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4. Fire DepartmentKalispell Fire/Ambulance Dept. 336 1 st Ave. East • P.O. Box 1997 Kalispell, MT 59903-1997 REPORT FROM SUBJECT MEETING DATE Honorable Mayor and City Council Randy Brodehl, Fire Chief Ordinance no. , Ambulance Service Area May 6th, 2002 Telephone 406-758-7764 Fax 406-758-7758 BACKGROUND: The Kalispell Fire Department has provided ambulance service to the City of Kalispell and the surrounding areas in the Flathead Valley since the 1930s. This service is established as an enterprise fund, so operates without support of the tax base. Recently, it was discovered that the City has never established a process of Council approval for ambulance services operating within the City of Kalispell. There is nothing in Montana State Code that requires anything more than retaining the services of a Physician Advisor (any local physician), for an ambulance service to operate within the state. There is potential for another ambulance service to begin operating in the City. This would dilute the ability of other service providers to maintain excellent service, be a disservice to the community, and would disregard the needs of the sick and injured. The City can establish an Emergency Medical. Service Committee that has the authority to review and recommend action to the City Council regarding all EMS ambulance response in the City. This committee would be tasked with ensuring that the best Emergency Medical Service is available to the community, 24 hours a day. They would establish protocol based on good medical practice, the needs of the community, and a vision for the future. City Council's approval would then be required for any Emergency Medical Service Ambulance provider to operate inside the City. This committee would consist of 2 members of the community at large, an emergency medical physician appointed by the Kalispell Regional Medical Facility, a City Council member, and the Kalispell Fire Department EMS Coordinator. The committee would meet quarterly, with a report to the Council following each meeting. RECOMMENDATIONS: Council adopts Ordinance , establishing an Emergency Medical Service Committee that would review and recommend action to the City Council regarding all EMS response in the City. FISCAL EFFECTS: None. ALTERNATIVES: As recommended by Council Respectfully submitted, Ral4dy rodehl Fire Chie Chris Kukulski City Manager Kalispell Fire/Ambulance Dept. 336 1 st Ave. East • P.O. Box 1997 Kalispell, MT 59903-1997 REPORT FROM SUBJECT MEETING DATE Honorable Mayor and City Council Randy Brodehl, Fire Chief Resolution -Ambulance Fee Schedule change May 6th, 2002 Telephone 406-758-7764 Fax 406-758-7758 BACKGROUND: The Kalispell Fire Department provides ambulance service to the City of Kalispell and the surrounding areas in the Flathead Valley. This is an enterprise fund so operates without support of the general fund. To do this, the service must base its fees on actual costs and available revenue. For the past two years, our charges have not met the budget requirements for an enterprise fund. Cost for equipment, apparatus, and personnel are greater than the revenue we are able to generate by our current fee schedule. During that two-year period, our call volume increased about 7%, and our collection rate stayed relatively flat. To take every measure possible to compensate for this, we streamlined our service by reducing our office staff by .5 FTEs; we decreased our bad debt carry over; we are in the process of accepting credit card payment; and have reduced our turnaround time at the hospital through a change in reporting methods, thereby reducing overtime on some calls. We have exhausted all reserves including funding for replacement equipment and replacement ambulances. This does not meet the objectives in our EMS Goals of establishing a true relationship between expenditures and revenue. To do this, we need to correct our fee rates to sustain operations. While our proposed rate increase, at 45 %, appears substantial, the actual increase in revenue will only be 9 %. This is because the change does not effect Medicare/Medicaid payments, and 70 % of our calls are invoiced to Medicare/Medicaid (See the Medicare/Medicaid Fee Schedule). We "accept payment" from Medicare/Medicaid, which guarantees payment, but we are not allowed to invoice the patient for the additional amount associated with the response. This means we will only see an increase in fees on the 30% of our responses that are paid by insurance or private pay. This increase meets the objective of matching revenue and expenditures, and it brings us into line with charges of similar services in the State of Montana. The attached graph indicates the current rates of comparable cities in the State of Montana. As can be seen in the graph, this brings us in line with the average fee schedule in cities of comparable size. We propose a change as follows: Current: Recommended: Basic Life Support Base Rate $305.00 $580.00 Loaded mile rate 8.00 8.50 Advanced Life Support Base Rate $405.00 $520.00 Loaded mile rate 8.00 8.50 Oxygen 30.00 35.00 All other fees to remain the same. RECOMMENDATIONS: Council adopts Resolution _ allowing for an increase in ambulance rates. FISCAL EFFECTS: These changes are as reflected in the proposed 2002/2003 budget. ALTERNATIVES: As recommended by Council Respectfully submitted, y rode Fire Orief 9�" Chris Kukulski City Manager Instructions Effective September I, 1990, all physicians and suppliers who provide covered services to Medicare patients must submit claims to Medicare for their patients. This requirement is stated in Section 6102 of The Omnibus Budget Reconciliation Act of 1989. Congress believed that this would yield more accurate information with which to evaluate Medicare expenditures and other factors such as volume and intensity of services under the Medicare Volume Performance Standard (MVPS). Section III Claims Filing Instructions 1115101 2002 Ambulance Fee Schedule provided by CENTERS for MEDICARE & MEDICAID SERVICES Effective for April 1, 2002 Ambulance Fee Schedule Milage $5.47 Basic Life Support Emergency 249.18 Advanced Life Support Level 1 295.90 Advanced Life Support Level 2 428.28 Montana City Ambulance Rates $700.00 $600.00 $500.00 Rates $400.00 $300.00 $200.00 $100.00 $406.00 $306.00 n■ $0.00 P HI G FII Kf II P d ❑ ALS ■BLS Missoula olson a ena real a s a ispa ropose Kalispell Cities Kalispell Fire/Ambulance Dept. 312 1 St Ave East - P.O. Box 1997 Telephone 406-758-7763 Kalispell, MT 59903 -1997 Fax 406-758-7952 REPORT Honorable Mayor and City Council FROM Jim Stewart, Assistant Chief/Fire Marshal SUBJECT Resolution — Designation of Building Permit Fees for Fire Prevention. MEETING DATE April 22, 2002 BACKGROUND: The International Conference of Building Officials publishes a family of codes to provide jurisdictions with a complete set of building -related regulations for adoption. The State of Montana has adopted this family of codes, which are known as the Uniform Building, Uniform Mechanical, and Uniform Fire Codes. These codes work in concert with each other to provide the foundation for better building construction and greater public safety. The City of Kalispell has also adopted this model code as its building and fire code. The Uniform Building Code and Uniform Mechanical Code addresses all issues related to "construction" features within a structure while the Uniform Fire Code*laddresses the "maintenance" of building designfeatures that are related to fire and life safety. The Kalispell Fire Department has established a Prevention Division, which is responsible for all work related to fire and fife safety code compliance, fire investigation, and public education. A major portion of the Prevention Division's work is related to code enforcement. This responsibility requires close coordination with the City Building Department and in- depth knowledge of Building Code requirements. Fees are collected related to new building construction that provide for administrative review of building projects, plan review of architectural and engineered drawings, and on -site inspections for assurance of construction compliance. The Fire Marshal performs an active role in all three of these aspects of new construction. Upon completion of a building project, a Certificate of Occupancy is issued from the City of Kalispell. This certificate allows for building use by occupants and the general public. Once the Certificate of Occupancy has been issued, the Prevention Division is tasked with ensuring that the building's fire and life safety features are maintained. The Uniform Fire Code requires that all buildings be inspected to ensure this compliance. The Deputy Fire Marshal performs a major role in the completion of the annual fire inspection program. The level of activity that the Prevention Division staff provides warrants designation of 26% of building permit fees for fire prevention program costs. These costs are directly related to "Assisting The Community in Reducing And Preventing Emergencies" • Page 2 April 18, 2002 performing life safety plan reviews, construction inspections, and maintenance inspections of buildings. The Prevention staff is heavily involved in all aspects of project review for new construction and is the sole authority for performing follow-up inspections to ensure building code compliance for the life of the building. A successful code enforcement program requires a technically competent staff. Certification programs are in place to ensure local code officials have the training, experience, and knowledge in code application. Currently, the Fire Marshal is certified in the Uniform Fire Code. We have established a Prevention Division goal to obtain Uniform Building Code certification for the Fire Marshal and Deputy Fire Marshal, as well as Uniform Fire Code certification for the Deputy Fire Marshal. Completion of these certfications is planned for January 2003. The working relationship that has been established between the building and fire departments is one that serves to enhance a joint process of plan review and inspections of new and existing buildings within the City of Kalispell. This alliance supports Council's vision for a community that expects excellence and also serves to support the mission of enhancing the quality of life for all citizens. RECOMMENDATIONS: It is recommended that Council adopt resolution designating building permit fees for fire prevention. FISCAL EFFECTS: These changes are as reflected in the proposed 2002/2003 budget. ALTERNATIVES: As recommended by Council Respectfully submitted, Jim Stewart Assistant Fire Chief/Fire Marshal Chris Ku culski City Manager Assisting The Community In Reducing And Preventing Emergencies"