PURPOSE:

To obtain authorization to amend Article V, Section 1 of the City of Burbank Fee Schedule by increasing paramedic ambulance fees to match the recently adopted Los Angeles County rates.

BACKGROUND:

On January 21, 2003, the Burbank City Council approved Resolution 26,409 authorizing the amendment of the Citywide Fee Schedule to increase fees for paramedic ambulance transportation to match the current rates authorized by Los Angeles County.  The current Paramedic Ambulance Services Fee Schedule denotes a fee of $671.75 for response to call with equipment and personnel at an advanced life support (ALS) level and $438.00 for response to call with equipment and personnel at a basic life support (BLS) level.   

The County of Los Angeles recently adopted an increase to their �General Public Ambulance Rates� schedule, which went into effect on January 1, 2005.  This authorized an increase to the ALS rate of 16.5 percent and an increase to the BLS rate of 21.5 percent.  While an increase of this magnitude seems excessive, it is and unfortunate representation of the rising costs affecting the healthcare industry as a whole.  With Medicare and HMO reimbursement rates steadily decreasing, agencies providing emergency medical transport must adjust their fees to offset these losses in revenue and maintain the quality of services they provide.

The Fire Department invoices for Emergency Medical Transport (Paramedic Ambulance Services) through a contract with Wittman Enterprises.  This outsourcing is necessary as the required knowledge base for medical services billing and revenue tracking continues to specialize.  Through the use of Wittman Enterprises, the City has been able to maximize collection rates with a minimal impact to City staff.  Additionally, Wittman Enterprises provides excellent tools for tracking and projecting revenues and has kept Department Staff abreast of changing trends within the prehospital billing industry.

ANALYSIS:

In keeping with the philosophy of aligning the Burbank�s rates with those of Los Angeles County, Staff is proposing to increase City�s fees by an amount equivalent to the increase adopted by the County.  This adjustment will allow the City of Burbank to maximize its revenues for providing this service and prevent further revenue loss incurred from decreasing Medicare and HMO payment rates.

The Burbank Fire Department staff recommends the modification to Article V-Public Safety, "Paramedic Ambulance Services" fee schedule as follows:

(A) 1. Response to call with equipment and personnel at an advanced life support (ALS) level

Current:  $671.75         Proposed  $782.50      Percent Increase: 16.5%

(A) 2. Response to call with equipment and personnel at a basic life support (BLS) level

Current:  $438.00         Proposed  $532.00      Percent Increase: 21.5%

As a means of curbing the loss of revenue as dictated through the Medicare reimbursement process, Fire Department staff will continue to propose future rate increases for paramedic ambulance services as the County adjusts its �General Public Ambulance Rates� schedule.  This generally occurs twice a year (January and July).  By keeping on top of these changes in County rates, the City can maximize its allowable return in revenues while staying within the limits of Medicare allowed billing.  More importantly, it will allow the Burbank Fire Department to maintain the outstanding quality of emergency care it provides to City residents and businesses.

FISCAL IMPACT:   

Although staff is proposing fee increases of 16.5 percent and 21.5 percent for ALS and BLS ambulance services respectively, the City will only collect between 50 and 70 percent of this rate from Medicare and HMO agencies.  Therefore, the Fire Department is projecting only a five percent increase compared to current emergency medical transport revenues, or approximately $60,000 per fiscal year.  Choosing not to increase emergency medical transport rates could result in an annual loss of up to $120,000 in revenue in the coming years.

RECOMMENDATION:

Staff recommends that the Council adopt the resolution amending Article V, Section 1 of the City of Burbank Fee Schedule by increasing paramedic ambulance transportation fees.

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