City of Ocean Shores. Preliminary Results Ambulance Utility Rate Study. August 14, 2017

Transcription

1 City of Ocean Shores Preliminary Results Ambulance Utility Rate Study August 14, 2017

2 Agenda Introductions Ambulance Utility Requirements Overall Ambulance Cost of Service Key Cost Assumptions 2016 Cost of Service and Rate Scenarios Status Quo Scenario Incident Forecast Staffing Adequacy Review Issues Non Staffing Alternatives Staffing Alternatives Other Issues Alternative Staffing Rate Scenarios Page 2

3 Key Elements In RCW Provides for ambulance service to be operated as a public utility Authorizes the City Council to set and collect rates and charges for regulating, operating, and maintaining an ambulance utility Requires that rates and charges be based on a cost of service study Does not allow capital costs for construction, major renovation, or major repair of facilities Categorizes costs by availability of ambulance service and the demand placed on the service Availability costs are attributable to the basic infrastructure needed to respond to a single call for service and may include dispatch, labor, training, equipment, patient care supplies, and equipment maintenance costs Demand costs are attributable to the burden placed on the ambulance service by individual calls, such as those associated with the frequency of calls or the distance from hospitals Exempts Medicaid eligible persons in a nursing home, boarding home, or adult family home and persons who receive in home services Page 3 Page 3

4 2016 Cost of Service Framework General Fund Emergency Care Fund $1,170,098 $2,105,187 Calculate Total Costs Total Fire Department Costs $3,275,285 Fire and EMS Allocation Fire EMS $530,180 $2,745,105 Availability and Demand Allocation City Availability City Demand $1,806,240 $549,281 Out of City Cost $389,584 Page 4

5 Key Cost Assumptions Fire and EMS administration staff costs based on incidents (9% Fire, 91% EMS) Firefighter and Paramedic costs allocated based on total response time (4% Fire, 96% EMS) Other costs allocated based on other factors such as square feet, number of calls, all to fire, all to EMS, etc. Personnel costs allocated by availability demand ratio (86% availability, 14% demand), supplies and facility costs allocated to availability, dispatch services allocated to demand Out of City demand time is 14% of total demand time, so out of City availability time is 14% of the assumed standby time Page 5

6 Customers by Class Customer Class Regular Single Family 5,534 Multi Family 427 Nursing Home 50 Commercial 344 Hotels/Motels 332 Public/Streets/Schools 2 Total 6,689 Page 6

7 Adjusted 2016 Availability and Demand Costs Ambulance Utility Revenue Requirement Availability Demand Total Annual In City Cost $ 1,806,240 $ 549,281 $ 2,355,521 Offsetting Revenues Availability Demand Total Department of Health Grant $ 1,290 $ 1,290 Grays Harbor Transit Grant $ 3,178 $ 3,178 Ambulance Fees $ 726,685 $ 726,685 EMS Levy $ 467,081 $ 467,081 Oyhut Mitigation Fees - EMS $ 952 $ 952 Casino Impact Funds - EMS $ 7,027 $ 7,027 Investment Interest $ 142 $ 142 Sale of Surplus Property $ 3,205 $ 3,205 Safer Grant $ 592,818 $ 592,818 Total Revenue $ 15,794 $ 1,786,584 $ 1,802,378 Adjusted Cost $ 1,790,446 $ (1,237,303) $ 553,143 Calculated Rates per Billing Unit - No Out of City Subsidy Annual Cost per Account $ Monthly Cost per Account $ 6.89 Calculated Rates per Billing Unit - Including Out of City Subsidy Annual Cost per Account $ Monthly Cost per Account $ Page 7

8 2016 Alternative Rate Scenarios Cost Recovery 2016 Cost Full Cost 75% Cost 50% Cost Recovery (64%) Recovery Recovery Recovery Monthly Fee $ 7.48 $ $ 8.73 $ 5.82 Annual Fee $ $ $ $ Total Annual Cost $ 2,745,105 $ 2,745,105 $ 2,745,105 $ 2,745,105 Revenues Ambulance Utility Fee $ 547,699 $ 934,127 $ 700,595 $ 467,064 Transport Fees 726, , , ,685 Miscellaneous Fees 608, , , ,612 Out of City Revenue 8,600 8,600 8,600 8,600 General Fund Contribution 853, , , ,145 Total Revenue $ 2,745,105 $ 2,745,105 $ 2,745,105 $ 2,745,105 Page 8

9 Scenario -1 Status Quo Forecast Maintain staffing levels, Offset SAFER Grant Funding Loss General Fund Support Needed to Offset Fire Portion of SAFER Staff Costs Includes out of City costs General Inflation at 2.1% Salaries and Benefits Inflation 2.6% Page 9

10 Scenario 1 Status Quo Rates Current Rate Full Cost Recovery Rates Difference Year Monthly Annual Monthly Annual Monthly Annual 2016 $ 7.48 $ $ $ $ 4.16 $ $ 7.48 $ $ 8.88 $ $ 1.40 $ $ 7.48 $ $ $ $ $ $ 7.48 $ $ $ $ $ $ 7.48 $ $ $ $ $ $ 7.48 $ $ $ $ $ Page 10

11 Scenario 1 General Fund Contribution General Fund Contribution Current Rate Full Cost 75% Cost 50% Cost Recovery Recovery Recovery 2018 $ 874,756 $ - $ 374,194 $ 748, $ 895,909 $ - $ 382,266 $ 764, $ 930,926 $ - $ 393,859 $ 787, $ 974,772 $ - $ 407,716 $ 815,433 Page 11

12 Projected Incident Growth 3,000 2,500 2,000 2,254 1,872 2,323 1,929 2,393 1,988 2,466 2,048 2,541 2,110 2,618 2,174 1,500 1, Actual Non-EMS/Fire EMS Total Page 12

13 Staffing Adequacy Review Scope of Work EMS staffing Fire Department Services Challenges on how EMS and fire services impact each other Page 13

14 Staffing and Response Adequacy Issues Current Operations to Deliver EMS Concurrent EMS calls and response times Fire response and capabilities Overtime & shift schedule EMS training and oversight Response standards (RCW ) Page 14

15 2016 Calls by Time of Day Page 15

16 Concurrent Calls by Time of Day Page 16

17 2016 Workload and Response Times EMS 1,872 FIRE 382 Total 2,254 Call TYPE Less than 5 Minutes Less than 7 Minutes Average Minutes Fire Related 51.5% 67.4% Medical 63.1% 82.5% 5.93 CONCURRENT INCIDENT RATE RESPONSE % of AMOUNT TOTAL Double Triple Quad Quint TOTAL CONCURRENT RESPONSE % Page 17

18 Non-Staffing Alternatives Move an ALS unit to Station 2 for a test period and monitor response results Improve response times in the southern part of the city Improve the dispatch protocol software to more precisely screen BLS from ALS/BLS emergencies Sends the most appropriate unit and judiciously uses paramedic resources Improve public education Develop a comprehensive bystander/neighbor intervention program to augment first responder medical efforts Enhance volunteer operations Provides a larger fire fighting work force Evaluate the current shift schedule and the number of Kelly days given the low staffing level Page 18

19 Staffing Alternatives Two ALS units could be adequate if they were backed up by an additional unit that provides first response to BLS service demand Enhances ALS service and fire response and directly impacts concurrent calls Focuses ALS units on transport service Add 3 FF/Paramedics and 6 FF/EMTs to staff an Engine company and cross staff a 3 rd Medic Unit Responds to selected BLS and ALS overload situations Add 3 FF/Paramedics to reduce reliance on overtime and provide more resources Reduces overtime, improves paramedic availability, reduces demand to work more than 72 concurrent hours Add a Medical Services Officer/Training Officer Improves EMS policies, conducts specialized training, evaluates medical services, oversees training to insure higher service performance Page 19

20 Other Issues Improve data collection and analysis Comply with NFIRS data recording and reporting requirements Improve non-nfirs data recording and analysis of emergency and onoemergency activities Performance standards Regional Collaboration Specialized services ( Rescue, Haz Mat, EMS) Page 20

21 Alternative Staffing Rate Scenarios Scenario 2 Add a new Engine Company (three full time FF/Paramedics and six EMTs) Scenario 3 Add three full time FF/Paramedics Page 21

22 Scenario 2 New Engine Company Current Rate Full Cost Recovery Rates Difference Year Monthly Annual Monthly Annual Monthly Annual 2016 $ 7.48 $ $ $ $ 4.16 $ $ 7.48 $ $ 8.88 $ $ 1.40 $ $ 7.48 $ $ $ $ $ $ 7.48 $ $ $ $ $ $ 7.48 $ $ $ $ $ $ 7.48 $ $ $ $ $ Page 22

23 Scenario 2 General Fund Contribution General Fund Contribution Current Rate Full Cost 75% Cost 50% Cost Recovery Recovery Recovery 2018 $ 1,753,044 $ - $ 593,766 $ 1,187, $ 1,759,878 $ - $ 598,258 $ 1,196, $ 1,817,358 $ - $ 615,467 $ 1,230, $ 1,884,251 $ - $ 635,086 $ 1,270,172 Page 23

24 Scenario 3 Three FF/Paramedics Current Rate Full Cost Recovery Rates Difference Year Monthly Annual Monthly Annual Monthly Annual 2016 $ 7.48 $ $ $ $ 4.16 $ $ 7.48 $ $ 8.88 $ $ 1.40 $ $ 7.48 $ $ $ $ $ $ 7.48 $ $ $ $ $ $ 7.48 $ $ $ $ $ $ 7.48 $ $ $ $ $ Page 24

25 Scenario 3 General Fund Contribution General Fund Contribution Current Rate Full Cost 75% Cost 50% Cost Recovery Recovery Recovery 2018 $ 1,201,905 $ - $ 455,982 $ 911, $ 1,219,180 $ - $ 463,084 $ 926, $ 1,262,601 $ - $ 476,778 $ 953, $ 1,315,071 $ - $ 492,791 $ 985,582 Page 25

26 Questions Page 26

27 Peter Moy Principal Contact :