services (EMS) (exhibit 1, Section 2.5 of the
Health and Safety Code). In accepting this responsibility it
establishes personnel and performance standards for EMS (exhibit
2 and 3, Emergency Medical Services plan and OrdinanCe 3251). The
County also sets ambulance rates by utilizing an "Ambulance Cost
Index" (ACI) (exhibit 4).
The ACI in an equation which measures the cost of service to
revenues generated proportionately by payment sources. The cost
side of the equation is a measurement of the Consumer Price Index
and various specific cost indicators produced by the Bureau of
Labor Statistics which is factored by proportionate private paymerit
source. The revenue side of the equation is a measurement of the
upward or downward motion of each payment source which is also
factored by the private payment source.
The ACI is received after the first quarter of each calendar
year and adjusted during the secopd quarter by the County Health
Officer. If revenues produced by the ACI are in excess of 10%
within a year the County Board of Supervisors will conduct a public
hearing before the increase can be granted.
The ACI has been adjusted and validated in 1986 and 1988 for
accuracy.
The reasons for indexing to this ACI are:
1. External influences have profound impacts on the delivery
and economics of ambulance service, policy and payment
decisions made by the Health Care Finance Agency
(Federal), Department of Health Services (State) and the
EMS Authority are closely monitored by the County. As
external changes occur they are accurately and timely
reflected in the ACI.
2 . The Health Department which regulates the local EMS
delivery system will be establishing the rates.
3. Shifts in the local health care economy are closely
monitored by the Health Department.
4. It is redundant to have the County and City set rates.
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COURTESY SERVICES
0..
SAR BERBARDIRO, IRC.
AMBULAlICB RATE IRCREASE REQUEST
Courtesy Services of San Bernardino, Inc. requests the resolution
of rates for ambulance service be amended as follows:
o
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RESOLUTION NO.
j
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
SAN BERNARDINO ADOPTING THE METHOD OF INDEXING THE CHARGES
FOR AMBULANCE SERVICES TO THOSE APPROVED BY
THE COUNTY OF SAN BERNARDINO
The City Council of the City of San Bernardino finds as
follows:
1. At the present time the rates to be charged by an
ambulance provider operating within the City of San Bernardino are
those set forth in Resolution 87-282 adopted by the City Council
on August 18, 1987.
2. In the past, the City Council of the City of San
Bernardino has, from time to time, independently reviewed the rates
for services charged by the operators of ambulance services
functioning within the City.
3. Since the time of the last such review, the State of
California has supplemented the California Health & Safety to
Counties the right to control the delivery of emergency medical
services.
4. In furtherance of this authority, the County of San
Bernardino has now adopted a specific Emergency Medical Services
Plan and has also set forth a detailed plan to review and modify
the charges for services performed by ambulance providers.
5 . The County, by its. Ordinance 2841, adopted Section
31.0819 to the San Bernardino County Code to set ambulance rates
in accordance with the Ambulance Cost Index ("ACI") as adjusted by
certain other specific factors and limitations.
6. Under the circumstances, the independent consideration
of rates by the City of San Bernardino is now redundant and not in
the best interests of its citizens.
THEREFORE, BE IT RESOLVED by the City Council of the City of
San Bernardino as follows:
Effective with the final adoption of this Resolution, the
rates permitted to be charged for ambulance services within the
City of San Bernardino shall be exactly the same rates as those in
effect within the County of San Bernardino as they may from time
to time be amended.