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CITY OF SAN BERNIa:.DINO - REQUEST .9.. COUNCIL ACTION
Su~~t: Adoption of Emergency Medical fee.
From: Chief William L. wright
Dept: Fire
One: November 2, 1990
Synopsis of Previous Council action:
03/22/90 Legislative Review Committee recommended approval of proposed
ordinance.
04/02/90
04/16/90
09/10/90
10/01/90
11/05/90
Set public hearing date on proposed ordinance authorizing
collection of Emergency Medical Service/Paramedic fees.
Council meeting, agenda item *45 -- failed by 3 to 3 vote.
ways and Means Committee approved in concept.
Establishment of Emergency Medical fee approved in concept.
Public Hearing set relative to the establishment of the
emergency medical fee.
Recommended motion:
1. Close hearing.
2. Adopt resolution.
3. That further reading of said ordinance be waived and said ordinance
be laid over for final adoption.
i;V~ ~ -fl/-
. Sign re
Contact person:
Chief William L. Wriqht
Phone:
384-5286
Yes
Ward:
Supporting data HtaChed:
Amount:
FUNDING REQUIREMENTS:
Source: (Acct. No.l
(Acct. DescriPtion)
Finance:
Council Notes:
Aoenda Item No.
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CITY OF SAN BERNA~'NO - REQUEST FOR'dOUNCIL ACTION
STAFF REPORT
EMERGENCY MEDICAL SERVICES/ PARAMEDIC 'USER FEES'
AND
VOLUNTARY
'MEMBERSHIP' PROGRAM
ppOPOSAL:
The City establish fees for providing emergency medical services (EMS). A fee of
$100 for basic life support (BLS>. provided by ali 11 fire engines. and 0 fee of $200 for
advanced life support (ALS). provided by 3 medic-engines and 1 medic-squad.
These costs would be referred to os 'User Fees'. The user fee is charged for fire
deportment EMS services rendered. independent of the need for ambulance
transportation.
If residents wont to ovoid the 'out of pocket' expense of on ALS or BLS user fee they
would hove the opportunity to become 'members' of the VOluntary Paramedic
Membership Program by paying 0 'membenhlp fee' of $24. User fee would then
be charged to the member's insurance company and will be accepted os
payment in fuli. A 'Low Income' membership fee of $12 would also be available for
those who qualify.
The net revenue for 'User Fee' charges alone. based on 0 flat rate of $100 for BLS
and $200 for ALS or paramedic level service. Is projected to
be approximately $374,640. 'User fees' plus 0 modest membership of 10% of the
59 JX1J dwelling units in the city could generate $610,764 annually.
Under NO circumstances wDl tlr. department services be delayed or denied to
anyone. Verification of membership and ability to pay will NOT occur at the scene of
any emergency.
BACKGROUND:
'User fees' and 'membership programs' ore becoming increasingly popular to
augment city revenues. City Are Department stoff surveyed the departments of like
size in Southem Califomia. Model programs exist In Huntington Beach and Fulierton
where 60-70% of municipal water customers ore members. Anaheim. Orange.
Hawthorne. Monterey Pork. and Westminster also hove successful programs that
recover 011 or 0 major portion of their EMS budgets. '
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fIaC~ IMP~CT:
Minimal JDltlollv. 'User Fee' billing services will be contracted to Courtesy Services.
They will send all users. or their designated health Insurance provider. a separate bill
for fire department emergency medical services. Courtesy Services has proposed
a fee of 9.5% of gross collections. The gross revenue projected for 'non-resident user
fees' alone Is $109.D68. Courtesy Services fee of 9.5% would amount to
approximately $10.361 annually. Initially the program's revenue will be directed Into
an 'Trust Account'. These funds will be used for marketing. public education.
advertising. mailings. consultation costs. and to evaluate the management needs to
ensure maximum success of the program.
The Anance and Data Processing Departments are putting together a proposal for
'membership fee' collections and membership verification.
Temporary help will be needed during the enrollment period for data entry and
other related tasks.
1Mf1EMENTATlON:
A phase-in process is recommended:
Phase On. - 'Non- Resident User Fees'
The first four to six months only non-residents will be billed for 'User Fees' until the
Membership program becomes effective. This phase will allow us to evaluate
our methods and needs for record keeping. documentation. and billing
procedures with a relatively small sample group (24% of the patients tronsoorted
are non-residents) and begin generating revenue. Any changes that need to be
made will be less costly.and time consuming.
From the statistics provided. we can fairly accurately. determine the number of
BLS and ALS respanses that involve non-residents. Atter applying the fees to these
numbers for a gross revenue of $109.D68. we can then subtract the collection fee
of 9.5% ($10.361) and show a net revenue for 'user fees' generated from non-
residents alone of $98.707 annually.
During this phose the program's revenue will be directed Into a 'Trust Account'.
These funds will be used for marketing. public education. advertising. mailings.
and consultation costs. Consultants will be used to evaluate the coordination and
management needs to maximize the success of the program.
This 'non-resident phase' can be Implemented 90 days after approval. Funds will
be set aside for printing costs and establishing a marketing plan.
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Phase Two - 'Membership Enrollmenf
A two month open enrollment period for voluntary membership. following a
month of intensive marketing Is recommended. Multi-media public Information
programs win be developed along with brochures and. applications mailed in the
water bills. In addition a mass mailing to every dwelling unit in the city. would start
in March. AprIl. May. or June.
Phase Two - open enrollment for voluntary membership will repeat annually.
Phase Three - Fulllmplemenlatlon
Atter the voluntary membership open enrollment period ends. memberships
become effective. and at that time the 'User Fee' will be applicable to ALl. 'non-
member' users (residents and non-residents) from that time on .
Again, under NO circumstances will fire department services be delayed or denied.
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RESOLUTION NO.
RESOLUTION OF THE CITY OF SAN BERNARDINO ESTABLISHING EMERGENCY
MEDICAL FEES TO BE CHARGED BY THE FIRE DEPARTMENT OF THE CITY OF
SAN BERNARDINO
WHEREAS, the City of San Bernardino desires to establish
reasonable service fees to assist in defraying the cost of
emergency medical services to be paid by persons who utiltize
said services or benefit from having said services readily
available: and
WHEREAS, Chapter 3.72 of the Municipal Code of the City of
San Bernardino authorizes the collection of fees for emergency
medical services: and
WHEREAS, the fees hereinafter established do not exceed the
estimated reasonable cost of providing emergency medical service
in the City of San Bernardino for which the fee is charged:
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AS FOLLOWS:
Section 1.
That the following fees and charges shall be
18 collected by the Fire Department of the City of San Bernardino
19 for emergency medical services:
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(A) User Fees:
Emergencies requiring Basic Life Support
services by paramedics and Emergency
Medical Technicians
$100.00/call
Emergencies requiring Advanced Life Support
services by paramedics
$200.00/call
(B) Voluntary Membership Fees
$24.00 per year per household, due on June 1 of each year,
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RESOLUTION OF THE CITY OF SAN BERNARDINO ESTABLISHING EMERGENCY
MEDICAL FEES TO BE CHARGED BY THE FIRE DEPARTMENT OF THE CITY OF
SAN BERNARDINO
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covers all permanent residents of a household.
Residents
qualifying for low income utility tax exemption, pursuant to the
standards set forth in Section 3.44.144 of the Municipal Code,
may enroll for $12.00 per year per household.
(C) Administrative Late Fee
Residents enrolling in the membership program after the
open enrollment period terminates will be charged a $12.00 fee
for processing.
This fee shall be waived if the resident has
established residency within sixty (60) days prior to the date of
enrollment.
(D) Delinquency Fees
Delinquent accounts for User Fees shall be charged an
additional 15% delinquency fee on the balance due.
SECTION 2. . That said emergency medical service User Fees
will be charged for service outside of the City and to non-
residents of the City of San Bernardino commencing January 1,
1991.
SECTION 3.
That said emergency medical service user fees
will be charged for service to residents of the City of San
Bernardino commencing June 1, 1991.
SECTION 4.
That an open enrollment period for the
VOluntary Emergency Medical Services Membership Program shall
commence on April 1, 1991, and terminate on June 1, 1991; and
that membership fees shall be thereafter due on June 1 of each
year.
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RESOLUTION OF THE CITY OF SAN BERNARDINO ESTABLISHING EMERGENCY
MEDICAL FEES TO BE CHARGED BY THE FIRE DEPARTMENT OF THE CITY OF
SAN BERNARDINO
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I HEREBY CERTIFY that the foregoing resolution was duly
adopted by the Mayor and Common Council of the City of San
Bernardino at a
meeting therof, held on
the
day of
, 1989, by the
following vote, to wit:
Council Members:
AYES
NAYS
ABSTAIN
ESTRADA
REILLY
FLORES
MAUDSLEY
MINOR
POPE-LUDLAM
MILLER
City Clerk
The foregoing resolution is hereby approved this
day of
, 1989.
22 MAYOR W.R. HOLCOMB
Ci ty of San Bernardino
23 Approved as to form
and legal content:
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ORDINANCE NO.
ORDINANCE OF THE CITY OF SAN BERNARDINO ADDING CHAPTER
3.72 TO THE MUNICIPAL CODE ENTITLED "USER FEES FOR EMERGENCY
MEDICAL SERVICES," AUTHORIZING THE COLLECTION OF USER FEES AND
MEMBERSHIP FEES FOR FIRE DEPARTMENT EMERGENCY MEDICAL SERVICES.
THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO
5 DO ORDAIN AS FOLLOWS:
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SECTION l~
Chapter 3.72, entitled "User Fees for
7 Emergency Medical Services" is hereby added to the Municipal Code
8 of the City of San Bernardino.
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SECTION 2.
Section 3.72.010 is hereby added to the
10 Municipal Code of the City of San Bernardino as follows:
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"3.72.010
Authority to Render Emergency Medical
12 Services
J3 The Fire Suppression Division of the Fire Department of
14 the City of San Bernardino, when called upon by citizens of the
15 community, shall respond to emergency medical incidents and
16 render emergency medical care and lifesaving measures in
17 accordance with the emergency medical standards established by
18 the San Bernardino County Health Officer."
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SECTION 3.
Section 3.72.020 is hereby added to the
20 Municipal Code of the City of San Bernardino as follows:
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"3.72.020
User Fees
(A)
Any person receiving emergency medical services of
23 the City of San Bernardino shall be charged a user fee, as
24 established by resolution of the Mayor and Common Council.
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(B)
User Fees shall be charges designed to recover
26 costs associated with the delivery of paramedic services, and
27 shall be in two tiers:
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ORDINANCE OF THE CITY OF SAN BERNARDINO ADDING CHAPTER 3.72 TO
THE MUNICIPAL CODE ENTITLED "USER FEES FOR EMERGENCY MEDICAL
SERVICES," AUTHORIZING THE COLLECTION OF USER FEES AND MEMBERSHIP
FEES FOR FIRE DEPARTMENT EMERGENCY MEDICAL SERVICES.
(1)
Emergencies requiring Basic Life Support
5 services by San Bernardino City Fire Department Paramedics or
6 Emergency Medical Technicians; and,
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(2)
Emergencies requiring Advanced Life Support
8 services by San Bernardino City Fire Department Paramedics.
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(C)
A voluntary "Membership Fee" shall be offered to
10 residents of the City of San Bernardino for the purpose of
11 assuring members that the membership pre-pays any insurance
12 deductible for San Bernardino City Fire Department emergency
13 medical services.
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(D)
Residents participating in the vOluntary Membership
15 Fee program shall provide to the City information to enable the
16 Ci ty to file claims against their insurance providers, if any,
17 for the User Fees. Any payment made by a member's insurance
18 provider shall be deemed payment in full, and the member shall
19 incur no further direct personal liability for said User Fees.
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(E)
A charge for delinquent payment of fees for
21 services is hereby authorized, to be set by resolution of the
22 Mayor and Common Council.
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(F)
Verification of membership and/or ability to pay
24 . shall not occur at the scene of any emergency.
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(G)
No emergency medical services shall be denied or
26 delayed to anyone on the basis of inability to payor to provide
27 evidence of membership.
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10 ESTRADA
11 REILLY
12 FLORES
13 MAUDSLEY
14 MINOR
15 POPE-LUDLAM
16 MILLER
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ORDINANCE OF THE CITY OF SAN BERNARDINO ADDING CHAPTER 3.72 TO
THE MUNICIPAL CODE ENTITLED "USER FEES. FOR EMERGENCY MEDICAL
SERVICES," AUTHORIZING THE COLLECTION OF USER FEES AND MEMBERSHIP
FEES FOR FIRE DEPARTMENT EMERGENCY MEDICAL SERVICES.
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I HEREBY CERTIFY that the foregoing ordinance was duly
adopted by the Mayor and Common Council of the City of San
Bernardino at a
meeting thereof, held on the
day of
, 1990, by the following vote, to wit:
Council Members:
AYES
NAYS
ABSTAIN
City Clerk
of
The foregoing ordinance is hereby approved this
, 1990.
day
w. R. HOLCOMB, Mayor
City of San Bernardino
Approved as to
form and legal content:
JAMES F. PENMAN,
City Attorney
B"/J~/.,, J
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