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HomeMy WebLinkAboutMinutes - October 24, 2000 SSCITY OF LODI INFORMAL INFORMATIONAL MEETING "SHIRTSLEEVE" SESSION CARNEGIE FORUM, 305 WEST PINE STREET TUESDAY, OCTOBER 24, 2000 An Informal Informational Meeting ("Shirtsleeve" Session) of the Lodi City Council was held Tuesday, October 24, 2000 commencing at 7:03 a.m. A. ROLL CALL Present: Council Members — Hitchcock (arrived at 7:08 a.m.), Land, Nakanishi, Pennino and Mayor Mann Absent: Council Members — None Also Present: Deputy City Manager Keeter, City Attorney Hays and City Clerk Blackston B. CITY COUNCIL CALENDAR UPDATE Review of the Mayor's and Council Member's Weekly Calendar (filed) was waived. C. TOPIC(S) "Presentation by American Medical Response Regarding Ambulance Service" Deputy City Manager Keeter introduced Richard Keiser, new Director of Operations with American Medical Response (AMR). Mr. Keiser stated that locally AMR serves San Joaquin and Calaveras counties. He described the organization of the company with the aid of overheads (filed). AMR offers a variety of services either through its own company or through companies with which it subcontracts. Critical care transport is staffed by critical care nurses that come from Modesto or Sacramento. Staffing of Advanced Life Support (ALS) is done by paramedics, and Basic Life Support (BLS) by emergency medical technicians (EMTs). On each ambulance, there may be either two EMTs or two paramedics. In addition, AMR also has wheelchair services, which it subcontracts. AMR has the ability of sending the BLS services to Lodi from the Stockton area. There is an ALS field supervisor on call out of the Stockton area. In Lodi, AMR has two 24-hour paramedic ambulances and has the ability of bringing resources in from other areas (i.e. A-1 out of Stockton or ambulances from Sacramento should the need arise). In 1999 in Lodi, AMR had just under 6,000 patient contacts: 69% of the responses were Code 3, meaning with lights and sirens; 13% were Code 2; and 29% were Code 1, or private calls to Lodi Memorial or convalescent hospitals. Of those calls, AMR had one contact with a newborn patient; 7.3% were with patients ages 2 days to 14 years; 6.2% were ages 15 — 20 years; 39.1 % were ages 21 — 64 years; and 47% were older than 65 years. 51 % of these calls were female and 48% were male; 57% were medical calls, including respiratory or cardiac; 13% were due to motor vehicle accidents, and 8% were from falls. The most frequent reason patients were transported was due to pain. Only 2% of the calls resulted in the patient being transported to the hospital with lights and sirens. Council Member Pennino requested that copies of Mr. Keiser's overheads be provided to the City Council. In response to Council Member Pennino, Mr. Keiser reported that 98% of the time, patients could probably have gone to the hospital by means other than an ambulance. AMR employs 150 employees, maintains 22 ambulances and has 10 stations — two in Calaveras County, and the rest in San Joaquin. The biggest challenges facing AMR for Continued October 24, 2000 the upcoming year are staffing and revenue. There is a great shortage of paramedics, with only 15,000 paramedics and 25,000 available positions in the State of California. Beginning January 1, 2001, AMR will be negotiating for MediCare reimbursement. AMR has been receiving 80 — 90% MediCare reimbursement, but they anticipate a cut to about 20% due to a recent Health Care Finance Administration decision. A new deployment plan was put into place on October 8. Frequently in the past, AMR pulled the 911 ambulances out of the Lodi system to do an interfacility (hospital to hospital) call at Lodi Memorial Hospital. For two weeks prior to implementing this plan, AMR used the emergency ambulance for those types of transports 16 times. Since the new deployment plan has been in place, it has only been used 8 times. AMR has increased the BLS services in Stockton and utilize them in Lodi to run BLS transports. In response to Mayor Mann, Mr. Keiser reported that arrival time is judged on an 8 -minute clock. San Joaquin County requires that AMR arrive at the scene within 10 minutes of the call time. On the 8 -minute response standard, 95% of the time AMR arrives on scene in time. Council Member Hitchcock commented that she participated in a ride -along with AMR last Friday night. She noted that the fire department usually arrives prior to AMR ambulances to begin life support. She felt that who arrives at the scene first, should be taken into consideration by the Council. In reply to questions by Mayor Pro Tempore Nakanishi, Mr. Keiser stated that the estimated basic cost for ambulance transport is $800, the business revenue in Calaveras and San Joaquin counties is approximately $11 million, and AMR covers all lost costs. Mr. Keiser indicated that AMR has very little competition and they have a good relationship with A-1 Ambulance. Council Member Pennino requested to see the statistics for the last five years, specifically for Code 3 emergencies. Mr. Keiser replied that he would supply the Council with this information. At Council Member Land's request, Fire Chief Kenley reported that in 1985-87 counties were given the responsibility to deal with indigent care. They went to the state legislature and asked for the right to identify exclusive operating areas within the county so that they could make contracts with private ambulance companies to provide transport. In 1996- 97, the Ortiz Bill was enacted that said cities had ultimate first right of refusal, so that they could go back to having fire departments provide paramedic service and ambulance response. Over the last three years, the Fire Department has been working at the legislative level with private ambulance, county, cities and fire service (both labor and management) to develop a system that is best utilized by the citizens. As an example, the fire department arrives on scene within 3 — 5 minutes, but the county holds the ambulance to a standard of 10 minutes. The Fire Department believes that having paramedic service on scene sooner would be a better level of service. The issue, however, becomes cost. If the Fire Department provides paramedics on the engine, then that is a cost to the City that is really not borne back to the City by the system itself. The private ambulance cannot be held to any more scrutiny than the county sets in their standards. AMR does a very good job in trying to get there as soon as they can, but they are a private enterprise, and their business is to provide a high level of service and to make money. The Fire Department's business is to provide a better level of service to our community. One of the ways that has been done in other fire departments is to put paramedics on the engine. Chief Kenley predicted a system will be developed over the next 1 — 2 years that will ultimately put paramedics on every engine company. He posed the question to Council as to whether to take on that expense earlier than this and put paramedics on all of the engine companies now. Chief Kenley reported that there are some local emergency medical systems that actually prohibit fire departments from having paramedics on the engines. They also set the standards for what education and training paramedics need in order to obtain a license. 2 Continued October 14, 2000 Fire Chief Kenley indicated that if the City were to do this and put three people on an engine company, we would have to train the existing firefighters. This would mean overtime while at training, and it takes 9 to 12 months to train a paramedic. An estimated cost is about $500,000 the first year to do the training and then also the 10 — 12.5% salary increase for having this certification. The ongoing cost after that would be the salary differential and ongoing training. Training would need to be given to 12 firefighters in order to keep 9 (i.e. one per engine, per shift). In response to Council Member Hitchcock, Chief Kenley answered that he knows of only two systems in the state that actually charge for paramedic service and that do not transport. Providing paramedic service on each engine company would be something the City chose to do for its citizens, and money cannot be recouped by transporting, because Lodi does not have the authority from the County to do so. PUBLIC COMMENTS: a) Sandy Wichman, President of the United Firefighters of Lodi (UFL), stated that the cut in MediCare reimbursement represents 4% of AMR's profit. In Menlo Park, AMR aided the fire department by subsidizing their paramedic training. AMR is mostly interested in transport, because that is where profits can be made. Paramedic service is costly for them to provide. She warned that one day, we may not have AMR unless the City works out some type of program where the fire department provides paramedic service and AMR provides transport. b) Bob Johnson, 1311 Midvale Road, Lodi, questioned whether Laidlaw's (AMR's parent company) plans to sell AMR will affect San Joaquin County. Mr. Keiser responded that no area should see any major changes should this take place. C) Amy Dalrymple, Lodi Firefighter, Sonora, stated that a number of new firefighters coming to the City of Lodi are not staying very long because they are getting picked up in the Bay Area and other large fire departments who pay higher salaries and have paramedics on their rigs. There are more and more turnovers in the smaller departments, with cities spending more on training costs. She claimed that Lodi has already lost 4 or 5 firefighters to other departments in recent years. Council Member Pennino commented that some time ago Human Resources provided Council with a list of reasons employees left the fire department. The number quoted by Ms. Dalrymple was much higher; therefore, he requested that the information from Human Resources be updated. Mr. Pennino affirmed that he is hearing at this meeting the desire to further explore the issue of paramedics and requested that Chief Kenley place this issue on an agenda in the near future. The Mayor and all Council Members expressed their concurrence. Council Member Hitchcock commented that while on her ride -along with AMR, she spoke with a Sacramento Firefighter who lives in Lodi. She asked him whether he would ever consider joining the Lodi Fire Department. He replied that the pay is too low and staffing of teams is inadequate. Council Member Land responded that the City has been trying to address these issues for the past 2 — 3 years. In reply to Mayor Pro Tempore Nakanishi, Mr. Keiser stated that when you look at national health care and emergency services, the United States is far above Europe. The 8 -minute response is a standard number worldwide. 3 Continued October 24, 2000 D. COMMENTS BY THE PUBLIC ON NON -AGENDA ITEMS None. E. ADJOURNMENT No action was taken by the City Council. The meeting was adjourned at approximately 7:40 a.m. ATTEST: Susan J. Blackston City Clerk WEEK OF OCTOBER 24, 2000 Tuesday, October 24, 2000 7:00 a.m. Shirtsleeve Session. The topic(s) is: 1. Presentation by American Medical Response Regarding Ambulance Service Reminder: Please bring your calendars to rerfew wh* sWff. 7:00 a.m. Special City Council meeting. The topic(s) is: I . Closed Session a) Actual Litigation — Government Code §54956.9(x) Albert Thyn_ nan v. C& o di California Public Employees' Retirement System, Case No. 2850 11:00 — 2:00 p.m. United Way 2000-2001 Kick Off Celebration (Safari Style) Barbecue Lunch, City Hall parking lot. Sponsored by Lodi News Sentinel, Farmers and Merchants Bank and City of Lodi. Wednesday, October 25, 2000 Thursday, October 26, 2000 Reminder 2"d Pre -Election Campaign Statements due to City Clerk's Office. 6:30 p.m. Hitchcock LCC Central Valley Division Quarterly Dinner meeting, Newman. Friday, October 27, 2000 Saturday, October 28, 2000 10:00 a.m. Mann. Plaque dedication for Gertie DeForce Cluff, Publisher of Lodi's fust newspaper The Valley Review, Lodi News Sentinel Main Entrance. Sunday, October 29, 2000 Monday, October 30, 2000 Disclaimer: This calendar contains only information that was provided to the City Clerk's office councillmisclrricalndr.doc Mayor Steve Mann P.O. Box 3006 Lodi, CA 95 241-19 10 Dear Mr. Mayor, hit AINAJii�CAN r.I DICAL RESPONSE October 31, 2000 I would like to thank you and the council members for allowing me the opportunity to present to you the services American Medical Response provides the City of Lodi. We have been proudly serving the Lodi community for more than twenty-five years, and look forward to continuing to do so far in to the future. During the presentation a number of questions were raised regarding the response times of our Emergency Ambulances within the City of Lodi. I am very pleased with the results of our Lodi crews. Looking at a full five year history, and year to date, I have found the following; • Our average Code -3 response time is five (5) minutes. This is from time the call is received to the time our unit arrives on scene. • Fifty percent (50.1%) of the time we arrive before, or with, the Lodi Fire Department on the scene of Emergency Calls. • Ninety percent (90%) of the time we arrive on scene in less than eight minutes. The fractile method is the industry standard for measuring response times. (Please keep in mind that the county requires a 10 minute response 90% of the time.) Our field staff is dedicated to providing high-level service to the entire San Joaquin and Calaveras County area, and will continue to do so. Should you have any further questions, please do not hesitate to call. Since y, Ric and W. Keiser II Director of Operations San Joaquin and Calaveras Counties Cc: Councilmember Alan Nakanishi Councilmember Susan Hitchcock Councilmember Keith Land Councilmember Phil Pennino Dixon Flynn, City Manager Lou Meyer, AMR James Ridenour, AMR 888 East Lindsay St., Stockton, CA 95202-2642 Phone (209) 948-5136 • Fax (209) 466-0714 San, Joaquin and Calave ras Counties 7 tOf Ow■ - Patient Contacts • < 1 day old: 1 contact • 2days - 14y: 7.3% ILLk- AL - m • 51.7"/o FEMALE • 48.3% MALE • 57% - Medical ason? -- --------- za:• 1.0 station-s-,,..... •Clinical Services 2.nd Revenue .,�!1 •Paramedics Lodi City Council..