HomeMy WebLinkAboutDocumentation_Regular_Tab 12_9/10/2020Agenda Item #12.
Regular Council
STAFF MEMO
Meeting: Regular Council - Sep 10 2020
Staff Contact: James Trube, Fire Chief Department: Fire
Resolution 29-20, A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE OF TEQUESTA,
FLORIDA, AUTHORIZING THE UPWARD MODIFICATION OF EMS TRANSPORT USER FEES TO
KEEP RATES COMPARABLE WITH OTHER PALM BEACH COUNTY AMBULANCE TRANSPORT
SERVICES IDENTIFIED IN "EXHIBIT A"; AND AUTHORIZING THE VILLAGE MANAGER TO
PROCEED ON BEHALF OF THE VILLAGE
A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE OF TEQUESTA, FLORIDA,
AUTHORIZING THE UPWARD MODIFICATION OF EMS TRANSPORT USER FEES TO KEEP
RATES COMPARABLE WITH OTHER PALM BEACH COUNTY AMBULANCE TRANSPORT
SERVICES IDENTIFIED IN "EXHIBIT A"; AND AUTHORIZING THE VILLAGE MANAGER TO
PROCEED ON BEHALF OF THE VILLAGE; PROVIDING AN EFFECTIVE DATE; AND FOR OTHER
PURPOSES.
RESOLUTION 29-20.ada
Resolution 29-20 Exhibit A.ada
Page 808 of 852
Agenda Item #12.
states:
RESOLUTION NO. 29-20
A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE
OF TEQUESTA, FLORIDA, AUTHORIZING THE
UPWARD MODIFICATION OF EMS TRANSPORT USER FEES
TO KEEP RATES COMPRABLE WITH OTHER PALM
BEACH COUNTY AMBULANCE TRANSPORT SERVICES
IDENTIFIED IN -EXHIBIT A-; AND AUTHORIZING THE
VILLAGE MANAGER TO PROCEED ON BEHALF OF THE
VILLAGE; PROVIDING AN EFFECTIVE DATE; AND FOR OTHER
PURPOSES.
WHEREAS, the Village Ordinance Section 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.
WHEREAS, Tequesta Fire Rescue responds to more than 1200 calls for service each year
and transports approximately 700 distressed patients to local hospitals to receive emergency care.
Tequesta Fire Rescue enjoys an 82% collection fee rate, meaning 82% of our transport billable is
collected. The majority of ambulance transportation fees are paid by a patient's medical insurance,
or by the patient directly.
WHEREAS, the user fees for Tequesta Fire Rescue have fallen short of the average Palm
Beach County user fee and currently, we rank as the lowest fees in Palm Beach County.
WHEREAS, Tequesta Fire Rescue proposes to bring user fees to the bottom line of all
Palm Beach County Fire Rescue agencies. If approved, this proposal will increase both revenue
and write offs; and it will bring Tequesta in line with surrounding agencies while maintaining the
lowest EMS transport user fees in Palm Beach County.
NOW, THEREFORE, BE IT RESOLVED BY THE VILLAGE COUNCIL OF THE
VILLAGE OF TEQUESTA, PALM BEACH COUNTY, FLORIDA, AS FOLLOWS:
Section I Resolution No. 29-20 is hereby approved authorizing the upward
modification of EMS transportation fee accounts as listed in "Exhibit A" to remain on par with
other local Fire Rescue agencies;
Section 2 This Resolution shall become effective immediately upon passage.
Page 809 of 852
Agenda Item #12.
RESOLUTION 29-20 EXHIBIT A
2020 Insurance and Payment Methods
Medicare
• Medicare itself represents 345 of the 706 (48%)
• Mainstream insurances (AARP, Aetna, Blue Cross, Cigna, Humana, and United)
represent 234 (33%), of which the split is about 50-50 Medicare vs Commercial
plan type. Thus Medicare represents about 64.5% of our total call volume.
Other Transports
• 47 out of 706 were private pay (though some of those have Medicaid, which we
do not accept). So only 6.7% were "uninsured". The other 93.3% were insured in
one form or another.
• Another 27 were non-traditional coverage (VA, Hospice, Worker's Comp, etc.)
(5.8%)
• Futures represents 25 of the 706 (3.5%)
• Auto Insurance represents 18 (2.5%)
Corn parison
Compared to local municipalities, the user fees for Tequesta Fire -Rescue have
fallen behind the other Fire Rescue services in Palm Beach County as well as for
Martin County Fire Rescue. In fact, we rank below both private ambulances
companies in the BLS and ALS 1 Categories. See the current rates below.
The following is the current User Fee Schedule for Palm Beach County Ambulance
Transport Services provided by Palm Beach County Emergency Management:
Page 810 of 852
Agenda Item #12.
PBCO Fire Rescue Agencies
Mileage
BILS
ALS1
a
3.75 Mile
ALS
Boca Raton Fire Rescue
12.00
750.00
750.00
850.00
795.00
Boynton Beach Fire Rescue
14.50
710.00
710.00
870.00
764.38
Delray Beach Fire Rescue
12.00
650.00
700.00
800.00
745.00
Greenacres Fire Rescue
13.50
670.00
670.00
830.00
720.63
North Palm Beach Fire Rescue
12.00
610.00
675.00
745.00
720.00
Palm Beach County Fire
Rescue
13.50
670.00
670.00
830.00
720.63
Palm Beach Fire Rescue
12.00
750.00
750.00
850.00
795.00
Palm Beach Gardens Fire
Rescue
12.00
700.00
750.00
800.00
795.00
Riviera Beach Fire Rescue
1 12.00
1 700.00
1 700.00
1 750.00
1 745.00
West Palm Beach Fire Rescue
1 12.00
1 700.00
1 700.00
1 750.00
1 745.00
American Medical Response
10.50
450.00
550.00
- 589.38
Medics Ambulance
10.50
450.00
550.00
- 589.38
Martin County Fire Rescue
10.31
596.73
673.21
787.98 711.87
Palm Beach County Average
12.55
690.96
707.50
807.50
754.04
Te uesta Fire Rescue
10.00
435.00
500.00
700.00
537.50
Difference
-2.55
-255.96
-207.50
-107.50
-216.54
Our proposal is to bring Tequesta Fire Rescue user fees to the bottom line of all Palm
Beach County Fire Rescue Agencies. If approved, this proposal will increase both
revenue, and write offs and it will bring Tequesta in line with surrounding agencies
while we will still maintain the lowest EMS transport user fees of any Palm Beach
County Fire Rescue Agency.
Proposed
ft-
Tequesta Fire Rescue -Current
10.00
435.00
500.00
700.00
537.50
Tequesta Fire Rescue-
Proposed
12.00
610.00
670.00
745.00
715.00
Difference
2.00
175.00
170.00
45.00
177.50
Page 811 of 852
Agenda Item #12.
Additional Information on Insurance Definitions: Categories of Service
BLS Category (A0425 BASIC LIFE SUPPORT)
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 serious jeopardy;
2. Impairment to bodily functions; or
3. Serious dysfunction to any bodily organ or part.
ALS 1 Category (A0427ADVANCED LIFE SUPPORT LEVEL 1)
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.
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 serious jeopardy;
2. Impairment to bodily functions; or
3. Serious dysfunction to any bodily organ or part.
ALS 2 Emergency Category (A0433 ADVANCED LIFE SUPPORT LEVEL 2)
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
Page 812 of 852
Agenda Item #12.
Chest decompression
Surgical Airway
Intraosseous line
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 813 of 852