HomeMy WebLinkAbout1976-06-15; City Council; 3600-1; Paramedic ServicesCITY OF CARLSBAD
AGENDA BILL NO. J60- y��,i f #� Initial:`'"
Pr Dept.Hd.
DATE: June 15, 1976 C. Atty.\
DEPARTMENT: City Manager C. Mgr.
Subject:
PARAMEDIC SERVICES
Statement of the Matter
At the March 16, 1976 City Council meeting, the Council heard
from a resident regarding the establishment of paramedic "a
service. The Council requested the staff to obtain cost
information on the paramedic service in other agencies and
develop a preliminary cost estimate for providing the service a
in Carlsbad.
Exhibit
Report on paramedic service including preliminary
cost estimates.
Recommendation
This is an information report only and the staff has no
recommendation. If it is the Council's intent to proceed with
active consideration of the matter, the staff can prepare
further detailed studies regarding the funding and operation
of such a program.
Council action
6-15-76 The Council discussed the information received, and the
possibility of conducting a survey to learn the desires
o'f the public on this and other matters. It was agreed
that a Council Committee be formed to develop a format
for a survey, and the staff be requested to return with
more information. The Mayor appointed Councilmen
Packard and Skotnicki to serve as the committee to pursue
this concept, with staff participation.
DATE: MAY 25, 1976
TO: CITY MANAGER
FROM: Administrative Assistant
SUBJECT: PARAMEDIC SERVICES
Information has been gathered concerning the cost of paramedic
services provided by various public agencies. In San Diego
County, only three agencies currently provide such service; the
City of Oceanside, County Service Area 17 (in the San Dieguito
area), and County Service Area 69 (in the Santee and Lakeside
area of the East County). In order to develop information more
representative of cities, the paramedic program in orange
County was also surveyed. In addition, cost figures on providing
paramedic services in the City of San Diego were also reviewed,
although San Diego voters rejected the service at the polls.
Evaluating the Cost of Paramedic Service
When evaluating the cost of any service and making comparisons
amongst various providers of service, in addition to the readily
apparent differences, two improtant points should be kept in
mind. First, the level of service may vary significantly from
agency to agency. Secondly, the total cost of providing the
service is not always allocated to a single budget account and
significant cost factors may therefore be difficult to identify.
For the purpose of this report, it will be assumed that the level
of paramedic service provided is relatively uniform. This is
probably a safe assumption in that there are definitive standards
to be followed by the providers of the service and a comprehensive
training program must be completed in order to qualify as a
paramedic. However, research has revealed .gat there is a
significant deviation among providers of the service on how costs
are stated. Therefore, cost information should be used with
caution since there is little agreement among the various agencies
providing paramedic services as to which expenses should be
included in the cost of operating a paramedic unit. Some agencies
consider the cost of operating the paramedic program to be only
the most obvious additional costs of providing the service, and
other agencies allocate all direct, as well as any indirect costs,
to the operation of the service.
May 25, 1976
Page 2
Subject: Paramedic Services
Proposed Paramedic Budgets in San Diego County
Information was obtained on the proposed 1976-77 budgets
for paramedic service by the following agencies and is
summarized as follows:
County Service Area 17 $226,6001
County Service Area 69 $221,202
City of Oceanside $ 40,0222
Orange County Paramedic Costs
The Orange County Health Department provided information on
the cost of providing paramedic service in that County. A
total of 22 units provides service in 12 cities and the
unincorporated areas of Orange County. For the 1975-76 fiscal
year, a survey conducted by Orange County revealed a cost
range from $125,000 to $205,000 per paramedic unit, with the
average being approximately $170,000 per unit.
Paramedic Cost Estimates by the City of San Diego
In a report prepared in July, 1975 for the San Diego City
Council, the cost of providing paramedic service through the
San Di=jo Fire Department was analyzed. The cost of providing
paramedic service, once the 20 unit system was fully imple-
mented in the 1977-78 fiscal year, was approximately $165,0003
per unit.
Possible Methods of Providing Paramedic Service in Carlsbad
There are, theoretically, a number of possible methods of
supplying paramedic services to the residents of Carlsbad.
Naturally, there are relative advantages and disadvantages
to each method, but it is important to be cognizant of the
possiL a alternative methods of supplying service. A few
possible alternatives are summarized on the following page.
lIncludes $21,200 in County overhead, service area administration,
office rental, and contingency reserves.
20ceanside operates two paramedic units.
3All costs expressed in fiscal year 1976 dollars includes
no increase in salaries or fringe benefits.
FA
May 25, 1976
Page 3
Subject: Paramedic Services
City of Carlsbad Fire Department - The most common approach
in Southern California has been for City Fire Departments
to provide paramedic services. In many cases, the Fire
Department was already supplying emergency ambulance service
and it appeared logical to supply paramedic services through
this department.
Private Service - There are private firms in the ambulance
business who have expressed an interest in providing para-
medic service to a city on a contract basis. The private
firm would derive part of its income from user fees and the
remainder from a city funded operating subsidy.
Tri-City Hospital District - The hospital district,as an
existing subregional agency, currently supplies emergency
medical services. The possibility of expanding such emergency
room service to include paramedic service deserves serious
consideration.
Subregional Joint Power Authority - It would be possible to
join with other cities or agencies in a joint exercise of
powers agreement to supply paramedic service. Through this
method, a number of agencies could obtain paramedic services.
Join County Service Area 17 - The existing San Dieguito
paramedic service could be expanded and allowed to operate in
the City of Carlsbad. All or a portion of the City might obtain
paramedic service in this manner.
Although the above possibilities may be .feasible legally and
administratively, the economic advantages and disadvantages
would have to be carefully weighed. In addition, there may be
practical political problems which would have to be evaluated.
The above summarized alternatives are designed merely to be
illustrative of what may be possible. An exhaustive investigation
of each alternative, if that is desired, would be necessary to
determine the optimum method of delivering paramedic service
to Carlsbad residents. However, regardless of the service
delivery system selected, there are certain identifiable costs
involved in supplying paramedic service. An estimate of the
cost of supplying such service has been calculated. The estimate
assumes that the service would be provided through the City of
Carlsbad Fire Department.
May 25, 1976
Page 4
Subject: Paramedic Services
ESTIMATED COST OF PARAMEDIC SERVICE - CARLSBAD FIRE DEPARTMENT
The estimated cost to the City of Carlsbad of providing one
paramedic unit is summarized as follows:
Personnel Servicesl First Year Second Year
Salaries $ 93,091 $ 93,091
Overtime $ 66,384 $ 1,2004
Subtotal $159,475 $ 94,291
Materials, Supplies, Services
Medical Spplies
$ 21000
$
2,000
Insurance
$ 51000
$
51000
Equipment Main &
Operation
$ 51500
$
6,000
Subtotal
$ 12,500
$
13,000
Capital outlay
Capital Reserves
for Replace-
$
6,000
ment of Medical
Equip. and
Vehicles
Communication Equip.
Subtotal $ 6,000
TOTAL $171,975 $113,291
1Assumes no premium or incentive pay for fire fighters
assigned as paramedics.
2Allocating 60% of the time of eight fire fighters as
paramedics.
30vertime to replace eight fire fighters during 5 month
training program.
4Annual refresher training 18 hours per man.
5Anticipated increase in liability insurance.
6Assumes that existing ambulance equipment can be upgraded
for paramedic use.
7Grant funding is available to purchase and equip a paramedic
unit or purchase equipment necessary to upgrade the existing
ambulance. Approximately $10,000 would be needed to upgrade
the existing ambulance.
May 25, 1976
Page 5
Subject: Paramedic Services
The cost estimates assumed that there will initially be no
increase in personnel. it is assumed that the fire fighters
assigned as paramedics will initially be available at least
40% of the time for fire suppression activities. However,
as the frequency of calls for paramedic service increases, it
will be necessary to establish additional fire fighter positions
to maintain an adequate fire suppression staffing level.
As the demand for paramedic services increases, it should be
recognized that it may be necessary to add additional para-
medic units to maintain an adequate service level and to cove,:
all geographical areas of the City.
It should be noted that there is no charge made for adminis-
trative overhead or the cost of supervision. All costs are
stated in 1976 dollars and no incentive or premium pay or
salary adjustments are included for those fire fighters
serving as paramedics.
To initiate a paramedic program, it would be necessary to train
sufficient personnel to provide 24 hour a day, seven days a
week service. To provide such coverage, it will be necessary
to train 8 fire fighters as paramedics. The training program
runs for five months and while the fire fighters are undergoing
training, it would be necessary to bring in off duty personnel
at overtime rates so as to be able to maintain an adequate
staffing level. The direct cost of the training program,
approximately $2,000 per trainee, is funded jointly by the
County of San Diego and the Department of Health, Education
and Welfare. The City would still be responsible for paying
the cost of salaries and benefits for each trainee during the
training program.
Potential Program Revenue
it is anticipated that a user fee will be established for para-
medic serN-ICe. The fee most likely would be established somewhat
above the current charge for ambulance service. Assuming a fee
of $40.00 is established for paramedic service, potential revenue
is estimated as follows:
Calis where paramedic services are provided 500 calls
X $40
Revenue $20,000
If the present ambulance bill collection rate of 62% were applied
to potential paramedic revenues, annual program revenue would be
approximatelyqAN
$12,400../
F 4NK N. MN
Administrative Assistant
FNM:ldg
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