09. Resolution 4694 - Revising Ambulance FeesKalispell Fire/Ambulance Dept. *no
312 1 st Ave East - P.O. Box 1997 Telephone 406-758-7760
Kalispell, MT 59903 -1997 Fax 406-758-7952
REPORT Honorable Mayor and City Council
FROM Randy Brodehl, Fire Chief
SUBJECT Ambulance Fee Schedule change
MEETING DATE May 6 h, 2002
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 it
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, be 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
;Assisting The Community in Reducing And Preventing Emergencies"
• Page 2
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 $520.00
Loaded mile rate 8.00 8.50
Advanoed Life Support
Base Rate
$405.00
$580.00
Loaded mile rate
8.00
8.50
Oxygen
30.00
35.00
All other fees to remain the same.
RECOMMENDATIONS: Council adopts the 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,
A A�
Randy Brodehl
Fire Chief
Chris Kukulski
City Manager
'Assisting The Community In Reducing And Preventing Emergencies"
RESOLUTION NO. 4694
A RESOLUTION AMENDING RESOLUTION NO. 4633, BY REVISING AMBULANCE
RATES FOR THE USE OF THE KALISPELL AMBULANCE SERVICE AND DECLARING AN
EFFECTIVE DATE.
WHEREAS, the City of Kalispell maintains an ambulance service
through its fire department;
WHEREAS, on July 2, 2001, the City Council established Resolution
No. 4633, which set the rates for the Kalispell Ambulance
Service; and
WHEREAS, to support this service it is necessary to revise the rates
that are charged for its use.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
KALISPELL AS FOLLOWS:
SECTION I
Item
Base rate
Loaded mile rate
(First 100)
Over 100
Oxygen
Drugs
Disposables
That Resolution No
revising the rates
Service as follows:
B.L.S. Rate/
Disposables*
$520.00
8.50
4633 is hereby amended by
of the Kalispell Ambulance
Medicare allowed
35.00 First % hr.,
10.00 each add'l hr
Medicare allowed
Return Transfer Rate 150.00 plus mileage
A.L.S. Rate/
Disposables*
$580.00
8.50
Medicare allowed
35.00 First M hr.,
10.00 each add'1 hr.
Cost of Drugs
Medicare allowed
Stand-by Ambulance: $110.00 for the first hour and $85.00 per hour
thereafter. This rate will be figured on a quarter hour basis.
Anyone transported during stand-by will be billed per any normal run.
*B.L.S. = Basic Life Support A.L.S. = Advanced Life Support
SECTION II. This Resolution shall become effective
immediately upon its passage by the City
Council.
PASSED AND APPROVED BY THE CITY COUNCIL AND SIGNED BY THE MAYOR OF
THE CITY OF KALISPELL, THIS 6TH DAY OF MAY, 2002.
Pamela B. Kennedy
Mayor
ATTEST:
Theresa White
City Clerk
2002 Ambulance Fee Schedule provided by CENTERS for MEDICARE A
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
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