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:
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1.
That
the above recitations are true and correct.
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2.
That
the following fees are hereby established for the
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emergency medical transportation service:
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(a)
City of Carlsbad resident $55.00
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(b)
Second Family Member 30.00
10
(c)
Third Family Member 15.00
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(d)
The maximum fee for one resident family resulting
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from the
same
incident shall be $100.00.
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(e)
Victims classified as dead on arrival or City
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employees
whose
illness or injury results from their City employ-
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ment shall pay
no fee.
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(f)
Non-resident $75.00
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(g)
Each non-resident family member 75.00
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(h)
The maximum fee for one non-resident family
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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:
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16 ALETIIA L. ZAUTENKRANZ,M City Cle k
17 (SEAL)
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