201 S. Anaheim Blvd.
Suite #300
Anaheim, CA 92805
Tel: (714) 765-4000
Fax: (714) 765-4008
www.anaheim.net
CITY COUNCIL AGENDA REPORT
City of Anaheim
FIRE & RESCUE DEPARTMENT
DATE: JULY 28, 2020
FROM: FIRE & RESCUE DEPARTMENT
SUBJECT: ANAHEIM EMERGENCY MEDICAL TRANSPORTATION
PROGRAM
ATTACHMENT (Y/N): YES ITEM # 11
RECOMMENDATION:
That the City Council, by Motion, approve a transition from contracting for private emergency medical transportation service to providing in-house emergency medical transportation, staffed and supported by Anaheim Fire & Rescue.
DISCUSSION:
The City of Anaheim has contracted with CARE Ambulance Services Inc. (CARE), also known as Faulk Ambulance, for emergency medical (ambulance) transportation since 1998. The original agreement, and subsequent amendments, established a model in which CARE provided ambulance transports, billed the patients, and passed a portion of the payment, based on level of service, back to Anaheim.
In May 2019, Anaheim entered into a new contract with CARE, changing the model to one in which Anaheim contracted for a set number of unit hours of ambulance service. Under this new contract, Anaheim pays CARE a monthly rent for seven ambulances, owned, maintained and staffed by CARE based on a fixed “unit hour” cost. Anaheim has assumed the billing function. With this change, Anaheim has been able to increase the cost recovery to the City of Anaheim.
At this time, Anaheim Fire & Rescue (AF&R) is recommending the implementation of an in-house model of providing emergency medical transportation, in order to achieve three goals:
1. Expand the Public Safety pathway for the youth in Anaheim. While we currently offer public safety career education and popular Explorer and Fire Cadet Programs for local youth, being able to add a path to EMT positions will help the department continue to develop and train future Anaheim Firefighter candidates.
2. Control the delivery of Emergency Medical Services (EMS) in Anaheim in the future while maintaining the excellent service delivered to Anaheim residents and visitors.
3. Create a financially stable EMS system in Anaheim, where Anaheim has full control over future costs.
The fully implemented in-house model will require the acquisition of ten (10) ambulances, and hiring 42 civilian Emergency Medical Technicians (EMTs) to staff Anaheim Emergency Medical Transportation Program
July 28, 2020
the ambulances 24 hours per day, 365 days per year. Fiscal Year 2020-21 would be a transitional year, where Anaheim would reduce the number of ambulances, and therefore, unit hours, provided by CARE and replace them with Anaheim units and unit hours. The contracted fees paid to CARE Ambulance would be reduced, as Anaheim’s costs would increase. There will be a substantial savings in the transition into an Anaheim managed transportation model.
Understanding the details of the current contract will help to understand the monetary savings in switching to an Anaheim model. The current contract is set up with four main budget line items and broken down into sub items. One of the budget lines is set up as an administrative cost and profit, this line item is 23% of the contract. When comparing the cost of providing each of the additional items there is profit built into each section.
Below is a summary of the cost of each major budget line to a comparable Anaheim model.
CARE Ambulance Charges* (7 Ambulances /24 hrs)
Personnel Costs – $3,765,589
Ambulances – $143,000 (7 Ambulances)
On-Going Operating – $639,600
Administration (Profit) Costs – $1,046,083
Anaheim Ambulance Costs
(7 Ambulances / 24 hrs)
Personnel Costs – $3,198,762
Ambulances – $139,500** (7Ambulances / 3 Reserves)
On-Going Operating – $177,705
Administration (Profit) Costs – $0***
Savings
Total Savings per Year - $2,078,305
*Each of these charges have been broken down in the current contract. This gives Anaheim a very detailed understanding of the cost of starting an ambulance model. **Includes the cost of (10) ambulances vs contractors cost of (7) ambulances, in order to cover surge protection, special medic events, and reserve ambulances. ***The administrative functions for the program will fall under the EMS section in the Fire Department and not require additional staffing. The day to day management of the personnel will be absorbed by the station Captain and shift Battalions Chiefs.
Anaheim Emergency Medical Transportation Program
July 28, 2020
The upfront costs for the buying/leasing of the ambulances and for the initial hiring process of employees are supported by the FY 2020/21 budget.
IMPACT ON BUDGET:
If implementation of the proposed in-house Emergency Medical Transportation program is approved, it is expected to increase cost recovery to the General Fund during the second half of FY2020/21 by $200,000 - $350,000. The second year of the new model is expected to increase the cost recovery to the General Fund by approximately $2 million dollars.
There will be an initial cost of purchasing / leasing of ambulances for the Anaheim model; this will be done through the competitive bid process. Once the ambulances are purchased, the upkeep and future costs are built into the model.
Respectfully submitted,
Patrick Russell
Fire Chief