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HomeMy WebLinkAbout33- Fire CITY OF SAN BERN*-41DINO - REQUEST F 414 COUNCIL ACTION From: Peggy Ducey, Assistant to the City Subject: Public Hearing for Proposed City of Administrator San Bernardino Fire Department Emergency Dept: Administration Transport Services Date: July 7, 1993 Synopsis of Previous Council action: May 24, 1993 - Mayor and Common Council directed the City Administrator and Fire Chief to develop a plan for the provision of City Fire Department emergency transport services and present the plan in a public hearing scheduled for July 19, 1993. Recommended motion: That the Mayor and Common Council: 1. Close the public hearing; 2. Approve the operating plan for City Fire Department emergency transport services as submitted by the City Administrator's office; 3. Set a public hearing for August 16, 1993 to establish a rate schedule for City Fire Department emergency medical transport. Signature OV Contact person: Peggy Ducey Phone: 5122 Supporting data attached: yes Ward: FUNDING REQUIREMENTS: Amount: Source: (Acct. No.) (Acct. Description) Finance: Council Notes: an Emergency Medical Dispatcher (EMD) answers the call at the fire department dispatch center. All EMDs will be trained in emergency medical dispatching, a process which includes questioning of callers using skilled interrogation techniques and medically approved protocols so that the relative urgency of the call can be determined and more detailed information can be relayed to the responding safety personnel. Based on this information, the EMD will determine whether to dispatch a first-responder unit for a Basic Life Support (BLS) call, such as a broken bone, or paramedic responders for an Advanced Life Support (ALS) call, and dispatch the nearest available engine. While safety personnel are enroute to the emergency scene, the EMD may continue to instruct the caller on first aid steps, CPR, or other vital actions while emergency units are mustering and responding. All fire engines and ladder trucks are staffed with three cross- trained firefighter/Emergency Medical Technicians (EMTs) . The purpose of first responders is to provide basic life support to the emergency victim as quickly as possible. First responders will arrive at the scene within 3-5 minutes, on average. Six stations would serve as bases for paramedic ambulances, staffed by two firefighter/paramedics. If the ambulance is in the district where the emergency call originates, they will also arrive on scene within 3-5 minutes. If they are outside the district of the call, they will arrive on scene within six minutes. However, a first responding team will already be treating the patient and begin stabilization. The fire department's ambulance system is designed primarily for emergency transportation. Therefore, if the first responders or paramedics confirm that the patient does not require emergency transportation, they have the option of transporting themselves to appropriate medical care or calling for a unit from the local private ambulance provider. The private ambulance company also serves as back-up in the event of a major medical emergency and all fire department ambulances are in use. FIRE VEHICLE NEEDS Except for the leasing of eight ambulances (six in service, two in reserve) , this plan would utilize all existing Fire Department apparatus. In fact, there would be less wear on engine and truck companies since they would not be accompanying the patient to the hospital. Current and proposed vehicle configuration are as follows: VEHICLE CONFIGURATION Vehicles Current Proposed Paramedic Engine 5 0 EMT Engine Company 6 11 EMT Truck Company 2 2 (1-truck or ambulance) Paramedic Ambulance 0 6 STAFFING NEEDS The Fire Department currently has 162 field positions that are authorized and budgeted for, however, eleven have been held vacant and have been filled using overtime. The proposed plan would also require 162 positions, as delineated below: STAFFING CONFIGURATION Field Staffing Current Proposed Battalion Chief 6 6 Firefighter 40 42 Engineer 45 39 Captain 39 39 Paramedic 32 36 Total 162 162 Admin Staff ' Current Proposed EMS Coord/Capt 0 1 Accountant 0 1 Administrative Analyst 0 1 Clerk 0 1 COST ANALYSIS It is projected that revenues from the emergency transport service would completely offset the cost of the operation of the entire Emergency Medical Services program. 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QO � IqU) ICY -X O � tiaY ►W. zO ° a W tv Z 2 a 2 4 vZ W 2 2 2O a h W � ? 2 a in W tc ? 2 O CURRt"NT OPERATIONRL CONFIGURATION PHRHMEDIC ENGINE COURTESY HMBULRNCE FE C EMT P P P PROP ED OP ERATIOAL CONFIGURATION �- PRRRMEDIC ENGINE COMPRNY RMBULRNCE F E C P P F E f l �I *1 C) M y :3 (b Cb c� P o �o oo cb Cb O O a) ( � c� o o n� Cb � Z � C6 !N V NV �NN C� O4O O VQ004C) � O C31 �0 p G� O CO v1 V O p c zr oo n c� N) ry cVI 0 v4 v J W O V E O �o '**4 O 00 c3 � Z 0 0 °o o f4 O W � O n ZZ y y y y C t� O O N N T •O 'O `W `W 'y rill CO SID O O IV fV i O O O O O O O O a � � z ' t31 4 N V ti y v v V v p 1Cn 4N `O v y C Cv31 OV Cep of tp v O W N Oo 01 + Oo v V �A CZ COURTESYAMBULANCE SERviu�IS TRADITIONALLY ASKED A NUMBER OF QUESTIONS INCLUDING: HOW ARE RA TES SET? Rates and charges are established by the County of San Bernardino and the City of San Bernardino.On a county-by-county comparison throughout the State of California,Courtesy Ambulance Services' rates are in the middle of the group.In other words,half of the counties allow their ambulance providers to charge more than Courtesy. HOW DOES COURTESY HEAR ABOUT AN EMERGENCY? Courtesy Ambulance Service cannot respond to any call unless it receives a request through the communications centers operated by cities and the County of San Bernardino. WHO CERTIFIES PERSONNEL? All personnel are certified by the County of San Bernardino organization known as ICEMA. WHAT IS ICEMA? ICEMA stands for the Inland Counties Emergency Medical Agency,the agency which bears the responsibility for ensuring a viable and cohesive emergency medical service program for the County of San Bernardino. WOULD SERVICES BE OFFERED AT LOWER FEES BY THE CITY? According to the City's own figures,the fee structure will remain the same.However,taxpayers will absorb the costs of personnel,equipment and insurance."Hidden"in the request to provide services are the"write offs"that each private ambu- lance company must assume,if under contract to the County. For example,Courtesy,under contract to the County,provides services to the homeless,indigent,welfare recipient and others at fees set by the County.Those actual charges are"written off'as a matter of doing business for its residents. WHO PAYS FOR EMERGENCY MEDICAL SERVICES? Under the private carrier policy,Courtesy Ambulance only bills those who use its services,a so-called User Fee.If you don't use the service,you don't pay. Under the proposed City program each taxpayer will pay a little more.Even if you don't use the service,the cost of providing new paramedic services are on-going. WHY IS IT THAT BOTH THE FIRE DEPARTMENT AND COURTESY SHOWS UP FOR A MEDICAL EMERGENCY? Cities control their 911 calls,and they dispatch their own fire units first.The dispatcher then notifies Courtesy second,even if they are closer and could provide life-saving support.The first paramedic on the scene takes charge of patient treatment but Courtesy transports the patient.Because City wants an opportunity to"bill"its patients,the entire fire truck and its crew "accompany"Courtesy ambulances to the nearest hospital.This takes fire department personnel and equipment out of service and wastes tax payers dollars. IF THE FIRE DEPARTMENT LEAVES EMS, WHO DO I CALL IN AN EMERGENCY? The same 911 number,as always.The dispatcher will alert the nearest Courtesy Ambulance and response will be less than 10 minutes away. IF I DON'T HAVE INSURANCE, WHO WILL TREAT ME? Courtesy Ambulance! You are never asked if you have insurance.We have a contract with the County to provide the best service possible to everyone. IF THE CITY TAKES OVER EMS, WHO PAYS IF I CAN'T? The city's taxpayers.Obviously,sick people can't be left on the sidewalks.But overtime and other costs are always paid for by the taxpayer.If the city runs out of money,or hasn't properly budgeted all expenses,other services like the library,parks and recreation or police services are trimmed.Or a"special"tax assessment is passed. ARE THERE ANY CITIES THAT RELY ON PRIVATE AMBULANCES ONLY? Yes.Many cities,such as Riverside and San Diego,rely solely on private ambulance companies.The City of Riverside estimates that it has saved its taxpayers more than$1 million annually by using a private carrier.The City of San Diego has used private carriers since 1977.Don't believe the fire fighters arguments that private carriers aren't as good. WITHOUT COMPETITION, WON'T MY RATES SKYROCKET? Emergency Medical Service rates are regulated by state law and county agencies.Requests for rate increases must be based on operating costs and must be approved by the appropriate overseeing agency. OUTLINE OF PARAMEDIC EVENTS (all information provided by the City of San Bernardino) 1975 City Council votes to allow Fire Department to provide paramedic services with the understanding that no additional personnel will be needed, and training and equipment charges will not exceed $14,000. 1990 In October, Fire Department proposes charging citizens for paramedic services, projecting revenue of$610,000. The revenue figure includes selling 5,900 memberships to families at $24 each. 1991 In 1991-1992 budget year only 3,372 memberships are sold resulting in rev- enues of$178,959. The cost of providing paramedic services is $1,479,164 resulting in a $1,299,205 cost to taxpayers in the City of San Bernardino. 1993 Based on current costs, less the memberships sold, the City has paid $1,299,205 for paramedic services in 1991/1992, and $1,167,664 for services to date. Total net cost to the City's taxpayers is $2,466,869 for "free" paramedic services since inception. Courtesy provides these same services at no cost to the tax- payer, and with no complaints of service. Proposed City proposes two programs Option#3 and Option #4. Option#3 includes start- up costs of$710,296.66 and annual expenses of$1,882,629. Option #4 includes start-up costs of$628,936 and annual expenses of$1,391,683. Personnel, liability and workers compensation insurance costs are not included. Cost to the taxpayers in 1993 is: Option #3 $3,360,793 and Option #4 $2,869,847. Projection City proposes raising ambulance rates to earn revenue of$2,869,847. These figures are based on collection and transportation rates that Courtesy Ambu- lance has never been able to meet, and with six less ambulances. Shortfall City actually predicts LOSSES of(Option #3) $826,179 or (Option #4) $335,233. Taxpayers will be forced to pay these fees through further reduction of services. Additional Such expenses as insurance (both liability and workers' compensation), wear and-tear on equipment and fire fighters' lawsuits against the City are not in- cluded. TAXPAYER COST FOR THE PAST 43 YEARS WITH COURTESY AMBULANCE IS $0.00 V St. Bernardine Plaza • 550 WEST FIFTH STREET, SAN BERNARDINO, CALIFORNIA 92401 to 9; t 5 (909) 888-0153 Ms . Shawna Clark City Administrator City of San Bernardino City Hall San Bernardino , Ca . 92401 We , the undersigned citizens of San Bernardino wish to state that we are NOT in favor of the 911 paramedic service being removed from the Fire Department. We feel that our tax dollars would be better utilized in supporting our Fire Department in an Emergency Medical Transport System rather than having them used to subsidize private industry as in the present situation. It is our opinion that if the Fire Department could have the six ambulance units and the three back-up units , our needs would be more adequately provided for at a much reduced cost and , would afford much faster transport to the hospital . It just seems to make more sense to have the Fire Department be able to transport to the Medical Facilities since they are already on the scene and have stabilized our condition prior to the arrival of a private ambulance service . They then have to go to the hospital anyway in order the complete the call . Thank you for your consideration of our views and desires in this matter . cc : Mr . Tom Minor , Mayor Councilwoman Pope-Ludlam • Councilman Negrete Councilwoman Miller Councilman Curlin Supervisor Riordan Councilman Hernandez Supervisor Eaves Councilman Oberhelman Apt . Name Apt . Name 1 �;� � , Ire 6L R J h7l� Apt Name Apt . Name ("�Ild,14z- X13 � f lid 6 wl Gf b t` C... t I a— 4/JCL. I--f— I C, t n c.-L L; 777 4 0 v � � M J v 1163 i THE FOLLOWING PERSONS HAVE CALLED THE COUNCIL OFFICE TO EXPRESS THAT THEY ARE IN FAVOR OF KEEPING � PY PARAMEDICS FOR EMERGENC_ SERVICES: Joan Gibson Mr. M.J. Poteat - Wd. 7 4268 Mountain Drive 3621 Genevieve St. � 0 S.B. Phone: 381-6451 Phone: 886-1534 Helen Bracken - 7th Wd. Gloria Alverson 2325 Newport 2692 E. Highland Ave. S.B. Space 50 Phone: 886-4158 Phone: 862-3468 Betty Lou Riddle - 5th Wd. Beatrice Kuehne 837 W. 25th St. 2695 E. Highland Ave. S.B.S.B Phone: 882-3281 Highland, CA 92346 Phone: 864-3795Z Teresa Pettey - 5th Wd. 5549 Aster St. Rouch moore S.B. 5216 Carlton Phone: 887-3896 S.B. Phone: 886-2835 Ted Nece - Wd. 5 3264 N. "I" St. Jim Brooks S.B. 2588 Roxbury Dr. Phone: 881-2112 S.B. Phone: 881-3168 Donna Boyd - Wd. 5 1925 College Dr. #139 Arline Sendelbach -Wd. 4 S.B. Phone: 887-6637 Marge Topoleski wd. 4 Louise Ayala - Wd. 7 1663 Echo Drive 383 E. 28th St. Phone: 883-3870 S.B. Phone: 881-2218 M4. Linda Cooper (wd 7) 1166 E. Mon Aoze Ave. Jessie Methayer - Wd. 6 Phone: 886-6252 1483 W. 10th St. Mn. Cut is Pankea (wd 5) S.B. 2370 M"cup-i,ab e Dn. Phone: 884-1478 Phone: 8822428 Robert Morehead - Wd. 5 Hetene KoAen 1054 Sierra View 4040 E. Piedmont #282 (wd 4) S.B. H.ighta.nd, CA Phone: 883-0274 Phone: 864-8073 Billie Childs - Wd. 5 Hahotd pleats 5585 Wagon Wheel Rd. 1683 Lugo (wd 2) Phone: 880-3342 Phone: 886-2190 W. Dono.thy Lunn (wd 7) 2692 E. H-ighta.nd Sp. 41 Hightand, Ca Phone: 862-8070 W-,33 FOR FIREFIGHTERS By-NG PARAMEDICS Bonnie Caid Edna Plaiss 4494 N. Stoddard 2692 E. Highland #24 862-1601 Cheryl Neale William B. Garner 222 E. 17th 2745 Fremontia Shirley Smith Mr. & Mrs. George Sovey 371 W. 29th 4040 E. Piedmont #12 862-6359 Robert Ages Louise Stewart 2294 W. Evans 1811 Pumalo #214 Dexter & Michelle Thomas Harry Alexander 3072 W. Comstock 3154 Hudson 880-8772 Rose Scott Mary Graefe 1381 Colorado 4040 E. Piedmont #308 864-1249 Karen Hoke Mildred Davisson 4420 N. Varsity 721 E. 9th #139 880-2802 889-1393 Toby Potter Constance Lusk 1298 W. 27th 1218 N. Pico 882-2368 888-8466 Elizabeth Mallory 3734 Pacific #26 Fran Neuppert 862-6765 6271 N. Indigo 880-3700 Richard Boylan 4531 Stoddard Jovette Clark 882-5248 2904 Indian Canyon Ct. 862-3818 Sally & Ben Remick 760 E. 9th Sp. 16 884-4168 Lisa Brooks 2588 Roxbury Drive Janet Gaiton & Laverne 881-3168 1298 W. Marshall 882-22-90 Nancy Goforth Barbara Matthews 3740 La Hacienda 2692 E. Highland #113 883-6802 425-1931 Mary Lou Blevins Molly Romero 2692 E. Highland Ave Sp. 54 2692 E. Highland, Space 135 862-1207 864-7136 Jean Bogle 1094 E. Mirada 886-8658 YES - FOR PARAWDICS Jo Day.c6 3696 Leroy Reed Parke Kathteen Ho66mazteA (wd 4) 4040 E. Piedmont #337 3921 SiekAa Way 864-4913 Phone: 882-1931 Jacquetine Johnson (wd 4) Jim Ford 4040 F. Piedmont #362 1819 W. 20th Phone: 864-5117 887-4138 Yvette Baffin (7th Wd) Joey Shade 223 F. 47th St. 5280 N. Little Mountain Phone: 883-5171 880-1574 Agnes, HaAAigan (wd 7) Robert Moore Phone: 882-8576 5216 Carlton 886-2835 DoUthy Lunn (wd 4) Lois AUoway 2692 E. H.igk&nd #41 4120 N. Sepuiveda #11 Phone: 862-8070 Phone: 882-1073 Madeiine Shot (wd 7) 2846 Lawrence Phone: 883-0942 M/M Hwr y Hair tb e U 2692 F. Higk&nd #68 Phone: 862-6623 M/M Timothy Ra.mitez 393 F. 29th St. Phone: 883-0206 Wiiii,am F. RodgeAz 3354 Peuhing Phone: 882-3596 FAanceb FhAedeAicU 3595 BAoadmooA Phone: 883-3903 Liza South 5280 N. Lithe Mtn T-1 Phone: 880-1574 3 Order of Presentation: J 1 . Steve Rice ,! rl'2 Jean Stephens o 3 Mike Welsch v 4 ' Diana McCafferty V/ 5. Mark Cantrell ! -�-6. Willie Clark �r - 1'tt7' $-. Sylvia Martinez 9. Linda Grudz ✓ 10. Rev. McDonald /11 . Kathy Crow /12-4 Henry Vasquez VI 3. Jerry Harper �4. Dan Word /15. Shirley Sed i l l o 41/16. Danny Sedillo �17. Peter Hubbard