HomeMy WebLinkAboutDocumentation_Miscellaneous_Tab 4_10/30/1996 A.
Village of Tequesta
OCT 2 5 1996 lIleiiio Vili.;e Manager's Office
To: Thomas G. Bradford
From: James M. Weinand, Fire C
Date: October 25, 1996
Re: Ambulance Financing • • ions and Associated Costs of Transport Service ..
Attached are the costs associated with implementing transport service. The second
page of this report profiles the expenditures and revenues associated with this service
on a five year basis. A debt service payment of$31,989.22 is reflected in this five year
analysis utilizing Option 3 on page six of this report. This debt service payment
presumes that the Village Council would authorize a lease purchase agreement for the
ambulances and all the associated equipment. This dollar figure for debt service could
'
change up or down depending on the finance option chosen.
Page three details the anticipated needed expenditures for the FY96-97 Budget Year.
These expenditures are different than the annual costs of the program because we only
have nine months of operation in 1997.
Page four of this report reflects nine months of projected revenue. This revenue is
founded on 1995 statistics utilizing an emergency transport fee of $310.00 and a $6.00
per mile charge. I feel that the revenues shown for this report are accurate, if not low,
since we have treated 327 patients for the first nine months of this year, and 206 of
these patients were transported to the hospital.
Page five outlines the start-up equipment and associated costs to be financed.
Page six gives you six different lease purchase options to choose from. I recommend
Option 3. This recommendation is based upon a twenty-five year spreadsheet that I
compiled. This spread sheet details the costs associated with replacing all of the Fire
Department vehicles over a twenty-five period. Option 3 revealed the fact that we
could pay cash for every vehicle at time of replacement, including the aerial truck in FY
2018/19, if we reserved the debt service payment of $88,650.00 per year after the
current vehicles are paid off in FY 2003/04.
I am available to answer any additional questions you or the Council may have about
this report.
Five Year Analysis for Ambulance Transport Service
FY96/97 FY97/98 FY98/99 FY99/00 FY00/01 FY01/02
EXPENDITURES
Personal Services
-Labor Costs $0.00 $0.00 $0.00 $0.00 $0.00_ $0.00
Operating Expenses
f Insurance $0.00 $4,200.00 $4,410.00 $4,630.50 $4,862.03 $5,105.13
General Maintenance $140.00 $320.00 $336.00 $352.80 $370.44 $388.96
Vehicle Maintenance $570.00 $1,625.00 $1,706.25 $1,791.56 $1,881.14 $1,975.20
Communication Maintenance $0.00 $100.00 $105.00 $110.25 $115.76 $121.55
Miscellaneous $150.00 $150.00 $157.50 $165.38 $173.64 $182.33
• Office Supplies $450.00 $600.00 $630.00. $661.50 $694.58 $729.30
Safety Supplies $0.00 $50.00 $52.50 $55.13 $57.88 $60.78
Medical Supplies $4,750.00 $3,000.00 $3,150.00 $3,307.50 $3,472.88 $3,646.52
Gas/Oil $720.00 $960.00_ $1,008.00 - $1,058.40 $1,111.32 $1,166.89
Miscellaneous Equipment $1,250.00 $100.00 $105.00 $110.25 $115.76 $121.55
Capital Expenditures
Machinery&Equipment $35,180.00 $1,250.00 $1,312.50 $1,378.13 $1,447.03 $1,519.38
Debt Service
Debt Service Payment $0.00 $31,989.22 $31,989.22 $31,989.22 $31,989.22 $31,989.22
EXPENDITURE TOTALS $43,210.00 $44,344.22 $44,961.97 $45,610.61 $46,291.68 $47,006.80 $271,425.27
REVENUES
Advance Life Support Emergency transports calls 201 267 275 283 292 300
Non-transport calls 100 159 163 168 173 179
Emergency Transport Charges $62,310.00 $82,770.00 $85,250.00 $87,730.00 $90,520.00 $93,000.00
Non-Transport Charges $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Mileage Charges $4,824.00 $6,408.00 $6,600.00 $6,792.00 $7,008.00 $7,200.00
Sub total of revenues $67,134.00 $89,178.00 $91,850.00 $94,522.00 $97,528.00 $100,200.00
Collection Rate Collection rate 80.00% 80.00% 80.00% 80.00% 80.00% 0.00%
REVENUE TOTALS $53,707.20 $71,342.40 $73,480.00 $75,617.60 $78,022.40 $80,160.00 $432,329.60
SUMMARY Expenditures $43,210.00 $44,344.22 $44,961.97 $45,610.61- $46,291.68 $47,006.80 $271,425.27
Revenue $53.707.20 $71.342.40 $73.480.00 $75.617.60 $78.022.40 $80.160.00 $432.329.60
Surplus $10,497.20 $26,998.18 $28,518.03 $30,006.99 $31,730.72 $33,153.20 $160,904.33
(DEFICIT) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Expenditures listed above increase at a 5%rate per year.
Reveues,listed above are based upon a 3%rise in call volume per year. No rate adjustment is shown in the five years analysis.
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Page 2
VILLAGE OF TEQUESTA
FY 1996-97 Budget Expenditures
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Account Title Next Year
Number Quantity Unit Cost Annual Cost Requested
ii01.0.41#40400VIESENEWERONftekaiiiiiinnitiaitligniiiiIMIESEMBEN
Ambulance coverage . 0 175.00 0.00
iiii11t4 :0010.421•1•40.104.0140106000ESENNiiiiMINER!!:VM:FTER3 ! ig14000it;!:inigE140,00
Justification Vehicle cleaners, polish, rags, etc. 9 10.00 90.00
Justification Miscellaneous repairs 1 50.00 50.00
Justification Oil and Lub.for ambulances 6 45.00 270.00
Justification Miscellaneous repairs for ambulances 2 150.00 300.00
tailligi.15000
Justification Miscellaneous 1 150.00 150.00
Justification Biliin ‘,.. ii 9 §9.op 450..00
Medical Supplies 1094.1100015184,75000
Justification Replacement soft goods 9 250.00 2,250.00
Initial Stock for Startup 1 2,500.00 2,500.00
0019.50042ergrAMEMIN30443t!OURNMUMBES illeiddetEMENVEMEMM Eilleg720331
Justification Fuel for vehicles 9 80.00 720.00
3ititriOtt4MON-Vinit.M101,NOW eiteltitatigalhgigigianalgilkini$
Justification Equipment Purchases for start up 1 1,250.00 1,250.00
Total Fire Rescue-Transport Operating Exp.. 8,030.00
mos:;!:!i.menoweliiiiensumapgfreinetwolkolgoiRtmiikiiitt CiattOtiatompologganoMmesingolg,
Account Title Next Year
Number Quantity Unit Cost Cost Requested
100.****400118EMIRMONOttstioliWitaigliiigniiigigiiTilifigiailientani 101$011401121000100
Building Improvements 1 $21,050.00 $21,050.00
File Server Interconnects 6 $364.00 $2,184.00
Advancestach 100VG Computer Hubs 2 $999.00 $1,998.00
Nitronux Field Unit 1 $1,645.00 $1,645.00
EMS Billing Software 1 $8,300.00 $8,300.00
Total Fire Rescue-Transport Capital Outlay 35,180.00
Totals for Fire Rescue Transport Services 43,210.00
Page 3 •
Projected Revenue for FY 1996/97 Budget
REVENUE BASED ON 1995 STATISTICS
Emergency Non N-Trans Mileage Total
Month Year Transport Rate Transports Rate Mileage Rate Charges
January 1997 25 $310.00 12 $0.00 100 $6.00 $8,350.00
February 1997 26 $310.00 12 $0.00 104 $6.00 $8,684.00
March 1997 15 $310.00 11 $0.00 60 $6.00 $5,010.00
April 1997 27 $310.00 4 $0.00 108 $6.00 $9,018.00
May 1997 18 $310.00 9 $0.00 72 $6.00 $6,012.00
June 1997 28 $310.00 11 $0.00 112 $6.00 $9,352.00
July 1997 20 $310.00 14 $0.00 80 $6.00 $6,680.00
August 1997 25 $310.00 17 $0.00 100 $6.00 $8,350.00
September 1997 17 $310.00 10 $0.00 68 $6.00 $5,678.00
Average 22.33 11.11 89.33 $7,459.33
TOTALS 201 100 804 $67,134.00
Total EMS Charges - $67,134.00
Collection Rate 80%
Total Revenue $53,707.20
Total Expenditures $43,210.00
Net Income $10,497.20
(LOSS)
Page 4
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•
Start- p Purc to Fi.na:rt.ced-u �hayses � _b�= •
Quantity Unit Cost Cost Requested
StartupEquipment Purchases ��{s. .��:>�: �,::
Purchased
fr � .1 :1.�1<
Wheeled Coach Ferno 93ES Stretchers 2+ $1,891 $3,782
Wheeled Coach LSP Autovent 2000 2 $1,265 $2,530
Wheeled Coach CAS #65 Automatic B.P. Cuff 2 $1,743 $3,486
- Wheeled Coach Stretcher IV Poles 2 $145 $290
Wheeled Coach Ferno #40 Stair Chairs 2 $520 $1,040
Wheeled Coach Ferno #65 Scoop Stretchers 2 $370 $740
Wheeled Coach Triangle Safety Kit 2 $15 $30
Wheeled Coach LSP Halfback 1 $530 $530
Wheeled Coach Ohio Flowmeters 4 $50 $200
Motorola UHF Radios 2 $3,260 $6,520
Radiotronics VHF Radios - 2 $980 $1,960
Wheeled Coach Ambulances 2 $79,777 $159,554
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Page 5
Fire Rescue - Ten Year Capital Replacement Program
OPTION 1
Purchase 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07
Aerial $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00
Ambulance,5 Years $42,415.20 $42,415.20 $42,415.20 $42,415.20 $42,415.20
Replacement Amb(9 years) $15,339.79
'Structure Pumper $33,886.57 $33,886.57
Total $56,660.00 $99,075.20 $99,075.20 $99,075.20 $99,075.20 $99,075.20 $56,660.00 $56,660.00 $0.00 $33,886.57 $49,226.36 $748,468.93
OPTION 2
Purchase 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07
Aerial $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00
Ambulance,6 Years $36,323.61 $36,323.61 $36,323.61 $36,323.61 $36,323.61 $36,323.61
Replacement Amb(9 years) $15,339.79
Structure Pumper $33,886.57 $33,886.57
Total $56,660.00 $92,983.61 $92,983.61 $92,983.61 $92,983.61 $92,983.61 $92,983.61 $56,660.00 $0.00 $33,886.57 $49,226.36 $754,334.59
OPTION 3
Purchase 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07
Aerial $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00
Ambulance,7 Years $31,989.22' $31,989.22 $31,989.22 $31,989.22 $31,989.22 $31,989.22 $31,989.22
Replacement Amb(9years) $15,339.79
Total $56,660.00 $88,649.22 $88,649.22 $88,649.22 $88,649.22 $88,649.22 $88,649.22 $88,649.22 $0.00 $0.00 $15,339.79 $692,544.33
OPTION 4
Purchase 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07
Aerial $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00
Ambulance,8 Years _$28,757.18 $28,757.18 $28,757.18 $28,757.18 $28,757.18 $28,757.18 $28,757.18 $28,757.18
Replacement Amb(9 years) $15,339.79
Structure Pumper $33,886.57 $33,886.57
Total $56,660.00 $85,417.18 $85,417.18 $85,417.18 $85,417.18 $85,417.18 $85,417.18 $85,417.18 $28,757.18 $33,886.57 $49,226.36 $766,450.37
OPTION 5
Purchase 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 _ 2002/03 2003/04 2004/05 2005/06 2006/07
Aerial $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00
Ambulance,9 Years $26,243.82 $26,243.82 $26,243.82 $26,243.82 $26,243.82 $26,243.82 $26,243.82 $26,243.82 $26,243.82
Replacement Amb(9 years) $15,339.79
Structure Pumper $33,886.57 $33,886.57
Total $56,660.00 $82,903.82 $82,903.82 $82,903.82 $82,903.82 $82,903.82 $82,903.82 $82,903.82 $26,243.82 $60,130.39 $49,226.36 $772,587.31
OPTION 6
Purchase 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07
Aerial _$56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00 $56,660.00
Ambulance A(8 Year Baloon) $23,018.71 $23,018.71 $23,018.71 $23,018.71 $23,018.71_ $23,018.71 $23,018.71 $79,678.71
Replacement Amb(9 years) $15,339.79
Structure Pumper $33,886.57 $33,886.57
Total $56,660.00 $79,678.71 $79,678.71 $79,678.71 $79,678.71 $79,678.71 $79,678.71 $79,678.71 $79,678.71 $33,886.57 $49,226.36 $777,202.61
Page 6
Village ofTequesta
OCT 251996
11 'Je,no .,
Village Manager's Office
To: Thomas G. Bradford4P
From: James M. Weinand, Fire C
Date: October 25, 1996
Re: Ambulance User Fees
Below is a comparison of the current ambulance service rates charged by various
ambulance transport providers in Palm Beach County.
1996 AMBULANCE SERVICE FEES
Agency Base Rate Oxygen Mileage
BLS ALS Usage Charge
Everglades Memorial $221.75 $291.50 $29.25 $7.75
LifeFleet $220.50 $320.80 $28.35 $6.80
Jupiter Ambulance Inc. $256.00 $316.00 $30.00 INC.
Boca Raton Fire Rescue $165.00 $265.00 $24.20 $5.65
Boynton Beach Fire Rescue $289.00 $289.00 $0.00 $6.50
Delray Beach Fire Rescue $205.00 $275.00 $0.00 $5.00
Greenacres $175.00 $228.00 $25.00 $5.50
Lake Worth Fire Dept. $310.00 $310.00 $0.00 $6.00
Lantana Fire Rescue $310.00 $310.00 $0.00 $6.50
Palm Beach County $200.00 $300.00 $0.00 $6.50
Palm Beach Gardens $297.50 $297.50 $0.00 $5.50
Riviera Beach Fire Rescue $270.00 $270.00 $25.00 $6.00
Royal Palm Beach $286.00 $286.00 $0.00 $4.00
- West Palm Beach $310.00 $310.00 $0.00 $6.00
-Average J - ' ` ' $251..'t3 ' s290.63`, 526 97 , AR`$5.98
As you can see from rate structure above, there are various ways to define billing
charges. There is no set rule as every municipality charges differently for services, the
Town of Palm Beach does not even charge for this service. I personally think that there
should be a user fee associated with service, so that everyone who uses the system
helps pay for it. For example, according to our records, 33% of the patients we have
treated this year do not live within the corporate limits of Tequesta or Jupiter Inlet
Colony, therefore, our taxpayers are burdened with paying for pre-hospital medical
treatment given to these individuals and anyone who travels through the area.
If you elect to establish a user fee rate, this rate should be set above the Medicare
maximum prevailing allowance for ambulance service, which is $284.53 for this area.
The higher rate is important to maximize future revenues. Medicare periodically
reviews service fee rates for the area and when they review Palm Beach County for any
adjustments, only agencies having a higher rate than the maximum prevailing
allowance will be entitled for the rate increase. Individuals having Medicare will not be
burdened by the higher user fee rate because as a Medicare provider, we are not
authorized to invoice these patients for anything above maximum prevailing allowance
for ambulance service.
Most agencies set their rate structure around Medicare allowables. Medicare used to
pay extra for patients that were administered oxygen. This is no longer the case, that is
why most agencies that have adjusted their rates, recently dropped the oxygen
charges. Currently, there is no rate schedule differences for any level of treatment, that
is why you see some agencies with.the same rate for ALS and BLS, this is a flat rate
charge.
Below, I have included a chart showing all agencies the charge for service in Palm
Beach County. This is ranked from highest to lowest according to their charges. When
you look at the table below, you will see that I have included oxygen charges in the
ALS base rate for those entities that charge. separately, because almost every ALS
patient receives oxygen.
Highest to Lowest Service Fees
Agency Base Rate Mileage
BLS ALS Charge
LifeFleet $220.50 $349.15 $6.80
Jupiter Ambulance Inc. $256.00 $346.00 INC.
Everglades Memorial $221.75 $320.75 $7.75
Lake Worth Fire Dept. $310.00 $310.00 $6.00
Lantana Fire Rescue $310.00 $310.00 $6.50
West Palm Beach $310.00 $310.00 $6.00
Palm Beach County $200.00 $300.00 $6.50
Palm Beach Gardens $297.50 $297.50 $5.50
Riviera Beach Fire Rescue $270.00 $295.00 $6.00
Boca Raton Fire Rescue $165.00 $289.20 $5.65
Boynton Beach Fire Rescue $289.00 $289.00 $6.50
Royal Palm Beach $286.00 $286.00 $4.00
Delray Beach Fire Rescue $205.00 $275.00 $5.00
Greenacres $175.00 $253.00 - $5.50
Average - $287.941 $312 69 " -- $5.98
I recommend that we establish a flat rate fee schedule, with no charge for a non-
transport call, a $310.00 fee for emergency transport service, and a mileage charge of
$6.00. These rates are in line with the averages listed above.
DRAFT
-ORDINANCE NO.
AN ORDINANCE OF THE VILLAGE COUNCIL OF THE VILLAGE OF TEQUESTA,
PALM BEACH COUNTY, FLORIDA, AMENDING CHAPTER 9 OF THE CODE OF
ORDINANCES SO AS TO, PROVIDE FOR THE ESTABLISHMENT OF A
PRE-HOSPITAL EMERGENCY MEDICAL CARE SERVICE; PRESCRIBING
REGULATIONS GOVERNING THE SERVICE; ESTABLISHING USER FEE CHARGE
FOR SUCH SERVICE; PROVIDING FOR OTHER PROVISIONS RELATING TO FIRE
MEDICAL CARE WITHIN THE VILLAGE OF TEQUESTA; PROVIDING FOR
SEVERABILITY; PROVIDING FOR REPEAL OF ORDINANCES IN CONFLICT;
PROVIDING FOR CODIFICATION; PROVIDING AN EFFECTIVE DATE.
Chapter 9 of the Code of Ordinances of the Village of Tequesta relating to Fire
Protection and Prevention is hereby amended to include an Article IV PRE-HOSPITAL
EMERGENCY MEDICAL SERVICE within and to read as follows:
Article IV PRE-HOSPITAL EMERGENCY MEDICAL SERVICE
Section 1 Supervision of Pre-Hospital Emergency Medical Service
The Chief of the Fire-Rescue Department shall plan,
direct, eontrol and coordinate the pre-hospital emergency
medical services activities within the Fire Rescue
Department for the Village of Tequesta and other areas
the Village is obligated to service.
Section 2 Regulations Governing Service
The Chief of the Fire-Rescue Department shall assure that
every primary emergency medical response unit which
responds to medical calls within its service area be staffed
as an advanced life support unit as set forth in the Florida
Administrative Code Rule 10D-66.050 FAC. All advanced
life support units shall operate in compliance with all
requirements of the Florida Statutes and Florida
Administrative Code and be equipped as required by all
such rules and regulations governing the provision of
Advanced Life Support services.
Section 3 Levy and Purpose
For the purpose of regulating the use of pre-hospital
emergency medical care System in the Village of Tequesta
so as to assure that every user bears a proportionate
share of the costs of the fire rescue emergency medical
system and to help defray the costs attributable to this •
` service within the Village limits and service areas, user
' fees are hereby levied on every user of the pre-hospital
emergency care system in accordance with the schedule
of fees and other provisions of this chapter.
Section 4 Determination of Fee Amounts
The pre-hospital emergency care user fees shall be pA- -
determined and reviewed at least every Vie( year in �
accordance with a detailed analysis of associated costs. J--
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 costs of providing such
services, and to ensure that the user fees charged will not
exceed its reasonably anticipated costs of fire rescue
pre-hospital emergency medical care system. The Village
Council may annually adjust the established user fee rates
to reflect changes in the cost of relevant capital purchases
and equipment. All changes AL adjustments in the
established user fee rates sha3 made by ordinance or
resolution and shall apply after the effective date of such
modification.
Section 5 Schedule of User Fees
The fire rescue pre-hospital emergency medical care
system user fees for emergency medical care treatment
and transportation within the service areas shall be as
follows:
Emergency Medical Treatment $ 0.00
Emergency Medical Transportation $310.00
Plus, per mile charge, pickup to hospital $ 6.00
Fire Rescue emergency medical care service user fees `
shall be paid in cash, no in-kind contribution for such use
is permissible.