Title
Consider/Discuss/Act on an Ordinance Amending the Code of Ordinances - Appendix A - Schedule of Fees, Chapter 18 Relative to Ambulance Service Charges
Summary
MEETING DATE: April 5, 2011
DEPARTMENT: Fire Department
CONTACT: Mark Wallace, Fire Chief
RECOMMENDED CITY COUNCIL ACTION: Approve Ordinance
ITEM SUMMARY:
· The current Ambulance Service Fees were adopted in 2007.
· Revenues of $ 1,319,180 in Ambulance Services Fees were received in FY0910. This reflects a collection rate of approximately 70% of the incidents billed.
· The cost of providing the Advanced Life Support Ambulance Services per year is approximately $ 3.2 million per year.
· Our third-party billing service projects that an additional $ 300,000 would be received if the proposed ordinance is adopted.
· The proposed ordinances changes for Ambulance Service fees are as follows:
Item |
Current Rate |
Proposed New Rate |
BLS-Resident |
$ 425 |
$ 550 |
BLS-Nonresident |
$ 475 |
$ 625 |
ALS1-Resident |
$ 500 |
$ 650 |
ALS1-Nonresident |
$ 525 |
$ 725 |
ALS2-Resident |
$ 625 |
$ 750 |
ALS2-Nonresident |
$ 675 |
$ 825 |
Cost/loaded mile |
$ 10 |
$ 15 |
Extra Attendant(CPR) |
$ 0 |
$ 35 |
Oxygen |
$ 0 |
$ 60 |
ALS Treat/NoTransport |
$ 0 |
$ 150 |
BLS Treat/NoTransport |
$ 0 |
$ 100 |
ALS Routine Supplies |
$ 0 |
$ 50 |
BLS Routine Supplies |
$ 0 |
$ 100 |
BACKGROUND INFORMATION: N/A
· Ambulance Service Fees have existed in McKinney since McKinney took over the responsibility for providing ambulance services to the community since 1977.
· Current Ambulance Service Description
o Five (5) ambulances are in service 24/7/365
o Each ambulance is staffed by two Firefighter-Paramedics per shift
o Thirty (30) Firefighter-Paramedics are required to maintain 24/7/365 service.
o Additional costs of ambulance service include the cost of the ambulances which have a five-year useful service life; the cost of advanced life support equipment, medical supplies, pharmaceuticals, fuel, maintenance, etc.
o Costs for everything related to the ambulance services we provide, (such as supplies, services, pharmaceuticals, vehicles, equipment, and maintenance) have risen and are expected to continue rising each year.
· All of the personnel assigned to our "Med Units" are Firefighter-Paramedics. Not only do they provide the primary patient care on Emergency Medical Service (EMS) calls but they are also trained, certified, equipped and function as firefighters as the need arises.
· Every year, we ask out third-party billing service if our fees need to be revised. They were last revised in 2007. The proposed changes are what they recommended.
· Over 70 % of the emergency incidents in McKinney responded to by the Fire Department involve the delivery of EMS.
· Ambulance Service Fees in neighboring cities are summarized below for comparison. Based on our research, Plano and Allen charge the fees listed in the table below. Frisco's fees are more complex and are listed in a separate table as follows::
City |
Resident |
Non-resident |
Cost/Loaded Mile |
Plano |
$ 600 |
$ 700 |
$ 10 |
Allen |
$ 855 |
$ 855 |
$ 15 |
Frisco EMS Ambulance Fees |
Resident |
Non-resident |
Patient Transportation |
$ 550 |
$ 700 |
Cost/loaded mile |
$ 10 |
$ 10 |
Extrication/mva fee |
$ 500 |
$ 500 |
ALS Treat/No Transport |
$ 100 |
$ 100 |
EKG Monitoring |
$ 50 |
$ 50 |
ALS Airway Management |
$ 75 |
$ 75 |
IV Therapy |
$ 50 |
$ 50 |
Oxygen |
$ 50 |
$ 50 |
CPAP |
$ 65 |
$ 65 |
BIG I.O. |
$ 55 |
$ 55 |
Carbon Monoxide Detection |
$ 50 |
$ 50 |
Disposable SpO2 Sensor |
$ 15 |
$ 15 |
Spinal Immobilization |
$ 50 |
$ 50 |
Extra Attendant |
$ 30 |
$ 30 |
Amiodarone |
$ 10 |
$ 10 |
Etomidate |
$ 11.50 |
$ 11.50 |
Narcan |
$ 11.50 |
$ 11.50 |
Glucagon |
$ 80 |
$ 80 |
Zofran |
$ 13.25 |
$ 13.25 |
· The comparison city's fees used by our third party billing service are also complex schedules. For convenience, a simple comparison is provided as follows:
o Flower Mound (nearly the same as McKinney)
o Krum (much higher fees than McKinney)
o The Colony (slightly higher than McKinney)
o Little Elm (higher than McKinney)
o Lake Cities (much higher than McKinney)
o Mesquite (higher than McKinney)
o Farmers Branch (nearly the same as McKinney)
· It is typical throughout the United States that a portion of the costs for EMS service be spread out over the entire community (tax-funded) and is similar to an insurance policy that we all hope we don't need to use. A portion of the total costs is charged through user fees by those actually using the City-provided emergency medical services.
· Virtually all insurance companies, as well as Medicare/Medicaid, provide a contractual amount of payment with an agreed upon co-pay by the patient. We have considered that amount paid under the terms of the patient's insurance contract as an acceptable level of payment. Therefore, the amount charged is sometimes more than the amount actually received.
FINANCIAL SUMMARY:
· Adoption of this proposed ordinance will increase received City revenues by an estimated $ 300,000 annually.
· This would bring the cost recovery for this service to approximately one-half of the total cost of the services provided to the community.
BOARD OR COMMISSION RECOMMENDATION: N/A