HomeMy WebLinkAboutDocumentation_Regular_Tab 12b_03/10/1994 �
�
� VILLAGE OF TEQUESTA
; � �
DEPARTMENT OF FIRE-RESCUE
'' Post Office Box 3273 • 3>7 Tcqucsta Dnvc
�,
� t Tequcsta, Florida 33469-0273 •(407) 575-6250 —'-'— � r
; ° F�: (407) 575-6'03 ��
9 4 \\;�
F•e fOUN�
MEMORANDUM
TO: Thomas G. Bradford, Village Mana er
FROM: James M. Weinand, Fire Chie
v
DATE: March 4, 1994
RE Emergency Medical Service, Agenda Item
I respectively request that this item be placed on the March 10,
1994 Village Council Agenda for approval. I am prepared to make a
presentation to the Village Councilmembers of our proposed EMS
Alternative at the Village Council Meeting of Thursday, March 10.
At this meeting, I will show a presentation on Tequesta Fire
Rescue's Alternative Approach in providing Pre-Hospital Emergency
Medical Care.
This item was presented and approved by the Public Safety Committee
members on Wednesday, March 2, 1994.
I am prepared to answer any questions that the Village Council and
staff may have in regard to this important proposal.
JMW/cm
Rervcled Paper
' Memorandum
Tn: Thomus G. BrUdfnrd, Villag ►'
From: Jumes M Weinund, Fire Ch
Date: 02/2-�/199-�
Subject: Emergenc�� Medical Serve e
Since October l, 1993, Advanced Life Support (ALS) and Basic Life Support (BI.S) emergency
care, along with ambulance transportation, has been provided to the Village of Tequesta and
Jupiter Inlet Colony by contract with Jupiter Ambulance Service, Inc.,
Basic Life Support: Is generally defined as airway maintenance, ventilator support, CPR,
hemorrhage control, splinting of fractures, management of spinal injuries, protection and
transportation of the patient in accordance with other accepted procedures.
Advanced Life Support: Encompasses all basic life support measures, plus invasive medical
procedures, including intravenous therapy, cardiac defibrillation, administration of
antiarrhythmic medications....use of adjunctive ventilation techniques, and other procedures
authorized by state law.
The responsibility and administration of the emergency medical service was delegated to me
under the distinguished characteristics of my job description. Without having direct supervision
over this service, I have only been able to monitor its performance. This has been accomplished
by responding coinstantaneously with Jupiter Ambulance Service to all med.ical emergencies
within the corporate limits of Tequesta and Jupiter Inlet Colony.
When I was interviewed for this position, I stated that the costs associated with the EMS
contract was not as lucrative as it appeared. Although I d.iscounted the proposal, I felt this was
the best altemative due to the time limitations on building an entire Fire Department. Now that
this department is operational, I feel compelled to demonstrate our ability to provide a
prominent level of service at a reduced rate.
In the following pages of this report, I will demonstrate an alternate approach in providing
quality inhouse Emergency Medical Care, with beneficial consequences for our fire suppression
rating, which effects insurance rates. The projected costs in this report are based on the last five
years Comsumer Price Index, which demonstrated an average of 3.8 % increase in costs for the
southern region and an average of 7.625°Io increase in costs for the medical index.
The following outlines the yearly costs for EMS, if this service was provided by the Fire
Department.
� Villuge of Tequesta
Department of Fire Rescue
C()ST PR�),II�.CTtt�NS FOK E;11S
Acconat Number Title Budget
t-19-527-0-1-1200 S alary/W ages 79,632.78
Three employees @$22.6G1.00 f'or six months 33.991.5
Three employees C� 523,?27.i' for six months 3-�.8�31?8
Paramedic incentive pay 3 C� �3600.00 10,800
i -19-527-0-1-1400 Overti me 9 � Z � ��
Sick leave 48 hours @ 14.39'_8 * 3 '.080.4
Vacation time 106 hrs @$14.�472 * 3� 4,594.21
Holiday Pay 88 hours @ 59.6314 * 3 2.542.69
I-19-527-0-i-2100 Fica Taxes 6,667.35
Salary/Wages + Overtime * .076�
1-19-527-0-1-2210 Retirement 12,550.31
Salary/Wages + Overtime * .1440
1-19-527-0-1-2300 LifelHealth Insurance 13,200.72
Life Insurance S8Q000.00 * 1.5 *.0042 5�
One employee at family rate 1@$6,439.68 6,439.68
Two employees at single rate 2@$3,128.52 6,257.04
i-19-527-0-1-2400 Workers Compensation Insurance 8,140.27
Salary/Wages + Overtime * .0934
i-19-527-0-1-2855 Physicals 1,197
Three employees @ �399.00
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1 Medical Supplies 10,000
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1-19-527-0-2-5401 Training 1,050
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I realize that this proposed EMS Budget only reflects a$ 4,905.30 saving, but if we take these
` budgetary tiqures and multiply them by the CPI modifiers for five years, you will see more
considerable savings. The graph below demonstrates this hypothesis.
Five year cost projections
�
�.ns �,
............................................... ................................................................................... ........................................ .�. 240
�1'12.787�7'•'��
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.............. ...................�......................................_.._......_.......�,,.. 220
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$207.003 �p
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............. ...,..�:�::...._...._......___...._.._____....__.._...........___.._........_ ?pp �
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,,�--''' 194,192.49
$178.711 _ -'"� ..._..._......__5787,083,�i........____.........._ 180
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$1 �' $173.636.24
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$161,155.70
140
FY93�34 FY94/95 FY95196 FY96i97 FY9798 FY98i99
� Tequesta Fire Rescue
O Jupiter Ambulance Service
This demonstrates a$143,084.70 cost savings, if the EMS care was provided by the Fire
Department and if the CPI multipliers are correct.
In actuality, emergency services budgets usually do not increase at the same rate as the CPI
Index. Therefore, I have completed a five year budget analysis that takes into account a 3.8 9c
increase in all line items and an additional5% raises for salaries and overtime. This review
revealed a$119,728.38 savings of the same five year period, with the majority of the savings
coming after the first year of operation.
Budget year 94I95 encompasses six months' expenditures to Jupiter Ambulance Service and
six months' costs associated with our operation, thus resulting in an insignificant savings of
$526.83. The subsequent budget years disclose a more considerable amount of savings with
$24,332.95 in FY 95/96, $27,044.84 in FY 96/97, $29,931.36 in FY 97/98 and $32,998.10 in
FY 98i99.
These results are graphed on the following page for your review.
Five year cost analysis
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S27L 787.�7 �
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............................... $178:711.31-�'°',-
_ ................................................................ .......................___......................_._............_ 1B0
$166,050.Of1'"'� 8,184.48 179,968.99
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iao
�FY93/94 �FY94195 �FY95i96 FY96/97 FY97i98 �Y98/99
f- Tequesta Fire Rescue
4 Jupiter Ambulance Service
You can envision from the above illustrations, the amount of costs' savings that this proposal
would sustain over the next ten years. I understand that cost saving alone is not the only
consideration when constituting a change of this magnitude. �Therefore, I would like to detail
some of the indisputable side effects of this program.
l. With these additional Firefighter/Paramedics we will have the abiliry to split the on duty
personnel into two different crews, thus resulting in the efficiency to mitigate two emergencies
simultaneously ( with exception to building fires ).
2. This will provide a greater depth in our EMS system by always having a Paramedic in zone.
3. The increased staffing will help reduce our fue suppression rating which is established by
the Insurance Services Office ( ISO ). In addition to the extra person per shift credit, it also
maximizes our Volunteer firefighting force credits. ISO will give credit staffing as follows,
three volunteer firefighters are equal to one career firefighter, providing the number of volunteer
firefighters divided by three do not exceed the number of on duty career firefighters. Currently,
we have 15 volunteers and an on duty staffing of 4 career firefighters, therefore, we would
receive an additional credit of 4 members under ISO guidelines. If this proposal is adopted, we
will have five career firefighters on duty, therefore, we will receive m�imum credit for our
volunteer firefighting force.
4. This level of staff'ing will give us the ability to honor Mutual Aid requests without having to
call in additional personnel.
5. With the increased staffing, we will meet and sometimes exceed the minimum staffing levels
established by Palm Beach County Fire Rescue. Therefore, we should have the capacity to
request a reciprocal Mutual Aid Agreement.
6. Increased stafting affords the ability to join the contemplated Counry V1%ide Mutual Aid
System being developed by the Fire Chiefs Association, which will add notable depth to our
fire defenses.
7. By being an EMS provider, we will have the capacity to utilize the disbursement of State and
County EMS Grant funds. We also will be eligible to apply for the State of Florida Emergency
Medical Service 75/25 grant funds. If approved by Council, I will submit applications to these
grant programs to help fund the start-up costs.
8. Furnishes the mechanisms needed to provide direct supervision over the level of
pre-hospital emergency care administered to our residents and eliminates the liability associated
with a third party agency providing this service.
9. Concludes the goal of being a full service City, with respect to the emergency services. •
As with any significant modification in the level of service, undertaking of this service requires
the purchase of equipment (startup costs). The outline below itemizes the major equipment
purchases that would be required.
ftems # Qty. Description Unit Price Total
1 2 Marquette 1500 Defibrillator/Monitors $12,799.00 $25,598.00
2 1 Nickel Cadmium Battery Pack $140.00 $140.00
, 3 1 3-Lead Patient Cable $105.00 $105.00
4 1 Replacement Defibrillator Cable $125.00 $125.00
5 1 Case of ECG Recorder Paper $120.00 $120.00
6 1 Pair of Defibrillator Pads $16.00 $16.00
7 1 Pair of Pediatric Defibrillator Pads $16.00 $16.00I
8 1 Case of ECG Monitoring Electrodes $87.00 $87.00
9 3 Criticare 503 Pulse Oximeter $1,200.00 $3,600.00
10 3 Criticare 503 Pulse Oximeter Case $45.00 $135.00,
� 11 3 Complete sets of Laryngoscope Blades $248.04 $744.12
12 3 Laryngoscope Handles $34.72 $104.16
13 3 Laryngoscope Cases $14.32 $42.96
14 2 Magill Forceps ( Large ) $3.55 $7.10
15 2 Magill Forceps ( Small ) $3.46 $6.92
16 3 Adult Mast Trousers $482.66 $1,447.98
17 3 Child Mast Trousers $429.33 $1,287.99
18 3 Pressure Unfuser Cuffs $13.00 $39.00
19 3 Plano 747 Trauma cases $90.26 $270.78
f 20 3 Thermoscan Tympanic Therm. $313.33 $939.99
21 3 Glucometer Elite $145.00 $435.00
' 22 � 1 Set of Training Aids $3,995.00 $3,995.00
� 23 ! 1 Initial supply of Medications ; $2,150.00 $2,150.00
24 2 UHF 5 watt radios $950.00 $1,900.00
25 TOTAL START-UP COSTS � � $43,313.00/
The salaries and training requirements have already been included in the proposed FY 94/95
Budget year. This is another reason why the proposed EMS budget year only reflects a$526.83
sa��ing.
Demonstrated below is the effect of this proposal on the total Fire Rescue Budget for FY 94/95
(FY94/95 with EMS). For your comparison, I have included two other categories, the FY 93/94
Budget and the FY 94/95 Budget if we keep Jupiter Ambulance Service as our EMS provider
(FY 94/95 without EMS).
Account Number Title FY 93/94 FY 94/95 FY 94/95
Budget with EMS without EMS
1-19-527-0-1-1200 Salary/Wages $381,560.00 $472,052.26 $416,313.16
1-19-527-0-1-1400 Overtime $25,020.00 $35,719.48 $43,497.34
1-19-527-0-1-2100 FicaTaxes $32,830.00 $38,844.54 $35,175.50
1-19-527-0-1-2210 Retirement $56,765.00 $71,215.79 $64,118.64
1-19-527-0-1-2300 Life�Iealth $78,965.00 $80,441.21 $74,673.36
1-19-527-0-1-2400 Workers Comp. $35,115.00 $42,683.29 $38,651.67
1-19-527-0-1-2855 Physicals $2,465.00 $4,197.00 $3,000.00
TOTAL PERSONAL EXPENSES $612,720.00 $745,153.57 $675,429.67
1-19-527-0-2-3101 Legal Services $2,400.00 $0.00 $0.00
1-19-527-0-2-3118 Volunteer Fire Fighters $18,000.00 $15,500.00 $15,500.00
1-19-527-Q-2-3403 EMS Services $166,050.00 $89,355.55 $178,711.31
1-19-527-0-2-4000 TraveUPerDiem $2,650.00 $2,650.00 $2,650.00
1-19-527-0-2-4100 Communication Serv. $1,960.00 $1,960.00 $1,960.00
1-19-527-0-2-4300 Utility Service $4,200.0(? $2,400.00 $2,400.00
1-19-521-0-2-4403 Equipment Leases $0.00 $0.00 $0.00
1-19-527-0-2-4406 Office/Mach. Maint. $1,030.00 $1,030.00 $1,030.00
1-19-52?-0-2-4500 Insurance $11,770.00 $13,606.00 $11,456.00
1-19-527-0-2-4601 General Maintenance $4,300.00 $4,300.00 $4,300.00
1-19-527-0-2-4602 Vehicle Maintenance $10,900.00 $10,900.00 $10,900.00
1-19-527-0-2-4603 Building Maintenance $2,500.00 $2,500.00 $2,500.00
1-19-527-0-2-4607 Comm. Maintenance $2,500. $2,500.00 $2,500.00
1-19-527-0-2-4700 Printing & Binding $800. $800.00 $800.00
1-19-527-0-2-4900 Miscellaneous $2,500.00 $2,500.00 $2,500.00
%
1-19-527-0-2-4901 Licenses & Fees $O.QO $1,300.00 $0.00
1-19-527-0-2-5100 Office Supplies $1,500.00 $1,500.00 $1,500.00
1-19-527-0-2-5130 Fire Prevention Supplies $700.00 $700.00 $700.00
1-19-527-0-2-5140 Safety Supplies $1,500.00 $1,500.00 $1,500.00
1-19-527-0-2-5150 Medical Supplies $1,000.00 $6,000.00 $1,000.00
1-19-527-0-2-5201 Gas & Oil $3,500.00 $3,500.00 $3,500.00
1-19-527-0-2-5204 Hazardous Material Supplies $1,000.00 $1,000.00 $1,000.00
1-19-527-0-2-5207 Small tools & Equipment $0.00 $0.00 $0.00
1-19-527-0-2-5214 Uniforms & Equipment $8,475.00 $9,375.00 $8,475.00
1-19-527-0-2-5215 Misc. Equipment $2,300.00 $2,300.00 $2,300.00
1-19-527-0-2-5216 Photographic Supplies $600.00 $600.00 $600.00
1-19-527-0-2-5400 Books/Pub. & Dues $1,055.00 $1,055.00 $1,055.00
1-19-527-0-2-5401 Training $6,475.00 $6,475.00 $6,475.00
Medical Director $0.00 $6,000.00 $0.00
TOTAL OPERATING EXPENSES $259,665.00 $191,306.65 $265,312.31
1-19-527-0-3-6064 Machinery & Equipment $60,000.00 $56,660.00 $56,660.00
TOTAL CAPITAL EXPENSES $60,000.00 $56,660.00 $56,660.00
GRAND TOTAL FY94/95 BUDGET $932,385.00 $993,120.22 $997,401.98
Overall Budget Increase 6.51% 6.97%
Conclusion: Over the last four and one-half months, we have responded to 125 medical calls
with Jupiter Ambulance Service. To my surprise the adopted countywide medical protocols do
not provide for aggressive medical treatment in the field. Some other jurisdictions that I am
familiar with perform more assertive medical treatment, such as the City of Stuart, Royal Palm
Beach, Miami, Miami Beach and Indian River Shores. These medical protocols are
considerably less than my acceptable standard of care. These treatment guidelines, along with
the cost savings and operational benefits that are associated with being the EMS provider, has
driven me to bring this proposal to you.
People may go through life without utilizing the fire suppression services of the Fire
Department, but everyone will utilize the Emergency Medical Service at some point in their life,
therefore, we should provide, demand and expect the most competent level of care for our
families. I am confident that this program will meet your expectations and deliver a prefened
level of pre-hospital emergency care to the patients, at no additional cost to the tax payers and
provide a superior level of service for all.