7.7 EMS Rate Fee Schedule UpdateCITY OF SALINA
REQUEST FOR CITY COMMISSION ACTION
AGENDA SECTION ORIGINATING DEPARTMENT:
NO: 7
Finance & Administration
ITEM
NO: 7
Page 1 BY: Rod Franz
DATE TIME
3/7/2016 4:00 P.M.
FISCAL APPROVAL:
BY: (`
FINAL APPROVAL:
BY: 0
ITEM: Resolution No. 16-7329
Consider Resolution Number 16-7329 establishing and amending fees in the Comprehensive fee
schedule related to Emergency Medical Services.
BACKGROUND:
The City sets fees for EMS periodically with the objective of recovering as much cost as is equitably
reasonable while maximizing reimbursement from the major insurers for services performed. Staff
periodically reviews the allowed charges for Medicare and Blue Cross/Blue Shield coverage's. These
two providers generate approximately two-thirds of the revenue received for EMS services, and
effectively set the market for reimbursements. Typically we have set our rates at levels that would be
sufficient to recover our costs of service, provided that the full amount of the rate was allowed by the
insurance providers, but in no case less than the allowed reimbursement of any provider. Amounts
charged that exceed the provider's allowance are written off. Total revenue collected in 2015 was
$1,850,000.
Typically, fees for service recover about two-thirds of the expenses of the service. The remainder of
the expense is recovered through a Countywide tax levy (EMS is a Countywide service). In recent
years, the Countywide supplement has been on the order of $900,000, which includes the operations
supplement, as well as the cost of a replacement ambulance, and other medical equipment.
Staff has recently reviewed reimbursement levels for the services provided and is recommending the
changes noted in the attached schedule. These will allow the City to continue to maximize
reimbursement for services.
One new charge has been added for standby services. Standby is occasionally requested for events
in which the logistics and layout of the event makes it impossible to get a full sized ambulance to all
potential locations where a response may be required. In those cases, the City provides, in addition
to an Ambulance and a crew, a supplemental crew operating an ATV to transport crew, and if
necessary, a patient from the point of service to the ambulance unit for transport to an appropriate
medical facility. The proposal incorporates a higher fee for service when those additional services
are required.
FISCAL NOTE:
These changes will have a relatively modest effect on revenues; however, over time the incremental
changes allow the service charges to keep pace with the costs of providing the service.
CONFORMANCE WITH THE STRATEGIC PLAN:
The City Commission of Salina will have committed to providing the highest quality City services
possible within available resources. The City Commission recognizes their role and responsibility to
provide the needed policy direction and resources to its administration. At the same time, the City's
administrative personnel are committed daily to transforming this direction and resources into the
highest possible quality of municipal services, consistent with the expectations of both the City
Commission and the citizens of Salina.
CITY OF SALINA
REQUEST FOR CITY COMMISSION ACTION DATE TIME
3/7/2016 4:00 P.M.
AGENDA SECTION ORIGINATING DEPARTMENT: FISCAL APPROVAL
NO 7
Finance & Administration By
ITEM FINAL APPRO VAL-
NO 7
Wage 2 BY: Rod Franz BY.
RECOMMENDED ACTION:
Pass Resokidon 16-7329 amending the City's Comprehensive Fee Schedule relating to Emergency
Medical Service Fees.
ARTICLE IV: FIRE DEPARTMENT
DESCRIPTION AMOUNT/UNIT EFF. DATE ESTABLISHED BY
AMBULANCE:
Basic Life Sunnort Care BLS
Emergency A0429 $510.00 + mileage 6/1/2013 Resolution No. 13-7004
Non -Emergency A0428 $450.00 + mileage 6/1/2013 Resolution No. 13-7004
(Base Rate - One way Transport) All emergency and non -emergency transports requiring only basic life support care on the
scene and while in route to the destination.
Advance Life Support Care (ALS) Level 1
Emergency A0427 $600.00 $610.00 + mileage 4/1/2016 Resolution No. 16-7329
Non -Emergency A0426 $550.00 + mileage 6/1/2013 Resolution No. 13-7004
(Base Rate - One-way Transport) All emergency and non -emergency transports requiring use of monitoring/resuscitation
equipment, iv' , drags, or drawing of blood to treat patient at the scene or while in route to destination.
Advance Life Support Care (ALS) Level 2
Emergency A0433 $702.00 $725.00+ mileage 4/1/2016 Resolution No. 16-7329
(Base Rate - One-way Transport) ALS transport requiring the administration of 3 or more medications (or the same medication 3
times); or at least one of the following procedures: Manual Defibrillation/cardioversion; Endotracheal Intubation; Central Venous
Line; Chest Decompression; Surgical Airway, Intraosseous line or Cardiacpacing.
Specialty Care Transport A0434 $810.00 $850.00+ mileage 4/1/2016 Resolution No. 16-7329
(Base Rate - One-way Transport) When medically necessary, for a critically injured or ill beneficiary, a level of inter facility service
provided beyond the scope of the paramedic.
Treatment/No Transport $2W $225.00 4/1/2016 Resolution No. 16-7329
Round -Trip Transport $340 $450.00 4/1/2016 Resolution No. 16-7329
Patient transported from one location to another and then returned to place of origin (during the same trip).
Basic Stand -By Charge
Type II ambulance, with MICT/EMTs, as appropriate, standing by at a sporting or other event.
Stand -By Charge (all) $110.00 per hour 6/1/2013 Resolution No. 13-7004
mimimum of 2 hours
Standby with Medic Unit plus
ATV with additional crew $175.00 per hour 4/1/2016 Resolution No. 16-7329
mimimum oft hours
Waiting Time $110.00 per hour 6/1/2013 Resolution No. 13-7004
Any time ambulance crew is delayed for reason other than that which they can control and which is not considered pan of the run
(MICT discretion).
Mileage Q,� $15.00 per mile
One-way charge base on odometer equipment.
Use of Bariatric Capacity $200.00
(per hour, one hour minimum)
Fall Recovery and Medical Assist $100.00
City of Salina - Comprehensive Fee Schedule - Revised 2-2016
4/1/2016 Resolution No. 16-7329
6/1/2013 Resolution No. 13-7004
6/1/2013 Resolution No. 13-7004
Page 18
RESOLUTION NUMBER 16-7329
A RESOLUTION ESTABLISHING AND AMENDING FEES FOR EMERGENCY
MEDICAL SERVICES IN THE COMPREHENSIVE FEE SCHEDULE OF THE CITY OF
SALINA, KANSAS.
WHEREAS, the City of Salina provides many specific services for the Citizens of Salina; and
WHEREAS, specific individuals benefit from said services; and
WHEREAS, it is appropriate public policy to require specific individuals benefiting from specific
services to pay all or a portion of the cost of such services; and
WHEREAS, Salina Code Section 2-2 provides that the Board of Commissioners shall determine,
by resolution, all license fees, permit fees and oar user related fees or charges established by the
ordinances of the City; SO NOW, THEREFORE
BE IT RESOLVED by the Governing Body of the City of Salina., i
Section 1. That Article V of the Comprehensive Fee Schedule as amended pursuant to Exhibit A
(attached) is hereby adopted.
Section 2. That all fees are to be effective and affirmed April 1, 2016.
Section 3. That this Resolution shall be in fill[ force and effect from and after its adoption.
Adopted by the Board of Commissioners and signed by the Mayor this 7t' day of March, 2016.
[SEALI
ATTEST:
Shandi Wicks, CMC, City Clerk
Jon R. Blanchard, Mayor