Administrative
Report
N.4., File # 23-7101 Meeting Date: 2/6/2024
To: MAYOR AND CITY COUNCIL
From: PATRICK BUTLER, INTERIM FIRE CHIEF
TITLE
DISCUSSION AND POSSIBLE ACTION REGARDING THE IMPLEMENTATION OF A FIRE
DEPARTMENT EMERGENCY MEDICAL SERVICES FIRST RESPONDER FEE, AND DIRECTION TO INITIATE AN AGREEMENT WITH WITTMAN ENTERPRISES, LLC. FOR BILLING SERVICES
EXECUTIVE SUMMARY
On June 20, 2023, the City Council approved an amendment to the Master Fee Schedule to update the Fire Department Pre-Hospital Paramedic service fee from $100 to $313. The Pre-Hospital Paramedic service fee commonly referred to as the Emergency Medical Service (EMS) First Responder Fee is designed to recuperate the costs associated with the provision of EMS, supplies, equipment, and personnel. The fee was first approved in 2010 and, since that time, the fee had neither been implemented nor updated to reflect the current costs of providing EMS. Collection of the $313 fee is expected to generate roughly $935,000 annually.
Prior to implementing the fee, the City Council directed staff to develop a fee collection policy that fairly balances the costs associated with EMS provision for all users and includes a hardship clause for those users who cannot afford, or are unbale to pay the fee. To help develop the policy and to collect the fee once implemented, staff has identified Wittman Enterprises, LLC (Wittman), an EMS billing company that provides services to a large number of EMS providers, as the most qualified firm to assist the City. At the City Council meeting, Fire Department personnel will present the proposed fee collection policy/process and, if approved, will return with a service contract with Wittman Enterprises for subsequent execution.
BACKGROUND
The Redondo Beach Fire Department responds to a wide range of calls and provides EMS care to approximately 6,000 patients per year. The City has had an EMS fee in the Master Fee Schedule for over a decade, but never implemented the fee in practice. On June 20, 2023, as part of Decision Package #4, the City Council approved updating the fee from $100 to $313. The Council also directed staff to develop a billing policy, prior to implementation, that would include a compassionate billing clause designed to waive the fee, or portions of the fee, if a patient has a financial hardship and/or meets the federal poverty guidelines.
If the proposed billing process is approved, Wittman would first send the patient a bill requesting the patient’s insurance information so that Wittman can directly bill the insurance company. If the insurance company does not pay the bill, or the patient does not have health insurance, Wittman would then re-issue the bill to the patient for the balance, with the option to establish a payment plan.
N.4., File # 23-7101 Meeting Date: 2/6/2024
would then re-issue the bill to the patient for the balance, with the option to establish a payment plan.
In situations where patients are unable to pay the fee due to a hardship, the City could waive the fee, as desired, on a case by case basis.
Wittman specializes in EMS first responder billing and is the predominate billing company in the state of California. Staff surveyed other billing companies, but none of them provide EMS billing. Wittman charges a, one-time, flat rate of $17 per patient, which includes follow up billing, patient phone support, and any other related staff work. Wittman provides a flexible service that will allow the City to refine or adjust the billing process while still maintaining the flat rate of $17 per patient. If implemented for all EMS calls, the annual 6,000 patient calls would cost the City approximately $102,000 in administrative fees. Staff did consider an in-house billing process, but it would require hiring additional personnel to manage the program.
Requests to waive fees stemming from hardships would be delegated to the City’s Financial Services Department for review and approval, in line with the City’s existing collection policies.
Prior to bringing this item to Council, Fire Department Staff evaluated the potential impact of Assembly Bill (AB) 716 on the City’s ability to collect EMS fees. The Bill was signed by the California Governor on October 8, 2023 and establishes maximum rates that can be charged for ground ambulance service. The City’s EMS fee does not fall under the purview of the Bill, and will not hamper the City’s efforts to collect the EMS fee included in the Master Fee Schedule.
COORDINATION
The Fire Department coordinated this report with the City Manager’s Office and the Financial Services Department.
FISCAL IMPACT
The fee, once implemented, is estimated to generate $935,000 in annual revenue and help offset the ongoing cost of emergency medical services.
APPROVED BY:
Mike Witzansky, City Manager
ATTACHMENTS
· Agmt - Draft Agreement with Wittman Enterprises, LLC