FOR COUNCIL MEETING OF: AGENDA ITEM NO.:

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1 FOR COUNCIL MEETING OF: AGENDA ITEM NO.: June 9, (a) TO: THROUGH: r--... M~OR AND CITY COUNCIL ~~10~ LINDA NORRIS, CITY MANAGER FROM: SUBJECT: MIKE NIBLOCK, FIRE CHIEF SETTING FEES AND CHARGES FOR PREHOSPITAL EMERGENCY AND NON-EMERGENCY MEDICAL TREATMENT AND AMBULANCE TRANSPORT SERVICES PROVIDED BY SALEM FIRE DEPARTMENT ISSUE: Shall the City Council adopt Resolution No , increasing fees and charges for prehospital emergency and non-emergency medical treatment and ambulance transport services provided by Salem Fire Department by 1.14 percent? RECOMMENDATION: Adopt Resolution No , increasing fees and charges for prehospital emergency and non-emergency medical treatment and ambulance transport services provided by Salem Fire Department by 1.14 percent. SUMMARY AND BACKGROUND: ORS authorizes cities to regulate "ambulances and emergency medical services providers" provided that such regulation does not conflict with any of the following: Other state laws. Rules adopted by the Oregon Health Authority. The county plan for ambulance services and ambulance service areas. Since 2005, the City has contracted with Rural Metro Ambulance to meet most of the demand for prehospital emergency and non-emergency medical services within Salem. The City Council regulates the rates that may be changed. This regulation applies equally to the Fire Department and any contractors such as Rural Metro Ambulance. The City Council set the rates that are currently in effect on June 10, 2013, by adopting Resolution No :-42.

2 Setting Fees and Charges for Prehospital and Non- Medical Treatment and Ambulance transport Services Provided by Salem Fire Department City Council Meeting of June 9, 2014 Page 2 FACTS AND FINDINGS: Like the rate increase proposed and adopted one year ago, this proposed rate increase is based on the April-to-April change in the CPI-W B/C for Medical Care. Staff recommends using this version of the Consumer Price Index for the following reason: It is directly related to medical services. It is directly related to cities of our size in our region. It is less volatile than other price indices that might have been chosen (especially those related to transportation). Over the last ten years, the CPI-W West B/C for Medical Care has increased at an average rate of percent per year. For the twelve months ended April 30, 2014, the increase was 1.14 percent. The chart below shows the history of this index. CPI... w West B/C for Medical Care ~ Average -, , , , , ,---~----,---~--, , >- 0% 7% 6% ~ c 5%! u 4% 1:: 0. 3% ~ 0 2'% l 1% ~ The proposed increase will enable both the City and Rural Metro Ambulance to mitigate increasing financial pressure from factors such as fuel costs and the reimbursement policies of Medicare and Medicaid. At the same time, tying increases to a price index provides the public with increases that are reasonably stable and predictable. The table on page 3 compares the proposed rates with current rates:

3 Setting Fees and Charges for Prehospital and Non- Medical Treatment and Ambulance Transport Services Provided by Salem Fire Department City Council Meetirig of June 9, 2014 Page 3 PREHOSPITAL EMERGENCY AND NON-EMERGENCY MEDICAL FEE SCHEDULE Current and Proposed FY FY Fee Type Description Current Proposed Advanced Life Support 2 Dispatched as with increased $ $ 1, level of Advanced Life Support procedures Advanced Life Support 2 Dispatched as with increased $ 1, $ 1, Bariatric level of Advanced Life Support procedures, transport requires bariatric gurney Advanced Life Support Dispatched as with Advanced $ $ Life Support procedures Advanced Life Support Dispatched as with Advanced $ 1, $ 1, Bariatric Life Support procedures, transport requires bariatric gurney Advanced Life Support Dispatched as Non- with $ $ Non Advanced Life Support procedures Advanced Life Support Dispatched as Non- with $ 1, $ 1, Non Bariatric Advanced Life Support procedures, transport requires bariatric gurney Basic Life Support Dispatched as, no Advanced $ $ Emerqencv Life Support procedures Basic Life Support Dispatched as, no Advanced $ $ Bariatric Life Support procedures, transport requires bariatric gurney Basic Life Support Non Dispatched as Non-, no $ $ Advanced Life Support procedures Basic Life Support Non Dispatched as Non-, no $ $ Bariatric Advanced Life Support procedures, transport requires bariatric gurney. Advanced Life Support Dispatched as, Advanced Life $ $ On-Scene Treatment Support procedures, no transport Mileage Fees for Mileage reflect the transport $ $ distance traveled rounded to the nearest tenth of a mile, beginning from the point of patient pickup to the point of patient's delivery destination. Extra Attendant When a patient's condition warrants the $ $ presence of additional medic personnel to assist crew during transport. Wait Time Per hour for waiting time for a patient at a $ $ medical facility; charged in half-hour increments after the first half hour Event Coverage Per hour coverage for a Advanced Life $ $ Advanced Life Support Support ambulance staffed with two Ambulance Medical Technicians, at least one certified as a paramedic Event Coverage - Staff Per hour coverage for one Paramedic only $ $ Only Event Coverage - Basic Per hour coverage for a Basic Life Support $ $ Life Support Ambulance ambulance staffed with two Medical Technicians Event Coverage - Staff Per Hour coverage for one $ $ Only Medical Technician only

4 June 9, (a) RESOLUTION NO A RESOLUTION SETTING FEES AND CHARGES FOR PREHOSPITAL EMERGENCY AND NON-EMERGENCY MEDICAL SERVICES Whereas, City fees and charges related to prehospital emergency and non-emergency medical services are set forth in Resolution No ; and Whereas, the City desires to change the fees and charges related to prehospital emergency and non-emergency medical services as set forth in this resolution; NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF SALEM, OREGON, RESOLVES AS FOLLOWS: Section 1. There are hereby established, and there shall be collected, fees and charges as set forth in "Exhibit 1," which is attached hereto and incorporated herein by reference. Section 2. This resolution supersedes Resolution No and any other resolution to the extent that it enacts fees and charges of the type set forth herein. Section 3. Nothing in this resolution will affect or be construed to affect any fee or charge due or owing at the time this resolution takes effect. Section 4. This resolution is effective July 1, ADOPTED by the City Council this 9th day of June, ATTEST: City Recorder Approved by City Attorn Checked by: R. Hostetler g:\group\legall\council\2014\ prehospital emergency and nonemergency medical services fees and charges reso docx

5 EXHIBIT,1 PREHOSPITAL EMERGENCY AN:O NON-EMERGENCY M;EDICAL FEE SCHEDU~E FY Fee Type Description Fee Advanced Life Support 2 Dispatched as with increased level of Advanced Life $ 1, Support procedmes Advanced Life Supp01t 2 Dispatched as with increased level of Advanced Life $ 1, Bm iatric Support procedures, transport requires bariatric gurney Advanced Life Support Dispatched as with Advanced Life Support procedures $ Adva11ced Life Support Dispatched as with Advanced Life Support procedures, $ 1, Badatric transport requires bariatl'ic gurney Advanced Life Support Non Dispatched as Non- with Advanced Life Support $ procedures Advanced Life Suppott Non Dispatched as Non- with Advanced Life Supp01t $ 1, Bm iatric procedures, transport requires bariatric'gurney Basic Life Support Dispatched as Emet gency, no Advanced Life Support procedures $ Basic Life Suppott Dispatched as, no Advanced Life Support procedures, $ Emet gency Bat iatric transport requires bariatric gmney Basic Life Support Non Dispatched as Non-, no Advanced Life Suppott $ procedures Basic Life Support Non Dispatched as Non-, no Advanced Life Support $ Emet gency Bat'iatric!procedures, transport requires bariatl'ic gumey. Advanced Life Suppott 0~- Dispatched as, Advanced Life Support procedures, no $ Scene Treatment transport Mileage Fees for Mileage reflect the transport distance traveled rounded to $ the nearest tenth of a mile, beginning from the point of patient pickup to the point of patient's delivery destination. Extt a Attendant When a patient's condition warrants the presence of additional $ medic personnel to assist crew during transport. Wait Time Per hour for waiting thne for a patient at a medical facility; charged $ in half-hour increments after the first half hour Event Coverage Advanced Per hour coverage for a Advanced Life Support ambulance staffed $ Life Support Ambulance with two Medical Technicians, at least one ce1tified as a paramedic Event Coverage - Staff Only Per hour coverage for one Paramedic only $ Event Coverage - Basic Life Per hour coverage for a Basic Life Support ambulance staffed with $ l Suppott Ambulance two Medical Technicians Event Coverage H Staff Only Per Hour coverage for one Medical Technician only $ 19.38