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HomeMy WebLinkAbout1979-03-20; City Council; 5787; Adjust Ambulance & Paramedic Fee Survey1-11N #'Q� J) CITY OF CARLSBAD AGENDA BILL NO. _- 7 ,p 7 Initial: DATE: March 20, 1979 Dept.Hd. C.Atty. DEPARTMENT: Fire C. Mgr. Subject: Recommendation for an adjustment in ambulance and paramedic fees based on a fee analysis survey. Statement of the Matter Fire Department staff has been asked to make an analysis Of our current ambulance fee schedule and to make a recommendation for an adjustment in the present fee rates. We have conducted a statistical study of ambulance and paramedic activities for the calendar year 1978 and established a revenue figure collected by the City. Based on an analysis of the average cost per patient, a time versus cost study and a survey of other depart- ment and district charge rates we have offered, for council consideration, options to adjust our current fee schedule. Exhibit Resolution No. Memorandum to City Manager from Fire Chief dated 2-27-79 Ambulance Statistics for 1978 Current Survey of Ambulance Fees Suggested Options for Council consideration. Recommendation Fire Department staff recommends that City Council accept and adopt Option #2 Fee Schedule as described in the fee analysis study. If Council concurs with Option No. 2, adopt Resolution No. _EZ/A Council Action: 3-20-79 Council adopted Resolution 5712, establishing fees for the emergency medical transportation service. CARLSBAD FIRE DEPARTMENT MEMORANDUM TO: CITY MANAGER DATE: 2-27-79 FROM: FIRE CHIEF SUBJECT: Ambulance Fees Attached is a survey of ambulance fees charged in the County, some 1978 ambulance statistics, and three options for setting ambulance fees. The survey shows an average of $65.00 for resident and $89.00 for non-resident users. The 1978 statistics show that out of a total of 1341 patients transported, 75% or 1006 patients paid a fee for an average of $24.60 per patient. The actual collection rate is 73.8% based on the amount collected and the maximum amount possible. The total budget for 1978/79 to provide paramedic service i� $208,719.00, If we were to charge the user a fee commensur- ate with the total cost of operation, the fee would become very restrictive. Of the options submitted, we are recommending that Option Two be adopted. In the analysis of our records we find that the paramedics are spending 25% of their time in actual paramedic -related duties and the remainder of their time is fire pro- tection related work or stand-by time. Ja 6 Thompson att c hments AMBULANCE STATISTICS FOR 1978 Total Number of Calls 1513 Patients transported 1341 Patients Not Transported 569 Total Number of Patients Served 1910 Collections 969 Patients @$25.00 $ 24,225.00 32 " @ 1S.00 480.00 5 " @ 10.00 SO.00 1006 39 " No Charge/DOA 296 " Non -Payment (Skips) Total Amount Collected $ 24,7S5.00 Maximum Amt. Possible 1341 Patients @$25.00 33,525.00 Collection Rate 73.8% 1006 Patients Paid a Fee For an Average Cost of $24.60 Per Patient Fee Necessary for 100% recovery, based on 73.8% Collection Rate would be $210.00 per patient. Fire Department Budget 1978/79 - $208,719 SURVEY OF AMBULANCE FEES (February 28, 1979) Area Resident SAN DIEGUITO $ 95.00 LAKESIDE Paramedic 79.00 E.M.T. SANTEE Paramedic 79.00 E.M.T. 40.00 Extra Family Member S/A SPRING VALLEY Paramedic 40.00 Extra Family Member 5.00 ea. POWAY Paramedic 35.00 E -M.T. 35.00 Extra Family Member 35.00 $150.00 Mileage Fee VISTA Paramedic & E.M.T. 60.00 lst Family Member 30,00 2nd "i It 30.00 No Maximum OCEANSIDE Paramedic P E.M.T. 7S.00 2nd Member 50.00 3rd Member 25.00 No Maximum ESCONDIDO Paramedic 40.00 All Family Members A0.Q0 AMERICAN AMBULANCE E.M.T. Only 50.00 Base SAN DIEGO CITY Non -Resident $ 120.00 2.00 Per Mile 7.SO Emergency Call 7.50 02 Use 7.50 Night Calls 3.00 Supplies 77.S0 $102.00 108.00 25.00 100.00 80.00 S/A 80.00 10.00 ea. 35.00 3S.00 3S.00 OPTION #1 Retain Present Fee Schedule A. Resident & Non -Resident $ 25.00 Q. Second Family member 15.00 C. Third Family Member 10.00 D. The maximum fee for one family resulting from the same incident shall be $50.00. E. Victims classified as dead on arrival or City employees whose illness or injury results from their City employment shall pay no fee. Emergency service is traditionally a function provided by City government. The nominal user fee schedule was adopted to offset admini- strative and expendable supply costs. The present ambulance schedule was adopted by Resolution 3728 in August, 1975. OPTION TWO A. Resident $55.00 B. Second Family Member 30.00 C. Third Family Member 15.00 D. The maximum fee for one resident family resulting from the same incident shall be $100.00 E. Victims classified as dead on arrival or City employees whose illness or injury results from their City employment shall pay no fee. F. Non -Resident 75.00 G. Each non-resident family member 75.00 H. The maximum fee for one non-resident family resulting from the same incident shall be 225.00 Option Two is based on actual costs .Ln relation to actual tine spent on emergency medical incidents. The medical records show that the average time spent per patient is between 46 and 60 minutes. Using 60 minutes per call and an average of four calls per day plus two hcurs per day allotted to maintenance of ambulance, equipment and training, we find the paramedic spends 25% of his duty shift in medical service r.,lated work. The theory of Option Two is to divide the costs into the cost of actual time spent on patient care (25%) and those costs necessary to be in readiness o provide the service (75%). Based on the Fiscal Year 1978/79 budget and the 1978 medical statistics we would need to charge $51.86 per patient transport. To simplify the billing and collection process and to cover administrative costs this Option was adjusted slightly higher. Option Two also incorporates a non-resident fee of $75.00 on the baszs that non-residents are not supporting the fixed and ready-tc-serve costs. W OPTION THREE A. Resident $ 65.00 B. Second Family Member 35.00 C. Third Family Member 25.00 D. The maximum fee for one resident family resulting from the same incident shall be 125.00 E. Victims classified as dead on arrival or City employee whose illness or injury results from their City employment shall pay No Fee. F. Non -Resident 90.00 C. Each non-resident family member 90.00 H. The maximum fee for one resident family resulting from the same incident shall be 270.00 Option Three is based on a County average for resident and non-resident charges. The above option is based on a recent County survey. The average arrived at is taken from the primary charge per patient from each agency. The primary fees are for paramedic service provided by all agencies except for one private ambulance agency that occasionally responds into the City of Carlsbad. The private ambulance is manned by E.M.T. personnel. County Average: Resident $ 64.31 Non -Resident 88,60 1 RESOLUTION NO. 5712 2 A RESOLUTION OF THE CITY. COUNCIL OF THE CITY OF CARLSBAD, CALIFORNIA, ESTABLISHING FEES FOR THE EMERGENCY MEDICAL TRANSPORTP.- 4 TION SERVICE PURSUANT TO CIIAPTER 6.06 OF THE CARLSBAD MUNICIPAL CODE. 5 . 61 WIiEREAS, Chapter 6.06 of the Carlsbad Municipal Code estab- 7 lishes an emergency media g Y al transportation service for the City of 8 Carlsbad and authorizes the imposition of a fee on the users of 9 such service; and 10 WHEREAS, the City Council has determined an appropriate fee 11 schedule for such service; 12 NOW, THEREFORE, BE IT RESOLVED by the City Council of the 13 City of Carlsbad as follows: 14 1. That the above recitations are true and correct. 15 2. That the following fees are hereby established for the 16 emergency medical transportation service: 11 (a) City of Carlsbad resident $55.00 18 (b) Second Family Member 30.00 10 (c) Third Family Member 15.00 20 (d) The maximum fee for one resident family resulting 21 from the same incident shall be $100.00. 22 (e) Victims classified as dead on arrival or City 23 employees whose illness or injury results from their City employ- -24 ment shall pay no fee. 25 (f) Non-resident $75.00 26 (g) Each non-resident family member 75.00 27 (h) The maximum fee for one non-resident family 28 resulting from the same incident shall be $225.00. 1 3. That all fees established hereby are due and payable on 2 the day the service is rendered and are delinquent after 60 days. The City Manager is authorized to take any appropriate measures 4 to collect delinquent fees. 5 PASSED, APPROVED AND ADOPTED at a regular meeting of the 6 arlsbad City Council held c_, the 20th day of March 7 1979, by the following vote, to wit: 8 AYES: Councilmen Packard, Skotnicki, Anear, Lewis and Councilwoman Caster 9 NOES: None 10 ABSENT: None 1112 13 RONALD C. PACKARD, Mayor TTEST: 14 15 16 ALETIIA L. ZAUTENKRANZ,M City Cle k 17 (SEAL) 18 19 20 21 22 23 24 25 26 27 28