HomeMy WebLinkAboutDocumentation_Regular Council_Tab 12_07/11/2019Agenda Item #12.
Regular Council
STAFF MEMO
Meeting: Regular Council - 11 Jul 2019
Staff Contact: James Trube, Fire Chief Department: Fire
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Approve Upward Adjustment of Transport Rates for Tequesta Fire -Rescue
SUMMARY:
The EMS transport rates have not been increased since 2009. Pursuant to Village Ordinance Sec.
34-124 Pre -hospital emergency care user fees shall be determined and reviewed annually in
accordance with a detailed analysis of associated costs.
� BUDGET INFORMATION:
BUDGETED AMOUNT: N/A AVAILABLE AMOUNT: N/A EXPENDITURE AMOUNT: N/A
Additional Budgetary Information: Funding Source(s):
MA
N/A
POTENTIAL MOTION / DIRECTION REQUESTED:
Increase Fees to the Proposed New Rates.
ATTACHMENTS:
2019 Medicare Rates and Transport Fees
Page 84 of 537
Agenda Item #12.
PROPOSAL FOR UPWARD MODIFICATION OF EMS TRANSPORT FEE
Pursuant to Village Ordinance Sec. 34-124 - Establishment and Review of Fees:
The pre -hospital emergency care user fees shall be determined and reviewed
annually in accordance with a detailed analysis of associated costs. The
purpose of this review is to evaluate the level of service for the pre -hospital
emergency medical care system, to determine whether it should be adjusted
based on changed conditions, to analyze the effects of inflation or other cost
factors on the actual cost of providing such services, and to ensure that the
user fees charged will not exceed the reasonably anticipated costs of fire -
rescue pre -hospital emergency care system.
The transport rates for Tequesta Fire -Rescue have not been adjusted since 2009
and during that time we have fallen short of the Medicare fee schedule. In
addition/ we have fallen short of the average Palm Beach County transport fee and
currently we rank with the lowest fees in Palm Beach County. Falling short of the
Medicare rates results in a loss of revenue.
CURRENT RATES:
Mileage
BLS
ALS1
ALS2
ALS Avg.
Palm Beach County Average
12.16
642.5
672.08
795.5
717.71
(without Tequesta)
241f839.64
233f 186. 10
8,653.54
ALS2 11
7,039.01
Tequesta Fire Rescue
7.25
435.00
435.00
625.00
462.19
Medicare Allowable
7.55
378.36
449.31
650.31
477.62
Difference of
-0.30
56.64
-14.31
-25.31
-15.44
Please see below. Total Estimated Yearly Transports 2019 Projected Loss in Revenue,
Total Transports BLS, ALS, ALS2
Total Runs 2019
Projected Potential
Projected Revenue
Projected /
(Projected 720)
Revenue
at Current Rates
Potentially Lost
BLS 162
60f314.22
60f314.22
0.00
ALS 547
241f839.64
233f 186. 10
8,653.54
ALS2 11
7,039.01
6f765.00
274.01
Mileage 2635.2
19,895.76
19,105.20
790.56
TOTALS:
329,088.63
319f370.52
-9f 718. 11
Following is the Fee Schedule for Palm Beach County Ambulance Transport Services
provided by Palm Beach County Emergency Management:
Page 85 of 537
Agenda Item #12.
American Medical Response
Boca Raton Fire Rescue
Boynton Beach Fire Rescue
Delray Beach Fire Rescue
Greenacres Fire Rescue
Medics Ambulance
North Palm Beach Fire Rescue
Pam Beach County Fire Rescue
Palm Beach Fire Rescue
Palm Beach Gardens Fire Rescue
Riviera Beach Fire Rescue
West Palm Beach Fire Rescue
Palm Beach County Average
(without Tequesta)
Medicare Allowable
Tequesta Fire Rescue
7.55 378.36 449.31 650.31 477.62
7.25 435.00 435.00 625.00 462.19
Page 86 of 537
3.75 -Mile
Mileage
BLS
ALS1
ALS2
ALS Transport
10.5
450
550
---
589.38
12.0
750
750
850
795.00
14.0
690
690
850
742.50
12.0
650
700
800
745.00
13.5
670
670
830
720.63
10.5
450
550
---
589.38
12.0
530
585
645
630.00
13.5
670
670
830
720.63
12.0
750
750
850
795.00
12.0
700
750
800
795.00
12.0
700
700
750
745.00
12.0
700
700
750
745.00
12.16
642.5
672.08
795.5
717.71
7.55 378.36 449.31 650.31 477.62
7.25 435.00 435.00 625.00 462.19
Page 86 of 537
Agenda Item #12.
PROPOSED NEW RATES:
Mileage
BLS
ALS1
ALS2
ALS Avg.
Tequesta Fire Rescue:
10.00
435.00
500.00
700.00
537.50
Medicare Allowable
7.55
378.36
449.31
650.31
477.62
Difference of the Proposal:
2.45
56.64
50.69
49.69
59.88
If Approved, we will still maintain the lowest EMS Transport fees in Palm Beach County
while eliminating the $10,000 shortfall and thereby possibly increasing revenue beyond
that.
Page 87 of 537
Agenda Item #12.
Additional 2018 Statistics on Patients transported
and Definitions for your Review
0 Medicare itself represents 350 of the 711 (49%)
0 Mainstream insurances (AARP, Aetna, Blue Cross, Cigna, Humana, United)
represent 248 (35%), of which the split is about 50-50 Medicare vs Commercial
plan type. Thus Medicare represents about 66% of our total call volume.
0 38 out of 750 were private pay (though some of those have Medicaid, which we do
not accept). So only 5% were "uninsured". The other 95% were insured in one
form or another.
0 Another 27 were non-traditional coverage (VA, Hospice, Worker's Comp, etc)
(3.8%)
0 Futures represents 25 of the 711 (3.5%)
0 Auto Insurance represents 15 (2%)
GROUND AMBULANCE CATEGORIES OF SERVICE
A0425 BASIC LIFE SUPPORT - EMERGENCY (BLS EMERGENCY)
The Basic Life Support - Emergency category is the provision of BLS services as defined
in the National EMS Education and Practice Blueprint for the EMS -Basic, including the
establishment of a peripheral intravenous line, the context of an emergency response.
An emergency response is one that, at the time the ambulance supplier is called, is
provided after the sudden onset of a medical condition manifesting itself by acute
symptoms of sufficient severity such that the absence of immediate medical attention
could reasonably be expected to result in:
1. placing the beneficiary's health in serous jeopardy;
2. impairment to bodily functions; or
3. serious dysfunction to any bodily organ or part.
A0427ADVANCED LIFE SUPPORT LEVEL I (ALS I EMERGENCY)
The Advanced Life Support, Level 1 category is the provision of an assessment by an
advanced life support provider or the provision of one or more ALS interventions, in the
context of an emergency response.
An ALS provider is defined as a provider trained to the level of the EMT -Intermediate or
Paramedic as defined in the National EMS Education and Practice Blueprint.
An ALS Intervention is defined as procedure beyond the scope of an EMT -Basic as
defined in the National EMS Education and Practice Blueprint.
Page 88 of 537
Agenda Item #12.
An emergency response is one that, at the time the ambulance supplier is called, is
provided after the sudden onset of a medical condition manifesting itself by acute
symptoms of sufficient severity such that the absence of immediate medical attention
could reasonably be expected to result in:
4. placing the beneficiary's health in serious jeopardy;
5. impairment to bodily functions; or
6. serious dysfunction to any bodily organ or part.
A0433 ADVANCED LIFE SUPPORT LEVEL 2 (ALS 2 EMERGENCY)
The Advanced Life Support, Level 2 category is:
1. The administration of three or more different medications, and
2. The provision of at least one of the following ALS procedures:
Manual defibrillation/cardioversion
Endotracheal intubation
Central venous line
Cardiac pacing
Chest decompression
Surgical Airway
Intraosseous line
Page 89 of 537