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CITY OF SAN BERNJGDINO
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- REQUEST FOI COUNCIL ACTION
Data:
Lee Gagnon
Business License Supervisor
City Cl erk
May 24, 1989
Subject:
Set Public
at 10:00
increase
rates.
Hearing -- July 17, 1989
a.m. to discuss proposed
in medical transpo4Zation
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Synopsis of Previous Council action:
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August 17, 1987 - Council adopted current rates
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Recommended motion:
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That a public hearing be scheduled for the meeting of July 17, 1989 at 10:00 a.m.
to consider adopting the resolution to. increase ambulance rates and that the
City Attorney be instructed to prepare the necessary resolution for adoption.
That the City Clerk be authorized to publish notice of public hearing in
"block ad format" in the San Bernardino Sun newspaper.
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Signature
Contact patlan:
Lee Gagnon
5036
Phone:
Supporting data attached:
Yes
Ward:
N/A
FUNDING REaUIREMENTS:
Amount:
N/A
Source: (ACCT. NO.) N/ A
(ACCT. DESCRIPTION)
Flnance:_.
,....,
lilwJncil Notes:
AnAnrla I tAn, I\ln
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CIYY OF SAN 8ERN~DINO - REQUEST IdR COUNCIL ACTION
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STAFF REPORT
At their lIIeetinC) of May 9. 1989. the Ilureau 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
COlmon Counci 1 that the fo 11 owi ng rate structure be adopted wi th the s ti pu-
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
Coun~.
A. Ambulance Rates
1. Basic life support response
to a routine non-emergency
$143.88
$169.30
2. Unscheduled emergency call
additional
$ 65.35
$ 76.90
3. Additional tharges:
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A. Each mile or fraction
of a mil e
$ 7.19
$ 8.46
B. Waiting time after first
fifteen lIIi nute peri od;
for each subsequent fif-
teen minute period. or
fraction thereof there-
after
$ 13.18
$ 15.51
C. Night surcharge, 7:00 P.M.
to 7:00 A.M. Monday through
Friday or weekend services
$41. 97
$49.49
D. Each additional patient
fifty percent over charge
for one patient
E. Paramedic Rates:
1. Advanced life support
response to a call
$218.83
$257.49
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2. E.K.G. monitoring
3. All inclusive advanced
life support service
$ 29.97
$324.83
$ 35.26
$382.22
CITY OF SAN BERN~DINO - REQUEST ~R COUNCIL ACTION
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STAFF REPORT
Present Rate
City of San Bernardino
Proposed Rate
County
F. Oxygen Administration
G. Response to a call for
ambulance not used
$ 17.99
$ 15.00
$ 21.17
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H. Rigid Collar
$ 45.00
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75-0264
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Effects of Indexed Resolution Amendment
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 mile
b.
Waiting time after
first fifteen minute
period; for each sub-
sequent fifteen minute
period, or fraction
thereof thereafter
Current
Citv Rates
$143.88
65.35
7.19
13.18
Night surcharge, 7:00 PM 41.97
to 7:00 AM Monday through
Friday, or weekend service
c.
d. Each additional patient,
fifty percent over
charge for one patient
e. Paramedic Rates:
1.
Advanced Life
Support Response
to a Call
2.
3.
EKG Monitoring
All Inclusive
Advanced Life
Support Service
218.83
29.97
324.83
Current
County Rates
$169.30
76.90
8.46
15.51
49.49
257.49
35.26
382.22
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f.
17.99
21.17
Oxygen Administration
Response to a call for
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15.00
Rigid Collar
45.00
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Carrier shall be permitted
in its discretion to fix the
rates for other special
services not specified herein
ill
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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
!ndex" (ACI) (exhibit 4).
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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 payment
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 second 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.
It is redundant to have the County and City set rates.
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4.
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COURTESY SERVICES
OF
SO BEJUtARDIRO, IRC.
AMBULAIICE RATE IRCREASE REQUEST
Courtesy Services of San Bernardino, Inc. requests the resolution
of rates for ambulance service be amended as follows:
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RESOLUTION NO.
SAN
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
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.