HomeMy WebLinkAbout12/10/1990 B A K E R S F I E L D
Kevin McDermott, Chair
Patricia DeMond
Ken Peterson
Staff: John Stinson
AGENDA
BUDGET AND FINANCE COMMITTEE
Monday, December 10, 1990
12:00 Noon
City Manager's Conference Room
1. PRICE RESEARCH - PUBLIC SAFETY BOND ISSUE
2. SPACE NEEDS
3. BOOKING FEE AMOUNTS
4. AMBULANCE RATES
5. REFUSE CONTRACT
If time permits:
6. BUSINESS LICENSES
7. COURTHOUSE UPDATE
8. FINANCIAL REPORT
(Proposed- CPI adjusted) AMBULANCE RATES SURVEY ~,:~
City Calls for Service: Ave. Miles
IOoldcn Empire I 8.5% 45.9% 45.6% 3.3 39.9% 81.4% . 46.0%
IHall' I 7.1% 49.5% 43.5% 4.2 40.2% 91.8% 43.6%
I
I
SACRAMENTO 175.00 30.00 N/A 350.00 25.00 7.50 0.00 40.00 5.00 45.00 15.00 30.00 7.00 NIA N/A
MODESTO * 194.00 49.00 N/A 395.00 .70.00 9.00 1.50 50.00 15.00 60.00 30.00 50.00 27.00 42.50 28.50
STOCKTON * 236.00 91.00 N/A - 420.00 95.00 9.00 1.50 50.00 15.00 46.00 16.00 33.00 10.00 UNK -14.00
FRESNO 175.00 30.00 N/A 395.00 70.00 9.00 1.50 UNK -35.00 N/A N/A 48.00 25.00 48.00 34.00
- IN COUNTY GEA (Current)** 342.50 442.50 442.50 14.00 65.00 65.00 38.00 .18.00
.- IN COUNTY HALL (Current) 381.15 381.15 446.00 14.08 66.00 66.00 35.00 20.00
Rate Analysis:
IMEDICARE (Bakersfield Area) ] 194.00 49.00 N/A 400.00 75.00 10.00 2.50 46.00 11.00 N/A N/A 38.00 15.00 N/A N/A
EMS (Propo~d) 'l 199.00 54.00 N/A 405.00 80.00 10.00 2.50 51.00 16.00 35.00 5.00 43.00 20.00 19.00 5.00
AVERAGE RATE (4 Cities) [ 195.00 50.00 N/A 390.00 65.00 8.63 1.13 46.67 11.67 50.33 20.33 40.25 17.25 45.25 31.25
GOLDEN EMPIRE/HALL (Requested) ] 174.00 29.00 0.00 374.00 49.00 9.00 1.50 41.00 6.00 36.00 6.00 27.00 4.00 17.00 3.00
Increase Compared to Current Rates:
MEDICARE (Bakersfield Area) 33.79% N/A 23.08% 33.33% 31.43% N/A 65.22% N/A
[EMS (Proposed) I 37.24% N/A 24.62% 33.33% 45.71% 16.67% 86.96% 35.71%
]AVERAGE RATE (4 Cities) I 34.48% N/A 20.00% 15.00% 33.33% 67.78% 75.00% ' 223.21%
[GOLDEN EMPIRE/HALL (Requested) ] 20:00% N/A 15.08% 20.00% 17.14% 20.00% 17.39% 21.43%
N/A = NOT APPLICABLE UNK = UNKNOWN
CPI Adjustment Factors: Consumer % lncrcasc: Provider % Increase:
~i!~:ii~!~!iiiiiiii!iiiiiiiii!iiiiiiiliiiiiiili 9.4% ALS : 9.1~ Provider % Increa~ Adjusted for 35% of Business W/o Increase:
* Emergency response rate charged with BLS only
** Does not include additional charges for medical supplies and additional medical services 10-r~--90
GOLDEN EMPIRE AMBULANCE
'~ I11 801 18th STREET' P.O.BOX 918 93302' ~'~
~,. BAKERSFIELD. CALIFORNIAg.3L30,1 .... 9 '" ,~: 3~
325-9011 "-; "'
Honorable Mayor and~ Council .Members
City of Bakersfield
1501 Truxtun Ave.
Bakersfield, CA 93301 October 8,1990
Dear Honarble Mayor and Council Members,
As per Ordinance No. 2886 new Series of the City of'
Bakersfield, the City Council passed a resolution in
November 1989 setting the current ambulance rate schedule.
It also identified a subsequent rate review to be conducted
in December Of 1990.
Per this resolution, GOLDEN EMPIRE AMBULANCE SERVICE
respectfuly ask this council to provide for a rate review as
so indicated.
Currently there is not a set criteria for establishing a rate
review and adjustment. We would li~ke to request a set
procedure as to which data is required and how this data will
be utilized to establish a rate increase By establishing a
set criteria, we would be able to collect and provide this
data in a more timely fashion as the rate review and
ad.justment is percieved to be an annual occurance.
We thank you for your patience and understanding with these
matters. If we can be of any assistance, please call me.
Sincerely,
General Manager
"WE SERVE SO OTHERS MAY LIVE." J
~.~C~ SERVICE ~,'~ .
' .... ~ HALL ~zc£~v~D
~ AMBULANCE
SERWCE
INCORPORATED ~u ?¥ 13 ~:~-
· -'- ~,', l: ~3
1001-21st STREET BAKERSFIELD, CA 93301-4792
(805) 322-1625 FAX (805) 322-1638
C~TY CLE:~X
November 12, 1990
Honorable City council
1501 Truxtun Avenue
Bakersfield, California 93301
Honorable City Council:
On November 1, 1989 the City Council approved Resolution Number
183-89 establishing Ambulance Service Charges. In addition,
· resolution language was adopted to include a provision for the
review of Ambulance Service Charges prior to December 1990 and
annually thereafter.
Therefore, I respectfully request the City Council initiate
developmental procedures which will insure a timely annual review
of Ambulance Service Charges.
This correspondence should also be accepted as further endorsement
of the written request submitted by Golden Empire Ambulance on
October 8, 1990.
Please accept my gratitude and appreciation in allowance~ of this
request.
Sincerely,
President
cc: Golden Empire Ambulance Service
Kern County Emergency Medical Services Department
Carol Williams, City Clerk
.:~
.!.
"WE CARE. EVERY HOUR. EVERY DAY."
GOLDEN EMPIRE AMBULANCE
801 18th STREET · P.O.BOX 918 93302
BAKERSFIELD, CALIFORNIA 93301
325-9011
Mr John Stlnson
Assistant City Manager
City of Bakersfield
California 93301
November 20, 1990
Dear John,
Following your telephone call yesterday, I have pulled the
following data from the report we have submitted to the Kern
County B.M.S. Department. ! trust this data will enable you
to complete the task of compiling a realistic and feasible
Ambulance Cost Index.for the City of Bakersfleld.
If you have any further needs or ii you 'should require
further data, please do not hesitate to contact me. We are.
anxious to move forward with this review as it has now been
almost six (6) weeks since we first requested this rate
review. The ordinance calls for the review in December and
it is already at the end of November. I am sure you can
appreciate the need for our Company to develop and implement
our 1991 budget. As you easily tell, '1991 does not appear to
be any less of a budgeting challenge than either 1989 or 1990
was ,
Again, ii I can be of any further assistance, please, contact
me,
Sincerely,
Peter W, Brandon
General Manager .
ccl Kern County BMS
PB/da: rati'nc.90
"WE SERVE SO OTHERS MAY LIVE."
GOLDEN EMPIRE AMBULANCE SERVICE
Cost Analysis Data
(Cont'd)
Cost Comparison Data
3 YEAR
CATEGORY 1989 1990 1991 TOTALS
Wages/Benefits + 10 % + 12 % + 12 % 34 %
property Cost + 25 % + 19 % + 17 % 61%
Vehicle Purchase + 29 % + 30 % + 15 % 74 %
Fuel/Oil +119 % + 67 % + 27 % 213 %
Medical Supplies + 31% + 69 % + 70 % 170 %
Insurance + 5 % + 28 % + 24 % 57 %
All Maintenance + 25 % + 23 % + 15 % 63 %
Taxes/Lic. + 13 % + 10 % + 7 % 30 %
Laundry/Sundry + 28 % + 28 % + 32 % 88 %
Write Off Loss + 11% + 30 % + 11% 52 %
These numbers represent the additional cost associated when the Greater
Bakersfield Companies began System Status Management Operations after
the December 1987 changes.
The increases are caused by additional manpower, additional vehicles
and A.L.S. Equipment requirements, additional training for al.1
personnel, increased benefits package to remain competitive, and simple
.inflation cost.
GOLDEN EMPIRE AMBULANCE SERVICE
Cost Analysis Data
(Cont'd)
PAY SOURCE ANALYSIS BASED ON 9-1-1 RESPONSE
CATEGORY 1989 1990
Worker's Comp.. 1 % .3 %
County Billing Direct 4.9 % 4.6
D.R.G. Hospital N/A N/A
Medi-Cal/Medi-Care Cross Overs 6.6 % 6.2 %
Medi-Care Travelers N/A N/A
Medi-Care with Supplemental Insur. 2.7 % 2.5 %
Medi-Cal 18.8 % 19.6 %
Medi-Care 3.8 % 3.2 %
Medically Indigent Adult (state) N/A N/A
Private Insurance 10.1% 1 %
** Private Portion 28.0 % 45.5 %
TOTALS 76.5 % 83.5 %
The remaining calls are dry runs, therefor no pay source listed as
these calls have no reimbursement opportunities ~
** Private Portion is the category of patients with no coverage
and most will result in either Medi-Cal or County Billing.
BAKERSFIELD
1990
November 21, 1990
Mr. Harvey Hall
Hall Ambulance
1001 21st Street
Bakersfield, CA 93301 [
Dear Mr. Hall:
In response to your request of November 12, 1990 for the annual review of
ambulance servi6e charges by the City, I would like to inform you that I
am preparing material to present to the Budget and Finance Committee of
the City Council regarding this matter.
It is my intention at this time to prepare my review of the rates based
on changes in cost indices such as the Consumer Price Index, and th6
analysis of other selected cost indicators such as transportation, medical
care etc.
In addition to this analysis, I will be updating the rate data for the
survey cities which the City has used in the past for informational
purposes to provide to the committee.
If you have any additional information you would like to have considered
as part of this review please contact me.
It is my intent to have preliminary rate information to the Budget and
Finance Committee early in December. Depending on their direction and
ability to meet, a recommendation will be made to the full City Council.
I will do my best to keep you apprised of the timing of this process.
Please contact me at 326-3751 If you have any further questions regarding
this matter.
Since~.ly,
John W. Stinson
Assistant to the City Manager
JWS.alb
· City of Bakersfield * City Manager's Office * 1501 Truxtun Avenue
Bakersfield · California · 93301
BAKERSFIELD
1990
NOvember 21, 1990
Mr. Peter Brandon
Golden Empire Ambulance
P. O. Box 918
Bakersfield, CA 93302
Dear Mr. Brandon:
In response to your request of October 8, 1990 for the annual review of
ambulance service charges by the City, I would like to inform you that I
am preparing material to present to the Budget and Finance Committee of
the City Council regarding this matter.
It is my intention at this time to prepare my review of the rates based
on changes in cost indices such as the Consumer Price Index, and 'the
analysis of other selected cost indicators such as transportation, medical
care etc.
In addition to this analysis, I will be updating the rate data for the
survey cities which the City has used in the past for informational
purposes to provide to the 'committee.
If you have any additional information you would like tO have considered
as part of this review please contact me.
It is my intent to 'have preliminary rate information to the Budget and
Finance Committee early in December. Depending on their direction and
ability to meet, a recommendation will be made to the full City Council.
I will do my best to keep you apprised of the timing of this process.
Please contact me at 326-3751 If you have any further questions regarding
this matter.
Sincerel_y,
John W. Stinson
.Assistant to the City Manager
JWS. al b
City of Bakersfield i City Manager's Office * 1501 Truxtun Avenue
Bakersfield * California * 93301
(805) 326-3751 * Fax (805) 323-3780
EMERGENCY------ MEDICAL SERVICES DEP,~TMENT
MEMORANDUM
. Fred A. Drew Direcl,~r
Robert Barnes, M.D.
Medkal Director
November 21, 1990
TO: John Stinson,'Assistant City Manager
'City of Bakersfield
FROM: Fred Drew, Director
SUBJECT: Ambulance Rate Survey
A couple of months ago I began a process of updating the ten
city rate sUrvey, which you had used as part of your consideration
and analysis for last years City of Bakersfield rate increase to
the two metropolitan Bakersfield ambulance providers.
You had mentioned to me that the ten cities were selected
previously by 'the City Attorney, and as you can see, many of the
cities used are not comparative in size to the City of Bakersfield.
I had committed to you a copy of my rate comparison when finished,
and therefore it is attached at Enclosure One.
I spent considerable time discussing the "rates issue" with
the appropriate personnel at each EMS agency which supervises or
controls the EMS system within each city, 'and I have provided
detailed notes for your review. It is obvious that there are many
factors which influence rate levels. Public subsidies, whether or
not there had been an RFP used in an area, whether or not a county
ordinance is in effect, population, number of calls, number of
ambulance providers, and the actual EMS system in effect, are Just
a few.
As you-can see by the rate comparison, the average rates in
the ten cities is much higher than that currently allowed by the
City of Bakersfield. I believe that the only valid comparison .is
with the City of Modesto, not only because of the size of the city
(in 'relation to Bakersfield) but also because of the. type of EMS
system (with two private providers) they have in the city..
November 21, 1990
Page 2
I have also attached,~ for your general information, other rate
comparisons which were recently completed by the EMS Department.
I believe this.information supports my contention that the City of
Bakersfield's ambulance rates (by comparison) are regulated
unrealistically low and are, in fact, well below the charges
allowed by Medicare for the two local ambulance companies. I hope
this information will be helpful to you in your deliberations and
analysis of Bakersfield's current ambulance rates.
FAD:srs/cbraterev.90
cc: Board of Supervisors
County Administrative Office
Hall Ambulance Service, Inc.
Golden Empire Ambulance
Peter Brandon, President, Kern County Ambulance Association
· EN CITY RATE COMPARISON - UPDATED OCTOBER 1990 - EMS DEPARTMENT
CITY/POPULATION BLS ALS EMERGENCY OXYGEN MILES 15 MINUTE NIGHT
WAITING
SACRAMENTO (1) 175.00 350.00 45.00 30.00 7.50 N/A 40.00
(370,000)
MODESTO (2) 194.00 395.00 60.00* 50.00 9.00 42.50 50.00
(170,000)
MONTEBELLO (3) 163.00 271.00 60.50 30.25 9.00 24.00 39.00
(60,000)
WHITTIER (3) 16~.'00 271.00 60.50 30.~5 9.00 24.00 39.00
(76,000)
WOODLAND (4) DATA NOT AVAILABLE
PALM SPRINGS (5) 190.25 438.50 75.00* 52.85 9.00 30.00 63.40
(39,000)
CHOWCHILLA (6) 200.00 350.00 30.00* 30.00 8.00 N/A 30.00
(6,000)
STOCKTON (7) 236.00 420.00 46.00* 33.00 9.00 UNK 50.00
(250,000)
MANTECA (7) 236.00 420.00 46.00* 33.00 9.00 UNK 50.00
(32,000)
FRESNO (8) 175.00 395.00 N/A 48.00 9.00 48.00 UNK
(317,000)
AVERAGE 192.47 367'83 52.88 37.48 8.72 33.70 45.18
*Charged with BLS only
Enclosure On.
Attachment to EncloSure One
Ten City Rate Comparison
Notes
(1) Sacramento: Regulated by county ordinance; rates effective
July 1990; allows for ten additional charges; ordinance allows
for "reasonable rate of return" on investment; county subsidy
of $400,000 recently deleted; four ambulance providers in City
of Sacramento; EMS Director (Health Director) makes decision
on rates.
(2) Modesto:~ County ordinance in effect; does not regulate rates
at this time; rates effective in 1990 by using their Medicare
profile; allows for nine additional charges; county subsidy
$15 per dry run with maximum of $20,000 for the whole county.
(3) Montebello/Whittier (both in Los Angeles County):' County
ordinance in effect and does. regulate rates; large $2.5
million county subsidy to private ambulance providers; allows
for more than ten other charges in rate structure, plus
special consideration for rural transports; rates are adjusted
according to the CPI (3.5% in 1990).
(4) Woodland: Data not available.
(5) Palm Springs: County ordinance in effect and does regulate
rates; several other categories for additional charges
available; one provider in Palm Springs; county subsidY
reduced from $1.5 million to about $100,000 recently (county-
wide); annual process Used to increase rates using various
"indexes", wherein the EMS Director (Health Officer) can
approve up to 10% increase annually; 1990 increase was 5.08%.
(6) Chowchilla: County ordinance in effect with rates'negotiated
each year between EMS Department and operators; latest
increase in January 1990 using increased costs (e.g.
insurance, fuel and personnel costs); county subsidy of
approximately $66,000 with a city subsidy to one provider of
about $10,000.
(7) Stockton/Manteca - San Joaquin County: EMS system controlled
by county ordinance including rate regulation; only a few
additional categories allowed to be charged; some'agreements
between county and cities; rate review process is negotiated
annually by looking at increased costs to ambulance providers;
latest increase June 1989 and part of rate negotiation
included an analysis of Medicare allowed charges in that area;
county-wide subsidy of $175,000.
(8) Fresno: County-wide ordinance in effect (initially Used RFP
process) including rate. regulation; used Medicare as a factor
in establishing rates; annual process used to establish rate'
increases with detailed auditing process .and review of
provider costs; county-wide subsidy of about $260,000.
KERN COUNTY AMBULANCE SERVICE RATES
' ~-573.50
~-504.50 . ~
¢
~-429 '%-425
~ *%%-350
% B-325
,H-25o
B-175.
B-145
0
A~S ALS
BLS W/O WITH
PROCEDURES PROCEDURES
' ~-SHAFTER - OTHER CI~
B-BAKERSFIELD CIT~ AREA
%-KERN COUNTX AR~% WITH ORDINANCE
uA, TE nflMPARISON.SHOUING .REC~iT SURVEY AND_PREVTOUS_SURVEYS_CQI~_ARKD.-T-O-A.£OI~fON-ItATE ...................
COUNTY RATES (1990) CATEGORIES ·
' . ......... ALS ....... ~..' BLS ..............ENERO ...... NXflHT OXYGEN ......... rilLES..'. WAlT ( 15 ) ..... ~- ..... ' ...... ......
MONTEREY (90} 360 189 49 41 378 ........... i,,
i ............................ ~20 238 48 50 ---- :~3 ............... 9 .......
.. SAN JOAQUIN (90)
.] Fu~n (90) ................ _39S 17~ 41~ 48 ............. 9 :.l~
' NERCED' (90} 450 241 ................... ~.1
~1 INYO (90) ........ . --"5'66 250 50 50 40 ~4
'h ALAHEi)A._(.90} .................. 40_3 ........ 250_ 4:§ ........ .4.0 ................ _9.- ............. ' · "!,,..
"' ' 45 40 9
........ SAN LUIS OBISPO (90 ! 421 . 255 '
SANTA CLARA (90) 362 219 38 38' 8
l'I o~-i~R~LL'"A'~i~.RAG E: 413,30 227,10 51,00 46,78 41,00 9,33
~l RATES 40 COUNTIES' (88) 341.23 188.46 47,74 41,59 3'5.67 8,11 24,57
' ' ' RATES 9 couN'T~S'-(~-8~ ...... 364.41 219,48 . 56.82 51.3 38,29 9.38 20.39
' ' EH. SA ANALysIS-(DEC 89) ..408,.77 229,77 47,33 ....... 39~44 . .31,06 ...... 8,09 21,85
~.:~ .... AVG KERN RATES (90) 456 83 346,74 . 86,33 68,94 46,76 13,92 25,02
""i .BAKERSFIELD RATE: 325 145 .. 30 35 23 7.5 14
i'I . NEDI-CARE RATE: 400 194 NA 46 38 10 NA
405 199 35 51 43 10
i -'! ' ***COMMON RATE*S*: ..
TO: John Stinson / City of Bakersfield
FROM: Peter Brandon~/~olden Empire Ambulance
~ne Tackett / Hall Ambulance Service
DATE: December 4, 1990
SUBJECT: Bakersfield City Ambulance Rates
Golden Empire and Hall Ambulance Service agree that in order to
maintain the present level of service in Bakersfield, the rates
need to be adjusted as follows: (See Attachment) ,
The rate increases will .still keep the rates in the' Cit~y of
Bakersfield below the average of cities of Comparison, Fred Drew's o
common rates and the rates in the unincorporated areas of Greater
Bakersfield.
PRESENT P..,....rsUE,..,TE~ INCREASE DREW S COUNTY ~CITIF__S OF
,e,eT E RATE COMIdON RATE COMP ,eV EP..AG E
P, ATE
BLS 145.00 !74 O0 29.00. 1-99.00 381.15 i95.00
,eLS 522 O0 .574.00 ',"' ,",.o 405 O0 446, ,30 ~"'o"',.00
ou S6. O0 o O0
_/.,r..=c.~. .:_,_, O0 27 O0 4 O0 45 nc', '-'
!dlL .... c . . 14
aH~ 7,50 q O0 !.50 ~0.00 .08 8 65
1S MINUTE t 4. O0 17. O0 3. O0 19. O0 20. O0 45.25
WAIT TIHE
NIGHT S5, O0 4.!. O0 6. O0 51. O0 66. O0 46.67
SACRAMENTO
MODESTO
STOCKTON
'FRESNO