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Home My WebLink About2020-05-12 Item 12 - PresentationCHULA VISTA FIRE DEPARTMENT Fire Department Based Ambulance Transport CHULA VISTA FIRE DEPARTMENT •2013 implementation of First Responder ALS (FRALS) •A faster arrival of Fire Department paramedics •No impact to General Fund •Ambulance transport is provided via contract with a private ambulance company •Contract has been in place for 40 years •FRALS is paid for through the contract agreement Fire Department Based Ambulance Transport Current EMS Transport Contract •Three 10% compounding rate increases •October 2020 base rate $3,881 •Provides 6 ambulances 24 hours per day •Provides 2 ambulances 12 hours per day CHULA VISTA FIRE DEPARTMENT Fire Department Based Ambulance Transport Necessary system improvements •Service improvements •Cost improvements Fire Department Based Ambulance Transport CHULA VISTA FIRE DEPARTMENT CHULA VISTA FIRE DEPARTMENT Service Improvements •Comprehensive control of the transport system •Balanced response times throughout the service area •Ability to position ambulances for best performance •Increased daily ambulance unit hours; increased capacity •Ambulance response originates within the service area •Unified medical direction and training •Continuity of patient care Fire Department Based Ambulance Transport CHULA VISTA FIRE DEPARTMENT Service Improvements •Unified dispatch •Reduced dispatch processing time •Unified use of radio communications and information technology •Safety and accountability of resources •Data access and analysis Fire Department Based Ambulance Transport CHULA VISTA FIRE DEPARTMENT Cost Improvements •Reduce base rate cost and minimize fluctuations •Leverage federal reimbursements of $3.5 million •Reinvestment of revenues into system Fire Department Based Ambulance Transport CHULA VISTA FIRE DEPARTMENT System Assessment •Internal Fire Department analysis •Validation of analysis •External peer review •Internal review •Independent consultant –AP Triton •System valuation and optimization Fire Department Based Ambulance Transport CHULA VISTA FIRE DEPARTMENT January 28, Council Meeting authorized the City Manager to: •Engage in all necessary administrative actions to implement Fire Department based emergency medical transport services •Begin negotiations for contractual services to the City of Imperial Beach and the Bonita Sunnyside Fire Protection District Fire Department Based Ambulance Transport 10CHULA VISTA FIRE DEPARTMENT Fire Department Based Ambulance Transport Ambulance Locations Station Ambulance Response Unit 1 (City Hall)24 Hour 2 (Hilltop)12 Hour 3 (Sunbow) 4 (Rancho Del Rey)12 Hour 5 (Montgomery)24 Hour, Reserve 6 (Rolling Hills)24 Hour 7 (Otay Ranch)24 Hour 8 (Eastlake Woods)Reserve 9 (Castle Park)24 Hour 10 (Millenia)24 Hour 38 (Bonita)24 Hour 39 (Imperial Beach)24 Hour 11CHULA VISTA FIRE DEPARTMENT Fire Department Based Ambulance Transport Operational Startup Costs Phase I –Funded by Current ALS Program ITEM COST SOURCE City Overhead Departments (July-June)$317,521 ALS Fund Balance Facilities Improvements (Offices, Warehouse, Stations)$150,000 ALS Fund Balance EMS Training Equipment $75,000 FY21 ALS Budget Portable Medical Equipment $200,000 FY21 ALS Budget Initial Uniforms/PPE $130,000 FY21 ALS Budget 12CHULA VISTA FIRE DEPARTMENT Fire Department Based Ambulance Transport Operational Startup Costs Phase II ITEM COST SOURCE Pre-Deployment Costs Warehouse Inventory $150,000 Measure A Supply Van $60,000 Measure A EMS Academy (4 Weeks)$200,000 Measure A Transport Support Positions Hired $300,000 Measure A Liability Coverage $75,000 Measure A Total $785,000 ITEM COST SOURCE Deployment Costs-4th Quarter FY21 Total of Pre-Deployment Funds $785,000 Measure A QAF Matching Funds $125,000 Measure A IGT Matching Funds FY22 QTR 1 $900,000 Measure A Transport Costs FY21 QTR 4 $2,291,990 Measure A FRALS FY21 QTR 4 (Reimbursed 7/1/2021 by AMR)$779,720 Measure A TOTAL $4,881,710 13CHULA VISTA FIRE DEPARTMENT ITEM Number Total Ambulances 13 $2,815,485 Stryker System 13 $700,882 Zoll 11 $747,845 Motorola 13 $228,888 Total $4,493,100 Fire Department Based Ambulance Transport Capital Purchases 14CHULA VISTA FIRE DEPARTMENT Fire Department Based Ambulance Transport Revenue Projections Service Area Transports Payer Base Miles O2 Night Total Transports Net Revenue Commercial $2,800.00 $292.15 $104.70 $76.60 $3,273.45 3,267 $9,090,206 Medicare $2,800.00 $292.15 $104.70 $76.60 $3,273.45 7,051 $3,692,975 MediCal $2,800.00 $292.15 $104.70 $76.60 $3,273.45 4,729 $774,007 Private $2,800.00 $292.15 $104.70 $76.60 $3,273.45 2,149 $351,732 17,196 $13,908,921 Supplemental IGT $2,383,405 TOTAL $16,292,326 15CHULA VISTA FIRE DEPARTMENT Fire Department Based Ambulance Transport Five Year Budget and Revenue 4th Quarter Service Area with IGT Cost/Revenue FY 20-21 FY 21-22 FY 22-23 FY 23-24 FY 24-25 Transport Cost (Dispatch Included)$2,291,990 $10,144,060 $10,603,611 $11,051,171 $11,544,585 First Responder ALS (FRALS) Cost $779,720 $2,709,062 $2,894,560 $3,013,798 $3,127,966 Total Cost $3,071,710 $12,853,122 $13,498,171 $14,064,969 $14,672,551 Projected Revenue $3,431,899 $13,908,921 $14,187,099 $14,470,841 $14,760,258 QAF/Intergovernmental Transfer (IGT)$307,515 $2,383,405 $3,607,485 $3,679,635 $3,753,227 Total Revenue $3,739,414 $16,292,326 $17,794,584 $18,150,476 $18,513,486 Total Cost $3,071,710 $12,853,1 22 $13,498,171 $14,064,969 $14,672,551 Net Revenue $667,704 $3,439,204 $4,296,413 $4,085,507 $3,842,935 *Assumes 2% growth in transport volume and no change in base rate* CHULA VISTA FIRE DEPARTMENT Summary: •Balanced service delivery and improved response times •Improving service in eastern Chula Vista •Unified communications will reduce call processing times which will reduce response times •Continuity of patient care •Patient care begins with CVFD and ends upon arrival to the receiving hospital •Increased daily ambulance unit hours and capacity •Addition of two 24-hour ambulances to service area •Ambulance units will respond from within the service area •Unified medical direction and training •All EMT’s and Paramedics under 1 EMS system and 1 medical director •Reduction of base rate from $3,881 to $2,800 Fire Department Based Ambulance Transport CHULA VISTA FIRE DEPARTMENT Fire Department Based Ambulance Transport Projected timeline: May 12, 2020 Council approval of capital purchases and staffing changes. June 2020 Complete purchase of ambulances, gurney systems, cardiac monitors, and communications equipment. July 2020 Billing RFP conducted if necessary. September 2020 EMS personnel recruitment begins. October 2020 Required 180-day contract termination for convenience. December 2020 EMS BC positions begin transition. February 2021 All equipment and warehouse inventory prepared. Additional support positions begin to support transition. March 2021 Paramedics complete orientation academy and field training. EMT personnel complete orientation academy. April 9, 2021 Transport system begins. CHULA VISTA FIRE DEPARTMENT Staff recommends that Council: •Authorize and direct the City Manager to execute agreements with City of Imperial Beach and Bonita FPD •Approve capital purchases •Amend the budget and authorize FTE’s Fire Department Based Ambulance Transport CHULA VISTA FIRE DEPARTMENT Next Steps •Return to Council within 30 days: •Approval for use of Measure A –Fire Component funds for startup costs •Approval of capital loan agreements for purchase of necessary equipment •Approval of updated agreement with Local 2180 for non-safety employees Fire Department Based Ambulance Transport 20 QUESTIONS CHULA VISTA FIRE DEPARTMENT