HomeMy WebLinkAbout2009/09/15 Item 20CITY COUNCIL
AGENDA STATEMENT
~~ ~ ~\f// CITY OF
'~` CHUTA VISTA
September 15, 2009 Item 'gyp
ITEM TITLE: RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF CHULA VISTA APPROVING AN AMENDMENT TO
THE AMBULANCE SERVICE ORIGINAL
AGREEMENT BY AND BETWEEN AMERICAN
MEDICAL RESPONSE, AND THE CITY OF CHULA
VISTA AUTHORIZING THE MAYOR TO EXECUTE
THE AGREEM~~E``N^^T
SUBMITTED BY: FIRE CHIEF Yl~l
REVIEWED BY: CITY MANAGE
4/STHS VOTE: YES NO X
BACKGROUND:
On April 22, 2008 the City Council approved afive-year lease agreement in the amount
of $764,000 with Kansas State Bank of Manhattan for the acquisition of medical
resuscitation equipment from Zoll Corporation. New medical resuscitation equipment
was required as the existing equipment was beyond its useful performance life. This
equipment was acquired by the Fire Department and was put into service in 2008
enhancing the department's life saving capabilities. On June 9, 2009 the City Council
approved the fiscal year 2009-10 Fire Department budget. In an effort to generate
budgetary savings, revenue in the amount of $172,000 to offset the yearly lease cost
associated with the acquisition of the medical equipment was assumed in the Fire
Department budget. The Fire Department is requesting City Council approval of an
amendment to the Ambulance Service Original Agreement between American Medical
Response (AMR) and the City of Chula Vista that will increase the ambulance transport
rate that is charged by AMR in order to generate necessary pass-through revenues to fund
the yearly lease cost.
ENVIRONMENTAL REVIEW:
The Environmental Review Coordinator has reviewed the proposed activity for
compliance with the California Environmental Quality Act [CEQA] and has determined
that the activity is not a "Project" as defined under Section 15378 of the State CEQA
Guidelines because it does not involve a physical change to the environment; therefore,
pursuant to Section 15060[c][3] of the State CEQA Guidelines the activity is not subject
to CEQA. Thus, no environmental review is necessary.
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September 15, 2009 Item 20
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RECOMMENDATION:
That Council adopt the resolution.
BOARDS/COMMISSIONS RECOMMENDATION:
Not Applicable.
DISCUSSION:
The City is authorized by Government Codes Section 38794 and Municipal Code
sections 5.10.310-5 10.340 to contract for ambulance services. The City has contracted
with American Medical Response (formerly known as Hartson Medical Services) for the
provision of Basic and Advanced Life Support Ambulance services since 1989. The
current agreement with American Medical Response (AMR) permits AMR to provide
services to an Exclusive Operating Area (EOA) that was adopted by the County of San
Diego. This EOA consists of the City of Chula Vista, Bonita/Sunnyside Fire Protection
District, and the Ciry of Imperial Beach. On May 14, 2002, the City Council adopted an
amended and restated agreement (2002 Agreement) with AMR that clarified and
reinforced the following key stipulations:
• Definition of service requirements and performance standazds to optimize service
delivery
• Minimum resource requirements for the number of ambulances, staffing and
equipment to be deployed for the provision of service
• Provisions for termination that would provide the City with adequate notice in
order to avoid service interruptions
• Insurance requirements for motor vehicles operated by AMR in order to protect
the City from liability
• Hold harmless provisions that indemnified the City from liability azising from
negligence acts or omissions resulting from AMR's performance
• Renewal Provisions that provided the flexibility to extend the agreement at their
own discretion.
More recently, the City Council approved afour-yeaz extension to this agreement that
became effective December 11, 2007 through May 31, 2011 with two additional three-
yeaz extension options available thereafter. The adoption of this extension resulted in an
increase to the ALS transport rate that was requested by AMR in an effort to update their
business model.
Request for Increase in the Advanced Life Support Ambulance Transport Rates
On June 9, 2009 the City Council approved the fiscal year 2009-10 Fire Department
budget spending plan. In an effort to generate budgetary savings, revenue in the amount
of $172,000 to offset the yearly lease costs for the acquisition of medical resuscitation
equipment was assumed in the Fire Department budget. Current law allows the City to
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September 15, 2009 Item ~r7
Page 3 of 4
collect pass-through revenue from ambulance services providers provided that such
revenues are used to enhance service delivery in the emergency medical services (EMS)
system. The Fire Department is requesting that City Council approve an amendment to
the Ambulance Service Original Agreement that will increase the ambulance transport
rate that is charged by AMR in order to generate the necessary pass-through revenues to
fund the yearly lease agreement with Kansas State Bank of Manhattan for medical
resuscitation equipment acquired from Zoll Medical Corporation. If approved, the
transport rate will increase by $118.16 from $744.19 to $862.77. This revised rate is
summazized in the following table:
CHARGE CURRENT PROPOSED
ALS Emergency Base
Rate $744.19 $862.77
BLS Emergency Base
Rate $569.36 $569.36
Mileage Rate (per Mile
or ortion thereof) $22.92 $22.92
Ox en Chaz e $82.83 $82.83
Ni ht Char e $82.05 $82.05
Treatment Only (no
trans ort) $189.35 $189.35
This change represents an increase of $118.58 or 16%. This new transport rate will
result in Chula Vista continuing to have one of the lowest rates in the County. Examples
of other jurisdictions include: El Cajon $1,034.00, National City $1,346.48, San Miguel
$1,367.00.
The increase in the transport rate will allow the City to generate an estimated $214,000 of
additional pass-through revenues a year to pay for the lease purchase agreement with
Kansas State Bank of Manhattan for the medical resuscitation equipment acquired from
Zoll Medical Corporation. The additional revenue collected under this agreement will
allow the Fire Department to fund future acquisitions when it comes time to replace the
current generation of medical resuscitation equipment before it becomes obsolete.
Certification of Costs
Under the terms of this proposed amendment, the City will be responsible for certifying
to AMR that the funding received via pass-through revenues for enhanced services in the
prior calendaz yeaz did not exceed the cost to the City to provide for enhancements and
shall notify AMR of any proposed additions or deletions of defined enhancements.
AMR will make available to City financial data showing for the 12-month period, the
payer mix, number of transports, current collection rate, and estimated mazginal
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September 15, 2009 Item 20
Page 4 of 4
collection rate for any adjustment to fees. It is agreed that this information will remain
proprietary and confidential and shall be utilized in order for City staff to verify that any
rate adjustments predicated upon changes related to the enhancements desired pursuant to
the Original Agreement aze reasonable and necessary.
DECISION MAKER CONFLICT:
Staff has reviewed the decision contemplated by this action and has determined that it is
not site specific and consequently the 500-foot rule found in California Code of
Regulations section 18704.2(a)(1) is not applicable to this decision.
CURRENT YEAR FISCAL IMPACT:
Revenues in the amount of $172,000 from this proposal have been assumed in the in the
FY 2009-10 Fire Department budget. However, the entire revenue amount may not be
realized in the current fiscal yeaz due to the delayed implementation of the transport rate
increase, which may result in an impact to the General Fund. All costs associated with
this recommendation will be borne by the users of AMR services.
ONGOING FISCAL IMPACT:
There is no ongoing fiscal impact if this proposal is adopted. Revenues generated from
this proposal will be used to offset costs of future purchases of emergency medical
equipment.
ATTACHMENTS:
Attachment A -Ambulance Service Original Agreement between American Medical
Response (AMR) and the City of Chula Vista
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t~-1-I-ach n~n-~ ~ _
At~I>N:NDMF,NT TO
AMBULANCE SERVICE ORIGINAL AGREEMENT
by anal between
AMEI2[CAN 1VIEDICAL RESPONSE AMBULANCE SERVICE, INC.
and
THE CITY OF CHULA VISTA
THIS AMENDMENT ("Amendment") to the Ambulance Service Original. Agreement between
Americaar Medical Response Ambulance Service, hic., formerly known as Laidlaw Medical Transportation,
Inc., d/6/a American Medical Response (hereinafter "A.tvIR") and the City of CHiJLA VISTA (hereinafter
"City") is made and becomes effective as of September 1, 2009.
WHEREAS, fhe parties. hereto have previously entered into an "Amended and Restated Original
Ageement for Basic and Advanced Life Support. Ambulance Services" on. December 11, 2007 (the
"Original Agreement"), whereby AMR agreed to provide ambulance services for the City and other
Participating Agencies being the City of Imperial Beach and the Bonita/Sunnyside Fire protection Dishict;
and
WHEREAS, said Original Agreement al lows the rates to be charged in the various agencies to vary
6y politicaljurisdiction; and
WHEREAS, the parties hereto wish to amend the Original Agreement by this document to
formally confirm the mpdificafion of the Original Agreement terms- with. respect to approved fees for
enhancement(s) to the EMS system consistenrwith Section 23 of said Original Ageemem; and
WHEREAS, the City is desirous of obtaining ftmding for certain enhancement(s) to the EMS
delivery system and herein identify those enhancements as being consistent with the desired level of service
for the community (hereinater "Enhancements"). These .Enhancements are more particularly described as
providing one (L) Zo)I Deftbrillator/Monitors asstandard equipment on each of the first responder engines
within the City (`Enhancements"). These Enhancements hnprove patient care and outcomes.
NOW, TIIEREFpRE, is consideration of the foregoing premises the parties agree as follows.:
1. Exhibit "D" of tho Original Agreement is modified and amended to read as follows:
CAARGE CHULA VISTA.
__
ALS Emergency Base
Rale $862.77
BLS Frnergency Base
Rate $56936
Mileage Rate (per Mile-
or orfion thereo $22.92
Ox men Char a $82.83
Ni ht Char e $82.05
Treatment Only (no
trans ort $189.35
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2. Fmtding Mechanism For Enhanced Services Inclusive o'f Service Costs
The parties acknowledge their understanding that that funding and resul4vtt charges sel forth
in E,~hibit "U" above was determined by City and AMR based on a mechanism developed after a careful
review and analysis of the actual and potential costs of providing service(s) at level(s) detetvtined by the
City as appropriate. The parties acknowledge that the compensation to be pirovided to City for
Enhancement(s) under this Original Agreement is based on the cosh that AMR would bear if it provided
service at the level determined by the City, in the absence of this Original Agreement. Accordingly, the
pubes stipulate and af,.tee that the compensation. specified in the Original Agreement is the sole,
complete and total amount of compensation to be provided to City for the Enhancements to the EMS
services under this Original Agreement and are the necessary elements of production whereby those
services are provided, by City as defined in this Original Agreement.
3. CertiCcation of Costs.
a. During the term of this Original Agreement, ou or before March 15th of each year, City
shall certify to AMR that the funding received for enhanced services in the prior calendar year did not
exceed the cost to the City to provide For Enhancement(s) and shall notify AMR of any proposed
additions or deletions oEdefined Enhancements.
b. Dm•ing the term of this Original Agreement, on or before March 15'h of each year, AMR
will make available to City financial data showing for the 12-month period, the payer mix, number of
transports, current collection rate and estimated marginal collection rate for any adjustrnent to fees. The
parties agree that this information wilt remain proprietary and confdential and shall be utilized in order
for City staff to verify that uty rate adjustments predicated upon changes related to the Enhancements
desired pursuant to the Original Agreement are reasonable and necessary. Any statutory or case law
exemptions to the California Public Records Act will apply to any documentation provided to the City
under the Original Agreement and this Amendment.
4. Compliance. The parties will comply in all material respects with all applicable federal
attd state laws and regulations including, the Federal Anfi-kickback statute. The funding set forth in this
Amendment and the Original Agreement shall be used only for the City services or system Enhancements
set forth herein. The City warrants and represents that the payments made by AMR to City shall be less
than or eRunl to the Cily's actual costs to provide those services or system Enhancements. No fwtds shall
be used by the Ciry in a manner that may violate 42 U.S.C. Section 1320a-7b, the federal Anti-Kickback
Statute.
5. Compliance Program and Coda of Conduct AMR has made available to each parry a copy
of its Code of Conduct, Anti-kickback policies and other compliance policies, as may be changed from.
time-to-time, at AMR's web site, located at: www,amr.net, and each party aclatowledges receipt of such
documents. AMR warrtutts that its personnel shall comply with AMR's compliance policies, including
training related to the Anti-kickback Statute.
6. Non-Exclusion. Fach party represents and certifies that neither it nor uty practitioner who
orders or provide Services on its behalf hereunder has been convicted of any conduct that constitutes
grounds for mandatory exclusion as identified in 42 U.S.C.§ 1320a-7(a). Each party further represents
and certifies that it is not ineligible to participate in Pedeml health care programs or in any other state or
federal government payment program. Each party agrees that if DHHS/OIG excludes it, or any of its
practitioners or employees who order or provide Services, from participation in Federal health care
programs, the party must notify the other party within five (3) days of knowledge of such fact, utd the
20-6
other pa~Yy may immediately terminate the Original Agreement, unless the excluded party is a
practitioner or employee who immediately discontinues ordering or providing Services hereunder.
7. Referrals. It is not the intent of either party that any remuneration, benefit or privilege
provided for under the Original Agreement shall influence or in any way be based nn the referral or
recommended referal by either party of patients to the other party or i[s affiliated providers, if any, or dto
purchasing, leasing or ordering of any services other than the specific services descrbed in this Original
Agreement. Any payments specified herein are consistent with what the parties rearsonably believe to be
a fair market vaue for the services provided.
8. All other terms ant conditions oP Orightal Agreement not specified herein shall remain ut full
force and effect.
IN WPINESS THEREOF, the parties have caused ibis Amendment to be executed and effective
as of September t, 20l)9.
CITY OF CHULA VISTA
Name:
Title:
AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE INC.
Name: ~~~r'~-
Michael Murphy, Genera Manager
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RESOLUTION NO. 2009-
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CHULA
VISTA APPROVING AN AMENDMENT TO THE AMBULANCE
SERVICE ORIGINAL AGREEMENT BY AND BETWEEN
AMERICAN MEDICAL RESPONSE, AND THE CITY OF CHULA
VISTA AUTHORIZING THE MAYOR TO EXECUTE THE
AGREEMENT
WHEREAS, on April 22, 2008 the City Council approved afive-yeaz lease agreement in
the amount of $764,000 with Kansas State Bank of Manhattan for the acquisition of medical
resuscitation equipment from Zoll Corporation that was needed to replace existing equipment
that was beyond its useful performance life; and
WHEREAS, this equipment was acquired by the Fire Department and was placed into
service in 2008 enhancing the department's first response life saving capabilities; and
WHEREAS, in an effort to generate budgetary savings, revenue in the amount of
$172,000 to offset the yearly lease cost associated with the acquisition of the medical equipment
was assumed in the Fire Department budget; and
WHEREAS, on June 9, 2009 the City Council approved the fiscal yeaz 2009-10 Fire
Department budget; and
WHEREAS, the Fire Department is requesting City Council approval of an amendment
to the Ambulance Service Original Agreement between American Medical Response (AMR) and
the City of Chula Vista in order to generate the necessary pass-through revenues to fund the
yearly lease cost; and
WHEREAS, the City of Chula Vista and American Medical Response (AMR) wish to
amend the Original Agreement and formally confirm the modification of the Original Agreement
terms with respect to approved fees for enhancement(s) to the EMS system consistent with
Section 23 of said Original Agreement; and
WHEREAS, the amendment to the Original Agreement will increase the Advance Life
Support (ALS) transport rate in order to generate pass-through revenues to fund emergency
medical equipment to enhance emergency medical services delivery for the citizens of the City
of Chula Vista.
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Chula
Vista does hereby authorize the Mayor to execute an amendment to the original ambulance
service agreement by and between American Medical Response and the City of Chula Vista that
authorizes the necessazy increase in the transport rate necessary to generate pass-through revenue
for the purpose of funding the lease purchase agreement with Kansas State Bank of Manhattan
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and future acquisitions of emergency medical response equipment for the enhancement of
emergency medical response service delivery.
Presented by
..~1 IL~v^~'d~1rf1
Dave Hanneman
Fire Chief
Approved as to form by
~~~~
Bart Miesfeld ~ g P ~ 7
City Attorney
HshareNattorney/AIv1RComract Extension Defibrillators
20'.9
THE ATTACHED AGREEMENT HAS BEEN REVIEWED
AND APPROVED AS TO FORM BY THE CITY
ATTORNEY'S OFFICE AND WILL BE
FORMALLY SIGNED UPON APPROVAL BY
THE CITY COUNCIL
/,~
Bart C. iesfeld
City Attorney
Dated: / - ~ ' ~
Amendment to the Ambulance Service Original Agreement by and Between
American Medical Response, and the City of Chula Vista
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AMENDMENT TO
AMBULANCE SERVICE ORIGINAL AGREEMENT
by and between
AMEF[[CAN MEllICAL RESPONSE AMBULANCE SERVICE, INC.
and
THE CITY OF CHULA VLSTA
THIS AMENDMENT ("Amendment") to the Ambulance Service- Original. Agreement between
American Medical Response Ambulance Service, luc., formerly known as. Laidlaw Medical Transportation,
Inc., d/b/a American Medical Response (hereinafter "A.<vIR") and the City of CHUhA VISTA (hereinafter
"City') is made and becomes effective as of September 1, 2009.
WHEREAS, the parties. hereto have previously entered into an "Amended and Restated Original
Agreement for Basic and Advanced. Life Support. Ambulance Services" on. December 11, 2007 (the
"Original Agreement"}, whereby AMR agreed to provide ambulance services for the City and other
Participating Agencies being the Cly of Imperial Beach and the Bonita/Sunnyside Fire protection Dish•ict;
and
WHEI2EA5, said Original Agreement allows t'he rates to be charged in the various agencies to vary
6y political jurisdiction; and
~VH.F.I2F,AS, the parties hereto wish to amend. the Original Agreement 'by this doeurnerrt to
f'armally confine the modification of° the Original Agreement terms with respect to approved fees for
enhancement(s) fo the EMS system consistentwith Section 23 of said Original Agreement; and
WH ~ SAS, the City is desh•ous of obtaining ftnrding for certai~i enhancement(s) to the EMS
delivery system arxl herein identify those enhancements as being consistent-with the desired ievel of service
for the commm~ity (hereinafter "Enhancements"). These .Enhancements are more particularly described as
providing one (L) Zoll Defibrillator/Monitors. as standard equipment on each of the first responder engines
Fvitliin the City ("Enhancements"). These Enhvicemonts unprove patient care and outcomes,
NOW, THEREFORE, in c;onsidertilion of the foregoing premises the parties agree as follows:
L. Exhibit "D" of the Original Agreement is modified and amended to read as follows:
CHARGE
J CHOLA VISTA
_
_
ALS Emergency Rase
Rale $862.77
BLS Emergency Dase
Rate $569.36
Mileage Rate (per Mile
or action fhereot $22.92
Ox en Char e $82.83
Ni ht Char e $83:05 _
Treatment Only (no
trans o.rt $ l 89.35
20-11
2. Fmtdn~s Mechanism For Enhanced Services Inclusive of Service Casts.
The parties acknowledge their understanding that that funding and resultant charges sel Forth
in E.ihibit "D" above was determined by City and AMR based on a mechanism developed after a careful
review and artalysis of the actual and potential costs of providing service(s) at level(s) detertnined by the
City as appropriate. The parties acknowledge that the compensation to be provided to City for
Enhancement(s) under this Original Agreement is based nn the cosh that AMR would bear if it provided
service at the level determined by the City, in 4he absence of ffiis Original Agreement. Accordingly, the
parties stipulate and agree that the compensation. specified in the Original Agreement is the sole,
complete and total amount of compensation to be provided to City for the Enhancements to the EMS
services under this Original Agreement and are the necessary elements of production whereby those
services are provided, by City as defined in this Original Agreement.
3. CertiCctttionofCosts.
a. During the term o#• this Original Agreement, on or befora March 15'" of each year, City
shall certify to AMR that the funding received for enhanced services in the prior calendar year did not
exceed the cost to the City to provide for Enhancement(s) and shall notify AMR of any proposed
additions or deletions of defined Enhancements.
b. During the term of this Original Agreement, on or before March 15u' of each year, AMR
will make available to City financial data showing for the 12-month period, the payer mix, number of
transports, curcent collectiot rate attd estimated marginal collection rate for any adjustment to fees. The
parties agree that this information will remain proprietary and confidautial and shall be utilized in order
for City staff to verify that any rate adjustments predicated upon changes related to the Enhancements
desired pursuant to the Original Agreement are reasonable and necessary, Any statutory or case law
exemptions to the California Public Records Act will apply to any documentation provided to the City
under the Original Agreement and this Amendment.
4. Compliance. The parties will comply in all material respects with all applicable federal
and state laws and regulations including, the federal Anti-kickback statute. The fundntg set forth in this
Amendment artd the Original Agreement shall be used only for the City services or system Enhancements
set forth herein. T}tc City warrants and represents that .the payments made by AMR to City shall be less
than or eRual Co the City's actual costs to provide those services or system Enhancements. No funds shall
be used by the City in a manner that may violate 42 U.S.C. Secfion 1320a-7b, the federal Anti-Kickback
Statute.
5. Compliance Progrun and Coda o'P Conduct. AMR has made available to each party a copy
of its Code of Conduct; Anti-kickback policies and other compliance policies, as may be changed from.
time-to-time, at AMR's web site, located at: www,amr.net, and each pasty aclatowledges receipt of such
documents. AMR warrants that its personnel shall comply with AMR's compliance policies, including
training related to the Anti-kickback Statute.
h. Non-Exclusion. Each pasty represents and certifies that neither it nor any practitioner who
orders or provide Services on its behalf hereunder has been convicted of any conduct that constihrtes
grounds for mandatory exclusion as identified in 42 U.S.C.§ 1320a-7(a). Each party further represents
and certifies that it is not ineligible to participate in federal health care programs or in any other state or
federal government payment program. Each party agrees that if DHN$/OIG excludes it, or any of its
practitioners or employees who order or provide Services, from participakion in Federal health care
programs, the party must notify the other party within five (5) days of knowledge of s[reh fact, vid the
20-12
other pasty may immediateay ternrinate the Original Agreement, unless the excluded party is a
practitioner or employee who immediately discontinues ordering or providing Services hereunder.
7. Referrals. It is not fire intent of either party that any remuneratiar, benefit or privilege
provided for under the Otiginal Agreement shall influence or in any way be based on fire referral or
recommended referral by either party of patients to the other party or its affiliated providers, if guy, or the
purchasing, leasing or ordering of any services other than the specific services described in this Original
Abreement. Any payments specified herein are consistent with what the parties reasonably believe to be
a fair market value fnr fire services provided.
8. All other teens and conditions of Original Agreement eat specified herein shall remain in full
force and effect.
IN WITNESS THEREOF, the parties have caused this AmendmenC to be executed and effective
as of September L, 2009;
CITY OF CH'ULA VISTA
Name:
'Title:
AMERICAN MEDICAL RE5PON5E ANIBULANCG 51;RVICE INC.
Name;
Michael Murphy, General Manager
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